nitrogen-dioxide and Respiration-Disorders

To assess the quantitative association between short-term exposure to air pollution and respiratory disease outpatient visits among children in China.. We searched articles from 1 January 2000 to 31 December 2020 in six peer-reviewed literature databases following PRISMA guidelines.. Of 2668 records, 33 were included in meta-analysis. The pooled excess risks of respiratory disease outpatient visits among children in China per 10 μg/m. Short-term exposure to air pollution was significantly associated with an increased excess risk of respiratory disease outpatient visits among children in China.

Topics: Air Pollutants; Air Pollution; Child; China; Humans; Nitrogen Dioxide; Outpatients; Particulate Matter; Respiration Disorders; Respiratory Tract Diseases

Epidemiological studies on air pollution have mainly been interested in the effects of short- or long-term exposure on patients suffering from respiratory illnesses. Fewer studies have addressed the acute effects of air pollution on respiratory symptoms in the general population.. We conducted a review of the literature over the last 16years that has addressed the impact of atmospheric pollution on respiratory symptoms in the general population to estimate the magnitude of effect. The majority of studies demonstrated a significant association between exposure to air pollutants and the occurrence of respiratory symptoms, without any threshold.. Although a link between atmospheric pollution and respiratory symptoms has been demonstrated, knowledge of the effects of specific air pollutants and the effect of pollution on particular vulnerable groups (infants, young children, the elderly) is still limited.. There is a need for further studies in this area.

Topics: Adult; Air Pollutants; Air Pollution; Child; Humans; Nitrogen Dioxide; Particulate Matter; Respiration Disorders

There is large variation between individuals in their response to air pollutants. This review summarises the existing evidence that genetic factors influence the mechanisms of lung injury caused by air pollutants. Genetic association studies have compared the adverse effects of air pollutants between subjects with specific genotypes in biologically relevant genes. In human studies of ozone exposure, polymorphisms in oxidative stress genes (NQO1, GSTM1, GSTP1) modify respiratory symptoms, lung function, biomarkers and risk of asthma. Inflammatory gene polymorphisms (TNF) influence the lung function response to ozone, and the effect of different levels of ozone on the development of asthma. Polymorphisms in oxidative stress genes (GSTM1, GSTP1) alter the response to combined exposure to ragweed pollen and diesel exhaust particles. Importantly, polymorphisms in an oxidative stress gene (GSTM1) have predicted patients with asthma who benefit from antioxidant supplementation in Mexico City, which has chronically high ozone exposure. Genetic linkage studies of families have not been feasible for studying the effects of air pollution in humans, but some progress has been made with pedigrees of specially bred mice, in identifying chromosomal regions linked to effects of ozone or particles. A high priority now, in addition to avoiding exposure in the most susceptible people, is to clearly identify the most effective and safe chemopreventive agents for individuals who are genetically susceptible to the adverse effects of air pollution (eg, antioxidants to be taken during high ozone levels).

Topics: Air Pollution; Genetic Predisposition to Disease; Genetic Variation; Humans; Lung Diseases; Nitrogen Dioxide; Ozone; Particulate Matter; Phenotype; Polymorphism, Genetic; Respiration Disorders; Sulfur Dioxide

In the early days of abundant resources and minimal development pressures, little attention was paid to growing environmental concerns in Malaysia. The haze episodes in Southeast Asia in 1983, 1984, 1991, 1994, and 1997 imposed threats to the environmental management of Malaysia and increased awareness of the environment. As a consequence, the government established Malaysian Air Quality Guidelines, the Air Pollution Index, and the Haze Action Plan to improve air quality. Air quality monitoring is part of the initial strategy in the pollution prevention program in Malaysia. Review of air pollution in Malaysia is based on the reports of the air quality monitoring in several large cities in Malaysia, which cover air pollutants such as Carbon monoxide (CO), Sulphur Dioxide (SO2), Nitrogen Dioxide (NO2), Ozone (O3), and Suspended Particulate Matter (SPM). The results of the monitoring indicate that Suspended Particulate Matter (SPM) and Nitrogen Dioxide (NO2) are the predominant pollutants. Other pollutants such as CO, O(x), SO2, and Pb are also observed in several big cities in Malaysia. The air pollution comes mainly from land transportation, industrial emissions, and open burning sources. Among them, land transportation contributes the most to air pollution. This paper reviews the results of the ambient air quality monitoring and studies related to air pollution and health impacts.

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; Environmental Monitoring; Humans; Malaysia; Nitrogen Dioxide; Ozone; Respiration Disorders; Smoke; Sulfur Dioxide; Vehicle Emissions

Topics: Air Pollution, Indoor; Environmental Exposure; Female; Fossil Fuels; Humans; Male; Nitrogen Dioxide; Respiration Disorders; Sex Factors

Air pollution is a leading risk factor for global mortality and morbidity. Oxidative stress is a key mechanism underlying air-pollution-mediated health effects, especially in the pathogenesis/exacerbation of airway impairments. However, evidence lacks on subgroups at higher risk of developing more severe outcomes in response to air pollution. This multi-centre study aims to evaluate the association between air pollution and oxidative stress in healthy adults and in patients affected by airway diseases from the Italian GEIRD (Gene Environment Interactions in Respiratory Diseases) multi-case control study. Overall, 1841 adults (49 % females, 20-83 years) were included from four Italian centres: Pavia, Sassari, Turin, and Verona. Following a 2-stage screening process, we identified 1273 cases of asthma, chronic bronchitis, rhinitis, or COPD and 568 controls. Systemic oxidative stress was quantified by urinary 8-isoprostane and 8-OH-dG. Individual residential exposures to NO

Topics: 8-Hydroxy-2'-Deoxyguanosine; Adult; Air Pollutants; Air Pollution; Case-Control Studies; Environmental Exposure; Female; Gene-Environment Interaction; Humans; Male; Nitrogen Dioxide; Oxidative Stress; Particulate Matter; Respiration Disorders; Respiratory Tract Diseases

Increasing studies have reported temperature modification effects on air pollutants-induced respiratory diseases. In the current study, daily data of respiratory emergency room visits (ERVs), meteorological factors, and concentrations of air pollutants were collected from 2013 to 2016 in Lanzhou, a northwest city in China. Daily average temperature was stratified into low (≤ 25 percentile, P

Topics: Air Pollutants; Air Pollution; China; Female; Humans; Male; Nitrogen Dioxide; Particulate Matter; Respiration Disorders; Respiratory Tract Diseases; Temperature

This study investigates the relation between exposure to critical air pollution events with multipollutant (CO, PM

Topics: Air Pollutants; Air Pollution; Brazil; China; Environmental Monitoring; Hospitalization; Humans; Nitrogen Dioxide; Particulate Matter; Respiration Disorders; Respiratory Tract Diseases

Chiang Mai is one of the most known cities of Northern Thailand, representative for various cities in the East and South-East Asian region exhibiting seasonal smog crises. While a few studies have attempted to address smog crises effects on human health in that geographic region, research in this regard is still in its infancy. We exploited a unique situation based on two factors: large pollutant concentration variations due to the Chiang Mai smog crises and a relatively large sample of out-patient visits. About 216,000 out-patient visits in the area of Chiang Mai during the period of 2011 to 2014 for upper (J30-J39) and lower (J44) respiratory tract diseases were evaluated with respect to associations with particulate matter (PM10), ozone (O3), and nitrogen dioxide (NO2) concentrations using single-pollutant and multiple-pollutants Poisson regression models. All three pollutants were found to be associated with visits due to upper respiratory tract diseases (with relative risks RR = 1.023 at cumulative lag 05, 95% CI: 1.021-1.025, per 10 μg/m3 PM10 increase, RR = 1.123 at lag 05, 95% CI: 1.118-1.129, per 10 ppb O3 increase, and RR = 1.110 at lag 05, 95% CI: 1.102-1.119, per 10 ppb NO2 increase). Likewise, all three pollutants were found to be associated with visits due to lower respiratory tract diseases (with RR = 1.016 at lag 06, 95% CI: 1.015-1.017, per 10 μg/m3 PM10 increase, RR = 1.073 at lag 06, 95% CI: 1.070-1.076, per 10 ppb O3 increase, and RR = 1.046 at lag 06, 95% CI: 1.040-1.051, per 10 ppb NO2 increase). Multi-pollutants modeling analysis identified O3 as a relatively independent risk factor and PM10-NO2 pollutants models as promising two-pollutants models. Overall, these results demonstrate the adverse effects of all three air pollutants on respiratory morbidity and call for air pollution reduction and control.

Topics: Air Pollutants; Air Pollution; Humans; Nitrogen Dioxide; Outpatients; Ozone; Particulate Matter; Respiration Disorders; Respiratory Tract Diseases; Seasons; Smog; Thailand

The influences of air pollution exposure and temperature on respiratory diseases have become major global health concerns. This study investigated the relationship between ambient air pollutant concentrations and temperature in cold industrial cities that have the risk of hospitalization for respiratory diseases.. A time-series study was conducted in Changchun, China, from 2015 to 2019 to analyse the number of daily admissions for respiratory diseases, air pollutant concentrations, and meteorological factors. Time-series decomposition was applied to analyse the trend and characteristics of the number of admissions. Generalized additive models and distributed lag nonlinear models were constructed to explore the effects of air pollutant concentrations and temperature on the number of admissions.. The number of daily admissions showed an increasing trend, and the seasonal fluctuation was obvious, with more daily admissions in winter and spring than in summer and autumn. There were positive and gradually decreasing lag effects of PM10, PM2.5, NO. From 2015 to 2019, respiratory diseases in Changchun showed an increasing trend with obvious seasonality. The increased concentrations of SO

Topics: Air Pollutants; Air Pollution; China; Cities; Hospitalization; Hospitals; Humans; Nitrogen Dioxide; Particulate Matter; Respiration Disorders; Respiratory Tract Diseases; Temperature

Little information exists on interaction effects between air pollution and influenza vaccination on allergic respiratory diseases. We conducted a large population-based study to evaluate the interaction effects between influenza vaccination and long-term exposure to ambient air pollution on allergic respiratory diseases in children and adolescents.. A cross-sectional study was investigated during 2012-2013 in 94 schools from Seven Northeastern Cities (SNEC) in China. Questionnaires surveys were obtained from 56 137 children and adolescents aged 2-17 years. Influenza vaccination was defined as receipt of the influenza vaccine. We estimated air pollutants exposure [nitrogen dioxide (NO. We found statistically significant interactions between influenza vaccination and air pollutants on allergic respiratory diseases and related symptoms (doctor-diagnosed asthma, current wheeze, wheeze, persistent phlegm and allergic rhinitis). The adjusted ORs for doctor-diagnosed asthma, current wheeze and allergic rhinitis among the unvaccinated group per interquartile range (IQR) increase in PM. Influenza vaccination may play an important role in mitigating the detrimental effects of long-term exposure to ambient air pollution on childhood allergic respiratory diseases. Policy targeted at increasing influenza vaccination may yield co-benefits in terms of reduced allergic respiratory diseases.

Topics: Adolescent; Air Pollutants; Air Pollution; Asthma; Child; Child, Preschool; China; Cities; Cross-Sectional Studies; Environmental Exposure; Female; Humans; Hypersensitivity; Influenza, Human; Logistic Models; Male; Nitrogen Dioxide; Particulate Matter; Respiration Disorders; Respiratory Sounds; Respiratory Tract Diseases; Risk Factors; Schools; Surveys and Questionnaires; Vaccination

Children in Ulaanbaatar are exposed to air pollution, but few epidemiological studies have been conducted on the effects of environmental risk factors on children's health. Also, no studies have yet examined the prevalence of respiratory symptoms in children in suburban areas, where air quality-monitoring stations have not yet been installed. This cross-sectional study evaluated the associations between outdoor air pollution and respiratory symptoms among schoolchildren in urban and suburban districts of Ulaanbaatar.. The ATS-DLD-78 C questionnaire was used to investigate the respiratory symptoms of schoolchildren aged 6-12 years (n = 1190) who lived in one of three urban districts or a suburban district of Ulaanbaatar. In each district, the outdoor concentrations of nitrogen dioxide (NO. The outdoor concentration of SO. The prevalence of persistent cough symptom was markedly high among the schoolchildren in urban/suburban districts of Ulaanbaatar. Overall, the increases in the prevalence of respiratory symptoms among children might be associated with ambient air pollution in Ulaanbaatar.

Topics: Air Pollutants; Child; Coal; Cross-Sectional Studies; Environmental Exposure; Environmental Monitoring; Female; Humans; Male; Mongolia; Nitrogen Dioxide; Prevalence; Respiration Disorders; Sulfur Dioxide; Vehicle Emissions

This study aimed to investigate the effects of temperature inversions on the concentration of some pollutants in the atmosphere in Hanoi City, Vietnam, during the period from 2011 to 2015. This work also aimed to evaluate relationships between the thermal inversion and health effects that are associated with air pollution. During this period, the temperature inversions were most frequently presenting from November to March in Hanoi City. Air quality data was gathered from air quality monitoring stations located in the study area. The data showed that levels of NO

Topics: Adolescent; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Child; Cities; Environmental Exposure; Humans; Middle Aged; Nitrogen Dioxide; Particulate Matter; Respiration Disorders; Sulfur Dioxide; Temperature; Vietnam; Weather

The objective of this study was to investigate the potential association between air pollutants and respiratory diseases (RDs). Generalized additive models were used to analyze the effect of air pollutants on mortalities or outpatient visits. The average concentrations of air pollutants in Hangzhou (HZ) were 1.6-2.8 times higher than those in Zhoushan (ZS), except for O

Topics: Aged; Air Pollutants; Air Pollution; China; Environmental Exposure; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Outpatients; Ozone; Particulate Matter; Respiration Disorders; Sulfur Dioxide

Ambient air pollution has been consistently associated with exacerbation of respiratory diseases in schoolchildren, but the role of early exposure to traffic-related air pollution in the first occurrence of respiratory symptoms and asthma is not yet clear.. We assessed the association between indexes of exposure to traffic-related air pollution during different periods of life and respiratory outcomes in a birth cohort of 672 newborns (Rome, Italy). Direct interviews of the mother were conducted at birth and at 6, 15 months, 4 and 7 years. Exposure to traffic-related air pollution was assessed for each residential address during the follow-up period using a Land-Use Regression model (LUR) for nitrogen dioxide (NO2) and a Geographic Information System (GIS) variable of proximity to high-traffic roads (HTR) (>10 000vehicles/day). We used age-specific NO2 levels to develop indices of exposure at birth, current, and lifetime time-weighted average. The association of NO2 and traffic proximity with respiratory disorders were evaluated using logistic regression in a longitudinal approach (Generalised Estimating Equation). The exposure indexes were used as continuous and categorical variables (cut-off points based on the 75th percentile for NO2 and the 25th percentile for distance from HTRs).. The average NO2 exposure level at birth was 37.2 μg/m(3) (SD 7.2, 10-90th range 29.2-46.1). There were no statistical significant associations between the exposure indices and the respiratory outcomes in the longitudinal model. The odds ratios for a 10-µg/m(3) increase in time-weighted average NO2 exposure were: asthma incidence OR=1.09; 95 CI% 0.78 to 1.52, wheezing OR=1.07; 95 CI% 0.90 to 1.28, shortness of breath with wheezing OR=1.16; 95 CI% 0.94 to 1.43, cough or phlegm apart from cold OR=1.11; 95 CI% 0.92 to 1.33, and otitis OR=1.08; 95 CI% 0.89 to 1.32. Stronger but not significant associations were found considering the 75th percentile of the NO2 distribution as a cut-off, especially for incidence of asthma and prevalence of wheeze (OR=1.41; 95 CI% 0.88 to 2.28 and OR=1.27; 95 CI% 0.95 to 1.70, respectively); the highest OR was found for wheezing (OR=2.29; 95 CI% 1.15 to 4.56) at the 7-year follow-up. No association was found with distance from HTRs.. Exposure to traffic-related air pollution is only weakly associated with respiratory symptoms in young children in the first 7 years of life.

Topics: Adult; Air Pollutants; Air Pollution; Asthma; Child; Child, Preschool; Cohort Studies; Cough; Dyspnea; Environmental Exposure; Environmental Monitoring; Female; Geographic Information Systems; Humans; Incidence; Infant; Infant, Newborn; Interviews as Topic; Logistic Models; Longitudinal Studies; Male; Nitrogen Dioxide; Odds Ratio; Otitis; Prevalence; Respiration Disorders; Respiratory Sounds; Rome; Vehicle Emissions

In Japan, air pollution due to nitrogen oxides (NOx) and particulate matter (PM) has been gradually reduced since control measures based on the Automobile NOx/PM law were enforced beginning in 2001. The effects of decrease in air pollutants due to the control measures during the past decade on the prevalence of respiratory and allergic disorders such as asthma in children were evaluated.. Using data of 618,973 children collected in 28 regions of Japan from 1997 to 2009, we evaluated whether reductions in the concentrations of nitrogen dioxide (NO2) and suspended particulate matter (SPM) contribute to the decrease in the prevalence of asthma, wheezing, bronchitis, allergic rhinitis, and atopic dermatitis by multiple linear regression analysis, including adjustments for related factors.. The annual rates of decrease in air pollution in the PM-law-enforced areas were 2.0 and 2.5 times higher for NO2 and SPM, respectively, compared with those in the non-enforced areas. The prevalence of asthma decreased significantly at -0.073% per year in the areas in which measures based on the Automobile NOx/PM law were taken but not in area where such measures were not applied. Multiple linear regression analysis showed a reduction in the ambient air pollution was significantly associated with a reduction in the prevalence of asthma, with a rate of 0.118% [95% confidence interval (CI): 0.012-0.225] per 1 ppb for NO2, and 0.050% [95% CI: 0.020-0.080] per 1 μg/m(3) for SPM. An increase in the ambient air pollution was associated with an increase in the prevalence of atopic dermatitis of 0.390% [95% CI: 0.107-0.673] per 1 ppb for NO2, 0.141% [95% CI: 0.058-0.224] per 1 μg/m(3) for SPM. The changes in the prevalence of wheezing and allergic rhinitis were not significantly correlated with changes in air pollutant concentrations.. The enforcement of measures to control automobile emissions based on the Automobile NOx/PM law was shown to have reduced air pollution and contributed to decreases in the prevalence of respiratory and allergic disorders in 3-year-old children.

Topics: Air Pollution; Child, Preschool; Humans; Hypersensitivity; Japan; Nitrogen Dioxide; Particulate Matter; Prevalence; Respiration Disorders; Vehicle Emissions

Power plant workers are potentially exposed to nitrogen dioxide (NO2) and may therefore be at higher risk of pulmonary diseases than the general population.. To assess the association of NO2 exposure with spirometric abnormalities in power plant workers.. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and forced expiratory ratio (FER = FEV1/FVC) were correlated with demographic characteristics, smoking history and environmental exposure to NO2 in power plant workers exposed to environmental NO2 at work and in a control group of administrative employees. Twenty-four hour environmental NO2 concentrations were measured at each workplace.. The concentrations of environmental NO2 ranged from 1.21 to 7.82 mg m(-3) with a mean value of 3.91 + 1.51 mg m(-3). The results showed that FEV1 and FVC were significantly lower in 347 power plant workers than in the 349 controls (P < 0.001). The FER was significantly correlated with age, environmental NO2 concentration, smoking and height.. Occupational exposure to NO2 emissions in power plants is significantly associated with lung function abnormalities as assessed by spirometry. Spirometric measurements in power plant workers exposed to NO2 emissions may be an effective means of detecting early signs of impaired respiratory health in this group of workers.

Topics: Forced Expiratory Volume; Humans; Italy; Male; Nitrogen Dioxide; Occupational Diseases; Occupational Exposure; Power Plants; Respiration; Respiration Disorders; Smoking; Spirometry; Vital Capacity

Both outdoor air pollution and extreme temperature have been associated with daily mortality; however, the effect of their interaction is not known.. This time-series analysis examined the effect of the interaction between outdoor air pollutants and extreme temperature on daily mortality in Shanghai, China. A generalized additive model (GAM) with penalized splines was used to analyze mortality, air pollution, temperature, and covariate data. The effects of air pollutants were stratified by temperature stratum to examine the interaction effect of air pollutants and extreme temperature.. We found a statistically significant interaction between PM₁₀/O₃ and extreme low temperatures for both total nonaccidental and cause-specific mortality. On days with "normal" temperatures (15th-85th percentile), a 10-µg/m³ increment in PM₁₀ corresponded to a 0.17% (95% CI: 0.03%, 0.32%) increase in total mortality, a 0.23% (0.02%, 0.44%) increase in cardiovascular mortality, and a 0.26% (-0.07%, 0.60%) increase in respiratory mortality. On low-temperature days (<15th percentile), the estimates changed to 0.40% (0.21%, 0.58%) for total mortality, 0.49% (0.13%, 0.86%) for cardiovascular mortality, and 0.24% (-0.33%, 0.82%) for respiratory mortality. The interaction pattern of O₃ with lower temperature was similar. The interaction between PM₁₀/O₃ and lower temperature remained robust when alternative cut-points were used for temperature strata.. The acute health effects of air pollution might vary by temperature level.

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Cause of Death; China; Extreme Cold; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Respiration Disorders; Sulfur Dioxide; Time Factors

Many epidemiological studies have linked daily counts of hospital admissions to particulate matter (PM) with an aerodynamic diameter ≤ 10 μm (PM10) and ≤ 2.5 μm (PM2.5), but relatively few have investigated the relationship of hospital admissions with coarse PM (PMc; 2.5-10 μm aerodynamic diameter).. We conducted this study to estimate the health effects of PMc on emergency hospital admissions for respiratory diseases in Hong Kong after controlling for PM2.5 and gaseous pollutants.. We conducted a time-series analysis of associations between daily emergency hospital admissions for respiratory diseases in Hong Kong from January 2000 to December 2005 and daily PM2.5 and PMc concentrations. We estimated PMc concentrations by subtracting PM2.5 from PM10 measurements. We used generalized additive models to examine the relationship between PMc (single- and multiday lagged exposures) and hospital admissions adjusted for time trends, weather conditions, influenza outbreaks, PM2.5, and gaseous pollutants (nitrogen dioxide, sulfur dioxide, and ozone).. A 10.9-μg/m(3) (interquartile range) increase in the 4-day moving average concentration of PMc was associated with a 1.94% (95% confidence interval: 1.24%, 2.64%) increase in emergency hospital admissions for respiratory diseases that was attenuated but still significant after controlling for PM2.5. Adjusting for gaseous pollutants and altering models assumptions had little influence on PMc effect estimates.. PMc was associated with emergency hospital admissions for respiratory diseases in Hong Kong independent of PM2.5 and gaseous pollutants. Further research is needed to evaluate health effects of different components of PMc.

Topics: Air Pollutants; Asthma; Hong Kong; Hospitalization; Humans; Nitrogen Dioxide; Ozone; Particle Size; Particulate Matter; Pulmonary Disease, Chronic Obstructive; Respiration Disorders; Sulfur Dioxide; Time Factors

Particulate matter air pollution has been associated with adverse health effects. The fraction of ambient particles that are mainly responsible for the observed health effects is still a matter of controversy. Better characterization of the health relevant particle fraction will have major implications for air quality policy since it will determine which sources should be controlled.The RUPIOH study, an EU-funded multicentre study, was designed to examine the distribution of various ambient particle metrics in four European cities (Amsterdam, Athens, Birmingham, Helsinki) and assess their health effects in participants with asthma or COPD, based on a detailed exposure assessment. In this paper the association of central site measurements with respiratory symptoms and restriction of activities is examined.. At each centre a panel of participants with either asthma or COPD recorded respiratory symptoms and restriction of activities in a diary for six months. Exposure assessment included simultaneous measurements of coarse, fine and ultrafine particles at a central site. Data on gaseous pollutants were also collected. The associations of the 24-hour average concentrations of air pollution indices with the health outcomes were assessed in a hierarchical modelling approach. A city specific analysis controlling for potential confounders was followed by a meta-analysis to provide overall effect estimates.. A 10 μg/m3 increase in previous day coarse particles concentrations was positively associated with most symptoms (an increase of 0.6 to 0.7% in average) and limitation in walking (OR= 1.076, 95% CI: 1.026-1.128). Same day, previous day and previous two days ozone concentrations were positively associated with cough (OR= 1.061, 95% CI: 1.013-1.111; OR= 1.049, 95% CI: 1.016-1.083 and OR= 1.059, 95% CI: 1.027-1.091, respectively). No consistent associations were observed between fine particle concentrations, nitrogen dioxide and respiratory health effects. As for particle number concentrations negative association (mostly non-significant at the nominal level) was observed with most symptoms whilst the positive association with limitation of activities did not reach the nominal level of significance.. The observed associations with coarse particles are in agreement with the findings of toxicological studies. Together they suggest it is prudent to regulate also coarse particles in addition to fine particles.

Topics: Adult; Aged; Aged, 80 and over; Air Pollutants; Air Pollution; Asthma; Cities; Europe; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Odds Ratio; Ozone; Particulate Matter; Pulmonary Disease, Chronic Obstructive; Respiration Disorders; Walking

Evidence for a link between long-term exposure to air pollution and lung cancer is limited to Western populations. In this prospective cohort study, we examined this association in a Japanese population.. The study comprised 63 520 participants living in 6 areas in 3 Japanese prefectures who were enrolled between 1983 and 1985. Exposure to particulate matter less than 2.5 µm in aerodynamic diameter (PM(2.5)), sulfur dioxide (SO(2)), and nitrogen dioxide (NO(2)) was assessed using data from monitoring stations located in or nearby each area. The Cox proportional hazards model was used to calculate the hazard ratios associated with the average concentrations of these air pollutants.. The 10-year average concentrations of PM(2.5), SO(2), and NO(2) before recruitment (1974-1983) were 16.8 to 41.9 µg/m(3), 2.4 to 19.0 ppb, and 1.2 to 33.7 ppb, respectively (inter-area range). During an average follow-up of 8.7 years, there were 6687 deaths, including 518 deaths from lung cancer. The hazard ratios for lung cancer mortality associated with a 10-unit increase in PM(2.5) (µg/m(3)), SO(2) (ppb), and NO(2) (ppb) were 1.24 (95% confidence interval: 1.12-1.37), 1.26 (1.07-1.48), and 1.17 (1.10-1.26), respectively, after adjustment for tobacco smoking and other confounding factors. In addition, a significant increase in risk was observed for male smokers and female never smokers. Respiratory diseases, particularly pneumonia, were also significantly associated with all the air pollutants.. Long-term exposure to air pollution is associated with lung cancer and respiratory diseases in Japan.

Topics: Adult; Aged; Air Pollutants; Air Pollution; Environmental Exposure; Female; Follow-Up Studies; Humans; Japan; Lung Neoplasms; Male; Middle Aged; Nitrogen Dioxide; Particle Size; Particulate Matter; Prospective Studies; Respiration Disorders; Risk Factors; Sex Distribution; Smoking; Sulfur Dioxide; Time Factors

The number of studies investigating the health effects of long-term exposure to air pollution is increasing, however, most studies have been conducted in Western countries. The health status of Asian populations may be different to that of Western populations and may, therefore, respond differently to air pollution exposure. Therefore, we evaluated the health effects of long-term exposure to traffic-related air pollution in Shizuoka, Japan.. Individual data were extracted from participants of an ongoing cohort study. A total of 14,001 older residents, who were randomly chosen from all 74 municipalities of Shizuoka, completed questionnaires and were followed from December 1999 to March 2006. Individual nitrogen dioxide exposure data, as an index for traffic-related exposure, were modelled using a land use regression model. We assigned participants an estimated concentration of nitrogen dioxide exposure during 2000-2006. We then estimated the adjusted HR and their CI for a 10 microg/m(3) increase in exposure to nitrogen dioxide for all-cause or cause-specific mortality.. The adjusted HR for all-cause mortality was 1.02 (95% CI 0.96 to 1.08). Regarding cause-specific mortality, the adjusted HR for cardiopulmonary mortality was 1.16 (95% CI 1.06 to 1.26); in particular the adjusted HR for ischaemic heart disease mortality was 1.27 (95% CI 1.02 to 1.58) and for pulmonary disease mortality it was 1.19 (95% CI 1.02 to 1.38). Furthermore, among non-smokers, a 10 microg/m(3) increase in nitrogen dioxide was associated with a higher risk for lung cancer mortality (HR 1.30, 95% CI 0.85 to 1.93).. Long-term exposure to traffic-related air pollution, indexed by nitrogen dioxide concentration, increases the risk of cardiopulmonary mortality, even in a population with a relatively low body mass index and increases the risk of lung cancer mortality in non-smokers.

Topics: Aged; Aged, 80 and over; Air Pollution; Body Mass Index; Cardiovascular Diseases; Environmental Exposure; Environmental Monitoring; Epidemiological Monitoring; Female; Humans; Japan; Lung Neoplasms; Male; Mortality; Nitrogen Dioxide; Respiration Disorders; Smoking; Vehicle Emissions

Inconsistent effects of gas cooking on lung function have been reported. In a previous study from Austria, we demonstrated a significant, though small, reduction of lung function parameters in children living in homes with gas stoves. We used a larger international database to check if this finding can be generalised. To study the relative impact of cooking with gas on lung function parameters of primary school children in a wide range of geographical settings, we analysed flow and volume data of approximately 24,000 children (aged 6-12 yrs) from nine countries in Europe and North America. Exposure information was obtained by comparable questionnaires and spirometry according to an American Thoracic Society/European Respiratory Society protocol. Linear regressions were used, controlling for individual risk factors and study area. Heterogeneity between study-specific results and mean effects were estimated using meta-analytical tools. On average, gas cooking reduced lung function parameters. Overall effects were small (-0.1-0.7%) and only significant for forced vital capacity and forced expiratory volume in 1 s. There was some indication that allergic children were more affected by gas cooking. Under current housing conditions, gas cooking is associated with only small reductions in lung function.

Topics: Air Pollutants; Air Pollution, Indoor; Child; Environmental Exposure; Female; Food Handling; Fossil Fuels; Gases; Humans; Lung; Male; Nitrogen Dioxide; Regression Analysis; Respiration Disorders; Spirometry

The island factor of the cities of Las Palmas de Gran Canaria and Santa Cruz de Tenerife, along with their proximity to Africa and their meteorology, create a particular setting that influences the air quality of these cities and provides researchers an opportunity to analyze the acute effects of air-pollutants on daily mortality.. From 2000 to 2004, the relationship between daily changes in PM10, PM2.5, SO2, NO2, CO, and ozone levels and daily total mortality and mortality due to respiratory and heart diseases were assessed using Generalized Additive Poisson models controlled for potential confounders. The lag effect (up to five days) as well as the concurrent and previous day averages and distributed lag models were all estimated. Single and two pollutant models were also constructed.. Daily levels of PM10, PM2.5, NO2, and SO2 were found to be associated with an increase in respiratory mortality in Santa Cruz de Tenerife and with increased heart disease mortality in Las Palmas de Gran Canaria, thus indicating an association between daily ozone levels and mortality from heart diseases. The effects spread over five successive days. SO2 was the only air pollutant significantly related with total mortality (lag 0).. There is a short-term association between current exposure levels to air pollution and mortality (total as well as that due specifically to heart and respiratory diseases) in both cities. Risk coefficients were higher for respiratory and cardiovascular mortality, showing a delayed effect over several days.

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; Environmental Exposure; Environmental Monitoring; Epidemiological Monitoring; Geography; Heart Diseases; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Respiration Disorders; Spain; Sulfur Dioxide; Time

Topics: Air Pollution; Carbon Dioxide; Humans; Nitrites; Nitrogen Dioxide; Respiration Disorders; Vehicle Emissions

Whether there is a causal relation between long-term exposure to traffic and asthma development is so far not clear. This may be explained by inaccurate exposure assessment.. We investigated the associations of long-term traffic-related exposures with asthma onset assessed retrospectively and respiratory symptoms in 9- to 10-year-old children.. We collected information on respiratory outcomes and potential confounding variables by parental questionnaire in 2,871 children in Oslo. Nitrogen dioxide exposure was assessed by the EPISODE dispersion model and assigned at updated individual addresses during lifetime. Distance to major road was assigned at birth address and address by date of questionnaire. Cox proportional hazard regression and logistic regression were used.. We did not find positive associations between any long-term traffic-related exposure and onset of doctor-diagnosed asthma. An interquartile range (IQR) increase of NO(2) exposure before asthma onset was associated with an adjusted risk ratio of 0.82 [95% confidence interval (CI), 0.67-1.02]. Handling early asthma cases (children < 4 years of age) with recovery during follow-up as noncases gave a less negative association. The associations for late asthma onset (>/= 4 years of age) were positive but not statistically significant. For current symptoms, an IQR increase of previous year's NO(2) exposure was associated with adjusted odds ratios of 1.01 (95% CI, 0.83-1.23) for wheeze, 1.10 (95% CI, 0.79-1.51) for severe wheeze, and 1.01 (95% CI, 0.84-1.21) for dry cough.. We were not able to find positive associations of long-term traffic-related exposures with asthma onset or with current respiratory symptoms in 9- to 10-year-old children in Oslo.

Topics: Air Pollutants; Asthma; Child; Environmental Exposure; Humans; Logistic Models; Nitrogen Dioxide; Norway; Proportional Hazards Models; Respiration Disorders; Surveys and Questionnaires; Vehicle Emissions

Relatively few studies have been conducted of the association between air pollution and emergency department (ED) visits, and most of these have been based on a small number of visits, for a limited number of health conditions and pollutants, and only daily measures of exposure and response.. A time-series analysis was conducted on nearly 400,000 ED visits to 14 hospitals in seven Canadian cities during the 1990 s and early 2000s. Associations were examined between carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2), and particulate matter (PM 10 and PM2.5), and visits for angina/myocardial infarction, heart failure, dysrhythmia/conduction disturbance, asthma, chronic obstructive pulmonary disease (COPD), and respiratory infections. Daily and 3-hourly visit counts were modeled as quasi-Poisson and analyses controlled for effects of temporal cycles, weather, day of week and holidays.. 24-hour average concentrations of CO and NO2 lag 0 days exhibited the most consistent associations with cardiac conditions (2.1% (95% CI, 0.0-4.2%) and 2.6% (95% CI, 0.2-5.0%) increase in visits for myocardial infarction/angina per 0.7 ppm CO and 18.4 ppb NO2 respectively; 3.8% (95% CI, 0.7-6.9%) and 4.7% (95% CI, 1.2-8.4%) increase in visits for heart failure). Ozone (lag 2 days) was most consistently associated with respiratory visits (3.2% (95% CI, 0.3-6.2%), and 3.7% (95% CI, -0.5-7.9%) increases in asthma and COPD visits respectively per 18.4 ppb). Associations tended to be of greater magnitude during the warm season (April - September). In particular, the associations of PM 10 and PM2.5 with asthma visits were respectively nearly three- and over fourfold larger vs. all year analyses (14.4% increase in visits, 95% CI, 0.2-30.7, per 20.6 microg/m3 PM 10 and 7.6% increase in visits, 95% CI, 5.1-10.1, per 8.2 microg/m3 PM2.5). No consistent associations were observed between three hour average pollutant concentrations and same-day three hour averages of ED visits.. In this large multicenter analysis, daily average concentrations of CO and NO2 exhibited the most consistent associations with ED visits for cardiac conditions, while ozone exhibited the most consistent associations with visits for respiratory conditions. PM 10 and PM2.5 were strongly associated with asthma visits during the warm season.

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; Cities; Emergency Medical Services; Environmental Monitoring; Epidemiological Monitoring; Geography; Heart Diseases; Hospitalization; Humans; Inhalation Exposure; Nitrogen Dioxide; Ozone; Particulate Matter; Respiration Disorders; Seasons; Sulfur Dioxide

Aim of this study was to evaluate the impact of air pollution on hospital admissions for respiratory and cardiovascular diseases in an oil rich developing country, State of Qatar.. A prospective cohort population based study was conducted at different stations of Qatar during the period (2002-2005) for recording the concentration of air pollutants daily for sulphur dioxide (SO2), nitric oxide (NO), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3) and particulate matter (PM10). Hospital admission data were collected from the inpatient discharge database of the Medical Records Department, Hamad General Hospital.. An average of 5.36 admissions from ischemic heart diseases was counted daily in all the population which was even higher than the respiratory diseases (3.4/day). Minimum temperature was inversely correlated with all pollutants except for O3 and SO2.. There was an association between increasing air pollutant levels and patients admitted for respiratory and cardiovascular diseases.

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Cohort Studies; Environmental Exposure; Environmental Monitoring; Epidemiological Monitoring; Humans; Medical Records; Nitrogen Dioxide; Ozone; Particulate Matter; Patient Admission; Prospective Studies; Qatar; Respiration Disorders; Sulfur Dioxide

Poor indoor air quality and epidemic carbon monoxide (CO) and nitrogen dioxide (NO(2)) poisonings due to exhaust emissions from ice resurfacers have been continuously reported from enclosed ice arenas for over 30 years. The health risks in users of Finnish ice arenas were analysed in three ways: (1) evaluation of four cases of epidemic CO poisonings, (2) modelling the association between NO(2) exposure and respiratory symptoms among junior ice hockey players, and (3) estimation of the number of arena users at risk of breathing poor quality air due to non-compliance of ice arenas with recommended abatement measures. The common causes for the CO poisonings involving over 300 subjects were large emissions from propane-fuelled ice resurfacer, small arena volume, negligible ventilation, and very recent opening of the arena. Rhinitis (prevalence 18.3%) and cough (13.7%) during or after training or game were significantly associated with the estimated personal NO(2) exposure of young hockey players (n=793) to average concentrations ranging from 21 to 1176 microg/m(3) in their home arena. During a 6-year follow-up of an intensive information campaign the portion of electric resurfacers increased from 9% to 27%, and that of emission control technology on propane-fuelled resurfacers increased from 13% to 84%. The portion of inadequately ventilated arenas decreased from 34% to 25%. However, 48% of the investigated Finnish ice arenas (n=125) did not fully comply with the non-regulatory recommendations. Consequently, 20000 daily users of ice arenas were estimated to remain in 2001 at risk of breathing poor quality air. Modern small and inadequately ventilated ice arenas pose their users (mostly children and young adults) at risk of breathing poor quality air and suffering from acute adverse health effects. Governmental regulations are needed worldwide to ensure safe sports in enclosed ice arenas.

Topics: Adolescent; Adult; Air Pollutants; Air Pollution, Indoor; Carbon Monoxide Poisoning; Child; Female; Finland; Humans; Male; Nitrogen Dioxide; Prevalence; Public Facilities; Respiration Disorders; Risk Assessment

To evaluate the association of different indices of traffic-related air pollution (self-report of traffic intensity, distance from busy roads from geographical information system (GIS), area-based emissions of particulate matter (PM), and estimated concentrations of nitrogen dioxide (NO(2)) from a land-use regression model) with respiratory health in adults.. A sample of 9488 25-59-year-old Rome residents completed a self-administered questionnaire on respiratory health and various risk factors, including education, occupation, housing conditions, smoking, and traffic intensity in their area of residence. The study used GIS to calculate the distance between their home address and the closest high-traffic road. For each subject, PM emissions in the area of residence as well as estimated NO2 concentrations as assessed by a land-use regression model (R(2) value = 0.69), were available. Generalised estimating equations (GEE) were used to analyse the association between air pollution measures and prevalence of "ever" chronic bronchitis, asthma, and rhinitis taking into account the effects of age, gender, education, smoking habits, socioeconomic position, and the correlation of variables for members of the same family.. Three hundred and ninety seven subjects (4% of the study population) reported chronic bronchitis, 472 (5%) asthma, and 1227 (13%) rhinitis. Fifteen per cent of subjects reported living in high traffic areas, 11% lived within 50 m of a high traffic road, and 28% in areas with estimated NO2 greater than 50 microg/m(3). Prevalence of asthma was associated only with self-reported traffic intensity whereas no association was found for the other more objective indices. Rhinitis, on the other hand, was strongly associated with all traffic-related indicators (eg, OR = 1.13, 95% CI: 1.04 to 1.22 for 10 microg/m(3) NO2, especially among non-smokers.. Indices of exposure to traffic-related air pollution are consistently associated with an increased risk of rhinitis in adults, especially among non-smokers. The results for asthma are weak, possibly due to ascertainment problems.

Topics: Adult; Air Pollution; Asthma; Bronchitis, Chronic; Environmental Exposure; Humans; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Prevalence; Respiration Disorders; Rhinitis; Rome; Smoking; Vehicle Emissions

This study describes the short-term relationships between the daily levels of PM10, PM2.5, NO2 and the number of doctors' house calls for asthma, upper respiratory diseases (URD) and lower respiratory diseases (LRD) in Greater Paris for the years 2000-3. Doctors' house calls are a relevant health indicator for the study of short-term health effects of air pollution. Indeed, it is potentially more sensitive than indicators such as general hospital admissions due to the severity of diseases motivating the call. In this study, time-series analysis was used. The daily numbers of doctor's house calls were adjusted for time trends, seasonal factors, day of the week, influenza, weather and pollen. Up to 15 days of lag between exposure and health effects was considered using distributed lag models. A total of about 1,760,000 doctors' house calls for all causes occurred during the study period, among which 8027 were for asthma, 52,928 for LRD and 74,845 for URD. No significant increase in risk was found between air pollution and doctors' house calls for asthma. No significant association was found between NO2 and doctors' house calls. An increase of 10 microg/m3 in the mean levels of PM10 and PM2.5 encountered during the 3 previous days was associated with an increase of 3% (0.8% and 5.3%) and 5.9% (2.9% and 9.0%) in the number of doctor's house calls for URD and LRD, respectively. Considering up to 15 days between exposure and health outcomes, effects persist until 4 days after exposure and then decrease progressively. No morbidity displacement was observed. This study shows a significant heath effect of ambient particles (PM2.5 and PM10). When compared to the RRs obtained for mortality or hospital admissions in the same area, the values of the RRs obtained in this study confirm the higher sensibility of doctor's house calls for respiratory diseases as a health indicator.

Topics: Air Pollutants; Air Pollution; Asthma; Confounding Factors, Epidemiologic; Dust; Environmental Exposure; House Calls; Humans; Meteorological Concepts; Nitrogen Dioxide; Paris; Particle Size; Poisson Distribution; Respiration Disorders; Urban Health; Vehicle Emissions

Delhi is an instructive location for studying the impact of air pollution since it is a rapidly expanding centre of government, trade commerce and industry. We have made an attempt to (1) determine the association between environmental pollution and respiratory morbidity in Delhi for the period 1998-2004, (2) assess the impact on hospital admission of the implementation of recent governmental regulations and (3) calculate the relative risk of hospitalization due to respiratory ailments caused by air pollutants. Seven hospitals from different parts of Delhi were selected. The pollution profiles of these areas were assessed and subsequently Poisson regression model was performed for the patient population. There was a remarkable decrease in monthly average concentration of sulphur dioxide (from 17.9 to 11.1 microg m(-3)) and increase in monthly average concentration of nitrogen dioxide (from 34.2 to 49.1 microg m(-3)) after the newly introduced regulations. Particulates were observed to have marginal fall in their concentration but still remained above the permissible limits. Gaseous pollutants, in spite of being at a level lower than the permissible level, showed more consistent significant association with respiratory admissions. The relative risks of hospitalization due to respiratory diseases were in the range of 1.07-2.82 in residential cum commercial areas. Comparative study of pre and post new stringent governmental regulation showed significant positive association of NO(2) with respiratory disorders in southern (RR: 1.10; CI: 1.09-1.12) and northern regions (RR: 1.33; CI: 1.27-1.39), both mixed use areas. In spite of the improvement in the air quality, the associated health effects were found to be substantial.

Topics: Air; Air Pollutants; Cities; Environmental Monitoring; Epidemiological Monitoring; Hospitalization; Humans; India; Inhalation Exposure; Nitrogen Dioxide; Respiration Disorders; Risk Assessment; Seasons; Time Factors; Urban Health

Recent papers have reported that Asian dust events have been associated with increased risks of all-cause mortality and rates of respiratory illness. The current study was designed to estimate the relative risk of mortality associated with Asian dust events. We used the daily counts of non-accidental deaths, air pollution and meteorological data in Seoul, Korea from 2000 to 2004. We divided all days during the study period into two groups according to the presence or absence of Asian dust events. For each group, we conducted time-series analysis to estimate the relative risk of total non-accidental death when the concentration of each air pollutant increased by the inter-quartile range (IQR). The average concentrations of every air pollutant on the days without a dust event were lower than those on the days with such an event. We found that the effect sizes of air pollution on daily death rates in the model without Asian dust events were larger than those in the model with Asian dust events, and were statistically significant for all air pollutants (PM(10), CO, NO(2), and SO(2)) except for O(3). Our results suggest that we are likely to underestimate the risk of urban air particles if we analyze the effect size of air pollution on daily mortality during Asian dust events. We hypothesize that the real health effect is much larger than previous results suggested.

Topics: Carbon Monoxide; Cause of Death; Dust; Environmental Monitoring; Epidemiological Monitoring; Humans; Korea; Nitrogen Dioxide; Ozone; Particle Size; Particulate Matter; Respiration Disorders; Respiratory Tract Diseases; Sulfur Dioxide; Urban Health

Chronic exposure to indoor nitrogen dioxide (NO2) is a public health concern. Over half of U.S. households have a source of NO2, and experimental data suggest potential for adverse respiratory effects.. To examine associations of indoor NO2 exposure with respiratory symptoms among children with asthma.. NO2 was measured using Palmes tubes, and respiratory symptoms in the month before sampling were collected during home interviews of mothers of 728 children with active asthma. All were younger than 12 yr, lived at the sampled home for at least 2 mo, and had asthma symptoms or used maintenance medication within the previous year.. Respiratory symptoms (wheeze, persistent cough, shortness of breath, chest tightness).. Mean (SD) NO2 was 8.6 (9.1) ppb in homes with electric ranges and 25.9 (18.1) ppb in homes with gas stoves. In models stratified by housing type (a factor associated with socioeconomic status), gas stove presence and elevated NO2 were each significantly associated with respiratory symptoms, controlling for age, ethnicity, medication, mold/mildew, water leaks, and season of sampling. Among children in multifamily housing, exposure to gas stoves increased likelihood of wheeze (odds ratio [OR], 2.27; 95% confidence interval [95% CI], 1.15, 4.47), shortness of breath (OR, 2.33; 95% CI, 1.12, 5.06), and chest tightness (OR, 4.34; 95% CI, 1.76, 10.69), whereas each 20-ppb increase in NO2 increased both likelihood of any wheeze (OR, 1.52; 95% CI, 1.04, 2.21) or chest tightness (OR, 1.61; 95% CI, 1.04, 2.49), and days of wheeze (rate ratio (RR), 1.33; 95% CI, 1.05, 1.68) or chest tightness (RR, 1.51; 95% CI, 1.18, 1.91).. Exposure to indoor NO2 at levels well below the Environmental Protection Agency outdoor standard (53 ppb) is associated with respiratory symptoms among children with asthma in multifamily housing.

Topics: Air Pollution, Indoor; Asthma; Child; Child, Preschool; Cohort Studies; Female; Household Articles; Housing; Humans; Inhalation Exposure; Male; Nitrogen Dioxide; Oxidants, Photochemical; Respiration Disorders

The impact of major gaseous and particulate pollutants emitted by the wildfire of October 2003 on ambient air quality and health of San Diego residents before, during, and after the fire are analyzed using data available from the San Diego County Air Pollution Control District and California Air Resources Board. It was found that fine particulate matter (PM) levels exceeded the federal daily 24-hr average standard during the fire. There was a slight increase in some of the gaseous pollutants, such as carbon monoxide, which exceeded federal standards. Ozone (O3) precursors, such as total hydrocarbons and methane gases, experienced elevated concentration during the fire. Fortunately, the absence of sunlight because of the cloud of thick smoke that covered most of the county during the fire appears to have prevented the photochemical conversion of the precursor gases to harmful concentrations of O3. Statistical analysis of the compiled medical surveillance data has been used to establish correlations between pollutant levels in the region and the resultant health problems experienced by the county citizens. The study shows that the increased PM concentration above the federal standard resulted in a significant increase in hospital emergency room visits for asthma, respiratory problems, eye irritation, and smoke inhalation. On the basis of the findings, it is recommended that hospitals and emergency medical facilities engage in pre-event planning that would ensure a rapid response to an impact on the healthcare system as a result of a large wildfire and appropriate agencies engage in the use of all available meteorological forecasting resources, including real-time satellite imaging assets, to accurately forecast air quality and assist firefighting efforts.

Topics: Air Pollutants; Asthma; California; Carbon Monoxide; Cities; Dust; Emergency Service, Hospital; Environmental Monitoring; Epidemiological Monitoring; Eye Diseases; Fires; Hospitalization; Humans; Hydrocarbons; Nitrogen Dioxide; Ozone; Particle Size; Respiration Disorders; Smoke; Smoke Inhalation Injury; Sulfur Dioxide

A case-crossover study was undertaken to investigate the relationship between daily air pollutant concentrations and daily hospitalizations for selected disease categories in Perth, Western Australia. Daily measurements of particles (measured by nephelometry and PM2.5), photochemical oxidants (measured as ozone), nitrogen dioxide (NO2) and carbon monoxide (CO) concentrations were obtained from 1992 to 1998 via a metropolitan network of monitoring stations. Daily PM2.5 concentrations were estimated using monitored data, modelling and interpolation. Hospital morbidity data for respiratory, cardiovascular (CVD), gastrointestinal (GI) diseases, chronic obstructive pulmonary diseases (COPD) excluding asthma; pneumonia/influenza diseases; and asthma were obtained and categorized into all ages, less than 15 years and greater than 65 years. Gastrointestinal morbidity was used as a control disease. The data were analyzed using conditional logistic regression. The results showed a small number of significant associations for daily changes in particle concentrations, nitrogen dioxide and carbon monoxide for the respiratory diseases, CODP, pneumonia, asthma and CVD hospitalizations. Changes in ozone concentrations were not significantly associated with any disease outcomes. These data provide useful information on the potential health impacts of air pollution in an airshed with very low sulphur dioxide concentrations and lower nitrogen dioxide concentrations commonly found in many other cities.

Topics: Air Pollution; Asthma; Carbon Monoxide; Cardiovascular Diseases; Cities; Cross-Sectional Studies; Environmental Exposure; Gastrointestinal Diseases; Hospitalization; Humans; Morbidity; Nitrogen Dioxide; Ozone; Particle Size; Regression Analysis; Respiration Disorders; Respiratory Tract Diseases; Western Australia

In 1991, Neas et al. reported that indoor nitrogen dioxide (NO(2)), a byproduct of high-temperature combustion, was significantly associated with lower respiratory symptoms among a cohort of 1,159 white children aged 7-11 years in six US cities studied from 1983 to 1988. For each 15 p.p.b. increment of NO(2), the multivariate adjusted odds ratio (OR) was 1.4 (95% confidence interval (CI)=[1.1, 1.7]). Although indoor NO(2) concentration in the ambient air was assessed only in a subset of the children, the prevalence of lower respiratory symptoms and surrogate exposure variables were available in all of the children at the time of the indoor monitoring program. This paper evaluates the effect of indoor NO(2) exposure on the annual risk of lower respiratory symptoms by applying a regression calibration method to the 2,891 children in the overall study with complete covariate and outcome data, 1,137 of whom had NO(2) directly measured and 1,754 of whom only surrogate exposure data were available. An estimate of the indoor annual NO(2) exposure effect (p.p.b.) is obtained, which is adjusted for measurement error induced by the use of surrogate NO(2) sources among the 1,754. These sources include the presence of a gas stove with or without a pilot light, the presence of a kerosene space heater, the presence of a wood stove, and the usage of a stove for heating, and residential characteristics, including fan usage for kitchen ventilation and the total number of rooms in the home. After adjusting for age, gender, city, parental history of respiratory diseases, and smoking inside the children's home (packs/day), a 15-p.p.b. increment in NO(2) exposure was found to be associated with a significant 50% increased annual risk of lower respiratory symptoms (OR=1.5, 95% CI=[1.2, 1.8]). Simulation results indicated that, under conditions similar to those observed in these data, the estimator is unbiased and has a coverage probability close to the nominal value. Using the methodology illustrated in this paper, it became possible to utilize all data available and obtain a 34% more precise estimate of the NO(2) exposure effect on lower respiratory symptoms, which was adjusted for measurement error due to using NO(2) surrogates instead of directly measured NO(2).

Topics: Air Pollution, Indoor; Child; Data Interpretation, Statistical; Humans; Nitrogen Dioxide; Reproducibility of Results; Respiration Disorders

We evaluated the influence of outdoor air pollution on infant death in the South Coast Air Basin of California, an area characterized by some of the worst air quality in the United States.. Linking birth and death certificates for infants who died between 1989 and 2000, we identified all infant deaths, matched 10 living control subjects to each case subject, and assigned the nearest air monitoring station to each birth address. For all subjects, we calculated average carbon monoxide, nitrogen dioxide, ozone, and particulate matter < 10 microm in aerodynamic diameter exposures experienced during the 2-week, 1-month, 2-month, and 6-month periods before a case subject's death.. The risk of respiratory death increased from 20% to 36% per 1-ppm increase in average carbon monoxide levels 2 weeks before death in early infancy (age: 28 days to 3 months). We also estimated 7% to 12% risk increases for respiratory deaths per 10-microg/m3 increase in particulate matter < 10 microm in aerodynamic diameter exposure experienced 2 weeks before death for infants 4 to 12 months of age. Risk of respiratory death more than doubled for infants 7 to 12 months of age who were exposed to high average levels of particulates in the previous 6 months. Furthermore, the risk of dying as a result of sudden infant death syndrome increased 15% to 19% per 1-part per hundred million increase in average nitrogen dioxide levels 2 months before death. Low birth weight and preterm infants seemed to be more susceptible to air pollution-related death resulting from these causes; however, we lacked statistical power to confirm this heterogeneity with formal testing.. Our results add to the growing body of literature implicating air pollution in infant death from respiratory causes and sudden infant death syndrome and provide additional information for future risk assessment.

Topics: Air; Air Pollutants; Air Pollution; California; Carbon Monoxide; Case-Control Studies; Death Certificates; Environmental Monitoring; Epidemiological Monitoring; Female; Humans; Infant; Infant Mortality; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Male; Nitrogen Dioxide; Ozone; Particle Size; Respiration Disorders; Risk Assessment; Risk Factors; Sudden Infant Death

NO2)is a major urban air pollutant. Previously reported associations between ambient NO2)and children's respiratory health have been inconsistent, and independent effects of correlated pollutants hard to assess. The authors examined effects of NO2 on a spectrum of 11 respiratory symptoms, controlling for PM10 and SO2, using a large pooled dataset.. Cross sectional studies were conducted in Russia, Austria, Italy, Switzerland, and the Netherlands, during 1993-99, contributing in total 23 955 children. Study-specific odds ratios for associations with ambient NO2 are estimated using logistic regressions with area-level random effects. Heterogeneity between study-specific results, and mean estimates (allowing for heterogeneity) are calculated.. Long term average NO2 concentrations were unrelated to prevalences of bronchitis or asthma. Associations were found for sensitivity to inhaled allergens and allergy to pets, with mean odds ratios around 1.14 per 10 microg/m3 NO2. SO2 had little confounding effect, but an initial association between NO2 and morning cough was reduced after controlling for PM10. Associations with reported allergy were not reduced by adjustment for the other pollutants. Odds ratios for allergic symptoms tended to be higher for the 9-12 year old children compared with the 6-8 year old children.. Evidence for associations between NO2 and respiratory symptoms was robust only for inhalation allergies. NO2 most likely is acting as an indicator of traffic related air pollutants, though its direct effect cannot be ruled out. This remains important, as policies to reduce traffic related air pollution will not result in rapid reductions.

Topics: Air Pollutants; Allergens; Child; Cross-Sectional Studies; Effect Modifier, Epidemiologic; Environmental Exposure; Environmental Monitoring; Epidemiological Monitoring; Europe; Humans; Models, Biological; Nitrogen Dioxide; Respiration Disorders

Dust generating events frequently produce ambient dust particles that are less than 10 microm in diameter, and these have been linked to adverse effects in the general population. However, the evidence linking these particles to adverse effects on the airways of asthmatic individuals is limited. The objective of this study was to investigate the possible adverse effects of Asian dust events on the respiratory functions and symptoms of subjects with bronchial asthma.. From March to June 2002, individuals were enrolled who had been diagnosed as having asthma by bronchial challenge or by their bronchodilator response. The patients were divided into three groups according to asthma severity: mild, moderate and severe. Patients with other major disease states were excluded. Patients completed twice-daily diaries monitoring PEF, respiratory symptoms, and daily activities. The daily and hourly mean levels of particulate matter <10 microm in diameter (PM(10)), as well as nitrogen dioxide (NO(2)), sulphur dioxide (SO(2)), ozone (O(3)) and carbon monoxide (CO) were measured at 10 monitoring sites in Incheon, Korea.. Dust events occurred 14 times during the study period. On dusty days there were increased levels of PM(10), decreased levels of NO(2) and SO(2), and no change in the CO levels, compared to the levels on control days. An increase in PM(10) concentration was associated with increases in PEF variability of >20% (P<0.05), more night-time symptoms (P<0.05), and a decrease in the mean PEF (P<0.05), calculated by longitudinal data analysis. In contrast, there was no association between the PM(10) levels and bronchodilator inhaler use or daytime respiratory symptoms. Using a general additive Poisson regression model, a borderline association was noted between PM(10) and respiratory symptoms, with a relative risk of 1.05 (95% confidence interval (CI), 0.99--1.17). There was no association between the PM(10) concentrations and PEF measurements, with PEF variability of >20% between the morning and evening values and a relative risk of 1.05 (95% CI, 0.89--1.24) in all subjects.. This study provides evidence that Asian dust events are impacting on the respiratory symptoms of subjects with bronchial asthma, and ambient air pollution, particularly elevated PM(10), might be one of the aggravating factors.

Topics: Adult; Air Pollutants; Asthma; Carbon Monoxide; Dust; Environmental Monitoring; Female; Humans; Korea; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particle Size; Peak Expiratory Flow Rate; Respiration Disorders; Sulfur Dioxide

Air pollution has been associated with daily mortality in numerous studies over the past decade. However most of these studies were conducted in the United States and Europe with relatively few done in Asia. In the current study, the association between ambient air pollution and daily mortality in Taipei, Taiwan's largest city which has a subtropical climate was undertaken, for the period 1994-1998 using a case-crossover analysis. This design is an alternative to Poisson time series regression for studying the short-term adverse health effects of air pollution. The air pollutants examined included particulate matter (PM(10)), sulfur dioxide (SO(2)), ozone (O(3)), nitrogen dioxide (NO(2)), and carbon monoxide (CO). The largest observed effect, which was without statistical significance, was seen for NO(2) and CO levels on deaths due to respiratory diseases (ORs=1.013 and 1.014, respectively). The well established link between air pollution levels and daily mortality may not be as strong in cities in subtropical areas, although other factors such as differences in pollutant mix or the underlying health of the population may explain the lack of a strong association in this study. Further studies of this type in cities with varying climates and cultures are needed.

Topics: Air Pollution; Carbon Monoxide; Cities; Environmental Exposure; Environmental Monitoring; Humans; Mortality; Nitrogen Dioxide; Odds Ratio; Ozone; Particle Size; Respiration Disorders; Sulfur Dioxide; Taiwan

Effects of nitrogen dioxide (NO2) on respiratory health have been the subject of extensive research. The outcomes of these studies were not consistent. Exposure to nitrous acid, which is a primary product of combustion, and is also formed when NO2 reacts with water, may play an important role in respiratory health. We estimate the independent effects of exposure to nitrogen dioxide and nitrous acid on respiratory symptoms during the first year of life.. Nitrogen dioxide and nitrous acid concentrations were measured once (1996-1998) in the homes of 768 infants who were at risk for developing asthma. Infants were living in southern New England. The frequency of respiratory symptoms in these children was recorded during the first year of life.. Infants living in homes with an NO2 concentration exceeding 17.4 ppb (highest quartile) had a higher frequency of days with wheeze (rate ratio = 2.2; 95% confidence interval = 1.4-3.4), persistent cough (1.8; 1.2-2.7), and shortness of breath (3.1; 1.8-5.6) when compared with infants in homes that had NO2 concentrations lower than 5.1 ppb (lowest quartile), controlling for nitrous acid concentration. Nitrous acid exposure was not independently associated with respiratory symptoms.. Among infants at risk for developing asthma, the frequency of reported respiratory symptoms in the first year of life was associated with levels of NO2 not currently considered to be harmful.

Topics: Air Pollution, Indoor; Asthma; Connecticut; Cough; Dyspnea; Environmental Exposure; Humans; Infant; Interviews as Topic; Massachusetts; Nitrogen Dioxide; Nitrous Acid; Respiration Disorders; Respiratory Sounds; Risk Assessment

To investigate the acute health effects of winter outdoor air pollution (nitrogen dioxide (NO(2)), ozone (O(3)), sulphur dioxide (SO(2)), sulphate (SO(4)(2-)),and particles (PM(10))) on schoolchildren in an area of southern England where levels of SO(2) had been reported to be high.. A total of 179 children, aged 7-13, from three schools (two urban and one rural location), were included. Peak expiratory flow rate (PEFR) and presence or absence of upper respiratory infections were recorded on 63 school days from 1 November 1996 to 14 February 1997. Air pollution and meteorological data were taken from monitors at each school site. The analysis regressed daily PEFR on pollutant level adjusting for confounders and serial correlation and calculated a weighted pooled estimate of effect overall for each pollutant. In addition, large decrements in PEFR were analysed as a binary outcome. Same day, lag 1, lag 2, and a five day average of pollutant levels were used.. There were no clear effects of any pollutant on mean PEFR. In addition, we analysed large PEFR decrements (a binary outcome), observing consistent negative associations with NO(2), SO(4)(2-), and PM(10), although few lag/pollutant combinations were significant: odds ratios (95% CI) for five day average effect: NO(2) 24 h average 1.043 (1.000 to 1.089), SO(4)(2-) 1.090 (0.898 to 1.322), PM(10) 1.037 (0.992 to 1.084). The observed effects of PM(10) (only) were stronger in wheezy children (1.114 (1.057 to 1.174)). There were no consistent negative associations between large decrements and ozone or SO(2).. There is no strong evidence for acute effects of winter outdoor air pollution on mean PEFR overall in this area, but there is evidence for negative effects on large PEFR decrements.

Topics: Adolescent; Air Pollutants; Air Pollution; Child; England; Female; Forced Expiratory Volume; Humans; Male; Nitrogen Dioxide; Ozone; Peak Expiratory Flow Rate; Respiration Disorders; Respiratory Sounds; Rural Health; Seasons; Sulfates; Sulfur Dioxide; Urban Health; Vital Capacity

Susceptibility of target populations to air pollution is an important issue, because air pollution policies and standards should be based on the susceptibilities of those at particular risk. To evaluate which age group is more susceptible to the adverse health effects of air pollution, we compared the effects of air pollution on mortality among postneonates, those aged 2 to 64 years, and those over 65 years of age.. Daily counts of total and respiratory death along with daily levels of meteorological variables and air pollutants were analyzed using generalized additive Poisson regression. The relative risks (RR) of mortality for interquartile changes of the levels of particulate matter <10 micro m (PM(10)) were calculated on the same day.. For postneonates, the RR of total mortality for an interquartile change (42.9 micro g/m(3)) in PM(10) (RR: 1.142; 95% confidence interval [CI]: 1.096-1.190) was greatest among age groups. Next were the elderly over 65 years of age (RR: 1.023; 95% CI: 1.022-1.024). Regarding respiratory mortality, RR for an interquartile change of PM(10) in postneonates (RR: 2.018; 95% CI: 1.784-2.283) was also greater than those in the other groups.. These results agree with the hypothesis that infants are most susceptible to PM(10) in terms of mortality, particularly respiratory mortality.

Topics: Adolescent; Adult; Aged; Air Pollution; Carbon Monoxide; Child; Child, Preschool; Disease Susceptibility; Humans; Infant; Infant Mortality; Infant, Newborn; Korea; Middle Aged; Nitrogen Dioxide; Ozone; Respiration Disorders; Sulfur Dioxide

Air pollution has been associated with daily mortality in numerous studies over the past decade. However, most of these studies were conducted in the United States and Europe, with relatively few done in Asia. In this study, the association between ambient air pollution and daily mortality in Kaohsiung, Taiwan, a large industrial city with a tropical climate, was investigated for the period 1994-2000 using a case-crossover analysis. This design is an alternative to Poisson time-series regression for studying the short-term adverse health effects of air pollution. The air pollutants examined included particulate matter (PM10), sulfur dioxide (SO2), ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO). No significant effects were found between PM10 and SO2 exposure levels and respiratory-related mortality. The well-established link between air pollution levels and daily mortality may not be as strong in cities in tropical areas, although other factors such as differences in pollutant mixtures or underlying health of the population may explain the lack of a strong association in this study. Further studies of this type in cities with varying climates and cultures are needed.

Topics: Air Pollution; Carbon Monoxide; Cardiovascular Diseases; Cause of Death; Humans; Mortality; Nitrogen Dioxide; Odds Ratio; Ozone; Respiration Disorders; Sulfur Dioxide; Taiwan; Tropical Climate

We report analysis of data on outdoor air pollution and respiratory symptoms in children collected in the Czech part of the international Small Area Variations in Air pollution and Health (SAVIAH) Project, a methodological study designed to test the use of geographical information systems (GIS) in studies of environmental exposures and health at small area level. We collected the following data in two districts of Prague: (1) individual data on 3,680 children (response rate 88%) by questionnaires; (2) census-based socio-demographic data for small geographical units; (3) concentrations of nitrogen dioxide (NO2) and sulfur dioxide (SO2) measured by passive samplers in three 2-week surveys at 80 and 50 locations, respectively. We integrated all data into a geographical information system. Modeling of NO2 and SO2 allowed estimation of exposure to outdoor NO2 and SO2 at school and at home for each child. We examined the associations between air pollution and prevalence of wheezing or whistling in the chest in the last 12 months by logistic regression at individual level, weighted least squares regression at small area (ecological) level and multilevel modeling. The results varied by the level of analysis and method of exposure estimation. In multilevel analyses using individual data, odds ratios per 10 microg/m3 increase in concentrations were 1.16 (95% CI = 0.95-1.42) for NO2, and 1.08 (95% CI = 0.97-1.21) for SO2. While mapping of spatial distribution of NO2 and SO2 in the study area appeared valid, the interpolation from outdoor to personal exposures requires consideration.

Topics: Air Pollutants; Child; Czech Republic; Female; Humans; Linear Models; Male; Nitrogen Dioxide; Prevalence; Respiration Disorders; Respiratory Sounds; Sulfur Dioxide; Surveys and Questionnaires

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

To investigate short term effects of concentrations of pollutants in ambient air on hospital admissions for cardiovascular and respiratory diseases in Hong Kong.. Retrospective ecological study. A Poisson regression was performed of concentrations of daily air pollutant on daily counts of emergency hospital admissions in 12 major hospitals. The effects of time trend, season, and other cyclical factors, temperature, and humidity were accounted for. Autocorrelation and overdispersion were corrected. Daily concentrations of nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3), and particulate matter < 10 microns in aerodynamic diameter (PM10) were obtained from seven air monitoring stations in Hong Kong in 1994 and 1995. Relative risks (RR) of respiratory and cardiovascular disease admissions (for an increase of 10 micrograms/m3 in concentration of air pollutant) were calculated.. Significant associations were found between hospital admissions for all respiratory diseases, all cardiovascular diseases, chronic obstructive pulmonary diseases, and heart failure and the concentrations of all four pollutants. Admissions for asthma, pneumonia, and influenza were significantly associated with NO2, O3, and PM10. Relative risk (RR) for admissions for respiratory disease for the four pollutants ranged from 1.013 (for SO2) to 1.022 (for O3), and for admissions for cardiovascular disease, from 1.006 (for PM10) to 1.016 (for SO2). Those aged > or = 65 years were at higher risk. Significant positive interactions were detected between NO2, O3, and PM10, and between O3 and winter months.. Adverse health effects are evident at current ambient concentrations of air pollutants. Further reduction in air pollution is necessary to protect the health of the community, especially that of the high risk group.

Topics: Air Pollutants; Cardiovascular Diseases; Hong Kong; Hospital Records; Hospitalization; Humans; Nitrogen Dioxide; Ozone; Respiration Disorders; Retrospective Studies; Sulfur Dioxide

Topics: Bias; Child; Heating; Humans; Nitrogen Dioxide; Research Design; Respiration Disorders

Nitrogen dioxide levels were measured in 80 homes in the Latrobe Valley, Victoria, Australia, using passive samplers. Some 148 children between 7 and 14 yr of age were recruited as study participants, 53 of whom had asthma. Health outcomes for the children were studied using a respiratory questionnaire, skin prick tests, and peak flow measurements. Nitrogen dioxide concentrations were low, with an indoor median of 11.6 microgram/m3 (6.0 ppb), and a maximum of 246 microgram/m3 (128 ppb). Respiratory symptoms were more common in children exposed to a gas stove (odds ratio 2.3 [95% CI 1. 0-5.2], adjusted for parental allergy, parental asthma, and sex). Nitrogen dioxide exposure was a marginal risk factor for respiratory symptoms, with a dose-response association present (p = 0.09). Gas stove exposure was a significant risk factor for respiratory symptoms even after adjusting for nitrogen dioxide levels (odds ratio 2.2 [1.0-4.8]), suggesting an additional risk apart from the average nitrogen dioxide exposure associated with gas stove use. Atopic children tended to have a greater risk of respiratory symptoms compared with nonatopic children with exposure to gas stoves or nitrogen dioxide, but the difference was not significant.

Topics: Adolescent; Air Pollutants; Air Pollution, Indoor; Asthma; Child; Confidence Intervals; Cough; Dyspnea; Female; Fossil Fuels; Household Articles; Housing; Humans; Hypersensitivity; Male; Nitrogen Dioxide; Odds Ratio; Oxidants, Photochemical; Parents; Peak Expiratory Flow Rate; Respiration Disorders; Respiratory Sounds; Risk Factors; Sex Factors; Skin Tests; Surveys and Questionnaires

Topics: Humans; Nitrogen Dioxide; Occupational Diseases; Respiration Disorders; Vehicle Emissions

To investigate if the population living along streets with high traffic density has a higher prevalence of chronic respiratory symptoms.. A sample of 673 adults and 106 children (0-15 years), living along busy traffic streets in the city of Haarlem was compared with a control sample of 812 adults and 185 children living along quiet streets. Exposed and control streets were selected on the basis of model calculations of NO2 concentrations. A postal questionnaire containing questions about respiratory symptoms and several potential confounders was used to collect information from the study subjects.. After adjustment for potential confounders, children living along busy streets were found to have a higher prevalence of most respiratory symptoms than children living along quiet streets. Adjusted odds ratios were significant for wheeze and for respiratory medication used. Risk ratios were higher for girls than for boys, with significant adjusted odds ratios between 2.9 and 15.8 for girls. In adults, only mild dyspnoea was more often reported by subjects living along streets with high traffic density.. The results suggest that living along busy streets increases the risk of developing chronic respiratory symptoms in children.

Topics: Adolescent; Adult; Case-Control Studies; Child; Child, Preschool; Chronic Disease; Environmental Exposure; Female; Humans; Infant; Infant, Newborn; Male; Models, Theoretical; Netherlands; Nitrogen Dioxide; Odds Ratio; Prevalence; Respiration Disorders; Vehicle Emissions

To assess the short term relationship between air pollution and the daily number of emergency hospital admissions for respiratory disease.. Data were analysed using autoregressive Poisson regression allowing for overdispersion and controlling for possible confounding factors such as seasonal and other chronological variables, meteorological factors, and influenza epidemics.. The two major cities in The Netherlands-Amsterdam (694,700 inhabitants) and Rotterdam (576,200 inhabitants).. Emergency hospital admissions for respiratory diseases, registered on a daily basis by the National Medical Registration, for the period 1977-89 were used. ICD-9 codes included were: respiratory (460-519), chronic obstructive pulmonary disease (490-492, 494, 496), and asthma (493). The mean (range) of the total daily number of admissions for these three classifications were as follows: 6.70 (0-23), 1.74 (0-9) and 1.13 (0-7) respectively in Amsterdam and 4.79 (0-19), 1.57 (0-9), and 0.53 (0-5) in Rotterdam. Air pollution measurements were provided by the National Institute of Public Health and Environmental Protection. In The Netherlands, air pollution is at a low to moderate ("summer type") or a low ("winter type") level. The levels in Amsterdam and Rotterdam did not differ much for the "summer type". For 1977-89 the mean (range) values of ozone (O3), the "summer type" pollutant (O3-8 h), were 86 (0-252) micrograms/m3 in Amsterdam and 82 (0-286) micrograms/m3 in Rotterdam. The mean (range) of the values "winter type", pollutant, sulphur dioxide (SO2-24 h), were 38 (0-381) micrograms/m3 in Amsterdam and 50 (1-379) micrograms/m3 in Rotterdam. For black smoke (BS-24 h), values were 14 (1-84) micrograms/m3 and 28 (1-144) micrograms/m3 respectively (1986-89).. Ozone had a non-significant positive effect on the number of respiratory emergency admissions in summer in people aged > or = 65 years (relative risk for a 100 micrograms/m3 increase in O3-8 h of 1.127 (0.983, 1.292) in Amsterdam and a significant positive effect of 1.344 (1.097, 1.647) in 1977-81 in Rotterdam). Sulphur dioxide did not show any clear effects; in Amsterdam a significant negative effect was even found. The same was true for nitrogen dioxide in Amsterdam; in Rotterdam, however, nitrogen dioxide showed non-significant positive effects (RR 0.965, 1.342). Black smoke did not show any clear effects in Amsterdam; in Rotterdam it was positively but not significantly related to the number of admissions.. The results show that the relation between short term air pollution and emergency hospital admissions is not always consistent at these rather low levels of daily hospital admissions and of air pollution.

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Emergencies; Hospitalization; Humans; Middle Aged; Netherlands; Nitrogen Dioxide; Odds Ratio; Ozone; Regression Analysis; Respiration Disorders; Smoke; Sulfur Dioxide

The short term association between daily mortality and ambient air pollution in the city of Lyon, France (population, 410,000) between 1985 and 1990 was assessed using time series analysis.. This study followed the standardised design and statistical analysis (Poisson regression) that characterise the APHEA project.. Four categories of cause of death were studied: total (minus external causes), respiratory, cardiovascular, and digestive causes (as a control condition).. No association was found with any cause of death for nitrogen dioxide (NO2) and ozone (O3), nor, for any pollutant, for digestive conditions. Sulphur dioxide (SO2) and, to a much lesser degree, suspended particles (PM13), were significantly related to mortality from respiratory and cardiovascular conditions. The relative risk (RR) of respiratory deaths associated with a 50 micrograms/m3 increment of mean daily SO2 over the whole period was 1.22 (95% CI 1.05, 1.40); the RR for cardiovascular deaths was 1.54 (1.22, 1.96). The corresponding RRs for PM13 were 1.04 (1.00, 1.09) for respiratory mortality and 1.04 (0.99, 1.10) for cardiovascular deaths.. The effects of particulates were slightly increased during the cold season. When particulates concentrations were greater than 60 micrograms/m3, the joint SO2 effect was increased, suggesting some interaction between the two pollution indicators. These results agree with other studies showing an association between particulate pollution and daily mortality; however, they also suggest the noxious effect of SO2.

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Case-Control Studies; Cause of Death; Confounding Factors, Epidemiologic; France; Humans; Nitrogen Dioxide; Odds Ratio; Ozone; Regression Analysis; Respiration Disorders; Smoke; Sulfur Dioxide

To quantify the short term respiratory health effects of ambient air pollution in the Paris area.. Time series analysis of daily pollution levels using Poisson regression.. Paris, 1987-92.. Air pollution was monitored by measurement of black smoke (BS) (15 monitoring stations), sulphur dioxide (SO2), nitrogen dioxide (NO2), particulate matter less than 13 microns in diameter (PM13), and ozone (O3) (4 stations). Daily mortality and general admissions to public hospitals due to respiratory causes were considered. The statistical analysis was based on a time series procedure using linear regression modelling followed by a Poisson regression. Meterological variables, epidemics of influenza A and B, and strikes of medical staff were included in the models. The mean daily concentration of PM13 and daily 1 hour maximum of SO2 significantly affected daily mortality from respiratory causes. An increase in the concentration of PM13 of 100 micrograms/m3 above its 5th centile value increased the risk of respiratory death by 17%. PM13 and BS were also associated with hospital admissions due to all respiratory diseases (4.1% increased risk when the BS level exceeded its 5th centile value by 100 micrograms/m3). SO2 levels consistently influenced hospital admissions for all respiratory diseases, chronic obstructive pulmonary disease, and asthma. Asthma was also correlated with NO2 levels.. These results indicate that even though the relative risk is weak in areas with low levels of pollution, ambient air pollution, and especially particulate matter and SO2, nonetheless require attention because of the number of people exposed and the existence of high risk groups.

Topics: Adolescent; Adult; Air Pollutants; Air Pollution; Dust; Hospitalization; Humans; Middle Aged; Nitrogen Dioxide; Odds Ratio; Paris; Regression Analysis; Respiration Disorders; Seasons; Smoke; 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

Studies conducted in Barcelona reported a short term relation between daily air pollutant values and emergency department admissions for exacerbation of chronic obstructive pulmonary diseases and asthma. Air pollution in Barcelona is mainly generated by vehicle exhaust and is below the World Health Organization air quality guidelines. The acute relation between air pollution and mortality was assessed.. Daily variations in total mortality, mortality in subjects older than 70 years, and cardiovascular and respiratory mortality were related with daily variations in air pollutants for the period 1985-91, using autoregressive Poisson regression models that allow to control for temperature, relative humidity and variables handling temporal and autoregressive patterns.. Black smoke and sulphur dioxide (SO2) were related to total mortality (relative risks (RR) for 100 micrograms/m3 = 1.07 and 1.13 respectively), elderly mortality (RR = 1.06 and 1.13), cardiovascular mortality (RR = 1.09 and 1.14), and respiratory mortality (RR = 1.10 and 1.13); all the associations being statistically significant, except for respiratory mortality (p = 0.07). The association between SO2 and respiratory mortality was stronger in summer (1.24, p < 0.01) than in winter (1.08, p > 0.1). Oxidant pollutants (nitrogen dioxide and ozone) were positively related with elderly mortality (RR = 1.05 and 1.09, respectively) and cardiovascular mortality (RR = 1.07 and 1.09) during the summer (p < 0.05), but not during the winter.. Current air pollutant levels were related to mortality in Barcelona. These results were consistent with similar studies in other cities and coherent with previous studies with emergency room admissions in Barcelona.

Topics: Age Factors; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Cause of Death; Humans; Nitrogen Dioxide; Odds Ratio; Ozone; Regression Analysis; Respiration Disorders; Seasons; Smoke; Spain; Sulfur Dioxide

In 1994, 16,187 junior high school students were surveyed in Jakarta and surrounding cities, Indonesia, to study the effect of air pollution on respiratory illnesses. Nitrogen dioxide (NO2) was measured by the filter badge developed by Yanagisawa and Nishimura as a measure of air pollution. The average concentration of NO2 is the highest in central Jakarta and Tangerang (22-30 ppb), the lowest in rural areas (5-11 ppb), and in other cities, 11-20 ppb. Self-administered questionnaires were given to the students in 29 schools to obtain respiratory symptoms of cough, phlegm and wheeze. A significant relationship was found in this study between NO2 exposure levels and prevalence rates of cough, phlegm, and wheezing without cold, which were 27.7 to 38.7%, 15.0 to 21.9%, and 1.4 to 2.9%, respectively. Prevalence rates of persistent cough and persistent phlegm were 7.3 to 10.8% and 4.5 to 5.0% respectively. These rates were higher than those found by other researchers. This difference may be partly due to the survey methods. The more polluted, the higher the prevalence rate of respiratory symptoms.

Topics: Adolescent; Air Pollution; Cough; Female; Humans; Indonesia; Male; Nitrogen Dioxide; Prevalence; Respiration Disorders; Respiratory Sounds

Topics: Hockey; Humans; Nitrogen Dioxide; Respiration Disorders; Respiratory Function Tests

The relation of chronic respiratory symptoms and pulmonary function to formaldehyde (HCHO) in homes was studied in a sample of 298 children (6-15 years of age) and 613 adults. HCHO measurements were made with passive samplers during two 1-week periods. Data on chronic cough and phlegm, wheeze, attacks of breathlessness, and doctor diagnoses of chronic bronchitis and asthma were collected with self-completed questionnaires. Peak expiratory flow rates (PEFR) were obtained during the evenings and mornings for up to 14 consecutive days for each individual. Significantly greater prevalence rates of asthma and chronic bronchitis were found in children from houses with HCHO levels 60-120 ppb than in those less exposed, especially in children also exposed to environmental tobacco smoke. In children, levels of PEFR decreased linearly with HCHO exposure, with the estimated decrease due to 60 ppb of HCHO equivalent to 22% of PEFR level in nonexposed children. The effects in asthmatic children exposed to HCHO below 50 ppb were greater than in healthy ones. The effects in adults were less evident: decrements in PEFR due to HCHO over 40 ppb were seen only in the morning, and mainly in smokers.

Topics: Adolescent; Adult; Age Factors; Arizona; Asthma; Bronchitis; Child; Environmental Exposure; Female; Formaldehyde; Housing; Humans; Male; Models, Biological; Nitrogen Dioxide; Respiration Disorders; Smoking; Socioeconomic Factors; Time Factors; Tobacco Smoke Pollution

As part of a series of epidemiologic studies of the mortality patterns of railroad workers, various air contaminants were measured to characterize the workers' current exposures to diesel exhaust. Nitrogen dioxide (NO2), which is a constituent of diesel exhaust, was examined as one possible marker of diesel exposure. An adaptation of the Palmes personal passive sampler was used to measure the NO2 exposures of 477 U.S. railroad workers at four railroads. The range of NO2 exposures expressed as the arithmetic average +/- two standard errors for the five career job groups were as follows: signal maintainers, 16-24 parts per billion (ppb); clerks/dispatchers/station agents, 23-43 ppb; engineers/firers, 26-38 ppb; brakers/conductors, 50-74 ppb; and locomotive shop workers, 95-127 ppb. Variations among railroads and across seasons were not significant for most job groups.

Topics: Air Pollutants, Occupational; Chronic Disease; Environmental Exposure; Humans; Lung Neoplasms; Nitrogen Dioxide; Railroads; Respiration Disorders

During February 1987 an outbreak of nitrogen dioxide-induced respiratory illness occurred among players and spectators of two high school hockey games played at an indoor ice arena in Minnesota. The source of the nitrogen dioxide was the malfunctioning engine of the ice resurfacer. Case patients experienced acute onset of cough, hemoptysis, and/or dyspnea during, or within 48 hours of attending, a hockey game. One hundred sixteen cases were identified among hockey players, cheerleaders, and band members who attended the two games. Members of two hockey teams had spirometry performed at 10 days and 2 months after exposure; no significant compromise in lung function was documented. Nitrogen dioxide exposure in indoor ice arenas may be more common than currently is recognized; only three states require routine monitoring of air quality in ice arenas, and the respiratory symptoms caused by exposure to nitrogen dioxide are nonspecific and easily misdiagnosed.

Topics: Disease Outbreaks; Female; Hockey; Humans; Male; Minnesota; Nitrogen Dioxide; Respiration Disorders

Topics: Air Pollutants; Hockey; Humans; Nitrogen Dioxide; Occupational Diseases; Quebec; Respiration Disorders; Sports

Personal samples of nitrogen dioxide (NO2) and respirable particulate (RP) were collected over the shift on 232 workers in four diesel bus garages. Response was assessed by an acute respiratory questionnaire and before and after shift spirometry. Measures of exposure to NO2 and RP were associated with work-related symptoms of cough; itching, burning, or watering eyes; difficult or labored breathing; chest tightness; and wheeze. The prevalence of burning eyes, headaches, difficult or labored breathing, nausea, and wheeze experienced at work were higher in the diesel bus garage workers than in a comparison population of battery workers, while the prevalence of headaches was reduced. Mean reductions in forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), peak flow, and flows at 50 and 75% of FVC were not obviously different from zero. There was no detectable association of exposure to NO2 or respirable particulate and acute reductions in pulmonary function. Workers who often had respiratory work-related symptoms generally had a slightly greater mean acute reduction in FEV1 and FEF50 than did those who did not have these symptoms, but these differences were not statistically significant.

Topics: Adolescent; Adult; Dust; Epidemiologic Methods; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Occupational Diseases; Respiration Disorders; Respiratory Function Tests; Respiratory System; Transportation; Vehicle Emissions

Reported here are the results from an ongoing study of outdoor air pollution and respiratory health of children living in six cities in the eastern and midwestern United States. The study enrolled 10,106 white preadolescent children between 1974 and 1977 in 3 successive annual visits to each city. Each child received a spirometric examination, and a parent completed a standard questionnaire. Of this cohort, 8,380 children were seen for a second examination 1 yr later. An air pollution monitoring program was begun in each community at about the time of the first examination. For this report, measurements of total suspended particulates (TSP), the sulfate fraction of TSP (TSO4), and sulfur dioxide (SO2) concentrations at study-affiliated outdoor stations were combined with measurements at other public and private monitoring sites to create a record of TSP, TSO4, and SO2 concentrations in each of 9 air pollution regions during the 1-yr period preceding each examination and, for TSP, during each child's lifetime up to the time of testing. Across the 6 cities, frequency of cough was significantly associated with the average of 24-h mean concentrations of all 3 air pollutants during the year preceding the health examination (p less than 0.01). Rates of bronchitis and a composite measure of lower respiratory illness were significantly associated with average particulate concentrations (p less than 0.05). In analyses restricted to lifetime residents, these outcomes were significantly associated with measures of lifetime mean TSP concentration. Within the cities, however, temporal and spatial variation in air pollutant concentrations and illness and symptom rates were not positively associated.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Air Pollutants; Child; Humans; Lung Volume Measurements; Nitrogen Dioxide; Respiration Disorders; Respiratory Tract Diseases; Sulfur Dioxide; United States

Topics: Air Pollutants; Humans; Nitrogen Dioxide; Respiration Disorders

Topics: Adult; Asthma; Environment, Controlled; Female; Hot Temperature; Humans; Male; Nitrogen Dioxide; Physical Exertion; Respiration Disorders; Respiratory Function Tests; Smoking; Sulfur Dioxide; Tobacco Use Disorder

Serial physiologic studies were performed to characterize both the immediate and delayed effects of a single occupational exposure to nitrogen dioxide in a nonsmoker. During the initial acute stage of pulmonary edema, the abnormal static pressure-volume curve and decreased static compliance corresponded to a reduction in pulmonary volume. During the delayed acute stage, elastic recoil and properties of resistance to flow were normal, but dynamic compliance was reduced and dependent on respiratory frequency, and oxygen transport was abnormal during exercise, which is consistent with dysfunction of the small airways.

Topics: Forced Expiratory Flow Rates; Forced Expiratory Volume; Humans; Lung Diseases; Male; Middle Aged; Nitrogen Dioxide; Occupational Diseases; Pulmonary Edema; Respiration Disorders; Total Lung Capacity; Vital Capacity

Topics: Adult; Air Pollutants; Blood Pressure; Cardiac Output; Cardiovascular Diseases; Environmental Exposure; Humans; Male; Nitrogen Dioxide; Physical Exertion; Respiration Disorders; Respiratory Function Tests; Smoking