Short-term Effects Of Air Pollution Research Articles

The short-term effects of air pollution on respiratory disease hospitalizations in 5 cities in Poland: comparison of time-series and case-crossover analyses

Very few publications have compared different study designs investigating the short-term effects of air pollutants on healthcare visits and hospitalizations for respiratory tract diseases. This study describes, using two different study designs (a case-crossover design and a time-series analysis), the association of air pollutants and respiratory disease hospitalizations. The study has been conducted on 5 cities in Poland on a timeline of almost 4 years. DLNM and regression models were both used for the assessment of the short-term effects of air pollution peaks on respiratory hospitalizations. Both case-crossover and time-series studies equally revealed a positive association between air pollution peaks and hospitalization occurrences. Results were provided in the form of percentage increase of a respiratory visit/hospitalization, for each 10-μg/m3 increment in single pollutant level for both study designs. The most significant estimated % increases of hospitalizations linked to increase of 10 μg/m3 of pollutant have been recorded in general with particulate matter, with highest values for 24 h PM2.5 in Warsaw (6.4%, case-crossover; 4.5%, time series, respectively) and in Białystok (5.6%, case-crossover; 4.5%, time series, respectively). The case-crossover analysis results have shown a larger CI in comparison to the results of the time-series analysis, while the lag days were easier to identify with the case-crossover design. The trends and the overlap of the results occurring from both methods are good and show applicability of both study designs to air pollution effects on short-term hospitalizations.

Short-term effects of air pollution on daily single- and co-morbidity cardiorespiratory outpatient visits

Several studies have noted that the existence of comorbidities lead to an increase in the risk of premature mortality and morbidity. Most of the studies examining the effects of air pollution on comorbidity visits were from Northern American countries, with scarce literature from Asia. This study contributes to existing, yet limited understanding of air pollution-comorbidity by examining the effects of daily air pollutants on outpatient single morbidity and comorbid cardiorespiratory visits in Japan.A total of 1,452,505 outpatient cardiorespiratory visits were recorded among the 21 Japanese cities from 2013 to 2016. Daily outpatient cardiorespiratory visit data were obtained from a health insurance claims database managed by the Japan Medical Data Center Co., Ltd. (JMDC). A time-stratified case crossover analysis coupled with Generalized Additive Mixed Model was used to analyze the association of daily air pollutants (particulate matter 2.5 μm or less in diameter, ozone and nitrogen dioxide) on daily single (respiratory and cardiovascular) and comorbidity health outcomes. We further examined single and cumulative effects for 0–3 and 0–14 lag periods.Ozone, NO2, and PM2.5 were positively associated with cardiorespiratory visits in either shorter or longer lags, with more apparent comorbidity associations with NO2 exposure. A 10-unit increase in NO2, after adjusting for ozone, was associated with a 2.24% (95% CI: 1.34–3.15) and 6.49% (95% CI: 5.00–8.01) increase in comorbidity visit at Lag 0 (of Lag 0–3) and cumulative lag 0–3, respectively. Our results contribute to existing evidence suggesting that short-term and extended exposure to air pollution elicit health risks on cardiovascular, respiratory and comorbid clinic visits. Exposure to NO2, in particular, was associated with increase in the risk of single and comorbidity cardiorespiratory visits. Results can be potentially utilized for both individual health (e.g. risk population health management) and health facility management (e.g. health visit influx determination).

Short-term effects of air pollution on daily asthma-related emergency department visits in an industrial city.

Epidemiological studies from Europe and North America have provided evidence that exposure to air pollution can aggravate symptoms in asthmatic patients. Daily number of AEDv, air pollution levels (PM10, PM2.5, SO2, NO2 and CO) and meteorological variables was obtained from Jubail Industrial City, Saudi Arabia, for the period of 2007-11. Data were analyzed using a time-series approach. Relative risks (RRs) were estimated using Poisson regression. The associations between AEDv and PM10, PM2.5, SO2 and NO2 remained positive and statistically significant after mutual adjustment in the multi-pollutant model.The RR of AEDv increased by 5.4, 4.4, 3.4 and 2.2% per an inter-quartile range increase in SO2 (2.0ppb), PM2.5 (36μg/m3), NO2 (7.6ppb) and PM10 (140μg/m3), respectively. No significant associations between AEDv and CO were found. Current levels of ambient air pollution are associated with AEDv in this industrial setting in the Middle East. Greater awareness of environmental health protection and the implementation of effective measures to improve the quality of air in such settings would be beneficial to public health.

Short-term Effect of Air Pollution on Tuberculosis Based on Kriged Data: A Time-series Analysis.

Tuberculosis (TB) has a very high mortality rate worldwide. However, only a few studies have examined the associations between short-term exposure to air pollution and TB incidence. Our objectives were to estimate associations between short-term exposure to air pollutants and TB incidence in Wuhan city, China, during the 2015–2016 period. We applied a generalized additive model to access the short-term association of air pollution with TB. Daily exposure to each air pollutant in Wuhan was determined using ordinary kriging. The air pollutants included in the analysis were particulate matter (PM) with an aerodynamic diameter less than or equal to 2.5 micrometers (PM2.5), PM with an aerodynamic diameter less than or equal to 10 micrometers (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ground-level ozone (O3). Daily incident cases of TB were obtained from the Hubei Provincial Center for Disease Control and Prevention (Hubei CDC). Both single- and multiple-pollutant models were used to examine the associations between air pollution and TB. Seasonal variation was assessed by splitting the all-year data into warm (May–October) and cold (November–April) seasons. In the single-pollutant model, for a 10 μg/m3 increase in PM2.5, PM10, and O3 at lag 7, the associated TB risk increased by 17.03% (95% CI: 6.39, 28.74), 11.08% (95% CI: 6.39, 28.74), and 16.15% (95% CI: 1.88, 32.42), respectively. In the multi-pollutant model, the effect of PM2.5 on TB remained statistically significant, while the effects of other pollutants were attenuated. The seasonal analysis showed that there was not much difference regarding the impact of air pollution on TB between the warm season and the cold season. Our study reveals that the mechanism linking air pollution and TB is still complex. Further research is warranted to explore the interaction of air pollution and TB.

Effect modification of the short-term effects of air pollution on morbidity by season: A systematic review and meta-analysis.

Studies of the health effects of air pollution have traditionally controlled for ambient temperature as a confounder, and vice versa. However, season might be an important factor contributing to adverse health effects of air pollution. Given the current inconsistencies in results of previous studies on the effect modification of air pollution on morbidity by season, a systematic review and meta-analysis was conducted to synthesize the current evidence on effects of season on air pollution and morbidity. The electronic databases including PubMed, Web of Science, Embase, CNKI, and Wanfang were used to identify papers published up to the 30st of November in 2019. We identified 4284 articles, after screening, eighty papers met the inclusion criteria. Significant effect modification of CO, O3, SO2 and NO2 on morbidity by season was observed, with corresponding ratio of relative risk of 1.0009 (95% CI: 1.0001-1.0018), 1.0080 (95% CI: 1.0021-1.0138), 0.9828 (95% CI: 0.9697-0.9962) and 0.9896 (95% CI: 0.9824-0.9968), respectively. Season significantly modified the effect of CO on pneumonia, the effect of SO2 on cardiovascular disease, the effect of PM10 on stroke, and the effect of O3 on stroke, asthma and pneumonia. The effect modifications of air pollution by season were similar among males and females, while the effect estimates seem to be higher among children under 18years old and the elderly aged 75 or over. Further research is needed to better understand the mechanisms underlying the seasonal variance of the effect of air pollutants on morbidity.

Short-term effects of air pollution on exacerbations of allergic asthma in Užice region, Serbia.

IntroductionMany time-series studies have shown a positive association between air pollution and asthma exacerbation. However, till now only one study in Serbia has examined this relationship.AimTo examine the associations between air pollution and asthma emergency department (ED) visits in the Užice region, Serbia.Material and methodsA time-stratified case-crossover design was applied to 424 ED visits for asthma exacerbation that occurred in the Užice region, Serbia, in 2012–2014. Data about ED visits were routinely collected in the Užice Health Centre. The daily average concentrations of particulate matter (PM2.5 and PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2), and black carbon (BC) were measured by automatic ambient air quality monitoring stations. Odds ratios and their corresponding 95% confidence intervals were estimated using conditional logistic regression adjusted for the potential confounding influence of weather variables (temperature, humidity and air pressure).ResultsStatistically significant associations were observed between ED visits for asthma and 3-day lagged exposure to BC (OR = 3.23; 95% CI: 1.05–9.95), and between ED visits for asthma with coexisting allergic rhinitis and 0-day lag exposure to NO2 (OR = 1.57; 95% CI: 0.94–2.65), 2-day lag exposure to SO2 (OR = 1.97; 95% CI: 1.02–3.80), and 3-day lag exposure to PM10 (OR = 2.38; 95% CI: 1.17–4.84).ConclusionsExposure to ambient air pollution in the Užice region increases the risk of ED visits for asthma, particularly during the heating season.

Has respiratory emergencies changed during lockdown implemented for COVID-19 pandemic?

Sir, Coronavirus disease (COVID-19) is an infectious disease caused by novel coronavirus named as SARS Cov-2. It originated in the city of Wuhan, the capital of Hubei province of China in December 2019 and has been declared a pandemic by the World Health Organization.[12] The disease has now spread in more than 200 countries and even our country, India has been badly affected. More than 11 lacs cases and almost 20,000 deaths have occurred till date (20th July 2020). Our Honorable Prime Minister announced a “Janta curfew” on 22nd March 2020. Thereafter, a nationwide “Lockdown” was ordered which has been effective in slowing down the growth rate of pandemic. The unprecedented COVID-19 pandemic has seriously impacted people with pre-existing health conditions and has adversely affected the management of other diseases. Lockdown not only helped in containment of COVID-19 infection but reducing air pollution as evident by a bettering in the air quality index. The short-term effects of air pollution include reduction in pulmonary function, worsening of respiratory symptoms, non-infectious exacerbations of chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), and an increase in respiratory mortality.[345] Patna is among one of the most polluted cities of India and air quality index is generally more than 300 in month of April–May 2020. Air quality index of Patna during lockdown period was generally less than 100 which is considered as satisfactory. Our hypothesis was that with betterment of air quality, we should expect a reduction in hospital admission for diseases like exacerbation of COPD/BA. So, we compared the morbidity and mortality due to respiratory emergencies in same period of 2020 with 2019. Primary objective of the study was to comparison of number of episodes' and type respiratory emergency in period of lockdown to same period last year. Materials and Methods This was retrospective analysis of all the patients admitted in Pulmonary Medicine department for diseases other than COVID-19 through Emergency visits in month of April–May 2020. Sociodemographic and clinical details were recorded from case file available in hospital record system. We compared this data with same period for previous year, that is, 2019. Results A total of 41 patients were admitted in the period of lockdown between April and May 2020, which is 37.8% less, compared to same period of last year. There was reduction in admission for patients with COPD (25.7% vs. 17.0%) and asthma (6% vs. 4.8%) compared to previous year but this difference was statistically not significant and this could be due to short period of evaluation which might not reflect the actual number of patients [Table 1]. There were more cases of lower respiratory tract infection/pneumonia and post-tuberculosis sequel that were admitted in lockdown period compared to previous year for same period. There were lesser deaths among admitted patient (4.87%) in 2019 as compared to 2020 (9.8%) for the same period. In 2019, out of the 6 patients who died, 2 were patients of lung cancer and 1 each was patient of sepsis, acute respiratory distress syndrome, chronic obstructive lung disease, and interstitial lung disease.Table 1: Comparison of respiratory emergencies in 2019 with 2020We infer that air pollution is a major public health hazard, particularly in developing countries and is associated with hospitalizations from respiratory diseases.[6] Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Associations between air pollution and cardio-respiratory physiological measures in older adults exercising outdoors

ABSTRACT We examined whether exercising indoors vs. outdoors reduced the cardio-respiratory effects of outdoor air pollution. Adults ≥55 were randomly assigned to exercise indoors when the Air Quality Health Index was ≥5 and outdoors on other days (intervention group, n = 37), or outdoors everyday (control group, n = 35). Both groups completed cardio-respiratory measurements before and after exercise for up to 10 weeks. Data were analyzed using linear mixed effect regression models. In the control group, an interquartile range increase in fine particulate matter (PM2.5) was associated with increases of 1.4% in heart rate (standard error (SE) = 0.7%) and 5.6% (SE = 2.6%) in malondialdehyde, and decreases of 5.6% (SE = 2.5%) to 16.5% (SE = 7.5%) in heart rate variability measures. While the hypothesized benefit of indoor vs. outdoor exercise could not be demonstrated due to an insufficient number of intervention days (n = 2), the study provides evidence of short-term effects of air pollution in older adults. ISRCTN #26552763.

Short-term effects of air pollution on blood pressure

Elevated blood pressure (BP) has been proposed as a possible pathophysiological mechanism linking exposure to ambient air pollution and the increased risk of cardiovascular mortality and morbidity. In this study, we investigated the hourly relationship between ambient air pollutants and BP. BP measurements were extracted from the electronic health record database of the Seoul National University Bundang Hospital from February 2015 to June 2017. A total of 98,577 individual BP measurements were matched to the hourly levels of air pollutants. A generalized additive model was constructed for hour lags of 0–8 of air pollutants adjusting for age, sex, meteorological variables, and time trend. Systolic BP was shown to be significantly lower at 2–4 hours and 3–5 hours after increased levels of SO2 and CO, respectively (0.24 mmHg and 0.26 mmHg for an interquartile range, respectively). In contrast, O3 and NO2 were associated with significantly increased systolic BP at 3–5 lag hours and at 0–2 lag hours, respectively. BP elevation in association with O3 and NO2 was shown to be significantly greater in hypertensive patients than normotensive subjects. Our findings suggest that short-term exposure to air pollution may be associated with elevated BP.

The association of short-term effects of air pollution and sleep disorders among elderly residents in China

Sleep disorders, oftentimes co-occurring with other mental and neurological disorders in the elderly, have been previously linked to short-term exposures to air pollution. Here we assessed such associations among 395,651 elderly Chinese in Ningbo, China where air pollution exposures are high and the proportion of elderly in the population is growing. We utilized a regional health information database in China (2008–2017) that collected information on hospital visits for sleep disorders among the elderly (age 60+). Measures of daily air pollution concentrations including nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), inhalable particles (PM10), and ambient fine particulate matter (PM2.5) were generated from seven environmental air quality monitoring sites in the study area. We used a generalized additive model to evaluate the associations between hospital visits for sleep disorders and short-term air pollution exposures for up to 7 days prior to a hospital visit. Short-term exposure to multiple air pollutants was associated with hospital visits for sleep disorders in an elderly population; with the strongest associations during 2–3 days prior to a clinic visits for traffic-related pollutants including air quality index (AQI), PM2.5, PM10, and NO2 and for SO2 and O3 for 5 days prior to the visits. Our study based on large health care record system suggested that short-term air pollution exposures are associated with sleep disorders in the elderly. Considering the individual covariates that could not be adjusted in time-series analyses, future studies with individual level data and an ability to evaluate the severity of sleep disorders and their relation to mental and physical health in general and air pollution are needed. An aging population with increasing health problems and the frequency of high and very high air pollution events in China make our findings very health policy relevant.

The short-term effects of air pollutants on influenza-like illness in Jinan, China

BackgroundThere is valid evidence that air pollution is associated with respiratory disease. However, few studies have quantified the short-term effects of six air pollutants on influenza-like illness (ILI). This study explores the potential relationship between air pollutants and ILI in Jinan, China.MethodsDaily data on the concentration of particulate matters < 2.5 μm (PM 2.5), particulate matters < 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) and ILI counts from 2016 to 2017 were retrieved. The wavelet coherence analysis and generalized poisson additive regression model were employed to qualify the relationship between air pollutants and ILI risk. The effects of air pollutants on different age groups were investigated.ResultsA total of 81,459 ILI counts were collected, and the average concentrations of PM2.5, PM10, O3, CO, SO2 and NO2 were 67.8 μg/m3, 131.76 μg/ m3, 109.85 μg/ m3, 1133 μg/ m3, 33.06 μg/ m3 and 44.38 μg/ m3, respectively. A 10 μg/ m3 increase in concentration of PM2.5, PM10, CO at lag0 and SO2 at lag01, was positively associated with a 1.0137 (95% confidence interval (CI): 1.0083–1.0192), 1.0074 (95% CI: 1.0041–1.0107), 1.0288 (95% CI: 1.0127–1.0451), and 1.0008 (95% CI: 1.0003–1.0012) of the relative risk (RR) of ILI, respectively. While, O3 (lag5) was negatively associated with ILI (RR 0.9863; 95%CI: 0.9787–0.9939), and no significant association was observed with NO2, which can increase the incidence of ILI in the two-pollutant model. A short-term delayed impact of PM2.5, PM10, SO2 at lag02 and CO, O3 at lag05 was also observed. People aged 25–59, 5–14 and 0–4 were found to be significantly susceptible to PM2.5, PM10, CO; and all age groups were significantly susceptible to SO2; People aged ≥60 year, 5–14 and 0–4 were found to be significantly negative associations with O3.ConclusionAir pollutants, especially PM2.5, PM10, CO and SO2, can increase the risk of ILI in Jinan. The government should create regulatory policies to reduce the level of air pollutants and remind people to practice preventative and control measures to decrease the incidence of ILI on pollution days.

Acute effects of air pollution from road traffic in a panel of healthy students

TPS 681: Short-term health effects of air pollutants 1, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Background: Panel studies are an efficient means to assess short-term effects of air pollution and other time-varying environmental exposures. Repeated examinations of volunteers allow for in-depth analysis of physiological responses supporting biological interpretation of environmental impacts. Methods: Twenty-four healthy students walked at least 4 times for one hour under each of the 4 settings: By a busy road, by a busy road wearing ear plugs (reducing noise by approx. 30 dB), in a park, in a park but exposed to traffic noise (65 dB) through headphones. Particles (PM2.5, PM1, particle number) and ambient noise levels were measured throughout each walk. Lung function and exhaled NO were measured before, immediately, one hour, and approximately 24 hours after each walk. Blood pressure and heart rate variability were measured every 15 minutes during each walk. Ambient temperature was estimated using data from a local meteorological station. Particle mass (PM10) data was also obtained from a nearby monitor. Results: Personal particle exposures were highly correlated with each other and with the data from the fixed monitor. Particle exposure and noise levels were higher by the road compared to the park. But noise and air pollution were not correlated with each other due to different temporal trends. Temporal variation was by far stronger than differences between settings. Exhaled NO decreased immediately with increasing pollution levels but was significantly higher 24 hours after the walk by the road compared to the park. Air pollution levels reduced lung function levels. Effects mostly remained significant up to 24 hours. Cardiovascular effects of air pollutants were less pronounced. Effects were not confounded by noise or by temperature. Conclusion: While immediate increases in airway resistance could be interpreted as protective (muscular) responses the persisting effects indicate an adverse inflammatory reaction.

The association of short-term effects of air pollution and sleep disorders among elderly residents in China

The association of short-term effects of air pollution and sleep disorders among elderly residents in China

Short-term association between ambient air pollution and lung cancer mortality

RationaleLong-term exposure to air pollution has been associated with increased lung cancer incidence and mortality. However, the short-term association between air pollution and lung cancer mortality (LCM) remains largely unknown. MethodsWe collected daily data on particulate matter with diameter <2.5 μm (PM2.5), particulate matter with diameter < 10 μm (PM10), sulfur dioxide (SO2), and ozone (O3), and LCM in three of the biggest cities in China, i.e. Beijing, Chongqing, and Guangzhou, from 2013 to 2015. We first estimated city-specific relationships between air pollutants and LCM using time-series generalized linear models, adjusting for potential confounders. A classification and regression tree (CART) model was used to stratify LCM risk based on combinations of air pollutants and meteorological factors in each city. Then we pooled the city-specific associations using random-effects meta-analysis. Meta regression was used to explore if city-specific characteristics modified the air pollution-LCM association. Finally, we stratified the analyses by season, age, and sex. ResultsOver the entire period, the current-day concentrations of PM2.5 and PM10 in Chongqing and PM2.5, PM10, and SO2 in Guangzhou were positively associated with LCM (Excess risk ranged from 0.72% (95% CI 0.27%–1.17%) to 6.06% (95% CI 0.76%–11.64%) with each 10 μg/m3 increment in different pollutants), but the association between current-day air pollution and LCM in Beijing was not significant (P > 0.05). When considering the environmental and weather factors simultaneously, current-day PM2.5, relative humidity, and PM10 were the most important factors associated with LCM in Beijing, Chongqing, and Guangzhou, respectively. LCM risk related with daily PM2.5, PM10, and SO2 significantly increased with the increasing annual mean temperature and humidity of the city, while LCM risk related with daily O3 significantly increased with the increases of latitude, annual mean O3 concentration, and socioeconomic level. After stratification, the current-day PM2.5, PM10, and O3 during the warm season in Beijing and PM2.5, PM10, and SO2 during the cool season in Chongqing and Guangzhou were positively associated with LCM (Excess risk ranged from 0.93% (95% CI 0.42%–1.45%) to 7.16% (95% CI 0.64%–14.09%) with each 10 μg/m3 increment in different pollutants). Male and the elderly lung cancer patients were more sensitive to the short-term effect of air pollution. ConclusionsLung cancer patients should enhance protection measures against air pollution. More attentions should be paid for the high PM2.5, PM10, and O3 during the warm season in Beijing, and high PM2.5, PM10, and SO2 during the cool season in Chongqing and Guangzhou.

Short-term effect of PM2.5 on pediatric asthma incidence in Shanghai, China.

Recent epidemiological studies pointed out that air pollution has a significant impact on pediatric asthma. Shanghai is one of the biggest cities in China, and the short-term effect of atmospheric particulate matter on the incidence of pediatric asthma has become a hot topic. From January 1, 2009, to December 31, 2010, we used daily measurements of pollutant concentrations, daily weather data, and daily records of pediatric asthma hospital visits from local authorities to evaluate the short-term effect of air pollution on pediatric asthma incidence in Shanghai, China. We used a generalized additive model (GAM) in the analysis, and the controlled confounding factors include long-term trends, day-of-the-week effects, and weather elements. We divided the entire study group into different age-subgroups. In addition, we took a variety of lag models into consideration. The results showed a strong connection between concentrations of fine particulate matter (PM2.5) and pediatric asthma hospital visits from 2009 to 2010 in Shanghai, China. For the entire study group, the greatest relative risk (RR) of PM2.5 on pediatric asthma hospital visits was 1.060 on a lag of 4days. As for the three different age-subgroups, the greatest RR of PM2.5 on pediatric asthma hospital visits was 1.061 (at a lag of 5days), 1.071 (at a lag of 4days), and 1.052 (at a lag of 2days), for the under-2-year-olds, 3-to-5-year-olds, and the 6-to-18-year-olds, respectively. The overall short-term effect of PM2.5 on pediatric asthma hospital visits was relatively stronger in younger children. Within the year, we detected the strongest seasonal effect of PM2.5 on pediatric asthma hospital visits in Summer. When adding other air pollutants in the analysis model, RR of PM2.5 on pediatric asthma hospital visits would be increased.

Short-term effects of air pollution on lung function of school-age children in Hangzhou

A total of 1 685 school-age children selected from Hangzhou received lung function testing to evaluate the short-term effects of air pollution on their lung function. The results showed that in every 10 μg/m(3) increase of average concentration of PM(2.5) and PM(10) on the day of the test and the day before the test,peak expiratory flow (PEF) decreased 0.039 (95%CI: 0.012-0.067) L/s and 0.031 (95% CI:0.011-0.051) L/s,respectively. When the average concentration of SO(2) increased 10 μg/m(3) on the day of test and the day prior to the test, PEF and 75% of the forced vital capacity that has not been exhaled (MEF(75)) decreased 0.437 (95%CI: 0.217-0.658) L/s and 0.396 (95%CI: 0.180-0.613) L/s. After being adjusted for NO(2),with every 10 μg/m(3) increase of average concentration of PM(2.5) and PM(10) on the day of the test and the day before the test,PEF and MEF(75) decreased 0.056 (95%CI: 0.028-0.085), 0.053(95%CI: 0.027-0.081) and 0.047 (95%CI: 0.026-0.068) L/s,0.044 (95%CI: 0.023-0.065) L/s on the day before the test, respectively. The results indicate that air pollution have short-term and lag effects on lung function of school-age children in Hangzhou.

An evaluation of the air quality health index program on respiratory diseases in Hong Kong: An interrupted time series analysis

BackgroundOn December 30th, 2013, the Hong Kong government implemented the Air Quality Health Index (AQHI) alert programme warnings designed to reduce short-term effects of air pollution on population health. However, whether air quality alert programme warnings, such as the AQHI, reduce morbidity is still questionable. Using a quasi-experimental design, we conducted the first evaluation of the AQHI in Hong Kong focusing on respiratory morbidity. MethodInterrupted time series with Poisson segmented regression from 2010 to 2016 was used to detect any sudden or gradual changes in emergency respiratory hospital admissions, adjusted for air pollutants (NO2, SO2, PM10, O3), temperature and humidity, when the AQHI policy was implemented. The findings were validated using three false policy study periods and digestive diseases as a control. We also assessed effects on specific respiratory diseases (respiratory tract infections (RTI), asthma, chronic obstructive pulmonary disease and pneumonia) and by age. ResultsFrom January 1st, 2010 to December 31st, 2016, 10576.98 deseasonalized, age-standardized hospital admissions for respiratory disease occurred in Hong Kong. On implementation of the AQHI, RTI admissions immediately dropped by 14% (relative risk (RR) 0.86 95% confidence interval (CI) 0.76–0.98). In age specific analysis, immediate reductions in hospital admissions were only apparent in children for RTI (RR 0.84, 95% CI 0.74–0.96) and pneumonia (RR 0.88, 95% CI 0.60–0.96). ConclusionHong Kong's AQHI helped reduced hospital admissions in children, particularly for RTI and pneumonia. To maximize health benefits of the policy, at risk groups need to be able to follow the behavioral changes recommended by the AQHI warnings.

The effect of air pollution on hospitalization of individuals with respiratory and cardiovascular diseases in Jinan, China

To analyze the short-term effects of air pollution on the hospitalization rates of individuals with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), stroke, and myocardial infarction (MI) after adjusting for confounding factors including weather, day of the week, holidays, and long-term trends in Jinan, China.Hospitalization information was extracted based on data from the primary class 3-A hospitals in Jinan from 2013 to 2015. The concentrations of PM2.5, PM10, SO2, NO2, and O3 were obtained from Jinan Environment Monitoring Center. The relative risk and 95% confidence intervals of AECOPD, stroke, and MI were estimated using generalized additive models with quasi-Poisson distribution in the mgcv package, using R software, version 1.0.136.The incremental increased concentrations of particulate pollutants including PM2.5 and PM10 were significantly associated with increased risk of hospitalization of AECOPD, stroke, and MI, and the adverse influences of PM2.5 on these diseases were generally stronger than that of PM10. The incremental increased concentrations of gaseous pollutants including SO2, NO2, and O3 were significantly associated with increased risk of hospitalization of stroke and MI in this population.Air pollution has significant adverse effects on hospitalization rates of individuals with AECOPD, stroke, and MI in Jinan, China.

Population susceptibility differences and effects of air pollution on cardiovascular mortality: epidemiological evidence from a time-series study.

There is insufficient evidence on the relationship between air pollution and mortality from cardiovascular disease (CVD) in northeast China. Here, we explored the short-term effects of air pollution on CVD mortality and preliminarily investigated differences in population susceptibility to air pollution in Shenyang, China. CVD mortality, air pollution, and meteorological data during 2013-2016 were obtained. Time-series analysis was applied to evaluate the association between air pollution and daily CVD mortality with different lag structures. In the single-pollutant model, each 10μg/m3 increase in PM2.5, PM10, SO2, NO2, and O3 concentrations and 1mg/m3 increase in CO concentrations at lag0 (same day) was significantly associated with an increase of 0.40% (95% confidence interval, 0.22-0.59%), 0.26% (0.12-0.40%), 0.43% (0.16-0.70%), 0.90% (0.14-1.67%), 0.76% (0.21-1.32%), and 3.33% (0.97-5.75%), respectively, in overall CVD mortality. Susceptibility to air pollutants was higher among females, elderly people, and ischemic heart disease patients. Furthermore, air pollution effects on CVD mortality were 2-8 times greater during the non-heating period. In conclusion, the air pollutants PM2.5, PM10, SO2, NO2, O3, and CO showed significant positive effects on CVD mortality in Shenyang, China. These findings highlight the adverse effects of air pollution and suggest the need for personal protective equipment and reduction of air pollution sources.

Short-term effects of air pollution and temperature on cattle mortality in the Netherlands

BackgroundExtreme temperatures and air pollution are both associated with increased mortality risk in humans. However, the effects of temperature and air pollution on cattle have not been investigated much before. ObjectivesShort-term effects of temperature (heat and cold) and air pollution on cattle mortality were investigated and quantified in the Netherlands during 2012–2017. MethodsDaily data on cattle mortality, weather conditions and mean levels of particulate matter (PM10), ozone (O3), ammonia (NH3) and nitrogen dioxide (NO2) of the Netherlands during 2012–2017 were collected. Associations were investigated with time–series regression using distributed lag non–linear models including lags of up to 25 days. Effects of temperature were expressed as those associated with extreme and moderate heat or cold, defined as Temperature Humidity Index (THI) values below the 1st and 5th percentile, and above the 95th and 99th percentile of the national THI distribution. Effects of air pollutants were expressed per 10 μg/m3 change in daily mean concentrations. ResultsBoth high and low temperatures were associated with increased mortality amongst different age groups. For instance, the newborn calves of at most 14 days showed a cumulative relative risk (RR) of 2.13 (95%CI: 1.99–2.28) for extreme heat and the pre-weaned calves (15–55 days) showed a cumulative RR of 1.50 (95%CI: 1.37–1.64) for extreme cold. Associations of air pollution with mortality were not consistent, except for the effect of ozone of lag 0–7 and lag 0–25. Exposure to O3 in the newborn calves resulted in a cumulative RR of 1.09 (95%CI: 1.04–1.4) for lag 0–7 and 1.09 (95%CI: 1.03–1.16) for lag 0–25. ConclusionsBoth high and low temperatures were associated with increased mortality amongst pre-weaned calves of 15–55 days, whereas associations in weaned calves (56 days – 1 year) were only observed for low temperatures and in newborn calves of at most 14 days and lactating cattle >2 years only for high temperatures. Associations of air pollution with mortality in all age groups were not consistent, except for the effect of ozone of lag 0–7 and lag 0–25.