nitrogen-dioxide and Respiratory-Tract-Diseases

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

To determine whether long term exposure to outdoor nitrogen dioxide (NO2) is associated with all-cause or cause-specific mortality.. MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran's Q and I2 measures, and sources of heterogeneity were evaluated using meta-regression. Sensitivity of pooled estimates to individual studies was examined and publication bias was evaluated using Funnel plots, Begg's and Egger's tests, and trim and fill.. Seventy-nine studies based on 47 cohorts, plus one set of pooled analyses of multiple European cohorts, met inclusion criteria. There was a consistently high degree of heterogeneity. After excluding studies with probably high or high risk of bias in the confounding domain (n = 12), pooled hazard ratios (HR) indicated that long term exposure to NO2 was significantly associated with mortality from all/ natural causes (pooled HR 1.047, 95% confidence interval (CI), 1.023-1.072 per 10 ppb), cardiovascular disease (pooled HR 1.058, 95%CI 1.026-1.091), lung cancer (pooled HR 1.083, 95%CI 1.041-1.126), respiratory disease (pooled HR 1.062, 95%CI1.035-1.089), and ischemic heart disease (pooled HR 1.111, 95%CI 1.079-1.144). Pooled estimates based on multi-pollutant models were consistently smaller than those from single pollutant models and mostly non-significant.. For all causes of death other than cerebrovascular disease, the overall quality of the evidence is moderate, and the strength of evidence is limited, while for cerebrovascular disease, overall quality is low and strength of evidence is inadequate. Important uncertainties remain, including potential confounding by co-pollutants or other concomitant exposures, and limited supporting mechanistic evidence. (PROSPERO registration number CRD42018084497).

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Environmental Exposure; Humans; Lung Neoplasms; Myocardial Ischemia; Nitrogen Dioxide; Respiratory Tract Diseases

Air pollution is a leading global problem for public health. A number of ambient pollutants have been involved, including carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3) and particulate matter (PM). Although exposure to PM has been linked to a wide array of cardiovascular and respiratory disorders, its effect on venous thrombotic disorders is still uncertain. To elucidate this issue, we have performed a systematic review on the existing literature on the association between PM and venous thromboembolism (VTE), using MEDLINE, EMBASE and Cochrane electronic databases. Of the 158 reviewed studies, 11 of them (3 case-crossover studies, 2 time-series studies, 2 case-control studies, 2 prospective cohort studies, 2 retrospective studies) involving more than 500,000 events fulfilled the inclusion criteria and results are presented here. Because there was substantial heterogeneity in study design, duration of follow-up, statistical measure of effects, clinical outcomes and threshold, we refrained to perform a quantitative analysis of the available data and carried out only a systematic review. Overall, the literature data suggest a link between PM and VTE, but further trials on larger populations of patients with homogeneous study designs and outcomes are warranted.

Topics: Air Pollution; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Public Health; Respiratory Tract Diseases; Socioeconomic Factors; Sulfur Dioxide; Venous Thromboembolism

To quantitatively assess time-series studies of daily nitrogen dioxide (NO2) and mortality and hospital admissions which also controlled for particulate matter (PM) to determine whether or to what extent the NO2 associations are independent of PM.. A systematic review and meta-analysis.. Time-series studies-published in peer-reviewed journals worldwide, up to May 2011-that reported both single-pollutant and two-pollutant model estimates for NO2 and PM were ascertained from bibliographic databases (PubMed, EMBASE and Web of Science) and reviews. Random-effects summary estimates were calculated globally and stratified by different geographical regions, and effect modification was investigated.. Mortality and hospital admissions for various cardiovascular or respiratory diseases in different age groups in the general population.. 60 eligible studies were identified, and meta-analysis was conducted on 23 outcomes. Two-pollutant model study estimates generally showed that the NO2 associations were independent of PM mass. For all-cause mortality, a 10 µg/m(3) increase in 24-hour NO2 was associated with a 0.78% (95% CI 0.47% to 1.09%) increase in the risk of death, which reduced to 0.60% (0.33% to 0.87%) after control for PM. Heterogeneity between geographical region-specific estimates was removed by control for PM (I(2) from 66.9% to 0%). Estimates of PM and daily mortality assembled from the same studies were greatly attenuated after control for NO2: from 0.51% (0.29% to 0.74%) to 0.18% (-0.11% to 0.47%) per 10 µg/m(3) PM10 and 0.74% (0.34% to 1.14%) to 0.54% (-0.25% to 1.34%) for PM2.5.. The association between short-term exposure to NO2 and adverse health outcomes is largely independent of PM mass. Further studies should attempt to investigate whether this is a generic PM effect or whether it is modified by the source and physicochemical characteristics of PM. This finding strengthens the argument for NO2 having a causal role in health effects.

Topics: Air Pollutants; Cardiovascular Diseases; Hospitalization; Humans; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Risk Factors; Time Factors

To analyze the associations between air pollution and adverse health outcomes on respiratory diseases and to estimate the short-term effects of air pollutions [Particulate matter with particle size below 10 microns (PM(10)), PM(10) particulate matter with particle size below 2.5 microns (PM(2.5)), nitrogen dioxide (NO₂), sulphur dioxide (SO₂) and ozone (O₃)] on respiratory mortality in China.. Data related to the epidemiological studies on the associations between air pollution and adverse health outcomes of respiratory diseases that published from 1989 through 2014 in China, were collected by systematically searching databases of PubMed, SpringerLink, Embase, Medline, CNKI, CBM and VIP in different provinces of China. Short-term effects between (PM(10), PM(2.5), NO₂, SO₂, O₃) and respiratory mortality were analyzed by Meta-analysis method, and estimations were pooled by random or fixed effect models, using the Stata 12.0 software.. A total of 157 papers related to the associations between air pollution and adverse health outcomes of respiratory diseases in China were published, which covered 79.4% of all the provinces in China. Results from the Meta-analysis showed that a 10 µg/m³ increase in PM10, PM(2.5), NO₂, SO₂, and O₃was associated with mortality rates as 0.50% (95% CI: 0-0.90%), 0.50% (95% CI: 0.30%-0.70%), 1.39% (95% CI: 0.90%-1.78%), 1.00% (95% CI: 0.40%-1.59%) and 0.10% (95% CI: -1.21%-1.39%) in respiratory tracts, respectively. No publication bias was found among these studies.. There seemed positive associations existed between PM(10)/PM(2.5)/NO₂/SO₂and respiratory mortality in China that the relationship called for further attention on air pollution and adverse health outcomes of the respiratory diseases.

Topics: Air Pollutants; Air Pollution; China; Humans; Models, Theoretical; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide

Pooled estimates of air pollution health effects are important drivers of environmental risk communications and political willingness. In China, there is a lack of review studies to provide such estimates for health impact assessments.. We systematically searched the MEDLINE database using keywords of 80 major Chinese cities in Mainland China, Hong Kong and Taiwan on 30 June 2012, yielding 350 abstracts with 48 non-duplicated reports either in English or Chinese after screening. We pooled the relative risks (RR) per 10 μg/m3 of particulate matter (PM10), nitrogen dioxide (NO2), sulphur dioxide (SO2) and ozone (O3).. For short-term effects, the pooled RR (p<0.05) ranges were: 1.0031 (PM10) to 1.0140 (NO2) for all-cause mortality, 1.0034 (cardiopulmonary, PM10) to 1.0235 (influenza and pneumonia, SO2) for 9 specific-causes mortality, 1.0021 (cardiovascular, PM10) to 1.0162 (asthma, O3) for 5 specific-causes hospital admissions. For birth outcomes, the RR (p<0.05) ranged from 1.0051 (stillbirth, O3) to 1.1189 (preterm-birth, SO2) and for long-term effect on mortality from 1.0150 (respiratory, SO2) to 1.0297 (respiratory, NO2). Publication bias was absent (Egger test: p=0.326 to 0.624). Annual PM10 and NO2 concentrations were inversely associated with RR of mortality (p=0.017-0.028).. Evidence on short-term effects of air pollution is consistent and sufficient for health impact assessment but that on long-term effects is still insufficient.

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Cause of Death; China; Environmental Exposure; Female; Hong Kong; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Pregnancy; Pregnancy Outcome; Respiratory Tract Diseases; Sulfur Dioxide; Taiwan

This article reviews panel studies of air pollution on children's respiratory health and proposes future research directions.. The PubMed electronic database was used to search published original epidemiological studies in peer-reviewed journals from 2000 to November 2011. Children's age was limited to ≤18 years old. A total of 33 relevant articles were obtained, with 20 articles relating to lung function, 21 articles relating to respiratory symptoms, and 8 articles examining both.. Most studies suggested the adverse effects of air pollution on children's lung function and respiratory symptoms. Particles and NO(2) showed more significant results, whereas effects of SO(2) were not consistent. A few studies indicated that O(3) interacted with temperature and sometimes seemed to be a protective factor for children's respiratory health. Negative associations between air pollutants and pulmonary health were more serious in asthmatic children than in healthy subjects. However, many outcomes depended on the number of lag days. Peak expiratory flow (PEF) was the most usual measurement for children's lung function, followed by forced expiratory volume in 1 second (FEV(1)).. There are significant adverse effects of air pollution on children's pulmonary health, especially for asthmatics. Future studies need to examine the lag effects of air pollution on children's lung function and respiratory symptoms. Ambient temperature is predicted to change worldwide due to climate change, which will threaten population health. Further research is needed to examine the effects of ambient temperature and the interactive effects between air pollution and ambient temperature on children's lung function and respiratory symptoms.

Topics: Adolescent; Air Pollutants; Air Pollution; Child; Child, Preschool; Environmental Exposure; Global Health; Humans; Infant; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Function Tests; Respiratory Tract Diseases; Sulfur Dioxide

Nitrogen dioxide (NO2) is a ubiquitous atmospheric pollutant due to the widespread prevalence of both natural and anthropogenic sources, and it can be a respiratory irritant when inhaled at elevated concentrations. Evidence for health effects of ambient NO2 derives from three types of studies: observational epidemiology, human clinical exposures, and animal toxicology. Our review focuses on the human clinical studies of adverse health effects of short-term NO2 exposures, given the substantial uncertainties and limitations in interpretation of the other lines of evidence. We examined more than 50 experimental studies of humans inhaling NO2, finding notably that the reporting of statistically significant changes in lung function and bronchial sensitivity did not show a consistent trend with increasing NO2 concentrations. Functional changes were generally mild and transient, the reported effects were not uniformly adverse, and they were not usually accompanied by NO2-dependent increases in symptoms. The available human clinical results do not establish a mechanistic pathway leading to adverse health impacts for short-term NO2 exposures at levels typical of maximum 1-h concentrations in the present-day ambient environment (i.e., below 0.2 ppm). Our review of these data indicates that a health-protective, short-term NO2 guideline level for susceptible (and healthy) populations would reflect a policy choice between 0.2 and 0.6 ppm. EXTENDED ABSTRACT: Nitrogen dioxide (NO2) is a ubiquitous atmospheric pollutant due to the widespread prevalence of both natural and anthropogenic sources, and it can be a respiratory irritant when inhaled at elevated concentrations. Natural NO2 sources include volcanic action, forest fires, lightning, and the stratosphere; man-made NO2 emissions derive from fossil fuel combustion and incineration. The current National Ambient Air Quality Standard (NAAQS) for NO2, initially established in 1971, is 0.053 ppm (annual average). Ambient concentrations monitored in urban areas in the United States are approximately 0.015 ppm, as an annual mean, i.e., below the current NAAQS. Short-term (1-h peak) NO2 concentrations outdoors are not likely to exceed 0.2 ppm, and even 1-h periods exceeding 0.1 ppm are infrequent. Inside homes, 1-h NO2 peaks, typically arising from gas cooking, can range between 0.4 and 1.5 ppm. The health effects evidence of relevance to ambient NO2 derives from three lines of investigation: epidemiology studies, human clin

Topics: Air Pollutants; Animals; Cardiovascular Diseases; Environmental Monitoring; Epidemiological Monitoring; Humans; Inhalation Exposure; Nitrogen Dioxide; No-Observed-Adverse-Effect Level; Respiratory Tract Diseases; Time Factors; Toxicity Tests

Numerical research on the health effects of air pollution has been published in the last decade. Epidemiological studies have shown that children's exposure to air pollutants during fetal development and early postnatal life is associated with many types of health problems including abnormal development (low birth weight [LBW], very low birth weight [VLBW], preterm birth [PTB], intrauterine growth restriction [IUGR], congenital defects, and intrauterine and infant mortality), decreased lung growth, increased rates of respiratory tract infections, childhood asthma, behavioral problems, and neurocognitive decrements. This review focuses on the health effects of major outdoor air pollutants including particulates, carbon monoxide (CO), sulfur and nitrogen oxides (SO(2), NOx), ozone, and one common indoor air pollutant, environmental tobacco smoke (ETS). Animal data is presented that demonstrate perinatal windows of susceptibility to sidestream smoke, a surrogate for ETS, resulting in altered airway sensitivity and cell type frequency. A study of neonatal monkeys exposed to sidestream smoke during the perinatal period and/or early postnatal period that resulted in an altered balance of Th1-/Th2-cytokine secretion, skewing the immune response toward the allergy-associated Th2 cytokine phenotype, is also discussed.

Topics: Air Pollutants; Air Pollution; Air Pollution, Indoor; Allergens; Animals; Carbon Monoxide; Child; Child Development; Congenital Abnormalities; Humans; Hypersensitivity; Infant; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Sudden Infant Death; Sulfur Dioxide; Tobacco Smoke Pollution

In recent years, several studies in Europe have associated within-city contrasts in air pollution with various health end points including mortality in cohort studies of adults, and respiratory morbidity in cross-sectional and cohort studies of children. Many of these studies have used NO2 contrasts as the primary exposure variable, which raises the issue of whether such associations are uniquely found for NO2 per se, or whether NO2 acts as a surrogate for a complex mixture of combustion pollutants primarily derived from vehicular traffic. Exposure assessment in these studies has been based on dispersion modelling, on data from routine monitoring networks, on stochastic models developed from dedicated spatially resolved monitoring, or some combination of these. The results of a number of recent European studies are discussed.

Topics: Air Pollutants; Cities; Cohort Studies; Cross-Sectional Studies; Environmental Exposure; Europe; Humans; Models, Biological; Nitrogen Dioxide; Public Health; Respiratory Tract Diseases; Risk Assessment; Vehicle Emissions

The presented overview concerning health relevant effects caused by nitrogen dioxide (NO2) resumes the current state of results from animal experiments and human studies (epidemiology and short-term chambers studies). NO2 concentrations applied in animal experiments were mostly considerably higher than in ambient air. Therefore, short- and long-term limit values were derived from human data. Experimental studies conducted with humans demonstrate effects after short-term exposure to concentrations at or above 400 microg NO2/m3. Effects on patients with light asthma could not be observed after short-term exposure to concentrations below 200 microg/m3. On basis of epidemiological long-term studies a threshold below which no effect on human health is expected could not be specified. Two short-term limit values have been proposed to protect public health: a 1-h value of 100 microg/m3 and a 24-h mean value of 50 microg/m3. Due to the limitations of epidemiological studies to disentangle effects of single pollutants, a long-term limit value cannot be easily derived. However, applying the precautionary principle, it is desirable to adopt an annual mean of 20 microg NO2/m3 as a long-term mean standard to protect public health.

Topics: Air Pollutants; Animals; Environmental Exposure; Germany; Hospitalization; Humans; Mortality; Nitrogen Dioxide; No-Observed-Adverse-Effect Level; Respiratory Tract Diseases; Risk Assessment; Vehicle Emissions

Air is one of our most important natural resources; however, it is also in the front line for receiving environmental pollution. Air quality decreased markedly following the industrial revolution, but it was not until the great London Smog in 1952 that air quality made it onto the political agenda. The introduction of the Clean Air Act in 1956 led to dramatic decreases in black smoke and SO2 concentrations over the next two decades, as domestic and industrial coal-burning activities ceased. However, as these improvements progressed, a new threat to public health was being released into the air in ever-increasing quantities. Rapid motorisation of society from the 1960s onwards has led to the increased release of atmospheric pollutants such as tiny particles (particulate matter of <10 microm in aerodynamic diameter) and oxides of N, and the generation of the secondary pollutant O3. These primary and secondary traffic-related pollutants have all proved to be major risks factors to public health. Recently, oxidative stress has been identified as a unifying feature underlying the toxic actions of these pollutants. Fortunately, the surface of the lung is covered with a thin layer of fluid containing a range of antioxidants that appear to provide the first line of defence against oxidant pollutants. As diet is the only source of antioxidant micronutrients, a plausible link now exists between the sensitivity to air pollution and the quality of the food eaten. However, many questions remain unanswered in relation to inter-individual sensitivity to ambient air pollution, and extent to which this sensitivity is modified by airway antioxidant defences.

Topics: Air Pollutants; Antioxidants; Carbon Monoxide; Environmental Health; Humans; Lead; Nitrogen Dioxide; Oxidative Stress; Ozone; Public Health; Respiratory Tract Diseases; Risk Factors; Sulfur Dioxide

People spend about > or = 80-90%, of their daily time indoors, elderly people especially at home. Thus, it is important to investigate possible health effects of indoor air pollutants and to consider their contributions to the total human exposure. This report summarises current knowledge on health effects of three common indoor air pollutants, respirable suspended particles, nitrogen dioxide and environmental tobacco smoke, with focus on the adults and the elderly. Preliminary findings on exposure distributions and health effects of these pollutants in older subjects of two panel studies carried out in Italian general populations will also be reported. The two indoor pollution studies were performed in the Po Delta area in North Italy (428 subjects and 140 houses investigated) and in Pisa in Central Italy (761 subjects and 282 houses investigated). Individuals aged > or = 65 yrs spent a significantly larger number of hours at home than the other age groups both in winter and in summer. A trend of higher occurrence of acute respiratory symptoms in the presence of environmental tobacco smoke was shown in comparison to the unexposed elderly both in winter (31 versus 29%) and summer (33 versus 16%). The occurrence of acute respiratory symptoms was consistently higher in relation to the high respirable suspended particles-index exposure compared to low exposure (33 versus 27%, in winter, 27 versus 21% in summer). Both the presence of environmental tobacco smoke at home and exposure to the high respirable suspended particles-index were associated with a decrease in the mean daily peak expiratory flow.

Topics: Adult; Aged; Air Pollution, Indoor; Humans; Inhalation Exposure; Italy; Nitrogen Dioxide; Particle Size; Respiratory Tract Diseases; Tobacco Smoke Pollution

The health effects of air pollution have been subject to intense study in recent years. Exposure to pollutants such as airborne particulate matter and ozone has been associated with increases in mortality and hospital admissions due to respiratory and cardiovascular disease. These effects have been found in short-term studies, which relate day-to-day variations in air pollution and health, and long-term studies, which have followed cohorts of exposed individuals over time. Effects have been seen at very low levels of exposure, and it is unclear whether a threshold concentration exists for particulate matter and ozone below which no effects on health are likely. In this review, we discuss the evidence for adverse effects on health of selected air pollutants.

Topics: Air Pollutants; Cardiovascular Diseases; Environmental Monitoring; Europe; Humans; International Cooperation; Nitrogen Dioxide; Oxidants, Photochemical; Ozone; Respiratory Tract Diseases; Risk Factors; Sulfur Dioxide; United States; World Health Organization

Authors present the problem of air-pollution in Central Europe at the turn of centuries. The main sources (natural & antropogenic), main types of pollutants (particularly SO2 and O3), WHO atmospheric air quality Guidelines, outdoor & indoor air pollution, episodic and chronic consequences and mechanisms with clinical effects of air pollution on the respiratory system (function, self-defence) were shortly performed).

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; Europe; Humans; Nitrogen Dioxide; Respiratory Tract Diseases; Risk Factors

This article summarises the latest information on the adverse cardiorespiratory effects of exposure to carbon monoxide (CO) and nitrogen dioxide (NO(2)) in enclosed ice rinks. Sources of CO and NO(2) emissions are identified, current standards for these agents, as well as methods of controlling the emissions, dispersion, and evacuation of these toxic gases are presented. A detailed literature search involving 72 references in English and French from research conducted in North America and Europe was used. Material was from peer reviewed journals and other appropriate sources. Air pollutants such as carbon monoxide (CO), and nitrogen dioxide (NO(2)) which are present in enclosed skating facilities, may exacerbate a pre-existing pathogenic condition in those people who spend considerable time in these environments. Considering the popularity of ice hockey, short track speed skating, and figure skating, and the hundreds of hours that a sensitive person may spend each year in these environments, it would seem appropriate to seek more definitive answers to this important health problem. From the findings and conclusions of the research reviewed in this paper, 10 recommendations are listed.

Topics: Air Pollution, Indoor; Carbon Monoxide Poisoning; Carboxyhemoglobin; Confined Spaces; Heart Diseases; Humans; Nitrogen Dioxide; Practice Guidelines as Topic; Public Facilities; Respiratory Tract Diseases; Skating; Ventilation

Climate change may affect exposures to air pollutants by affecting weather, anthropogenic emissions, and biogenic emissions and by changing the distribution and types of airborne allergens. Local temperature, precipitation, clouds, atmospheric water vapor, wind speed, and wind direction influence atmospheric chemical processes, and interactions occur between local and global-scale environments. If the climate becomes warmer and more variable, air quality is likely to be affected. However, the specific types of change (i.e., local, regional, or global), the direction of change in a particular location (i.e., positive or negative), and the magnitude of change in air quality that may be attributable to climate change are a matter of speculation, based on extrapolating present understanding to future scenarios. There is already extensive evidence on the health effects of air pollution. Ground-level ozone can exacerbate chronic respiratory diseases and cause short-term reductions in lung function. Exposure to particulate matter can aggravate chronic respiratory and cardiovascular diseases, alter host defenses, damage lung tissue, lead to premature death, and possibly contribute to cancer. Health effects of exposures to carbon monoxide, sulfur dioxide, and nitrogen dioxide can include reduced work capacity, aggravation of existing cardiovascular diseases, effects on pulmonary function, respiratory illnesses, lung irritation, and alterations in the lung's defense systems. Adaptations to climate change should include ensuring responsiveness of air quality protection programs to changing pollution levels. Research needs include basic atmospheric science work on the association between weather and air pollutants; improving air pollution models and their linkage with climate change scenarios; and closing gaps in the understanding of exposure patterns and health effects.

Topics: Aerosols; Air Pollutants; Air Pollution; Allergens; Carbon Monoxide; Climate; Environmental Exposure; Fossil Fuels; Fungi; Greenhouse Effect; Humans; Lead; Nitrogen Dioxide; Oxidants, Photochemical; Ozone; Respiratory Tract Diseases; Risk Factors; Sulfur Dioxide; United States

Nitrogen dioxide (NO2) and particulate emissions play an important role in atmospheric pollution and might be a major cause of human respiratory problems in urban areas. This report provides an overview of traffic-related emissions monitored on several trunk roads and towns of the South Midlands of England between 1996 and 1999. NO2 pollution on major trunk roads frequently exceeded British and European Union air quality standards, while particle pollution was lower. The possible effects of traffic diversion activities in the research area are discussed. Bypasses of busy trunk roads might reduce NO2 pollution between 30 and 40% in urban centres and improve air quality for inhabitants in those areas.

Topics: Air Pollutants; England; Environmental Monitoring; Humans; Nitrogen Dioxide; Particle Size; Respiratory Tract Diseases; Vehicle Emissions

Topics: Air Pollution, Indoor; Cooking; Environmental Exposure; Female; Fossil Fuels; Humans; Male; Nitrogen Dioxide; Pulmonary Ventilation; Respiratory Hypersensitivity; Respiratory Tract Diseases

Topics: Acids; Air Pollutants; Air Pollution; Animals; Asthma; Ecosystem; Environmental Monitoring; Epidemiological Monitoring; Humans; Hypersensitivity; Lung Diseases, Obstructive; Lung Neoplasms; Nitrogen Dioxide; Ozone; Prognosis; Respiratory Tract Diseases; Respiratory Tract Infections; Rhinitis; Sulfur Dioxide; Vehicle Emissions

Particles, SOx, and acid aerosols are a complex group of distinct pollutants that have common sources and usually covary in concentration. During the past two decades, the chemical characteristics and the geographic distribution of sulfur oxide and particulate pollution have been altered by control strategies, specifically taller stacks for power plants, put in place in response to air pollution regulations adopted in the early 1970s. While the increasing stack heights have lowered local ambient levels, the residence time of SOx and particles in the air have been increased, thereby promoting transformation to various particulate sulfate compounds, including acidic sulfates. These sulfate particles constitute a large fraction of the total mass of smaller particles (< 3 microns in aerodynamic diameter). Epidemiologic studies have consistently provided evidence of adverse health effects of these air pollutants. Particulate and SO2 pollution were strongly implicated in the acute morbidity and mortality associated with the severe pollution episodes in Donora (Pennsylvania), London, and New York in the 1940s, 1950s, and 1960s. There is new evidence that even current ambient levels of PM10 (30 to 150 micrograms/m3) are associated with increases in daily cardiorespiratory mortality and in total mortality, excluding accidental and suicide deaths. These associations have been shown in many different communities, as widely different in particle composition and climate as Philadelphia, St. Louis, Utah Valley, and Santa Clara County, California. It has recently been shown in a long-term prospective study of adults in the United States that chronic levels of higher PM10 pollution are associated with increased mortality after adjusting for several individual risk factors. Daily fluctuations in PM10 levels have also been shown to be related to acute respiratory hospital admissions in children, to school and kindergarten absences, to decrements in peak flow rates in normal children, and to increased medication use in children and adults with asthma. Although some epidemiologic studies suggest that acid aerosols are an important toxic component of PM10, other studies do not support this hypothesis. Dockery and Pope (408) recently reviewed the epidemiologic literature for adverse effects, assuming that reported associations can be attributed to acute particle mass exposures. Combined effects were estimated as percent increase in comparable measures of mortality and morbidit

Topics: Adult; Aerosols; Air Pollutants; Air Pollution; Animals; Asthma; Biomarkers; Bronchial Hyperreactivity; Carbon Monoxide; Cardiovascular Diseases; Cattle; Cells, Cultured; Child; Emergencies; Environmental Health; Female; Hospitalization; Humans; Lead; Lung Diseases, Obstructive; Male; Models, Biological; Nitrogen Dioxide; Occupational Health; Ozone; Pregnancy; Rabbits; Rats; Respiratory Function Tests; Respiratory Tract Diseases; Sulfur Dioxide; United States

Nitrogen dioxide is produced from the combustion of fossil fuels and as an emission from gas-fired appliances, and is also a component of tobacco smoke. Nitrogen dioxide has been shown in experimental animals to be toxic to the respiratory tract. A n number of recent studies have suggested that children exposed to significant levels of nitrogen dioxide in the home may be more susceptible to respiratory illness than children exposed to normal ambient levels. Respiratory illness is a major cause of morbidity in children everywhere. Here, we review the available evidence of this association and explore methodological issues in measurement of nitrogen dioxide exposure--misclassification of subjects, symptom bias and confounding. It has recently been shown that some New South Wales school rooms, where unflued gas heaters are often used as a source of warmth, have nitrogen dioxide levels which are above recommended ambient levels for outside air. This has underlined the need for setting standards for indoor levels of various pollutants, and cohort studies are suggested, to include personal monitoring and prospective data collection techniques.

Topics: Air Pollution, Indoor; Child; Environmental Monitoring; Epidemiological Monitoring; Hot Temperature; Humans; New South Wales; Nitrogen Dioxide; Respiratory Tract Diseases

Topics: Environmental Exposure; Equipment Failure; Hockey; Humans; Nitrogen Dioxide; Pulmonary Edema; Respiratory Tract Diseases; Time Factors

Atmospheric pollution is increasingly responsible for chronic airway disease. Although outdoor pollution has decreased somewhat in recent years, indoor pollution has increased. Outdoor pollution results essentially from the combustion of coal and other fuels used for heating, industrial production and motor vehicles. The major sources of indoor pollution are heating and cooking devices. The main pollutants are suspended particulates, SO2, NO2 in indoor pollution and ozone which is linked to the photochemical effects. Transient increases in pollution cause transient decreases in pulmonary airflow. Chronic pollution seems to lead to an increase in the prevalence of lower and upper respiratory airway symptoms. In young children early exposure to pollution contributes to the development of chronic airways disease later in life. Asthmatics are at greater risk for pollution-related complications and several pollutants are known to increase bronchial reactivity. Further efforts are needed to reduce in pollution indoor and outdoor environments in particular with regard to tobacco smoke and especially for children.

Topics: Air Pollutants; Air Pollution; Child; Humans; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Sulfur Dioxide

The Japanese compensation system for pollution-related health damage, which resulted from experiences in the 1960s and 1970s with severe cases of environmental pollution, has recently come to a crisis. This article presents scientific evidence associated with the establishment of the system and analyzes the polluters' criticism of the system. The current controversy illustrates the difficulty of applying epidemiological methods to nonspecific health effects and demonstrates the strength of industrial resistance against environmental policy in Japan.

Topics: Air Pollutants; Air Pollution; Cross-Cultural Comparison; Disability Evaluation; Humans; Insurance, Liability; Japan; Maximum Allowable Concentration; Nitrogen Dioxide; Public Policy; Respiratory Tract Diseases

This article discusses the nomenclature of respiratory disease, acute respiratory distress syndromes, hypersensitivity diseases, chronic respiratory disease, and the differential diagnosis of respiratory disease.

Topics: Alveolitis, Extrinsic Allergic; Anaphylaxis; Animals; Brassica; Cattle; Cattle Diseases; Chronic Disease; Diagnosis, Differential; Granuloma; Lung Neoplasms; Manure; Monoterpenes; Nitrogen Dioxide; Plant Poisoning; Pneumonia; Pneumonia, Atypical Interstitial, of Cattle; Pulmonary Fibrosis; Respiratory Distress Syndrome; Respiratory Tract Diseases; Smog; Terpenes; Zinc Oxide

The effects of air pollution on human health are reviewed. Data from toxicology, epidemiology, clinical and laboratory exposures are presented as a basis for an emerging etiology. Sulfur dioxide, suspended particulates, nitrogen dioxide, photochemical oxidants, and carbon monoxide are examined as stress agents to the cardio-pulmonary system.

Topics: Air Pollutants; Air Pollution; Animals; Carbon Monoxide Poisoning; Carcinogens; Humans; Hydrocarbons; Immunity; Infant, Newborn; Mice; Nitrogen Dioxide; Occupations; Ozone; Photochemistry; Respiratory Tract Diseases; Respiratory Tract Neoplasms; Sulfur Dioxide; Vehicle Emissions

Topics: Air Pollutants; Animals; Bacterial Infections; Child; Cilia; Dark Adaptation; Environmental Exposure; Evaluation Studies as Topic; Humans; Lung Diseases; Macrophages; Maximum Allowable Concentration; Mucous Membrane; Nitrogen Dioxide; Occupational Diseases; Phagocytosis; Pulmonary Alveoli; Respiration; Respiratory Tract Diseases; Smell; Time Factors; United States

Topics: Air Pollution; Animals; Child; Environmental Exposure; Environmental Health; Fossil Fuels; Humans; Hydrocarbons; Maximum Allowable Concentration; Nitrogen Dioxide; Nitrous Oxide; Petroleum; Photochemistry; Respiratory Tract Diseases; Vehicle Emissions

Topics: Air Pollution; Bronchitis; Child; Child, Preschool; Cough; Dust; Environmental Exposure; Humans; Nitrogen Dioxide; Respiration; Respiratory Tract Diseases; Rhinitis; Sulfur Dioxide

Topics: Adolescent; Adult; Air Pollution; Carbon Monoxide; Child; Child, Preschool; Environmental Health; Humans; Hydrocarbons; Infant; Maximum Allowable Concentration; Models, Theoretical; Nitrogen Dioxide; Ozone; Public Health Administration; Respiratory Function Tests; Respiratory Tract Diseases; Specimen Handling; United States; Vehicle Emissions

Topics: Air Pollution; Arsenic Poisoning; Berylliosis; Cadmium Poisoning; Humans; Lung Diseases; Lung Diseases, Obstructive; Lung Neoplasms; Nitrogen Dioxide; Poisoning; Respiratory Tract Diseases; Solvents; Sulfur Dioxide

Topics: Air Pollution; Bacterial Infections; Carbon Monoxide Poisoning; Environmental Exposure; Environmental Pollution; Humans; Lung; Nitrogen Dioxide; Ozone; Pulmonary Emphysema; Respiratory System; Respiratory Tract Diseases; Sulfur Dioxide; Toxicology

Topics: Air Pollution; Animals; Blood Circulation; Bronchial Diseases; Lung Diseases; Nasal Mucosa; Nitrogen Dioxide; Nose Diseases; Ozone; Pulmonary Circulation; Pulmonary Edema; Respiratory Tract Diseases; Sulfoxides; Sulfur; Sulfur Dioxide

Topics: Aerosols; Air Pollution; Aldehydes; Asthma; Atmosphere; Beryllium; Bronchitis; Carbon Monoxide Poisoning; Carcinogens; Environmental Health; Europe; Formaldehyde; Gases; Humans; Hydrocarbons; Japan; Lead Poisoning; Nitrogen; Nitrogen Dioxide; Ozone; Petroleum; Pulmonary Emphysema; Respiratory Tract Diseases; Sulfur; Sulfur Dioxide; Sulfuric Acids; Toxicology; United States

A study of 4 comparable communities in central & northeastern Bombay (2 each) among randomly matched 349 subjects in 1988-9, along with ambient sulfur dioxide (SO2), Nitrogen dioxide (NO2) & suspended particulate matter (SPM) air monitoring was carried out. The levels in winter were higher particularly for SO2 in Parel (upto 584 micrograms) in Maravali; Deonar showed lower pollution. There were inter-area differences for housing, income, residential history but age-sex differences were small; these were reduced by matching. Clinical respiratory symptoms were higher in Parel & Maravali (cough 12% and 11.2%, dyspnoea 17% & 13.3% respectively). Cardiac problems are commoner in Parel (11.0%). Smoker had cough more often but not dyspnoea. Maravali had a high prevalence for headache and eye irritation (9.5%). Those using kerosene suffered more than those using gas (22.2% as compared to 9.2%) Lung functions (FVC, FEVI) were lowest in Parel for males and in Maravali for females. Expiratory flow rates were lower at Dadar and then at Maravali. Despite lower SO2 pollution, Maravali residents suffered equally as in Parel. This may be due to added effect of diesel exhausts (NO2, SPM) or other unmeasured chemicals.

Topics: Adolescent; Adult; Air Pollutants; Child; Cough; Female; Humans; India; Male; Middle Aged; Nitrogen Dioxide; Respiratory Tract Diseases; Seasons; Smoking; Sulfur Dioxide

Seasonal variations in cardiorespiratory diseases may be influenced by air pollution and meteorological factors. This work aims to highlight the relevance of a complete seasonal characterization of the pollutant-meteorological factors and cardio-respiratory mortality in Portugal and the relationships between health outcomes and environmental risk factors. To this end, air pollution and meteorological variables along with health outcomes were analyzed at national level and on a monthly basis for the period of 2011-2020. It was found that cardiorespiratory mortality rates during winter were 44% higher than during the summer. Furthermore, particulate matter with aerodynamic diameters of 10 and 2.5 μm (μm) or smaller (PM

Topics: Air Pollutants; Air Pollution; Environmental Pollutants; Humans; Meteorological Concepts; Nitrogen Dioxide; Particulate Matter; Portugal; Respiratory Tract Diseases; Seasons

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

The aim of this 10-year study was to investigate whether and how temperature modifies the association between daily ambient PM

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; China; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; South Africa; Temperature; Young Adult

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

Several epidemiological studies have examined the risk of asthma and respiratory diseases in association with long-term exposure to outdoor air pollution. However, little is known regarding the adverse effects of long-term exposure to outdoor air pollution on the development of these outcomes in low- and middle-income countries (LMICs). Our study aims to investigate the association between long-term exposure to outdoor air pollution and asthma and respiratory diseases in LMICs through a systematic review with meta-analysis.. This systematic review and meta-analysis will follow the PRISMA (Preferred Reporting for Systematic Reviews and Meta-Analyses) checklist and flowchart guidelines. The inclusion criteria that will be used in our study are 1) Original research articles with full text in English; 2) Studies including adult humans; 3) Studies with long-term air pollution assessment in LMICs, air pollutants including nitrogen oxide (NO2), sulfur oxide (SO2), particulate matter (PM2.5 and PM10), carbon monoxide (CO) and ozone (O3); 4) cohort and cross-sectional studies; 5) Studies reporting associations between air pollution and asthma and respiratory symptoms. A comprehensive search strategy will be used to identify studies published up till August 2022 and indexed in Embase, Medline, and Web of Science. Three reviewers will independently screen records retrieved from the database searches. Where there are enough studies with similar exposure and outcomes, we will calculate, and report pooled effect estimates using meta-analysis.. PROSPERO CRD42022311326.. Findings from the health effects of long-term exposure to outdoor air pollution may be of importance for policymakers. This review will also identify any gaps in the current literature on this topic in LMICs and provide direction for future research.

Topics: Adult; Air Pollutants; Air Pollution; Asthma; Cross-Sectional Studies; Developing Countries; Environmental Exposure; Humans; Meta-Analysis as Topic; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Review Literature as Topic; Systematic Reviews as Topic

Although emerging studies have illuminated the protective association between greenness and respiratory mortality, efforts to quantify the potentially complex role of air pollution in the causal pathway are still limited. We aimed to examine the potential roles of air pollution in the causal pathway between greenness and respiratory mortality in China.. We used data from a community-based prospective cohort of 654,115 participants in southern China (Jan 2009-Dec 2020). We evaluated the greenness exposure as a three-year moving average Normalized Difference Vegetation Index (NDVI) within the 500 m buffer around the residence. Cox proportional hazards model was applied to estimate the association between greenness and respiratory mortality. Causal mediation analysis combined with a four-way dimensional decomposition method was utilized to simultaneously quantify the interaction and mediation role of air pollution including PM. We observed 6954 respiratory deaths during 12 years of follow-up. Increasing NDVI level from the lowest to the highest quartile is associated with a 19 % (95%CI: 13-25 %) reduction in the respiratory mortality risk. For the total protective effect, the proportion attributable to the overall negative interaction between greenness and air pollution (PM. Increased greenness exposure mitigated respiratory mortality through both the antagonistic interaction and mediation pathway of air pollution (PM

Topics: Air Pollutants; Air Pollution; Environmental Exposure; Humans; Nitrogen Dioxide; Particulate Matter; Prospective Studies; Respiratory Tract Diseases

To analyze the association between exposure to air pollution and respiratory disease of primary school students in Chongqing City. Eight districts and counties were randomly selected based on the air pollution situation in Chongqing City. In each selected district and county, one primary school was randomly selected. A questionnaire survey was conducted on all primary school students in Grades 3-5 by the end of 2019. Air quality data from the nearest environmental monitoring sites were collected. A logistic regression model was used to analyze the impact of the living environment, lifestyle and air pollution on the respiratory disease of surveyed students. This study included 5 918 primary school students, with a prevalence rate of respiratory disease of 21.54%. The prevalence rates of boys and girls were 23.38% and 19.59%, respectively. The average Air quality index (AQI) of the surveyed school was 67, and the rates of exceeding standards of PM

Topics: Air Pollution; Child; Female; Humans; Male; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Schools; Students

The presence of criteria air pollutants (CAP) in the ambient air of a populated inhalation region is one of the main serious public health concerns. The present study evaluated the number of cardiovascular mortalities (CM), hospital admissions with cardiovascular disease (HACD), and hospital admissions for respiratory disease (HARD) due to CAP exposure between 2010 and 2014. The study used the Air Q model and descriptive analysis to investigate the health endpoint attributed to the ground level of ozone (O

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Humans; Iran; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Sulfides

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

Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis.. 398 cities in 22 low to high income countries/regions.. Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018.. On average, a 10 μg/m. This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Cities; Developed Countries; Developing Countries; Environmental Exposure; Global Health; Humans; Linear Models; Nitrogen Dioxide; Respiratory Tract Diseases; Urban Health

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

There is a discussion in Europe about the dominant role of air pollution for health effects, most researchers claim that the particulate matter is responsible for inflammatory processes in the respiratory system, while others underline the role of nitrogen dioxide. The aim of the study was to assess the risk related to NO

Topics: Air Pollutants; Air Pollution; Ambulatory Care Facilities; Asthma; Bronchitis; Europe; Hospitalization; Humans; Inhalation Exposure; Nitrogen Dioxide; Particulate Matter; Poland; Respiratory Tract Diseases; Smog

We examined the association of long-term, daily 1-h maximum O

Topics: Aged; Air Pollutants; Air Pollution; Cause of Death; Cohort Studies; Environmental Exposure; Female; Heart Failure; Humans; Male; Medicare; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Seasons; United States

We examined the association between acute exposure to sulfur dioxide (SO

Topics: Aged; Aged, 80 and over; Air Pollutants; Cardiovascular Diseases; Cities; Cross-Over Studies; Environmental Exposure; Female; Humans; Japan; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide

The study investigated the associations between the prevalence of the childhood respiratory diseases and the long-term exposure to air pollution in the burdened area of Moravian-Silesian Region in the Czech Republic. The health data were collected during 2014 in 7,239 children 5, 9, 13 and 17 years of age. Exposure to PM

Topics: Adolescent; Air Pollutants; Child; Child, Preschool; Czech Republic; Environmental Exposure; Europe; Female; Humans; Hypersensitivity; Male; Models, Theoretical; Nitrogen Dioxide; Odds Ratio; Particulate Matter; Prevalence; Respiratory Tract Diseases; Vehicle Emissions

In 2014, the European Environment Agency estimated 59 630 premature deaths in Italy attributable to long-term exposure to PM2.5, 17 290 to NO2 and 2900 to O3. The aim of this study was to test an approach for assessing health impact of the above pollutants analyzing possible associations between annual municipal concentrations, estimated by the national dispersion model developed by ENEA, and mortality rates for trachea, bronchus and lung (TBL) cancer, total respiratory diseases (RD) and chronic obstructive pulmonary diseases (COPD). Tuscany was selected as test case.. For the 287 municipalities, 2009-13 standardized mortality rates (SMRates) for each cause of death were calculated by the ENEA epidemiological database. The SMRates of municipalities, aggregated on the basis of the 2003 or 2010 estimated pollutant concentration tertiles, were also computed.. TBL cancer SMRate in municipalities with 2003 PM2.5 levels >15.2 μg/m3 was significantly higher than the SMRates of the two lowest tertiles and COPD SMRates in the two highest O3 tertiles were significantly higher than that of the lower tertile. No association between PM2.5 or NO2 concentrations and RD and COPD was detected. Approximately 625 TBL cancer deaths attributable to PM2.5 levels above 10 μg/m3 in 2003 were estimated in the region. Smoking habits and deprivation index were homogeneously distributed among municipalities.. This methodological approach allowed detecting associations between mortality and specific air pollutants even at levels below the Italian normative limits and could be employed to evaluate the potential health impact of air pollution in areas where direct measures of concentration are unavailable.

Topics: Adult; Air Pollution; Humans; Italy; Mortality; Nitrogen Dioxide; Ozone; Particulate Matter; Pulmonary Disease, Chronic Obstructive; Respiratory Tract Diseases; Respiratory Tract Neoplasms

Rapid urbanisation in Malaysian cities poses risks to the health of residents. This study aims to estimate the relative risk (RR) of major air pollutants on cardiovascular and respiratory hospitalisations in Kuala Lumpur. Daily hospitalisations due to cardiovascular and respiratory diseases from 2010 to 2014 were obtained from the Hospital Canselor Tuanku Muhriz (HCTM). The trace gases, PM

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Environmental Exposure; Female; Hospitalization; Humans; Malaysia; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Prevalence; Respiratory Tract Diseases; Risk Assessment; Sulfur Dioxide; Urban Population; Urbanization; Weather

The impact of long-term exposure to nitrogen dioxide (NO. To assess mortality risks associated with long-term NO. We examined the association between 12-month moving average NO. We found significant associations between 12-month NO. Our findings provide additional evidence of the increased risk posed by long-term NO

Topics: Aged; Air Pollutants; Air Pollution; Environmental Exposure; Female; Humans; Male; Middle Aged; Neoplasms; Nitrogen Dioxide; Pneumonia; Respiratory Tract Diseases; United States

There has been growing global concern about air pollution due to its great risk to public health. In Japan, although industrial- and traffic-related air pollution has been decreasing, concerns about particulate matter air pollution has been growing in recent years. In this study, we examined the effects of air pollution on symptoms and the health status of healthy subjects in Japan.. Participants (n = 2887) who visited healthcare centers in Kumamoto or Niigata prefectures in February from 2010 to 2015 were asked to fill out a questionnaire, which was a self-completed booklet containing questions on the characteristics of participants, their respiratory symptoms, and questionnaires on their health status in February, May, and July. Generalized estimating equation analyses were performed to predict the factors associated with the symptoms and health status using two-week averages of air quality parameters obtained from 49 monitoring stations as independent variables.. Only allergy was associated with air quality in both areas. Prevalence of the other respiratory symptoms were correlated with air quality only in Kumamoto. The health statuses including the 'physical fitness', 'daily activities', and 'social activities' domains were related only to time spent outdoors. The 'overall health' was associated with time spent outdoors and concentrations of nitrogen dioxide and suspended particulate matters (SPM) in Kumamoto, and with temperatures and SPM in Niigata. The 'pain' score was correlated with temperature and carbon monoxide concentration only in Kumamoto. In Kumamoto, the 'quality of life (QoL)' was worse in those who spent shorter hours outdoors, were exposed to lower humidity, higher concentrations of oxidants, SPM, and PM2.5, and who experienced more Asian sand dust (ASD) events. In Niigata, a worsened 'QoL' was associated with time spent outdoors, temperature, and SPM.. The associations between air quality and the health status was found mainly in the comprehensive domain of the health status such as 'overall health' and 'QoL'. The effect of short-term exposure to larger particles, such as SPM, on health status was observed when compared to smaller particles such as PM2.5 and gaseous pollutants.

Topics: Adult; Air Pollutants; Air Pollution; Carbon Monoxide; Diagnostic Self Evaluation; Dust; Environmental Exposure; Female; Health Status; Humans; Humidity; Hypersensitivity; Japan; Male; Nitrogen Dioxide; Particulate Matter; Quality of Life; Respiratory Tract Diseases; Surveys and Questionnaires; Temperature; Time Factors

The association between short-term exposure to particulate air pollution, especially fine particles, and cardiopulmonary health has been well-established in previous studies. However, previous findings regarding the effect of ultrafine particles (UFPs) on cardiopulmonary health are inconsistent. We repeatedly measured the mass concentrations of UFPs using a Micro-Orifice Uniform Deposit Impactor (MOUDI) in the apartments of 100 adult participants and collected the participants' health data from the pulmonary outpatient unit of Shuang-Ho Hospital to investigate the association between short-term exposure to UFPs and cardiopulmonary health using mixed-effects models from January 1, 2014 to August 31, 2017. We also collected ambient air pollution monitoring data from the Taiwan Environmental Protection Administration for data analysis. We observed that an interquartile range increase in the 24-hour mean UFPs (0.97 μg/m

Topics: Adult; Air Pollutants; Air Pollution; Cardiovascular Diseases; Environmental Exposure; Humans; Nitrogen Dioxide; Particle Size; Particulate Matter; Respiratory Tract Diseases; Taiwan

The present study reports short-term impact of poor air quality on cardiovascular and respiratory morbidity rate in Delhi. The data on monthly count of patients visiting Out Patient Department (OPD) and hospital admission due to respiratory and cardiovascular illnesses from hospitals along with daily air quality data from air quality monitoring stations of Central Pollution Control Board (CPCB), Government of India, across Delhi were collected for the period 2008 to 2012. A semi-parametric Quasi-Poisson regression model was used to examine the association of high pollution episodes with relative risk of hospital OPD visit and hospital admission due to respiratory and cardiovascular diseases. This study has confirmed the substantial adverse health effects due to air pollution across criterion air pollutants. The study reports the short-term effects of air pollution on morbidity from a time-series study first time in India. The study findings illustrate the evidence of adverse health impact of air pollution from India to the global pool and can influence the policy makers to implement better air quality management system for Indian cities.. OPD: Out Patient Department; IPD: Inpatient Department; RD: Respiratory Disease; CVD: Cardiovascular Disease; COPD: Chronic Obstructive Pulmonary Disease; CPCB: Central Pollution Control Board; NAAQMP: National Ambient Air Quality Monitoring Programme; NAAQS: National Ambient Air Quality Standards; RR; Relative Risk; IMD: Indian Meteorological Department; PM

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; Cardiovascular Diseases; Cities; Environmental Exposure; Hospitalization; Humans; India; Interrupted Time Series Analysis; Morbidity; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Sulfur Dioxide

Few studies have been conducted on the effect of air pollution on morbidity in Latin America. This study analyzed the effects of air pollution on respiratory and circulatory morbidity in four major cities in Colombia. An ecological time-series analysis was conducted with pollution data from air quality monitoring networks and information on emergency department visits between 2011 and 2014. Daily 24-h averages were calculated for NO₂, PM

Topics: Adolescent; Adult; Air Pollutants; Air Pollution; Carbon Monoxide; Cardiovascular Diseases; Child; Child, Preschool; Cities; Colombia; Emergency Service, Hospital; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Morbidity; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide; Young Adult

The effects of exposure to air pollutants on human health are mainly reflected in respiratory diseases in children and elderly ones. An ecological time series study was carried out in Ribeirão Preto/SP data to examine the role of exposure to air pollutants and hospital admissions due to respiratory diseases in children under 10 years old. The study period was between January, 2011 and December, 2013. Particulate Matter (PM10), Nitrogen dioxide (NO2), and ozone (O3), temperature and air relative humidity, were analyzed to estimate the association with hospital admissions using a generalized linear model of Poisson's regression with lags of zero up to seven days after exposure to pollutants, adjusted by the day of the week, seasonality and effective temperature. The significance level adopted was p < 0.05. NO2, when analyzed in single pollutant model shown to be significant at lag 2 and 3 and when analyzed in the multi-pollutant model it shown to be significant at lags 2 up to 5, and lag 7 with relative risk between 1.05 and 1.09 per 10 μg/m3 increase in NO2 concentration, with an excess of 150 hospital admission and substantial increase in costs to Public Health System. The data enable the local health managers can take action to minimize these effects.

Topics: Air Pollutants; Air Pollution; Brazil; Child; Child, Preschool; Environmental Exposure; Female; Hospitalization; Humans; Infant; Infant, Newborn; Linear Models; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Poisson Distribution; Respiratory Tract Diseases; Temperature

This paper aimed to estimate health risks focusing on respiratory diseases from exposure to gaseous multi-pollutants based on new data and revealed new evidence after the most stringent air pollution control plan in Beijing which was carried out in 2013. It used daily respiratory diseases outpatient data from a hospital located in Beijing with daily meteorological data and monitor data of air pollutants from local authorities. All data were collected from 2014 to 2016. Distributed lag non-linear model was employed. Results indicated that NO₂ and CO had positive association with outpatients number on the day of the exposure (1.045 (95% confidence interval (CI): 1.003, 1.089) for CO and 1.022 (95% CI: 1.008, 1.036) for NO₂) (and on the day after the exposure (1.026 (95% CI: 1.005, 1.048) for CO and 1.013 (95% CI: 1.005, 1.021) for NO₂). Relative risk (RR) generally declines with the number of lags; ozone produces significant effects on the first day (RR = 0.993 (95% CI: 0.989, 0.998)) as well as second day (RR = 0.995 (95% CI: 0.991, 0.999)) after the exposure, while particulate pollutants did not produce significant effects. Effects from the short-term exposure to gaseous pollutants were robust after controlling for particulate matters. Our results contribute to a comprehensive understanding of the dependencies between the change of air pollutants concentration and their health effects in Beijing after the implementation of promising air regulations in 2013. Results of the study can be used to develop relevant measures minimizing the adverse health consequences of air pollutants and supporting sustainable development of Beijing as well as other rapidly growing Asian cities.

Topics: Air Pollutants; Air Pollution; Beijing; Carbon Monoxide; Humans; Nitrogen Dioxide; Outpatients; Ozone; Particulate Matter; Respiratory Tract Diseases

In this study, we estimated the short-term effects of ambient air pollution on respiratory disease hospitalization in Taiyuan, China. Daily data of respiratory disease hospitalization, daily concentration of ambient air pollutants and meteorological factors from 1 October 2014 to 30 September 2017 in Taiyuan were included in our study. We conducted a time-series study design and applied a generalized additive model to evaluate the association between every 10-μg/m³ increment of air pollutants and percent increase of respiratory disease hospitalization. A total of 127,565 respiratory disease hospitalization cases were included in this study during the present period. In single-pollutant models, the effect values in multi-day lags were greater than those in single-day lags. PM

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Child; Child, Preschool; China; Female; Hospitalization; Humans; Infant; Infant, Newborn; Male; Meteorological Concepts; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide; Young Adult

Estimating the long-term health impact of air pollution in a spatio-temporal ecological study requires representative concentrations of air pollutants to be constructed for each geographical unit and time period. Averaging concentrations in space and time is commonly carried out, but little is known about how robust the estimated health effects are to different aggregation functions. A second under researched question is what impact air pollution is likely to have in the future.. We conducted a study for England between 2007 and 2011, investigating the relationship between respiratory hospital admissions and different pollutants: nitrogen dioxide (NO. NO

Topics: Air Pollutants; Bayes Theorem; England; Environmental Monitoring; Hospitalization; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Risk; Sulfur Dioxide

Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m³ increase in nitrogen dioxide (NO₂) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m³ increase in PM

Topics: Adult; Air Pollutants; Air Pollution; Cities; Emergency Service, Hospital; Female; Hospitalization; Humans; Male; Nitrogen Dioxide; Particulate Matter; Primary Health Care; Respiratory Tract Diseases; Sweden

Little is known about the long-term health effects of ambient ultrafine particles (<0.1 μm) (UFPs) including their association with respiratory disease incidence. In this study, we examined the relationship between long-term exposure to ambient UFPs and the incidence of lung cancer, adult-onset asthma, and chronic obstructive pulmonary disease (COPD).. In total, 74,543 incident cases of COPD, 87,141 cases of asthma, and 12,908 cases of lung cancer were observed during follow-up period. In single pollutant models, each interquartile increase in ambient UFPs was associated with incident COPD (HR = 1.06, 95% CI: 1.05, 1.09) but not asthma (HR = 1.00, 95% CI: 1.00, 1.01) or lung cancer (HR = 1.00, 95% CI: 0.97, 1.03). Additional adjustment for NO. In general, we did not observe clear evidence of positive associations between long-term exposure to ambient UFPs and respiratory disease incidence independent of other air pollutants. Further replication is required as few studies have evaluated these relationships.

Topics: Adult; Aged; Air Pollutants; Cohort Studies; Environmental Exposure; Female; Humans; Incidence; Male; Middle Aged; Nitrogen Dioxide; Ontario; Particle Size; Particulate Matter; Respiratory Tract Diseases

Ambient particulate matter (PM) has an adverse effect on respiratory morbidity. Desert dust outbreaks contribute to increased PM levels but the toxicity of desert dust mixed with anthropogenic pollutants needs clarification.. We identified 132 days with desert dust episodes and 177 matched days by day of the week, season, temperature and humidity between 2001 and 2006 in Athens, Greece. We collected data on regulated pollutants and daily emergency outpatient visits and admissions for respiratory causes. We applied Poisson regression models adjusting for confounding effects of seasonality, meteorology, holidays and influenza epidemics. We evaluated the sensitivity of our results to co-pollutant exposures and effect modification by age and sex.. A 10 μg/m. Desert dust episode days are associated with higher respiratory emergency room visits and hospital admissions. This effect is insufficiently explained by increased PM

Topics: Adolescent; Adult; Aged; Air Pollutants; Dust; Emergency Service, Hospital; Environmental Monitoring; Female; Greece; Hospitalization; Humans; Male; Middle Aged; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Sulfur Dioxide; Young Adult

Understanding how local land use and land cover (LULC) shapes intra-urban concentrations of atmospheric pollutants-and thus human health-is a key component in designing healthier cities. Here, NO₂ is modeled based on spatially dense summer and winter NO₂ observations in Portland-Hillsboro-Vancouver (USA), and the spatial variation of NO₂ with LULC investigated using random forest, an ensemble data learning technique. The NO

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Child; Child, Preschool; Cities; Conservation of Natural Resources; Environmental Monitoring; Humans; Incidence; Models, Theoretical; Nitrogen Dioxide; Respiratory Tract Diseases; Seasons; Trees

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

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

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

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

Few studies have compared different methods when exploring the short-term effects of air pollutants on respiratory disease mortality in Wuhan, China. This study assesses the association between air pollutants and respiratory disease mortality with both time-series and time-stratified-case-crossover designs. The generalized additive model (GAM) and the conditional logistic regression model were used to assess the short-term effects of air pollutants on respiratory disease mortality. Stratified analyses were performed by age, sex, and diseases. A 10 μg/m

Topics: Aged; Air Pollutants; China; Cross-Over Studies; Female; Humans; Humidity; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide; Temperature; Time Factors

Topics: Air Pollution; Automobiles; Cardiovascular Diseases; City Planning; Environmental Exposure; Gasoline; Health Policy; Humans; Mortality; Nitrogen Dioxide; Nitrogen Oxides; Public Health; Public Policy; Respiratory Tract Diseases; Transportation; United States; United States Environmental Protection Agency; Vehicle Emissions

The aim of this study was to investigate the association between short- and long-term exposure to particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and soot and mortality attributed to circulatory and respiratory diseases in Belgrade area (Serbia). The analyzed data set comprised results of regular pollutant monitoring and corresponding administrative records on frequency of daily mortality in the period 2009-2014. Nonlinear exposure-response dependencies and delayed effects of temperature were examined by means of distributed lag nonlinear models. The air pollutant loadings and circulatory system-related death rates in Belgrade area are among the highest in Europe. Data demonstrated that excess risk of death with short-term exposure to elevated concentrations of PM10, SO2, and soot was not significant, whereas marked effect size estimates for exposure over 90 d preceding mortality were found. The influence of chronic exposure was shown to be greater for respiratory than circulatory system-related mortality. When stratified by age and gender, higher risk was noted for male individuals below the age of 65 years.

Topics: Adult; Age Factors; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Environmental Monitoring; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Risk; Seasons; Serbia; Sex Factors; Soot; Sulfur Dioxide

In recent years, Panama has experienced a marked economic growth, and this, in turn, has been associated with rapid urban development and degradation of air quality. This study is the first evaluation done in Panama on the association between air pollution and mortality. Our objective was to assess the possible association between monthly levels of PM10, O3, and NO2, and cardiovascular, respiratory, and diabetes mortality, as well as the seasonal variation of mortality in Panama City, Panama.The study was conducted in Panama City, using air pollution data from January 2003 to December 2013. We utilized a Poisson regression model based on generalized linear models, to evaluate the association between PM10, NO2, and O3 exposure and mortality from diabetes, cardiovascular, and respiratory diseases. The sample size for PM10, NO2, and O2 was 132, 132, and 108 monthly averages, respectively.We found that levels of PM10, O3, and NO2 were associated with increases in cardiovascular, respiratory, and diabetes mortality. For PM10 levels ≥ 40 μg/m3, we found an increase in cardiovascular mortality of 9.7% (CI 5.8-13.6%), and an increase of 12.6% (CI 0.2-24.2%) in respiratory mortality. For O3 levels ≥ 20 μg/m3 we found an increase of 32.4% (IC 14.6-52.9) in respiratory mortality, after a 2-month lag period following exposure in the 65 to <74 year-old age group. For NO2 levels ≥20 μg/m3 we found an increase in respiratory mortality of 11.2% (IC 1.9-21.3), after a 2-month lag period following exposure among those aged between 65 and <74 years.There could be an association between the air pollution in Panama City and an increase in cardiovascular, respiratory, and diabetes mortality. This study confirms the urgent need to improve the measurement frequency of air pollutants in Panama.

Topics: Adult; Aged; Air Pollutants; Cardiovascular Diseases; Confidence Intervals; Databases, Factual; Diabetes Mellitus; Environmental Exposure; Environmental Monitoring; Female; Humans; Incidence; Male; Maximum Allowable Concentration; Middle Aged; Nitrogen Dioxide; Odds Ratio; Ozone; Panama; Particulate Matter; Respiratory Tract Diseases; Retrospective Studies; Risk Assessment; Sulfur Dioxide; Survival Analysis

Concentrations of particulate matter that contains particles with diameter ≤ 10 mm (PM10) and diameter ≤ 2.5 mm (PM2.5) as well as nitrogen dioxide (NO2) have considerable impact on human mortality, especially in the cases when cardiovascular or respiratory causes are attributed. Additionally, they affect morbidity. An estimation of human mortality and morbidity due to the increased concentrations of PM10, PM2.5 and NO2 between the years 2005-2013 was performed for the city of Kraków, Poland. For this purpose the Air Quality Health Impact Assessment Tool (AirQ) software was successfully applied.. The Air Quality Health Impact Assessment Tool was used for the calculation of the total, cardiovascular and respiratory mortality as well as hospital admissions related to cardiovascular and respiratory diseases. Data on concentrations of PM10, PM2.5 and NO2, which was obtained from the website of the Voivodeship Inspectorate for Environmental Protection (WIOS) in Kraków, was used in this study.. Total mortality due to exposure to PM10 in 2005 was found to be 41 deaths per 100 000 and dropped to 30 deaths per 100 000 in 2013. Cardiovascular mortality was 2 times lower than the total mortality. However, hospital admissions due to respiratory diseases were more than an order of magnitude higher than the respiratory mortality.. The calculated total mortality due to PM2.5 was higher than that due to PM10. Air pollution was determined to have a significant effect on human health. The values obtained by the use of the AirQ software for the city of Kraków imply that exposure to polluted air can result in serious health problems.

Topics: Air Pollution; Cardiovascular Diseases; Cause of Death; Cities; Environmental Exposure; Hospitalization; Humans; Nitrogen Dioxide; Particulate Matter; Poland; Respiratory Tract Diseases

Air pollution has become a major global public health problem. A number of studies have confirmed the association between air pollutants and emergency room (ER) visits for respiratory diseases in developed countries and some Asian countries, but little evidence has been seen in Western China. This study aims to concentrate on this region.. A time-series analysis was used to examine the specific effects of major air pollutants (PM10, SO₂ and NO₂) on ER visits for respiratory diseases from 2007 to 2011 in the severely polluted city of Lanzhou. We examined the effects of air pollutants for stratified groups by age and gender, accounting for the modifying effect of dust storms in spring to test the possible interaction.. Significant associations were found between outdoor air pollution concentrations and respiratory diseases, as expressed by daily ER visits in Lanzhou in the spring dust season. The association between air pollution and ER visits appeared to be more evident on dust days than non-dust days. Relative risks (RRs) and 95% CIs per 10 µg/m³ increase in 3-day PM10 (L3), 5-day SO₂ (L5), and the average of current and previous 2-day NO₂ (L01) were 1.140 (1.071-1.214), 1.080 (0.967-1.205), and 1.298 (1.158-1.454), respectively, on dust days. More significant associations between PM10, SO₂ and NO₂ and ER visits were found on dust days for elderly females, elderly males and adult males, respectively.. This study strengthens the evidence of dust-exacerbated ER visits for respiratory diseases in Lanzhou.

Topics: Adolescent; Adult; Air Pollutants; Air Pollution; Child; Child, Preschool; China; Dust; Emergency Service, Hospital; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Risk; Seasons; Sulfur Dioxide; Young Adult

Particulate matter (PM) from traffic and other sources has been associated with adverse health effects. One unifying theory is that PM, whatever its source, acts on the human body via its capacity to cause damaging oxidation reactions related to its content of pro-oxidants components. Few epidemiological studies have investigated particle oxidative potential (OP) and health. We conducted a time series analysis to assess associations between daily particle OP measures and numbers of deaths and hospital admissions for cardiovascular and respiratory diseases.. During 2011 and 2012 particles with an aerodynamic diameter less than 2.5 and 10μm (PM2.5 and PM10 respectively) were collected daily on Partisol filters located at an urban background monitoring station in Central London. Particulate OP was assessed based on the capacity of the particles to oxidize ascorbate (OP(AA)) and glutathione (OP(GSH)) from a simple chemical model reflecting the antioxidant composition of human respiratory tract lining fluid. Particulate OP, expressed as % loss of antioxidant per μg of PM, was then multiplied by the daily concentrations of PM to derive the daily OP of PM mass concentrations (% loss per m(3)). Daily numbers of deaths and age- and cause-specific hospital admissions in London were obtained from national registries. Poisson regression accounting for seasonality and meteorology was used to estimate the percentage change in risk of death or admission associated with an interquartile increment in particle OP.. We found little evidence for adverse associations between OP(AA) and OP(GSH) and mortality. Associations with cardiovascular admissions were generally positive in younger adults and negative in older adults with confidence intervals including 0%. For respiratory admissions there was a trend, from positive to negative associations, with increasing age although confidence intervals generally included 0%.. Our study, the first to analyse daily particle OP measures and mortality and admissions in a large population over two years, found little evidence to support the hypothesis that short-term exposure to particle OP is associated with adverse health effects. Further studies with improved exposure assessment and longer time series are required to confirm or reject the role of particle OP in triggering exacerbations of disease.

Topics: Adolescent; Adult; Aged; Air Pollutants; Antioxidants; Ascorbic Acid; Cardiovascular Diseases; Child; Child, Preschool; Environmental Monitoring; Glutathione; Hospitalization; Humans; Infant; Infant, Newborn; London; Middle Aged; Nitrogen Dioxide; Oxidation-Reduction; Ozone; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide; Young Adult

Road traffic noise has well-documented effects on cardiovascular, respiratory, and metabolic health. Numerous studies have reported long-term associations of urban noise with some diseases and outcomes, including death. However, to date there are no studies on the short-term association between this pollutant and a set of various specific causes of death.. To investigate the short-term association of road traffic noise with daily cause-specific mortality.. We used a time-stratified case-crossover design with Poisson regression. Predictor variables were daytime, nighttime, and 24-h equivalent noise levels, and maximum daytime and nighttime noise levels. Outcome variables were daily death counts for various specific causes, stratifying by age. We adjusted for primary air pollutants (PM2.5 and NO2) and weather conditions (mean temperature and relative humidity).. In the ≥65 age group, increased mortality rates per 1 dBA increase in maximum nocturnal noise levels at lag 0 or 1 day were 2.9% (95% CI 1.0, 4.8%), 3.5% (95% CI 1.1, 6.1%), 2.4% (95% CI 0.1, 4.8%), 3.0% (95% CI 0.2, 5.8%), and 4.0% (95% CI 1.0, 7.0%), for ischemic heart disease, myocardial infarction, cerebrovascular disease, pneumonia, and COPD, respectively. For diabetes, 1 dBA increase in equivalent nocturnal noise levels at lag 1 was associated with an increased mortality rate of 11% (95% CI 4.0, 19%). In the <65 age group, increased mortality rates per 1 dBA increase in equivalent nocturnal noise levels at lag 0 were 11% (95% CI 4.2, 18%) and 11% (95% CI 4.2, 19%) for ischemic heart disease and myocardial infarction, respectively.. Road traffic noise increases the short-term risk of death from specific diseases of the cardiovascular, respiratory, and metabolic systems.

Topics: Aged; Air Pollutants; Cardiovascular Diseases; Cities; Diabetes Mellitus; Humans; Humidity; Motor Vehicles; Nitrogen Dioxide; Noise; Particulate Matter; Respiratory Tract Diseases; Spain; Temperature

To propose a new method for including the cumulative mid-term effects of air pollution in the traditional Poisson regression model and compare the temperature-related mortality risk estimates, before and after including air pollution data.. The analysis comprised a total of 56,920 residents aged 65 years or older who died from circulatory and respiratory diseases in Belgrade, Serbia, and daily mean PM10, NO2, SO2 and soot concentrations obtained for the period 2009-2014. After accounting for the cumulative effects of air pollutants, the risk associated with cold temperatures was significantly lower and the overall temperature-attributable risk decreased from 8.80 to 3.00 %. Furthermore, the optimum range of temperature, within which no excess temperature-related mortality is expected to occur, was very broad, between -5 and 21 °C, which differs from the previous findings that most of the attributable deaths were associated with mild temperatures.. These results suggest that, in polluted areas of developing countries, most of the mortality risk, previously attributed to cold temperatures, can be explained by the mid-term effects of air pollution. The results also showed that the estimated relative importance of PM10 was the smallest of four examined pollutant species, and thus, including PM10 data only is clearly not the most effective way to control for the effects of air pollution.

Topics: Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Cities; Female; Humans; Male; Mortality; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Serbia; Sulfur Dioxide; Temperature

Air pollution episodes are associated with increased cardiopulmonary hospital admissions. Cohort studies showed associations of spatial variation in traffic-related air pollution with respiratory and cardiovascular mortality. Much less is known in particular about associations with cardiovascular morbidity. We explored the relation between spatial variation in nitrogen dioxide (NO. This ecological study was based on hospital admissions data (2001-2004) from the National Medical Registration and general population data for the West of the Netherlands (population 4.04 million). At the 4-digit postcode area level (n=683) associations between modeled annual average outdoor NO. At the postcode level, positive associations were found between outdoor NO. Our study suggests an increased risk of hospitalization for respiratory and cardiovascular causes in areas with higher levels of NO

Topics: Adolescent; Adult; Aged; Air Pollutants; Cardiovascular Diseases; Child; Child, Preschool; Cohort Studies; Female; Humans; Infant; Inhalation Exposure; Male; Middle Aged; Netherlands; Nitrogen Dioxide; Patient Admission; Respiratory Tract Diseases; Spatial Analysis; Urbanization; Vehicle Emissions; Young Adult

Estimating the health effects of ambient air pollutant mixtures is necessary to understand the risk of real-life air pollution exposures.. Pediatric Emergency Department (ED) visit records for asthma or wheeze (n = 148,256), bronchitis (n = 84,597), pneumonia (n = 90,063), otitis media (n = 422,268) and upper respiratory tract infection (URI) (n = 744,942) were obtained from Georgia hospitals during 2002-2008. Spatially-contiguous daily concentrations of 11 ambient air pollutants were estimated from CMAQ model simulations that were fused with ground-based measurements. Using a case-crossover study design, odds ratios for 3-day moving average air pollutant concentrations were estimated using conditional logistic regression, matching on ZIP code, day-of-week, month, and year.. In multipollutant models, the association of highest magnitude observed for the asthma/wheeze outcome was with "oxidant gases" (O. Short-term exposures to air pollution mixtures were associated with ED visits for several different pediatric respiratory diseases.

Topics: Adolescent; Air Pollutants; Air Pollution; Ammonium Compounds; Carbon Monoxide; Child; Child, Preschool; Cross-Over Studies; Emergency Service, Hospital; Environmental Exposure; Georgia; Humans; Infant; Infant, Newborn; Nitrates; Nitrogen Dioxide; Odds Ratio; Otitis Media; Ozone; Particulate Matter; Respiratory Tract Diseases; Sulfates; Sulfur Dioxide

Our results provide evidence for respiratory effects of combined exposure to airborne pollutants in Santiago de Chile. Different pollutants account for varying adverse effects. Ozone was not found to be significantly associated with respiratory morbidity.. High concentrations of various air pollutants have been associated with hospitalization due to development and exacerbation of respiratory diseases. The findings of different studies vary in effect strength and are sometimes inconsistent.. We aimed to assess associations between airborne exposures by particulate matter as well as gaseous air pollutants and hospital admissions due to respiratory disease groups under the special orographic and meteorological conditions of Santiago de Chile.. The study was performed in the metropolitan area of Santiago de Chile during 2004-2007. We applied a time-stratified case-crossover analysis taking temporal variation, meteorological conditions and autocorrelation into account. We computed associations between daily ambient concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5 - particulate matter with aerodynamic diameters less than 10 or 2.5 μm, respectively) or ozone (O3) and hospital admissions for respiratory illnesses.. We found for CO, NO2, PM10 and PM2.5 adverse relationships to respiratory admissions while effect strength and lag depended on the pollutant and on the disease group. By trend, in 1-pollutant models most adverse pollutants were CO and PM10 followed by PM2.5, while in 2-pollutant models effects of NO2 persisted in most cases whereas other effects weakened and significant effects remain for PM2.5, only. In addition the strongest effects seemed to be immediate or with a delay of up to one day, but effects were found until day 7, too. Adverse effects of ozone could not be detected.. Taking case numbers and effect strength of all cardiovascular diseases into account, mitigation measures should address all pollutants especially CO, NO2, and PM10.

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; Cardiovascular Diseases; Chile; Environmental Exposure; Hospitalization; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases

In large cities in China, the traffic-related air pollution has become the focus of attention, and its adverse effects on health have raised public concerns. We conducted a study to quantify the association between exposure to three major traffic-related pollutants - particulate matter < 10 μm in aerodynamic diameter (PM10), carbon monoxide (CO) and nitrogen dioxide (NO2) and the risk of respiratory mortality in Beijing, China at a daily spatiotemporal resolution. We used the generalized additive models (GAM) with natural splines and principal component regression method to associate air pollutants with daily respiratory mortality, covariates and confounders. The GAM analysis adjusting for the collinearity among pollutants indicated that PM10, CO and NO2 had significant effects on daily respiratory mortality in Beijing. An interquartile range increase in 2-day moving averages concentrations of day 0 and day 1 of PM10, CO and NO2 corresponded to 0.99 [95% confidence interval (CI): 0.30, 1.67], 0.89 (95% CI: 0.27, 1.51) and 0.95 (95% CI: 0.29, 1.61) percent increase in daily respiratory mortality, respectively. The effects were varied across the districts. The strongest effects were found in two rural districts and one suburban district but significant in only one district. In conclusion, high level of several traffic-related air pollutants is associated with an increased risk of respiratory mortality in Beijing over a short-time period. The high risk found in rural areas suggests a potential susceptible sub-population with undiagnosed respiratory diseases in these areas. Although the rural areas have relatively lower air pollution levels, they deserve more attention to respiratory disease prevention and air pollution reduction.

Topics: Aged; Air Pollutants; Air Pollution; Carbon Monoxide; China; Environmental Exposure; Female; Humans; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Time Factors

High levels of indoor NO2 are associated with increased asthma symptoms and decreased expiratory peak flows in children. We investigated the association of exposure to domestic indoor NO2, objectively measured in winter and spring, with respiratory symptoms and lung function in a sample of adolescents from a southern Mediterranean area.. From a large school population sample (n=2150) participating in an epidemiological survey in the urban area of the City of Palermo (southern Italy), a sub-sample of 303 adolescents was selected which furnished an enriched sample for cases of current asthma. All subjects were evaluated by a health questionnaire, skin prick tests and spirometry. One-week indoor NO2 monitoring of their homes was performed by diffusive sampling during spring and again during winter.. We found that about 25% of subjects were exposed to indoor NO2 levels higher than the 40µg/m(3) World Health Organization limit, during both spring and winter. Moreover, subjects exposed to the highest indoor NO2 concentrations had increased frequency of current asthma (p=0.005), wheeze episodes in the last 12 months (p<0.001), chronic phlegm (p=0.013), and rhinoconjunctivitis (p=0.008). Finally, subjects with a personal history of wheeze ever had poorer respiratory function (FEF25-75%, p=0.01) when exposed to higher indoor NO2 concentrations.. Home exposure to high indoor NO2 levels frequently occurs in adolescents living in a southern Mediterranean urban area and is significantly associated with the risks for increased frequency of both respiratory symptoms and reduced lung function.

Topics: Adolescent; Air Pollutants; Air Pollution, Indoor; Child; Cities; Cross-Sectional Studies; Environment; Environmental Exposure; Environmental Monitoring; Female; Humans; Italy; Lung; Male; Nitrogen Dioxide; Respiratory Function Tests; Respiratory Tract Diseases; Seasons; Socioeconomic Factors

Long-term exposure to air pollution has been associated with mortality in urban cohort studies. Few studies have investigated this association in large-scale population registries, including non-urban populations.. The aim of the study was to evaluate the associations between long-term exposure to air pollution and nonaccidental and cause-specific mortality in the Netherlands based on existing national databases.. We used existing Dutch national databases on mortality, individual characteristics, residence history, neighborhood characteristics, and national air pollution maps based on land use regression (LUR) techniques for particulates with an aerodynamic diameter ≤ 10 μm (PM10) and nitrogen dioxide (NO2). Using these databases, we established a cohort of 7.1 million individuals ≥ 30 years of age. We followed the cohort for 7 years (2004-2011). We applied Cox proportional hazard models adjusting for potential individual and area-specific confounders.. After adjustment for individual and area-specific confounders, for each 10-μg/m3 increase, PM10 and NO2 were associated with nonaccidental mortality [hazard ratio (HR) = 1.08; 95% CI: 1.07, 1.09 and HR = 1.03; 95% CI: 1.02, 1.03, respectively], respiratory mortality (HR = 1.13; 95% CI: 1.10, 1.17 and HR = 1.02; 95% CI: 1.01, 1.03, respectively), and lung cancer mortality (HR = 1.26; 95% CI: 1.21, 1.30 and HR = 1.10 95% CI: 1.09, 1.11, respectively). Furthermore, PM10 was associated with circulatory disease mortality (HR = 1.06; 95% CI: 1.04, 1.08), but NO2 was not (HR = 1.00; 95% CI: 0.99, 1.01). PM10 associations were robust to adjustment for NO2; NO2 associations remained for nonaccidental mortality and lung cancer mortality after adjustment for PM10.. Long-term exposure to PM10 and NO2 was associated with nonaccidental and cause-specific mortality in the Dutch population of ≥ 30 years of age.

Topics: Adult; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Cohort Studies; Female; Humans; Incidence; Longitudinal Studies; Lung Neoplasms; Male; Middle Aged; Netherlands; Nitrogen Dioxide; Particulate Matter; Regression Analysis; Respiratory Tract Diseases

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Cause of Death; Environmental Exposure; Environmental Monitoring; Humans; London; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Urban Health; Vehicle Emissions

Household indoor air pollution (IAP) is a global health problem and a risk factor for childhood respiratory disease; the leading cause of mortality in African children. This study aimed to describe the home environment and measure IAP in the Drakenstein Child Health Study (DCHS), an African birth cohort.. An antenatal home visit to assess the home environment and measure IAP (particulate matter, sulphur dioxide, nitrogen dioxide, carbon monoxide and volatile organic compounds (VOCs)) was done on pregnant women enrolled to the DCHS, in a low-socioeconomic, peri-urban South African community. Urine cotinine measured maternal tobacco smoking and exposure. Dwellings were categorised according to 6 household dimensions. Univariate and multivariate analysis explored associations between home environment, seasons and IAP levels measured.. 633 home visits were completed, with IAP measured in 90% of homes. Almost a third of participants were of the lowest socio-economic status and the majority of homes (65%) lacked 2 or more of the dwelling category dimensions. Most households had electricity (92%), however, fossil fuels were still used for cooking (19%) and heating (15%) in homes. Antenatal maternal smoking prevalence was 31%; 44% had passive smoke exposure. Of IAP measured, benzene (VOC) was significantly above ambient standards with median 5.6 μg/m3 (IQR 2.6-17.1). There were significant associations between the use of fossil fuels for cooking and increased benzene [OR 3.4 (95% CI 2.1-5.4)], carbon monoxide [OR 2.9 (95% CI 1.7-5.0)] and nitrogen dioxide [OR 18.6 (95% CI 3.9-88.9)] levels. A significant seasonal association was found with higher IAP levels in winter.. In this low-socioeconomic African community, multiple environmental factors and pollutants, with the potential to affect child health, were identified. Measurement of IAP in a resource-limited setting is feasible. Recognising and quantifying these risk factors is important in effecting public health policy changes.

Topics: Adult; Air Pollutants; Air Pollution, Indoor; Carbon Monoxide; Cohort Studies; Environmental Monitoring; Female; Humans; Maternal Exposure; Nitrogen Dioxide; Particulate Matter; Pregnancy; Respiratory Tract Diseases; South Africa; Tobacco Smoke Pollution; Volatile Organic Compounds

Long-term exposure to air pollution (AP) has been shown to have an impact on mortality in numerous countries, but since 2005 no data exists for France.. We analyzed the association between long-term exposure to air pollution and mortality at the individual level in a large French cohort followed from 1989 to 2013.. The study sample consisted of 20,327 adults working at the French national electricity and gas company EDF-GDF. Annual exposure to PM10, PM10–2.5, PM2.5, NO2, O3, SO2, and benzene was assessed for the place of residence of participants using a chemistry-transport model and taking residential history into account. Hazard ratios were estimated using a Cox proportional-hazards regression model, adjusted for selected individual and contextual risk factors. Hazard ratios were computed for an interquartile range (IQR) increase in air pollutant concentrations.. The cohort recorded 1967 non-accidental deaths. Long-term exposures to b aseline PM2.5, PM10-25, NO2 and benzene were associated with an increase in non-accidental mortality (Hazard Ratio, HR = 1.09; 95% CI: 0.99, 1.20 per 5.9 μg/m3, PM10-25; HR=1.09; 95% CI: 1.04, 1.15 per 2.2 μg/m3, NO2: HR=1.14; 95% CI: 0.99, 1.31 per 19.3 μg/m3 and benzene: HR=1.10; 95% CI: 1.00, 1.22 per 1.7 μg/m3).The strongest association was found for PM10: HR = 1.14; 95% CI: 1.05, 1.25 per 7.8 μg/m3. PM10, PM10-25 and SO2 were associated with non-accidental mortality when using time varying exposure. No significant associations were observed between air pollution and cardiovascular and respiratory mortality.. Long-term exposure to fine particles, nitrogen dioxide, sulfur dioxide and benzene is associated with an increased risk of non-accidental mortality in France. Our results strengthen existing evidence that outdoor air pollution is a significant environmental risk factor for mortality. Due to the limited sample size and the nature of our study (occupational), further investigations are needed in France with a larger representative population sample.

Topics: Adult; Air Pollutants; Benzene; Cardiovascular Diseases; Environmental Exposure; Female; Follow-Up Studies; France; Humans; Male; Models, Theoretical; Mortality; Nitrogen Dioxide; Ozone; Particulate Matter; Proportional Hazards Models; Respiratory Tract Diseases; Risk Factors; Sulfur Dioxide; Surveys and Questionnaires

Short-term exposure to air pollution has been associated with exacerbation of asthma and chronic obstructive pulmonary disease (COPD). This study investigated the relationship between emergency hospital admissions for asthma, COPD and episodes of poor air quality in an English city (Southampton) from 2008-2013. The city's council provides a forecasting service for poor air quality to individuals with respiratory disease to reduce preventable admissions to hospital and this has been evaluated. Trends in nitrogen dioxide, ozone and particulate matter concentrations were related to hospital admissions data using regression analysis. The impacts of air quality on emergency admissions were quantified using the relative risks associated with each pollutant. Seasonal and weekly trends were apparent for both air pollution and hospital admissions, although there was a weak relationship between the two. The air quality forecasting service proved ineffective at reducing hospital admissions. Improvements to the health forecasting service are necessary to protect the health of susceptible individuals, as there is likely to be an increasing need for such services in the future.

Topics: Air Pollutants; Air Pollution; Environmental Exposure; Health Communication; Hospitalization; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Patient Admission; Public Health; Regression Analysis; Respiratory Tract Diseases; Risk; Seasons

Synoptic weather and ambient air quality synergistically influence human health. We report the relative risk of mortality from all non-accidental, respiratory-, and cardiovascular-related causes, associated with exposure to four air pollutants, by weather type and season, in 10 major Canadian cities for 1981 through 1999. We conducted this multi-city time-series study using Poisson generalized linear models stratified by season and each of six distinctive synoptic weather types. Statistically significant relationships of mortality due to short-term exposure to carbon monoxide, nitrogen dioxide, sulphur dioxide, and ozone were found, with significant modifications of risk by weather type, season, and mortality cause. In total, 61% of the respiratory-related mortality relative risk estimates were significantly higher than for cardiovascular-related mortality. The combined effect of weather and air pollution is greatest when tropical-type weather is present in the spring or summer.

Topics: Air Pollutants; Air Pollution; Canada; Carbon Monoxide; Cities; Environmental Exposure; Humans; Meteorology; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Risk Assessment; Seasons; Sulfur Dioxide; Time Factors; Weather

The chronic health effects from exposure to ambient air pollution are still unclear. This study primarily aims to examine the relationship between long-term exposure to ambient air pollution and respiratory morbidities in Chinese children.. A cross-sectional study was conducted among 2,203 school children aged 8-10 in three districts with different air pollution levels in Hong Kong. Annual means for ambient PM10, SO2, NO2 and O3 in each district were used to estimate participants' individual exposure. Two questionnaires were used to collect children's respiratory morbidities and other potential risk factors. Multivariable logistic regression was fitted to estimate the risks of air pollution for respiratory morbidities.. Compared to those in the low-pollution district (LPD), girls in the high-pollution district (HPD) were at significantly higher risk for cough at night (ORadj. = 1.81, 95% CI: 1.71-2.78) and phlegm without colds (ORadj. = 3.84, 95% CI: 1.74-8.47). In addition, marginal significance was reached for elevated risks for asthma, wheezing symptoms, and phlegm without colds among boys in HPD (adjusted ORs: 1.71-2.82), as well as chronic cough among girls in HPD (ORadj. = 2.03, 95% CI: 0.88-4.70).. Results have confirmed certain adverse effects on children's respiratory health from long-term exposure to ambient air pollution. PM10 may be the most relevant pollutant with adverse effects on wheezing and phlegm in boys. Both PM10 and NO2 may be contributing to cough and phlegm in girls.

Topics: Air Pollution; Asthma; Child; Cough; Cross-Sectional Studies; Female; Hong Kong; Humans; Inhalation Exposure; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Sounds; Respiratory Tract Diseases; Risk Factors; Sex Factors; Sulfur Dioxide; Surveys and Questionnaires

Extreme ambient temperatures are an increasing public health concern. The aim of this study was to assess if persons with comorbid health conditions were at increased risk of adverse cardiorespiratory morbidity during temperature extremes.. A time series study design was applied to 292,666 and 562,738 emergency room (ER) visits for cardiovascular and respiratory diseases, respectively, that occurred in Toronto area hospitals between April 1st 2002 and March 31st 2010. Subgroups of persons with comorbid health conditions were identified. Relative risks (RRs) and their corresponding 95% confidence intervals (CIs) were estimated using a Poisson regression model with distributed lag non-linear model, and were adjusted for the confounding influence of seasonality, relative humidity, day-of-the-week, outdoor air pollutants and daily influenza ER visits. Effect modification by comorbid health conditions was tested using the relative effect modification (REM) index.. Stronger associations of cardiovascular disease ER visits were observed for persons with diabetes compared to persons without diabetes (REM = 1.12; 95% CI: 1.01 - 1.27) with exposure to the cumulative short term effect of extreme hot temperatures (i.e. 99th percentile of temperature distribution vs. 75th percentile). Effect modification was also found for comorbid respiratory disease (REM = 1.17; 95% CI: 1.02 - 1.44) and cancer (REM = 1.20; 95% CI: 1.02 - 1.49) on respiratory disease ER visits during short term hot temperature episodes. The effect of extreme cold temperatures (i.e. 1st percentile of temperature distribution vs. 25th percentile) on cardiovascular disease ER visits were stronger for individuals with comorbid cardiac diseases (REM = 1.47; 95% CI: 1.06 - 2.23) and kidney diseases (REM = 2.43; 95% CI: 1.59 - 8.83) compared to those without these conditions when cumulated over a two-week period.. The identification of those most susceptible to temperature extremes is important for public health officials to implement adaptation measures to manage the impact of extreme temperatures on population health.

Topics: Air Pollutants; Carbon Monoxide; Cardiovascular Diseases; Comorbidity; Emergency Service, Hospital; Extreme Cold; Extreme Heat; Humans; Nitrogen Dioxide; Ontario; Ozone; Particulate Matter; Respiratory Tract Diseases; Risk; Sulfur Dioxide

Respiratory health effects of ambient air pollution were studied in 605 school children 9 to 13 years in Eskişehir, Turkey. Each child performed a fractional exhaled nitric oxide (FENO) measurement and a lung function test (LFT). Self-reported respiratory tract complaints (having cold, complaints of throat, runny nose and shortness of breath/wheezing) in the last 7 days and on the day of testing were also recorded. As acute health outcomes were investigated, weekly average ambient concentrations of ozone (O3), nitrogen dioxide (NO2) and sulfur dioxide (SO2) were determined by passive sampling in the school playgrounds simultaneously with the health survey. Effects of air pollution on respiratory tract complaints and exhaled NO/lung function were estimated by multivariate logistic regression and multivariate linear mixed effects models, respectively. Upper respiratory tract complaints were significantly (p<0.05) associated with weekly average O3 concentrations during the health survey (adjusted odds ratios (OR) of 1.21 and 1.28 for a 10 μgm(-3) increment for having cold and a runny nose on day of testing, respectively). FENO levels were significantly (p<0.05) increased in children with various upper respiratory tract complaints (ratio in FENO varied between 1.16 and 1.40). No significant change in FENO levels was detected in association with any of the measured pollutants (p ≥ 0.05). Lung function was not associated with upper respiratory tract complaints and FENO levels. Peak Expiratory Flow (PEF) levels were negatively associated with weekly average O3 levels for children without upper respiratory tract complaints. In summary, elevated levels of air pollutants increased respiratory tract complaints in children.

Topics: Air Pollutants; Air Pollution; Child; Environmental Exposure; Female; Humans; Inflammation; Male; Nitric Oxide; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Function Tests; Respiratory Tract Diseases; Schools; Sulfur Dioxide; Turkey; Urban Health

Modeled atmospheric pollution removal by trees based on eddy flux, leaf, and chamber studies of relatively few species may not scale up to adequately assess landscape-level air pollution effects of the urban forest. A land use regression (LUR) model (R(2) = 0.70) based on NO2 measured at 144 sites in Portland, Oregon (USA), after controlling for roads, railroads, and elevation, estimated every 10 ha (20%) of tree canopy within 400 m of a site was associated with a 0.57 ppb decrease in NO2. Using BenMAP and a 200 m resolution NO2 model, we estimated that the NO2 reduction associated with trees in Portland could result in significantly fewer incidences of respiratory problems, providing a $7 million USD benefit annually. These in-situ urban measurements predict a significantly higher reduction of NO2 by urban trees than do existing models. Further studies are needed to maximize the potential of urban trees in improving air quality.

Topics: Air Pollutants; Air Pollution; Environmental Monitoring; Models, Chemical; Nitrogen Dioxide; Oregon; Respiratory Tract Diseases; Trees

There is evidence that outdoor workers exposed to high levels of air pollution exhibit airway inflammation and increased airway symptoms. We hypothesized that these workers would experience increased airway symptoms and decreased nasal mucociliary clearance associated with their exposure to air pollution.. In total, 25 non-smoking commercial motorcyclists, aged 18-44 years, were included in this study. These drivers work 8-12 hours per day, 5 days per week, driving on urban streets. Nasal mucociliary clearance was measured by the saccharine transit test; airway acidification was measured by assessing the pH of exhaled breath condensate; and airway symptoms were measured by the Sino-nasal Outcome Test-20 questionnaire. To assess personal air pollution exposure, the subjects used a passive-diffusion nitrogen dioxide (NO2) concentration-monitoring system during the 14 days before each assessment. The associations between NO2 and the airway outcomes were analyzed using the Mann-Whitney test and the Chi-Square test. Clinicaltrials.gov: NCT01976039.. Compared with clearance in healthy adult males, mucociliary clearance was decreased in 32% of the motorcyclists. Additionally, 64% of the motorcyclists had airway acidification and 92% experienced airway symptoms. The median personal NO2 exposure level was 75 mg/m3 for these subjects and a significant association was observed between NO2 and impaired mucociliary clearance (p=0.036).. Non-smoking commercial motorcyclists exhibit increased airway symptoms and airway acidification as well as decreased nasal mucociliary clearance, all of which are significantly associated with the amount of exposure to air pollution.

Topics: Adolescent; Adult; Air Pollution; Cross-Sectional Studies; Environmental Exposure; Forced Expiratory Volume; Humans; Male; Motorcycles; Mucociliary Clearance; Nitrogen Dioxide; Nose Diseases; Respiratory Tract Diseases; Statistics, Nonparametric; Surveys and Questionnaires; Time Factors; Urban Population; Young Adult

Air pollution exposure is associated with hospital admissions and emergency room visits for cardiopulmonary disease and stroke. Iceland's capital area, Reykjavik, has generally low air pollution levels, but traffic and natural sources contribute to pollution levels. The objective of this study was to investigate temporal associations between emergency hospital visits and air pollutants ozone (O3), nitrogen dioxide (NO2), and particulate matter (PM10) in the Icelandic capital area.. We constructed a time series of the daily number of adults who visited the emergency room, or were acutely admitted for stroke or cardiorespiratory causes to Landspitali University Hospital 1 January 2003 - 31 December 2009 from the hospital in-patient register. We used generalized additive models assuming Poisson distribution, to analyze the daily emergency hospital visits as a function of the pollutant levels, and adjusted for meteorological variables, day of week, and time trend with splines.. Daily emergency hospital visits increased 3.9% (95% confidence interval (CI) 1.7-6.1%) per interquartile (IQR) change in average O3 the same and two previous days. For females, the increase was 7.8% (95% CI 3.6-12.1) for elderly (70+), the increase was 3.9% (95% CI 0.6-7.3%) per IQR increase of NO2. There were no associations with PM10.. We found an increase in daily emergency hospital visits associated with O3, indicating that low-level exposure may trigger cardiopulmonary events or stroke.

Topics: Adult; Aged; Air Pollutants; Cardiovascular Diseases; Comorbidity; Emergency Service, Hospital; Environmental Exposure; Environmental Monitoring; Female; Hospitalization; Humans; Iceland; Incidence; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Poisson Distribution; Respiratory Tract Diseases; Seasons; Stroke; Time Factors; Urban Health

Evaluation of the adverse health effects of PM10 pollution (particulate matter less than 10 microns in diameter) is very important for protecting human health and establishing pollution control policy. Population exposure estimation is the first step in formulating exposure data for quantitative assessment of harmful PM10 pollution.. In this paper, we estimate PM10 concentration using a spatial interpolation method on a grid with a spatial resolution 0.01° × 0.01°. PM10 concentration data from monitoring stations are spatially interpolated, based on accurate population data in 2000 using a geographic information system. Then, an interpolated population layer is overlaid with an interpolated PM10 concentration layer, and population exposure levels are calculated. Combined with the exposure-response function between PM10 and health endpoints, economic costs of the adverse health effects of PM10 pollution are analyzed.. The results indicate that the population in Lanzhou urban areas is distributed in a narrow and long belt, and there are relatively large population spatial gradients in the XiGu, ChengGuan and QiLiHe districts. We select threshold concentration C0 at: 0 μg m(-3) (no harmful health effects), 20 μg m(-3) (recommended by the World Health Organization), and 50 μg m(-3) (national first class standard in China) to calculate excess morbidity cases. For these three scenarios, proportions of the economic cost of PM10 pollution-related adverse health effects relative to GDP are 0.206%, 0.194% and 0.175%, respectively. The impact of meteorological factors on PM10 concentrations in 2000 is also analyzed. Sandstorm weather in spring, inversion layers in winter, and precipitation in summer are important factors associated with change in PM10 concentration.. The population distribution by exposure level shows that the majority of people live in polluted areas. With the improvement of evaluation criteria, economic damage of respiratory disease caused by PM10 is much bigger. The health effects of Lanzhou urban residents should not be ignored. The government needs to find a better way to balance the health of residents and economy development. And balance the pros and cons before making a final policy.

Topics: Air Pollutants; Air Pollution; China; Environmental Exposure; Environmental Monitoring; Geographic Information Systems; Health Care Costs; Humans; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide

Exposure to air pollutants has been associated with increased hospital admissions (HAs) for respiratory and cardiovascular diseases. This work describes a short-term epidemiological study in Brindisi, a highly industrialized town in Southern Italy. The effects of daily exposure to PM10 and NO2 on daily HAs for cardiac, respiratory, and cerebrovascular diseases were investigated by means of a case-crossover design in the period 2001-2007. Results showed positive associations between PM10 and HAs for cardiac and respiratory diseases and between NO2 and HAs for all the categories of diseases considered, particularly among females. Although not statistically significant, increased risk was observed for wind blowing from the port and the industrial area. Findings confirm the health risks associated with ambient air pollution exposure, even though NO2 and PM10 concentrations were below the legal limits. This may be due to the complex scenario of emissions in the area, which should be better investigated.

Topics: Adult; Aged; Air Pollutants; Cardiovascular Diseases; Cerebrovascular Disorders; Cities; Environmental Exposure; Environmental Monitoring; Female; Humans; Italy; Male; Middle Aged; Nitrogen Dioxide; Particle Size; Particulate Matter; Respiratory Tract Diseases; Risk Factors; Seasons; Time Factors; Wind

This study investigated associations between long-term exposure to ambient volatile organic compounds (VOCs) and mortality. 58,760 Toronto residents (≥35 years of age) were selected from tax filings and followed from 1982 to 2004. Death information was extracted using record linkage to national mortality data. Land-use regression surfaces for benzene, n-hexane, and total hydrocarbons were generated from sampling campaigns in 2002 and 2004 and assigned to residential addresses in 1982. Cox regression was used to estimate relationships between each VOC and non-accidental, cardiovascular, and cancer mortality. Positive associations were observed for each VOC. In multi-pollutant models the benzene and total hydrocarbon signals were strongest for cancer. The hazard ratio for cancer that corresponded to an increase in the interquartile range of benzene (0.13 μg/m(3)) was 1.06 (95% CI = 1.02-1.11). Our findings suggest ambient concentrations of VOCs were associated with cancer mortality, and that these exposures did not confound our previously reported associations between NO2 and cardiovascular mortality.

Topics: Adult; Aged; Aged, 80 and over; Air Pollutants; Air Pollution; Cardiovascular Diseases; Environmental Exposure; Female; Geographic Information Systems; Humans; Male; Middle Aged; Neoplasms; Nitrogen Dioxide; Ontario; Respiratory Tract Diseases; Volatile Organic Compounds

Numerous studies have described the adverse associations between particle mass and respiratory health. The aim of the study was to analyze the associations of particle properties, especially size-segregated particle number concentrations (PNC), and respiratory mortality in Beijing, P.R. China. We gathered daily values of respiratory mortality and air pollution data of the Beijing urban area. Generalized additive models were used to estimate the associations. Single pollutant models showed that delayed concentrations of SO(2), total PNCs, and PNC of 300-1000 nm were adversely associated with total respiratory mortality. There was an indication that adverse health effects of PNCs might be stronger for stagnant air masses. Two-pollutant models verified the independence of associations of total PNCs of other pollutants (SO(2), NO(2), and PM(10)). In conclusion, particle number concentrations, especially accumulation mode particles, might be factors influencing the adverse associations between particulate matter and respiratory health.

Topics: Adult; Air Pollutants; China; Environmental Monitoring; Epidemiological Monitoring; Humans; Nitrogen Dioxide; Particle Size; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide; Weather; Young Adult

Epidemiologic studies have attributed adverse health effects to air pollution; however, controversy remains regarding the relationship between ambient oxidants [ozone (O₃) and nitrogen dioxide (NO₂)] and mortality, especially in Asia. We conducted a four-city time-series study to investigate acute effects of O₃ and NO₂ in the Pearl River Delta (PRD) of southern China, using data from 2006 through 2008.. We used generalized linear models with Poisson regression incorporating natural spline functions to analyze acute mortality in association with O₃ and NO₂, with PM₁₀ (particulate matter ≤ 10 μm in diameter) included as a major confounder. Effect estimates were determined for individual cities and for the four cities as a whole. We stratified the analysis according to high- and low- exposure periods for O₃.. We found consistent positive associations between ambient oxidants and daily mortality across the PRD cities. Overall, 10-μg/m³ increases in average O₃ and NO₂ concentrations over the previous 2 days were associated with 0.81% [95% confidence interval (CI): 0.63%, 1.00%] and 1.95% (95% CI: 1.62%, 2.29%) increases in total mortality, respectively, with stronger estimated effects for cardiovascular and respiratory mortality. After adjusting for PM₁₀, estimated effects of O₃ on total and cardiovascular mortality were stronger for exposure during high-exposure months (September through November), whereas respiratory mortality was associated with O₃ exposure during nonpeak exposure months only.. Our findings suggest significant acute mortality effects of O₃ and NO₂ in the PRD and strengthen the rationale for further limiting the ambient pollution levels in the area.

Topics: Cardiovascular Diseases; China; Cities; Female; Humans; Linear Models; Male; Nitrogen Dioxide; Oxidants, Photochemical; Ozone; Particulate Matter; Respiratory Tract Diseases; Time Factors

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

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

Few epidemiological studies have reported the spatial characteristics of the association between particulate matter <10μm in aerodynamic diameter (PM(10)) and mortality in China. This study explored the spatial characteristics of the association between ambient PM(10) and mortality in the urban area of Beijing, China. We collected daily data on air pollution, weather conditions and mortality in the eight urban districts of Beijing from Jan. 1st 2008 to Dec. 31st 2009. A Poisson Generalized Additive Model (GAM) was used to examine the district-specific effects of PM(10) on cause-specific mortality. A Poisson Generalized Additive Mixed Model (GAMM) was used to examine the urban-wide association between PM(10) and cause-specific mortality while controlling for the random effects of districts, compared with GAM which did not control for the random effects of districts. The inter-quartile ranges (IQRs) of annual PM(10) ranged from 83.5 μg/m(3) (Chaoyang district) to 96.0 μg/m(3) (Shijingshan district). A 96.0 μg/m(3) increase of PM(10) was associated with a 7.52% (95%CI: 1.78%-13.56%) increase of cardiovascular mortality in Shijingshan district while an 87.0 μg/m(3) increase of PM(10) was associated with a 7.68% (95%CI: 0.08%-15.86%) increase of respiratory deaths in Dongcheng district. The urban-wide effects derived from GAMM showed that an 88.0 μg/m(3) increase of PM(10) was associated with an increase of 1.30% (95%CI: 0.45%-2.16%), 2.60% (95%CI: 0.14%-5.11%) in non-accidental and respiratory mortality, illustrating, higher results than those from the GAM. In conclusion, there is spatial variation in ambient PM(10) concentration as well as in the effects of PM(10) on cause-specific mortality in the urban area of Beijing. Additionally, GAMM model may be more effective in estimating the spatial association between urban-wide PM(10) and cause-specific mortality.

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; China; Humans; Models, Biological; Mortality; Nitrogen Dioxide; Particle Size; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide; Urban Health; Weather

To evaluate the relationship between exposure to gaseous air pollutants (NO2 and SO2) and daily hospital admissions for respiratory diseases.. After controlling long time trend, the "day of week" effect and confounding factors of meteorology, a semi-parametric generalized additive model (GAM) was used to analyze the exposure-effect relationship between gaseous air pollutants and daily respiratory hospital visits from 2001 to 2005 in Lanzhou city.. Both NO2 and SO2 have positive relationships with residents' hospital visits for respiratory complaints. In single-pollutant models, the best fits for NO2 and SO2 were one day after (Lag1) and the same day visit (Lag0). With an IQR concentration increase in NO2 (Lag1) and SO2 (Lag0), the relative risks of daily hospital admissions for respiratory diseases were 1.060 (95% CI 1.046-1.074) and 1.048 (95% CI 1.031-1.065), respectively. The susceptible populations were female and the elderly. The health effect of gaseous air pollution was more obvious in autumn and winter.. The ambient NO2 and SO2 concentrations have an adverse effect on daily hospital visits for respiratory diseases of residents in Lanzhou.

Topics: Aged; Air Pollutants; China; Environmental Exposure; Female; Hospitalization; Humans; Male; Middle Aged; Models, Statistical; Nitrogen Dioxide; Respiratory Tract Diseases; Sulfur Dioxide

The link between concentrations of particulate matter (PM) and respiratory morbidity has been investigated in numerous studies.. The aim of this study was to analyze the role of different particle size fractions with respect to respiratory health in Beijing, China.. Data on particle size distributions from 3 nm to 1 µm; PM10 (PM ≤ 10 µm), nitrogen dioxide (NO(2)), and sulfur dioxide concentrations; and meteorologic variables were collected daily from March 2004 to December 2006. Concurrently, daily counts of emergency room visits (ERV) for respiratory diseases were obtained from the Peking University Third Hospital. We estimated pollutant effects in single- and two-pollutant generalized additive models, controlling for meteorologic and other time-varying covariates. Time-delayed associations were estimated using polynomial distributed lag, cumulative effects, and single lag models.. Associations of respiratory ERV with NO(2) concentrations and 100-1,000 nm particle number or surface area concentrations were of similar magnitude-that is, approximately 5% increase in respiratory ERV with an interquartile range increase in air pollution concentration. In general, particles < 50 nm were not positively associated with ERV, whereas particles 50-100 nm were adversely associated with respiratory ERV, both being fractions of ultrafine particles. Effect estimates from two-pollutant models were most consistent for NO(2).. Present levels of air pollution in Beijing were adversely associated with respiratory ERV. NO(2) concentrations seemed to be a better surrogate for evaluating overall respiratory health effects of ambient air pollution than PM(10) or particle number concentrations in Beijing.

Topics: Air Pollutants; Air Pollution; China; Emergency Service, Hospital; Hospitalization; Humans; Nitrogen Dioxide; Particle Size; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide

Few studies have attempted to quantify the integrated health burden, incorporating both mortality and morbidity as these factors pertain to air pollutants, on the population in the vicinity of the incinerators. The aims of this study are to estimate the attributable burden of disease caused by incinerators in Seoul, Korea and to present an approach based on source-specific exposure for the estimation of the environmental burden of disease (EBD). With particular attention on the development of a measurement means of the source-specific, exposure-based population attributable fraction (PAF), we integrated air dispersion modeling, Geographic Information Systems (GIS), the population distribution of exposure, and the exposure-response relationship. We then estimated the PAFs caused by additional concentrations of four air pollutants (PM(10), NO(2,) SO(2), and CO) emitted from four municipal solid waste incinerators (MSWIs) in Seoul in 2007. We, finally, estimated the attributable burden of disease, using the estimated PAF and the disability-adjusted life years (DALY) method developed by the Global Burden of Disease Group of the World Health Organization (WHO). The PAF for NO(2) to all-cause mortality was assessed at approximately 0.02% (95% CI: 0.003-0.036%), which was the highest among all air pollutants. The PAFs for respiratory and cardiovascular disease were 0.12% (95% CI: 0.01-0.16%) and 0.10% (95% CI: 0.04-0.16%), respectively. The sum of the attributable burden of disease for four pollutants was about 297 person-years (PYs) (95% CI: 121-472 PYs) when the incinerators observed to the emission standards. The attributable burdens of respiratory disease and cardiovascular disease were about 0.2% and 0.1%, respectively, of the total burden of respiratory disease and cardiovascular disease of Seoul citizens for the year 2007. Although the air emissions from one risk factor, an incinerator, are small, the burden of disease can be significant to the public health when population exposure is considered.

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; Cardiovascular Diseases; Cities; Demography; Environmental Exposure; Geographic Information Systems; Humans; Incineration; Models, Chemical; Nitrogen Dioxide; Particulate Matter; Republic of Korea; Respiratory Tract Diseases; Sulfur Dioxide

This paper demonstrates association of short-term variation in pollution and health outcomes within the same geographical area for a typical urban setting in the northern part of the UK from time series analysis. It utilises publicly available datasets for regulated air pollutants (PM₁₀, NO₂, SO₂, CO and O₃), meteorology and respiratory hospital admissions (and mortality) between April 2002 and December 2005 to estimate the respiratory health effect of pollution exposure, mainly in the elderly. Our results show that PM₁₀ and O₃ are positively associated with respiratory hospital admissions in the elderly, specifically in the age group 70-79. CO effects seem to be concentrated on the most elderly age group (80+) whereas NO₂ seems to have the opposite age-related effect, with lower effects on the more elderly.

Topics: Aged; Aged, 80 and over; Air Pollutants; Air Pollution; Carbon Monoxide; Health; Hospitalization; Humans; Models, Biological; Models, Chemical; Nitrogen Dioxide; Ozone; Particulate Matter; Regression Analysis; Respiratory Tract Diseases; Sulfur Dioxide; Urban Health

Several studies have been conducted on the possible health effects for people living close to incinerators and well-conducted reviews are available. Nevertheless, several uncertainties limit the overall interpretation of the findings. We evaluated the health effects of emissions from two incinerators in a pilot cohort study.. The study area was defined as the 3.5 km radius around two incinerators located near Forlì (Italy). People who were residents in 1/1/1990, or subsequently became residents up to 31/12/2003, were enrolled in a longitudinal study (31,347 individuals). All the addresses were geocoded. Follow-up continued until 31/12/2003 by linking the mortality register, cancer registry and hospital admissions databases. Atmospheric Dispersion Model System (ADMS) software was used for exposure assessment; modelled concentration maps of heavy metals (annual average) were considered the indicators of exposure to atmospheric pollution from the incinerators, while concentration maps of nitrogen dioxide (NO2) were considered for exposure to other pollution sources. Age and area-based socioeconomic status adjusted rate ratios and 95% Confidence Intervals were estimated with Poisson regression, using the lowest exposure category to heavy metals as reference.. The mortality and morbidity experience of the whole cohort did not differ from the regional population. In the internal analysis, no association between pollution exposure from the incinerators and all-cause and cause-specific mortality outcomes was observed in men, with the exception of colon cancer. Exposure to the incinerators was associated with cancer mortality among women, in particular for all cancer sites (RR for the highest exposure level = 1.47, 95% CI: 1.09, 1.99), stomach, colon, liver and breast cancer. No clear trend was detected for cancer incidence. No association was found for hospitalizations related to major diseases. NO2 levels, as a proxy from other pollution sources (traffic in particular), did not exert an important confounding role.. No increased risk of mortality and morbidity was found in the entire area. The internal analysis of the cohort based on dispersion modeling found excesses of mortality for some cancer types in the highest exposure categories, especially in women. The interpretation of the findings is limited given the pilot nature of the study.

Topics: Adult; Aged; Air Pollutants; Cardiovascular Diseases; Cohort Studies; Environmental Exposure; Female; Humans; Incidence; Incineration; Italy; Longitudinal Studies; Male; Metals, Heavy; Middle Aged; Models, Theoretical; Neoplasms; Nitrogen Dioxide; Pilot Projects; Poisson Distribution; Respiratory Tract Diseases; Risk Assessment; Sex Factors; Socioeconomic Factors

Fine particulate matter (PM₂.₅) is not a criteria pollutant in China, and few studies were conducted in the country to investigate the health impact of PM₂.₅. In this study, we did a time-stratified case-crossover analysis to examine the association between PM₂.₅ and daily mortality in Shenyang, an industrial center in northeast China. Daily mortality, air pollution and weather data from August 1, 2006 to December 31, 2008 in Shenyang were collected. A time-stratified case-crossover approach was used to estimate the association of PM₂.₅ with both total and cause-specific mortality. Controls were selected as matched days of the week in the same month. Potential effect modifiers, such as age, gender, and season, were also examined. We found significant associations between PM₂.₅ and daily mortality in Shenyang. A 10 μg/m³ increment in the 2-day moving average (lag 01) concentrations of PM₂.₅ corresponded to 0.49% (95% CI: 0.19%, 0.79%), 0.53% (95% CI: 0.09%, 0.97%), and 0.97% (95% CI: 0.01%, 1.94%) increase of total, cardiovascular, and respiratory mortality, respectively. The associations appeared to be stronger in older people (aged ≥ 75 years), in females and during the warm season. To our knowledge, this is the longest PM₂.₅ health study in time duration in China. Our findings provide new information on the adverse health effects of PM₂.₅, and may have implications for environmental policy making and standard setting in China.

Topics: Accidents; Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Child; Child, Preschool; China; Cities; Cross-Over Studies; Environmental Monitoring; Female; Humans; Inhalation Exposure; Male; Middle Aged; Mortality; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide; Young Adult

Air pollution from vehicular traffic has been associated with respiratory diseases. In Palermo, the largest metropolitan area in Sicily, urban air pollution is mainly addressed to traffic-related pollution because of lack of industrial settlements, and the presence of a temperate climate that contribute to the limited use of domestic heating plants. This study aimed to investigate the association between traffic-related air pollution and emergency room admissions for acute respiratory symptoms.. From January 2004 through December 2007, air pollutant concentrations and emergency room visits were collected for a case-crossover study conducted in Palermo, Sicily. Risk estimates of short-term exposures to particulate matter and gaseous ambient pollutants including carbon monoxide, nitrogen dioxide, and sulfur dioxide were calculated by using a conditional logistic regression analysis.. Emergency departments provided data on 48,519 visits for respiratory symptoms. Adjusted case-crossover analyses revealed stronger effects in the warm season for the most part of the pollutants considered, with a positive association for PM10 (odds ratio = 1.039, 95% confidence interval: 1.020 - 1.059), SO2 (OR = 1.068, 95% CI: 1.014 - 1.126), nitrogen dioxide (NO2: OR = 1.043, 95% CI: 1.021 - 1.065), and CO (OR = 1.128, 95% CI: 1.074 - 1.184), especially among females (according to an increase of 10 μg/m3 in PM10, NO2, SO2, and 1 mg/m3 in CO exposure). A positive association was observed either in warm or in cold season only for PM10.. Our findings suggest that, in our setting, exposure to ambient levels of air pollution is an important determinant of emergency room (ER) visits for acute respiratory symptoms, particularly during the warm season. ER admittance may be considered a good proxy to evaluate the adverse effects of air pollution on respiratory health.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Air Pollutants; Carbon Monoxide; Case-Control Studies; Climate; Emergency Service, Hospital; Female; Humans; Logistic Models; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Risk Factors; Seasons; Sicily; Sulfur Dioxide; Urban Health; Young Adult

Several studies have shown an association between nitrogen dioxide (NO2) and mortality. In Italy, the EpiAir multicentric study, "Air Pollution and Health: Epidemiological Surveillance and Primary Prevention," investigated short-term health effects of air pollution, including NO2.. To study the individual susceptibility, we evaluated the association between NO2 and cause-specific mortality, investigating individual sociodemographic features and chronic/acute medical conditions as potential effect modifiers.. We considered 276,205 natural deaths of persons > 35 years of age, resident in 10 Italian cities, and deceased between 2001 and 2005. We chose a time-stratified case-crossover analysis to evaluate the short-term effects of NO2 on natural, cardiac, cerebrovascular, and respiratory mortality. For each subject, we collected information on sociodemographic features and hospital admissions in the previous 2 years. Fixed monitors provided daily concentrations of NO2, particulate matter ≤ 10 μm in aerodynamic diameter (PM10) and ozone (O3).. We found statistically significant associations with a 10-μg/m3 increase of NO2 for natural mortality [2.09% for lag 0-5; 95% confidence interval (CI), 0.96-3.24], for cardiac mortality (2.63% for lag 0-5; 95% CI, 1.53-3.75), and for respiratory mortality (3.48% for lag 1-5; 95% CI, 0.75-6.29). These associations were independent from those of PM10 and O3. Stronger associations were estimated for subjects with at least one hospital admission in the 2 previous years and for subjects with three or more specific chronic conditions. Some cardiovascular conditions (i.e., ischemic heart disease, pulmonary circulation impairment, heart conduction disorders, heart failure) and diabetes appeared to confer a strong susceptibility to air pollution.. Our results suggest significant and likely independent effects of NO2 on natural, cardiac, and respiratory mortality, particularly among subjects with specific cardiovascular preexisting chronic conditions and diabetes.

Topics: Adult; Aged; Aged, 80 and over; Air Pollutants; Air Pollution; Cardiovascular Diseases; Cross-Over Studies; Diabetes Mellitus; Environmental Exposure; Female; Hospitalization; Humans; Italy; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Population Surveillance; Respiratory Tract Diseases; Socioeconomic Factors; Time Factors; Urban Health

Asthma is a growing epidemic worldwide. Exacerbations of asthma have been associated with bacterial and viral respiratory tract infections and air pollution. We correlated the asthma admission rates with fluctuations in respiratory virus activity and traffic-related air pollution, namely particulate matter with an aerodynamic diameter ≤ 10 μm (PM₁₀), nitrogen dioxide (NO₂), carbon monoxide (CO), sulfur dioxide (SO₂), and ozone (O₃). A probabilistic risk assessment framework was developed based on a detrended fluctuation analysis to predict future respiratory virus and air pollutant associated asthma incidence. Results indicated a strong association between asthma admission rate and influenza (r=0.80, p<0.05) and SO₂ level (r=0.73, p<0.05) in Taiwan in the period 2001-2008. No significant correlation was found for asthma admission and PM₁₀, O₃, NO₂, and CO. The proposed fluctuation analysis provides a simple correlation exponent describing the complex interactions of respiratory viruses and air pollutants with asthma. This study revealed that there was a 95% probability of having exceeded 2987 asthma admissions per 100,000 population. It was unlikely (30% probability) that the asthma admission rate exceeded 3492 per 100,000 population. The probability of asthma admission risk can be limited to below 50% by keeping the correlation exponent of influenza to below 0.9. We concluded that fluctuation analysis based risk assessment provides a novel predictor of asthma incidence.

Topics: Air Microbiology; Air Pollutants; Air Pollution; Asthma; Carbon Monoxide; Environmental Monitoring; Epidemiological Monitoring; Humans; Nitrogen Dioxide; Ozone; Particle Size; Particulate Matter; Respiratory Tract Diseases; Risk Assessment; Sulfur Dioxide

In this study, we aimed to investigate the frequency of respiratory health symptoms among high school students attending schools at industrial, urban and rural areas in a Turkish city. Three schools located in different zones of the city having different pollution characteristics were chosen based on the pollutant distribution maps using Geographical Information Systems (GIS) software. A cross-sectional survey was performed among 667 high school students in the schools. Outdoor and indoor nitrogen dioxide (NO(2)) and ozone (O(3)) concentrations were also measured by passive samplers in the same schools to investigate possible routes of exposure. Chronic pulmonary disease (OR = 1.49; 95%CI: 1.11-1.99; p = 0.008), tightness in the chest (OR = 1.57; 95%CI: 1.22-2.02; p = 0.001), morning cough (OR = 1.81 95%CI: 1.19-2.75; p = 0.006) were higher among students in the industrial zone where nitrogen dioxide and ozone levels were also highest. There were no indoor sources of nitrogen dioxide and ozone exists in the schools except for the dining hall. As a conclusion, this study has noticed that air pollution and respiratory health problems among high school students are high in industrial zones and the use of passive samplers combined with GIS is an effective tool that may be used by public health researchers to identify pollutant zones and persons at risk.

Topics: Adolescent; Air Pollutants; Air Pollution; Cities; Cross-Sectional Studies; Female; Humans; Male; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Students; Turkey; Urban Population

Temperature, a key climate change indicator, is expected to increase substantially in the Northern Hemisphere, with potentially grave implications for human health. This study is the first to investigate the association between the daily 3-hour maximum apparent temperature (Tapp(max)), and respiratory, cardiovascular and cerebrovascular mortality in Copenhagen (1999-2006) using a case-crossover design. Susceptibility was investigated for age, sex, socio-economic status and place of death. For an inter-quartile range (7 °C) increase in Tapp(max), an inverse association was found with cardiovascular mortality (-7% 95% CI -13%; -1%) and none with respiratory and cerebrovascular mortality. In the cold period all associations were inverse, although insignificant.

Topics: Adult; Aged; Aged, 80 and over; Air Pollutants; Carbon Monoxide; Cardiovascular Diseases; Cause of Death; Denmark; Environmental Monitoring; Epidemiological Monitoring; Female; Hospitals; Humans; Humidity; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Patient Admission; Respiratory Tract Diseases; Temperature; Young Adult

To determine whether air quality influences the prevalence of pediatric frequent ear infections and respiratory allergy.. Case-control study.. Academic medical center.. The National Health Interview Survey child sample for the calendar years 1997 through 2006 was analyzed, extracting 12-month prevalence data for the following three disease conditions: frequent (>/=3 within 12 months) ear infections, respiratory allergy, and seizures (nonrespiratory control condition). Based on information from the Environmental Protection Agency, yearly historical data for the air quality criteria pollutants carbon monoxide, nitrous dioxide, sulfur dioxide, and particulate matter were tabulated. Graphical and linear regression analyses were conducted to determine the influence of air quality on each of the disease conditions.. A total of 126,060 children were studied (51.4% male, mean age 8.6 yrs). Overall, the 12-month prevalence for three or more ear infections, respiratory allergy, and seizures was 6.6%, 11.7%, and 0.7%, respectively. Air quality steadily improved over the study period. Statistically significant positive regression coefficients were obtained for each of the criteria pollutants with ear infections (all P < 0.001), with regression coefficients ranging from 0.007 (particulate matter) to 11.2 (sulfur dioxide). For respiratory allergies, nonstatistically significant regression coefficients for the criteria pollutants were obtained (range <0.001-0.379, all P > or = 0.409). For the nonrespiratory condition seizures, nonsignificant regression coefficients were again identified (all P > or = 0.404).. Better air quality is significantly associated with lower prevalence of pediatric frequent ear infections but is not associated with the prevalence of pediatric respiratory allergy. Improvements in air quality may be implicated in the decreased rates of pediatric ear infections over time.

Topics: Air Pollution; Boston; Carbon Monoxide; Case-Control Studies; Child; Female; Health Surveys; Humans; Male; Nitrogen Dioxide; Otitis; Particle Size; Particulate Matter; Population Surveillance; Prevalence; Regression Analysis; Respiratory Tract Diseases; Risk Assessment; Risk Factors; Seizures; Sulfur Dioxide; Time Factors

To evaluate whether a relationship exists in hospital admissions for respiratory conditions in children with outdoor pollution in the Southwest Milan, Italy.. Daily count of hospital admissions for asthma, upper or lower respiratory diseases (LRD) occurred among children aged < or =14 years at the San Paolo Hospital during 2007-2008 was recorded. Pollutants included the particular matter of <10 microm diameter, ozone, carbon monoxide (CO) and nitrogen dioxide (NO(2)), reported on the same day of admission and 1 up to 5 days before admission. The moving weekly average (MWA) was also considered.. Total respiratory admissions were associated with the same day level of CO (30.6% increase per 1 mg/m(3) increase, 95% confidence interval, 3.9-69.9%) and with the MWA of NO(2) (9.0% increase per 10 microg/m(3) increase, 1.2-16.8%). The effect of CO was stronger on upper respiratory diseases (URD) (lag 0, 21.3% increase, 6.4-38.3%). The effect of NO(2) was stronger on LRD (MWA, 5.3% increase, 0.9-10.2%). Multipollutant models confirmed the role of CO on URD and that of NO(2) on LRD.. Carbon monoxide and nitrogen dioxide may be associated with emergency hospital admissions for respiratory conditions among children in Southwest Milan.

Topics: Adolescent; Air Pollutants; Air Pollution; Asthma; Carbon Monoxide; Child; Environmental Monitoring; Epidemiological Monitoring; Female; Hospitalization; Humans; Italy; Male; Nitrogen Dioxide; Respiratory Tract Diseases; Weather

The associations between air pollution and children's respiratory health in the high pollution range have not yet been clearly characterized. We evaluated the effects of outdoor air pollution on respiratory morbidity in children selected from multiple sites in a heavy industrial province of northeastern China.. The study included 11,860 children aged 3-12 years, selected from 18 districts of 6 cities in Liaoning province, the participation rate is 89.9%. Informed consent and written responses to surveys about children's historic and current health status, personal and household characteristics, and other information were obtained from parents. A two-stage regression approach was applied in data analyses.. There were wide gradients for TSP (188-689 μg/m(3)), SO(2) (14-140 μg/m(3) and NO(2) (29-94 μg/m(3)) across the 18 districts of 6 cities. The three air pollutants significantly increased the prevalence of persistent cough (21-28%), persistent phlegm (21-30%) and current asthma (39-56%) for each interquartile range increment (172 μg/m(3) for TSP, 69 μg/m(3) for SO(2), 30 μg/m(3) for NO(2)), showing larger between-city effects than within-city. Rates of respiratory symptoms were significantly higher for children with younger age, atopy, respiratory disease in early age, family history of asthma or chronic bronchitis, and tobacco smoke exposure.. The high levels of outdoor air pollution in north China are positively associated with children's respiratory symptoms, the associations with TSP appear to be stronger than SO(2) and NO(2).

Topics: Air Pollutants; Air Pollution; Child; Child, Preschool; China; Environmental Monitoring; Female; Humans; Male; Nitrogen Dioxide; Particle Size; Prevalence; Respiratory Tract Diseases; Sulfur Dioxide; Surveys and Questionnaires; Tobacco Smoke Pollution

Although the relation between outdoor air pollution and daily mortality has been examined in several Chinese cities, there are still a number of key scientific issues to be addressed concerning the health effects of air pollution in China. Given the changes over the past decade in concentrations and sources of air pollution (e.g., the change from one predominant source [coal combustion], which was typical of the twentieth century, to a mix of sources [coal combustion and motor-vehicle emissions]) and transition in China, it is worthwhile to investigate the acute effects of outdoor air pollution on mortality outcomes in the country. We conducted a time-series study to investigate the relation between outdoor air pollution and daily mortality in Shanghai using four years of daily data (2001-2004). This study is a part of the Public Health and Air Pollution in Asia (PAPA) program supported by the Health Effects Institute (HEI). We collected data on daily mortality, air pollution, and weather from the Shanghai Municipal Center of Disease Control and Prevention (SMCDCP), Shanghai Environmental Monitoring Center, and Shanghai Meteorologic Bureau. An independent auditing team assigned by HEI validated all the data. Our statistical analysis followed the Common Protocol of the PAPA program (found at the end of this volume). Briefly, a natural-spline model was used to analyze the mortality, air pollution, and covariate data. We first constructed the basic models for various mortality outcomes excluding variables for air pollution, and used the partial autocorrelation function of the residuals to guide the selection of degrees of freedom for time trend and lag days for the autoregression terms. Thereafter, we introduced the pollutant variables and analyzed their effects on mortality outcomes, including both mortality due to all natural (nonaccidental) causes and cause-specific mortality. We fitted single- and multipollutant models to assess the stability of the effects of the pollutants. For mortality due to all natural causes, we also examined the associations stratified by sex and age. Stratified analyses by education level, used as a measure of socioeconomic status, were conducted as well. In addition to an analysis of the entire study period, the effects of air pollution in just the warm season (from April to September) and cool season (from October to March) were analyzed. We also examined the effects of alternative model specifications--such as lag effects of

Topics: Adolescent; Adult; Age Factors; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Child; Child, Preschool; China; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particle Size; Particulate Matter; Population Surveillance; Respiratory Tract Diseases; Seasons; Sex Factors; Socioeconomic Factors; Sulfur Dioxide; Time Factors; Weather; Young Adult

Fewer studies have been published on the association between daily mortality and ambient air pollution in Asia than in the United States and Europe. This study was undertaken in Wuhan, China, to investigate the acute effects of air pollution on mortality with an emphasis on particulate matter (PM*). There were three primary aims: (1) to examine the associations of daily mortality due to all natural causes and daily cause-specific mortality (cardiovascular [CVD], stroke, cardiac [CARD], respiratory [RD], cardiopulmonary [CP], and non-cardiopulmonary [non-CP] causes) with daily mean concentrations (microg/m3) of PM with an aerodynamic diameter--10 pm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), or ozone (O3); (2) to investigate the effect modification of extremely high temperature on the association between air pollution and daily mortality due to all natural causes and daily cause-specific mortality; and (3) to assess the uncertainty of effect estimates caused by the change in International Classification of Disease (ICD) coding of mortality data from Revision 9 (ICD-9) to Revision 10 (ICD-10) code. Wuhan is called an "oven city" in China because of its extremely hot summers (the average daily temperature in July is 37.2 degrees C and maximum daily temperature often exceeds 40 degrees C). Approximately 4.5 million residents live in the core city area of 201 km2, where air pollution levels are higher and ranges are wider than the levels in most cities studied in the published literature. We obtained daily mean levels of PM10, SO2, and NO2 concentrations from five fixed-site air monitoring stations operated by the Wuhan Environmental Monitoring Center (WEMC). O3 data were obtained from two stations, and 8-hour averages, from 10:00 to 18:00, were used. Daily mortality data were obtained from the Wuhan Centres for Disease Prevention and Control (WCDC) during the study period of July 1, 2000, to June 30, 2004. To achieve the first aim, we used a regression of the logarithm of daily counts of mortality due to all natural causes and cause-specific mortality on the daily mean concentrations of the four pollutants while controlling for weather, temporal factors, and other important covariates with generalized additive models (GAMs). We derived pollutant effect estimations for 0-day, 1-day, 2-day, 3-day, and 4-day lagged exposure levels, and the averages of 0-day and 1-day lags (lag 0-1 day) and of 0-day, 1-day, 2-day, and 3-day lags (lag 0-3 days) before t

Topics: Age Factors; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; China; Female; Hot Temperature; Humans; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particle Size; Particulate Matter; Population Surveillance; Respiratory Tract Diseases; Seasons; Sex Factors; Socioeconomic Factors; Sulfur Dioxide; Time Factors; Weather

While the effects of particulate matter (PM*) on mortality have been well documented in North America and Western Europe, considerably less is known about its effects in developing countries in Asia. Existing air pollution data in Bangkok, Thailand, indicate that airborne concentrations of PM < or = 10 pm in aerodynamic diameter (PM10) are as high or higher than those experienced in most cities in North America and Western Europe. At the same time, the demographics, activity patterns, and background health status of the population, as well as the chemical composition of PM, are different in Bangkok. It is important, therefore, to determine whether the effects of PM10 on mortality occurring in this large metropolitan area are similar to those in Western cities. The quality and completeness of Bangkok mortality data have been recently enhanced by the completion of a few mortality studies and through input from monitors currently measuring daily PM10 in Bangkok. In this analysis, we examined the effects of PM10 and several gaseous pollutants on daily mortality for the years 1999 through 2003. Our results suggest strong associations between several different mortality outcomes and levels of PM10 and several of the gaseous pollutants, including nitrogen dioxide (NO2), nitric oxide (NO), and ozone (O3). In many cases, the effect estimates were higher than the approximately 6% per 10 microg/m3 typically reported in Western industrialized nations-based on reviews by the U.S. Environmental Protection Agency (U.S. EPA) and the World Health Organization (WHO) (Anderson et al. 2004). For example, the excess risk (ER) for mortality due to all natural causes was 1.3% (95% confidence interval [CI], 0.8 to 1.7), with higher ERs for cardiovascular and respiratory mortality of 1.9% (95% CI, 0.8 to 3.0) and 1.0% (95% CI, -0.4 to 2.4), respectively. Of particular note, for this warm, tropical city of approximately 6 to 10 million people, is that there is no covariation between pollution and cold weather, with its associated adverse health problems. Multiday averages of PM10 generated even higher effect estimates. Our analysis of age- and disease-specific mortality indicated elevated ERs for young children, especially infants with respiratory illnesses, children less than 5 years of age with lower respiratory infections (LRIs), and people with asthma. Age-restricted analyses showed that the associations between mortality due to all natural causes and PM10 concentration increa

Topics: Adolescent; Adult; Age Factors; Air Pollutants; Air Pollution; Cardiovascular Diseases; Child; Child, Preschool; Female; Humans; Male; Middle Aged; Nitric Oxide; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Sex Factors; Sulfur Dioxide; Thailand; Weather

In recent years, Asia has experienced rapid economic growth and a deteriorating environment caused by the increasing use of fossil fuels. Although the deleterious effects of air pollution from fossil-fuel combustion have been demonstrated in many Western nations, few comparable studies have been conducted in Asia. Time-series studies of daily mortality in Asian cities can contribute important new information to the existing body of knowledge about air pollution and health. Not only can these studies verify important health effects of air pollution in local regions in Asia, they can also help determine the relevance of existing air pollution studies to mortality and morbidity for policymaking and environmental controls. In addition, the studies can help identify factors that might modify associations between air pollution and health effects in various populations and environmental conditions. Collaborative multicity studies in Asia-especially when designed, conducted, and analyzed using a common protocol-will provide more robust air pollution effect estimates for the region as well as relevant, supportable estimates of local adverse health effects needed by environmental and public-health policymakers.. The Public Health and Air Pollution in Asia (PAPA*) project, sponsored by the Health Effects Institute, consisted of four studies designed to assess the effects of air pollution on mortality in four large Asian cities, namely Bangkok, in Thailand, and Hong Kong, Shanghai, and Wuhan, in China. In the PAPA project, a Common Protocol was developed based on methods developed and tested in NMMAPS, APHEA, and time-series studies in the literature to help ensure that the four studies could be compared with each other and with previous studies by following an established protocol. The Common Protocol (found at the end of this volume) is a set of prescriptive instructions developed for the studies and used by the investigators in each city. It is flexible enough to allow for adjustments in methods to optimize the fit of health-effects models to each city's data set. It provides the basis for generating reproducible results in each city and for meta-estimates from combined data. By establishing a common methodology, factors that might influence the differences in results from previous studies can more easily be explored. Administrative support was provided to ensure that the highest quality data were used in the analysis. It is anticipated that the PAPA results will contribute to the international scientific discussion of how to conduct and interpret time-series studies of air pollution and will stimulate the development of high-quality routine systems for recording daily deaths and hospital admissions for time-series analysis.. Mortality data were retrieved from routine databases with underlying causes of death coded using the World Health Organization (WHO) International Classification of Diseases, 9th revision or 10th revision (ICD-9, ICD-10). Air quality measurements included nitrogen dioxide (NO2), sulfur dioxide (SO2), particulate matter with aerodynamic diameter < or = 10 microm (PM10), and ozone (O3) and were obtained from several fixed-site air monitoring stations that were located throughout the metropolitan areas of the four cities and that met the standards of procedures for quality assurance and quality control carried out by local government units in each city. Using the Common Protocol, an optimized core model was established for each city to assess the effects of each of the four air pollutants on daily mortality using generalized linear modeling with adjustments for time trend, seasonality, and other time-varying covariates by means of a natural-spline smoothing function. The models were adjusted to suit local situations by correcting for influenza activity, autocorrelation, and special weather conditions. Researchers in Hong Kong, for example, used influenza activity based on frequency of respiratory mortality; researchers in Hong Kong and Shanghai used autoregressive terms for daily outcomes at lag days; and researchers in Wuhan used additional smoothing for periods with extreme weather conditions.. For mortality due to all natural (nonaccidental) causes at all ages, the effects of air pollutants per 10-microg/m3 increase in concentration was found to be higher in Bangkok than in the three Chinese cities, with the exception of the effect of NO2 in Wuhan. The magnitude of the effects for cardiovascular and respiratory mortality were generally higher than for all natural mortality at all ages. In addition, the effects associated with PM10 and O3 in all natural, cardiovascular; and respiratory mortality were found to be higher in Bangkok than in the three Chinese cities. The explanation for these three findings might be related to consistently higher daily mean temperatures in Bangkok, variations in average time spent outdoors by the susceptible populations, and the fact that less air conditioning is available and used in Bangkok than in the other cities. However, when pollutant concentrations were incorporated into the excess risk estimates through the use of interquartile range (IQR), the excess risk was more comparable across the four cities. We found that the increases in effects among older age groups were greater in Bangkok than in the other three cities. After excluding data on extremely high concentrations of PM10 in Bangkok, the effect estimate associated with PM10 concentrations decreased in Bangkok (suggesting a convex relationship between risk and PM10, where risk levels off at high concentrations) instead of increasing, as it did in the other cities. This leveling off of effect estimates at high concentrations might be related to differences in vulnerability and exposure of the population to air pollution as well as to the sources of the air pollutant. IMPLICATIONS OF THE STUDY: The PAPA project is the first coordinated Asian multicity air pollution study ever published; this signifies the beginning of an era of cooperation and collaboration in Asia, with the development of a common protocol for coordination, data management, and analysis. The results of the study demonstrated that air pollution in Asia is a significant public health burden, especially given the high concentrations of pollutants and high-density populations in major cities. When compared with the effect estimates reported in the research literature of North America and Western Europe, the study's effect estimates for PM10 were generally similar and the effect estimates for gaseous pollutants were relatively higher. In Bangkok, however, a tropical city where total exposures

Topics: Aged; Air Pollutants; Air Pollution; Asia; Cardiovascular Diseases; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Public Health; Respiratory Tract Diseases; Sulfur Dioxide; Time Factors

Urban air pollution can trigger asthma exacerbations, but the effects of long-term exposure to traffic-related air pollution on lung function or onset of airway disease and allergic sensitisation in children is less clear.. All 2107 children aged 9-14 years from 40 schools in Rome in 2000-1 were included in a cross-sectional survey. Respiratory symptoms were assessed on 1760 children by parental questionnaires (response rate 83.5%). Allergic sensitisation was measured by skin prick tests and lung function was measured by spirometry on 1359 children (77.2%). Three indicators of traffic-related air pollution exposure were assessed: self-reported heavy traffic outside the child's home; the measured distance between the child's home and busy roads; and the residential nitrogen dioxide (NO2) levels estimated by a land use regression model (R2 = 0.69).. There was a strong association between estimated NO2 exposure per 10 microg/m3 and lung function, especially expiratory flows, in linear regression models adjusted for age, gender, height and weight: -0.62% (95% CI -1.05 to -0.19) for forced expiratory volume in 1 s as a percentage of forced vital capacity, -62 ml/s (95% CI -102 to -21) for forced expiratory flow between 25% and 75% of forced vital capacity and -85 ml/s (95% CI -135 to -35) for peak expiratory flow. The other two exposure indicators showed similar but weaker associations. The associations appeared stronger in girls, older children, in children of high socioeconomic status and in those exposed to parental smoking. Although lifetime asthma was not an effect modifier, there was a suggestion of a larger effect on lung function in subjects with a positive prick test. Multiple logistic regression models did not suggest a consistent association between traffic-related air pollution exposure and prevalence of respiratory symptoms or allergic sensitisation.. The results of this study suggest that residential traffic-related air pollution exposure is associated with reduced expiratory flows in schoolchildren.

Topics: Adolescent; Air Pollution; Anthropometry; Child; Cross-Sectional Studies; Environmental Exposure; Female; Forced Expiratory Volume; Humans; Male; Nitrogen Dioxide; Respiratory Hypersensitivity; Respiratory Tract Diseases; Rome; Urban Health; Vehicle Emissions; Vital Capacity

The objective of this study is to investigate the relationship between five air pollutants (PM(10), SO(2), NO(2), O(3), CO) measured on the daily basis, and adverse health symptoms using epidemiological surveillance data. The generalized estimated equation (GEE) model, a logistic regression analysis model, was used to estimate the effects of air pollution on children's daily health symptoms, focusing on the morbidity including both respiratory and allergic symptoms in four different cities. Analysis of the effects of each pollutant on children's respiratory and allergic symptoms demonstrated that CO affected all symptoms in all the study areas. When the concentration of SO(2) and NO(2) was elevated, upper respiratory symptoms increased significantly. In contrast, when the concentration of O(3) rose, the symptoms decreased significantly. The relationship between measured concentrations and health symptoms was site-dependent for each pollutant.

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; Child; Environmental Exposure; Female; Humans; Hypersensitivity; Korea; Logistic Models; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Population Surveillance; Respiratory Tract Diseases; Sulfur Dioxide; Urban Population

The current air quality limit values for airborne pollutants in the UK are low by historical standards and are at levels that are believed not to harm health. We assess whether this view is correct. We examine the relationship between common sources of airborne pollution and population mortality for England. We use data at local authority level for 1998-2005 to examine whether current levels of airborne pollution, as measured by annual mean concentrations of carbon monoxide, nitrogen dioxide, particulate matter less than 10 microm in diameter (PM(10)) and ozone, are associated with excess deaths. We examine all-cause mortality and deaths from specific cardiovascular and respiratory causes that are known to be exacerbated by air pollution. The panel nature of our data allows us to control for any unobserved time-invariant associations at local authority level between high levels of air pollution and poor population health and for common time trends. We estimate multi-pollutant models to allow for the fact that three of the pollutants are closely correlated. We find that higher levels of PM(10) and ozone are associated with higher mortality rates, and the effect sizes are considerably larger than previously estimated from the primarily time series studies for England.

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Carbon Monoxide; Cardiovascular Diseases; Cross-Sectional Studies; Environmental Monitoring; Epidemiological Monitoring; Humans; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Smoking; United Kingdom

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

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

Air quality has deteriorated in Hong Kong over more than 15 yr. As part of a program of public accountability, photographs on Poor and Better visibility days were used as representations of the relationships among visibility, air pollution, adverse health effects, and community costs for health care and lost productivity. Coefficients from time-series models and gazetted costs were used to estimate the health and economic impacts of different levels of pollution. In this population of 6.9 million, air quality improvement from the annual average to the lowest pollutant levels of Better visibility days, comparable to the World Health Organization air quality guidelines, would avoid 1335 deaths, 60,587 hospital bed days, and 6.7 million doctor visits for respiratory complaints each year. Direct costs and productivity losses avoided would be over US$240 million a year. The dissemination of these findings led to increased demands for pollution controls from the public and legislators, but denials of the need for urgent action arose from the government. The outcome demonstrates the need for more effective translation of the scientific evidence base into risk communication and public policy.

Topics: Air Pollution; Cost of Illness; Hong Kong; Hospitalization; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Respiratory Tract Diseases; Social Responsibility; Sulfur Dioxide

Identification of the specific pollutants contributing most to the health hazard of the air pollution mixture may have important implications for environmental and social policies. In the current study, we conducted a time-series analysis to examine the specific effects of major air pollutants [particulate matter less than 10 microns in diameter (PM(10)), sulfur dioxide (SO(2)), and nitrogen dioxides (NO(2))] on daily mortality in Shanghai, China, using both single-pollutant and multiple-pollutant models. In the single-pollutant models, PM(10), SO(2), and NO(2) were found to be associated with mortality from both all non-accidental causes and from cardiopulmonary diseases. Unlike some prior studies in North America, we found a significant effect of gaseous pollutants (SO(2) and NO(2)) on daily mortality even after adjustment for PM(10) in the multiple-pollutant models. Our findings, combined with previous Chinese studies showing a consistent, significant effect of gaseous pollutants on mortality, suggest that the role of outdoor exposure to SO(2) and NO(2) should be investigated further in China.

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Child; Child, Preschool; China; Environmental Exposure; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Mortality; Nitrogen Dioxide; Particulate Matter; Respiratory Tract Diseases; Sulfur Dioxide

The nature of spatial variation in the relationship between air pollution and health outcomes within a city remains an open and important question. This study investigated the spatial variability of particle matter air pollution and its association with respiratory emergency hospital admissions across six geographic areas in Brisbane, Australia. Data on particles of 10 microm or less in aerodynamic diameter per cubic metre (PM10), meteorological conditions, and daily respiratory emergency hospital admissions were obtained for the period of 1 January 1998 to 31 December 2001. A Poisson generalised linear model was used to estimate the specific effects of PM10 on respiratory emergency hospital admissions for each geographic area. A pooled effect of PM10 was then estimated using a meta-analysis approach for the whole city. The results of this study indicate that the magnitude of the association between particulate matter and respiratory emergency hospital admissions varied across different geographic areas in Brisbane. This relationship appeared to be stronger in areas with heavy traffic. We found an overall increase of 4.0% (95% confidence interval [CI]: 1.1-6.9%) in respiratory emergency hospital admissions associated with an increase of 10 microg /m3 in PM10 in the single pollutant model. The association was weaker but still statistically significant (an increase of 2.6%; 95% CI: 1.0-5.5%) after adjusting for O3, but did not appear to be affected by NO2. The effect estimates of PM10 were generally consistent for three spatial methods used in this study, but appeared to be underestimated if the spatial nature of the data was ignored. Therefore, the spatial variation in the relationship between PM10 and health outcomes needs to be considered when the health impact of air pollution is assessed, particularly for big cities.

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Child; Child, Preschool; Emergency Service, Hospital; Environmental Monitoring; Epidemiological Monitoring; Hospitalization; Humans; Infant; Infant, Newborn; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Queensland; Respiratory Tract Diseases

There has been an increasing concern about the effect of climatic change on human health in recent years. It has been suggested that young children are particularly at risk due to the reduced regulating mechanism against extreme climatic changes. However, few studies on the associations between climatic factors and childhood illness, specifically among young children, have been found in the literature. This epidemiological study utilized data collected on all young patients aged less than 6 years who presented to an emergency department for a period of two years. Information on climate and outdoor air quality variables was obtained from the Bureau of Meteorology. Data were analysed with various ARIMA time series models for each common childhood illness. Results suggested that maximum daily temperature was a significant risk factor for fever (t = 5.29, p < 0.001) with a regression coefficient of 0.37 (SE = 0.07) and gastroenteritis (t = 2.69, p = 0.007) with a regression coefficient of 0.10 (SE = 0.04). The UV index was also found to be significantly but negatively related to gastroenteritis (t = -2.37, p = 0.018). However, none of the climatic variables were associated with respiratory problems after adjusting for other air quality variables and infectious disease.

Topics: Air Pollutants; Child, Preschool; Climate; Communicable Diseases; Emergency Service, Hospital; Environmental Monitoring; Epidemiological Monitoring; Fever; Gastroenteritis; Hospitals, Pediatric; Humans; Humidity; Infant; Infant, Newborn; New South Wales; Nitrogen Dioxide; Ozone; Particulate Matter; Rain; Respiratory Tract Diseases; Sulfur Dioxide; Sunlight; Temperature

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

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

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

Indoor air pollution (IAP) is an important environmental health issue in developing countries and is a major contributor to mortality and morbidity from acute lower respiratory illness in children. In developed countries, IAP in homes is not nearly as severe as it can be in developing countries; however, evidence suggests that it does contribute significantly to the risk of adverse respiratory health in children. Children spend the majority of their time indoors, mostly at home. Homes are built so that air exchange between the indoor and outdoor environments is minimised and there is a large range of pollution emission sources inside. For many pollutants, indoor concentrations regularly exceed those outdoors. Although there has been considerable interest in the health effects of IAP, questions still remain regarding the role of IAP in the exacerbation and/or development of respiratory disease. Prospective, longitudinal studies are required to better clarify the contribution of IAP to the respiratory health of children.

Topics: Air Pollution, Indoor; Asthma; Child; Formaldehyde; Humans; Nitrogen Dioxide; Respiratory Tract Diseases; Tobacco Smoke Pollution

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

The short-term effects of nitrogen dioxide (NO(2)) on total, cardiovascular and respiratory mortality in 30 European cities participating in the Air Pollution on Health: a European Approach (APHEA)-2 project were investigated. The association was examined using hierarchical models implemented in two stages. In the first stage, data from each city were analysed separately, whereas in the second stage, the city-specific air pollution estimates were regressed on city-specific covariates to obtain overall estimates and to explore sources of possible heterogeneity. A significant association of NO(2) with total, cardiovascular and respiratory mortality was found, with stronger effects on cause-specific mortality. There was evidence of confounding in respiratory mortality with black smoke and sulphur dioxide. The effect of NO(2) on total and cardiovascular mortality was observed mainly in western and southern European cities, and was larger when smoking prevalence was lower and household gas consumption was higher. The effect of NO(2) on respiratory mortality was higher in cities with a larger proportion of elderly persons in the population and higher levels of particulate matter with a 50% cut-off aerodynamic diameter of 10 mum. The results of this large study are consistent with an independent effect of nitrogen dioxide on mortality, but the role of nitrogen dioxide as a surrogate of other unmeasured pollutants cannot be completely ruled out.

Topics: Air Pollutants; Cardiovascular Diseases; Cause of Death; Cross-Cultural Comparison; Dust; Europe; Humans; Models, Statistical; Nitrogen Dioxide; Respiratory Tract Diseases; Smoke; Smoking; Statistics as Topic; Sulfur Dioxide; Urban Population

The authors propose a new statistical procedure that utilizes measurement error models to estimate missing exposure data in health effects assessment. The method detailed in this paper follows a Bayesian framework that allows estimation of various parameters of the model in the presence of missing covariates in an informative way. The authors apply this methodology to study the effect of household-level long-term air pollution exposures on lung function for subjects from the Southern California Children's Health Study pilot project, conducted in the year 2000. Specifically, they propose techniques to examine the long-term effects of nitrogen dioxide (NO2) exposure on children's lung function for persons living in 11 southern California communities. The effect of nitrogen dioxide exposure on various measures of lung function was examined, but, similar to many air pollution studies, no completely accurate measure of household-level long-term nitrogen dioxide exposure was available. Rather, community-level nitrogen dioxide was measured continuously over many years, but household-level nitrogen dioxide exposure was measured only during two 2-week periods, one period in the summer and one period in the winter. From these incomplete measures, long-term nitrogen dioxide exposure and its effect on health must be inferred. Results show that the method improves estimates when compared with standard frequentist approaches.

Topics: Air Pollutants; Air Pollution; Bayes Theorem; Bias; California; Child; Data Collection; Environmental Monitoring; Epidemiological Monitoring; Forced Expiratory Volume; Humans; Models, Statistical; Nitrogen Dioxide; Regression, Psychology; Respiratory Function Tests; Respiratory Tract Diseases; Risk Assessment; Risk Factors; Vital Capacity

Living close to major roads or highways has been suggested to almost double the risk of dying from cardiopulmonary causes. We assessed whether long-term exposure to air pollution originating from motorized traffic and industrial sources is associated with total and cause-specific mortality in a cohort of women living in North Rhine-Westphalia, Germany.. The study was a follow-up of a series of cross-sectional studies carried out during the 1980s and 1990s on the health of women (age 50-59 years). Approximately 4800 women were followed up for vital status and migration. Exposure to air pollution was defined by distance to major roads calculated from Geographic Information System data and by 1- and 5-year average nitrogen dioxide (NO2) and particle (PM10) concentrations calculated from air monitoring station data. We analyzed associations between exposure and mortality using Cox's proportional hazards models adjusting for confounders. Relative risks (RRs) refer to an interquartile range increase in exposure (16 microg/m for NO2; 7 microg/m for PM10).. During the follow-up period, 8% of the women died, 3% from cardiopulmonary causes. Cardiopulmonary mortality was associated with living within a 50-meter radius of a major road (adjusted RR = 1.70; 95% confidence interval = 1.02-2.81), with NO2 (1.57; 1.23-2.00 for 1-year average), and with PM10 (1.34; 1.06-1.71 for 1-year average). Exposure to NO2 was also associated with all-cause mortality (1.17; 1.02-1.34). No association was seen with noncardiopulmonary nonlung cancer mortality.. Living close to major roads and chronic exposure to NO2 and PM10 may be associated with an increased mortality due to cardiopulmonary causes.

Topics: Aged; Air Pollutants; Cause of Death; Cohort Studies; Cross-Sectional Studies; Developed Countries; Environmental Exposure; Female; Follow-Up Studies; Germany; Heart Diseases; Humans; Industry; Middle Aged; Mortality; Nitrogen Dioxide; Particulate Matter; Proportional Hazards Models; Respiratory Tract Diseases; Risk; Sex Factors; Vehicle Emissions

Recurrent events, such as repeated hospital admissions for the same health outcome, occur frequently in environmental health studies. In this study, we conducted an analysis of data on repeated respiratory hospitalizations among the elderly in Vancouver, Canada, for the period of June 1, 1995, to March 31, 1999, using a new method proposed by (Dewanji and Moolgavkar 2000, 2002) for recurrent events, and compared it with some traditional methods. In particular, we assessed the impact of ambient gaseous (SO2, NO2, CO, and O3) and particulate pollutants (PM10, PM2.5, and PM10-2.5) as well as the coefficient of haze (CoH) on recurrent respiratory hospital admissions. Using the new procedure, significant associations were found between admissions and 3-day, 5-day, and 7-day moving averages of the ambient SO2 concentrations, with the strongest association observed at the 7-day lag (RR = 1.044, 95% CI: 1.018-1.070). We also found PM10-2.5 for 3-day and 5-day lag to be significant, with the strongest association at 5-day lag (RR = 1.020, 95% CI: 1.001-1.039). No significant associations with admission were found with current day exposure.

Topics: Aged; Air Pollutants; British Columbia; Carbon Monoxide; Environmental Pollution; Humans; Inhalation Exposure; Models, Statistical; Nitrogen Dioxide; Particle Size; Patient Readmission; Respiratory Tract Diseases; Retrospective Studies; Sulfur Dioxide; Weather

A few epidemiological studies have examined whether there was an interactive effect between temperature and ambient particulate matter on cardiorespiratory morbidity and mortality, but the results were inconsistent. The present study used three time-series approaches to explore whether maximum temperature modified the impact of ambient particulate matter less than 10 microm in diameter (PM(10)) on daily respiratory hospital admissions, cardiovascular hospital admissions, respiratory emergency visits, cardiovascular emergency visits, non-external cause mortality and cardiovascular mortality in Brisbane between 1996 and 2001. The analytical approaches included a bivariate response surface model, a non-stratification parametric model and a stratification parametric model. Results show that there existed a statistically significant interaction between PM(10) and temperature on most health outcomes at various lags. PM(10) exhibited more adverse health effects on warm days than cold days. The choice of the degree of freedom for smoothers to adjust for confounders and the selection of arbitrary cut-offs for temperature affected the interaction estimates to a certain extent, but did not change the overall conclusion. The results imply that it is important to control and reduce the emission of air particles in Brisbane, particularly when temperature increases.

Topics: Air Pollutants; Cardiovascular Diseases; Cause of Death; Emergency Service, Hospital; Hospitalization; Humans; Models, Biological; Nitrogen Dioxide; Ozone; Particulate Matter; Queensland; Respiratory Tract Diseases; Temperature

Current levels of ambient air pollution are associated with morbidity and mortality in the general population. To determine the influence of gaseous air pollutants on neonatal respiratory morbidity, we tested the association between daily respiratory hospitalizations and daily concentrations of ambient air pollution gases: ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide, in 11 large Canadian cities.. Daily time-series analyses were employed and results were adjusted for day of the week, temperature, barometric pressure, and relative humidity.. The percent increases in hospitalization associated with an increase in air pollution equivalent to its interquartile range were 3.35 [95% confidence interval (CI), 1.73-4.77] for O3, 2.85 (95% CI, 1.68-4.02) for NO2, 1.66 (95% CI, 0.63-2.69) for SO2, and 1.75 (95% CI, 0.48-3.02) for CO. The independent effect of all pollutants combined was 9.61% (95% CI, 4.52-14.7%).. Our results suggest that neonates are experiencing adverse effects of air pollution at current levels in Canada, and that accounts for a significant proportion of hospitalizations in this subgroup.

Topics: Air Pollutants; Canada; Carbon Monoxide; Hospitalization; Humans; Infant, Newborn; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Sulfur Dioxide

Experimental data suggest that asthma exacerbation by ambient air pollutants is enhanced by exposure to endotoxin and allergens; however, there is little supporting epidemiologic evidence.. We evaluated whether the association of exposure to air pollution with annual prevalence of chronic cough, phlegm production, or bronchitis was modified by dog and cat ownership (indicators of allergen and endotoxin exposure). The study population consisted of 475 Southern California children with asthma from a longitudinal cohort of participants in the Children's Health Study. We estimated average annual ambient exposure to nitrogen dioxide, ozone, particulate matter < 10, 2.5, and 10-2.5 microm in aerodynamic diameter (PM10, PM2.5, and PM10-2.5, respectively), elemental and organic carbon, and acid vapor from monitoring stations in each of the 12 study communities. Multivariate models were used to examine the effect of yearly variation of each pollutant. Effects were scaled to the variability that is common for each pollutant in representative communities in Southern California.. Among children owning a dog, there were strong associations between bronchitic symptoms and all pollutants examined. Odds ratios ranged from 1.30 per 4.2 microg/m3 for PM10-2.5 [95% confidence interval (CI), 0.91-1.87) to 1.91 per 1.2 microg/m3 for organic carbon (95% CI, 1.34-2.71). Effects were somewhat larger among children who owned both a cat and dog. There were no effects or small effects with wide CIs among children without a dog and among children who owned only a cat.. Our results suggest that dog ownership, a source of residential exposure to endotoxin, may worsen the relationship between air pollution and respiratory symptoms in asthmatic children.

Topics: Adolescent; Air Pollution; Animals; Asthma; California; Cats; Child; Cohort Studies; Dogs; Female; Humans; Male; Multivariate Analysis; Nitrogen Dioxide; Ownership; Ozone; Particulate Matter; Respiratory Sounds; Respiratory Tract Diseases

The objective of the study reported here was to analyze relationships between levels of air pollutants and emergency admissions for cardiorespiratory disease. Admission data from January 1, 1992, to December 31, 1995, were obtained from the Marques de Valdecilla University Hospital Admission Service; meteorological data (rainfall, temperatures wind speed, wind direction) were obtained from the National Meteorology Institute in Santander. Pollutant data on sulfur dioxide (SO2), hydrogen sulfide (H2S), total suspended particles (TSP), nitrogen oxide (NO), and nitrogen dioxide (NO2) were provided by the secretary of environment for the Cantabrian Regional Government. Rate ratios were estimated for each pollutant by Poisson regression; they were adjusted for meteorological variables. It was found that elevated NO2 increased by 20 percent the risk of having an admission for cardiorespiratory diseases; this effect was mainly due to respiratory diseases (rate ratio = 1.7, p < .001) and was negligible for cardiac diseases (rate ratio = 1.1, p = .28). In the one-pollutant model, elevated particulates and nitrogen monoxide were also related to admissions, but this effect disappeared when a five-pollutant model was used (p = .21 and p = 0.36, respectively. SO2 and SH2 did not show any relationship with admissions. Thus, nitrogen dioxide was the only pollutant the authors found to be related to emergency admissions for cardiorespiratory diseases. It is difficult to generalize from these results because of the small number of daily admissions and the variability in pollutant levels; therefore, more studies are necessary to improve knowledge about the relationship between air pollution and health in small towns.

Topics: Air Pollutants; Heart Diseases; Hospitalization; Humans; Hydrogen Sulfide; Nitrogen Dioxide; Nitrogen Oxides; Respiratory Tract Diseases; Spain; Sulfur Dioxide

To assess whether meteorological conditions modify the relationship between short-term exposure to ambient air pollution and mortality, an examination of air pollution and human mortality associations (ecologic) using hybrid spatial synoptic classification procedures was conducted. Concentrations of air pollutants and human mortality from all non-accidental and cardiorespiratory causes were examined according to typical winter and summer synoptic climatologies in Toronto, Canada, between 1981 and 1999. Air masses were derived using a hybrid spatial synoptic classification procedure associating each day over the 19-year period with one of six different typical weather types, or a transition between two weather types. Generalized linear models (GLMs) were used to assess the risk of mortality from air pollution within specific air mass type subsets. Mortality follows a distinct seasonal pattern with a maximum in winter and a minimum in summer. Average air pollution concentrations were similar in both seasons with the exception of elevated sulfur dioxide levels in winter and elevated ozone levels in summer. Subtle changes in meteorological composition can alter the strength of pollutant associations with health outcomes, especially in the summer season. Although there does not appear to be any systematic patterning of modification, variation in pollutant concentrations seems dependent on the type of synoptic category present.

Topics: Air Pollutants; Air Pollution; Canada; Carbon Monoxide; Cardiovascular Diseases; Cities; Dust; Environmental Exposure; Humans; Mortality; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Seasons; Sulfur Dioxide; Weather

Personal exposures to particulate and gaseous pollutants and corresponding ambient concentrations were measured for 56 subjects living in Baltimore, Maryland, and 43 subjects living in Boston, Massachusetts. The 3 Baltimore cohorts consisted of 20 healthy older adults (seniors), 21 children, and 15 individuals with physician-diagnosed chronic obstructive pulmonary disease (COPD*). The 2 Boston cohorts were 20 healthy seniors and 23 children. All children were 9 to 13 years of age; seniors were 65 years of age or older; and the COPD participants had moderate to severe physician-diagnosed COPD. Personal exposures to particulate matter with aerodynamic diameters less than 2.5 microm (PM2.5), sulfate (SO(4)2-), elemental carbon (EC), ozone (03), nitrogen dioxide (NO2), and sulfur dioxide (SO2) were measured simultaneously for 24 hours/day. All subjects were monitored for 8 to 12 consecutive days. The primary objectives of this study were (1) to characterize the personal particulate and gaseous exposures for individuals sensitive to PM health effects and (2) to assess the appropriateness of exposure assessment strategies for use in PM epidemiologic studies. Personal exposures to multiple pollutants and ambient concentrations were measured for subjects from each cohort from each location. Pollutant data were analyzed using correlation and mixed-model regression analyses. In Baltimore, personal PM2.5 exposures tended to be comparable to (and frequently lower than) corresponding ambient concentrations; in Boston, the personal exposures were frequently higher. Overall, personal exposures to the gaseous pollutants, especially O3 and SO2, were considerably lower than corresponding ambient concentrations because of the lack of indoor sources for these gases and their high removal rate on indoor surfaces. Further, the impact of ambient particles on personal exposure (the infiltration factor) and differences in infiltration factor by city, season, and cohort were investigated. No difference in infiltration factor was found among the cohorts, which suggests that all subjects were exposed to the same fraction of ambient PM2.5 for a given ambient concentration. In addition, the results show significant correlations between ambient PM2.5 concentrations and corresponding personal exposures over time and provide further indication that ambient gaseous pollutant concentrations may be better surrogates for personal PM2.5 exposures, especially personal exposures to PM2.5 of amb

Topics: Adolescent; Aged; Air Pollutants; Air Pollution, Indoor; Baltimore; Boston; Carbon; Child; Cohort Studies; Disease Susceptibility; Environmental Exposure; Humans; Nitrogen Dioxide; Ozone; Particle Size; Pulmonary Disease, Chronic Obstructive; Regression Analysis; Residence Characteristics; Respiratory Tract Diseases; Seasons; Sulfates; Urban Population

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

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

Ambient (outdoor) air pollution is now recognized as an important problem, both nationally and worldwide. Our scientific understanding of the spectrum of health effects of air pollution has increased, and numerous studies are finding important health effects from air pollution at levels once considered safe. Children and infants are among the most susceptible to many of the air pollutants. In addition to associations between air pollution and respiratory symptoms, asthma exacerbations, and asthma hospitalizations, recent studies have found links between air pollution and preterm birth, infant mortality, deficits in lung growth, and possibly, development of asthma. This policy statement summarizes the recent literature linking ambient air pollution to adverse health outcomes in children and includes a perspective on the current regulatory process. The statement provides advice to pediatricians on how to integrate issues regarding air quality and health into patient education and children's environmental health advocacy and concludes with recommendations to the government on promotion of effective air-pollution policies to ensure protection of children's health.

Topics: Air Pollutants; Air Pollution; Asthma; Child; Government Regulation; Humans; Infant; Nitrogen Dioxide; Organizational Policy; Ozone; Pediatrics; Public Health; Respiratory Tract Diseases; Societies, Medical; United States

The authors investigated whether exposure to high levels of nitrogen dioxide (NO2) in an indoor ice hockey arena might be associated with airway symptoms 5 yr later. A follow-up questionnaire was answered by 71 subjects who had experienced such an exposure, accompanied by acute respiratory illness, in Stockholm in 1994. The same questionnaire was answered by 40 reference subjects. The overall response rate for both groups was 71%. Information was obtained regarding various background factors, such as smoking and respiratory symptoms since 1994. For those who had stopped playing ice hockey during the follow-up period, the exposure to high NO2 levels appeared to be associated with an increase in upper airways symptoms (i.e., nasal blockage or rhinitis) (odds ratio = 3.1, 95% confidence interval = 1.1, 8.8), after adjustment for age, smoking, and family history of allergy. These data suggest that exposure to high NO2 levels in an indoor ice arena may be associated with increased airway symptoms several years later.

Topics: Adolescent; Adult; Air Pollution, Indoor; Child; Child, Preschool; Follow-Up Studies; Hockey; Humans; Incidence; Nitrogen Dioxide; Respiratory Tract Diseases; Time Factors

We studied the independent role of air pollution and passive smoking on respiratory symptoms and group of symptoms by following 46 adult nonsmokers for 14 wk. Outcomes included the incidence of 15 symptoms. After adjustment for passive smoking, clear rhinorrhea and cough were positively related to nitrogen dioxide (NO2), particles (PM10), and black smoke (BS); whereas headache was positively related to BS. Sneezing, sore throat, and cough were independently positively related to passive smoking. After adjustment for passive smoking, the occurrence of groups of symptoms and of the "sore throat group" were related to three pollutants. The occurrence of the "possible infection group" was positively related to BS. The occurrence of every group of symptoms was independently related to passive smoking. In conclusion, the prevailing levels of air pollution and passive smoking had independent effects on symptoms and groups of symptoms.

Topics: Adolescent; Adult; Air Pollutants; Environmental Exposure; Female; France; Humans; Incidence; Male; Middle Aged; Nitrogen Dioxide; Respiratory Tract Diseases; Tobacco Smoke Pollution

The concentration-response relationship between daily ambient inhalable particle (particulate matter less than or equal to 10 micro m; PM(10)) concentrations and daily mortality typically shows no evidence of a threshold concentration below which no relationship is observed. However, the power to assess a relationship at very low concentrations of PM(10) has been limited in studies to date. The concentrations of PM(10) and other air pollutants in Vancouver, British Columbia, Canada, from January 1994 through December 1996 were very low: the 50th and 90th percentiles of daily average PM(10) concentrations were 13 and 23 micro g/m(3), respectively, and 27 and 39 ppb, respectively, for 1-hr maximum ozone. Analyses of 3 years of daily pollution (PM(10), ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide) concentrations and mortality counts showed that the dominant associations were between ozone and total mortality and respiratory and cardiovascular mortality in the summer, and between nitrogen dioxide and total mortality in the winter, although some association with PM(10) may also have been present. We conclude that increases in low concentrations of air pollution are associated with increased daily mortality. These findings may support the notion that no threshold pollutant concentrations are present, but they also raise concern that these effects may not be effects of the measured pollutants themselves, but rather of some other factor(s) present in the air pollution-meteorology mix.

Topics: Air Pollutants; Air Pollution; British Columbia; Carbon Monoxide; Carbon Monoxide Poisoning; Cardiovascular Diseases; Cause of Death; Databases as Topic; Humans; Linear Models; Meteorological Concepts; Nitrogen Dioxide; Ozone; Particle Size; Respiratory Tract Diseases; Seasons; Sulfur Dioxide; Urban Health

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

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

A total of 16,663 pairs of junior high school students and their mothers in Indonesian cities were surveyed, using a self-administered questionnaire, to measure the effect of air pollution on respiratory health and the cost of associated illness. Multiple regression analysis showed that the prevalence rates of the symptoms of cough, phlegm, persistent cough, wheezing without a cold, and asthma, in the student and mother groups, were significantly correlated with the nitrogen dioxide (NO2) emitted along large roads near their residences, and to a lesser extent with smoking. In Central Jakarta and Tangerang, where the average NO2 concentrations were highest (37 ppb and 31 ppb, respectively), reduction of NO2 to a proposed level of 25 ppb could yield savings in mean direct out-of-pocket expense per capita for treatment of the above symptom(s) of 15,639-18,165 Indonesian rupiah (6.80-7.90 US dollars), and reduce average work/school days lost per capita by 3.1-5.5 days.

Topics: Adolescent; Adult; Air Pollutants; Female; Health Care Costs; Health Surveys; Humans; Indonesia; Male; Middle Aged; Nitrogen Dioxide; Regression Analysis; Respiratory Tract Diseases; Urban Population

Sources and concentrations of indoor nitrogen dioxide (NO2) were examined in Barcelona, Spain, during 1996-1999. A total of 340 dwellings of infants participating in a hospital-based cohort study were selected from different areas of the city. Passive filter badges were used for indoor NO2 measurement over 7-30 days. Dwelling inhabitants completed a questionnaire on housing characteristics and smoking habits. Data on outdoor NO2 concentrations were available for the entire period of the study in the areas of the city where indoor concentrations were determined. Bivariate analysis was performed to investigate relationships between indoor NO2 concentrations on one hand and outdoor NO2 concentrations, housing, and occupant characteristics on the other. Stepwise multiple linear regression was performed with variables that were found to have a significant bivariate relationship. Indoor NO2 mean values ranged between 23.57 ppb in 1996 and 27.02 ppb in 1999, with the highest yearly value of 27.82 ppb in 1997. In the same time period, mean outdoor NO2 concentration ranged between 25.26 and 25.78 ppb with a peak of 30.5 ppb in 1998. Multiple regression analysis showed that principal sources of indoor NO2 concentrations were the use of a gas cooker, the absence of an extractor fan when cooking, and cigarette smoking. The absence of central heating was also associated with higher NO2 concentrations. Finally, each ppb increase in outdoor NO2 was associated with a 1% increase in indoor concentrations.

Topics: Air Pollution, Indoor; Cities; Cooking; Environmental Monitoring; Facility Design and Construction; Housing; Humans; Nitrogen Dioxide; Respiratory Tract Diseases; Smoking; Spain; Urban Population

The Korean peninsula has a long history of dust clouds blown by winds from the arid deserts of Mongolia and China in springtime; these are called Asian dust events. Public concern about the possible adverse effects of this dust has increased, because the dust arrives in Korea after having passed over heavily industrialized eastern China. The present study explored the effect of Asian dust events on daily mortality in Seoul, South Korea, during the period 1995-1998. We evaluated the association between daily death counts and the dust events using Poisson regression analysis, adjusted for time trends, weather variables, and the day of the week. Between 1995 and 1998, we identified 28 Asian dust days in Seoul. The estimated percentage increase in the rate of deaths from 3-day moving averages of exposure was 1.7% (95/ confidence interval: -1.6 to 5.3) for all causes, 2.2% (95% confidence interval: -3.5 to 8.3) for deaths of persons aged 65 years and older, and 4.1% (95% confidence interval: -3.8 to 12.6) for cardiovascular and respiratory causes. Our results provide weak evidence that the Asian dust events are associated with risk of death from all causes. However, the association between the dust events and deaths from cardiovascular and respiratory causes was stronger and it suggests that persons with advanced cardiovascular and respiratory disease may be susceptible to the Asian dust events.

Topics: Age Factors; Aged; Air Pollutants; Carbon Monoxide; Cardiovascular Diseases; Dust; Humans; Korea; Linear Models; Middle Aged; Mortality; Nitrogen Dioxide; Respiratory Tract Diseases; Seasons; Sulfur Dioxide; Weather

A cross-sectional epidemiological study was conducted in an effort to investigate the effects of automobile exhaust on respiratory symptoms of school children in Kaohsiung, Taiwan. One school (Yang-Ming primary school) was located in the vicinity of 150 m from the highway and designated as a heavy-traffic area. The control school (Zhuang-Jing primary school) was situated in the same district but the distance of the school address to the freeway was 1500 m and designated as a low-traffic area. All of the primary school children in those schools were used in the study. In total, 3221 children were from the heavy-traffic school and 2969 from the low-traffic area. The respiratory health was assessed by an evaluation of the child's respiratory symptoms and illnesses using a parent-completed questionnaire. Data on traffic flow on the freeway were obtained from the Department of Transportation. Road traffic flows in front of the study schools were also measured with a portable counter. This study showed that a freeway surrounding a child's school may not be associated with an increased risk of respiratory symptoms. This may be due to insufficiently large contrasts in traffic pollution levels between these areas.

Topics: Child; Child, Preschool; Cross-Sectional Studies; Environmental Exposure; Environmental Monitoring; Epidemiological Monitoring; Female; Humans; Male; Motor Vehicles; Nitrogen Dioxide; Prevalence; Respiratory Tract Diseases; Schools; Surveys and Questionnaires; Taiwan; Vehicle Emissions

The benefits and costs of past nitrogen dioxide (NO2) control policies were calculated for Tokyo, Japan, using environmental, economic, political, demographic, and medical data from 1973 to 1994. The benefits of NO2 control were estimated as medical expenses and lost work time due to hypothetical no-control air concentrations of NO2. Direct costs were calculated as annualized capital expenditures and 1 year's operating costs for regulated industries plus governmental agency expenses. The major findings were as follows: (1) Using Tokyo's average medical cost of pollution-related illness, the best net estimate of the avoided medical costs due to incidence of phlegm and sputum in adults was 730 billion yen ($6.08 billion; 1 U.S. dollar = 120 yen). (2) The best net estimate of the avoided medical costs due to incidence of lower respiratory illness in children was 93 billion yen ($775 million). (3) Using Tokyo's average duration of pollution-related illness and average wages, the best net estimate of the avoided costs of lost wages in workers was 760 billion yen ($6.33 billion). (4) The best net estimate of the avoided costs of lost wages in mothers caring for their sick children was 100 billion yen ($833 million). (5) Using Tokyo-specific data, the best net costs were estimated as 280 billion yen ($2.33 billion). (6) Using human health and productivity benefits, and annualized capital cost and operating cost estimates, the best net benefits-to-costs ratio was 6:1 (upper limit 44:1; lower limit 0.3:1). Benefit calculations were sensitive to assumptions of mobile source emissions and certain health impacts that were not included. Cost calculations were highly dependent on assumptions of flue gas volume and fuel use. For comparative purposes, we identified other studies for air pollution-related illness. Assumptions that formed the basis for most of the inputs in the present study, such as duration of illness, medical treatment costs, per person illness in children, and lost wages for working mothers, were similar to those recommended in the literature. Lost wages in sick workers and per capita illness incidence in adults were higher than numbers reported elsewhere. Further advances in cost-benefit analysis (CBA) procedures to evaluate the economic effectiveness of NO2 controls in Tokyo are recommended to estimate impacts and values for additional human health benefits, ecosystem health and productivity effects, and nonliving system effects, as well as benefits

Topics: Adult; Air Pollution; Cost-Benefit Analysis; Humans; Nitrogen Dioxide; Oxidants, Photochemical; Respiratory Tract Diseases; Tokyo

Topics: Air Pollution; Case-Control Studies; Female; Humans; Italy; Logistic Models; Male; Nitrogen Dioxide; Oxidants, Photochemical; Respiratory Tract Diseases

From late July to the beginning of October 1997, countries of Southeast Asia experienced severe smoke haze pollution from uncontrolled forest fires mainly in the Indonesian states of Kalimantan and Sumatra. In Singapore, the impact of the 1997 haze was felt in the period from the end of August to the first week of November 1997 as a result of prevailing winds.. The Ministry of the Environment monitors ambient air quality by a country-wide telemetric air quality monitoring and management network, with 15 stations located throughout the island, linked via a public telephone network to a central control station at the Environment Building. The monitoring methods used are the United States Environmental Protection Agency (USEPA) reference methods. The Pollutant Standards Index (PSI) developed by the USEPA is used for the reporting of daily air pollution concentrations. Intervals on the PSI scale are related to the potential health effects of the daily measured concentrations of the five major air pollutants: sulfur dioxide, particulate matter (PM10), nitrogen dioxide, ozone and carbon monoxide. Public sector health facilities which come under the Ministry of Health, have computerized patient care systems which enable the routine ongoing surveillance of disease conditions for the period of the haze. Attention during the period of the haze was focused on conditions related to health effects of the haze. Data sources for the monitoring of the lung health effects of the haze included morbidity from public sector outpatient care facilities, accidents and emergency departments, public sector inpatient care facilities and national mortality data.. Findings from the health impact of the haze showed that there was a 30% increase in outpatient attendance for haze-related conditions. An increase in PM10 levels from 50 microg/m3 to 150 microg/m3 was significantly associated with increases of 12% of upper respiratory tract illness, 19% asthma and 26% rhinitis. Supplementary findings from scanning the electron microscopic sizing of the haze particles showed that 94% of the particles in the haze were below 2.5 microm in diameter. This was consistent with emissions from combustion sources originating over 500 km from Singapore. This has been of some concern because particles smaller than 2.5 microm in diameter can easily bypass normal body defence metabolism and penetrate deeply into the alveoli of the lungs. During the same period, there was also an increase in accident and emergency attendance for haze-related conditions. There was no significant increase in hospital admissions or in mortality.. The present study found that the health effects from the 1997 smoke haze in Singapore were generally mild.

Topics: Air Pollutants; Carbon Monoxide; Conjunctivitis; Dermatitis; Fires; Humans; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Singapore; Smoke; Sulfur Dioxide; Trees

Observations have been made on the long-term trends of major air pollutants in Malaysia including nitrogen dioxide, carbon monoxide, the ozone and total suspended particulate matter (particularly PM10), and sulfur dioxide, emitted from industrial and urban areas from early 1970s until late 1998.. The data show that the status of atmospheric environment in Malaysia, in particular in highly industrialized areas such as Klang Valley, was determined both by local and transboundary emissions and could be described as haze and non-haze periods.. During the non-haze periods, vehicular emissions accounted for more than 70% of the total emissions in the urban areas and have demonstrated two peaks in the diurnal variations of the aforementioned air pollutants, except ozone. The morning 'rush-hour' peak was mainly due to vehicle emissions, while the late evening peak was mainly attributed to meteorological conditions, particularly atmospheric stability and wind speed. Total suspended particulate matter was the main pollutant with its concentrations at few sites often exceeding the Recommended Malaysia Air Quality Guidelines. The levels of other pollutants were generally within the guidelines. Since 1980, six major haze episodes were officially reported in Malaysia: April 1983, August 1990, June 1991, October 1991, August to October 1994, and July to October 1997. The 1997 haze episode was the worst ever experienced by the country. Short-term observations using continuous monitoring systems during the haze episodes during these periods clearly showed that suspended particulate matter (PM10) was the main cause of haze and was transboundary in nature. Large forest fires in parts of Sumatra and Kalimantan during the haze period, clearly evident in satellite images, were identified as the probable key sources of the widespread heavy haze that extended across Southeast Asia from Indonesia to Singapore, Malaysia and Brunei. The results of several studies have also provided strong evidence that biomass burning is the dominating source of particulate matter. The severity and extent of 1997's haze pollution was unprecedented, affecting some 300 million people across the region. The amount of economic costs suffered by Southeast Asian countries during this environmental disaster was enormous and is yet to be fully determined. Among the important sectors severely affected were air and land transport, shipping, construction, tourism and agro-based industries. The economic cost of the haze-related damage to Malaysia presented in this study include short-term health costs, production losses, tourism-related losses and the cost of avertive action. Although the cost reported here is likely to be underestimated, they are nevertheless significant (roughly RM1 billion).. The general air quality of Malaysia since 1970 has deteriorated. Studies have shown that should no effective countermeasures be introduced, the emissions of sulfur dioxide, nitrogen oxides, particulate matter, hydrocarbons and carbon monoxide in the year 2005 would increase by 1.4, 2.12, 1.47 and 2.27 times, respectively, from the 1992 levels.

Topics: Air Pollutants; Carbon Monoxide; Fires; Humans; Lead; Malaysia; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Smoke; Sulfur Dioxide; Trees

In this paper, the authors propose a new statistical modeling technique, the subject-domain approach, which is theoretically proven to be equivalent to the time-domain approach in detecting an association between exposure and response with time trends. The authors use an empirical data set from a school absence monitoring study conducted during the 1994-1995 school year in Taiwan to demonstrate this subject-domain approach's application to environmental epidemiologic studies. Because the subject-domain models can control the influential personal confounding factors in the models, they show greater statistical power than the traditional time-domain approaches in determining the relation between air pollution and illness absences. The authors' models found that the schoolchildren's risks of illness absence were significantly related to acute exposures to nitrogen dioxide and nitrogen oxides with a 1-day lag (p < 0.01) at levels below the World Health Organization's guidelines. By contrast, the authors could not detect significant associations between air pollution and schoolchildren's absenteeism using time-domain approaches. Such findings imply that the models built on subject domain may be a general solution to the problem of the ecologic fallacy, which is commonly encountered in environmental and social epidemiologic studies.

Topics: Absenteeism; Air Pollution; Child; Environmental Exposure; Humans; Models, Statistical; Nitrogen Dioxide; Nitrogen Oxides; Respiratory Tract Diseases; Schools

Nitrogen dioxide (NO(2)), an oxidant gas that contaminates both outdoor and indoor air, is considered to be a potential risk factor for asthma. We investigated concurrently the effects of outdoor and indoor NO(2) on the prevalence and incidence of respiratory symptoms among children.. A cohort study was carried out over 3 years on 842 schoolchildren living in seven different communities in Japan. Indoor NO(2) concentrations over 24 hours were measured in both winter and summer in the homes of the subjects, and a 3-year average of the outdoor NO(2) concentration was determined for each community. Respiratory symptoms were evaluated every year from responses to questionnaires.. The prevalence of bronchitis, wheeze, and asthma significantly increased with increases of indoor NO(2) concentrations among girls, but not among boys. In neither boys nor girls were there significant differences in the prevalence of respiratory symptoms among urban, suburban, and rural districts. The incidence of asthma increased among children living in areas with high concentrations of outdoor NO(2). Multiple logistic regression analysis showed that a 10 parts per billion (ppb) increase of outdoor NO(2) concentration was associated with an increased incidence of wheeze and asthma (odds ratios [OR] = 1.76, 95% CI : 1.04-3.23 and OR = 2.10, 95% CI : 1.10-4.75, respectively), but that no such associations were found with indoor NO(2) concentration (OR = 0.73, 95% CI : 0.45-1.14 and OR = 0.87, 95% CI : 0.51-1.43, respectively).. These findings suggest that outdoor NO(2) air pollution may be particularly important for the development of wheeze and asthma among children. Indoor NO(2) concentrations were associated with the prevalence of respiratory symptoms only among girls. Girls may be more susceptible to indoor air pollution than boys.

Topics: Air Pollutants; Air Pollution, Indoor; Asthma; Child; Cohort Studies; Female; Heating; Humans; Incidence; Japan; Logistic Models; Male; Nitrogen Dioxide; Oxidants, Photochemical; Prevalence; Respiratory Tract Diseases; Sex Distribution; Surveys and Questionnaires

The aim of this study was to evaluate feasibility of using both the emergency phone calls (SAMU) and medical interventions (SMUR) related to ambulatory emergency services for local epidemiological surveillance of health impact of air pollution.. A temporal ecological study was performed at Rouen area (France) (380,000 inhabitants) for 1990-1997 (SAMU) and 1990-1996 (SMUR). The pollutants tested were: Sulphur dioxide (SO(2)), Particles (PM13), and Nitrogen dioxide (NO(2)), as collected routinely by a local automated network. For each phone call (SAMU) or emergency interventions (SMUR), the date, medical reason for calling (SAMU) or diagnosis after interventions (SMUR) (classified as respiratory, cardiovascular or other diseases) have been extracted from a specific information system. A statistical analysis based on time series analysis associated to a Poisson regression was conducted, taking into account temporal trend, seasonal variations, influenza, days of the week, holiday and meteorological data.. An association was observed between ambulatory emergency services activity for cardiovascular diseases, and the daily variations of both SO(2) (relative risk=1.008 [1.001-1.016] for SAMU with an increase of 10 microg/m(3)) and NO(2) (relative risk=1.018 [1.008-1. 030] for SAMU, relative risk=1.016 [1.001-1.032] for SMUR with an increase of 10 microg/m(3)). No association could be observed with the respiratory diseases for these pollutants.. The ambulatory emergency services activity data could contribute to an epidemiological surveillance of the health impact of the air pollution, but a better quality of data collected (concerning both procedures and codification) is requested. The interest of an epidemiological surveillance, rather than usual pollutant monitoring, remains to evaluate.

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Data Interpretation, Statistical; Emergency Medical Services; Environmental Monitoring; Epidemiological Monitoring; France; Humans; Nitrogen Dioxide; Poisson Distribution; Population Surveillance; Respiratory Tract Diseases; Risk; Seasons; Sulfur Dioxide; Urban Population

Air pollution in cities has been linked to increased rates of mortality and morbidity in developed and developing countries. Although these findings have helped lead to a tightening of air-quality standards, their validity with respect to public health has been questioned.. We assessed the effects of five major outdoor-air pollutants on daily mortality rates in 20 of the largest cities and metropolitan areas in the United States from 1987 to 1994. The pollutants were particulate matter that is less than 10 microm in aerodynamic diameter (PM10), ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide. We used a two-stage analytic approach that pooled data from multiple locations.. After taking into account potential confounding by other pollutants, we found consistent evidence that the level of PM10 is associated with the rate of death from all causes and from cardiovascular and respiratory illnesses. The estimated increase in the relative rate of death from all causes was 0.51 percent (95 percent posterior interval, 0.07 to 0.93 percent) for each increase in the PM10 level of 10 microg per cubic meter. The estimated increase in the relative rate of death from cardiovascular and respiratory causes was 0.68 percent (95 percent posterior interval, 0.20 to 1.16 percent) for each increase in the PM10 level of 10 microg per cubic meter. There was weaker evidence that increases in ozone levels increased the relative rates of death during the summer, when ozone levels are highest, but not during the winter. Levels of the other pollutants were not significantly related to the mortality rate.. There is consistent evidence that the levels of fine particulate matter in the air are associated with the risk of death from all causes and from cardiovascular and respiratory illnesses. These findings strengthen the rationale for controlling the levels of respirable particles in outdoor air.

Topics: Air Pollutants; Air Pollution; Analysis of Variance; Carbon Monoxide; Cardiovascular Diseases; Humans; Linear Models; Mortality; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Sulfur Dioxide; United States

Long-term ambient concentrations of inhalable particles less than 10 microm in diameter (PM10) (1973- 1992) and other air pollutants-total suspended sulfates, sulfur dioxide, ozone (O3), and nitrogen dioxide-were related to 1977-1992 mortality in a cohort of 6,338 nonsmoking California Seventh-day Adventists. In both sexes, PM10 showed a strong association with mortality for any mention of nonmalignant respiratory disease on the death certificate, adjusting for a wide range of potentially confounding factors, including occupational and indoor sources of air pollutants. The adjusted relative risk (RR) for this cause of death as associated with an interquartile range (IQR) difference of 43 d/yr when PM10 exceeded 100 microg/m3 was 1.18 (95% confidence interval [CI]: 1.02, 1.36). In males, PM10 showed a strong association with lung cancer deaths-RR for an IQR was 2.38 (95% CI: 1.42, 3.97). Ozone showed an even stronger association with lung cancer mortality for males with an RR of 4.19 (95% CI: 1.81, 9.69) for the IQR difference of 551 h/yr when O3 exceeded 100 parts per billion. Sulfur dioxide showed strong associations with lung cancer mortality for both sexes. Other pollutants showed weak or no association with mortality.

Topics: Adult; Aged; Aged, 80 and over; Air Pollutants; California; Cause of Death; Environmental Monitoring; Epidemiological Monitoring; Female; Follow-Up Studies; Humans; Inhalation Exposure; Male; Middle Aged; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Retrospective Studies; Smoking; Sulfates; Sulfur Dioxide; Surveys and Questionnaires; Survival Rate

To study possible chronic respiratory effects of air pollutants, we initiated a 10-yr prospective cohort study of Southern California children, with a study design focused on four pollutants: ozone, particulate matter, acids, and nitrogen dioxide (NO2). Twelve demographically similar communities were selected on the basis of historic monitoring information to represent extremes of exposure to one or more pollutants. In each community, about 150 public school students in grade 4, 75 in grade 7, and 75 in grade 10 were enrolled through their classrooms. Informed consent and written responses to surveys about students' lifetime residential histories, historic and current health status, residential characteristics, and physical activity were obtained with the help of the parents. In the first testing season, 3,676 students returned questionnaires. We confirmed associations previously reported between respiratory morbidity prevalence and the presence of personal, demographic, and residential risk factors. Rates of respiratory illness were higher for males, those living in houses with pets, pests, mildew, and water damage, those whose parents had asthma, and those living in houses with smokers. Wheeze prevalence was positively associated with levels of both acid (odds ratio [OR] = 1.45; 95% confidence interval [CI], 1.14-1.83) and NO2 (OR = 1.54; 95% CI, 1.08-2.19) in boys. We conclude, based on this cross-sectional assessment of questionnaire responses, that current levels of ambient air pollution in Southern California may be associated with effects on schoolchildren's respiratory morbidity as assessed by questionnaire.

Topics: Acids; Air Pollutants; Asthma; Bronchitis; California; Child; Chronic Disease; Cohort Studies; Cough; Female; Humans; Male; Nitrogen Dioxide; Ozone; Prevalence; Prospective Studies; Respiratory Sounds; Respiratory Tract Diseases; Surveys and Questionnaires

Nitrogen dioxide is known as a deep lung irritant. The aim of this study was to find out whether the relatively low ambient air NO2 concentrations in the northern city of Helsinki had an impact on the respiratory health of children. The association between personal exposure to ambient air NO2 and respiratory health was investigated in a 13-week follow-up study among 163 preschool children aged 3-6 yrs. Personal weekly average exposure to NO2 was measured by passive diffusion samplers attached to the outer garments. Symptoms were recorded daily in a diary by the parents. Among 53 children, peak expiratory flow (PEF) was measured at home in the mornings and evenings. The association between NO2 exposure and respiratory symptoms was examined with Poisson regression. The median personal NO2 exposure was 21.1 microg x m(-3) (range 4-99 microg x m(-3)). An increased risk of cough was associated with increasing NO2 exposure (risk ratio = 1.52; 95% confidence interval 1.00-2.31). There was no such association between personal weekly NO2 exposure and nasal symptoms, but a nonsignificant negative association was found between the exposure and the weekly average deviation in PEF. In conclusion, even low ambient air NO2 concentrations can increase the risk of respiratory symptoms among preschool children.

Topics: Child; Child, Preschool; Environmental Exposure; Female; Finland; Humans; Male; Nitrogen Dioxide; Oxidants, Photochemical; Peak Expiratory Flow Rate; Prospective Studies; Respiratory Tract Diseases; Seasons

There is evidence that people who use gas for cooking have reduced lung function and experience more respiratory symptoms than those who use other fuels for cooking.. To study the effect of the presence of a gas cooker in the home, during both childhood and adulthood, on respiratory symptoms, allergic sensitization and ventilatory function among young adults.. A sample of 1449 young adults born in Britain 3-9 March 1958, who have been followed from birth to ages 7, 11, 16, 23 and 33 years, were examined at home at age 34-35 years. FEV1 and FVC were measured before and 20 min after inhalation of 400 microg salbutamol, and skin prick tests performed with three allergen extracts (grass, Der p 1 and cat). An interview on respiratory symptoms and indoor environmental exposures was included.. No association was found between gas cooking in childhood or adulthood and incidence or prognosis of asthma/wheeze, allergic sensitization or current severity of respiratory symptoms. Subjects who currently used gas for cooking had a significantly reduced FEV1 (- 70 mL, 95% CI +/- 56) but not FVC (- 35 mL, 95% CI +/- 61) compared with those who used electricity for cooking. This reduction in FEV1 was concentrated among men and current asthmatics.. The use of gas for cooking is unlikely to be a major influence on respiratory morbidity in young adults.

Topics: Adult; Air Pollution, Indoor; Child; Cohort Studies; Cooking; Female; Fossil Fuels; Humans; Inhalation Exposure; Male; Nitrogen Dioxide; Pulmonary Ventilation; Respiratory Hypersensitivity; Respiratory Tract Diseases; Skin Tests; Surveys and Questionnaires

In the winter of 1994, 2300 school-age children in Oslo participated in a panel study of the role of traffic pollution on the exacerbation of diseases of the respiratory system and other symptoms of reduced health and well being in children. The children filled out a diary daily with information for five time points over six weeks. In order to quantify exposure-effect relationships for the symptoms, individual exposure to NO2 and particulate matter (PM2.5) was estimated, using the DINEX method a combination of information from the diary as to the children's whereabouts during the five time points each day, coupled with continuous dispersion modelling. An individual exposure estimate for each time point for each child was defined. Individual exposure estimated using dispersion modelling can be used to examine patterns of exposure such as isolating geographic areas with higher concentrations or describing concentrations of pollution by time of day. The diary allowed the time-use of the children to be described.

Topics: Air Pollution; Child; Data Collection; Environmental Exposure; Female; Health Status; Humans; Inhalation Exposure; Male; Nitrogen Dioxide; Oxidants, Photochemical; Particle Size; Respiratory Tract Diseases; Urban Population; Vehicle Emissions

Indoor air pollution could play an important role in the susceptibility to respiratory diseases of vulnerable individuals, such as elders and infants.. To evaluate indoor air pollution in a low income population of South East Santiago.. A domiciliary survey of contaminant sources was carried out in the bouses of a cohort of 522 children less than one year old. Using a case-control design, 121 children consulting for respiratory diseases were considered as cases and 131 healthy infants of the same age and sex were considered as controls. In the houses of both groups, active monitors for particulate matter (PM10) and passive monitors for NO2 were installed.. Forty two percent of fathers and 30% of mothers were smokers, and in two thirds of the families there was at least one smoker. Eighty five percent used portable heaters in winter. Of these, 77% used kerosene as fuel. Only 27% had water heating appliances. The rest heated water on the kitchen store or on bonfires. Most kitchen stoves used liquid gas as fuel. Twenty four hour PM10 was 109 +/- 3.2 micrograms/m3. Mean indoor and outdoor NO2 in 24 h was 108 +/- 76.3 and 84 +/- 53.6 micrograms/m3 respectively. Indoor NO2 levels were related to the use of heating devices and smoking. No differences in PM10 and NO2 levels were observed between cases and controls.. There is a clear relationship between indoor pollution and contaminating sources. Indoor NO2 levels are higher than outdoors.

Topics: Air Pollution, Indoor; Case-Control Studies; Chile; Cohort Studies; Female; Humans; Infant; Male; Nitrogen Dioxide; Respiratory Tract Diseases; Smoking; Social Class

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

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

To determine the effect of air pollution in Mexico City on respiratory health, patient visits for upper respiratory tract infections were monitored in five clinics. Levels of ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide, and climatological variables were collected. Correlations of filtered data revealed an association between NO2 and O3 with an increase in visits to clinics because of respiratory problems. Autoregressive analysis indicated that pollutant levels/respiratory visits associations remained significant even after simultaneous inclusion of temperature, suggesting that air pollution was associated with 10 to 16% of the clinic visits. The relative risk indicated that high levels of O3 and NO2 could increase the total number of clinic visits to between 19 and 43% above average. The other pollutants and the control group did not demonstrate significant associations.

Topics: Adolescent; Adult; Age Factors; Aged; Air Pollution; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Meteorological Concepts; Mexico; Middle Aged; Nitrogen Dioxide; Outpatient Clinics, Hospital; Ozone; Regression Analysis; Respiratory Tract Diseases; Risk

The primary objective of the SAVIAH, a multi-centre study funded by European Union, was to assess new methodology for study of small area health statistics and to implement it in epidemiological health statistics and geography. In Prague, the study has been conducted in two city districts with large variation in air pollution. Data at individual level (health symptoms and socio-economic circumstances of the family) were collected by questionnaires completed by parents of 3680 children aged 7-10 both resident and attending schools within the area (response rate 88%). Aggregated data for geographical areas were available from census and urban planning sources for 692 enumeration districts in the study area which were aggregated into 75 medium sized areas. Outdoor concentrations of nitrogen dioxide (NO2) were monitored by passive samplers. All these data were integrated into a geographic information system (GIS). Spatial distribution of air pollution was estimated by kriging and multiple regression modelling. These models explained about 80% of the variation in air pollution measured by passive samplers. GIS was then used to assign to individuals an exposure based on place of residence and school in order to conduct individual based analyses. Association between NO2 and life-time prevalence of wheezing and/or whistling, and wheezing/whistling in the last 12 months was studied by logistic regression. For both outcomes, school levels of NO2 were positively related to symptoms but home levels of NO2 showed a negative association. Logistic regression at individual level gives similar results as ecological analysis and multilevel modelling. Hierarchical model yielded somewhat wider confidence limits. Adjustment for parental behavioural and socio-economic factors did not affect these estimates substantially. This study demonstrated the power of the GIS methodology in studying the effects of complex environmental factors on respiratory health of children.

Topics: Air Pollution; Child; Czech Republic; Female; Humans; Information Systems; Least-Squares Analysis; Logistic Models; Male; Nitrogen Dioxide; Odds Ratio; Prevalence; Respiratory Tract Diseases; Risk Factors; Small-Area Analysis; Socioeconomic Factors; Vehicle Emissions

The human health effects of exposure to indoor nitrogen dioxide (NO2) are unclear, and few studies have examined the effects of short-term peak levels of exposure.. The association between indoor exposure to NO2 and respiratory illness was examined in 388 children aged 6-11 years. The NO2 levels were monitored during winter in 41 classrooms, from four schools with unflued gas heating and four schools with electric heating. Each classroom was monitored daily with 6-hour passive diffusion badge monitors over nine alternate weeks, and with hourly monitors over two of those weeks. Children living in homes with unflued gas appliances were also monitored daily over four evenings during times of gas use.. Exposure to NO2 at hourly peak levels of the order of > or = 80 ppb, compared with background levels of 20 ppb, was associated with a significant increase in sore throat, colds and absences from school. An increase in cough with phlegm was marginally significant. Significant dose-response relationships were demonstrated for these four measures with increasing levels of NO2 exposure.. Short-term peak levels of exposure are important to consider in relation to adverse respiratory effects associated with NO2 exposure.

Topics: Air Pollution, Indoor; Child; Environmental Exposure; Female; Humans; Male; Nitrogen Dioxide; Prospective Studies; Respiratory Tract Diseases; Schools

Topics: Adult; Air Pollution, Indoor; Child; Environmental Exposure; Fossil Fuels; Heating; Housing; Humans; Maximum Allowable Concentration; New South Wales; Nitrogen Dioxide; Respiratory Tract Diseases; Schools

The aim of this study was to determine whether outdoor nitrogen dioxide (NO2) was associated with the prevalence of asthma and respiratory symptoms. In eight nonurban communities, 843 children resident for a minimum of 2 yrs were studied. Since industrial sources of air pollution were at least 20 km away from the study communities, NO2 was considered to primarily indicate traffic-related air pollution. NO2 was recorded at central monitors, and the 3 yr mean exposure was calculated. Asthma and respiratory symptoms were assessed according to the International Study on Asthma and Allergy in Childhood. Prevalence of asthma at some time ("ever asthma") was associated with long-term NO2. In parallel with increasing levels of NO2 (community specific 3 yr mean 6.0-17.0 parts per billion (ppb)), asthma prevalence was 2.5, 1.4, 1.6, 2.3, 3.4, 3.6, 7.6 and 8.5%, respectively (p=0.002 for trend). The prevalence odds ratios (PORs) for "ever asthma", following adjustment for gender, age, parental education, passive smoke exposure, type of indoor heating, and parental asthma, were 1.28 (95% confidence interval (95% CI) 0.20-7.98), 2.14 (95% CI 0.40-11.3) and 5.81 (95% CI 1.27-26.5), when each of two communities with low, regular and high NO2, respectively, were compared with the two communities with very low NO2. For symptoms "wheeze" (adjusted PORs for increased NO2: 1.47, 1.23 and 2.27) and "cough apart from colds" (adjusted PORs for increased NO2: 1.49, 1.93 and 2.07), a similar trend was seen. In this study a significant relationship was observed between traffic-related nitrogen dioxide and the prevalence of asthma and symptoms. Whether this association is causal has to be tested in longitudinal studies.

Topics: Asthma; Austria; Automobile Driving; Child; Data Collection; Environmental Monitoring; Environmental Pollutants; Epidemiological Monitoring; Female; Humans; Male; Nitrogen Dioxide; Prevalence; Respiratory Tract Diseases

To investigate whether outdoor air pollution levels in London influence daily mortality.. Poisson regression analysis of daily counts of deaths, with adjustment for effects of secular trend, seasonal and other cyclical factors, day of the week, holidays, influenza epidemic, temperature, humidity, and autocorrelation, from April 1987 to March 1992. Pollution variables were particles (black smoke), sulphur dioxide, ozone, and nitrogen dioxide, lagged 0-3 days.. Greater London.. Relative risk of death from all causes (excluding accidents), respiratory disease, and cardiovascular disease.. Ozone levels (same day) were associated with a significant increase in all cause, cardiovascular, and respiratory mortality; the effects were greater in the warm seasons (April to September) and were independent of the effects of other pollutants. In the warm season an increase of the eight hour ozone concentration from the 10th to the 90th centile of the seasonal change (7-36 ppb) was associated with an increase of 3.5% (95% confidence interval 1.7 to 5.3), 3.6% (1.04 to 6.1), and 5.4% (0.4 to 10.7) in all cause, cardiovascular, and respiratory mortality respectively. Black smoke concentrations on the previous day were significantly associated with all cause mortality, and this effect was also greater in the warm season and was independent of the effects of other pollutants. For black smoke an increase from the 10th to 90th centile in the warm season (7-19 microg/m3) was associated with an increase of 2.5% (0.9 to 4.1) in all cause mortality. Significant but smaller and less consistent effects were also observed for nitrogen dioxide and sulphur dioxide.. Daily variations in air pollution within the range currently occurring in London may have an adverse effect on daily mortality.

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Cause of Death; Humans; London; Mortality; Nitrogen Dioxide; Ozone; Regression Analysis; Respiratory Tract Diseases; Risk Factors; Smoke; Sulfur Dioxide

Particulate air pollution, in association with other common urban air pollutants, has been associated with various measured health endpoints, including the incidence and duration of respiratory symptoms, lung function, absence from work or school due to respiratory illness, hospitalization for respiratory disease, and cardiopulmonary disease mortality. In this study, the association between daily mortality and air pollution was assessed in Zurich, Basle, and Geneva (Switzerland) for the time period 1984 through 1989. Various regression modeling techniques were used to estimate the effect of air pollution on mortality, to control for time trends, seasonal factors, and weather variables, and to assess the sensitivity of the results. A positive, statistically significant association between daily mortality counts and measures of ambient air pollution in all three cities was observed. Mortality was associated with total suspended particulate pollution, sulfur dioxide, and nitrogen dioxide. The strongest association was with a 3-day moving average (including the concurrent day and the preceding 2 days) of these pollutants. The estimated mortality-air pollution effects were not highly sensitive to regression modeling techniques used to control for seasonality, long-term trends, and weather variables.

Topics: Aged; Air Pollution; Cardiovascular Diseases; Humans; Meteorological Concepts; Mortality; Nitrogen Dioxide; Regression Analysis; Respiratory Tract Diseases; Seasons; Sulfur Dioxide; Switzerland; Urban Population

Two-thirds of complaints received by the Hong Kong Environmental Protection Department in 1988 were related to poor air quality. In July 1990 legislation was implemented to reduce fuel sulphur levels. The objective of this study was to measure the impact of the intervention on respiratory health in primary school children.. In all, 3521 children, mean age 9.51 years (SD = 0.78), from two districts with good and poor air quality respectively before intervention were followed yearly from 1989 to 1991. Children and parents reported the children's respiratory symptoms using self-completed questionnaires. Factor analysis was used to derive independent scores from 12 symptoms. Four groups of related symptoms were identified and binary variables (presence of any symptom in each group) were treated as dependent variables in modelling using generalized estimating equations procedures.. In 1989 and 1990 an excess of respiratory symptoms was observed in the polluted compared with unpolluted district. The significant effects (odds ratio [OR], 95% confidence interval [CI], P value) associated with living in the polluted district were: cough and sore throat (OR = 1.22, 95% CI: 1.04-1.43, P < 0.01) and wheezing (OR = 1.35, 95% CI: 1.10-1.66, P < 0.01). After the intervention, in the polluted district only, sulphur dioxide levels fell by up to 80% and sulphate concentrations in respirable particulates by 38%. Between 1989 and 1990-1991 there was a greater decline in the polluted compared with the unpolluted district for reported symptoms of cough or sore throat, phlegm, and wheezing. The risks to respiratory health for children exposed to tobacco smoke in the home were higher than those for air pollution in both 1989 and 1990 and remained unchanged in 1991.. Air quality can be improved by fuel controls but an effective intersectoral approach is required if other risks from environmental tobacco smoke are to be avoided.

Topics: Air Pollution; Child; Environmental Exposure; Family Health; Female; Hong Kong; Humans; Logistic Models; Male; Nitrogen Dioxide; Odds Ratio; Prevalence; Prospective Studies; Respiratory Tract Diseases; Socioeconomic Factors; Sulfur Dioxide; Tobacco Smoke Pollution

In a prospective study of infants' exposure to nitrogen dioxide (NO2)* and respiratory illness, NO2 concentrations were measured in more than 1,400 homes in Albequerque, NM, From January 1988 through June 1991 (Health Effects Institute Research Report Number 58, Parts I, II and III). This report characterizes the variability in indoor NO2 concentrations across seasons and years, and identifies factors associated with variation in concentrations between homes and across seasons. In regression analyses of winter data, NO2 levels in the infants' bedrooms were predominately determined by the presence of gas cooking ranges with continuously burning pilot lights, the presence of wall or floor furnaces, the use of the stove for space heating, and the square footage of the living space. These findings are consistent with previously published analysis of data from homes in other U.S. cities. Relatively small differences in seasonal NO2 levels were observed across years. The correlation coefficient (r) of bedroom NO2 levels obtained in the same homes was 0.66 over two winters and 0.48 over two summers. For homes that had gas cooking ranges with continuously burning pilot lights, the NO2 bedroom concentrations differed, on average, less than 5 parts per billion (ppb) across winters. These differences were hypothesized to be caused by differences in the use of indoor NO2 sources, ventilation, and ambient (outdoor) NO2 levels. We were, however, unable to demonstrate an association between year-to-year differences in seasonal indoor NO2 concentrations and reported use of cooking range, furnace, or heater, or ambient NO2 levels, or temperature.

Topics: Air Pollution, Indoor; Environmental Monitoring; Housing; Humans; Infant; Meteorological Concepts; New Mexico; Nitrogen Dioxide; Prospective Studies; Regression Analysis; Respiratory Tract Diseases; Seasons; Urban Health

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; Cause of Death; Humans; Nitrogen Dioxide; Ozone; Particle Size; Respiratory Tract Diseases; Sulfur Dioxide; United Kingdom; Urban Health

Whereas evidence of adverse effects of air pollution on lower respiratory tract illnesses in children is increasing, little is known about the effects of high and moderate levels of air pollution on the incidence of upper respiratory illnesses. 9 to 11 year old schoolchildren (n = 1,854) living in Leipzig, East Germany were studied. The presence of upper respiratory symptoms was documented by a physician. Daily mean and maximum concentrations of SO2, particulate matter (PM) and NOx, as well as temperature and humidity, were measured. Furthermore, a self-administered questionnaire was distributed to the parents to assess confounding factors. Parents of 1,500 (81%) children returned the questionnaire. When controlling for paternal education, passive smoke exposure, number of siblings, temperature and humidity, increased risks for the development of upper respiratory symptoms were found in the winter months for SO2 mean concentrations (odds ratio (OR) = 1.72; 95% confidence interval (95% CI) 1.19-2.49). NOx mean concentrations (OR = 1.53; 95% CI 1.01-2.31) and PM maximum values (OR = 1.62; 95% CI 1.08-2.45). In the summer months, only NOx mean concentrations were associated with a significantly increased risk (OR = 1.82; 95% CI 1.21-2.73). A combination of high mean levels of different pollutants resulted in the highest risk (OR = 2.10; 95% CI 1.30-3.37 in the winter, and OR = 2.16; 95% CI 1.23-3.81 in the summer). We conclude that high concentrations of SO2, and moderate levels of particulate matters and NOx are associated with an increased risk of developing upper respiratory symptoms in childhood.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Air Pollutants; Air Pollution; Child; Female; Germany; Humans; Incidence; Male; Nitrogen Dioxide; Prevalence; Random Allocation; Regression Analysis; Respiratory Tract Diseases; Risk Factors; Seasons; Sulfur Dioxide; Tobacco Smoke Pollution

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

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

In December 1991 London experienced a unique air pollution episode during which concentrations of nitrogen dioxide rose to record levels, associated with moderate increases in black smoke. The aim of this study was to investigate whether this episode was associated with adverse health effects and whether any such effects could be attributed to air pollution.. The numbers of deaths and hospital admissions occurring in Greater London during the week of the episode were compared with those predicted using data from the week before the episode and from equivalent periods from the previous four years. Relative risks (RR) (episode week versus predicted) for adverse health events were estimated using log linear modelling and these were compared with estimates from control areas which had similar cold weather but without increased air pollution.. In all age groups mortality was increased for all causes (excluding accidents) (relative risk = 1.10) and cardiovascular diseases (1.14); non-significant increases were observed for all respiratory diseases (1.22), obstructive lung diseases (1.23), and respiratory infections (1.23). In the elderly (65 + years) the relative risk of hospital admission was increased for all respiratory diseases (1.19) and for obstructive lung diseases (1.43), and a non-significant increase was observed for ischaemic heart disease (1.04). In children (0-14 years) there was no increase in admissions for all respiratory diseases and only a small non-significant increase for asthma. When compared with control areas the relative risks became non-significant but remained increased.. The air pollution episode was associated with an increase in mortality and morbidity which was unlikely to be explained by the prevailing weather, a coincidental respiratory epidemic, or psychological factors due to publicity. Air pollution is a plausible explanation but the relative roles of nitrogen dioxide and particulates cannot be distinguished.

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Cause of Death; Child; Child, Preschool; England; Hospitalization; Humans; Infant; London; Middle Aged; Mortality; Nitrogen Dioxide; Respiratory Tract Diseases; Risk Factors; Temperature

This report describes the quality assurance and quality control program developed for the previously reported epidemiologic study of nitrogen dioxide (NO2) and respiratory illness in children (Health Effects Institute Research Report 58, Parts I and II). The specific aims of the program were to make certain that data were sufficiently accurate, complete, verifiable, and retrievable. The quality assurance and quality control program consisted of: a written protocol, standard operating procedures, written records, a project management system, appropriate data processing, data verification, and data analysis planning, and was staffed by qualified and appropriately trained personnel. Within the activities of the overall program, two focused quality assurance studies were conducted. During the first of these focused studies, parents maintained a calendar-diary of their child's daily respiratory symptoms. Telephone interviews were conducted at intervals of two weeks, and parents used the calendars to report on symptom occurrence since the previous call. To assess the comparability of illness events based on symptom reports from the parents with usual clinical diagnostic methods, nurse practitioners examined children during illness, and office and clinic records of outpatient visits were reviewed. Using the parent reports, respiratory illnesses were defined as symptom episodes of at least two consecutive days; lower respiratory illnesses included at least one day of either wet cough or wheeze. Runny or stuffy nose was reported for 93% of illnesses; and wet cough for 33% and wheeze for 6% of illnesses. In comparison with the diagnoses made by a nurse practitioner, parent reports of wet cough or wheeze were sensitive (93.4%) for detecting lower respiratory illnesses, but nonspecific (with specificity of only 24.2%). The majority of the false-positive lower respiratory illnesses had the symptom of wet cough. The comparison of parent reports with outpatient records provided similar findings. These findings indicate that standardized reporting of respiratory illnesses can be achieved with regular telephone interviews, but the classification of specific illnesses from the observations of parents' information may differ from diagnoses made by clinicians. The second focused quality assurance study evaluated the measurement error associated with the parents' use of passive diffusion samplers for NO2. Midway through the study, technicians conducted home visits to assess c

Topics: Data Collection; Environmental Exposure; Environmental Monitoring; Epidemiologic Methods; Epidemiological Monitoring; Female; Humans; Incidence; Infant; Male; Nitrogen Dioxide; Patient Compliance; Prospective Studies; Quality Control; Reproducibility of Results; Respiratory Tract Diseases; Sensitivity and Specificity; Surveys and Questionnaires

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

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

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

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

During three consecutive winters acute effects of air pollution on respiratory health of more than 1000 children living in four nonindustrial communities in the Netherlands have been investigated. Each child performed between 6 and 10 pulmonary function tests on predetermined days. The occurrence of acute respiratory symptoms in the children was registered in a daily diary filled out by the parents of the children for periods of 3 months. Exposure to air pollution was characterized by the ambient concentration of sulfur dioxide, nitrogen dioxide, PM10, fine particle sulfate, fine particle nitrate, and nitrous acid. No major winter air pollution episode occurred during these winters. Concentrations of acid aerosol were low. A weak negative association between the concentrations of nitrogen dioxide, PM10, aerosol sulfate, aerosol nitrate, nitrous acid, and pulmonary function was found. Sulfur dioxide concentration was not associated with pulmonary function. No association of the concentration of the measured pollutants with daily incidence and prevalence of acute respiratory symptoms was found.

Topics: Aerosols; Air Pollutants; Air Pollution; Child; Female; Humans; Incidence; Male; Netherlands; Nitrates; Nitrogen Dioxide; Nitrous Acid; Odds Ratio; Prevalence; Regression Analysis; Respiratory Function Tests; Respiratory System; Respiratory Tract Diseases; Seasons; Sulfates; Sulfur Dioxide; Temperature

Nitrogen dioxide is an oxidant gas that contaminates outdoor air and indoor air in homes with unvented gas appliances. A prospective cohort study was carried out to test the hypothesis that residential exposure to NO2 increases incidence and severity of respiratory illnesses during the first 18 months of life. A cohort of 1,205 healthy infants from homes without smokers was enrolled. The daily occurrence of respiratory symptoms and illnesses was reported by the mothers every 2 wk. Illnesses with wheezing or wet cough were classified as lower respiratory tract. Indoor NO2 concentrations were serially measured with passive samplers place in the subjects' bedrooms. In stratified analyses, illness incidence rates did not consistently increase with exposure to NO2 or stove type. In multivariate analyses that adjusted for potential confounding factors, odds ratios were not significantly elevated for current or lagged NO2 exposures, or stove type. Illness duration, a measure of illness severity, was not associated with NO2 exposure. The findings can be extended to homes with gas stoves in regions of the United States where the outdoor air is not heavily polluted by NO2.

Topics: Air Pollutants; Air Pollution, Indoor; Cohort Studies; Female; Heating; Humans; Incidence; Infant; Male; New Mexico; Nitrogen Dioxide; Odds Ratio; Prospective Studies; Residence Characteristics; Respiratory Tract Diseases; Seasons

We have carried out a prospective cohort study to test the hypothesis that exposure to nitrogen dioxide increases the incidence and severity of respiratory infections during the first 18 months of life. Between January 1988 and June 1990, 1,315 infants were enrolled into the study at birth and followed with prospective surveillance for the occurrence of respiratory infections and monitoring of nitrogen dioxide concentrations in their homes. The subjects were healthy infants from homes without smokers; they were selected with stratification by type of cooking stove at a ratio of four to one for gas and electric stoves. Illness experience was monitored by a daily diary of symptoms completed by the mother and a telephone interview conducted every two weeks. Illnesses with wheezing or wet cough were classified as involving the lower respiratory tract; all other respiratory illnesses were designated as involving the upper respiratory tract. Exposure to nitrogen dioxide was estimated by two-week average concentrations measured in the subjects' bedrooms with passive samplers. This analysis is limited to the 1,205 subjects completing at least one month of observation; of these, 823 completed the full protocol, contributing 82.8% of the total number of days during which the subjects were under observation. Incidence rates for all respiratory illnesses, all upper respiratory illness, all lower respiratory illnesses, and lower respiratory illness further divided into those with any wheezing, or wet cough without wheezing, were examined within strata of nitrogen dioxide exposure at the time of the illness, nitrogen dioxide exposure during the prior month, and type of cooking stove. Consistent trends of increasing illness incidence rates with increasing exposure to nitrogen dioxide were not evident for either the lagged or unlagged exposure variables. The effect of nitrogen dioxide exposure on illness occurrence during at-risk intervals of two weeks' duration was examined using the generalized estimating equation approach. In these multivariate analyses, none of the odds ratios was significantly elevated for unlagged nitrogen dioxide exposures, lagged nitrogen dioxide exposures, or stove type. Duration of illness was assessed in relation to the same exposure variables; illness duration and nitrogen dioxide exposure were not associated. We have found that indoor exposure to nitrogen dioxide is associated with neither the incidence nor the duration of respiratory illnes

Topics: Air Pollutants; Air Pollution, Indoor; Cohort Studies; Female; Heating; Humans; Incidence; Infant; Infant, Newborn; Logistic Models; Male; New Mexico; Nitrogen Dioxide; Odds Ratio; Prospective Studies; Residence Characteristics; Respiratory Tract Diseases; Seasons; Severity of Illness Index

Repeated measurements of nitrogen dioxide were obtained from 1988 to 1991 in the homes of 1,205 infants living in Albuquerque, NM. Passive diffusion samplers were used to obtain a series of two-week integrated measurements from the home of each infant for use in a cohort study of the relation of residential exposure to nitrogen dioxide and respiratory illnesses. Information on stove use and time spent inside the residence was collected at two-week and two-month intervals, respectively. During the winter, in the bedrooms of homes with gas cooking stoves, mean nitrogen dioxide concentrations were 21 parts per billion (ppb); mean concentrations in the living room and kitchen were 29 ppb and 34 ppb, respectively. In homes with electric cooking stoves, the mean bedroom concentration was 7 ppb during the winter. Lower indoor concentrations were observed during the summer in homes with both gas and electric stoves. On average, infants spent approximately 12.3 hours per day in their bedrooms, 7.3 hours in the living rooms, 35 minutes in the kitchens, and 3.8 hours out of their homes. (As a condition of participation, none of the infants spent more than 20 hours per week in day care outside of their homes). The mean time infants spent in the kitchen during cooking was approximately nine minutes per day. We tested whether exposures of infants living in homes with gas stoves could be reasonably estimated by measurements in the bedroom in comparison with time-weighted average concentrations based on time-activity data and simultaneous nitrogen dioxide measurements in the kitchen, living room, and bedroom. In 1,937 two-week intervals from 587 infants, 90% of time-weighted exposure (on the three-level classification used in this study) estimates were in agreement with estimates based on bedroom concentrations alone. The agreement of the time-weighted nitrogen dioxide exposure estimates with the bedroom concentrations is attributed to limited amounts of cooking stove use (the mean was 29 minutes per day), small room-to-room differences in nitrogen dioxide concentrations (the mean kitchen-bedroom difference was 12 ppb), and the relatively large proportion of time that infants spent in their bedrooms.

Topics: Air Pollution, Indoor; Child, Preschool; Cooking; Environmental Monitoring; Epidemiological Monitoring; Female; Humans; Infant; Male; Nitrogen Dioxide; Prospective Studies; Quality Control; Residence Characteristics; Respiratory Tract Diseases; Time Factors

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

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

Inhalation toxicology experiments in whole animals have demonstrated a remarkable lack of toxicity of sulfuric acid in the form of respirable aerosols, especially in rats and nonhuman primates. Thus, much of the current experimental emphasis has shifted to the evaluation of the potential health effects of acid aerosols as components of mixtures. Rats have been concurrently exposed to mixtures of ozone or nitrogen dioxide with respirable-sized aerosols of sulfuric acid, ammonium sulfate, or sodium chloride, or to each pollutant individually. Their responses to such exposures have been evaluated by various quantitative biochemical analysis of lung tissue or wash fluids ("lavage fluid") or by quantitative morphological methods ("morphometry"). Such studies have mainly been performed in the acute time frame due to the inherent limitations of the most sensitive assays available and have generally involved exposures for 1 to 9 days, depending on the assays used. Good correlations were found between the most sensitive biochemical indicators of lung damage (protein content of lung lavage fluid or whole lung tissue and lung collagen synthesis rate) and the exposure concentration of oxidant gas present alone or in mixtures with acidic aerosols showing interactive effects. Synergistic interaction between ozone and sulfuric acid aerosol was demonstrated to occur at environmentally relevant concentrations of both pollutants by several of the analytical methods used in this study. Such interactions were demonstrated at concentrations of ozone as low as 0.12 ppm and of sulfuric acid aerosol at concentrations as low as 5 to 20 micrograms/m3.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acids; Administration, Inhalation; Aerosols; Air Pollutants; Animals; Atmosphere; Drug Synergism; Guinea Pigs; Hydrogen-Ion Concentration; Lung; Nitrogen Dioxide; Ozone; Proteins; Rats; Respiratory Tract Diseases; Sodium Chloride; Species Specificity; Sulfuric Acids

Several approaches can be taken to estimate or classify total personal exposures to air pollutants. While personal exposure monitoring (PEM) provides the most direct measurements, it is usually not practical for extended time periods or large populations. This paper describes the use of indirect approaches to estimate total personal exposure for NO2 and particulate matter (PM), summarizes the distributions of these estimates, and compares the effectiveness of these estimates with microenvironmental concentrations for evaluating effects on respiratory function and symptoms. Pollutant concentrations were measured at several indoor and outdoor locations for over 400 households participating in an epidemiological study in Tucson, Arizona. Central site monitoring data were significantly correlated with samples collected directly outside homes, but the former usually had higher pollutant concentrations. Integrated indices of daily total personal exposure were calculated using micro-environmental (ME) measurements or estimates and time-budget diary information. Peak expiratory flow rates (PEFR) were measured for up to four times a day during two-week study periods. In thirty children (ages 6-15 years) with current diagnosed asthma, a significant reduction in PEFR was associated with NO2 levels measured outside of their homes. Additional decrements of morning PEFR were found in those children sleeping in bedrooms with higher measured NO2 levels. Morning and noon PEFR decrements were also linked to higher morning NO2 levels that were measured at central monitoring stations. Effects of PM were also found, but were limited to morning PEFR. No effects were found in non-asthmatic children. The relationship of PEFR to the calculated indices of daily average total exposure were weaker than to the microenvironment concentrations. This suggests that diary and ME monitoring data need to yield better time resolution in order to incorporate short-term average exposures to higher concentrations into the exposure indices and into the analysis of within day health responses.

Topics: Adolescent; Air Pollutants; Air Pollution, Indoor; Asthma; Child; Environmental Exposure; Environmental Monitoring; Humans; Nitrogen Dioxide; Peak Expiratory Flow Rate; Respiratory Tract Diseases

The effect of indoor nitrogen dioxide on the cumulative incidence of respiratory symptoms and pulmonary function level was studied in a cohort of 1,567 white children aged 7-11 years examined in six US cities from 1983 through 1988. Week-long measurements of nitrogen dioxide were obtained at three indoor locations over 2 consecutive weeks in both the winter and the summer months. The household annual average nitrogen dioxide concentration was modeled as a continuous variable and as four ordered categories. Multiple logistic regression analysis of symptom reports from a questionnaire administered after indoor monitoring showed that a 15-ppb increase in the household annual nitrogen dioxide mean was associated with an increased cumulative incidence of lower respiratory symptoms (odds ratio (OR) = 1.4, 95% confidence interval (95% Cl) 1.1-1.7). The response variable indicated the report of one or more of the following symptoms: attacks of shortness of breath with wheeze, chronic wheeze, chronic cough, chronic phlegm, or bronchitis. Girls showed a stronger association (OR = 1.7, 95% Cl 1.3-2.2) than did boys (OR = 1.2, 95% Cl 0.9-1.5). An analysis of pulmonary function measurements showed no consistent effect of nitrogen dioxide. These results are consistent with earlier reports based on categorical indicators of household nitrogen dioxide sources and provide a more specific association with nitrogen dioxide as measured in children's homes.

Topics: Air Pollutants; Child; Female; Humans; Incidence; Logistic Models; Male; Nitrogen Dioxide; Odds Ratio; Respiratory Function Tests; Respiratory Tract Diseases; Seasons; United States

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

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

Recent concern regarding health effects of air pollution in Japan has concentrated mainly on traffic-induced air pollution and its health effects in large cities. In Japan, where many people in large cities have been living near major roadways, the increase of automobile exhaust due to heavy traffic congestion will predictably cause a greater impact on people living near major roadways. We surveyed the characterization of residential suspended particulate matter (SPM) and nitrogen dioxide (NO2) concentrations along the major roadways in Tokyo, along with a health survey on the respiratory conditions of residents living in the same area, to examine the relationships between indoor pollutant levels, prevalence of respiratory symptoms and distance from roadways. The environmental monitoring was conducted in five phases. Using a newly developed SPM sampler and NO2 filter badge, continuous 4 day (96 hours) measurements were conducted in two hundred residential homes for four weeks. NO2 was measured in the living room, kitchen and outside of each home, while SPM was monitored in the living room. Health information was collected in October 1987 using ATS-DLD self-administered questionnaires. Of the 1,093 homes investigated, responses from 805 homes were received. The following results were obtained. SPM and NO2 concentrations showed large variations. Indoor pollution levels mostly depended on indoor sources, i.e. cigarette smoking and unventilated space heaters, and the effects of those indoor sources were influenced by the building structure with respect to air tightness. An association between increase in pollutant levels and the distance from the roadway was observed. However its effect is small compared to indoor source effects. The prevalence rate of respiratory symptoms was higher in those areas nearest roadways with heavy traffic both in children and adults. These results suggest the presence of a relationship between automobile exhaust and health effects.

Topics: Adult; Air Pollution; Air Pollution, Indoor; Child; Child, Preschool; Environmental Monitoring; Epidemiological Monitoring; Female; Housing; Humans; Male; Middle Aged; Nitrogen Dioxide; Respiratory Tract Diseases; Tokyo; Vehicle Emissions

The determination of hydroxyproline (HOP) and of the HOP-creatinine ratio in urine, respectively, is according to the literature probably a parameter of NO2-caused collagen damage of the respiratory organs and therefore a parameter which could be used for biological monitoring of indoor exposures. Own studies on children from gas or electrical house keeping presented no significant differences. Various interpretations are discussed, further investigations seem to be indicated.

Topics: Air Pollutants; Child; Collagen Diseases; Creatinine; Female; Humans; Hydroxyproline; Male; Nitrogen Dioxide; Respiratory Tract Diseases

The effect of indoor exposure to nitrogen dioxide on respiratory health was studied over a period of 2 yr in a population of nonsmoking Dutch children 6 to 12 yr of age. Lung function was measured at the schools, and information on respiratory symptoms was collected from a self-administered questionnaire completed by the parents of the children. Nitrogen dioxide was measured in the homes of all children with Palmes' diffusion tubes. In addition, information on smoking and dampness in the home was collected by questionnaire. There was no relationship between exposure to nitrogen dioxide in the home and respiratory symptoms. Respiratory symptoms were found to be associated with exposure to tobacco smoke and home dampness. There was a weak, negative association between maximal midexpiratory flow (MMEF) and exposure to nitrogen dioxide. FEV1, peak expiratory flow, and MMEF were all negatively associated with exposure to tobacco smoke. Home dampness was not associated with pulmonary function. Lung function growth, measured over a period of 2 yr, was not consistently associated with any of the indoor exposure variables. The development of respiratory symptoms over time was not associated with indoor exposure to nitrogen dioxide. There was a significant association between exposure to environmental tobacco smoke in the home and the development of wheeze. There was also a significant association between home dampness and the development of cough.

Topics: Air Pollutants; Child; Female; Forced Expiratory Volume; Housing; Humans; Humidity; Male; Maximal Expiratory Flow Rate; Nitrogen Dioxide; Peak Expiratory Flow Rate; Respiratory Mechanics; Respiratory Tract Diseases; Tobacco Smoke Pollution; Vital Capacity

In 1985, 362 primary schoolchildren and their 319 mothers were surveyed in Hong Kong to study the possible relationship of air pollution to respiratory illnesses. Using nitrogen dioxide (NO2) measured by personal samplers as a measure of air pollution, the study aimed to identify the major sources of NO2 in the indoor environment and see whether its increased presence was associated with respiratory symptoms. The levels of NO2 among the mothers was found to increase by 21% if dust exposure was reported from the workplace, 18% if they used such cooking fuels as liquid petroleum gas or kerosene, 11% when kitchens did not have ventilating fans, and 10% when incense was burned at home. In terms of respiratory symptoms, an increase in NO2 levels of 19% was reported among those with allergic rhinitis and 18% among those with chronic cough. The levels of NO2 among children were correlated with levels measured in classrooms, all of which had opened windows so that the NO2 came from outdoors. No association was found between children's NO2 levels and respiratory symptoms. With the exception of smoking by the father and the children's NO2 levels, no association was found between smoking at home and NO2 levels.

Topics: Adult; Air Pollutants; Child; Environmental Exposure; Female; Heating; Hong Kong; Humans; Male; Middle Aged; Nitrogen Dioxide; Respiratory Tract Diseases; Smoke

The weekly changes in ambient sulfur dioxide, nitrogen dioxide, and temperature were compared with the figures for respiratory infection in children and adults and for absenteeism from day-care centers (DCC), schools, and workplaces during a 1-year period in Helsinki. The annual average level of sulfur dioxide was 21 micrograms/m3 and of nitrogen dioxide 47 micrograms/m3; the average temperature was +3.1 degrees C. The levels of these pollutants and the temperature were significantly correlated with the number of upper respiratory infections reported from health centers. Low temperature also correlated with increased frequency of acute tonsillitis, of lower respiratory tract infection among DCC children, and of absenteeism from day-care centers, schools and workplaces. Furthermore, a significant association was found between levels of sulfur dioxide and absenteeism. After statistical standardization for temperature, no other correlations were observed apart from that between high levels of sulfur dioxide and numbers of upper respiratory tract infections diagnosed at health centers (P = 0.04). When the concentrations of sulfur dioxide were above the mean, the frequency of the upper respiratory tract infections was 15% higher than that during the periods of low concentration. The relative importance of the effects of low-level air pollution and low temperature on health is difficult to assess.

Topics: Absenteeism; Adult; Air Pollutants; Child; Child, Preschool; Cold Temperature; Epidemiologic Methods; Finland; Humans; Infant; Nitrogen Dioxide; Respiratory Tract Diseases; Sulfur Dioxide; Urban Health

The effect of air pollution caused by oil-fired electricity-generating stations on the annual ring growth of the Japanese cedar (Cryptomeria japonica, D. Don) and prevalence of respiratory symptoms in schoolchildren were investigated. By retrospective analysis the annual ring growth has been demonstrated to show good agreement with the general trend in air pollution. In addition it was found to be related to the prevalence of respiratory symptoms. The reduction in annual ring growth and increase in the prevalence of respiratory symptoms followed a deterioration in air pollution. Following upgrading of the power station and an improvement in air pollution, the annual ring growth and prevalence of respiratory symptoms showed opposite changes, respectively. Concerning the latter, the prevalence of wheezing and respiratory symptoms associated with school absence in schoolchildren with a positive skin test to house dust extract showed a closer correlation with the annual ring growth when compared with those who had never had a positive skin test.

Topics: Adolescent; Air Pollutants; Child; Environmental Monitoring; Epidemiological Monitoring; Female; Fuel Oils; Humans; Japan; Male; Nitrogen Dioxide; Power Plants; Respiratory Tract Diseases; Rural Health; Skin Tests; Sulfur Dioxide; Trees

In January 1985 a smog period occurred for 5 days in parts of West Germany, including the Rhur District. Mortality (24,000 death certificates), morbidity in hospitals (13,000 hospital admissions, 5400 outpatients, 1500 ambulance transports) and consultations in doctors' offices (1,250,000 contacts) were studied for a 6-week period including the smog episode and a time interval before and thereafter. The study region was the State of North Rhine-Westfalia (16 million inhabitants), but the analysis is restricted to the comparison of the polluted area and a control area (6 million inhabitants each). During the smog period, mortality and morbidity in hospitals increased in the polluted area, but there was no substantial increase in the control area. The increases were for the total number of deaths 8 vs. 2% (polluted area vs. control area), for hospital admissions 15 vs. 3%, for outpatients 12 vs. 5% and for deliveries by ambulance to hospitals 28% in the polluted area (not investigated in the control area). The effects were more pronounced for cardiovascular diseases than for respiratory diseases. The consultations in doctors' offices show a slight decrease (-2 vs. -4%). Regression analysis shows a moderate influence of temperature, but a strong influence of ambient air pollution. The maxima of the ambient concentrations are more important on the same day, whereas the influence of the daily averages is more pronounced after a delay of 2 days. The results are discussed considering other possible confounders such as indoor pollution and psychogenic influences of the alarm situation. In total, the study suggests moderate health effects due to increased air pollution during the smog episode.

Topics: Acid Rain; Air Pollutants; Carbon Dioxide; Carbon Monoxide; Cardiovascular Diseases; Cross-Sectional Studies; Germany, West; Humans; Nitrogen Dioxide; Respiratory Tract Diseases; Risk Factors; Smog; Sulfates; Sulfur Dioxide

Research on human exposure to acidic aerosols and the health effects of such exposures has substantially strengthened the hypothesis that such aerosols are a causal factor for excesses in human mortality and morbidity that have been previously associated with crude exposure indices such as British Smoke, total suspended particulate matter, and sulfur dioxide. Research reported at this symposium also showed that combined exposures to acid aerosols and other ubiquitous air pollutants such as O3, NO2, HNO3, and SO2 produce greater effects in both humans and animals than exposures to each agent separately. The responses reported ranged from physiological functions to lung structure. Furthermore, some of the effects were cumulative with increasing duration of daily exposure and number of repetitive exposures. Critical areas for further research include better definition of the critical temporal parameters affecting exposure and response, effects of mixed pollutant exposures, and pathogenetic mechanisms for acid aerosol-induced chronic lung damage.

Topics: Acid Rain; Aerosols; Air Pollutants; Dose-Response Relationship, Drug; Humans; Nitrates; Nitric Acid; Nitrogen Dioxide; Ozone; Respiratory Tract Diseases; Risk Factors; Sulfur Dioxide; Sulfuric Acids

Previously published data from the Ontario Air Pollution study are reviewed. It has been shown that there is a consistent association in summer between hospital admissions for respiratory disease in Southern Ontario, and daily levels of SO4, O3, and temperature. No association exists for a group nonrespiratory conditions. Multiple regression analyses are presented that show all environmental variables account for 5.6% of the variability in respiratory admissions and that if temperature is forced into the analysis first, it accounts for 0.89% of the variability only. Distribution plots of standardized residuals are presented. In June of 1983, there were an exceptional number of ozone episodes (defined as occasions when ozone was greater than 82 ppb for 3 or more hours in a calendar day) in this region. A separate analysis of hospital admissions for acute respiratory diseases for the month of June for several years shows no demonstrable excess in June of 1983; previously regional analyses have indicated that ozone is associated with increased levels in July and August over a 9-year period. It has also been found that daily SO4 data collected at one monitoring site in the center of the region are not correlated with respiratory admissions, whereas the SO4 values collected every sixth day, on different days of the week, at 17 stations in the region had the highest correlation with respiratory admissions.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acid Rain; Aerosols; Air Pollutants; Carbon Monoxide; Cross-Sectional Studies; Humans; Nitrogen Dioxide; Ontario; Ozone; Respiratory Tract Diseases; Risk Factors; Sulfur Dioxide; Sulfuric Acids

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

An attempt was made to investigate the effects of automobile exhaust to the people living alongside major traffic arterial in Tokyo. Several hundreds of housewives aged from 40 to 59 who lived more than 3 years were sampled both from the area A; within 20 m from road side, and from the area B which extended from 20 m to 150 m along the road next to the area A. ATS-DLD questionnaire was used to check the prevalence of respiratory symptom, its results was analysed with a deliberate consideration on smoking habits and using status of unvented kerosene space heater. Among each symptom prevalence, difference between the area A and the B was observed significantly in symptom rate related persistent cough and phlegm. These differences became much distinguished in non-smoking group and people not using unvented heater. For about one tenth of sample subject, joined the study of measurement of personal exposure to NO2 for 24 hr using NO2 filter badge. The average concentration of exposure depends largely on heater using status but does not on the study area, even though the atmospheric concentration of NO2 in the area A was higher than that of the area B. The difference of symptom prevalence between the study area becomes not significant compared with the group of using unvented heater. This means that, we suppose, the substantial higher symptom prevalence which observed in the area along the roadside is masked by repeated exposure to elevated indoor concentration of NO2 resulted from using kerosene space heater.

Topics: Climate; Housing; Humans; Microclimate; Nitrogen Dioxide; Respiratory Tract Diseases; Smoking; Tobacco Smoke Pollution; Tokyo; Urban Population; Vehicle Emissions

Observations of high acidity (pH as low as 1.7) in fogwater collected in polluted areas have provoked concern for public health. Effects of exposure to acidic pollutants have not been studied under foggy conditions; thus there is no directly relevant information from which to estimate the health risk. Indirectly relevant information is available from numerous studies of volunteers exposed to "acid fog precursors" under controlled conditions at less than 100% relative humidity. The effect of fog in modifying responses to inhaled acidic pollutants is difficult to predict: depending on circumstances, fog droplets might either increase or decrease the effective dose of pollutants to the lower respiratory tract. Fog inhalation per se may have unfavorable effects in some individuals. Sulfur dioxide is known to exacerbate airway constriction in exercising asthmatics, at exposure concentrations attainable in ambient air. Nitrogen dioxide has shown little untoward respiratory effect at ambient concentrations in most studies, although it has been suggested to increase bronchial reactivity. Sulfuric acid aerosol has shown no clear effects at concentrations within the ambient range. At somewhat higher levels, increased bronchial reactivity and change in mucociliary clearance have been suggested. Almost no information is available concerning nitric acid.

Topics: Acids; Air Pollutants; Ammonium Sulfate; Humans; Humidity; Nitrates; Nitric Acid; Nitrogen Dioxide; Respiratory Tract Diseases; Sulfur Dioxide; Sulfuric Acids; Time Factors; Weather

This paper attempts to assess health risks associated with nitrogen oxides (NOx) exposures. Experimental animal studies show that continuous or intermittent exposures to concentration of 0.04 to 0.5 ppm nitrogen dioxide (NO2) produce a number of pulmonary and systemic effects. Controlled human exposure studies show that short-term exposures to 0.3 to 0.5 ppm NO2 or 1.0 ppm nitric oxide produce bronchoconstriction and blood biochemical changes in some subjects. When we consider together both findings of the animal and human exposure studies, we may suggest with some reliability that the concentrations of NOx in ambient and indoor air pollutions may have adverse health effects on some subjects, and may partly contribute to the respiratory symptoms or illness and reduced pulmonary function observed in the epidemiological studies.

Topics: Animals; Humans; Hydroxyproline; Nitrogen Dioxide; Nitrogen Oxides; Respiratory Function Tests; Respiratory Tract Diseases; Risk

In 1977 an association was reported between the prevalence of respiratory illness and use of gas for cooking at home in a national sample of six to 11 year olds living in England and Scotland (p less than .10). Other variables such as social class and number of cigarette smokers at home did not seem to explain the association. As the gas cooker is an unflued appliance emitting a variety of pollutants during gas combustion it was suggested that indoor air pollution might explain the finding. Nitrogen dioxide (NO2) was suspected so a series of studies was conducted to investigate the distribution of levels of NO2 in the home, the relative contribution of sources of NO2 to indoor exposure and the relation between respiratory illness in six to 11 year olds and levels of NO2 in the home. The gas cooker was found to be one of the main sources of NO2 in the home. Winter weekly averages in kitchens with gas cookers had a mean of 112.2 ppb (n = 428, range 5-317 ppb). Levels in electric cooking kitchens were significantly lower (n = 87, mean 18 ppb, range 6-188 ppb). Studies of health indicated a relation between respiratory illness and bedroom levels of NO2 over the range 4-169 ppb (p .10). Results for living room levels of NO2 suggested a similar but non-significant relationship (p greater than .10). No relation was found for kitchen levels of NO2. For schoolchildren any effect on health from indoor NO2 is likely to be weak. However other sections of the population such as infants and the elderly who may spend more time indoors and are particularly susceptible to respiratory illness need to be studied to assess fully the impact that NO2 may be having on health.

Topics: Child; Cooking; England; Female; Humans; Longitudinal Studies; Male; Microclimate; Nitrogen Dioxide; Respiratory Tract Diseases; Scotland

The influence of indoor nitrogen-dioxide exposure on respiratory symptoms of schoolchildren was investigated in a case-control study. The election method used was useful in obtaining symptomatic children, but insufficient in defining cases and controls without additional information. No relationship between indoor NO2 and respiratory symptoms was found. Bias may have been present, especially because of the high mobility of the study population. Attempts to estimate historical exposure were inaccurate. Therefore the results do not exclude that an association between indoor NO2 and respiratory symptoms exists.

Topics: Air Pollutants; Child; Humans; Nitrogen Dioxide; Respiratory Tract Diseases

Five hundred and sixty British coalminers with relatively high or relatively low exposures to oxides of nitrogen, based on measurements of concentrations of these gases at nine collieries over four years, and records of the men's places of work and colliery mining conditions over a total of eight years have been studied. Data on these men's respiratory symptoms and ventilatory capacity (FEV1), obtained as part of an epidemiological study of British coalminers, have been used to investigate possible adverse effects of exposure to oxides of nitrogen. Exposures to oxides of nitrogen were generally well below threshold limit values, though occasional peaks after shotfiring and during diesel locomotive use did exceed short term limits. No relationship was found between exposure and respiratory symptoms or decline in FEV1 nor was there any evidence of differences in symptoms of FEV1 between 44 pairs of men matched for age, dust exposure, smoking habit, coal rank, and type of work, but differing in respect of exposure to oxides of nitrogen. It has not been possible to detect any adverse effects on the health of this working population of the levels of nitrogen oxides that have occurred in British mines over the past decade. With the current levels of these gases, any long term effects on respiratory health are so small as to be undetectable in the presence of smoking and dust exposure.

Topics: Coal Mining; Forced Expiratory Volume; Humans; Male; Maximum Allowable Concentration; Middle Aged; Nitric Oxide; Nitrogen Dioxide; Occupational Diseases; Respiratory Tract Diseases; Smoking; United Kingdom

The relation of respiratory illness to nitrogen dioxide (NO2), temperature and relative humidity in homes with a gas cooker was investigated in five and six year old children living in an urban area of the northern England. NO2 was measured for one week in the child's bedroom and living room of each home, and temperature and relative humidity were measured in the bedroom only. Information on respiratory conditions experienced by the child and characteristics of the home was collected in a self-administered questionnaire completed by the child's mother. Access was gained to 183 homes (54.3% of 337) where only gas was used for cooking. Complete information was obtained for 179 (93.7%) of 191 children who lived in the 183 homes. After allowing for the effects of age, sex, social class, and number of cigarette smokers in the home and temperature or relative humidity, no statistically significant relation was found between the prevalence of having one or more respiratory conditions and weekly average levels of NO2 in the bedroom (range 4.7 to 160.8 ppb) or living room (range 9.0 to 292.2 ppb). However, the prevalence of having one or more respiratory conditions tended to be highest in homes with high levels of NO2 and lowest in homes with low levels, consistent with earlier findings. A significant positive association was found between the prevalence of respiratory conditions and relative humidity (p less than .05). A harmful effect on health from NO2 cannot be totally dismissed but if it exists it is weak and difficult to detect in small samples of children.

Topics: Air Pollutants; Child; Child, Preschool; England; Female; Fossil Fuels; Humans; Humidity; Male; Nitrogen Dioxide; Regression Analysis; Respiratory Tract Diseases; Smoking; Surveys and Questionnaires; Temperature

The results of three studies on the effect of gas cooking on the lung function of children are reported. The studies which have been carried out in England and Scotland with children aged 6-11, 6-7 and 5-6 years, respectively, show that there is only a weak association between indoor levels of NO2 and respiratory illness. Nevertheless, the consistency of the difference in the rate of respiratory diseases in children from homes with electric and gas cookers suggest there is some hazard to the use of unflued gas appliances which may warrant further epidemiological investigation.

Topics: Child; Child, Preschool; Heating; Humans; Nitrogen Dioxide; Respiratory Tract Diseases; United Kingdom

As part of a long-range, prospective study of the health effects of air pollution, approximately 8,000 children from 6 yrs to 10 yrs of age from 6 communities had questionnaires completed by their parents and had simple spirometry performed in school. Comparisons were made between children living in homes with gas stoves and those living in homes with electric stoves. Children from households with gas stoves had a greater history of respiratory illness before age 2 (average difference, 32.5/1,000 children) and small but significantly lower levels of FEV1 and FVC corrected for height (average difference, 16 ml and 18 ml, respectively). These findings were not explained by differences in social class or by parental smoking habits. Measurements taken in the homes for 24-h periods showed that NO2 levels were 4 to 7 times higher in homes with gas stoves than in homes with electric stoves. However, these 24-h measurements were generally well below the current federal 24-h outdoor standard of 100 micrograms/m3. Short-term peak exposures, which were in excess of 1,100 micrograms/m3, regularly occurred in kitchens. Further work will be required to determine the importance of these short-term peaks in explaining the effects noted.

Topics: Air Pollutants; Child; Environmental Exposure; Female; Forced Expiratory Volume; Fossil Fuels; Humans; Lung; Male; Massachusetts; Nitrogen Dioxide; Population Surveillance; Respiratory Tract Diseases; Socioeconomic Factors; Vital Capacity

The animal studies in mice resulted as follows. Long-term exposure to NO2 at or above 0.5 ppm affected primarily the respiratory organs. The pulmonary effect of NO was slighter than NO2. Nitrosylhemoglobin formation in vivo was much smaller than in vitro strong affinity of NO with hemoglobin. The components other than O3 contained in the photochemically formed oxidant mixtures enhanced the effect of O3 alone. Symptoms of the patients seriously injured by photochemical smog in Japan suggested the different type in quality from the Los Angeles-type smog.

Topics: Air Pollution; Animals; Dizziness; Eye Diseases; Glutathione; Hemoglobins; Humans; Japan; Lung; Mice; Nausea; Nitric Oxide; Nitrogen Dioxide; Respiratory System; Respiratory Tract Diseases; Smog

The study was designed to determine whether there was an association between indoor levels of nitrogen dioxide (NO2) and respiratory illness and lung function in schoolchildren. NO2 was measured for one week in the winter outside and inside the homes of children aged 6-7 years living and attending primary schools in a defined 4 square km area in Middlesbrough, Cleveland, UK. Outdoor levels of NO2 measured at 75 points within the area ranged from 14-24 ppb weekly average. Measurements were also made in 428 kitchens with gas cookers, range 5-317 ppb, mean 112.2 ppb, and in 87 kitchens with electric cookers, range 6-188 ppb, mean 18.0 ppb. In a random subsample of homes the range of NO2 levels in 107 children's bedrooms in homes where gas was used for cooking was 4-169 ppb, mean 30.5 ppb, in 18 bedrooms in electric cooking homes the range was 3-37 ppb, mean 13.9 ppb. NO2 levels in the gas cooking kitchens were positively related to the presence of pilot lights, use of gas fires for main heating, number of regular smokers, and the number of people in the home. Information from 29 homes with the highest kitchen NO2 levels paired with 29 low NO2 gas cooking homes showed that the daily number of meals eaten and the frequency with which the cooker was used for heating and drying clothes were significantly greater in the high NO2 homes.

Topics: Air Pollutants; Air Pollution; Child; Cooking; England; Female; Follow-Up Studies; Fossil Fuels; Gases; Humans; Male; Nitrogen Dioxide; Respiratory Tract Diseases

We examined the relation between lung function and respiratory illness in a population of 808 primary school children aged 6-7 years and the levels of nitrogen dioxide (NO2) in the kitchens and bedrooms in their homes. Complete data were collected on about 66% of the population. The children lived in a defined 4 square km area in Middlesbrough, Cleveland, UK. One week average outdoor levels of NO2 varied little over the area (14-24 ppb); The prevalence of respiratory illness was higher in children from gas than electric cooking homes (p approximately or equal to 0.1). Although prevalence was not related to kitchen NO2 levels (range 5-317 ppb) it increased with increasing levels of NO2 in the children's bedrooms in gas cooking homes (range 4-169 ppb, p approximately or equal to 0.1). Symptoms in siblings and parents were not related to kitchen NO2 levels. Lung function was not related to NO2 levels in the kitchen or bedroom. Because of the very low levels of NO2 at which an association with illness was observed and the inconsistency between our results in the UK and those from several studies in the US, it is possible that the NO2 levels were a proxy for some other factor more directly related to respiratory disease such as temperature or humidity.

Topics: Air Pollutants; Child; Cooking; Electricity; England; Female; Fossil Fuels; Health Surveys; Humans; Humidity; Lung; Male; Nitrogen Dioxide; Respiratory Tract Diseases; Social Class; Time Factors

Topics: Air Pollution; Child; Cooking; Electricity; Fossil Fuels; Humans; Nitrogen Dioxide; Respiratory Tract Diseases

Eight adult male volunteers were exposed to ozone (O3) alone and then in combination with nitrogen dioxide and carbon monoxide under conditions simulating ambient air pollution exposures. Four "normal" men showed few or no effects from repeated exposures. Four male volunteers with a history of "hyperreactive" airways, but with normal base line pulmonary function spirometric studies, after O3 exposure developed definite symptoms and decrement in pulmonary function.

Topics: Adult; Air Pollutants; Carbon Dioxide; Dose-Response Relationship, Drug; Environmental Exposure; Forced Expiratory Flow Rates; Humans; Lung Compliance; Lung Volume Measurements; Male; Middle Aged; Nitrogen Dioxide; Ozone; Pulmonary Diffusing Capacity; Respiratory Function Tests; Respiratory System; Respiratory Tract Diseases; Smoking

Adult male volunteers were exposed to ozone (O3) at 0.25, 0.37, or 0.50 ppm, and to O3 in combination with nitrogen dioxide (NO2) and carbon monoxide (CO), with secondary stresses of heat, intermittent light exercise, and repeated exposure. Few important physiological changes, and only mild symptoms, were found with 0.25 ppm O3, with 0.25 ppm 03 plus 0.30 ppm NO2, or when 30 ppm CO was added to the latter mixture. With 0.37 ppm O3, more symptoms were present and some subjects developed definite decreases in pulmonary function. With 0.50 ppm O3, most subjects had symptoms and about half showed substantial pulmonary function decrement. In reactive subjects exposed on two successive days, changes were usually greater the second day, indicating that effects of successive exposures were cumulative.

Topics: Adult; Air Pollutants; Analysis of Variance; Asthma; Carbon Dioxide; Environmental Exposure; Humans; Hypersensitivity; Male; Nitrogen Dioxide; Ozone; Respiratory Function Tests; Respiratory System; Respiratory Tract Diseases; Smoking

Topics: Air Pollution; California; Carbon Monoxide; Disease Susceptibility; Environmental Exposure; Female; Gastroenteritis; Health Surveys; Humans; Humidity; Hydrocarbons; Male; Morbidity; Nitric Oxide; Nitrogen Dioxide; Oxidation-Reduction; Respiratory Tract Diseases; Sampling Studies; Seasons; Smoking; Sports; Student Health Services; Students; Sulfur Dioxide; Temperature; Time Factors; Weather

Topics: Air Pollution; Carbon Monoxide; Environmental Health; Mortality; Neoplasms; Nitrogen Dioxide; Respiratory Tract Diseases; Sulfur Dioxide; Switzerland; United States; Weather

Topics: Air Pollution; Environmental Exposure; Environmental Health; Humans; Maximum Allowable Concentration; Nitrates; Nitrogen Dioxide; Respiratory Tract Diseases; Sulfur Dioxide; Sulfuric Acids; Tennessee

Topics: Age Factors; Air Movements; Air Pollution; Atmospheric Pressure; Carbon Monoxide; Government Agencies; Health Occupations; Humans; Nitrogen Dioxide; Nitrogen Oxides; Respiratory Tract Diseases; Sulfoxides; Sulfur Dioxide; Sunlight; Vehicle Emissions; Weather

Topics: Aged; Air Pollution; Cardiovascular Diseases; Environmental Health; Environmental Pollution; Female; Humans; Male; Middle Aged; Neoplasms; Nitrogen Dioxide; Respiratory Tract Diseases; Sulfur Dioxide; Switzerland

Topics: Air Pollution; Bronchitis; California; Carbon Monoxide; Cough; Dust; Environmental Exposure; Expectorants; Female; Humans; Hydrocarbons; Male; Middle Aged; Nitric Oxide; Nitrogen Dioxide; Respiratory Tract Diseases; Sex Factors; Smoking; Social Class; Spirometry; Sulfur Dioxide; Time Factors; Vital Capacity

Topics: Animals; Bronchitis; Chronic Disease; Cricetinae; Disease Models, Animal; Lung; Lung Diseases; Nitrogen Dioxide; Papain; Pneumonia; Pulmonary Emphysema; Respiratory Tract Diseases; Trachea

Topics: Air Pollution; Environmental Health; Humans; Hydrocarbons; Nitrogen Dioxide; Ozone; Public Health Administration; Respiratory Tract Diseases; Vehicle Emissions

Topics: Air Pollution; Animals; Dogs; Guinea Pigs; Haplorhini; Humans; Mice; Nitrogen Dioxide; Rabbits; Respiratory Tract Diseases

Topics: Cadmium; Environmental Exposure; Fluorides; Humans; Nitrogen Dioxide; Occupational Diseases; Oxides; Pulmonary Edema; Respiratory Tract Diseases; Silver

Topics: Air Pollution; Child; Disease Outbreaks; Environmental Exposure; Female; Humans; Influenza, Human; Male; Mass Screening; Nitrogen Dioxide; Respiratory Tract Diseases; Respiratory Tract Infections; Tennessee

Topics: Accidents, Occupational; Adult; Bronchitis; Elasticity; Environmental Exposure; Hospitalization; Humans; Lung; Lung Compliance; Male; Middle Aged; Mining; Nitrogen Dioxide; Occupational Diseases; Radiography, Thoracic; Respiratory Tract Diseases; Spirometry; Time Factors

Topics: Animals; Nitrogen Dioxide; Rats; Respiration; Respiratory Tract Diseases

Topics: Humans; Nitrogen Dioxide; Respiratory Tract Diseases