nitrogen-dioxide and Acute-Disease

Few studies have investigated the effects of air pollutants on children with acute bronchitis. This study aimed to explore the acute effects of four air pollutants [fine particulate matter (PM. The 49,975 records of hospitalized children with acute bronchitis from medical institutions in nine cities/prefectures, Sichuan Province, China, as well as the simultaneous meteorological data and air pollution data from 183 monitoring sites, were collected from 1 January 2017 to 31 December 2018. A generalized additive model was adopted to analyze the exposure-response and lag effects of hospitalizations of children with acute bronchitis to air pollutants. Stratified analyses were conducted based on sex, age, and season.. The single-pollutant model showed that a 10 µg/m. The higher daily average concentrations of four pollutants in Sichuan Province can result in an increased number of children hospitalized for acute bronchitis.

Topics: Acute Disease; Air Pollutants; Air Pollution; Bronchitis; Child; China; Cities; Hospitalization; Hospitals; Humans; Nitrogen Dioxide; Particulate Matter

We evaluated associations between air pollution (nitrogen dioxide [NO

Topics: Acute Disease; Air Pollutants; Air Pollution; Child, Preschool; Cross-Sectional Studies; Female; Humans; Indonesia; Infant; Infant Death; Infant, Low Birth Weight; Infant, Newborn; Logistic Models; Male; Nitrogen Dioxide; Odds Ratio; Perinatal Death; Respiratory Tract Infections; Sulfur Dioxide

Acute bronchitis (AB) is one of the principal causes of childhood morbidity. Increasing number of studies has shown that air pollution is an important environmental contributor of respiratory disease. However, evidence so far is scarce regarding the effects of air pollution on childhood AB, and it also remains unclear how the risk of AB will change by season and age.. Data on hospital visits for AB in children, air pollution and meteorological factors from 1 January 2015 to 31 December 2016 were collected in Hefei, China. Time-series analysis was applied to assess the short-term effects of traffic-related air pollution on childhood AB outpatient visits. A Poisson generalised linear regression model combined with a distributed lag non-linear model was used to estimate the relationships, controlling for long-term trends, seasonal patterns, meteorological factors and other possible confounders.. We found that an IQR increase in concentrations of nitrogen dioxide, particulate matter <2.5 µm and carbon monoxide significantly increased the daily hospital visits for childhood AB with 4-day cumulative effect estimates (relative risks: 1.03, 95% CI 1.01 to 1.05; 1.09, 95% CI 1.07 to 1.11; 1.07, 95% CI 1.05 to 1.09). Notably, the risk estimates during the cold season are pronounced; however, no significant association was observed during the warm season. Interestingly, children aged 6-14 years were more vulnerable to air pollutants than children aged less than 1 year and within 1-5 years. However, no gender difference was observed.. A significant association of traffic-related air pollution and increased department visits for childhood AB was observed, notably in school-age children and during the cold season.

Topics: Acute Disease; Air Pollutants; Air Pollution; Bronchitis; Carbon Monoxide; Child; China; Emergency Service, Hospital; Environmental Exposure; Female; Humans; Infant; Male; Motor Vehicles; Nitrogen Dioxide; Particulate Matter; Time Factors; Traffic-Related Pollution; Urban Population

We investigated seasonal variation of acute exacerbation of atrial fibrillation (AAF) and contributing environmental factors.. AAF events, meteorological elements, and air pollutants in Seoul between 2013 and 2015 were obtained from the nationwide database. AAF was defined if a patient visited the emergency room due to any AF-relevant symptoms or signs.. AAF occurred less frequently in summer than in other seasons (6.71 vs 7.25 events/d, P = 0.005). AAF tended to decrease with an increase of air temperature (r = -0.058). Among air pollutants, NO2 was significantly lower in summer and positively correlated with AAF after adjusting for other variables (β = 3.197).. The rate of AAF events was the lowest in summer; air temperature and NO2 were contributing factors. The weather and environmental conditions should be considered as risk factors of AAF.

Topics: Acute Disease; Adult; Aged; Air Pollutants; Atmospheric Pressure; Atrial Fibrillation; Disease Progression; Emergency Service, Hospital; Female; Humans; Humidity; Male; Middle Aged; Nitrogen Dioxide; Republic of Korea; Seasons; Temperature

The aim of the study was to investigate the unknown effect of air pollutants on the occurrence or deterioration of respiratory diseases in the area with a humid continental climate. This retrospective study included 5868 patients with respiratory symptomatology (upper respiratory tract infection (URTI), pneumonia, acute bronchitis, chronic obstructive pulmonary disease (COPD), and asthma) admitted to emergency department (ED). The number of patients, values of meteorological parameters (mean daily values of air temperature pressure and relative humidity) and concentrations of air pollution particles (≤10 μm (PM10), ozone (O3) and nitrogen dioxide (NO2)) were collected during a two-year ( July 2008 - June 2010) period. There were 1839 (31.3%), 1712 (29.2%), 1313 (22.4%), 614 (10.5%) and 390 (6.6%) patients with pneumonia, COPD, URTI, acute bronchitis and asthma, respectively. The mean daily concentrations of NO2 (25.9 (1.7-89.7) μg/m3), O3 (47.1 (4.7-135.4) μg/m3) and PM10 particles (25.7 (4.6-146.6) μg/m3) were below the legally defined thresholds. Among other results, the occurrence of respiratory diseases showed positive Spearman's correlation with the values of air humidity (days 0-3, r=0.15 to 0.19), PM10(days 0-3, r=0.10 to 0.13) and NO2 concentrations (day 0, r=0.11), and negative correlation with the values of air temperature (days 0-3, r=-0.36 to -0.34), pressure (day 0, r=-0.10) and O3 concentrations (days 0-3, r=-0.21 to -0.22) (p<0.05 all). In conclusion, the occurrence of respiratory diseases showed correlation with weather conditions and air pollutants despite the legally permitted values in the region with a humid continental climate.

Topics: Acute Disease; Adult; Aged; Air Pollutants; Air Pollution; Asthma; Bronchitis; Croatia; Emergency Service, Hospital; Hospitalization; Humans; Male; Maximum Allowable Concentration; Middle Aged; Nitrogen Dioxide; Ozone; Pulmonary Disease, Chronic Obstructive; Reference Standards; Respiratory Tract Diseases; Respiratory Tract Infections; Retrospective Studies

The air pollution in China is a severe problem. The aim of our study was to investigate the impact of air pollutants on acute respiratory outcomes in outpatients. Outpatient data from 2 December 2013 to 1 December 2014 were collected, as well as air pollutant data including ozone (O₃), nitrogen dioxide (NO₂), carbon monoxide (CO), sulfur dioxide (SO₂), and particulate matter (PM

Topics: Acute Disease; Air Pollutants; Air Pollution; Ambulatory Care; Asthma; Bronchitis; Carbon Monoxide; China; Cross-Over Studies; Female; Humans; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Pneumonia; Pulmonary Disease, Chronic Obstructive; Respiratory Tract Diseases; Respiratory Tract Infections; Sulfur Dioxide

While many studies have evaluated the association between acute childhood leukemia and environmental factors, knowledge is limited. Ambient air pollution has been classified as a Group 1 carcinogen, but studies have not established whether traffic-related air pollution is associated with leukemia. The goal of our study was to determine if children with acute leukemia had higher odds of exposure to traffic-related air pollution at birth compared to controls.. We conducted a case-control study using the Oklahoma Central Cancer Registry to identify cases of acute leukemia in children diagnosed before 20 years of age between 1997 and 2012 (n=307). Controls were selected from birth certificates and matched to cases on week of birth (n=1013). Using a novel satellite-based land-use regression model of nitrogen dioxide (NO2) and estimating road density based on the 2010 US Census, we evaluated the association between traffic-related air pollution and childhood leukemia using conditional logistic regression.. The odds of exposure to the fourth quartile of NO2 (11.19-19.89ppb) were similar in cases compared to controls after adjustment for maternal education (OR: 1.08, 95% CI: 0.75, 1.55). These estimates were stronger among children with acute myeloid leukemia (AML) than acute lymphoid leukemia, with a positive association observed among urban children with AML (4th quartile odds ratio: 5.25, 95% confidence interval: 1.09, 25.26). While we observed no significant association with road density, male cases had an elevated odds of exposure to roads at 500m from the birth residence compared to controls (OR: 1.39, 95% CI: 0.93, 2.10), which was slightly attenuated at 750m.. Although we observed no association overall between NO2 or road density, this was the first study to observe an elevated odds of exposure to NO2 among children with AML compared to controls suggesting further exploration of traffic-related air pollution and AML is warranted.

Topics: Acute Disease; Adolescent; Air Pollutants; Air Pollution; Case-Control Studies; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Leukemia; Logistic Models; Male; Motor Vehicles; Nitrogen Dioxide; Odds Ratio; Oklahoma; Vehicle Emissions; Young Adult

We investigated the association between indoor air pollutants and childhood acute leukemia (AL). A total of 105 newly diagnosed cases and 105 1:1 gender-, age-, and hospital-matched controls were included. Measurements of indoor pollutants (including nitrogen dioxide (NO2) and 17 types of volatile organic compounds (VOCs)) were taken with diffusive samplers for 64 pairs of cases and controls. Higher concentrations of NO2 and almost half of VOCs were observed in the cases than in the controls and were associated with the increased risk of childhood AL. The use of synthetic materials for wall decoration and furniture in bedroom was related to the risk of childhood AL. Renovating the house in the last 5 years, changing furniture in the last 5 years, closing the doors and windows overnight in the winter and/or summer, paternal smoking history and outdoor pollutants affected VOC concentrations. Our results support the association between childhood AL and indoor air pollution.

Topics: Acute Disease; Air Pollutants; Air Pollution, Indoor; Child; Child, Preschool; China; Environmental Exposure; Environmental Monitoring; Female; Humans; Leukemia; Male; Nitrogen Dioxide; Seasons; Volatile Organic Compounds

Upper and lower respiratory infections are common in early childhood and may be exacerbated by air pollution. We investigated short-term changes in ambient air pollutant concentrations, including speciated particulate matter less than 2.5 μm in diameter (PM2.5), in relation to emergency department (ED) visits for respiratory infections in young children. Daily counts of ED visits for bronchitis and bronchiolitis (n = 80,399), pneumonia (n = 63,359), and upper respiratory infection (URI) (n = 359,246) among children 0-4 years of age were collected from hospitals in the Atlanta, Georgia, area for the period 1993-2010. Daily pollutant measurements were combined across monitoring stations using population weighting. In Poisson generalized linear models, 3-day moving average concentrations of ozone, nitrogen dioxide, and the organic carbon fraction of particulate matter less than 2.5 μm in diameter (PM2.5) were associated with ED visits for pneumonia and URI. Ozone associations were strongest and were observed at low (cold-season) concentrations; a 1-interquartile range increase predicted a 4% increase (95% confidence interval: 2%, 6%) in visits for URI and an 8% increase (95% confidence interval: 4%, 13%) in visits for pneumonia. Rate ratios tended to be higher in the 1- to 4-year age group compared with infants. Results suggest that primary traffic pollutants, ozone, and the organic carbon fraction of PM2.5 exacerbate upper and lower respiratory infections in early life, and that the carbon fraction of PM2.5 is a particularly harmful component of the ambient particulate matter mixture.

Topics: Acute Disease; Air Pollution; Antimetabolites; Bronchiolitis; Bronchitis; Carbon Monoxide; Child, Preschool; Emergency Service, Hospital; Female; Georgia; Humans; Infant; Infant, Newborn; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Pneumonia; Respiratory Tract Infections; Retrospective Studies; Socioeconomic Factors; Time Factors

To investigate the short-term association between outdoor air pollution and outpatient visits for acute bronchitis, which is a rare subject of research in the mainland of China.. A time-series analysis was conducted to examine the association of outdoor air pollutants with hospital outpatient visits in Shanghai by using two-year daily data (2010-2011).. Outdoor air pollution was found to be associated with an increased risk of outpatient visits for acute bronchitis in Shanghai. The effect estimates of air pollutants varied with the lag structures of the concentrations of the pollutants. For lag06, a 10 μg/m(3) increase in the concentrations of PM10, SO(2), and NO(2) corresponded to 0.94% (95% CI: 0.83%, 1.05%), 11.12% (95% CI: 10.76%, 11.48%), and 4.84% (95% CI: 4.49%, 5.18%) increases in hospital visits for acute bronchitis, respectively. These associations appeared to be stronger in females (P<0.05). Between-age differences were significant for SO(2) (P<0.05), and between-season differences were also significant for SO(2) (P<0.05).. Our analyses have provided the first evidence that the current air pollution level in China has an effect on acute bronchitis and that the rationale for further limiting air pollution levels in Shanghai should be strengthened.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Air Pollutants; Ambulatory Care; Bronchitis; Child; Child, Preschool; China; Cities; Data Interpretation, Statistical; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Seasons; Sex Factors; Sulfur Dioxide; Young Adult

Even though air pollutants exposure is associated with changes in the ocular surface and tear film, its relationship to the clinical course of blepharitis, a common eyelid disease, had not yet been investigated. Our objective was to investigate the correlation between air pollution and acute manifestations of blepharitis.. We recorded all cases of changes in the eyelids and ocular surface, and rated clinical findings on a scale from zero (normal) to two (severe alterations). Daily values of carbon monoxide, particulate matter smaller than 10 μm in diameter and nitrogen dioxide concentrations and meteorological variables (temperature and relative humidity) in the vicinity of the medical service were obtained. Specific linear regression models for each outcome were constructed including pollutants as independent variables (single pollutant models). Temperature and humidity were included as confounding variables.. increases of 28.8 μg/m(3) in the concentration of particulate matter and 1.1 ppm in the concentration of CO were associated with increases in cases of blepharitis on the day of exposure (5 cases, 95% CI: 1-10 and 6 cases, 95% CI: 1-12, respectively).. Exposure to usual air pollutants concentrations present in large cities affects, in a consistent manner, the eyes of residents contributing to the increasing incidence of diseases of the eyelid margin.

Topics: Acute Disease; Air Pollutants; Air Pollution; Blepharitis; Brazil; Carbon Monoxide; Cities; Female; Humans; Linear Models; Male; Middle Aged; Nitrogen Dioxide; Particle Size; Particulate Matter; Severity of Illness Index; Urban Population

In January 2011, the New Hampshire Department of Health and Human Services (NHDHHS) investigated acute respiratory symptoms in a group of ice hockey players. The symptoms, which included cough, shortness of breath, hemoptysis, and chest pain or tightness, were consistent with exposure to nitrogen dioxide gas (NO), a byproduct of combustion. Environmental and epidemiologic investigations were begun to determine the source of the exposure and identify potentially exposed persons. This report summarizes the results of those investigations, which implicated a local indoor ice arena that had hosted two hockey practice sessions during a 24-hour period when the arena ventilation system was not functioning. A total of 43 exposed persons were interviewed, of whom 31 (72.1%) reported symptoms consistent with NO exposure. The highest attack rate was among the hockey players (87.9%). After repair of the ventilation system, no additional cases were identified. To prevent similar episodes, ice arena operators should ensure ventilation systems and alarms are operating properly and that levels of NO and carbon monoxide (CO) are monitored continuously for early detection of increased gas levels.

Topics: Acute Disease; Air Pollution, Indoor; Hockey; Humans; Inhalation Exposure; Male; New Hampshire; Nitrogen Dioxide; Respiratory Tract Diseases; Time Factors; Ventilation; Young Adult

Apart from the conventional risk factors, cerebro-cardiovascular disease (CVD) are also reported to be associated with air pollution, thus lowering the level of exposure might contribute in prevention activities to reduce the associated adverse outcomes. Though few studies conducted in Japan have reported on the CVD mortality but none have explored the effect of air pollutant exposure on the acute case-fatality of CVD. We investigated the effects of air pollution exposure on acute case-fatality of stroke and acute myocardial infarction (AMI) in a setting where pollutant levels are rather low.. We leveraged the data from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County located in central Japan. The study period of 6,210 days (16 years, leap years also taken into account) were divided into quartiles of daily average pollutant concentration; suspended particulate matter (SPM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)), and photochemical oxidants (Ox). The stroke and AMI events were categorized to corresponding quartiles based on the pollution levels of the onset day. To study the effects of air pollutants, we estimated the fatality rate ratio across quartiles of the pollutants where the lowest quartile served as the reference.. There were 307 (men: 153 and women: 154) fatal stroke cases within 28 days of onset among the 2,038 first ever stroke during 1988-2004. In the same period, there were 142 (men: 94 and women: 54) fatal AMI cases within 28 days of onset among the 429 first ever AMI events. The mean of the measured pollutant levels were as follows: SPM 26.9 µg/m(3), SO(2) 3.9 ppb, NO(2) 16.0 ppb, and Ox 28.4 ppb. Among the pollutants, higher levels of NO(2) showed increased fatality risk. In multi-pollutant model, the highest quartile of NO(2) was associated with 60% higher stroke case-fatality risk in comparison to lowest quartile of NO(2). In the fully adjusted model the fatality-rate ratio was 1.65 (95% CI 1.06-2.57). This association was more prominent among stroke subtype of cerebral infarction. Other pollutant levels did not show any association with stroke or AMI case-fatality.. We observed association between NO(2) levels, an index of traffic related air pollution, with the acute case-fatality of stroke, especially cerebral infarction in our study population. Further studies are needed in different regions to determine the association between ambient air pollutants and acute cardiovascular fatalities.

Topics: Acute Disease; Adult; Aged; Air Pollutants; Air Pollution; Cerebral Hemorrhage; Cerebral Infarction; Female; Humans; Japan; Male; Middle Aged; Models, Biological; Myocardial Infarction; Nitrogen Dioxide; Oxidants, Photochemical; Particulate Matter; Registries; Stroke; Subarachnoid Hemorrhage; Sulfur Dioxide; Vehicle Emissions

The direct and accurate estimation of nitric dioxide levels is an extremely laborious and technically demanding procedure in the molecular diagnostics of inflammatory processes. The aim of this work is to demonstrate that a stop-flow technique utilizing a specific spectroscopic biosensor can be used for detection of nanomolar quantities of NO(2) in biological milieu. The use of novel compound cis-[Cr(C(2)O(4))(AaraNH(2))(OH(2))(2)](+) increases NO(2) estimation accuracy by slowing down the rate of NO(2) uptake. In this study, an animal model of pancreatitis, where nitrosative stress is induced by either 3g/kg bw or 1.5 g/kg bw dose of L-arginine, was used. Biochemical parameters and morphological characteristics of acute pancreatitis were monitored, specifically assessing pancreatic acinar cell death mode, NO(2) generation and cellular glutathione level. The severity of the process correlated positively with NO(2) levels in pancreatic acinar cell cytosol samples, and negatively with cellular glutathione levels.

Topics: Acute Disease; Animals; Apoptosis; Biosensing Techniques; Equipment Design; Equipment Failure Analysis; Flow Injection Analysis; Male; Necrosis; Nitrogen Dioxide; Pancreatitis; Rats; Rats, Wistar

Urban air pollution has been associated with morbidity but little information exists on how it affects diurnal variation of lung function in children with asthma. The purpose of this study was to investigate the acute effects of traffic-related pollution on lung function among children with asthma. We recorded morning and evening forced expiratory volume in 1 s (FEV(1)) for 28 consecutive days in 182 elementary schoolchildren with physician-diagnosed asthma, and monitored ambient hourly air pollution concentrations. An interquartile range (IQR) increase (6.0 microg m(-3)) in the previous 24-h (20:00 h to 20:00 h) mean concentration of fine particulate matter 2.5 microm in diameter (PM(2.5)) was associated with a 0.54% (95% confidence interval (CI) 0.06-1.02) decrease in bedtime FEV(1) (p = 0.027). This association persisted in two-pollutant models with ozone, nitrogen dioxide and sulphur dioxide. An IQR increase in mean daytime (08:00 h to 20:00 h) PM(2.5) of 6.5 microg m(-3) was associated with a 0.73% (95% CI 0.10-1.37) decrease in FEV(1) over the course of the day expressed as 100 x (FEV(1) bedtime - FEV(1) morning)/FEV(1) morning (p = 0.024). This study suggests that, in children with asthma, relatively low concentrations of urban air pollution worsen lung function over a short period of time, even within a day. Of the pollutants measured, PM(2.5 )appears to be the most important.

Topics: Acute Disease; Adolescent; Air Pollutants; Air Pollution; Asthma; Child; Cities; Female; Forced Expiratory Volume; Humans; Inhalation Exposure; Longitudinal Studies; Male; Nitrogen Dioxide; Ozone; Sulfur Dioxide

The individual effect of functional single nucleotide polymorphisms within the catalase and myeloperoxidase genes (CAT and MPO) has been studied in relation to asthma; however, their interrelationship with ambient air pollution exposures has yet to be determined. The authors investigated the interrelationships between variants in CAT and MPO, ambient air pollutants, and acute respiratory illness. Health information, air pollution, and incident respiratory-related school absences were ascertained in January-June 1996 for 1,136 Hispanic and non-Hispanic white US elementary schoolchildren as part of the prospective Children's Health Study. Functional and tagging single nucleotide polymorphisms for the CAT and MPO loci were genotyped. The authors found epistasis between functional polymorphisms in the CAT/MPO loci, which differed by levels of oxidant-stress-producing air pollutants. Risk of respiratory-related school absences was elevated for children with the CAT (G/G) and MPO (G/A or A/A) genes (relative risk = 1.35, 95% confidence interval: 1.03, 1.77; P-interaction = 0.005). The epistatic effect of CAT and MPO variants was most evident in communities exhibiting high ambient ozone levels (P-interaction = 0.03). The association of respiratory-illness absences with functional variants in CAT and MPO that differ by air pollution levels illustrates the need to consider genetic epistasis in assessing gene-environment interactions.

Topics: Absenteeism; Acute Disease; Air Pollutants; Catalase; Child; Epistasis, Genetic; Genetic Predisposition to Disease; Hispanic or Latino; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Peroxidase; Polymorphism, Single Nucleotide; Prospective Studies; Respiratory Tract Diseases; Schools; White People

To explore the relationship between air pollution and acute onset of cerebral hemorrhage in Hangzhou.. Time-stratified case-crossover study was used to analyze the effect of aerosol optical depth (AOD), PM(10), SO(2) and NO(2) on the acute onset of cerebral hemorrhage. Conditional logistic regression was used to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs) in relation to an increase of one unit of AOD and 10 microg/m(3) of air pollutants.. After adjusted temperature and relative humidity, the ORs of acute onset of cerebral hemorrhage by a unit increase in AOD at a 2 day-lag were 1.727 (95%CI: 1.103 - 2.703) in first half year and 2.412 (95%CI: 1.230 - 4.733) at a 2 day-lag in spring. For a 10 microg/m(3) increase in SO(2), the ORs were 1.119 (95%CI: 1.019 - 1.229), 1.230 (95%CI: 1.092 - 1.386), 1.254 (95%CI: 1.076 - 1.460) in the whole year (2 day-lag), in first half year (2 day-lag) and in spring (2 day-lag), respectively. NO(2) exposure in first half year (2 day-lag) was associated with cerebral hemorrhage, with OR as 0.841 (95%CI: 0.734 - 0.964). However, there were no statistical significances for AOD, SO(2), NO(2) in the rest time-periods (P > 0.05). Additionally, no association was found between PM(10) and the acute onset of cerebral hemorrhage in any time-periods (P > 0.05).. Our data showed that there was association between air pollution and the acute onset of cerebral hemorrhage, especially in spring and in the first half of the year.

Topics: Acute Disease; Aerosols; Air Pollutants; Air Pollution; Cerebral Hemorrhage; China; Confidence Intervals; Humans; Logistic Models; Nitrogen Dioxide; Odds Ratio; Particulate Matter; Sulfur Dioxide; Time Factors

The clinical severity of sickle-cell disease (SCD) is dependent on genetic and environmental variables. Environmental factors have been poorly studied. We have investigated possible links between air pollution and acute pain in SCD. We retrospectively studied the numbers of daily admissions with acute sickle-cell pain to King's College Hospital, London, in relation to local daily air quality measurements. We analysed 1047 admissions over 1400 d (1st January 1998-31st October 2001). Time series analysis was performed using the cross-correlation function (CCF). CCF showed a significant association between increased numbers of admissions and low levels of nitric oxide (NO), low levels of carbon monoxide (CO) and high levels of ozone (O(3)). There was no association with sulphur dioxide (SO(2)), nitrogen dioxide or PM(10) (dust). The significant results were further examined using quartile analysis. This confirmed that high levels of O(3) and low levels of CO were associated with increased numbers of hospital admissions. Low NO levels were also associated with increased admissions but did not reach statistical significance on quartile analysis. Our study suggests air quality has a significant effect on acute pain in SCD and that patients should be counselled accordingly. The potential beneficial effect of CO and NO is intriguing and requires further investigation.

Topics: Acute Disease; Adult; Air Pollutants; Air Pollution; Analysis of Variance; Anemia, Sickle Cell; Carbon Monoxide; Child; Cities; Dust; Environmental Exposure; Hospitalization; Humans; London; Nitric Oxide; Nitrogen Dioxide; Ozone; Pain; Retrospective Studies; Sulfur Dioxide; Weather

To evaluate the association between air pollutants and the occurrence of acute stroke from 10-year population-based study.. The daily stroke count was obtained from Dijon Stroke Register between March 1994 and December 2004. The register recorded all first-ever strokes among residents of Dijon (150,000 inhabitants) in France, using standard diagnostic criteria. Pollutant concentrations (SO2, CO, NO2, O3 and PM10) were measured hourly. A bi-directional case-crossover design was used to examine the association between air pollutant and stroke onset. The conditional logistic regression model included the meteorological parameters (temperature, relative humidity), influenza epidemics and holidays.. The authors collected 493 large artery infarcts, 397 small artery infarcts, 530 cardio-embolic infarcts, 67 undeterminate infarcts, 371 transient ischaemic attacks and 220 haemorrhagic strokes. For single-pollutant model and for a 10 mg/m(3) increase of O3 exposure, a positive association was observed only in men, over 40 years of age, between ischaemic stroke occurrence and O3 levels with 1-day lag, (OR 1.133, 95% CI 1.052 to 1.220) and 0-day lag (OR 1.058, 95% CI 0.987 to 1.134). No significant associations were found for haemorrhagic stroke. In two-pollutant models, the effects of O3 remained significant after each of the other pollutants were included in the model, in particular with PM10. A significant association was observed for ischaemic strokes of large arteries (p = 0.02) and for transient ischaemic attacks (p = 0.01). Moreover, the authors found an exposure-response relations between O3 exposure and ischaemic stroke (test for trend, p = 0.01). An increase in association in men with several cardiovascular risk factors (smoker, dyslipidemia and hypertension) was also observed.. These observational data argue for an association between ischaemic stroke occurrence and O3 pollution levels; these results still need to be confirmed by other studies.

Topics: Acute Disease; Adult; Age Factors; Aged; Air Pollutants; Arteries; Carbon Monoxide; Climate; Epidemiologic Methods; Female; France; Holidays; Humans; Ischemic Attack, Transient; Male; Middle Aged; Nitrogen Dioxide; Ozone; Registries; Sex Factors; Stroke; Sulfur Dioxide

Respiratory Diseases are public health concern worldwide. The diseases have been associated with air pollution especially indoor air pollution from biomass fuel burning in developing countries. However, researches on pollution levels and on association of respiratory diseases with biomass fuel pollution are limited. A study was therefore undertaken to characterize the levels of pollutants in biomass fuel using homes and examine the association between biomass fuel smoke exposure and Acute Respiratory Infection (ARI) disease in Nianjema village in Bagamoyo, Tanzania. Pollution was assessed by measuring PM10, NO2, and CO concentrations in kitchen, living room and outdoors. ARI prevalence was assessed by use of questionnaire which gathered health information for all family members under the study. Results showed that PM10, NO2, and CO concentrations were highest in the kitchen and lowest outdoors. Kitchen concentrations were highest in the kitchen located in the living room for all pollutants except CO. Family size didn't have effect on the levels measured in kitchens. Overall ARI prevalence for cooks and children under age 5 making up the exposed group was 54.67% with odds ratio (OR) of 5.5; 95% CI 3.6 to 8.5 when compared with unexposed men and non-regular women cooks. Results of this study suggest an association between respiratory diseases and exposure to domestic biomass fuel smoke, but further studies with improved design are needed to confirm the association.

Topics: Acute Disease; Air Pollution, Indoor; Biomass; Carbon Monoxide; Cooking; Environmental Monitoring; Epidemiological Monitoring; Family Characteristics; Fossil Fuels; Housing; Humans; Inhalation Exposure; Nitrogen Dioxide; Particulate Matter; Prevalence; Quality Control; Respiratory Tract Diseases; Tanzania

During inspiration the lung is exposed to numerous oxidants and therefore has developed a system of antioxidant defense. This organ, besides the liver, is the major source of glutathione (GSH) metabolism, from which type II pneumocytes are metabolically the most active cells.. To analyze oxidative stress, rats were exposed to air (control) or to 10 ppm nitrogen dioxide (NO2) for 3 and 20 days to induce acute and chronic lung injury. As measure of oxidative stress, GSH/GSSG ratios in blood, bronchoalveolar lavage (BAL) and type II pneumocytes were determined. Lipid peroxidation (LPO) was also measured in type II cells. To investigate the basis of these observations, GSH metabolism in type II pneumocytes was studied, analyzing mRNA expression of gamma-glutamyl-cysteine synthetase (gamma-GCS), glutathione synthetase (GS), gamma-glutamyltranspeptidase (gamma-GT), glutathione peroxidases (GPXs) and glutathione reductase (GR). Furthermore, enzyme activities of GPX and GR were determined.. In acute and chronic lung injury the GSH/GSSG ratio was reduced in blood and BAL, but there was no change in type II pneumocytes. LPO in type II cells was only reduced in acute lung injury. In both kinds of lung injury mRNA expression of gamma-GCS, GS and GPX3 decreased, while expression of gamma-GT and GR increased. GPX4 mRNA expression decreased in acute lung injury and increased in the chronic state. Enzyme activity of GPX and GR was generally increased in lung injury.. In NO2 induced acute and chronic lung injury, GSH metabolism is imbalanced.

Topics: Acute Disease; Animals; Chronic Disease; Enzymes; Glutathione; Glutathione Peroxidase; Lung; Lung Injury; Nitrogen Dioxide; Oxidation-Reduction; Oxidative Stress; Rats; RNA, Messenger

A study of indoor air exposures and acute respiratory effects in adults was conducted in the Po Delta (rural) and Pisa (urban) areas of Italy. Indoor exposures were monitored for nitrogen dioxide (NO(2)) and particulate matter <2.5 microm (PM(2.5)) for 1 week during the winter or summer in a total of 421 houses (2/3 in Pisa). Information on house characteristics, subjects' daily activity pattern and presence of acute respiratory symptoms was collected by a standardized questionnaire. Peak expiratory flow (PEF) maneuvers were performed by adult subjects four times daily; maximum amplitude and diurnal variation were taken into account. Indices of NO(2) and PM(2.5) exposures were computed as the product of weekly mean pollutant concentration by the time of daily exposure. Mean levels of pollutants were significantly higher in winter than in summer, regardless of the area. The relationship between exposure indices and acute respiratory symptoms was investigated only in winter. In spite of a slightly lower indoor level in the urban than in the rural area in winter (NO(2): 15 vs. 22 ppb; PM(2.5): 67 vs. 76 microg/m(3)), prevalence rates of acute respiratory symptoms were significantly higher in the urban than in the rural area. Acute respiratory illnesses with fever were significantly associated with indices of NO(2) (odds ratio (OR)=1.66; 95% CI=1.08-2.57) and PM(2.5) exposures (OR=1.62; 95% CI=1.04-2.51), while bronchitic/asthmatic symptoms were associated only with PM(2.5) (OR=1.39; 95% CI=1.17-1.66). PEF variability was positively related only to PM(2.5) exposure index (OR=1.38; 95% CI=1.24-1.54, for maximum amplitude; OR=1.37; 95% CI=1.23-1.53, for diurnal variation). In conclusion, indoor pollution exposures were associated with the presence of acute respiratory symptoms and mild lung function impairment in a rural and an urban area of Northern-Central Italy.

Topics: Activities of Daily Living; Acute Disease; Adult; Air Pollution, Indoor; Environmental Exposure; Epidemiologic Studies; Female; Humans; Italy; Male; Middle Aged; Nitrogen Dioxide; Oxidants, Photochemical; Respiratory Function Tests; Respiratory Tract Diseases; Rural Population; Seasons; Urban Population

The aim of this study was to estimate the associations between seven ambient air pollutants [particulate matter (PM10), nitrous dioxide (NO2), sulfur dioxide (SO2), ozone (O3), benzene, formaldehyde and toluene] and acute hospital admissions for respiratory diseases in Drammen, Norway 1995-2000. Time-series analysis of counts was performed by means of generalized additive models with log link and Poisson distribution. The results showed that benzene was the pollutant having the strongest association with respiratory diseases for the total study period, the relative risk of an interquartile increase of benzene was 1.095 with 95% confidence interval: 1.031-1.163. The corresponding results were 1.049 (0.990-1.112) for formaldehyde, 1.044 (1.000-1.090) for toluene, 1.064 (1.019-1.111) for NO2, 1.043 (1.011-1.075) for SO2, 0.990 (0.936-1.049) for O3 and 1.022 (0.990-1.055) for PM10. Dividing the total study period into two 3-year periods, there was a substantial reduction in the exposure levels of the volatile organic compounds (benzene, formaldehyde and toluene) from the first to the second period. Separate analyses for the second time period showed weaker association between these pollutants and the health outcome. This study provides further evidence for short-term respiratory health effects of traffic related air pollution.

Topics: Acute Disease; Benzene; Environmental Exposure; Formaldehyde; Humans; Humidity; Models, Statistical; Nitrogen Dioxide; Norway; Ozone; Patient Admission; Poisson Distribution; Population Surveillance; Registries; Respiratory Tract Diseases; Risk Factors; Sulfur Dioxide; Temperature; Toluene; Vehicle Emissions; Weather

Many time-series studies have shown positive associations between air pollutants and asthma morbidity. However, few studies have included pollen as a potential confounder when examining this relationship. This study analysed the short-term association between air pollutants (sulphur dioxide (SO2), particles measured with a median aerodynamic diameter of <10 microm (PM10), nitrogen dioxide (NO2) and ozone (O3)) and asthma emergency room admissions in Madrid, Spain, in 1995-1998, adjusting for four types of pollen with allergenic potential (Olea europaea, Plantago sp., Poaceae and Urticaceae). Data were analysed using autoregressive Poisson regression and generalised additive models (GAM). The strongest associations were observed at 1 day lag for O3, and 3 days lag for the remaining pollutants. Using Poisson regression, a single-pollutant model showed that a 10-microg x m(-3) rise in pollutant level led to relative risks of: 1.039 for PM10; 1.029 for SO2; 1.033 for NO2; and 1.045 for O3. Adjustment for the different types of pollen led to no substantial variation in these associations. In the multipollutant models for cold-season pollutants (including PM10, SO2 and the four types of pollen) and photochemical pollutants (including NO2, O3 and the four types of pollen) the associations for PM10, NO2 and O3 held, but no relationship with SO2 was evident. GAM analysis yielded the same results, both in terms of lags and of quantification of the effect for all pollutants. In conclusion, the usual air pollution levels in Madrid were associated with an increase in asthma emergency room admissions, and this association remained controlling for the presence of ambient pollen.

Topics: Acute Disease; Adolescent; Air Pollutants; Air Pollution; Allergens; Asthma; Child; Child, Preschool; Emergency Service, Hospital; Female; Humans; Infant; Male; Nitrogen Dioxide; Ozone; Pollen; Risk Factors; Sulfur Dioxide

Topics: Accidents, Occupational; Acute Disease; Humans; Japan; Male; Middle Aged; Nitrogen Dioxide; Poisoning; Pulmonary Fibrosis

Two time-series studies, aimed at evaluating the acute health effect of air pollution among Rome inhabitants, were carried out. In the first study the correlation between daily mortality (1992 to 1995) and daily concentrations of five air pollutants (particles, SO2, NO2, CO, O3) was analyzed. In the second study the association between daily levels of the same pollutants and hospital admissions for respiratory and cardiovascular disease (1995-97) was evaluated. Poisson regression models were used to estimate the association between pollutant levels and health effect variables; the models included smooth functions of day of study, mean temperature, mean humidity and indicator variables for day of the week and holidays. Daily total mortality was associated with particle average concentration on that day and with NO2 levels of one or two days before. Hospital admissions for cardiovascular disease were positively correlated to particles, SO2, NO2, e CO. Hospital admissions for respiratory disease were associated with NO2 and CO levels of the same day and of two days before among children (0-14 years) and among adults (15-64 years). Increments of ozone were associated with increments of total respiratory and of acute respiratory diseases in children (0-14 years).

Topics: Acute Disease; Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Carbon Monoxide; Cardiovascular Diseases; Child; Child, Preschool; Hospitalization; Humans; Infant, Newborn; Meteorological Concepts; Middle Aged; Mortality; Nitrogen Dioxide; Ozone; Regression Analysis; Respiration Disorders; Rome; Sulfur Dioxide

Air-pollution levels have been shown to be associated with increased morbidity of respiratory diseases.. Data for ambient air-pollutant levels, meteorologic factors, and hospitalization or emergency room (ER) visits for acute asthma in Singapore children over a 5-year period (1990-4) were obtained and analyzed for associations by time-series methods.. Throughout this period, the annual mean and 24-h mean levels for sulfur dioxide (SO2), nitrogen dioxide (NO2), and total suspended particles (TSP) and maximum 1-h daily average for ozone were generally within the air-quality guidelines established by the World Health Organization (WHO). However, positive correlation between levels of each of these pollutants and daily ER visits for asthma was observed in children aged 3-12 years, but not among adolescents and young adults (13-21 years old). The association with SO2 and TSP persisted after standardization for meteorologic and temporal variables. An adjusted increase in 2.9 ER visits for every 20 microg/m3 increase in atmospheric SO2 levels, lagged by 1 day, was observed on days when levels were above 68 microg/m3. With TSP, an adjusted increase of 5.80 ER visits for every 20 microg/m3 increase in its daily atmospheric levels, lagged by 1 day, was observed on days with levels above 73 microg/m3. Similar results were also obtained after controlling for autocorrelation by time-series analysis.. These associations were observed even though the overall levels of all pollutants were generally within the air-quality guidelines established by the WHO. These findings suggest that asthmatic children are susceptible to increased levels of air pollutants, particularly SO2 and TSP, although the ambient levels are generally within "acceptable" ranges.

Topics: Acute Disease; Adolescent; Adult; Air Pollutants; Air Pollution; Asthma; Child; Child, Preschool; Emergency Service, Hospital; Hospitalization; Humans; Meteorological Concepts; Nitrogen Dioxide; Ozone; Singapore; Sulfur Dioxide

This study aimed to investigate the association between daily air pollution levels and the occurrence of acute respiratory signs and symptoms among people with asthma or asthma-like problems. Thirty eight subjects in the southern Swedish city of Landskrona kept a daily diary for 10 weeks. The daily prevalence of symptoms, supplementary bronchodilator use and peak flow deviations were compared with measurements of environmental nitrogen dioxide (NO2), sulphur dioxide, temperature and humidity in the city. The occurrence of severe asthma, both during the day and during the evening, was significantly positively associated with the concurrent 24 h average concentration of NO2, which never exceeded 72 microg x m(-3). A correlation of borderline significance was found between the use of on-demand medication and the NO2 level. However, peak flow deviations were not associated with air pollution or weather conditions, which may be explained by the beneficial effect of bronchodilators used by 28 of the subjects. The results of this study confirm those of some earlier studies and suggest that aggravation of asthma is related to daily variations in air quality, as indicated by relatively low ambient concentrations of nitrogen dioxide. These results also indicate that it may be appropriate to examine severe asthma symptoms separately.

Topics: Acute Disease; Air Pollutants; Asthma; Environmental Monitoring; Epidemiological Monitoring; Female; Health Surveys; Humans; Incidence; Linear Models; Male; Nitrogen Dioxide; Respiratory Function Tests; Risk Factors; Sampling Studies; Sulfur Dioxide; Sweden; Urban Population

Bronchial hyperresponsiveness (BHR) and peak expiratory flow (PEF) variability are associated expressions of airway lability, yet probably reflect different underlying pathophysiologic mechanisms. We investigated whether both measures can be used interchangeably to identify subjects who are susceptible to ambient air pollution. Data on BHR (>= 20% fall in FEV1), PEF variability (ampl%mean PEF > 5% on any day during an 8-d period with low air pollution levels) and diary data on upper and lower respiratory symptoms, cough, and phlegm were collected in 189 subjects (48-73 yr). The acute effects (lag0) of particulate matter with a diameter less than 10 micrometers (PM10), black smoke, SO2 and NO2 on the prevalence of symptoms were estimated with logistic regression. In subjects with airway lability, both when expressed as PEF variability (69%) and BHR (28%), the prevalence of symptoms increased significantly with increasing levels of air pollution, especially in those with the greater PEF variability (n = 55, 29%). We found no such consistent positive associations in adults without airway lability. PEF variability, and to a smaller extent BHR, can be used to identify adults who are susceptible to air pollution. Though odds ratios were rather low (ranging from 1.13 to 1.41), the impact on public health can be substantial because it applies to large populations.

Topics: Acute Disease; Adult; Air Pollutants; Air Pollution; Bronchial Hyperreactivity; Cough; Disease Susceptibility; Female; Forced Expiratory Volume; Humans; Logistic Models; Male; Middle Aged; Nitrogen Dioxide; Odds Ratio; Particle Size; Peak Expiratory Flow Rate; Prevalence; Public Health; Respiratory Tract Diseases; Rural Health; Smoke; Sputum; Sulfur Dioxide; Urban Health

To study the association of the daily frequency of registration of patients with acute asthma at the emergency department of a central hospital in the south-west of Sweden with levels of air pollution and meteorological observations.. A retrospective longitudinal study was made of asthma patients taken from a hospital registry. This information was correlated with measurements of ozone, nitrogen dioxide, sulphur dioxide, toluene, temperature and relative humidity. Patients were from the catchment area of the Central Hospital of Halmstad containing around 120,000 inhabitants. A total of 4127 visits of patients with acute asthma to the emergency department at the Central Hospital of Halmstad were registered during a period of 1247 days from January 1990 to May 1993. The differential optical absorption spectroscopy (DOAS) technique was used to monitor levels of air pollutants over a distance of 1000 m in the central part of the town of Halmstad. Data on temperature, relative humidity, precipitation, wind speed and wind direction for the time period were supplied by the Swedish Meteorological and Hydrological Institute (SMHI).. There were many statistically significant correlations between the levels of air pollutants and the meteorological measurements and a strong negative correlation between ozone and nitrogen dioxide. There was a statistically significant effect on asthma visits in children of low temperature and high nitrogen dioxide levels, and on asthma visits in adults of high temperature and high levels of ozone.. There was a different reaction pattern in children and adults with asthma regarding temperature and ozone/nitrogen dioxide. The strong correlations between temperature and air pollution and between the levels of ozone and nitrogen dioxide made the true relation between asthma, air pollution and temperature hard to evaluate statistically.

Topics: Acute Disease; Adolescent; Adult; Air; Air Pollutants; Asthma; Child; Child, Preschool; Humans; Longitudinal Studies; Middle Aged; Nitrogen Dioxide; Ozone; Retrospective Studies; Sweden; Weather

To examine the association between the air pollutants ozone, sulphur dioxide, and nitrogen dioxide and the incidence of acute childhood wheezy episodes.. Prospective observational study over one year.. District general hospital.. 1025 children attending the accident and emergency department with acute wheezy episodes; 4285 children with other conditions as the control group.. Daily incidence of acute wheezy episodes.. After seasonal adjustment, day to day variations in daily average concentrations of ozone and sulphur dioxide were found to have significant associations with the incidence of acute wheezy episodes. The strongest association was with ozone, for which a non-linear U shaped relation was seen. In terms of the incidence rate ratio (1 at a mean 24 hour ozone concentration of 40 microg/m3 (SD=19.1)), children were more likely to attend when the concentration was two standard deviations below the mean (incidence rate ratio=3.01; 95% confidence interval 2.17 to 4.18) or two standard deviations above the mean (1.34; 1.09 to 1.66). Sulphur dioxide had a weaker log-linear relation with incidence (1.12; 1.05 to 1.19 for each standard deviation (14.1) increase in sulphur dioxide concentration). Further adjustment for temperature and wind speed did not significantly alter these associations.. Independent of season, temperature, and wind speed, fluctuations in concentrations of atmospheric ozone and sulphur dioxide are strongly associated with patterns of attendance at accident and emergency departments for acute childhood wheezy episodes. A critical ozone concentration seems to exist in the atmosphere above or below which children are more likely to develop symptoms.

Topics: Acute Disease; Adolescent; Air Pollutants; Child; Child, Preschool; Emergency Service, Hospital; England; Humans; Incidence; Infant; Infant, Newborn; Nitrogen Dioxide; Ozone; Patient Acceptance of Health Care; Prospective Studies; Respiratory Sounds; Seasons; Sulfur Dioxide

To investigate whether air pollution levels in London have short term effects on hospital admissions for respiratory disease.. Poisson regression analysis of daily counts of hospital admissions, adjusting for effects of trend, seasonal and other cyclical factors, day of the week, holidays, influenza epidemic, temperature, humidity, and autocorrelation. Pollution variables were particulates (black smoke: BS), sulphur dioxide (SO2), ozone (O3), and nitrogen dioxide (NO2), lagged 0-3 days.. All immediate admissions for respiratory disease (ICD 460-519) to hospitals in London health districts in the five years April 1987 to February 1992 for all ages and the 0-14, 15-64, and 65+ age groups.. O3 (lagged one day) was significantly associated with an increase in daily admissions among all age groups, except the 0-14 group, and this effect was stronger in the "warm" season (April-September). In this season, the relative risks of admission associated with an increase in 8 hour O3 levels of 29 ppb (10th to 90th centile) were 1.0483 (95% CI 1.0246, 1.0726), 1.0294 (0.9930,1.0672), 1.0751 (1.0354,1.1163), and 1.0616 (1.0243,1.1003) for all ages and age groups 0-14, 15-64, and 65+ respectively. Very few significant associations were observed with the other pollutants, though these tended to be positive. Controlling for other pollutants made little difference to the O3 coefficients. There was evidence of a threshold at about 40-60 ppb O3 (maximum hourly or maximum 8 hour).. O3 levels in London have a small but significant effect on hospital admissions for respiratory disease at all ages. The possible role of aerollergen as a confounding factor needs to be examined. Unlike other cities where similar effects have been reported, little or no effect of particulates was observed in London.

Topics: Acute Disease; Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Child; Child, Preschool; Emergencies; Hospitalization; Humans; Infant; Infant, Newborn; London; Middle Aged; Nitrogen Dioxide; Odds Ratio; Ozone; Regression Analysis; Respiration Disorders; Seasons; Smoke; Sulfur Dioxide

A study was undertaken to determine the relationship between hospital admissions for asthma and all respiratory conditions in electoral wards in the West Midlands and ambient levels of smoke, sulphur dioxide, and nitrogen dioxide, and to establish whether the relationship is independent of social deprivation and ethnicity, and is different for young children and older individuals.. Data on hospital admissions for acute respiratory conditions were obtained by electoral ward from the West Midlands Regional Health Authority Information Department Körner inpatient data including asthma (ICD 493) and all acute respiratory disease (466, 480-486, 490-496) for the period April 1988 to March 1990. The population for each electoral ward, percentage of ward population that was from non-white ethnic groups, and Townsend deprivation score were all calculated from 1991 census information. Data on smoke and sulphur dioxide (SO2) levels were obtained for 24 wards in Birmingham, Coventry, Wolverhampton, Dudley, Stafford, and Burton-on-Trent, and on nitrogen dioxide (NO2) levels from 39 wards in the same local authority areas. All were background urban sites and most participated in the Warren Spring national quality control programme for SO2 and smoke monitoring. Indirect age-sex standardised hospitalisation rates (SHR) for all respiratory conditions and asthma were calculated using the 1991 rates for the West Midlands RHA as the standard. Multivariate regression models were used to assess the relationship between individual pollutants and the SHR. The Townsend score and percentage of the population from non-white ethnic groups were included in all models to adjust for ethnicity and socioeconomic deprivation.. The SHR for asthma varied almost fourfold across the region, and all respiratory SHR showed more than three fold variation. Bivariate regression revealed both Townsend score and percentage of non-white individuals to be associated with SHR for asthma and all respiratory conditions at all ages, but not for children under 5 years. NO2 was associated with hospital admission rates for all ages including children under 5. SO2 and smoke were not associated with hospital admissions. Multivariate analysis including Townsend score and percentage of non-white subjects in the model revealed that NO2 was associated with hospital admission rates for all respiratory conditions only for children under 5. The Townsend score was associated with SHR for all respiratory conditions, and both the Townsend score and percentage of non-white subjects were associated with SHR for asthma in children under 5 in two of three models. The association between SHR for asthma and percentage of non-white subjects was negative.. Socioeconomic deprivation, as measured by the Townsend score, is a significant predictor of hospital admission rates for respiratory disease in older individuals, and both the percentage of non-white subjects and the Townsend score are significant predictors of hospital admission rates for asthma in children. After correction for socioeconomic deprivation and ethnicity, background urban NO2 levels in the ward of residence are significantly associated with standardised hospital admission rates for all respiratory disease in children under 5. This may represent a causal effect of NO2 on the respiratory health of children, or the effect of confounding factors not corrected by use of the Townsend score.

Topics: Acute Disease; Adult; Air Pollutants; Air Pollution; Asthma; Child, Preschool; England; Humans; Nitrogen Dioxide; Patient Admission; Respiratory Tract Diseases; Retrospective Studies; Risk Factors; Socioeconomic Factors

A daily diary of respiratory symptoms was collected from the parents of 1,844 school children in six U.S. cities to study the association between ambient air pollution exposures and respiratory illness. A cohort of approximately 300 elementary school children in each of six communities were asked to keep a daily log of the study child's respiratory symptoms for one year. Daily measurements of ambient sulfur dioxide, nitrogen dioxide, ozone, inhalable particles (PM10), respirable particles (PM2.5), light scattering, and sulfate particles were made, along with integrated 24-h measures of aerosol strong acidity. The analyses were limited to the five warm season months between April and August. Significant associations were found between incidence of coughing symptoms and incidence of lower respiratory symptoms and PM10, and a marginally significant association between upper respiratory symptoms and PM10. There was no evidence that other measures of particulate pollution including aerosol acidity were preferable to PM10 in predicting incidence of respiratory symptoms. Significant associations in single pollutant models were also found between sulfur dioxide or ozone and incidence of cough, and between sulfur dioxide and incidence of lower respiratory symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acute Disease; Air Pollutants; Child; Cohort Studies; Cough; Humans; Hydrogen-Ion Concentration; Nitrogen Dioxide; Odds Ratio; Ozone; Respiratory Tract Diseases; Seasons; Sulfur Dioxide; Temperature

In 535 primary school children we studied the effects of exposure to summer smog on respiratory health. Baseline measurements were performed during low air pollution levels (max. 24-h concentrations of SO2, O3 and NO2 were 55, 49 and 58 micrograms/m3, respectively) consisting of lung function measurements using spirometry and the forced oscillation technique (FOT) and the prevalence of respiratory symptoms, determined by a written questionnaire. During a summer smog episode, 212 randomly chosen children were re-examined, characterised by 8-h ozone levels > 120 micrograms/m3 (max. 163 micrograms/m3) and 1-h ozone levels > 160 micrograms/m3 (max. 215 micrograms/m3). Overall, small decrements were observed in the forced expiratory volume in 1 s (FEV1), (P < 0.05) and the forced expiratory volume between 25 and 75% of the vital capacity (FEF25-75%) (P < 0.01). On the contrary, there was a statistically significant decrease in resistance parameters. No increases were observed in the prevalence of acute respiratory symptoms. In conclusion, in this study we found small inconsistent changes in lung function and no increase of respiratory symptoms after short-time exposure to moderately high ozone levels.

Topics: Acute Disease; Aerosols; Air Pollutants; Child; Evaluation Studies as Topic; Humans; Lung; Nitrogen Dioxide; Oscillometry; Ozone; Prevalence; Respiratory Tract Diseases; Seasons; Smog; Spirometry; Sulfur Dioxide

Six men were accidentally exposed to NO2 when they were changing a propeller using a gas burner in the poorly ventilated hold of a ship. All of them were admitted to hospital with shortness of breath and cough. Chest X-ray on admission revealed diffuse, patchy and infiltrative shadows, leading to the diagnosis of pulmonary edema in all five patients. Steroid therapy was effective and followed by a quick recovery in all patients. None developed third phase manifestations characterized pathologically by bronchiolitis obliterans.

Topics: Accidents, Occupational; Acute Disease; Adult; Humans; Male; Middle Aged; Nitrogen Dioxide; Respiratory Insufficiency; Ships

The biologic impact of consecutive exposures to two environmental pollutants was examined in mice exposed to silica crystals (SI) by intratracheal (IT) injection followed by an inhalation exposure to nitrogen dioxide (NO2). C57Bl/6 mice received an IT injection of 2 mg SI or sterile saline (SAL) followed by a 2-h inhalation exposure to NO2 at 20 ppm either within 2 h of or 24 h after SI instillation. During acute inflammation (d 3 postsilica), mice exposed to NO2 at either time showed a dramatic and significant reduction in the number of lavaged alveolar neutrophils (PMN) when compared to silica/air-exposed mice. Animals exposed to NO2 24 h after silica also evidenced significant decreases in levels of lavage albumin and lactate dehydrogenase (LDH) 3 d after silica, as well as significant decreases in hydroxyproline content of the lung 30 and 60 d postsilica injection when compared to silica/air-exposed animals. NO2 administration 24 h after silica appeared to shift the appearance of PMN in the lung from d 3 to d 14, but did not otherwise alter chronic cellular inflammation. These data suggest that the marked neutrophil response and collagen deposition induced by SI can be modulated by NO2 exposure and that the time of oxidant gas exposure after silica administration is critical to this modulation.

Topics: Acute Disease; Air Pollutants; Albumins; Animals; Biomarkers; Chronic Disease; Collagen; Drug Interactions; Female; L-Lactate Dehydrogenase; Lung; Mice; Mice, Inbred C57BL; Neutrophils; Nitrogen Dioxide; Oxidants; Pneumonia; Proteins; Pulmonary Alveoli; Pulmonary Fibrosis; Silicon Dioxide; Time Factors

In October 1989, the Hungarian National Institute of Hygiene initiated the Children's Acute Respiratory Morbidity (CHARM) Surveillance System to assess the association between nine reportable respiratory diseases and air pollution. The weekly number of physician-diagnosed, reportable respiratory diseases among four age groups of children (less than 1, 1-2, 3-5, and 6-14 years) was tabulated for Sopron, a city with 60,000 residents. We calculated the proportion of diseases occurring during weeks with low, moderate, and high sulfur dioxide (SO2) and nitrogen dioxide (NO2) concentrations. The weekly averages of the 24-hour median SO2 concentrations were divided into thirds at less than or equal to 17.6, greater than 17.6 to less than or equal to 26.3, and greater than 26.3 micrograms/m3 (range: 0.9-79.6 micrograms/m3), and the NO2 concentrations at less than or equal to 29.8, greater than 29.8 to less than or equal to 44.1, and greater than 44.1 micrograms/m3 (range: 4.2-90.1 micrograms/m3). During 1990, 11,474 respiratory disease cases occurred among the 4,020 children less than 15 years of age living in Sopron and monitored by the CHARM system. The two most frequently reported disease categories were rhinitis/tonsillitis/pharyngitis (71.5%) and acute bronchitis (8.5%). Sixty-seven percent of pneumonia cases occurred when SO2 concentrations were highest. We found no association between levels of NO2 and respiratory diseases. The CHARM Surveillance System may characterize more fully which groups of children develop particular respiratory diseases following exposure to air pollution.

Topics: Acute Disease; Adolescent; Air Pollutants; Child; Child, Preschool; Humans; Hungary; Infant; Morbidity; Nitrogen Dioxide; Population Surveillance; Respiratory Tract Diseases; Sulfur Dioxide

The first stage of a 2-year survey of respiratory morbidity in primary school children was conducted in two districts of Hong Kong in April/May 1989. One group (2009) of children was from Kwai Tsing District, which had high levels of exhaust emission from factories. The other group (1837) was from Southern District where atmospheric pollution was considered to be relatively low. After adjustment for gender, age, socioeconomic factors, child smoking and exposure to parental smoking, the prevalence ratios of sore throat, evening cough, cough for more than 3 months, morning phlegm and wheezing were found to be significantly higher in Kwai Tsing. The difference between the districts is likely to be related to the environmental air quality. The study, which is continuing, will provide the basis for an evaluation of the impact of new low sulphur fuel regulations introduced in July 1990.

Topics: Acute Disease; Air Pollution; Analysis of Variance; Child; Chronic Disease; Female; Geography; Hong Kong; Humans; Male; Morbidity; Nitrogen Dioxide; Respiratory Tract Diseases; Smoking; Socioeconomic Factors; Sulfur Dioxide; Urban Population

Between 1955 and 1987, 17 patients were examined at the Mayo Clinic shortly after exposure to silo gas. All exposures had occurred in conventional top-unloading silos. Acute lung injury occurred in 11 patients, 1 of whom died; early diffuse alveolar damage with hyaline membranes and hemorrhagic pulmonary edema and acute edema of the airways were found at autopsy. In one patient, hypoxemia and transient obstruction of the airways developed, but no pulmonary infiltrates were noted. One patient had symptoms for 5 weeks and diffuse confluent pulmonary infiltrates; many years later, chronic obstructive pulmonary disease developed (he had, however, been a heavy smoker before exposure). Bronchiolitis obliterans was not observed in the other patients, probably because of less severe exposure or early corticosteroid therapy. Prophylactic corticosteroid therapy is advised for workers who have been exposed to silo gas. The management of patients with established acute lung injury is reviewed. Previously unreported patterns of exposure to silo gas in conventional silos are described, and recommendations for avoiding exposure are suggested.

Topics: Acute Disease; Adolescent; Adrenal Cortex Hormones; Adult; Diagnosis, Differential; Humans; Lung Diseases; Lung Injury; Male; Middle Aged; Minnesota; Nitrogen Dioxide; Silo Filler's Disease

A case of acute nitrogen dioxide toxicity is described, together with its management and a review of the possible complications.

Topics: Acute Disease; Aged; Hobbies; Humans; Male; Nitrogen Dioxide; Numismatics; Pneumonia

Topics: Acute Disease; Air Pollutants; Child; Child, Preschool; Female; Humans; Infant; Male; Nitrogen Dioxide; Respiratory Insufficiency; Tennessee

Topics: Acute Disease; Gases; Humans; Hydrofluoric Acid; Male; Middle Aged; Nitrogen Dioxide; Occupational Diseases; Respiratory Insufficiency

Topics: Acute Disease; Adult; Alcohol Amnestic Disorder; Brain; Female; Glucose; Humans; Male; Methods; Middle Aged; Nitrogen Dioxide