A systematic review and meta-analysis of haematological malignancies in residents living near petrochemical facilities.

BACKGROUND: The petrochemical industry is a major source of hazardous and toxic air pollutants that are recognised to have mutagenic and carcinogenic properties. A wealth of occupational epidemiology literature exists around the petrochemical industry, with adverse haematological effects identified in employees exposed to 'low' concentrations of aromatic hydrocarbons (benzene, toluene, ethylbenzene, and xylene). Releases from the petrochemical industry are also thought to increase the risk of cancer incidence in fenceline communities. However, this emerging and at times inconclusive evidence base remains fragmented. The present study's aim was to conduct a systematic review and meta-analysis of epidemiological studies investigating the association between incidences of haematological malignancy and residential exposure to the petrochemical industry. METHODS: Epidemiological studies reporting the risk of haematological malignancies (Leukaemia, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, and Multiple myeloma) were included where the following criteria were met: (i) Cancer incidence is diagnosed by a medical professional and coded in accordance to the International Classification of Diseases; (ii) A clear definition of fenceline communities is provided, indicating the proximity between exposed residents and petrochemical activities; and (iii) Exposure is representative of normal operating conditions, not emergency events. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks and their 95% confidence intervals were pooled across studies for the four categories of haematological malignancy, using a random effects meta-analysis. RESULTS: The systematic review identified 16 unique studies, which collectively record the incidence of haematological malignancies across 187,585 residents living close to a petrochemical operation. Residents from fenceline communities, less than 5 km from a petrochemical facility (refinery or manufacturer of commercial chemicals), had a 30% higher risk of developing Leukaemia than residents from communities with no petrochemical activity. Meanwhile, the association between exposure and rarer forms of haematological malignancy remains uncertain, with further research required. CONCLUSIONS: The risk of developing Leukaemia appears higher in individuals living near a petrochemical facility. This highlights the need for further policy to regulate the release of carcinogens by industry.

Aircraft noise and cardiovascular morbidity and mortality near Heathrow Airport: A case-crossover study.

Aircraft noise causes annoyance and sleep disturbance and there is some evidence of associations between long-term exposures and cardiovascular disease (CVD). We investigated short-term associations between previous day aircraft noise and cardiovascular events in a population of 6.3 million residing near Heathrow Airport using a case-crossover design and exposure data for different times of day and night. We included all recorded hospitalisations (n = 442,442) and deaths (n = 49,443) in 2014-2018 due to CVD. Conditional logistic regression was used to estimate the ORs and adjusted for NO2 concentration, temperature, and holidays. We estimated an increase in risk for 10 dB increment in noise during the previous evening (Leve OR = 1.007, 95% CI 0.999-1.015), particularly from 22:00-23:00 h (OR = 1.007, 95% CI 1.000-1.013), and the early morning hours 04:30-06:00 h (OR = 1.012, 95% CI 1.002-1.021) for all CVD admissions, but no significant associations with day-time noise. There was effect modification by age-sex, ethnicity, deprivation, and season, and some suggestion that high noise variability at night was associated with higher risks. Our findings are consistent with proposed mechanisms for short-term impacts of aircraft noise at night on CVD from experimental studies, including sleep disturbance, increases in blood pressure and stress hormone levels and impaired endothelial function.

Spatial assessment of the attributable burden of disease due to transportation noise in England.

BACKGROUND: Noise pollution from transportation is one of the leading contributors to the environmental disease burden in Europe. We provide a novel assessment of spatial variations of these health impacts within a country, using England as an example. METHODS: We estimated the burden of annoyance (highly annoyed), sleep disturbance (highly sleep disturbed), ischemic heart disease (IHD), stroke, and diabetes attributable to long-term transportation noise exposures in England for the adult population in 2018 down to local authority level (average adult population: 136,000). To derive estimates, we combined literature-informed exposure-response relationships, with population data on noise exposures, disease, and mortalities. Long-term average noise exposures from road, rail and aircraft were sourced from strategic noise mapping, with a lower exposure threshold of 50 dB (decibels) Lden and Lnight. RESULTS: 40 %, 4.5 % and 4.8 % of adults in England were exposed to road, rail, and aircraft noise exceeding 50 dB Lden. We estimated close to a hundred thousand (∼97,000) disability adjusted life years (DALY) lost due to road-traffic, ∼13,000 from railway, and âˆ¼ 17,000 from aircraft noise. This excludes some noise-outcome pairs as there were too few studies available to provide robust exposure-response estimates. Annoyance and sleep disturbance accounted for the majority of the DALYs, followed by strokes, IHD, and diabetes. London, the South East, and North West regions had the greatest number of road-traffic DALYs lost, while 63 % of all aircraft noise DALYs were found in London. The strategic noise mapping did not include all roads, which may still have significant traffic flows. In sensitivity analyses using modelled noise from all roads in London, the DALYs were 1.1x to 2.2x higher. CONCLUSION: Transportation noise exposures contribute to a significant and unequal environmental disease burden in England. Omitting minor roads from the noise exposure modelling leads to underestimation of the disease burden.

Sources of particle number concentration and noise near London Gatwick Airport.

There is increasing evidence of potential health impacts from both aircraft noise and aircraft-associated ultrafine particles (UFP). Measurements of noise and UFP are however scarce near airports and so their variability and relationship are not well understood. Particle number size distributions and noise levels were measured at two locations near Gatwick airport (UK) in 2018-19 with the aim to characterize particle number concentrations (PNC) and link PNC sources, especially UFP, with noise. Positive Matrix Factorization was used on particle number size distribution to identify these sources. Mean PNC (7500-12,000 p cm-3) were similar to those measured close to a highly trafficked road in central London. Peak PNC (94,000 p cm-3) were highest at the site closer to the runway. The airport source factor contributed 17% to the PNC at both sites and the concentrations were greatest when the respective sites were downwind of the runway. However, the main source of PNC was associated with traffic emissions. At both sites noise levels were above the recommendations by the WHO (World Health Organisation). Regression models of identified UFP sources and noise suggested that the largest source of noise (LAeq-1hr) above background was associated with sources of fresh traffic and urban UFP depending on the site. Noise and UFP correlations were moderate to low suggesting that UFP are unlikely to be an important confounder in epidemiological studies of aircraft noise and health. Correlations between UFP and noise were affected by meteorological factors, which need to be considered in studies of short-term associations between aircraft noise and health.

Impact of road traffic noise on annoyance and preventable mortality in European cities: A health impact assessment.

BACKGROUND: Road traffic is the main source of environmental noise in European cities and one of the main environmental risks to health and wellbeing. In this study we aimed to provide an in-depth assessment of available road traffic noise data and to estimate population exposure and health impacts for cities in Europe. METHODS: We conducted the analysis for 724 cities and 25 greater cities in 25 European countries. We retrieved road traffic strategic noise maps delivered under the Environmental Noise Directive (END) or available from local sources. We assessed noise exposure using the 24 h day-evening-night noise level indicator (Lden) starting at exposure levels of 55 dB Lden - based on data availability - for the adult population aged 20 and over (n = 123,966,346). For the adults exposed to noise levels above 55 dB Lden we estimated the health impacts of compliance with the World Health Organization (WHO) recommendation of 53 dB Lden. Two primary health outcomes were assessed: high noise annoyance and Ischemic Heart Disease (IHD), using mortality from IHD causes as indicator. Exposure Response Functions (ERFs) relating road traffic noise exposure to annoyance and IHD mortality were retrieved from the literature. Uncertainties in input parameters were propagated using Monte Carlo simulations to obtain point estimates and empirical 95% Confidence Intervals (CIs). Lastly, the noise maps were categorized as high, moderate and low quality following a qualitative approach. RESULTS: Strategic noise map data was delivered in three distinct formats (i.e. raster, polygon or polyline) and had distinct noise ranges and levels of categorization. The majority of noise maps (i.e. 83.2%) were considered of moderate or low quality. Based on the data provided, almost 60 million adults were exposed to road traffic noise levels above 55 dB Lden, equating to a median of 42% (Interquartile Range (IQR): 31.8-64.8) of the adult population across the analysed cities. We estimated that approximately 11 million adults were highly annoyed by road traffic noise and that 3608 deaths from IHD (95% CI: 843-6266) could be prevented annually with compliance of the WHO recommendation. The proportion of highly annoyed adults by city had a median value of 7.6% (IQR: 5.6-11.8) across the analysed cities, while the number preventable deaths had a median of 2.2 deaths per 100,000 population (IQR: 1.4-3.1). CONCLUSIONS: Based on the provided strategic noise maps a considerable number of adults in European cities are exposed to road traffic noise levels harmful for health. Efforts to standardize the strategic noise maps and to increase noise and disease data availability at the city level are needed. These would allow for a more accurate and comprehensive assessment of the health impacts and further help local governments to address the adverse health effects of road traffic noise.

Changes in air quality during COVID-19 'lockdown' in the United Kingdom.

The UK implemented a lockdown in Spring (2020) to curtail the person-to-person transmission of the SARS-CoV-2 virus. Measures restricted movements to one outing per day for exercise and shopping, otherwise most people were restricted to their dwelling except for key workers (e.g. medical, supermarkets, and transport). In this study, we quantified changes to air quality across the United Kingdom from 30/03/2020 to 03/05/2020 (weeks 14-18), the period of most stringent travel restrictions. Daily pollutant measurements of NO2, O3 and PM2.5 from the national network of monitoring sites during this period were compared with measurements over the same period during 2017-19. Comparisons were also made with predicted concentrations for the 2020 period from business-as-usual (BAU) modelling, where the contributions of normal anthropogenic activities were estimated under the observed meteorological conditions. During the lockdown study period there was a 69% reduction in traffic overall (74% reduction in light and 35% in heavy vehicles). Measurements from 129 monitoring stations, identified mean reductions in NO2 of 38.3% (-8.8 µg/m3) and PM2.5 of 16.5% (-2.2 µg/m3). Improvements in NO2 and PM2.5 were largest at urban traffic sites and more modest at background locations where a large proportion of the population live. In contrast, O3 concentrations on average increased by 7.6% (+4.8 µg/m3) with the largest increases at roadside sites due to reductions in local emissions of NO. A lack of VOC monitoring limited our capacity to interpret changes in O3 at urban background locations. BAU models predicted comparable NO2 reductions and O3 gains, although PM2.5 episodes would have been more prominent without lockdown. Results demonstrate the relatively modest contribution of traffic to air quality, suggesting that sustained improvements in air quality require actions across various sectors, including working with international and European initiatives on long-range transport air pollutants, especially PM2.5 and O3.

Regional inequalities in benzene exposures across the European petrochemical industry: A Bayesian multilevel modelling approach.

BACKGROUND: Pollutants released from the petrochemical industry are thought to increase the risk of mortality in fence-line communities, yet the results from previous studies are often inconsistent and lack a global perspective, hampered by the absence of cohesive cross-country research. OBJECTIVES: To provide the first Pan-European analysis of benzene exposures from the petrochemical industry, connecting polluting practices to pollution episodes and disparities in regional mortality rates, identifying the measures of best environmental practice to mitigate adverse outcomes. METHODS: The activity, classification and location of onshore petrochemical facilities within EU-28 Member States were extracted from the 'European Pollutant Release and Transfer Register' (E-PRTR), which holds records on 31,753 industrial operations for the reporting period of 2007-15. Parent company records were collected from the Moody's Analytics Amadeus database of 487,338 active companies across Europe. The EUROSTAT census provided records of income, life expectancy, and the underlying demographics used to calculate standardised health outcomes based on 9,936 sub-populations within the NUTS2 regions. The European Environment Agency provided ambient concentrations of benzene from 579 air quality stations. Bayesian multilevel models were constructed to account for variability caused by spatial hierarchical structures, uncertainty in the estimates, and to incorporate both individual and group-level influences. RESULTS: Higher levels of benzene emissions from petrochemical operations, both overall and in terms of specific pollution events, were associated with increased mortality rates for nearby residential populations, particularly in areas with socioeconomic deprivation. We identify uneven patterns of polluting practices within the industry, and locations that require epidemiological studies. CONCLUSIONS: While petrochemical facilities in all European Union regions are regulated to be compliant with the annual average benzene limit of 5 µg/m3, uneven exposures still present regional health inequalities. We recommend extending benzene regulations to an hourly or daily limit, alongside the strengthening of regulation for other toxic petrochemical releases.

Geospatial analysis of naturally occurring boundaries in road-transport emissions and children's respiratory health across a demographically diverse cityscape.

The motor-vehicle is accountable for emitting a substantial concoction of air quality objective pollutants and carcinogenic hydrocarbons within close proximity to urbanised residential districts. The spatial extent of health impacts associated with road-transport pollutants have traditionally been explored through the examination of artificially created buffers, defined by subjective distances from specified major road links. Within this paper an alternative approach is presented using boundary statistics, which describe naturally occurring shifts of magnitude in socio-environmental and health outcomes across the wider urban area. In contrast, previous distance-threshold investigations have used arbitrarily sized buffers placed upon predetermined locations in response to environmental attributes, without considering the combined influence of additional social burdens. The demographically diverse City of Leicester, situated within the heart of the United Kingdom's major road-transport network, was selected to showcase such methods. Descriptive multilevel modelling strategies accommodating for generalised spatial structures across Leicester, globally associated issues of deprivation, road-transport emissions and ethnic minorities with increased respiratory risks. Getis-Ord Gi* spatial pattern recognition statistics identified the existence of localised variations, with inner city neighbourhoods tending to house children of ethnic minority groups whom experience disproportionately large environmental and respiratory health burdens. Crisp polygon wombling boundary detection across Leicester appeared to broadly complement the Gi* statistics, identifying naturally occurring boundaries in road-transport emissions to result in elevated children's respiratory admissions within a distance of 283 m (P < 0.05). The designated threshold was identified to reduce in relation to certain ethnic groups, thus suggesting environmental injustices likely prevail within the model British multicultural City of Leicester. The study's findings have applications within healthcare management and urban planning for locating vulnerable populaces and for minimising health risks in future road network designs.

Environmental injustices of children's exposure to air pollution from road-transport within the model British multicultural city of Leicester: 2000-09.

The significant contribution of road-transport to air pollution within the urban arena is widely acknowledged, and traditionally explored in relation to health outcomes across a temporal scale. However, the structure of the urban environment is also of importance in dictating the existence of extremely variable traffic pollutant levels, which often tend to be linked with social disparities. Nevertheless 'Environmental Justice' studies have rarely tackled the adverse health implications of exposures from mobile sources (Chakraborty, 2009), or have applied statistical techniques that are appropriate for such spatial data (Gilbert and Chakraborty, 2011). This article addresses these gaps by spatially examining the distribution of respiratory hospitalisation incidents of children aged 0-15 years in relation to social circumstances and residential exposures of annual PM(10) road-transport emissions within Leicester during 2000-09. Continuing upon the theme of 'Environmental Justice', the research explores the intra-urban spatial distribution of those who produce and residentially experience the majority of road-transport emissions. The findings indicate significant global relationships to exist between children's hospitalisation rates and social-economic-status, ethnic minorities, and PM(10) road-transport emissions within Leicester. Local Indicators of Spatial Association (LISA) and Geographically Weighted Regression (GWR) identified important localised variations within the dataset, specifically relating to a double-burden of residentially experienced road-transport emissions and deprivation effecting inner city children's respiratory health. Furthermore, affluent intra-urban communities tended to contribute the highest levels of emission from private transport, while residentially experiencing relatively low exposure of transport emissions. This would suggest that environmental injustices prevail across the model British multicultural city of Leicester.