Human health impacts attributable to inhalation exposure of particulate matter (PM10 and PM2.5) during the Holi festival.

OBJECTIVE: The present study focuses on residential areas of Delhi to identify the elevated levels of ambient PM10 and PM2.5 due to biomass burning followed by the coloring activity in the Holi festival celebrated at the end of the winter season. This study also focuses on the health risk assessment and mortality among different age groups due to the change in particulate matter levels during the Holi festival in Delhi, India. MATERIALS AND METHODS: Secondary data of particulate matters have been procured from the Central Pollution Control Board (CPCB), Delhi Pollution Control Committee (DPCC), and Indian Institute of Tropical Meteorology (IITM), Pune for the period of the pre-, during, and post-Holi period for the year 2018-2020 at four selected residential locations in Delhi, India. The health impacts of particle inhalation were quantified using the AirQ + models. RESULTS: The results indicated the levels of PM10 and PM2.5 rise about 3-4 times higher during the Holi festival than on normal days, resulting in health risks and causing an excess number of mortality and Asthma cases in Delhi. Such cases were also found to be higher in 2018, followed by 2019 and 2020 at all the selected locations in Delhi. CONCLUSIONS: The study linked the increasing particulate levels in the Holi festival with the increased health risk through short-term exposure of the population. The excess number of cases (ENCs) of mortality, all causes of mortality among adults (age > 30 years) associated with short-term exposure to particulate were also identified.

Air pollution status and attributable health effects across the state of West Bengal, India, during 2016-2021.

Air pollution is one of the most significant threats to human safety due to its detrimental health consequences worldwide. This study examines the air pollution levels in 22 districts of West Bengal from 2016 to 2021, using data from 81 stations operated by the West Bengal Pollution Control Board (WBPCB). The study assesses the short- and long-term impacts of particulate matter (PM) on human health. The highest annual variation of PM10 was noted in 2016 (106.99 ± 34.17 µg/m3), and the lowest was reported in 2020 (88.02 ± 13.61 µg/m3), whereas the highest annual variations of NO2 (µg/m3) were found in 2016 (35.17 ± 13.55 µg/m3), and lowest in 2019 (29.72 ± 13.08 µg/m3). Similarly, the SO2 level was lower (5.35 µg/m3) in 2017 and higher in 2020 (7.78 µg/m3). In the state, Bardhaman, Bankura, Kolkata, and Howrah recorded the highest PM10 concentrations. The monthly and seasonal variations of pollution showed higher in December, January, and February (winter season) and lowest observed in June, July, and August (rainy season). The southern part of West Bengal state has recorded higher pollution levels than the northern part. The short- and long-term health impact assessment due to particulate matter shows that the estimated number of attributable cases (ENACs) for incidence of chronic bronchitis in adults and prevalence of bronchitis in children were 305,234 and 14,652 respectively. The long-term impact of PM2.5 on human health ENACs for mortality due to chronic obstructive pulmonary disease for adults, acute lower respiratory infections in children aged 0-5, lung cancer, and stroke for adults were 21,303, 12,477, 25,064, 94,406, and 86,272 respectively. This outcome assists decision-makers and stakeholders in effectively addressing the air pollution and health risk concerns within the specified area.

Comparative evaluation of self-pressurized Air-Q® and Proseal™ LMA® in patients undergoing elective surgery under general anaesthesia: A randomized clinical trial.

Background and Aims: Intra-cuff pressure of Air-Q self-pressurized laryngeal airways (Air-Q SP) balances airway pressure and adapts to patient's pharyngeal and periglottic structures, thus improves oropharyngeal leak pressure (OLP).This study was performed to compare efficacy of Air-Q SP with Proseal laryngeal mask airway (PLMA) in patients undergoing elective surgery. Material and Methods: The study design was prospective, randomized and controlled. Ninety patients were randomly assigned to Air-Q SP or PLMA group. All patients were premedicated and shifted to operation theatre. Monitoring was instituted. After securing IV-line, induction with inj. Morphine + Propofol, relaxation with inj. Vecuronium was done. Supraglottic was inserted according to group allocation. Outcome measures were OLP, fibreoptic view of larynx, success rate, device insertion parameters, haemodynamic and respiratory parameters and post-operative laryngopharyngeal complications. Neostigmine + glycopyrrolate were given, device was extubated. Results: All supraglottic airway devices (SADs) were successfully placed in two attempts. The mean initial OLP, OLP at 10 minutes, and device insertion time were significantly lower in Air-Q SP group. Fiber-optic laryngeal view grading was significantly better with Air-Q SP. No significant difference was observed with respect to rate of successful insertion in first attempt, ease of insertion, and manipulations required. The hemodynamic/respiratory parameters and post-operative sore throat in the two both groups were similar. Conclusions: Proseal LMA has a higher OLP than Air-Q SP but average insertion time was better, and fiber-optic grading of laryngeal view was shorter with Air-Q SP. However, Air-Q SP and Proseal LMA were both effective for lung ventilation.

Spatio-temporal health benefits attributable to PM2.5 reduction in an Indian city.

Fine particulate matter (PM2.5) is linked with a wide spectrum of human health effects and has the highest contribution to total air pollution mortality. This study aims to quantify health benefits of reducing PM2.5 concentration to World Health Organization standard (annual mean = 10 µg m-3) for various health endpoints during 2011-2019 period using AirQ+ and BenMAP-CE software packages. Intraurban assessment in Vellore city, India was done by estimating health benefits at ward level. Both software packages estimated annual average all-cause, ischemic heart disease, stroke, and chronic obstructive pulmonary disease health benefits in the range of 919-945, 175-234, 70-152, and 99-175 cases at city level and 15-16, 3-4, 1-3, and 2-3 cases at ward level, respectively. Sensitivity analysis showed that relative risk had a large influence on health benefit estimates. Present study results will play a crucial role in the future air quality and public health policies of Vellore city.

Health impact assessment and evaluation of economic costs attributed to PM2.5 air pollution using BenMAP-CE.

Air pollution is considered the most prominent public health. Economically, air pollution imposes additional costs on governments. This study aimed to quantify health effects and associated economic values of reducing PM2.5 air pollution using BenMAP-CE in Qom in 2019. The air quality data were acquired from Qom Province Environmental Protection Agency, and the population data were collected from Qom Province Management and Planning Organization website. The number of deaths due to Stroke, Chronic Obstructive Pulmonary Disease, Lung Cancer, and Ischemic Heart Disease attributable to PM2.5 were estimated using BenMAP-CE based on two control scenarios, 2.4 and 10 µg/m3, known as scenarios I and II, respectively. The associated economic effect of premature deaths was assessed by value of a statistical life (VSL) approach. The annual average of PM2.5 concentration was found to be 16.32 µg/m3 (SD: 9.93). A total of 4694.5 and 2475.94 premature deaths in scenarios I and II were found to be attributable to PM2.5 in overall, respectively. The total associated cost was calculated to be 855.91 and 451.40 million USD in scenarios I and II, respectively. The total years of life lost due to PM2.5 exposure in 2019 was 158,657.06 and 78,351.51 in scenarios I and II, respectively. The results of both health and economic assessment indicate the importance of solving the air pollution problem in Qom, as well as other big cities in Iran. The elimination of limitations, such as insufficient local data, should be regarded in future studies.

Characteristics and health risk assessment of fine particulate matter and surface ozone: results from Bengaluru, India.

Urban air pollution is a complex problem, which requires a multi-pronged approach to understand its dynamics. In the current study, various aspects of air pollution over Bengaluru city were studied utilizing simultaneous reference-grade measurements (during the period July 2019 to June 2020) of fine particulate matter mass concentration (PM2.5), aerosol black carbon mass concentrations (BC), and surface ozone (O3) concentrations. The study period mean PM2.5, BC, and O3 were observed to be 26.8 ± 11.5 µg m-3, 5.6 ± 2.8 µg m-3, and 25.5 ± 12.4 ppb, respectively. Statistical methods such as principal component analysis, moving average subtraction method, conditional bivariate probability function, and concentration weighted trajectory analysis were performed to understand the dynamics of air pollution over Bengaluru and its long-range transportation pathways. Some of the major findings from the statistical analyses include (i) contrasting association in BC versus O3 and PM2.5 versus O3; (ii) around one-fourth of the observed receptor site BC was contributed by local sources/emissions; and (iii) the source locations potentially contributing to BC and PM2.5 were spatially different. In Bengaluru, long-term exposure to PM2.5 resulted in around 3413, 3393, 1016, and 147 attributable deaths for the health endpoints chronic obstructive pulmonary disorder, ischemic heart disease, stroke, and lung cancer, respectively. Long-term exposure to O3 resulted in around 155 attributable deaths for respiratory diseases, as estimated by the AirQ + model. Finally, the limitations of the study in terms of data availability and analysis have been detailed.

Ambient air pollutants and respiratory health outcomes in Tabriz and Urmia, two metropolises of Iran.

Polluted air affects human life and it is crucial to assess air pollutants to inform policy and protect human lives. In this study, we sought to assess the respiratory outcomes associated with PM10, O3, SO2, and NO2 in the Iranian population. The required data, which included concentrations of air pollutants, meteorology, and population size, were obtained from the department of environment and meteorological organizations. The validity of the data was evaluated, and appropriate calculations were conducted on the data to extract the required values and parameters for modeling (using the AirQ2.2.3). This study was conducted in two megacities of Iran (Tabriz and Urmia) with over 2 million population. The annual averages of SO2, NO2, and PM10 concentrations were 9, 73, and 43 µg/m3 in Tabriz and 76, 29, and 76 µg/m3 in Urmia, respectively. Excess deaths from respiratory diseases associated with PM10 and SO2 were estimated to be 33.1 and 1.2 cases in Tabriz and 31.6 and 24.7 cases in Urmia, respectively. The proportions of hospitalizations for chronic obstructive pulmonary disease (COPD) attributable to SO2 and NO2 in Tabriz were 0.07% and 1.61%, respectively, whereas they were 2.84% and 0.48% in Urmia. O3 had an annual average of 56 µg/m3 in Tabriz and with 44.5 excess respiratory deaths and 42.5 excess hospital admissions for COPD, it had the greatest health impacts among the pollutants studied. Findings from this study add to the growing literature, especially from developing countries, that provides insights to help authorities and decision-makers develop and implement effective interventions to curb air pollution and save lives.

Health effects of particulate matter in major Indian cities.

Background: Particulate matter (PM) is one among the crucial air pollutants and has the potential to cause a wide range of health effects. Indian cities ranked top places in the World Health Organization list of most polluted cities by PM. Objectives: Present study aims to assess the trends, short- and long-term health effects of PM in major Indian cities. Methods: PM-induced hospital admissions and mortality are quantified using AirQ+ software. Results: Annual PM concentration in most of the cities is higher than the National Ambient Air Quality Standards of India. Trend analysis showed peak PM concentration during post-monsoon and winter seasons. The respiratory and cardiovascular hospital admissions in the male (female) population are estimated to be 31,307 (28,009) and 5460 (4882) cases, respectively. PM2.5 has accounted for a total of 1,27,014 deaths in 2017. Conclusion: Cities with high PM concentration and exposed population are more susceptible to mortality and hospital admissions.

Air pollution characteristics and human health risks in key cities of northwest China.

Air pollution events occur frequently in northwest China, which results in serious detrimental effects on human health. Therefore, it is essential to understand the air pollution characteristics and assess the risks to humans. In this study, we analyzed the pollution characteristics of criteria pollutants in six key cities in northwest China from 2015 to 2018. We used the air quality index (AQI), aggregate AQI (AAQI), and health-risk based AQI (HAQI) to assess the health risks and determine the proportion of people exposed to air pollution. Additionally, on this basis, the AirQ2.2.3 model was used to quantify the health effects of the pollutants. The results showed that PM10 pollution occurred mainly in spring and winter and was caused by frequent dust storms. PM2.5 pollution was caused mainly by anthropogenic activities (especially coal-fired heating in winter). Because of a series of government policies and pollutant reduction measures, PM2.5, SO2, NO2, and CO concentrations showed a downward trend during the study period (except for a small increase in the case of NO2 in some years.). However, O3 showed high concentrations due to the high intensity of solar radiation in summer and inadequate emission reduction measures. The air quality levels based on their classification were generally higher than the Chinese ambient air quality standard classified by the AQI index. We also found that the higher the AQI index was, the more serious the air pollution classified based on the AAQI and HAQI indices was. The HAQI index could better reflect the impact of pollutants on human health. Based on the HAQI index, 20% of the population in the study area was exposed to polluted air. The total mortality values attributable to PM10, PM2.5, SO2, O3, NO2, and CO, quantified by the AirQ2.2.3 model, were 3.00%, 1.02%, 1.00%, 4.22%, 1.57%, and 0.95% (Confidence Interval:95%), respectively; the attributable proportions of mortality for respiratory system and cardiovascular diseases were consistent with the change rule of total mortality, because the number of deaths attributable to the latter was greater than that for the former. According to the exposure reaction curves of pollutants, PM10 and PM2.5 still showed a large change at high concentrations. However, the tendencies of SO2, NO2, CO, and O3 were more obvious under low concentration exposure, which indicated that the expected mortality rate due to lower air pollution concentrations was much higher than the mortality due to high air pollution concentrations.

Comparison of conventional with Parker flex-tip tracheal tube for intubation through air-Q intubating laryngeal airway.

BACKGROUND AND AIMS: The problem of difficult and failed intubation led to increased development of equipment for airway management. A number of supraglottic airways have now been developed to facilitate the passage of tracheal tubes. Conventional PVC tracheal tubes are recommended for intubation through the air-Q ILA. No study has compared different PVC tubes for blind intubation through air-Q ILA. Thus, we undertook this prospective, randomised, single blind study to compare two PVC tracheal tubes with different designs viz. conventional PVC tracheal tube (TT) and Parker flex-tip TT with regards to success rate, ease of intubation and total time required for successful intubation through air-Q ILA. MATERIAL AND METHODS: One hundred patients of either sex, aged 18-60 years, belonging to American Society of Anesthesiologists (ASA) physical status class I and II scheduled for elective surgery under general anesthesia requiring endotracheal intubation were included in the study. Blind intubation using conventional PVC TT and Parker flex-tip tube was done in group A (n = 50) and group B (n = 50), respectively. RESULTS: The first attempt success rate in Parker flex-tip TT was significantly more as compared to conventional PVC TT (P = 0.002). Success rate of intubation was significantly more in Parker flex-tip TT as compared to conventional PVC TT (P = 0.004). The intubation was significantly easy in Parker flex-tip tube as compared to conventional PVC TT (P = 0.002). Total time of intubation was less in Parker flex-tip tube as compared to PVC TT (P = 0.043). CONCLUSION: Unique design of the Parker Flex-tip TT resulted in increase in success rate, first attempt success rate and ease of intubation in group B in present study.

[Application of AirQ+ software in air pollution acute health risk assessment in China].

OBJECTIVE: To promote the application of software AirQ +developed by WHO in the air pollution health risk assessment in China. METHODS: Introduced the calculation principle, scope of application, required data, results output and application examples of the model. Meta-analysis result of exposure-response relationship coefficients of acute health risks of air pollution in China are also provided in this paper. RESULTS: The air quality and other related parameters of the study area in China can be input into AirQ+ software to obtain the attributable risk value of the health outcome of the exposed population compared with the reference concentration. CONCLUSION: The AirQ + software can be used for quantitative assessment of acute health risks of air pollution in China.

A comparison between ProSeal laryngeal mask airway and Air-Q Blocker in patients undergoing elective laparoscopic cholecystectomy.

BACKGROUND AND AIMS: ProSeal laryngeal mask airway (PLMA) is an established device for airway management, while Air-Q Blocker (AQB) is a relatively new supraglottic device. The aim of this study is to compare AQB against PLMA in adults undergoing laparoscopic cholecystectomy under general anesthesia. MATERIAL AND METHODS: Eighty-eight adult patients scheduled for laparoscopic cholecystectomy under general anesthesia were randomly allocated into two groups. A drain tube (gastric tube for PLMA and blocker tube for AQB) was inserted through the drain channel of the respective device. PLMA was inserted in Group P (n = 44) and AQB was inserted in Group A (n = 44) to secure the airway. The primary endpoint was airway seal pressure. Secondarily, we sought to compare overall insertion success, ease of insertion, hemodynamic effects after initial placement, ease of drain tube placement, and perioperative oropharyngolaryngeal morbidity between the devices. RESULTS: Oropharyngeal seal pressures for AQB and PLMA were 31.5 ± 2.41 and 29.41 ± 2.14 cm H2O, respectively (P = 0.01). Insertion time was longer with AQB than PLMA, 25.59 ± 5.71 and 18.66 ± 3.15 seconds, respectively (P = 0.001). Ease and success rate of insertion was better with PLMA compared to AQB. Failure of device insertion was seen in 2 cases of Group A. Gastric distension was seen in 4 patients in Group A, requiring replacement with endotracheal tube in two patients. Ventilation was successful in all 44 patients with PLMA. Both the devices were comparable in providing a patent airway and adequate oxygenation during controlled ventilation. There was an increased trend of airway trauma and complications in the AQB group. CONCLUSION: Both PLMA and AQB show similar efficacy in maintaining ventilation and oxygenation, during laparoscopic surgery. However, proper positioning and functioning of the blocker tube of AQB is a limiting factor, and needs further evaluation.

Health impacts quantification of ambient air pollutants using AirQ model approach in Hamadan, Iran.

Iranian western cities, including Hamadan, have been experiencing Middle East Dust Storms (MEDS) phenomenon problems in recent years, so the air quality is getting worse every year in these cities. The aim of this study was to evaluate the human health impacts of criteria air pollutants including PM10, PM2.5, NO2, SO2, CO and O3 on the citizens of Hamadan using AirQ model software 2.2.3. Considering the determined baseline incidence (BI) and relative risk (RR) rate, the attributable proportion (AP) of deaths due to cardiovascular and respiratory mortality attributed to PM2.5, PM10, O3, NO2, and CO pollutants was estimated to be 4.42%, 3.37%, 1.75%, 1.74% and 0.92% (95% CI) of the total mortality and the excess death cases were respectively estimated to be 131.9, 100.4, 52.1, 51.9 and 27.3 persons. In addition, cardiovascular mortality brings more contribution than respiratory mortality in total death number. The results of our study also showed that PM2.5 poses the greatest health effects on the citizens. Analyzing the average seasonal concentrations of studied pollutants (PM10, PM2.5, and NO2) and the mean seasonal temperature values revealed a positive linear correlation. Significant negative correlations were observed between the studied pollutants (PM10, PM2.5 and NO2) and relative humidity, and between PM and wind speed. This study, therefore, provides additional data in decision-makings for the development of strategies for reduction of ambient air pollution which will result in improvements of air quality.

Mortality and morbidity due to exposure to ambient particulate matter.

The aim of this study was to investigate spatial variation and health risk of the exposure to PM2.5 (particulate matter with a diameter of 2.5 µm or less) and PM10 (particulate matter with a diameter of 10 µm or less) in Sabzevar, Iran. PM2.5 and PM10 were measured during three campaigns from April to November 2017, in 26 sampling points. Spatial analysis was performed using kriging and autocorrelations (Moran's index) model in Arc GIS software. Relationship between exposure to the PM2.5 and PM10 and their health impacts were investigated by AirQ 2.2.3 software. The mean concentrations (and standard deviation) of PM 2.5 and PM10 over the entire study period were 32.54 (37.28) and 42.61 (47.76) µg/m3, respectively, which were higher than the guideline of World Health Organization. According to the spatial analysis, the maximum concentrations of PM2.5 and PM10 were around the main highway (beltway) which placed all over the south of Sabzevar. According to the Moran's index, the emission patterns for PM2.5 (Z-score = 2.53; P-value = 0.011) and PM10 (Z-score = 2.82; P-value = 0.004) were clustered. The attributable percentage (AP) of total mortality related to PM2.5 and PM10 were 3.544% (95% confidence interval (CI): 2.623-4.447%) and 2.055% (95% CI: 1.379-2.721%) per increasing each 10 µg/m3 of these pollutants, respectively. According to observed results, it is suggested that the beltway and other pollution sources, such as industries, should be placed at a greater distance from the city, to reduce PM amounts in residential areas.

Comparison of ventilation effectiveness of the bag valve mask and the LMA Air-Q SP in nurses during simulated CPR.

In a case of sudden cardiac arrest (SCA) in a health facility there is a procedure to summon a resuscitation team. Nurses are obliged to begin cardiopulmonary resuscitation with chest compressions and implement ventilation using the bag valve mask of 30:2 compressionventilation ratio. Nurses are not allowed to implement methods of advanced airway management. However, the laryngeal mask airway (LMA) was designed for people inexperienced in intubation who would be able to provide advanced airway management quickly and effectively after a short training. It is advisable to check how nurses, who in case of SCA are often the first responders, deal with advanced airway management. AIM: The aim of the study was to evaluate the quality of ventilation using the bag valve mask and the LMA Air-Q SP by professionally active nurses. MATERIALS AND METHODS: The study was conducted on a 38-person group of professionally active nurses working or affiliated with the District Health Care Facility in Piotrków Trybunalski. After a short pre-training lecture the nurses were assigned to ventilate the manikin with the bag valve mask (BVM) using 30:2 compressionventilation ratio and then asynchronously with the use of the LMA Air-Q SP. RESULTS: The average time elapsed from the beginning of CPR to the onset of ventilation was 18 ± 5,4 s. as for the BVM and 16,15 ± 4,4 s regarding the LMA. Minute ventilation achieved with the BVM was 3,47 ± 1,43 l / min, and in case of the LMA it amounted 5,54 ± 1,73 l / min. There was no case of gastric insufflation in case of the LMA, while as for the BVM it occurred in five cases. There are very few studies focused on the LMA Air-Q SP, but some research (Jagannathan, Alexandera or Gruber) devoted to the use of the LMA in nurses, demonstrate that ventilation with the use of the LMA is effective and ensure more appropriate ventilation parameters than with the use of the BVM. CONCLUSIONS: The nurses achieved better ventilation results when using the LMA. Attempts to insert the LMA were shorter than in case of the BVM.

Acute myocardial infarction and COPD attributed to ambient SO2 in Iran.

Acute myocardial infarction (MI) and chronic obstructive pulmonary disease (COPD) are important diseases worldwide. Inhalation is the major route of short-term exposure to air sulfur dioxide (SO2) that negatively affect human health. The objective of this study was to estimate the health effects of short-term exposure to SO2 in Khorramabad, Iran using the AirQ software developed by the World Health Organization (WHO). Daily mean SO2 concentrations were used as the estimates of human short-term exposure and allow calculation of the attributable excess relative risk of an acute MI and hospital admissions due to COPD (HACOPD). The annual mean SO2 concentration in Khorramabad was 51.33µg/m3. Based on the relative risk (RR) and baseline incidence (BI) approach of WHO, an increased risk of 2.7% (95% CI: 1.1-4.2%) of acute MI and 2.0% (95% CI: 0-4.6%) of HACOPD, respectively, were attributed to a 10µg/m3 SO2 increase. Since the geographic, demographic, and climatic characteristics are different from the areas in which the risk relationships were developed and not evaluated here, further investigations will be needed to fully quantify other health impacts of SO2. A decreased risk for MIs and COPD attributable to SO2 could be achieved if mitigation strategies and measures are implemented to reduce the exposure.

Health benefits of PM10 reduction in Iran.

Air pollution contains a complex mixture of poisonous compounds including particulate matter (PM) which has wide spectrum of adverse health effects. The main purpose of this study was to estimate the potential health impacts or benefits due to any changes in annual PM10 level in four major megacities of Iran. The required data of PM10 for AirQ software was collected from air quality monitoring stations in four megacities of Iran. The preprocessing was carried out using macro coding in excel environment. The relationship between different presumptive scenarios and health impacts was determined. We also assessed the health benefits of reducing PM10 to WHO Air Quality Guidelines (WHO-AQGs) and National Ambient Air Quality Standards (NAAQSs) levels with regard to the rate of mortality and morbidity in studied cities. We found that the 10 µg/m3 increase in annual PM10 concentration is responsible for seven (95% CI 6-8) cases increase in total number of deaths per 2 × 105 person. We also found that 10.7, 7.2, 5.7, and 5.3% of total death is attributable to short-term exposure to air pollution for Ahvaz, Isfahan, Shiraz, and Tehran, respectively. We found that by attaining the WHO's proposed value for PM10, the potential health benefits of 89, 84, 79, and 78% were obtained in Ahvaz, Isfahan, Shiraz, and Tehran, respectively. The results also indicated that 27, 10, 3, and 1% of health impacts were attributed to dust storm days for Ahvaz, Isfahan, Shiraz, and Tehran, respectively.

Health risk assessment of exposure to the Middle-Eastern Dust storms in the Iranian megacity of Kermanshah.

OBJECTIVE: This study assessed the effects of particulate matter (PM), equal or less than 10 µm in aerodynamic diameter (PM10), from the Middle-Eastern Dust events on public health in the megacity of Kermanshah (Iran). STUDY DESIGN: This study used epidemiological modeling and monitored ambient air quality data to estimate the potential PM10 impacts on public health. METHODS: The AirQ2.2.3 model was used to calculate mortality and morbidity attributed to PM10 as representative of dust events. Using Visual Basic for Applications, the programming language of Excel software, hourly PM10 concentrations obtained from the local agency were processed to prepare input files for the AirQ2.2.3 model. RESULTS: Using baseline incidence, defined by the World Health Organization, the number of estimated excess cases for respiratory mortality, hospital admissions for chronic obstructive pulmonary disease, for respiratory diseases, and for cardiovascular diseases were 37, 39, 476, and 184 persons, respectively, from 21st March, 2014 to 20th March, 2015. Furthermore, 92% of mortality and morbidity cases occurred in days with PM10 concentrations lower than 150 µg/m3. The highest percentage of person-days occurred for daily concentrations range of 100-109 µg/m3, causing the maximum health end-points among the citizens of Kermanshah. CONCLUSIONS: Calculating the number of cumulative excess cases for mortality or morbidity attributed to PM10 provides a good tool for decision and policy-makers in the field of health care to compensate their shortcomings particularly at hospital and healthcare centers for combating dust storms. To diminish these effects, several immediate actions should be managed in the governmental scale to control dust such as spreading mulch and planting new species that are compatible to arid area.

Evaluation of Chronic Obstructive Pulmonary Disease (COPD) attributed to atmospheric O3, NO2, and SO2 using Air Q Model (2011-2012 year).

Chronic obstructive pulmonary disease (COPD) is an important disease worldwide characterized by chronically poor airflow. The economic burden of COPD on any society can be enormous if not managed. We applied the approach proposed by the World Health Organization (WHO) using the AirQ2.2.3 software developed by the WHO European Center for Environment and Health on air pollutants in Tabriz (Iran) (2011-2012 year). A 1h average of concentrations of ozone (O3), daily average concentrations of nitrogen dioxide (NO2) and sulfur dioxide (SO2) were used to assess human exposure and health effect in terms of attributable proportion of the health outcome and annual number of excess cases of Hospital Admissions for COPD (HA COPD). The results of this study showed that 2% (95% CI: 0.8-3.1%) of HA COPD were attributed to O3 concentrations over 10 µg/m(3). In addition, 0.7 % (95% CI: 0.1-1.8%) and 0.5% (95% CI: 0-1%) of HA COPD were attributed to NO2 and SO2 concentrations over 10 µg/m(3) respectively. In this study, we have shown that O3, NO2 and SO2 have a significant impact on COPD hospitalization. Given these results the policy decisions are needed in order to reduce the chronic pulmonary diseases caused by air pollution and furthermore better quantification studies are recommended.

Health impacts due to particulate air pollution in Volos City, Greece.

There is great consensus among the scientific community that suspended particulate matter is considered as one of the most harmful pollutants, particularly the inhalable particulate matter with aerodynamic diameter less than 10 µm (PM10) causing respiratory health problems and heart disorders. Average daily concentrations exceeding established standard values appear, among other cases, to be the main cause of such episodes, especially during Saharan dust episodes, a natural phenomenon that degrades air quality in the urban area of Volos. In this study the AirQ2.2.3 model, developed by the World Health Organization (WHO) European Center for Environment and Health, was used to evaluate adverse health effects by PM10 pollution in the city of Volos during a 5-year period (2007-2011). Volos is a coastal medium size city in the Thessaly region. The city is located on the northern side of the Gulf of Pagassitikos, on the east coast of Central Greece. Air pollution data were obtained by a fully automated monitoring station, which was established by the Municipal Water Supply and Sewage Department in the Greater Area of Volos, located in the centre of the city. The results of the current study indicate that when the mean annual PM10 concentration exceeds the corresponding European Union (EU) threshold value, the number of hospital admissions for respiratory disease (HARD) is increased by 25% on average. There is also an estimated increase of about 2.5% in HARD compared to the expected annual HARD cases for Volos. Finally, a strong correlation was found between the number of days exceeding the EU daily threshold concentration ([PM10] ≥ 50 µg m(-3)) and the annual HARD cases.