Air pollution and chronic obstructive pulmonary disease.
Ko Fanny W S,Hui David S C
Respirology (Carlton, Vic.)
Limited data suggest that outdoor air pollution (such as ambient air pollution or traffic-related air pollution) and indoor air pollution (such as second-hand smoking and biomass fuel combustion exposure) are associated with the development of chronic obstructive pulmonary disease (COPD), but there is insufficient evidence to prove a causal relationship at this stage. It also appears that outdoor air pollution is a significant environmental trigger for acute exacerbation of COPD, leading to increasing symptoms, emergency department visits, hospital admissions and even mortality. Improving ambient air pollution and decreasing indoor biomass combustion exposure by improving home ventilation are effective measures that may substantially improve the health of the general public.
10.1111/j.1440-1843.2011.02112.x
Air pollution and COPD in China.
Hu Guoping,Zhong Nanshan,Ran Pixin
Journal of thoracic disease
Recently, many researchers paid more attentions to the association between air pollution and chronic obstructive pulmonary disease (COPD). Haze, a severe form of outdoor air pollution, affected most parts of northern and eastern China in the past winter. In China, studies have been performed to evaluate the impact of outdoor air pollution and biomass smoke exposure on COPD; and most studies have focused on the role of air pollution in acutely triggering symptoms and exacerbations. Few studies have examined the role of air pollution in inducing pathophysiological changes that characterise COPD. Evidence showed that outdoor air pollution affects lung function in both children and adults and triggers exacerbations of COPD symptoms. Hence outdoor air pollution may be considered a risk factor for COPD mortality. However, evidence to date has been suggestive (not conclusive) that chronic exposure to outdoor air pollution increases the prevalence and incidence of COPD. Cross-sectional studies showed biomass smoke exposure is a risk factor for COPD. A long-term retrospective study and a long-term prospective cohort study showed that biomass smoke exposure reductions were associated with a reduced decline in forced expiratory volume in 1 second (FEV1) and with a decreased risk of COPD. To fully understand the effect of air pollution on COPD, we recommend future studies with longer follow-up periods, more standardized definitions of COPD and more refined and source-specific exposure assessments.
10.3978/j.issn.2072-1439.2014.12.47
Effect of Indoor Air Pollution on Chronic Obstructive Pulmonary Disease (COPD) Deaths in Southern Asia-A Systematic Review and Meta-Analysis.
Shetty Bellipady Shyam Prasad,D'Souza George,Padukudru Anand Mahesh
Toxics
BACKGROUND:About half of the population in developing countries are exposed to indoor pollution such as combustion fuels at present. Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality globally and the primary cause of COPD in women is indoor air pollution exposure, while tobacco smoking is the leading cause in men. The aim of this systematic review and meta-analysis is to evaluate the correlation between the indoor air pollution and deaths related to COPD and COPD prevalence in South Asia. METHODS:A systematic search on studies with sufficient statistical power has been conducted from 1985 until 30 June 2020, in English electronic databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in MEDLINE and PubMed databases with the terms Chronic Obstructive Pulmonary disease COPD or Chronic Bronchitis or Emphysema or COPD Deaths or Chronic Obstructive Lung Disease or Airflow Obstruction or Chronic Airflow Obstruction or Airflow Obstruction, Chronic or Bronchitis, Chronic and Mortality or Death or Deceased was conducted. Studies were eligible if they were Prospective controlled or non-controlled trials conducted in Southern Asia/ Asia and Retrospective studies conducted in Southern Asia/ Asia. RESULTS:The results have concluded that long term exposure to indoor pollution had a significant effect on COPD deaths as well as its symptoms. Odd's ratio was in a range of 1.05 (Randomized controlled trials) to 7.87 (Cross sectional studies) for all the studies mentioned. Meta-analysis observed a significantly higher Odds Ratio of 2.13 for COPD mortality and 2.08 for COPD prevalence on exposure to indoor air pollution. CONCLUSION:Exposure to solid fuel smoke is consistently and significantly correlated with COPD mortality and COPD prevalence in South Asian countries, in spite of heterogeneity observed in the studies included. For performing domestic tasks, initiatives are to be taken to reduce dependency on solid fuel by using cleaner alternatives or comparatively cleaner technology.
10.3390/toxics9040085
Air pollution and chronic obstructive pulmonary disease.
Duan Rui-Rui,Hao Ke,Yang Ting
Chronic diseases and translational medicine
There is considerable epidemiological evidence indicating that air pollution has adverse effects on human health and is closely related to respiratory diseases, including chronic obstructive pulmonary disease (COPD). These effects, which can be divided into short- and long-term effects, can manifest as an exacerbation of existing symptoms, impaired lung function, and increased hospitalization and mortality rates. Long-term exposure to air with a high concentration of pollutants may also increase the incidence of COPD. The combined effects of different pollutants may become more complex in the future; hence, there is a need for more intensive research on specific at-risk populations, and formulating corresponding protective strategies is crucial. We aimed to review the epidemiological evidence on the effect of air pollution on COPD, the possible pathophysiological mechanisms underlying this effect, as well as protective measures against the effects of air pollutants in patients with COPD.
10.1016/j.cdtm.2020.05.004
Short-term associations between size-fractionated particulate air pollution and COPD mortality in Shanghai, China.
Peng Li,Xiao Shaotan,Gao Wei,Zhou Yi,Zhou Ji,Yang Dandan,Ye Xiaofang
Environmental pollution (Barking, Essex : 1987)
Particulate air pollution is a continuing challenge in China, and its adverse effects on chronic obstructive pulmonary disease (COPD) have been widely reported. However, epidemiological evidence on the associations between size-fractionated particle number concentrations (PNCs) and COPD mortality is limited. In this study, we utilized a time-series approach to investigate the associations between PNCs of particles at 0.25-10 μm in diameter and COPD mortality in Shanghai, China. Quasi-Poisson regression generalized additive models were applied to evaluate these associations, with adjustment of time trend, day of week, holidays, temperature and relative humidity. Stratification analyses were performed by season and gender. There were a total of 3238 deaths due to COPD during the study period. We found that daily COPD deaths were significantly associated with PNCs of particles <0.5 μm, and the magnitude of associations increased with decreasing particle size. An interquartile range (IQR) increase in PNC, PNC, PNC, PNC, PNC and PNC was associated with increments of 7.51% (95%CI: 2.45%, 12.81%), 7.22% (95%CI: 2.16%, 12.53%), 6.95% (95%CI: 1.81%, 12.35%), 6.26% (95%CI: 1.25%, 11.52%), 5.24% (95%CI: 0.56%, 10.13%) and 4.15% (95%CI: 0.14%, 8.32%), respectively. The associations remained robustness after controlling for the mass concentrations of gaseous air pollutants. In stratification analyses, significant associations between PNCs and COPD mortality were observed in the cold seasons, and in males. Our results suggested that particles <0.5 μm in diameter might be most responsible for the adverse effects of particulate air pollution on COPD mortality, and COPD patients are more susceptible to PM air pollution in the cold seasons, especially for males.
10.1016/j.envpol.2019.113483
Exacerbations of COPD: environmental mechanisms.
MacNee W,Donaldson K
Chest
Air pollution as a trigger for exacerbations of COPD has been recognized for > 50 years, and has led to the development of air quality standards in many countries that substantially decreased the levels of air pollutants derived from the burning of fossil fuels, such as black smoke and sulfur dioxide. However, the recent dramatic increase in motor vehicle traffic has produced a relative increase in the levels of newer pollutants, such as ozone and fine-particulate air pollution < 10 microm in diameter. Numerous epidemiologic studies have shown associations between the levels of these air pollutants and adverse health effects, such as exacerbations of airways diseases and even deaths from respiratory and cardiovascular causes. Elucidation of the mechanism of the harmful effects of these pollutants should allow improved risk assessment for patients with airways diseases who are be susceptible to the effects of these air pollutants.
10.1378/chest.117.5_suppl_2.390s
Hydrogen peroxide in exhaled breath condensate: A clinical study.
Nagaraja C,Shashibhushan B L,Sagar ,Asif Mohamed,Manjunath P H
Lung India : official organ of Indian Chest Society
OBJECTIVES:To study the ongoing inflammatory process of lung in healthy individuals with risk factors and comparing with that of a known diseased condition. To study the inflammatory response to treatment. BACKGROUND:Morbidity and mortality of respiratory diseases are raising in trend due to increased smokers, urbanization and air pollution, the diagnosis of these conditions during early stage and management can improve patient's lifestyle and morbidity. MATERIALS AND METHODS:One hundred subjects were studied from July 2010 to September 2010; the level of hydrogen peroxide concentration in exhaled breath condensate was measured using Ecocheck. RESULTS:Of the 100 subjects studied, 23 were healthy individuals with risk factors (smoking, exposure to air pollution, and urbanization); the values of hydrogen peroxide in smokers were 200-2220 nmol/l and in non-smokers 340-760 nmol/l. In people residing in rural areas values were 20-140 nmol/l in non-smokers and 180 nmol/l in smokers. In chronic obstructive pulmonary disease cases, during acute exacerbations values were 540-3040 nmol/l and 240-480 nmol/l following treatment. In acute exacerbations of bronchial asthma, values were 400-1140 nmol/l and 100-320 nmol/l following treatment. In cases of bronchiectasis, values were 300-340 nmol/l and 200-280 nmol/l following treatment. In diagnosed pneumonia cases values were 1060-11800 nmol/l and 540-700 nmol/l following treatment. In interstitial lung diseases, values ranged from 220-720 nmol/l and 210-510 nmol/l following treatment. CONCLUSION:Exhaled breath condensate provides a non-invasive means of sampling the lower respiratory tract. Collection of exhaled breath condensate might be useful to detect the oxidative destruction of the lung as well as early inflammation of the airways in a healthy individual with risk factors and comparing the inflammatory response to treatment.
10.4103/0970-2113.95303
Vulnerability to the impact of temperature variability on mortality in 31 major Chinese cities.
Yang Jun,Zhou Maigeng,Li Mengmeng,Liu Xiaobo,Yin Peng,Sun Qinghua,Wang Jun,Wu Haixia,Wang Boguang,Liu Qiyong
Environmental pollution (Barking, Essex : 1987)
Few studies have analyzed the health effects of temperature variability (TV) accounting for both interday and intraday variations in ambient temperature. In this study, TV was defined as the standard deviations of the daily minimum and maximum temperature during different exposure days. Distributed lag non-linear Poisson regression model was used to examine the city-specific effect of TV on mortality in 31 Chinese municipalities and provincial capital cities. The national estimate was pooled through a meta-analysis based on the restricted maximum likelihood estimation. To assess effect modification on TV-mortality association by individual characteristics, stratified analyses were further fitted. Potential effect modification by city characteristics was performed through a meta-regression analysis. In total, 259 million permanent residents and 4,481,090 non-accidental deaths were covered in this study. The effect estimates of TV on mortality were generally increased by longer exposure days. A 1 °C increase in TV at 0-7 days' exposure was associated with a 0.60% (95% CI: 0.25-0.94%), 0.65% (0.24-1.05%), 0.82% (0.29-1.36%), 0.86% (0.42-1.31%), 0.98% (0.57-1.39%) and 0.54% (-0.11-1.20%) increase in non-accidental, cardiovascular, IHD, stroke, respiratory and COPD mortalities, respectively. Those with lower levels of educational attainment were significantly susceptible to TV. Cities with dense population, higher mean temperatures, and relative humidity and lower diurnal temperature ranges also had higher mortality risks caused by TV. This study demonstrated that TV had considerable health effects. An early warning system to alert residents about large temperature variations is recommended, which may have a significant impact on the community awareness and public health.
10.1016/j.envpol.2018.04.090
Global burden of COPD: risk factors, prevalence, and future trends.
Mannino David M,Buist A Sonia
Lancet (London, England)
Chronic obstructive pulmonary disease (COPD) continues to be an important cause of morbidity, mortality, and health-care costs worldwide. It is a global health issue, with cigarette smoking being an important risk factor universally; other factors, such as exposure to indoor and outdoor air pollution, occupational hazards, and infections, are also important. As the global population ages, the burden of COPD will increase in years to come. Prevalence estimates of the disorder show considerable variability across populations, suggesting that risk factors can affect populations differently. Other advances in our understanding of COPD are increased recognition of the importance of comorbid disease, identification of different COPD phenotypes, and understanding how factors other than lung function affect outcome in our patients. The challenge we will all face in the next few years will be implementation of cost-effective prevention and management strategies to stem the tide of this disease and its cost.
10.1016/S0140-6736(07)61380-4
Associations between short-term ambient ozone exposure and cause-specific mortality in rural and urban areas of Jiangsu, China.
Environmental research
Most previous studies on the acute health effects of ozone are limited to urban areas, largely due to the paucity of air pollutant measurements in rural areas. We here estimated the county-specific daily maximum 8-h average ozone concentration in Jiangsu Province, China during 2015-2018, using a recently developed spatiotemporal machine learning model at a spatial resolution of 0.1° × 0.1° (∼11 × 11 km). Counties were equally divided into urban and rural groups based on the median of the percentage of urban residents across Jiangsu counties obtained from the National Population Census in 2010. We first conducted time-series analyses to estimate the county-specific effect of ozone using generalized linear models, then pooled the effect estimates by random-effects modeling. A 10 μg/m increase in the 4-day moving average (lag 0-3) of ambient ozone exposure was associated with increases of 0.66% (95% confidence interval [CI] 0.36%-0.95%) in daily nonaccidental mortality in rural areas and 0.42% in urban areas (95% CI, 0.27%-0.56%). Short-term ambient ozone exposure was associated with an increased risk of mortality caused by chronic obstructive pulmonary disease, hypertension, ischemic heart disease, and stroke. Our finding suggests that both urban and rural residents suffer adverse health effects from short-term ozone exposure.
10.1016/j.envres.2022.113098
Influence of heat wave definitions to the added effect of heat waves on daily mortality in Nanjing, China.
Chen Kai,Bi Jun,Chen Jin,Chen Xiaodong,Huang Lei,Zhou Lian
The Science of the total environment
BACKGROUND:Few studies have explored the added effect of heat waves, especially in China. Moreover, no prior studies have assessed whether the choice of heat wave definitions affected this added effect. This study compared the associations between heat waves defined by different heat wave definitions (HWs) and cause-specific mortality in warm season in Nanjing, China. METHODS:A distributed lag model was applied to evaluate the differences in daily mortality during heat-wave days (defined using 15 HWs) compared with non-heat-wave days in Nanjing, during 2007 to 2013. For different HWs, model fits were examined by the Akaike Information Criterion for quasi-Poisson and effects were compared by stratified analysis and bootstrapping. In addition, we explored the effect modifications by individual characteristics under different HWs. RESULTS:Different HWs resulted in considerable differences in associations between heat waves and mortality. Heat waves defined as ≥4 consecutive days with daily average temperature >98th percentile had the best model fit and were associated with an increase of 24.6% (95% CI: 15.6%, 34.3%) total mortality, 46.9% (95% CI: 33.0%, 62.3%) cardiovascular mortality, 32.0% (95% CI: 8.5%, 60.5%) respiratory mortality, 51.3% (95% CI: 23.4%, 85.6%) stroke mortality, 63.4% (95% CI: 41.5%, 88.8%) ischemic heart disease mortality, and 47.6% (95% CI: 14.5%, 90.3%) chronic obstructive pulmonary disease mortality at lag day 2. Under different HWs, added effects of heat waves on mortality were higher for females versus males, the elderly versus young residents, and people with low education versus those with high education. Results were less sensitive to the inclusion of air pollutants. CONCLUSIONS:Heat wave definition plays a critical role in the relationship between heat waves and mortality. Selecting an appropriate definition of heat waves is therefore important to design local heat warning systems and to reduce the burden of disease during heat waves.
10.1016/j.scitotenv.2014.10.092
Mortality burden attributable to PM in Zhejiang province, China.
Hu Kejia,Guo Yuming,Hu Deyun,Du Rongguang,Yang Xuchao,Zhong Jieming,Fei Fangrong,Chen Feng,Chen Gongbo,Zhao Qi,Yang Jun,Zhang Yunquan,Chen Qian,Ye Tingting,Li Shanshan,Qi Jiaguo
Environment international
BACKGROUND:Limited evidence is available on the health effects of particulate matter with an aerodynamic diameter of <1 μm (PM), mainly due to the lack of its ground measurement worldwide. OBJECTIVES:To identify and examine the mortality risks and mortality burdens associated with PM, PM, and PM in Zhejiang province, China. METHODS:We collected daily data regarding all-cause (stratified by age and gender), cardiovascular, stroke, respiratory, and chronic obstructive pulmonary disease (COPD) mortality, and PM, PM, and PM, from 11 cities in Zhejiang province, China during 2013 and 2017. We used a quasi-Poisson regression model to estimate city-specific associations between mortality and PM concentrations. Then we used a random-effect meta-analysis to pool the provincial estimates. To show the mortality burdens of PM, PM, and PM, we calculated the mortality fractions and deaths attributable to these PMs. RESULTS:Daily concentrations of PM, PM, and PM ranged between 0-199 μg/m, 0-218 μg/m, and 0-254 μg/m, respectively; Mortality effects were significant in lag 0-2 days. The relative risks for all-cause mortality were 1.0064 (95% CI: 1.0034, 1.0094), 1.0061 (95% CI: 1.0034, 1.0089), and 1.0060 (95% CI: 1.0038, 1.0083) associated with a 10 μg/m increase in PM, PM and PM, respectively. Age- and gender-stratified analysis shows that elderly people (aged 65+) and females are more sensitive to PMs. The mortality fractions of all-cause mortality were estimated to be 2.39% (95% CI: 1.28, 3.48) attributable to PM, 2.53% (95% CI: 1.42, 3.63) attributable to PM, and 3.08% (95% CI: 1.95, 4.19) attributable to PM. The ratios of attributable cause-specific deaths for PM/PM, PM/PM, and PM/PM were higher than the ratios of their respective concentrations. CONCLUSIONS:PM, PM and PM are risk factors of all-cause, cardiovascular, stroke, respiratory, and COPD mortality. PM accounts for the vast majority of short-term PM- and PM-induced mortality. Our analyses support the notion that smaller size fractions of PM have a more toxic mortality impacts, which suggests to develop strategies to prevent and control PM in China, such as to foster strict regulations for automobile and industrial emissions.
10.1016/j.envint.2018.09.033
Patients with chronic obstructive pulmonary disease are at increased risk of death associated with urban particle air pollution: a case-crossover analysis.
Sunyer J,Schwartz J,Tobías A,Macfarlane D,Garcia J,Antó J M
American journal of epidemiology
The authors assessed the acute association between particulate air pollution and mortality among subjects suffering from chronic obstructive pulmonary disease by using a case-crossover analysis. This design avoided the common concerns about the methods used to assess the acute effects of air pollution. The 1,845 men and the 460 women included were residents of Barcelona, Spain, who were over age 35 years, had died during the period 1990-1995, and had visited emergency rooms because of a chronic obstructive pulmonary disease exacerbation during the period 1985-1989. Particle levels (measured as black smoke at the city monitoring stations) were associated with mortality for all causes (odds ratio (OR) for an increase of 20 microg/m3, the interquartile change, adjusted for temperature, humidity, and influenza = 1.112, 95 percent confidence interval (CI): 1.017, 1.215). The association was stronger for respiratory causes (OR = 1.182, 95 percent CI: 1.025, 1.365), but was not significant for cardiovascular causes (OR = 1.077, 95 percent CI: 0.917, 1.264). Older women, patients admitted to intensive care units, and patients with a higher rate of emergency room visits were at greater risk of dying associated with black smoke. The results reinforced the deleterious role of urban pollution and provided information on factors possibly conferring susceptibility to the acute role of air pollution.
10.1093/oxfordjournals.aje.a010121
The Burden of COPD Due to Ozone Exposure in Germany.
Breitner Susanne,Steckling-Muschack Nadine,Markevych Iana,Zhao Tianyu,Mertes Hanna,Nowak Dennis,Heinrich Joachim
Deutsches Arzteblatt international
BACKGROUND:The chronic effects of ozone have only rarely been investigated in disease burden studies to date. Our goal was to determine this disease burden in Germany over the period 2007-2016, with particular attention to estimation based on effect estimates adjusted for particulate matter (PM2.5) and nitrogen dioxide (NO2). METHODS:The nationwide, high-spatial-resolution (2 km × 2 km), population-based exposure to ozone in the summer months ("summer ozone") was calculated on the basis of modeled ozone data and population counts in Germany. Next, risk estimates derived from cohort studies were used to quantify the burden of chronic obstructive pulmonary disease (COPD). Data on population counts, life expectancy, and mortality in Germany were used to reflect the situation across the country as accurately as possible. RESULTS:The estimates of years of life lost (YLL) due to summer ozone ranged from 18.33 per 100 000 people (95% confidence interval [14.02; 22.08]) in 2007 to 35.77 per 100 000 people [27.45; 42.98] in 2015. These findings indicate that ozone affects the COPD burden independently of other harmful components of the air. No clear secular trend in the COPD burden can be seen over the period 2007 to 2016. CONCLUSION:Long-term exposure to ozone contributes to the COPD burden among the general population in Germany. As climate change may lead to a rise in the ozone concentration, more intensive research is required on the effects of ozone on health.
10.3238/arztebl.m2021.0258
Global burden of COPD.
López-Campos José Luis,Tan Wan,Soriano Joan B
Respirology (Carlton, Vic.)
It is estimated that the world population will reach a record 7.3 billion in 2015, and the high burden of chronic conditions associated with ageing and smoking will increase further. Respiratory diseases in general receive little attention and funding in comparison with other major causes of global morbidity and mortality. In particular, chronic obstructive pulmonary disease (COPD) has been a major public health problem and will remain a challenge for clinicians within the 21st century. Worldwide, COPD is in the spotlight, since its high prevalence, morbidity and mortality create formidable challenges for health-care systems. This review emphasizes the magnitude of the COPD problem from a clinician's standpoint by drawing extensively from the new findings of the Global Burden of Disease study. Updated, distilled information on the population distribution of COPD is useful for the clinician to help provide an appreciation of the relative impact of COPD in daily practice compared with other chronic conditions, and to allocate minimum resources in anticipation of future needs in care. Despite recent trends in reduction of COPD standardized mortality rates and some recent successes in anti-smoking efforts in a number of Western countries, the overarching demographic impact of ageing in an ever-expanding world population, joined with other factors such as high rates of smoking and air pollution in Asia, will ensure that COPD will continue to pose an ever-increasing problem well into the 21st century.
10.1111/resp.12660
Effects of short-term exposure to ambient airborne pollutants on COPD-related mortality among the elderly residents of Chengdu city in Southwest China.
Chen Jianyu,Shi Chunli,Li Yang,Ni Hongzhen,Zeng Jie,Lu Rong,Zhang Li
Environmental health and preventive medicine
BACKGROUND:Chronic obstructive pulmonary disease (COPD) has become a severe global burden in terms of both health and the economy. Few studies, however, have thoroughly assessed the influence of air pollution on COPD-related mortality among elderly people in developing areas in the hinterland of southwestern China. This study is the first to examine the association between short-term exposure to ambient airborne pollutants and COPD-related mortality among elderly people in the central Sichuan Basin of southwestern China. METHODS:Data on COPD-related mortality among elderly people aged 60 and older were obtained from the Population Death Information Registration and Management System (PDIRMS). Data on airborne pollutants comprised of particulate matter < 2.5 μm in aerodynamic diameter (PM), sulfur dioxide (SO), nitrogen dioxide (NO), carbon monoxide (CO), and ozone (O) were derived from 23 municipal environmental monitoring sites. Data on weather conditions, including daily mean temperature and relative humidity, were obtained from the Chengdu Meteorological Bureau. All data were collected from January 1, 2015, to December 31, 2018. A quasi-Poisson general additive model (GAM) was utilized to assess the effects of short-term exposure to airborne pollutants on COPD-related mortality among elderly people. RESULTS:A total of 61,058 COPD-related deaths of people aged 60 and older were obtained. Controlling the influences of daily temperature and relative humidity, interquartile range (IQR) concentration increases of PM (43 μg/m), SO (8 μg/m), NO (18 μg/m), CO (0.4 mg/m), and O (78 μg/m) were associated with 2.7% (95% CI 1.0-4.4%), 4.3% (95% CI 2.1-6.4%), 3.6% (95% CI 1.7-5.6%), 2.7% (95% CI 0.6-4.8%), and 7.4% (95% CI 3.6-11.3%) increases in COPD-related mortality in people aged 60 and older, respectively. The exposure-response curves between each pollutant and the log-relative risk of COPD-related mortality exhibited linear relationships. Statistically significant differences in the associations between pollutants and COPD-related mortality were not observed among sociodemographic factors including age, gender, and marital status. The effects of O remained steady after adjusting for PM, SO, NO, and CO each time in the two-pollutant models. CONCLUSIONS:Increased concentrations of ambient airborne pollutants composed of PM, SO, NO, O, and CO were significantly and positively associated with COPD-related mortality in the central Sichuan Basin, which is located in the hinterland of southwestern China. The adverse effects of O were stable, a finding that should receive more attention.
10.1186/s12199-020-00925-x
Associations between Coarse Particulate Matter Air Pollution and Cause-Specific Mortality: A Nationwide Analysis in 272 Chinese Cities.
Chen Renjie,Yin Peng,Meng Xia,Wang Lijun,Liu Cong,Niu Yue,Liu Yunning,Liu Jiangmei,Qi Jinlei,You Jinling,Kan Haidong,Zhou Maigeng
Environmental health perspectives
BACKGROUND:Coarse particulate matter with aerodynamic diameter between 2.5 and [Formula: see text] ([Formula: see text]) air pollution is a severe environmental problem in developing countries, but its challenges to public health were rarely evaluated. OBJECTIVE:We aimed to investigate the associations between day-to-day changes in [Formula: see text] and cause-specific mortality in China. METHODS:We conducted a nationwide daily time-series analysis in 272 main Chinese cities from 2013 to 2015. The associations between [Formula: see text] concentrations and mortality were analyzed in each city using overdispersed generalized additive models. Two-stage Bayesian hierarchical models were used to estimate national and regional average associations, and random-effect models were used to pool city-specific concentration-response curves. Two-pollutant models were adjusted for fine particles with aerodynamic diameter [Formula: see text] ([Formula: see text]) or gaseous pollutants. RESULTS:Overall, we observed positive and approximately linear concentration-response associations between [Formula: see text] and daily mortality. A [Formula: see text] increase in [Formula: see text] was associated with higher mortality due to nonaccidental causes [0.23%; 95% posterior interval (PI): 0.13, 0.33], cardiovascular diseases (CVDs; 0.25%; 95% PI: 0.13, 0.37), coronary heart disease (CHD; 0.21%; 95% PI: 0.05, 0.36), stroke (0.21%; 95% PI: 0.08, 0.35), respiratory diseases (0.26%; 95% PI: 0.07, 0.46), and chronic obstructive pulmonary disease (COPD; 0.34%; 95% PI: 0.12, 0.57). Associations were stronger for cities in southern vs. northern China, with significant differences for total and cardiovascular mortality. Associations with [Formula: see text] were of similar magnitude to those for [Formula: see text] in both single- and two-pollutant models with mutual adjustment. Associations were robust to adjustment for gaseous pollutants other than nitrogen dioxide and sulfur dioxide. Meta-regression indicated that a larger positive correlation between [Formula: see text] and [Formula: see text] predicted stronger city-specific associations between [Formula: see text] and total mortality. CONCLUSIONS:This analysis showed significant associations between short-term [Formula: see text] exposure and daily nonaccidental and cardiopulmonary mortality based on data from 272 cities located throughout China. Associations appeared to be independent of exposure to [Formula: see text], carbon monoxide, and ozone. https://doi.org/10.1289/EHP2711.
10.1289/EHP2711
Air pollution and chronic airway diseases: what should people know and do?
Jiang Xu-Qin,Mei Xiao-Dong,Feng Di
Journal of thoracic disease
The health effects of air pollution remain a public health concern worldwide. Exposure to air pollution has many substantial adverse effects on human health. Globally, seven million deaths were attributable to the joint effects of household and ambient air pollution. Subjects with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma are especially vulnerable to the detrimental effects of air pollutants. Air pollution can induce the acute exacerbation of COPD and onset of asthma, increase the respiratory morbidity and mortality. The health effects of air pollution depend on the components and sources of pollutants, which varied with countries, seasons, and times. Combustion of solid fuels is a major source of air pollutants in developing countries. To reduce the detrimental effects of air pollution, people especially those with COPD or asthma should be aware of the air quality and take extra measures such as reducing the time outdoor and wearing masks when necessary. For reducing the air pollutants indoor, people should use clean fuels and improve the stoves so as to burn fuel more efficiently and vent emissions to the outside. Air cleaners that can improve the air quality efficiently are recommended.
10.3978/j.issn.2072-1439.2015.11.50
Fine Particulate Air Pollution and Daily Mortality. A Nationwide Analysis in 272 Chinese Cities.
Chen Renjie,Yin Peng,Meng Xia,Liu Cong,Wang Lijun,Xu Xiaohui,Ross Jennifer A,Tse Lap A,Zhao Zhuohui,Kan Haidong,Zhou Maigeng
American journal of respiratory and critical care medicine
RATIONALE:Evidence concerning the acute health effects of air pollution caused by fine particulate matter (PM) in developing countries is quite limited. OBJECTIVES:To evaluate short-term associations between PM and daily cause-specific mortality in China. METHODS:A nationwide time-series analysis was performed in 272 representative Chinese cities from 2013 to 2015. Two-stage Bayesian hierarchical models were applied to estimate regional- and national-average associations between PM concentrations and daily cause-specific mortality. City-specific effects of PM were estimated using the overdispersed generalized additive models after adjusting for time trends, day of the week, and weather conditions. Exposure-response relationship curves and potential effect modifiers were also evaluated. MEASUREMENTS AND MAIN RESULTS:The average of annual mean PM concentration in each city was 56 μg/m (minimum, 18 μg/m; maximum, 127 μg/m). Each 10-μg/m increase in 2-day moving average of PM concentrations was significantly associated with increments in mortality of 0.22% from total nonaccidental causes, 0.27% from cardiovascular diseases, 0.39% from hypertension, 0.30% from coronary heart diseases, 0.23% from stroke, 0.29% from respiratory diseases, and 0.38% from chronic obstructive pulmonary disease. There was a leveling off in the exposure-response curves at high concentrations in most, but not all, regions. The associations were stronger in cities with lower PM levels or higher temperatures, and in subpopulations with elder age or less education. CONCLUSIONS:This nationwide investigation provided robust evidence of the associations between short-term exposure to PM and increased mortality from various cardiopulmonary diseases in China. The magnitude of associations was lower than those reported in Europe and North America.
10.1164/rccm.201609-1862OC
The short term burden of ambient fine particulate matter on chronic obstructive pulmonary disease in Ningbo, China.
Li Guoxing,Huang Jing,Xu Guozhang,Pan Xiaochuan,Qian Xujun,Xu Jiaying,Zhao Yan,Zhang Tao,Liu Qichen,Guo Xinbiao,He Tianfeng
Environmental health : a global access science source
BACKGROUND:Numerous studies have found associations between ambient fine particulate matter (PM) and increased mortality risk. However, little evidence is available on associations between PM and years of life lost (YLL). We aimed to estimate the YLL due to chronic obstructive pulmonary disease (COPD) mortality related to ambient PM exposure. METHODS:A time-series study was conducted based on the data on air pollutants, meteorological conditions and 18,472 registered COPD deaths in Ningbo, China, 2011-2015. The effects of PM on YLL and daily death of COPD were estimated, after controlling long term trend, meteorological index and other confounders. RESULTS:The impact of PM on YLL due to COPD lasted for 5 days (lag 0-4). Per 10 μg/m increase in PM was associated with 0.91 (95%CI: 0.16, 1.66) years increase in YLL. The excess YLL of COPD mortality were 8206 years, and 0.38 day per person in Ningbo from 2011 to 2015. The exposure-response curve of PM and YLL due to COPD showed a non-linear pattern, with relatively steep at low levels and flattened out at higher exposures.. Furthermore, the effects were significantly higher in the elderly than those in the younger. CONCLUSIONS:Our findings explored burden of PM on YLL due to COPD and highlight the importance and urgency of ambient PM pollution control and protection of the vulnerable populations.
10.1186/s12940-017-0253-1