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1.
N Engl J Med ; 381(8): 705-715, 2019 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-31433918

RESUMO

BACKGROUND: The systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias. METHODS: We evaluated the associations of inhalable particulate matter (PM) with an aerodynamic diameter of 10 µm or less (PM10) and fine PM with an aerodynamic diameter of 2.5 µm or less (PM2.5) with daily all-cause, cardiovascular, and respiratory mortality across multiple countries or regions. Daily data on mortality and air pollution were collected from 652 cities in 24 countries or regions. We used overdispersed generalized additive models with random-effects meta-analysis to investigate the associations. Two-pollutant models were fitted to test the robustness of the associations. Concentration-response curves from each city were pooled to allow global estimates to be derived. RESULTS: On average, an increase of 10 µg per cubic meter in the 2-day moving average of PM10 concentration, which represents the average over the current and previous day, was associated with increases of 0.44% (95% confidence interval [CI], 0.39 to 0.50) in daily all-cause mortality, 0.36% (95% CI, 0.30 to 0.43) in daily cardiovascular mortality, and 0.47% (95% CI, 0.35 to 0.58) in daily respiratory mortality. The corresponding increases in daily mortality for the same change in PM2.5 concentration were 0.68% (95% CI, 0.59 to 0.77), 0.55% (95% CI, 0.45 to 0.66), and 0.74% (95% CI, 0.53 to 0.95). These associations remained significant after adjustment for gaseous pollutants. Associations were stronger in locations with lower annual mean PM concentrations and higher annual mean temperatures. The pooled concentration-response curves showed a consistent increase in daily mortality with increasing PM concentration, with steeper slopes at lower PM concentrations. CONCLUSIONS: Our data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe. These data reinforce the evidence of a link between mortality and PM concentration established in regional and local studies. (Funded by the National Natural Science Foundation of China and others.).


Assuntos
Poluição do Ar/efeitos adversos , Exposição Ambiental/análise , Mortalidade , Material Particulado/efeitos adversos , Poluição do Ar/análise , Doenças Cardiovasculares/mortalidade , Causas de Morte , Exposição Ambiental/efeitos adversos , Exposição Ambiental/legislação & jurisprudência , Saúde Global , Humanos , Tamanho da Partícula , Material Particulado/análise , Doenças Respiratórias/mortalidade , Risco
2.
JAMA ; 322(6): 546-556, 2019 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-31408135

RESUMO

Importance: While air pollutants at historical levels have been associated with cardiovascular and respiratory diseases, it is not known whether exposure to contemporary air pollutant concentrations is associated with progression of emphysema. Objective: To assess the longitudinal association of ambient ozone (O3), fine particulate matter (PM2.5), oxides of nitrogen (NOx), and black carbon exposure with change in percent emphysema assessed via computed tomographic (CT) imaging and lung function. Design, Setting, and Participants: This cohort study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) Air and Lung Studies conducted in 6 metropolitan regions of the United States, which included 6814 adults aged 45 to 84 years recruited between July 2000 and August 2002, and an additional 257 participants recruited from February 2005 to May 2007, with follow-up through November 2018. Exposures: Residence-specific air pollutant concentrations (O3, PM2.5, NOx, and black carbon) were estimated by validated spatiotemporal models incorporating cohort-specific monitoring, determined from 1999 through the end of follow-up. Main Outcomes and Measures: Percent emphysema, defined as the percent of lung pixels less than -950 Hounsfield units, was assessed up to 5 times per participant via cardiac CT scan (2000-2007) and equivalent regions on lung CT scans (2010-2018). Spirometry was performed up to 3 times per participant (2004-2018). Results: Among 7071 study participants (mean [range] age at recruitment, 60 [45-84] years; 3330 [47.1%] were men), 5780 were assigned outdoor residential air pollution concentrations in the year of their baseline examination and during the follow-up period and had at least 1 follow-up CT scan, and 2772 had at least 1 follow-up spirometric assessment, over a median of 10 years. Median percent emphysema was 3% at baseline and increased a mean of 0.58 percentage points per 10 years. Mean ambient concentrations of PM2.5 and NOx, but not O3, decreased substantially during follow-up. Ambient concentrations of O3, PM2.5, NOx, and black carbon at study baseline were significantly associated with greater increases in percent emphysema per 10 years (O3: 0.13 per 3 parts per billion [95% CI, 0.03-0.24]; PM2.5: 0.11 per 2 µg/m3 [95% CI, 0.03-0.19]; NOx: 0.06 per 10 parts per billion [95% CI, 0.01-0.12]; black carbon: 0.10 per 0.2 µg/m3 [95% CI, 0.01-0.18]). Ambient O3 and NOx concentrations, but not PM2.5 concentrations, during follow-up were also significantly associated with greater increases in percent emphysema. Ambient O3 concentrations, but not other pollutants, at baseline and during follow-up were significantly associated with a greater decline in forced expiratory volume in 1 second per 10 years (baseline: 13.41 mL per 3 parts per billion [95% CI, 0.7-26.1]; follow-up: 18.15 mL per 3 parts per billion [95% CI, 1.59-34.71]). Conclusions and Relevance: In this cohort study conducted between 2000 and 2018 in 6 US metropolitan regions, long-term exposure to ambient air pollutants was significantly associated with increasing emphysema assessed quantitatively using CT imaging and lung function.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Pulmão/fisiologia , Enfisema Pulmonar , Idoso , Idoso de 80 Anos ou mais , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Carbono/efeitos adversos , Carbono/análise , Estudos de Coortes , Progressão da Doença , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Óxidos de Nitrogênio/efeitos adversos , Óxidos de Nitrogênio/análise , Ozônio/efeitos adversos , Ozônio/análise , Material Particulado/efeitos adversos , Material Particulado/análise , Enfisema Pulmonar/epidemiologia , Enfisema Pulmonar/fisiopatologia , Testes de Função Respiratória , Tomografia Computadorizada por Raios X , Estados Unidos/epidemiologia
3.
Pneumologie ; 73(7): 407-429, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31291669

RESUMO

The third part of the DGP statement introduces the current body of knowledge on less studied health outcomes associated with exposure to ambient air pollution: the negative impact on metabolism leading to impaired glucose tolerance and diabetes as well as contribution to the development of neurodegenerative disorders and delayed cognitive function in children. Furthermore, prenatal exposure and adverse effects on mother and child are addressed. Finally, the currently discussed biological mechanisms underlying various health effects associated with exposure to air pollution are described.Differing, but often complementary biological mechanisms create the basis for the diverse health outcomes caused by air pollution. Oxidative stress and a subclinical inflammatory response in the lungs and on a systemic level ("low-grade systemic inflammation") are considered to be key mechanisms. They promote secondary alterations in the body, such as vascular or metabolic processes, and may also result in the currently studied epigenetic phenomena or neuroinflammation. In this context, the health significance of soluble particulate matter and the role of ultrafine particles translocated across biological membranes into blood vessel and transported via the circulation to secondary target organs, such as liver, brain or the fetus, are intensively discussed.Diabetes is one of the leading chronic diseases worldwide, with a prevalence of almost 14 % in Germany. Although lifestyle factors are the main causes, current evidence suggests that long-term exposure to air pollution may additionally increase the risk for type 2 diabetes. Supporting evidence for a causal role of air pollution is provided by studies addressing the regulation of the blood glucose levels in metabolically healthy participants, insulin sensitivity, or pregnancy-related diabetes. Experimental studies provide further support for plausible biological mechanisms. However, prospective studies are needed to gain more evidence, taking multiple lifestyle and environmental factors, such as green space and noise, and an improved individual exposure assessment into account.The aging population has an increased risk of neurodegenerative diseases. First studies point towards a contribution of chronic exposure to air pollution, specifically by particulate matter. Several studies report its association with decreased neurocognitive capacity or an increased prevalence of dementia or Alzheimer's disease in adults. However, the studies are inhomogeneous regarding design, exposure and outcome, leading to inconsistent results. With respect to the influence on neurocognitive development of children, first studies suggest an association between the level of air pollution, e. g. at school, and delayed cognitive development.Even though the evidence for the different biological endpoints during pregnancy is still heterogeneous, the studies generally point towards an adverse impact of air pollution on the maternal and fetal organisms. The strongest evidence exists for low birth weight, with small effect sizes of only some grams, and for a higher incidence of reduced birth weight (< 2500 g). An increased risk for gestational hypertension and preeclampsia underscores the possible impact of exposure to air pollution on the maternal organism. However, the current body of evidence does not yet allow a final conclusion on the influence of intrauterine exposure to air pollution regarding early childhood lung function and development of allergies, particularly in light of the fact that it is hard to distinguish in epidemiological studies between the effects of pre- and postnatal exposure.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Diabetes Mellitus Tipo 2/epidemiologia , Exposição Ambiental , Material Particulado/efeitos adversos , Resultado da Gravidez/epidemiologia , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Alemanha/epidemiologia , Humanos , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Estudos Prospectivos
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 686-691, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238620

RESUMO

Objective: To explore the short-term effects of ambient PM(2.5) on the outpatient visits of chronic obstructive pulmonary disease (COPD) in Ningbo city. Methods: Through the regional health information platform, number of daily COPD outpatients from the four general hospitals in Ningbo was gathered. Related data on meteorological and air pollution from 2014 to 2016 was also collected. Generalized additive model (GAM) of Possion regression was used to estimate the impact of PM(2.5) pollution on COPD outpatients and the lagging effects. Results: In cold (November- April) or warm seasons (May-October), an 10 µg/m(3) increase of PM(2.5) would result in the excessive number of COPD outpatients as 1.87% (95%CI: 0.98%-2.76%), 2.09% (95%CI: 1.11%-3.08%) and 2.56% (95%CI: 0.56%-4.59%), respectively. In terms of the short-term effects of PM(2.5) the strongest was seen in the days of warm season but without delay (P<0.05). The strongest effect appeared at day 4 in cold season and the effect was particularly significant seen in the over 65 year-old group or in the female population. After the introduction of PM(10), SO(2) and NO(2), the concentration of PM(2.5), did not show significant effect on the number of hospital visits due to COPD on the same day (P>0.05). The effect of COPD on the fourth day showed a slight change after the lagging, and the effect was statistically significant (P<0.05). Conclusion: The increase of PM(2.5) concentration in Ningbo was related to the increase of COPD outpatient numbers. Effective prevention measures should be taken to protect the vulnerable population and to reduce the risk of COPD.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Exposição Ambiental/efeitos adversos , Ambulatório Hospitalar/estatística & dados numéricos , Pacientes Ambulatoriais/estatística & dados numéricos , Material Particulado/efeitos adversos , Doença Pulmonar Obstrutiva Crônica/etiologia , Idoso , Poluição do Ar/estatística & dados numéricos , Assistência Ambulatorial , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Material Particulado/análise , Doença Pulmonar Obstrutiva Crônica/epidemiologia , População Urbana
5.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(6): 614-618, 2019 Jun 06.
Artigo em Chinês | MEDLINE | ID: mdl-31177760

RESUMO

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.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Pulmão , Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Criança , China , Humanos , Pulmão/efeitos dos fármacos , Pulmão/fisiopatologia , Material Particulado , Testes de Função Respiratória , Capacidade Vital
6.
Pneumologie ; 73(6): 347-373, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31185518

RESUMO

The second part of the DGP-statement on adverse health effects of ambient air pollution provides an overview of the current ambient air quality in Germany and its development in the past 20 years. Further, effects of air pollution on the cardiovascular system und underlying pathophysiological mechanisms are introduced. Air pollutants form a highly complex and dynamic system of thousands of organic and inorganic components from natural and anthropogenic sources. The pollutants are produced locally or introduced by long-range transport over hundreds of kilometers and are additionally subjected to local meteorological conditions. According to air quality regulations ambient air quality is monitored under uniform standards including immission of particulate matter, up to 2.5 µm (PM2.5) or 10 µm (PM10) in aerodynamic diameter, and of nitrogen dioxide (NO2) or ozone (O3). The clean air measures of recent years led to a continuous decline of air pollution in the past 20 years in Germany. Accordingly, the focus is nowadays directed at population-related health hazards caused by low concentrations of air pollution. Exceeded limits for sulfur dioxide, carbon monoxide, benzene and lead are not detected anymore. Also the number of days with increased ozone concentration declined, although the annual mean concentration is unaltered. Decreasing concentrations of particulate matter and NO2 have been observed, however, about 40 % of the monitoring stations at urban traffic sites still measure values exceeding current limits for NO2. Moreover, the stricter, solely health-based WHO-standards for PM2.5, PM10 and NO2 are still not met so that an optimal protection from air pollution-related health hazards is currently not given for the German population. In recent years, the findings of numerous cross-sectional and longitudinal studies underscored adverse effects of air pollution on the cardiovascular system, especially for particulate matter, although the level of evidence still varies for the different health outcomes. Further, the studies show that cardiovascular health hazards on the population level are of higher relevance than those for the respiratory system. The existing evidence for cardiovascular mortality, hospitalization, ischemic heart diseases, myocardial infarction and stroke can be regarded as strong, while that for heart failure is rather moderate. While the evidence for air pollution-related short-term alteration of the cardiac autonomic balance can be considered as sufficient, long-term effects are still unclear. Likewise, the heterogeneous findings on air pollution-related arrhythmia do currently not allow a distinct conclusion in this regard. A large number of studies support the observation that both, short- and long-term air pollution exposure contribute to increased blood pressure, may impair vascular homeostasis, induce endothelial dysfunction and promote the progression of atherosclerotic lesions. These effects provide reasonable biological explanation for the fatal events associated with exposure to air pollution. Short-term exposure may not pose a significant risk on healthy individuals but may be considered as precursor for fatal events in susceptible populations, while repetitive or long-term exposure may contribute to the development of cardiovascular diseases even in healthy subjects.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Exposição Ambiental/efeitos adversos , Saúde Pública , Estudos Transversais , Alemanha , Humanos , Material Particulado
7.
BMC Public Health ; 19(1): 705, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31174511

RESUMO

BACKGROUND: Air pollution is becoming an increased burden to the world. Previous studies have confirmed its effects on adverse birth outcomes, but few associated with premature small for gestational age (SGA). We report a retrospective cohort study conducted in Changzhou city to evaluate the association between air pollutants (PM2.5, SO2 and NO2) and premature SGA during pregnancy. METHODS: A total of 46,224 births were collected from January, 2013 to December, 2016, in Changzhou Maternity and Child Health Care Hospital, finally 2709 preterm births were admitted for study. Corresponding air monitoring data were collected from Changzhou Environmental Protection Agency. Generalized estimating equations were used to examine the association between these air pollutants and premature SGA controlling for individual covariates in single- and multi-pollutant models. RESULTS: We found that, in the third trimester, every 10 µg/m3 increments in PM2.5 concentration were associated with premature SGA (OR = 1.18, 95% CI: 1.03-2.83; OR = 1.37, 95% CI: 1.03-3.58) in two- and three-pollutants models. In the whole gestation, a 10 µg/m3 increment in PM2.5 concentration in two- and three-pollutant models were related to premature SGA (OR = 1.53, 95% CI: 1.38-2.47; OR = 1.73, 95% CI: 1.18-2.57). The OR (95% CI) of premature SGA were increasing across quintiles of PM2.5, SO2, NO2 concentrations during the whole gestation period adjusting for confounders (P for trend < 0.001). CONCLUSIONS: These results indicated that pregnant women exposed to PM2.5, combined with other pollutants in the third trimester have a higher risk to deliver premature SGA babies, providing further evidence linking PM2.5 and pregnancy outcomes.


Assuntos
Poluição do Ar/efeitos adversos , Exposição Ambiental/efeitos adversos , Recém-Nascido Pequeno para a Idade Gestacional , Exposição Materna/efeitos adversos , Nascimento Prematuro/epidemiologia , Adulto , Poluentes Atmosféricos/análise , China/epidemiologia , Feminino , Humanos , Recém-Nascido , Material Particulado/análise , Gravidez , Resultado da Gravidez , Nascimento Prematuro/etiologia , Estudos Retrospectivos
8.
BMC Public Health ; 19(1): 795, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226978

RESUMO

BACKGROUND: We aimed to examine the effect of ambient air pollution at the district level on adolescents' happiness and their change in happiness over time in a cohort sample from Taiwan. METHOD: A cohort from the Taiwan Youth Project was evaluated. The adolescents (n = 2571) were in the 7th grade (mean age = 14.3 years) when the study was initiated and resided in 40 districts in three cities and counties in northern Taiwan. We examined the effects of the concentration level of air pollution, including PM2.5, PM10, and NO2, at the district level on adolescents' happiness and their change in happiness over time (7th to 9th grade). Due to the high correlations of the three pollutants, we examined each separately with similar covariates. The analyses were based on both multilevel modeling and latent growth curve modeling. RESULTS: Higher concentration levels of each of the three air pollutants measured were associated with adolescent happiness such that a higher level of concentration was related to lower levels of adolescents' happiness. These results were observed after controlling for important individual- and district-level covariates. However, further analyses did not reveal that the concentration level of air pollution was associated with the change in happiness in the study period (after 3 years). Some sensitivity checks (e.g., adjusting district size) did not change the substantive results. CONCLUSION: Many previous studies have shown the influence of air pollution on physical health and negative emotions, but only a few using adult samples have shown that air pollution is inversely related to positive wellbeing. This study may be the first to examine the effects of air pollution on adolescents' positive affect. Our results echo recent research on the consequent health burden of air pollution. Given that positive affect has been linked to future adult health, the results of the current study provide empirical grounds for early intervention concerning environmental factors.


Assuntos
Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Felicidade , Adolescente , Poluentes Atmosféricos/análise , Estudos de Coortes , Feminino , Humanos , Masculino , Taiwan
9.
Pan Afr Med J ; 32: 99, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223389

RESUMO

Introduction: Air pollution is a global health problem. It's responsible for over 4 million deaths each year and constitutes a risk factor for acute respiratory infections (ARI). The aims of this study was to assess knowledge about air pollution, and to determine environmental risk factors associated with ARIs occurence in the city of Bamenda, Cameroon. Methods: We conducted a cross sectional study and performed a rectrospective analysis of ARI consultation within the period March 2016 to July 2016 in the Bamenda Health District. We interviewd 201 patients and recorded 1849 cases from hospital registers of patients diagnosed ARI from January 2013 to April 2016. Epi-info 7.2 was used for data entry and analysis. Logistic regression analysis was conducted to determine the importance of the different environmental risk factors. Results: Over 70% of the participants used at least a form of solid fuel for cooking. The Odds of developing an ARI was 3.62 greater among those exposed to indoor cooking compared to the unexposed (OR 3.62, CI 1.45-4.90). Participants exposed to open fire burning were 1.91 times more like to develop ARI compared to unexposed (OR: 1.91, CI 1.03-3.55: p : 0.03). Particulate Matter (PM 2.5) levels was 13.2 times higher than the World Health Organization (WHO) recommended levels. Dry and dusty weathers increased the risk of ARIs (OR 3.24; CI 1.47-7.13). The prevalence of ARIs in the Bamenda Health District was 6% of all consultations. Conclusion: Using solid fuels in poorly ventilated homes increase the total air particle suspension indoor. Inhalling this poor air irritates the repiratory tract, eyes while longterm exposure increases the odds of cancers. Ventilating homes with indoor cooking space reduces exposure while using clean fuels like electricity reduces the odds of ARI associated with pollution.


Assuntos
Poluição do Ar/efeitos adversos , Material Particulado/efeitos adversos , Infecções Respiratórias/epidemiologia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Poluição do Ar em Ambientes Fechados/efeitos adversos , Camarões/epidemiologia , Criança , Pré-Escolar , Culinária , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Infecções Respiratórias/etiologia , Fatores de Risco , Fatores de Tempo , Ventilação/métodos , Tempo (Meteorologia) , Adulto Jovem
11.
Ecotoxicol Environ Saf ; 179: 290-300, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31071567

RESUMO

Epidemiological and experimental studies have indicated that ambient fine particulate matter (PM2.5) exposure is associated with the occurrence and development of metabolic disorders such as obesity and type 2 diabetes mellitus (T2DM). However, the mechanism is not clear yet, and there are few studies to explore the possible prevention measure. In this study, C57BL/6 and db/db mice were exposed to concentrated PM2.5 or filtered air using Shanghai Meteorological and Environmental Animal Exposure System (Shanghai-METAS) for 12 weeks. From week 11, some of the mice were assigned to receive a subcutaneous injection of AMPK activator (AICAR). Lipid metabolism, glucose tolerance, insulin sensitivity and energy homeostasis were measured. Meanwhile, the respiratory, systemic and visceral fat inflammatory response was detected. The results showed that PM2.5 exposure induced the impairments of glucose tolerance, insulin resistance, lipid metabolism disorders and disturbances of energy metabolism in both C57BL/6 and db/db mice. These impairments might be consistent with the increased respiratory, circulating and visceral adipose tissue (VAT) inflammatory response, which was characterized by the release of IL-6 and TNF-α in lung, serum and VAT. More importantly, AICAR administration led to the significant enhancement of energy metabolism, elevation of AMPK as well as the decreased IL-6 and TNF-α in VAT of PM2.5-exposed mice, which suggesting that AMPK activation might attenuate the inflammatory responses in VAT via the inhibition of MAPKs and NFκB. The study indicated that exposure to ambient PM2.5 under the concentration which is often seen in some developing countries could induce the occurrence of metabolic disorders in normal healthy mice and exacerbate metabolic disorders in diabetic mice. The adverse impacts of PM2.5 on insulin sensitivity, energy homeostasis, lipid metabolism and inflammatory response were associated with AMPK inhibition. AMPK activation might inhibit PM2.5-induced metabolic disorders via inhibition of inflammatory cytokines release. These findings suggested that AMPK activation is a potential therapy to prevent some of the metabolic disorders attributable to air pollution exposure.


Assuntos
Proteínas Quinases Ativadas por AMP/metabolismo , Poluição do Ar/efeitos adversos , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Tipo 2/induzido quimicamente , Metabolismo Energético/efeitos dos fármacos , Obesidade/induzido quimicamente , Material Particulado/toxicidade , Animais , China , Citocinas/metabolismo , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Homeostase/efeitos dos fármacos , Exposição por Inalação , Resistência à Insulina , Metabolismo dos Lipídeos/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/metabolismo , Tamanho da Partícula , Fator de Necrose Tumoral alfa/metabolismo
12.
Cochrane Database Syst Rev ; 5: CD010919, 2019 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-31106396

RESUMO

BACKGROUND: Ambient air pollution is associated with a large burden of disease in both high-income countries (HICs) and low- and middle-income countries (LMICs). To date, no systematic review has assessed the effectiveness of interventions aiming to reduce ambient air pollution. OBJECTIVES: To assess the effectiveness of interventions to reduce ambient particulate matter air pollution in reducing pollutant concentrations and improving associated health outcomes. SEARCH METHODS: We searched a range of electronic databases with diverse focuses, including health and biomedical research (CENTRAL, Cochrane Public Health Group Specialised Register, MEDLINE, Embase, PsycINFO), multidisciplinary research (Scopus, Science Citation Index), social sciences (Social Science Citation Index), urban planning and environment (Greenfile), and LMICs (Global Health Library regional indexes, WHOLIS). Additionally, we searched grey literature databases, multiple online trial registries, references of included studies and the contents of relevant journals in an attempt to identify unpublished and ongoing studies, and studies not identified by our search strategy. The final search date for all databases was 31 August 2016. SELECTION CRITERIA: Eligible for inclusion were randomized and cluster randomized controlled trials, as well as several non-randomized study designs, including controlled interrupted time-series studies (cITS-EPOC), interrupted time-series studies adhering to EPOC standards (ITS-EPOC), interrupted time-series studies not adhering to EPOC standards (ITS), controlled before-after studies adhering to EPOC standards (CBA-EPOC), and controlled before-after studies not adhering to EPOC standards (CBA); these were classified as main studies. Additionally, we included uncontrolled before-after studies (UBA) as supporting studies. We included studies that evaluated interventions to reduce ambient air pollution from industrial, residential, vehicular and multiple sources, with respect to their effect on mortality, morbidity and several air pollutant concentrations. We did not restrict studies based on the population, setting or comparison. DATA COLLECTION AND ANALYSIS: After a calibration exercise among the author team, two authors independently assessed studies for inclusion, extracted data and assessed risk of bias. We conducted data extraction, risk of bias assessment and evidence synthesis only for main studies; we mapped supporting studies with regard to the types of intervention and setting. To assess risk of bias, we used the Graphic Appraisal Tool for Epidemiological studies (GATE) for correlation studies, as modified and employed by the Centre for Public Health Excellence at the UK National Institute for Health and Care Excellence (NICE). For each intervention category, i.e. those targeting industrial, residential, vehicular and multiple sources, we synthesized evidence narratively, as well as graphically using harvest plots. MAIN RESULTS: We included 42 main studies assessing 38 unique interventions. These were heterogeneous with respect to setting; interventions were implemented in countries across the world, but most (79%) were implemented in HICs, with the remaining scattered across LMICs. Most interventions (76%) were implemented in urban or community settings.We identified a heterogeneous mix of interventions, including those aiming to address industrial (n = 5), residential (n = 7), vehicular (n = 22), and multiple sources (n = 4). Some specific interventions, such as low emission zones and stove exchanges, were assessed by several studies, whereas others, such as a wood burning ban, were only assessed by a single study.Most studies assessing health and air quality outcomes used routine monitoring data. Studies assessing health outcomes mostly investigated effects in the general population, while few studies assessed specific subgroups such as infants, children and the elderly. No identified studies assessed unintended or adverse effects.The judgements regarding the risk of bias of studies were mixed. Regarding health outcomes, we appraised eight studies (47%) as having no substantial risk of bias concerns, five studies (29%) as having some risk of bias concerns, and four studies (24%) as having serious risk of bias concerns. Regarding air quality outcomes, we judged 11 studies (31%) as having no substantial risk of bias concerns, 16 studies (46%) as having some risk of bias concerns, and eight studies (23%) as having serious risk of bias concerns.The evidence base, comprising non-randomized studies only, was of low or very low certainty for all intervention categories and primary outcomes. The narrative and graphical synthesis showed that evidence for effectiveness was mixed across the four intervention categories. For interventions targeting industrial, residential and multiple sources, a similar pattern emerged for both health and air quality outcomes, with essentially all studies observing either no clear association in either direction or a significant association favouring the intervention. The evidence base for interventions targeting vehicular sources was more heterogeneous, as a small number of studies did observe a significant association favouring the control. Overall, however, the evidence suggests that the assessed interventions do not worsen air quality or health. AUTHORS' CONCLUSIONS: Given the heterogeneity across interventions, outcomes, and methods, it was difficult to derive overall conclusions regarding the effectiveness of interventions in terms of improved air quality or health. Most included studies observed either no significant association in either direction or an association favouring the intervention, with little evidence that the assessed interventions might be harmful. The evidence base highlights the challenges related to establishing a causal relationship between specific air pollution interventions and outcomes. In light of these challenges, the results on effectiveness should be interpreted with caution; it is important to emphasize that lack of evidence of an association is not equivalent to evidence of no association.We identified limited evidence for several world regions, notably Africa, the Middle East, Eastern Europe, Central Asia and Southeast Asia; decision-makers should prioritize the development and implementation of interventions in these settings. In the future, as new policies are introduced, decision-makers should consider a built-in evaluation component, which could facilitate more systematic and comprehensive evaluations. These could assess effectiveness, but also aspects of feasibility, fidelity and acceptability.The production of higher quality and more uniform evidence would be helpful in informing decisions. Researchers should strive to sufficiently account for confounding, assess the impact of methodological decisions through the conduct and communication of sensitivity analyses, and improve the reporting of methods, and other aspects of the study, most importantly the description of the intervention and the context in which it is implemented.


Assuntos
Poluição do Ar/efeitos adversos , Poluição do Ar/prevenção & controle , Nível de Saúde , Material Particulado/efeitos adversos , Humanos , Análise de Séries Temporais Interrompida , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Medicine (Baltimore) ; 98(20): e15730, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096531

RESUMO

BACKGROUND: Various studies have explored the association between outdoor air pollution and semen quality. However, the results were still controversial. The object of the current meta-analysis is to evaluate the role of outdoor air pollution in semen quality. METHODS: Databases including PubMed, Web of Science, and Embase will be searched to identify qualified studies. All qualified cross-sectional studies researching the association between outdoor air pollution and sperm parameters will be included. Relative data in participants under higher exposure and lower exposure to air pollution will be extracted by 2 investigators independently. Only participants under the highest and the lowest exposure will be enrolled if the original study contained more than 2 exposure levels. The semen volume, sperm concentration, progressive motility, total motility, and normal morphology rate will be the primary outcomes of the current study. Pooled estimates with corresponding 95% confidence intervals will be calculated to assess the specific effects of outdoor air pollution in semen quality. Moreover, trial sequential analyses will be performed to obtain a more comprehensive assessment of analyses. RESULTS: A high-quality synthesis of the current evidence for the association between sperm parameters and outdoor air pollution will be provided. CONCLUSIONS: This meta-analysis and systematic review will generate evidence for judging whether outdoor air pollution can impair semen quality. PROSPERO REGISTRATION NUMBER: PROSPERO CRD 42019126060.


Assuntos
Poluição do Ar/efeitos adversos , Análise do Sêmen/métodos , Motilidade Espermática/efeitos dos fármacos , Estudos Transversais , Humanos , Masculino , Contagem de Espermatozoides
14.
JAMA ; 321(19): 1906-1915, 2019 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-31112259

RESUMO

Importance: Exposure to air pollutants is a well-established cause of asthma exacerbation in children; whether air pollutants play a role in the development of childhood asthma, however, remains uncertain. Objective: To examine whether decreasing regional air pollutants were associated with reduced incidence of childhood asthma. Design, Setting, and Participants: A multilevel longitudinal cohort drawn from 3 waves of the Southern California Children's Health Study over a period of air pollution decline. Each cohort was followed up from 4th to 12th grade (8 years): 1993-2001, 1996-2004, and 2006-2014. Final follow-up for these data was June 2014. Population-based recruitment was from public elementary schools. A total of 4140 children with no history of asthma and residing in 1 of 9 Children's Health Study communities at baseline were included. Exposures: Annual mean community-level ozone, nitrogen dioxide, and particulate matter less than 10 µm (PM10) and less than 2.5 µm (PM2.5) in the baseline year for each of 3 cohorts. Main Outcomes and Measures: Prospectively identified incident asthma, collected via questionnaires during follow-up. Results: Among the 4140 children included in this study (mean [SD] age at baseline, 9.5 [0.6] years; 52.6% female [n = 2 179]; 58.6% white [n = 2273]; and 42.2% Hispanic [n = 1686]), 525 incident asthma cases were identified. For nitrogen dioxide, the incidence rate ratio (IRR) for asthma was 0.80 (95% CI, 0.71-0.90) for a median reduction of 4.3 parts per billion, with an absolute incidence rate decrease of 0.83 cases per 100 person-years. For PM2.5, the IRR was 0.81 (95% CI, 0.67-0.98) for a median reduction of 8.1 µg/m3, with an absolute incidence rate decrease of 1.53 cases per 100 person-years. For ozone, the IRR for asthma was 0.85 (95% CI, 0.71-1.02) for a median reduction of 8.9 parts per billion, with an absolute incidence rate decrease of 0.78 cases per 100 person-years. For PM10, the IRR was 0.93 (95% CI, 0.82-1.07) for a median reduction of 4.0 µg/m3, with an absolute incidence rate decrease of 0.46 cases per 100 person-years. Conclusions and Relevance: Among children in Southern California, decreases in ambient nitrogen dioxide and PM2.5 between 1993 and 2014 were significantly associated with lower asthma incidence. There were no statistically significant associations for ozone or PM10.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Asma/epidemiologia , Dióxido de Nitrogênio/efeitos adversos , Material Particulado/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Asma/etiologia , California/epidemiologia , Criança , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Dióxido de Nitrogênio/análise , Ozônio/efeitos adversos , Ozônio/análise , Material Particulado/análise
15.
Nat Commun ; 10(1): 2095, 2019 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-31064982

RESUMO

The health co-benefits of CO2 mitigation can provide a strong incentive for climate policy through reductions in air pollutant emissions that occur when targeting shared sources. However, reducing air pollutant emissions may also have an important co-harm, as the aerosols they form produce net cooling overall. Nevertheless, aerosol impacts have not been fully incorporated into cost-benefit modeling that estimates how much the world should optimally mitigate. Here we find that when both co-benefits and co-harms are taken fully into account, optimal climate policy results in immediate net benefits globally, overturning previous findings from cost-benefit models that omit these effects. The global health benefits from climate policy could reach trillions of dollars annually, but will importantly depend on the air quality policies that nations adopt independently of climate change. Depending on how society values better health, economically optimal levels of mitigation may be consistent with a target of 2 °C or lower.


Assuntos
Poluição do Ar/prevenção & controle , Análise Custo-Benefício , Política Ambiental/economia , Saúde Global/economia , Efeito Estufa/economia , Aerossóis , Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Poluição do Ar/economia , Mudança Climática , Política Ambiental/tendências , Saúde Global/tendências , Humanos
16.
Sci Total Environ ; 677: 564-570, 2019 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-31067477

RESUMO

Transregional transport plays an important role in air pollution. This study investigated the impact of transregional transport on particle pollution in Shanghai from 2013 to 2017. A conditional potential source contribution function (CPSCF) method with high time resolution (1 h) PM2.5 and PM10 data was used to quantify the contribution of transregional transport. The corresponding health impact was also assessed. The average annual contribution of transregional transport to PM2.5 (PM2.5_CTRT) and PM10 (PM10_CTRT) was 22 and 30 µg/m3, 18 and 24 µg/m3, 19 and 24 µg/m3, 14 and 19 µg/m3, and 14 and 19 µg/m3, for 2013 to 2017, respectively, thus accounting for 31-37% of total PM2.5 and PM10. As PM2.5_CTRT is a dominant component of PM10_CTRT, the health effects related to PM2.5_CTRT were assessed to avoid double counting. The number of annual deaths associated with PM2.5_CTRT in Shanghai during the study period ranged from 636 (95% confidence intervals: 350, 936) to 1039 (573, 1530), among which cardiovascular disease and respiratory disease accounted for 62.8-67.6% and 16.6-19.5% of mortality, respectively. PM2.5_CTRT-related deaths accounted for 5.3-8.2‰ of the total mortality in Shanghai during the study period. Between 9764 (9251, 10,277) and 12,190 (11,549, 12,830) cases of all-cause hospital admissions were attributable to PM2.5_CTRT in Shanghai in one year, among which cardiovascular disease and respiratory disease hospital admissions accounted for 15.9-20.0% and 7.9-9.2%, respectively. Internal medicine and pediatrics outpatient visits related to PM2.5_CTRT ranged from 70,684 (39,009, 100,829) to 97,380 (53,788, 138,793) cases and 23,185 (8302, 37,173) to 32,702 (11,726, 52,361) cases, respectively. The current work provides scientific evidence of the impact of transregional transport on air pollution and its health burden in Shanghai.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Doenças Cardiovasculares/mortalidade , Exposição Ambiental/efeitos adversos , Material Particulado/efeitos adversos , Doenças Respiratórias/mortalidade , Poluentes Atmosféricos/análise , Doenças Cardiovasculares/induzido quimicamente , China/epidemiologia , Cidades , Exposição Ambiental/análise , Humanos , Tamanho da Partícula , Material Particulado/análise , Doenças Respiratórias/induzido quimicamente , População Urbana
17.
Huan Jing Ke Xue ; 40(3): 1512-1520, 2019 Mar 08.
Artigo em Chinês | MEDLINE | ID: mdl-31088004

RESUMO

With the rapid development of the economy, the atmospheric pollution in China has become very severe, and poses a great threat to human health. On the basis of relevant research achievements at home and abroad, this paper summarizes the impact of atmospheric pollution on the health of residents from the two aspects of research content and method. It was found that current research is mainly focused on calculating the health losses, evaluating the economic cost of health losses, and analyzing the health benefits of controlling atmospheric pollutants at the macro level, while studies at the micro level are relatively scarce. Moreover, current studies at the micro individual level is mostly empirical research related to epidemic cases abroad; however, domestic research at the micro individual level is still at the initial stage of qualitative analysis. In addition, the quantitative assessment method of atmospheric pollution on the health of residents is also improving. Apart from methods in common use (meta-analysis, Poisson regression model, human capital method, willingness to pay method and disease cost method), there are other methods that are widely used (input-output model and computable general equilibrium model). In general, the effects of atmospheric pollution on resident health include both chronic and short-term acute effects, and involve many other factors as well, such as socioeconomics, natural conditions, behavioral preferences, and personal physiology. Although the depth and breadth of the research are expanding, and the level of discipline integration is being continuously improved, it is necessary to strengthen domestic epidemiological studies, to pay attention to the integration of macro (regions) and micro (individuals), to focus on the reduction and distribution of atmospheric pollutants from a health perspective, and to attach importance to the construction of a basic database in the future to provide a scientific basis for establishing a systematic framework for the analysis of the effects of atmospheric pollution on the health of residents.


Assuntos
Poluição do Ar/efeitos adversos , Nível de Saúde , China , Humanos
18.
Environ Sci Pollut Res Int ; 26(19): 19749-19762, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31089995

RESUMO

In the present study, the distribution and chemical fractionation of heavy metals (Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Zn) in PM2.5 collected at Sikandarpur in Agra from September 2015 to February 2016 were carried out to evaluate their mobility potential, environmental, and human health risk through inhalation. Sequential extraction procedure was applied to partition the heavy metals into four fractions (soluble and exchangeable fraction (F1); carbonates, oxides, and reducible fraction (F2); bound to organic matter, oxidizable, and sulphidic fraction (F3); and residual fraction (F4)) in PM2.5 samples. The metals in each fraction were analyzed by inductively coupled plasma-atomic emission spectroscopy (ICP-AES). Daily PM2.5 concentration ranged between 13 and 238 µg m-3 during the study period. For more than 92% of the days, the mass concentrations were greater than the National Ambient Air Quality Standard (NAAQS) set at 60 µg m-3. The total mass concentration of the eight metals was 3.3 µg m-3 that accounted for 2.5% of the PM2.5 mass concentration and followed the order Fe > Zn > Cu > Mn > Pb > Ni > Cd > Cr in dominance. The carcinogenic metals (Cd, Cr, Ni, and Pb) comprised 10% of the total metal determined. Almost all the metals had the highest proportion in the residual fraction (F4) except Ni, which had the highest proportion in the reducible fraction (F2). Chemical fractionation and contamination factor (CF) showed that Pb and Ni are readily mobilized and more bioavailable. Risk assessment code (RAC) showed that Cd, Cu, Mn, Ni, Pb, and Zn had medium environmental risk, while Cr and Fe had low risk. When the bioavailable (F1 + F2) concentrations were applied to calculate non-carcinogenic and carcinogenic risk, the results showed that the value of hazard index (HI) for toxic metals was 1.7 for both children and adults through inhalation. The integrated carcinogenic risk was 1.8 × 10-6 for children and 7.3 × 10-6 for adults, with both values being higher than the precautionary criterion (1 × 10-6). Enrichment factor (EF) calculations showed that Cd, Pb, Zn, and Ni were enriched being contributed by anthropogenic activities carried out in the industrial sectors of the city.


Assuntos
Monitoramento Ambiental/métodos , Exposição por Inalação/análise , Metais Pesados/análise , Material Particulado/análise , Adulto , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Disponibilidade Biológica , Fracionamento Químico , Criança , Cidades , Feminino , Humanos , Índia , Exposição por Inalação/efeitos adversos , Metais Pesados/metabolismo , Material Particulado/metabolismo , Medição de Risco
19.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(5): 475-479, 2019 May 06.
Artigo em Chinês | MEDLINE | ID: mdl-31091604

RESUMO

Objective: To analyze the lung cancer deaths attributable to ambient PM(2.5) exposure in China in 2016. Methods: All data were from the Global Burden of Disease Study 2016 (GBD 2016). Multiple-source data, including satellite observation, ground measurement, chemical migration model simulation, etc., and the data integration model for air quality (DIMAQ) were used to estimate the grid-level exposure to ambient PM(2.5). Data from the vital registry and cancer registry were used to establish statistical model to estimate the lung cancer deaths by province, age and gender. The lung cancer deaths attributable to PM(2.5) were calculated based on the calculation of population attributable fraction (PAF). The GBD world population age structure was adopted to calculate age-standardized rates for comparison among provinces (including 31 provinces, autonomous regions and municipalities directly under the central government, as well as Hong Kong and Macao special administrative regions, excluding Taiwan of China). Results: In 2016, the lung cancer deaths attributable to ambient PM(2.5) exposure in China were 14.56×10(4) (95% uncertainty interval (UI): 9.63×10(4)-19.55×10(4)), accounting for 24.66% (95%UI: 16.38%-33.12%) of total lung cancer deaths. The lung cancer death rate attributable to PM(2.5) increased with age, with the lowest among 25-29 age group (0.25/10(5), 95%UI: 0.17/10(5)-0.34/10(5)), the highest among ≥80 age group (90.70/10(5), 95%UI: 59.85/10(5)-122.20/10(5)). The lung cancer death rate attributable to PM(2.5) among males (14.84/10(5), 95%UI: 9.78/10(5)-19.93/10(5)) was higher than that in females (6.21/10(5), 95%UI: 4.07/10(5)-8.40/10(5)). The age-standardized death rates (ASDR) of lung cancer attributable to PM(2.5) among males and females in China were higher than the global average level. The attributable ASDR of lung cancer varied among provinces, highest in Shandong (13.51/10(5), 95%UI: 9.14/10(5)-18.20/10(5)) and lowest in Tibet (0.85/10(5), 95%UI: 0.44/10(5)-1.51/10(5)). Conclusion: In 2016, the lung cancer deaths attributable to ambient PM(2.5) exposure in China was heavy, and varied in different age groups, genders and provinces.


Assuntos
Poluentes Atmosféricos/envenenamento , Poluição do Ar/efeitos adversos , Exposição Ambiental/efeitos adversos , Neoplasias Pulmonares/mortalidade , Material Particulado/envenenamento , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte/tendências , China/epidemiologia , Cidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
Sci Total Environ ; 678: 399-408, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31077918

RESUMO

Aim This explorative study aimed to investigate the association of residential greenness, traffic noise, and air pollution with birth outcomes in several Alpine areas with unique topography. METHODS: We used data from two cross-sectional studies (UIT, n = 573 and BBT, n = 518) in the Tyrol Region (Austria/Italy). Only mothers who had lived in their current residence during the whole pregnancy were included. They completed a questionnaire, and medical records were used to draw data on birth weight, low birth weight (LBW), preterm birth, and small for gestational age (SGA). Normalized Difference Vegetation Index (NDVI) in the year of birth was assigned at the residential address as a measure of greenness. Road/railway traffic noise (Ldn) and air pollution (NO2) were calculated about 10 years after birth and used as surrogates for exposure levels during pregnancy. RESULTS: In the UIT survey, higher NDVI500-m was consistently associated with lower odds for LBW and SGA, while an increase of Ldn was associated with higher odds for LBW. Other effect estimates were in the expected direction albeit non-significant. In the BBT survey, most findings were inconclusive (for NDVI) or present only in subgroups (for Ldn and NO2). CONCLUSION: This study provides inconclusive evidence that the surrounding environment might be associated with birth outcomes in mountainous areas. Given the disparate associations across the study areas, further research in larger representative samples is warranted.


Assuntos
Poluição do Ar/efeitos adversos , Monitoramento Ambiental , Veículos Automotores , Ruído/efeitos adversos , Resultado da Gravidez/epidemiologia , Adulto , Altitude , Estudos Transversais , Meio Ambiente , Feminino , Geografia , Humanos , Itália , Masculino , Gravidez , Adulto Jovem
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