Short-term exposure to ambient air pollution and individual emergency department visits for COVID-19: a case-crossover study in Canada.

BACKGROUND: Ambient air pollution is thought to contribute to increased risk of COVID-19, but the evidence is controversial. OBJECTIVE: To evaluate the associations between short-term variations in outdoor concentrations of ambient air pollution and COVID-19 emergency department (ED) visits. METHODS: We conducted a case-crossover study of 78 255 COVID-19 ED visits in Alberta and Ontario, Canada between 1 March 2020 and 31 March 2021. Daily air pollution data (ie, fine particulate matter with diameter less than 2.5 µm (PM2.5), nitrogen dioxide (NO2) and ozone were assigned to individual case of COVID-19 in 10 km × 10 km grid resolution. Conditional logistic regression was used to estimate associations between air pollution and ED visits for COVID-19. RESULTS: Cumulative ambient exposure over 0-3 days to PM2.5 (OR 1.010; 95% CI 1.004 to 1.015, per 6.2 µg/m3) and NO2 (OR 1.021; 95% CI 1.015 to 1.028, per 7.7 ppb) concentrations were associated with ED visits for COVID-19. We found that the association between PM2.5 and COVID-19 ED visits was stronger among those hospitalised following an ED visit, as a measure of disease severity, (OR 1.023; 95% CI 1.015 to 1.031) compared with those not hospitalised (OR 0.992; 95% CI 0.980 to 1.004) (p value for effect modification=0.04). CONCLUSIONS: We found associations between short-term exposure to ambient air pollutants and COVID-19 ED visits. Exposure to air pollution may also lead to more severe COVID-19 disease.

Daily Summer Temperatures and Hospitalization for Acute Cardiovascular Events: Impact of Outdoor PM 2.5 Oxidative Potential on Observed Associations Across Canada.

BACKGROUND: Oxidative stress plays an important role in the health impacts of both outdoor fine particulate air pollution (PM 2.5 ) and thermal stress. However, it is not clear how the oxidative potential of PM 2.5 may influence the acute cardiovascular effects of temperature. METHODS: We conducted a case-crossover study of hospitalization for cardiovascular events in 35 cities across Canada during the summer months (July-September) between 2016 and 2018. We collected three different metrics of PM 2.5 oxidative potential each month in each location. We estimated associations between lag-0 daily temperature (per 5ºC) and hospitalization for all cardiovascular (n = 44,876) and ischemic heart disease (n = 14,034) events across strata of monthly PM 2.5 oxidative potential using conditional logistical models adjusting for potential time-varying confounders. RESULTS: Overall, associations between lag-0 temperature and acute cardiovascular events tended to be stronger when outdoor PM 2.5 oxidative potential was higher. For example, when glutathione-related oxidative potential (OP GSH ) was in the highest tertile, the odds ratio (OR) for all cardiovascular events was 1.040 (95% confidence intervals [CI] = 1.004, 1.074) compared with 0.980 (95% CI = 0.943, 1.018) when OP GSH was in the lowest tertile. We observed a greater difference for ischemic heart disease events, particularly for older subjects (age >70 years). CONCLUSIONS: The acute cardiovascular health impacts of summer temperature variations may be greater when outdoor PM 2.5 oxidative potential is elevated. This may be particularly important for ischemic heart disease events.

Air Pollution and Pediatric Respiratory Hospitalizations: Effect Modification by Particle Constituents and Oxidative Potential.

Rationale: Outdoor particulate and gaseous air pollutants impair respiratory health in children, and these associations may be influenced by particle composition. Objectives: To examine whether associations between short-term variations in fine particulate air pollution, oxidant gases, and respiratory hospitalizations in children are modified by particle constituents (metals and sulfur) or oxidative potential. Methods: We conducted a case-crossover study of 10,500 children (0-17 years of age) across Canada. Daily fine particle mass concentrations and oxidant gases (nitrogen dioxide and ozone) were collected from ground monitors. Monthly estimates of fine particle constituents (metals and sulfur) and oxidative potential were also measured. Conditional logistic regression models were used to estimate associations between air pollutants and respiratory hospitalizations, above and below median values for particle constituents and oxidative potential. Measurements and Main Results: Lag-1 fine particulate matter mass concentrations were not associated with respiratory hospitalizations (odds ratio and 95% confidence interval per 10 µg/m3 increase in fine particulate matter: 1.004 [0.955-1.056]) in analyses ignoring particle constituents and oxidative potential. However, when models were examined above or below median metals, sulfur, and oxidative potential, positive associations were observed above the median. For example, the odds ratio and 95% confidence interval per 10 µg/m3 increase in fine particulate matter were 1.084 (1.007-1.167) when copper was above the median and 0.970 (0.929-1.014) when copper was below the median. Similar trends were observed for oxidant gases. Conclusions: Stronger associations were observed between outdoor fine particles, oxidant gases, and respiratory hospitalizations in children when metals, sulfur, and particle oxidative potential were elevated.

Long-term Exposure to Oxidant Gases and Mortality: Effect Modification by PM 2.5 Transition Metals and Oxidative Potential.

BACKGROUND: Populations are simultaneously exposed to outdoor concentrations of oxidant gases (i.e., O 3 and NO 2 ) and fine particulate air pollution (PM 2.5 ). Since oxidative stress is thought to be an important mechanism explaining air pollution health effects, the adverse health impacts of oxidant gases may be greater in locations where PM 2.5 is more capable of causing oxidative stress. METHODS: We conducted a cohort study of 2 million adults in Canada between 2001 and 2016 living within 10 km of ground-level monitoring sites for outdoor PM 2.5 components and oxidative potential. O x exposures (i.e., the redox-weighted average of O 3 and NO 2 ) were estimated using a combination of chemical transport models, land use regression models, and ground-level data. Cox proportional hazards models were used to estimate associations between 3-year moving average O x and mortality outcomes across strata of transition metals and sulfur in PM 2.5 and three measures of PM 2.5 oxidative potential adjusting for possible confounding factors. RESULTS: Associations between O x and mortality were consistently stronger in regions with elevated PM 2.5 transition metal/sulfur content and oxidative potential. For example, each interquartile increase (6.27 ppb) in O x was associated with a 14.9% (95% CI = 13.0, 16.9) increased risk of nonaccidental mortality in locations with glutathione-related oxidative potential (OP GSH ) above the median whereas a 2.50% (95% CI = 0.600, 4.40) increase was observed in regions with OP GSH levels below the median (interaction P value <0.001). CONCLUSION: Spatial variations in PM 2.5 composition and oxidative potential may contribute to heterogeneity in the observed health impacts of long-term exposures to oxidant gases.

Within-City Variation in Reactive Oxygen Species from Fine Particle Air Pollution and COVID-19.

Rationale: Evidence linking outdoor air pollution with coronavirus disease (COVID-19) incidence and mortality is largely based on ecological comparisons between regions that may differ in factors such as access to testing and control measures that may not be independent of air pollution concentrations. Moreover, studies have yet to focus on key mechanisms of air pollution toxicity such as oxidative stress. Objectives: To conduct a within-city analysis of spatial variations in COVID-19 incidence and the estimated generation of reactive oxygen species (ROS) in lung lining fluid attributable to fine particulate matter (particulate matter with an aerodynamic diameter ⩽2.5 µm [PM2.5]). Methods: Sporadic and outbreak-related COVID-19 case counts, testing data, population data, and sociodemographic data for 140 neighborhoods were obtained from the City of Toronto. ROS estimates were based on a mathematical model of ROS generation in lung lining fluid in response to iron and copper in PM2.5. Spatial variations in long-term average ROS were predicted using a land-use regression model derived from measurements of iron and copper in PM2.5. Data were analyzed using negative binomial regression models adjusting for covariates identified using a directed acyclic graph and accounting for spatial autocorrelation. Measurements and Main Results: A significant positive association was observed between neighborhood-level ROS and COVID-19 incidence (incidence rate ratio = 1.07; 95% confidence interval, 1.01-1.15 per interquartile range ROS). Effect modification by neighborhood-level measures of racialized group membership and socioeconomic status was also identified. Conclusions: Examination of neighborhood characteristics associated with COVID-19 incidence can identify inequalities and generate hypotheses for future studies.

Impacts of Subway System Modifications on Air Quality in Subway Platforms and Trains.

Subway PM2.5 can be substantially sourced from the operation of the system itself. Improvements in subway air quality may be possible by examining the potential to reduce these emissions. To this end, PM2.5 was measured on the trains and station platforms of the Toronto subway system. A comparison with previously published data for this system reveals significant changes in below ground platform PM2.5. A reduction of nearly one-third (ratio (95% CI): 0.69 (0.63, 0.75)) in PM2.5 from 2011 to 2018 appears to have resulted from a complete modernization of the rolling stock on one subway line. In contrast, below ground platform PM2.5 for another line increased by a factor of 1.48 (95% CI; 1.42, 1.56). This increase may be related to an increase in emergency brake applications, the resolution of which coincided with a large decrease in PM2.5 concentrations on that line. Finally, platform PM2.5 in two newly opened stations attained, within one year of operation, typical concentrations of the neighboring platforms installed in 1963. Combined, these findings suggest that the production of platform PM2.5 is localized and hence largely freshly emitted. Further, PM2.5 changed across this subway system due to changes in its operation and rolling stock. Thus, similar interventions applied intentionally may prove to be equally effective in reducing PM2.5. Moreover, establishing a network of platform PM2.5 monitors is recommended to monitor ongoing improvements and identify impacts of future system changes on subway air quality. This would result in a better understanding of the relationship between the operations and air quality of subways.

Predicting Spatial Variations in Multiple Measures of Oxidative Burden for Outdoor Fine Particulate Air Pollution across Canada.

Fine particulate air pollution (PM2.5) is a leading contributor to the overall global burden of disease. Traditionally, outdoor PM2.5 has been characterized using mass concentrations which treat all particles as equally harmful. Oxidative potential (OP) (per µg) and oxidative burden (OB) (per m3) are complementary metrics that estimate the ability of PM2.5 to cause oxidative stress, which is an important mechanism in air pollution health effects. Here, we provide the first national estimates of spatial variations in multiple measures (glutathione, ascorbate, and dithiothreitol depletion) of annual median outdoor PM2.5 OB across Canada. To do this, we combined a large database of ground-level OB measurements collected monthly prospectively across Canada for 2 years (2016-2018) with PM2.5 components estimated using a chemical transport model (GEOS-Chem) and satellite aerosol observations. Our predicted ground-level OB values of all three methods were consistent with ground-level observations (cross-validation R2 = 0.63-0.74). We found that forested regions and urban areas had the highest OB, predicted primarily by black carbon and organic carbon from wildfires and transportation sources. Importantly, the dominant components associated with OB were different than those contributing to PM2.5 mass concentrations (secondary inorganic aerosol); thus, OB metrics may better indicate harmful components and sources on health than the bulk PM2.5 mass, reinforcing that OB estimates can complement the existing PM2.5 data in future national-level epidemiological studies.

Characterizing long-term NO2 concentration surfaces across a large metropolitan area through spatiotemporal land use regression modelling of mobile measurements.

A spatiotemporal land use regression (LUR) model optimized to predict nitrogen dioxide (NO2) concentrations obtained from on-road, mobile measurements collected in 2015-16 was independently evaluated using concentrations observed at multiple sites across Toronto, Canada, obtained more than ten years earlier. This spatiotemporal LUR modelling approach improves upon estimates of historical NO2 concentrations derived from the previously used method of back-extrapolation. The optimal spatiotemporal LUR model (R2 = 0.71 for prediction of NO2 data in 2002 and 2004) uses daily average NO2 concentrations observed at multiple long-term monitoring sites and hourly average wind speed recorded at a single site, along with spatial predictors based on geographical information system data, to estimate NO2 levels for time periods outside of those used for model development. While the model tended to underestimate samplers located close to the roadway, it showed great accuracy when estimating samplers located beyond 100 m which are probably more relevant for exposure at residences. This study shows that spatiotemporal LUR models developed from strategic, multi-day (30 days in 3 different months) mobile measurements can enhance LUR model's ability to estimate long-term, intra-urban NO2 patterns. Furthermore, the mobile sampling strategy enabled this new LUR model to cover a larger domain of Toronto and outlying suburban communities, thereby increasing the potential population for future epidemiological studies.

An ecological analysis of long-term exposure to PM2.5 and incidence of COVID-19 in Canadian health regions.

BACKGROUND: Ambient fine particulate matter (PM2.5) is associated with a wide range of acute and chronic health effects, including increased risk of respiratory infection. However, evidence specifically related to novel coronavirus disease (COVID-19) is limited. METHODS: COVID-19 case counts for 111 Canadian health regions were obtained from the COVID-19 Canada Open Data portal. Annual PM2.5 data for 2000-2016 were estimated from a national exposure surface based on remote sensing, chemical transport modelling and ground observations, and minimum and maximum temperature data for 2000-2015 were based on a national interpolated surface derived from thin-plate smoothing splines. Population counts and sociodemographic data by health region were obtained from the 2016 census, and health data (self-rated health and prevalence of smoking, obesity, and selected chronic diseases) by health region, were obtained from the Canadian Community Health Survey. Data on total number of COVID-19 tests and changes in mobility comparing post-vs. pre-introduction of social distancing measures were available by province. Data were analyzed using negative binomial regression models. RESULTS: After controlling for province, temperature, demographic and health characteristics and days since peak incidence by health region, long-term PM2.5 exposure exhibited a positive association with COVID-19 incidence (incidence rate ratio 1.07, 95% confidence interval 0.97-1.18 per µg/m3). This association was larger in magnitude and statistically significant in analyses excluding provinces that reported cases only for aggregated health regions, excluding health regions with less than median population density, and restricted to the most highly affected provinces (Quebec and Ontario). CONCLUSIONS: We observed a positive association between COVID-19 incidence and long-term PM2.5 exposure in Canadian health regions. The association was larger in magnitude and statistically significant in more highly affected health regions and those with potentially less exposure measurement error. While our results generate hypotheses for further testing, they should be interpreted with caution and require further examination using study designs less prone to bias.

Within-City Spatial Variations in Multiple Measures of PM2.5 Oxidative Potential in Toronto, Canada.

Few studies have characterized within-city spatial variations in the oxidative potential of fine particulate air pollution (PM2.5). In this study, we evaluated multiple measures of PM2.5 oxidative potential across Toronto, Canada (2016-2017), including glutathione/ascorbate-related oxidative potential (OPGSH and OPAA) and dithiothreitol depletion (OPDTT). Integrated 2-week samples were collected from 67 sites in summer and 42 sites in winter. Multivariable linear models were developed to predict OP based on various land use/traffic factors, and PM2.5 metals and black carbon were also examined. All three measures of PM2.5 oxidative potential varied substantially across Toronto. OPAA and OPDTT were primarily associated with traffic-related components of PM2.5 (i.e., Fe, Cu, and black carbon) whereas OPGSH was not a strong marker for traffic during either season. During summer, multivariable models performed best for OPAA ( RCV2 = 0.48) followed by OPDTT ( RCV2 = 0.32) and OPGSH ( RCV2 = 0.22). During winter, model performance was best for OPDTT ( RCV2 = 0.55) followed by OPGSH ( RCV2 = 0.50) and OPAA ( RCV2 = 0.23). Model parameters varied between seasons, and between-season differences in PM2.5 mass concentrations were weakly/moderately correlated with seasonal differences in OP. Our findings highlight substantial within-city variations in PM2.5 oxidative potential. More detailed information is needed on local sources of air pollution to improve model performance.

Urinary bisphenol A and incidence of metabolic syndrome among Chinese men: a prospective cohort study from 2013 to 2017.

OBJECTIVES: Experimental studies suggested that bisphenol A (BPA) exposure increased the risk of metabolic syndrome (MetS) through the mechanism of insulin resistance. All previous epidemiological studies of BPA and MetS were cross-sectional studies, and their findings were mixed. This study aims to provide further evidence on the association between urinary BPA and risk of MetS using a prospective cohort study in China. METHODS: The study population was from the Shenzhen Night shift workers' cohort. A total of 1227 male workers were recruited from the baseline survey in 2013 and then followed until 2017. Modified Adult Treatment Panel III criteria were used to identify the cases of MetS. Urinary BPA concentration was assessed using high-performance liquid chromatography-tandem mass spectrometry, and it was categorised into three subgroups by tertiles to obtain the adjusted HR (aHR) and 95% CI using Cox proportional hazard model. RESULTS: During 4 years of follow-up, 200 subjects developed MetS. Compared with the lowest urinary BPA subgroup, a weakly increased risk of MetS was suggested among those with the middle (aHR=1.19, 95% CI 0.87 to 1.63) and high level of urinary BPA (aHR=1.16, 95% CI 0.84 to 1.59); however, the significant association with MetS was restricted primarily to the smokers, showing a positive gradient with urinary BPA (middle level: aHR=2.40, 95% CI 1.13 to 5.08; high level: aHR=2.87, 95% CI 1.38 to 5.98; p trend=0.010). CONCLUSION: This prospective cohort study provided further evidence that exposure to BPA may increase the risk of MetS, and this association was further positively modified by cigarette smoking.

Night shift work and abnormal liver function: is non-alcohol fatty liver a necessary mediator?

OBJECTIVES: Accumulated evidence implies that night shift work may trigger liver dysfunction. Non-alcoholic fatty liver (NAFL) is suggested to be a necessary mediator in this process. This study aimed to examine the relationship between night shift work and elevated level of alanine transaminase (e-ALT) of workers and investigate the potential mediation effect of NAFL. METHODS: This study included all male workers from the baseline survey of a cohort of night shift workers. Information on demographics, lifestyle and lifetime working schedule was collected by face-to-face interview. Liver sonography was used to identify NAFL cases. Serum ALT level was detected by an automatic biochemical analyser. e-ALT was defined as ALT >40 U/L. Logistic regression models were used to evaluate ORs, and mediation analysis was employed to examine the mediation effect. RESULTS: Among 4740 male workers, 39.5% were night shift workers. Night shift workers had an increased risk of e-ALT (OR, 1.19, 95% CI 1.00 to 1.42). With the increase in night shift years, the OR of e-ALT increased from 1.03 (95% CI 0.77 to 1.36) to 1.60 (95% CI 1.08 to 2.39) among workers without NAFL. A similar trend was not found among workers with NAFL. In addition, no significant mediation effect of NAFL in the association between night shift work and e-ALT was found. CONCLUSIONS: Night shift work is positively associated with abnormal liver function, in particular among workers without NAFL. Shift work involving circadian disruption is likely to exert a direct effect on liver dysfunction rather than rely on the mediation effect of NAFL.

Near-Road Air Pollutant Measurements: Accounting for Inter-Site Variability Using Emission Factors.

A daily integrated emission factor (EF) method was applied to data from three near-road monitoring sites to identify variables that impact traffic related pollutant concentrations in the near-road environment. The sites were operated for 20 months in 2015-2017, with each site differing in terms of design, local meteorology, and fleet compositions. Measurement distance from the roadway and local meteorology were found to affect pollutant concentrations irrespective of background subtraction. However, using emission factors mostly accounted for the effects of dilution and dispersion, allowing intersite differences in emissions to be resolved. A multiple linear regression model that included predictor variables such as fraction of larger vehicles (>7.6 m in length; i.e., heavy-duty vehicles), vehicle speed, and ambient temperature accounted for intersite variability of the fleet average NO, NO x, and particle number EFs (R2:0.50-0.75), with lower model performance for CO and black carbon (BC) EFs (R2:0.28-0.46). NO x and BC EFs were affected more than CO and particle number EFs by the fraction of larger vehicles, which also resulted in measurable weekday/weekend differences. Pollutant EFs also varied with ambient temperature and because there were little seasonal changes in fleet composition, this was attributed to changes in fuel composition and/or post-tailpipe transformation of pollutants.

Association of Albuminuria and Estimated Glomerular Filtration Rate with Functional Performance Measures in Older Adults with Chronic Kidney Disease.

BACKGROUND: Chronic kidney disease (CKD) is increasingly common and disproportionately affects older adults. The contribution of kidney disease to the functional impairment noted in the elderly CKD population is unclear. METHODS: This is a cross-sectional analysis of a hypertensive cohort of people aged ≥75 years from the Systolic Blood Pressure Intervention Trial. We evaluated estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) as predictors of 3 measures of functional status: EuroQol-5 Dimensional (EQ-5D) score, Falls Efficacy Scale (FES) score, and gait speed. Linear regression models were used to evaluate the associations between our independent variables and outcome measures. RESULTS: Our analysis included 2,620 participants, mean age of 79.9 (4.0) years. Unadjusted models showed that lower eGFR level and higher UACR level were associated with lower EQ-5D (p < 0.001 for both) and slower gait speed (p < 0.001 for both) and worse scores on FES (p = 0.032 and p = 0.039). In the fully adjusted models, higher levels of UACR remained significantly associated with lower EQ-5D scores and slower gait speed (p = 0.011 and p = 0.002, respectively). In contrast, level of eGFR was not associated with any functional outcome measures when accounting for covariates. CONCLUSIONS: In individuals aged ≥75 years, albuminuria and eGFR were associated with impairments in physical performance and self-reported functional status; however, only the association with albuminuria remained after adjusting for relevant demographics and comorbidities. Evaluation of albuminuria may provide an additional tool for identifying older individuals at risk for functional impairment.

The Kingston Allergy Birth Cohort: Exploring parentally reported respiratory outcomes through the lens of the exposome.

BACKGROUND: The Kingston Allergy Birth Cohort (KABC) is a prenatally recruited cohort initiated to study the developmental origins of allergic disease. Kingston General Hospital was chosen for recruitment because it serves a population with notable diversity in environmental exposures relevant to the emerging concept of the exposome. OBJECTIVE: To establish a profile of the KABC using the exposome framework and examine parentally reported respiratory symptoms to 2 years of age. METHODS: Data on phase 1 of the cohort (n = 560 deliveries) were compiled, and multivariate Cox proportional hazards regression models were used to determine associations with respiratory symptoms. RESULTS: The KABC exhibits diversity within the 3 exposome domains of general external (socioeconomic status, rural or urban residence), specific external (cigarette smoke, breastfeeding, mold or dampness), and internal (respiratory health, gestational age), as well as significant associations between exposures from different domains. Significant associations emerged between parental reports of wheeze or cough without a cold and prenatal cigarette smoke exposure, mold or dampness in the home, and the use of air fresheners in the early-life home environment. Breastfeeding, older siblings, and increased gestational age were associated with decreased respiratory symptoms. CONCLUSION: The KABC is a unique cohort with diversity that can be leveraged for exposomics-based studies. This study found that all 3 domains of the exposome had effects on the respiratory health of KABC children. Ongoing studies using phase 1 of the KABC continue to explore the internal exposome through allergy skin testing and epigenetic analyses and the specific external domain through in-home environmental analyses, air pollution modeling, and ultimately potential convergences within and among domains.

Real-World Emission of Particles from Vehicles: Volatility and the Effects of Ambient Temperature.

A majority of the ultrafine particles observed in real-world conditions are systematically excluded from many measurements that help to guide regulation of vehicle emissions. To investigate the impact of this exclusion, coincident near-road particle number (PN) emission factors were quantified up- and downstream of a thermodenuder during two seasonal month-long campaigns with wide-ranging ambient temperatures (-19 to +30 °C) to determine the volatile fraction of particles. During colder temperatures (<0 °C), the volatile fraction of particles was 94%, but decreased to 85% during warmer periods (>20 °C). Additionally, mean PN emission factors were a factor of 3.8 higher during cold compared to warm periods. On the basis of 130 000 vehicle plumes including three additional campaigns, fleet mean emission factors were calculated for PN (8.5 × 1014 kg-fuel-1), black carbon (37 mg kg-fuel-1), organic aerosol (51 mg kg-fuel-1), and particle-bound polycyclic aromatic hydrocarbons (0.7 mg kg-fuel-1). These findings demonstrate that significant differences exist between particles in thermally treated vehicle exhaust as compared to in real-world vehicle plumes to which populations in near-road environments are actually exposed. Furthermore, the magnitude of these differences are dependent upon season and may be more extreme in colder climates.

Metro Commuter Exposures to Particulate Air Pollution and PM2.5-Associated Elements in Three Canadian Cities: The Urban Transportation Exposure Study.

System-representative commuter air pollution exposure data were collected for the metro systems of Toronto, Montreal, and Vancouver, Canada. Pollutants measured included PM2.5 (PM = particulate matter), PM10, ultrafine particles, black carbon, and the elemental composition of PM2.5. Sampling over three weeks was conducted in summer and winter for each city and covered each system on a daily basis. Mixed-effect linear regression models were used to identify system features related to particulate exposures. Ambient levels of PM2.5 and its elemental components were compared to those of the metro in each city. A microenvironmental exposure model was used to estimate the contribution of a 70 min metro commute to daily mean exposure to PM2.5 elemental and mass concentrations. Time spent in the metro was estimated to contribute the majority of daily exposure to several metallic elements of PM2.5 and 21.2%, 11.3% and 11.5% of daily PM2.5 exposure in Toronto, Montreal, and Vancouver, respectively. Findings suggest that particle air pollutant levels in Canadian metros are substantially impacted by the systems themselves, are highly enriched in steel-based elements, and can contribute a large portion of PM2.5 and its elemental components to a metro commuter's daily exposure.

Alcohol Consumption and Common Carotid Intima-Media Thickness: The USE-IMT Study.

AIMS: Epidemiological evidence indicates a protective effect of light to moderate alcohol consumption compared to non-drinking and heavy drinking. Although several mechanisms have been suggested, the effect of alcohol on atherosclerotic changes in vessel walls is unclear. Therefore, we explored the relationship between alcohol consumption and common carotid intima media thickness, a marker of early atherosclerosis in the general population. METHODS: Individual participant data from eight cohorts, involving 37,494 individuals from the USE-IMT collaboration were used. Multilevel age and sex adjusted linear regression models were applied to estimate mean differences in common carotid intima-media thickness (CIMT) with alcohol consumption. RESULTS: The mean age was 57.9 years (SD 8.6) and the mean CIMT was 0.75 mm (SD 0.177). About, 40.5% reported no alcohol consumed, and among those who drank, mean consumption was 13.3 g per day (SD 16.4). Those consuming no alcohol or a very small amount (<5 g per day) had significantly lower common CIMT values than those consuming >10 g per day, after adjusting for a range of confounding factors. CONCLUSION: In this large CIMT consortium, we did not find evidence to support a protective effect of alcohol on CIMT.

Fine Particulate Matter and Emergency Room Visits for Respiratory Illness. Effect Modification by Oxidative Potential.

RATIONALE: Fine particulate air pollution (PM2.5; particulate matter 2.5 µm or less in diameter) is thought to contribute to acute respiratory morbidity in part through oxidative stress. OBJECTIVES: To examine the association between PM2.5 oxidative burden and emergency room visits for respiratory illnesses. METHODS: We conducted a case-crossover study in Ontario, Canada between 2004 and 2011, including 127,836 cases of asthma, 298,751 cases of chronic obstructive pulmonary disease, and more than 1.1 million cases of all respiratory illnesses. Daily air pollution data were collected from ground monitors, and city-level PM2.5 oxidative potential was measured on the basis of a synthetic respiratory tract lining fluid containing the antioxidants glutathione and ascorbate. Conditional logistic regression was used to estimate associations between air pollution concentrations and emergency room visits, adjusting for time-varying covariates. MEASUREMENTS AND MAIN RESULTS: Three-day mean PM2.5 concentrations were consistently associated with emergency room visits for all respiratory illnesses. Among children (<9 yr), each interquartile change (5.92 µg/m(3)) in 3-day mean PM2.5 was associated with a 7.2% (95% confidence interval, 4.2-10) increased risk of emergency room visits for asthma. Glutathione-related oxidative potential modified the impact of PM2.5 on emergency room visits for respiratory illnesses (P = 0.001) but only at low concentrations (≤10 µg/m(3)). Between-city differences in ascorbate-related oxidative potential did not modify the impact of PM2.5 on respiratory outcomes. CONCLUSIONS: Between-city differences in glutathione-related oxidative potential may modify the impact of PM2.5 on acute respiratory illnesses at low PM2.5 concentrations. This may explain in part how small changes in ambient PM2.5 mass concentrations can contribute to acute respiratory morbidity in low-pollution environments.

Assessing the Climate Trade-Offs of Gasoline Direct Injection Engines.

Compared to port fuel injection (PFI) engine exhaust, gasoline direct injection (GDI) engine exhaust has higher emissions of black carbon (BC), a climate-warming pollutant. However, the relative increase in BC emissions and climate trade-offs of replacing PFI vehicles with more fuel efficient GDI vehicles remain uncertain. In this study, BC emissions from GDI and PFI vehicles were compiled and BC emissions scenarios were developed to evaluate the climate impact of GDI vehicles using global warming potential (GWP) and global temperature potential (GTP) metrics. From a 20 year time horizon GWP analysis, average fuel economy improvements ranging from 0.14 to 14% with GDI vehicles are required to offset BC-induced warming. For all but the lowest BC scenario, installing a gasoline particulate filter with an 80% BC removal efficiency and <1% fuel penalty is climate beneficial. From the GTP-based analysis, it was also determined that GDI vehicles are climate beneficial within <1-20 years; longer time horizons were associated with higher BC scenarios. The GDI BC emissions spanned 2 orders of magnitude and varied by ambient temperature, engine operation, and fuel composition. More work is needed to understand BC formation mechanisms in GDI engines to ensure that the climate impacts of this engine technology are minimal.