Assessment of Air Pollution Impacts on Population Health in Bejaia City, Northern Algeria.

To assess the health impact of air pollution on Bejaia population in the north of Algeria, we carried out a descriptive epidemiologic inquiry near the medical establishments of three areas.From hospital admissions registers, we collected data on the hospital mortality and admissions relating to the various cardiorespiratory pathologies generated by this type of pollution. In parallel, data on the automobile fleet of Bejaia and other measurements were exploited to show that the pollutants concentrations are strongly correlated with the urban traffic concentration.This study revealed that the whole of the population is touched, but the sensitivity to pollution can show variations according to the age, the sex and the residence place. Population of Bejaia town marked the most raised death and morbidity rates, followed by that of Kherrata. Weak rates are recorded for the rural population of Feraoun. Stronger correlation (>0.9) is evident amongst CO and deaths due to asthma and COPD in Béjaia city.This approach enables us to conclude that the population of Béjaia could not escape the urban pollution generated by her old automobile fleet. Installation of a monitoring and measuring site of air pollution in this city could provide a beneficial tool to protect its inhabitants by informing on air quality they breathe and the measures to following order to minimize the impacts on their health and by alerting the authorities during the critical situations

Chapter 5. Health consequences in the Mediterranean region

The Mediterranean basin is highly vulnerable to climate change, and a warming trend with changes in rainfall patterns with more heavy rains has already been observed. The frequency of dust storm and wildfire has also increased. Both non-communicable and communicable diseases will be seriously impacted by climate change since climate modification or air pollution influence the development of the former and weather conditions the latter. Different socioeconomic characteristics within the Mediterranean basin will also exacerbate or on the contrary reduce health outcomes. Surprisingly few quantitative studies have explored the impacts of climate change on health in the Mediterranean region, and the few are geographically limited to specific areas of the basin. Here we review the scientific literature on this topic and make some recommendations for the development of national and regional research, preparedness and adaptation policy in the Mediterranean region.La zone méditerranéenne est très exposée aux changements climatiques, et un réchauffement régional de la température avec une modification du régime des pluies, généralement plus fortes, est actuellement observé. Les tempêtes de sable et les incendies non contrôlés sont en augmentation. Les maladies infectieuses et chroniques humaines peuvent être affectées par ces bouleversements de façon directe ou indirecte; les conditions bioclimatiques conditionnent le développement des agents pathogènes et de leurs hôtes vecteurs ou réservoirs; les modifications du climat ou la pollution atmosphérique qui en dérive ont une influence sur le développement de certaines maladies chroniques. Des déterminants, en particulier socio-économiques, prévalant ou en évolution dans la zone méditerranéenne affecteront aussi la santé de la population. Curieusement, peu de travaux scientifiques ont étudié les effets des changements climatiques sur la santé humaine dans la région, et les quelques rares études restent géographiquement limitées à des zones particulières du bassin méditerranéen. Dans ce chapitre, nous synthétisons la recherche réalisée dans le domaine, et proposons des recommandations en termes de recherches scientifiques nationales et régionales, et de stratégies de préparation et d’adaptation à ce nouveau contexte

The impact of cold on the respiratory tract and its consequences to respiratory health

Abstract The increasing use, and sometimes the abuse, particularly in industrialized countries of air conditioning at home, in car, hotel and shopping centres has highlighted new emerging public health issues, resulting from exposure of the airways to cool air or, more properly, resulting from sudden temperature changes. This is part of a wider problem, relating to air quality in indoor environment, such as homes or offices, where people spend more than 90% of their time. In particular, if indoor exposure occurs quickly and without any gradual adaptation to a temperature 2°–3° lower than the external temperature and especially with a 5° difference (avoiding indoor temperature below 24°) and an humidity between 40 and 60%, there is a risk of negative consequences on the respiratory tract and the patient risks to be in a clinical condition characterized by an exacerbation of the respiratory symptoms of his chronic respiratory disease (asthma and COPD) within a few hours or days. Surprisingly, these effects of cold climate remain out of the focus of the media unless spells of unusually cold weather sweep through a local area or unstable weather conditions associated with extremely cold periods of increasing frequency and duration. Moreover, the energy consumed by air conditioning induces an increase of CO2 in atmosphere with increase of global warming. There is a need to better define the consequences of repeated exposure to cold air and the mechanisms by which such exposure could modify airway function and affect the outcomes of patients with pre-existing airway disease. This could help to promote adequate policy and public health actions to face the incoming challenges induced by climate change and global warming

Concentration and determinants of molds and allergens in indoor air and house dust of French dwellings

International audienceMolds and allergens are common indoor biocontaminants. The aims of this study were to assess the concentrations of common molds in indoor air and floor dust and the concentrations of house dust mite, cat and dog allergens in mattress dust in French dwellings, and to assess predictors of these concentrations. A sample of 150 houses in Brittany (western France) was investigated. Airborne Cladosporium and Penicillium were detected in more than 90% of the dwellings, Aspergillus in 46% and Alternaria in only 6% of the housings. Regarding floor dust samples, Cladosporium and Penicillium were detected in 92 and 80% of the housings respectively, Aspergillus in 49% and Alternaria in 14%. House dust mite allergens Der p1 and Der f1 were detected in 90% and 77% of the mattress dust samples respectively and Can f1 and Fel d1 in 37% and 89% of the homes. Airborne and dustborne mold concentrations, although not statistically correlated (except for Aspergillus) shared most of their predictors. Multivariate linear models for mold levels, explaining up to 62% of the variability, showed an influence of the season, of the age of the dwelling, of aeration habits, presence of pets, smoking, signals of dampness, temperature and relative humidity. Allergens in the dust of the mattress were strongly related to the presence of pets and cleaning practices of bedsheets, these factors accounting for 60% of the variability. This study highlights ubiquitous contamination by molds and underlines complex interaction between outdoor and indoor sources and factor

[Thunderstorm and asthma outbreaks during pollen season]

An increasing body of evidence shows the occurrence of asthma epidemics, sometimes also severe, during thunderstorms in the pollen season in various geographical zones. The main hypothesis explaining association between thunderstorms and asthma claims that thunderstorms can concentrate pollen grains at ground level; these grains may then release allergenic particles of respirable size in the atmosphere after their rupture by osmotic shock. During the first 20-30 minutes of a thunderstorm, patients suffering from pollen allergy may inhale a high concentration of the allergenic material dispersed into the atmosphere, which can, in turn, induce asthmatic reactions, often severe. Subjects without asthma symptoms but affected by seasonal rhinitis can also experience an asthma attack. All subjects affected by pollen allergy should be alerted to the danger of being outdoors during a thunderstorm in the pollen season, as such events may be an important cause of severe bronchial obstruction. Considering this background, it is useful to predict thunderstorms during pollen season and, thus, to prevent thunderstorm-related clinical event. However, it is also important to focus on therapy, and it is not sufficient that subjects at risk of asthma follow a correct therapy with bronchodilators, but they also need to inhale corticosteroids, using both in case of emergency

Establishing a sorting protocol for healthcare databases

Background: Health information records in many countries, especially developing countries, are still paper based. Compared to electronic systems, paper-based systems are disadvantageous in terms of data storage and data extraction. Given the importance of health records for epidemiological studies, guidelines for effective data cleaning and sorting are essential. They are, however, largely absent from the literature. The following paper discusses the process by which an algorithm was developed for the cleaning and sorting of a database generated from emergency department records in Lebanon.Design and methods: Demographic and health related information were extracted from the emergency department records of three hospitals in Beirut. Appropriate categories were selected for data categorization. For health information, disease categories and codes were selected according to the International Classification of Disease 10th Edition.Results: A total of 16,537 entries were collected. Demographic information was categorized into groups for future epidemiological studies. Analysis of the health information led to the creation of a sorting algorithm which was then used to categorize and code the health data. Several counts were then performed to represent and visualize the data numerically and graphically.Conclusions: The article describes the current state of health information records in Lebanon and the associated disadvantages of a paper-based system in terms of storage and data extraction. Furthermore, the article describes the algorithm by which health information was sorted and categorized to allow for future data analysis using paper records

Climate change and air pollution Effects on pollen allergy and other allergic respiratory diseases

The observational evidence indicates that recent regional changes in climate, particularly temperature increases, have already affected a diverse set of physical and biological systems in many parts of the world. Allergens patterns are also changing in response to climate change and air pollution can modify the allergenic potential of pollen grains especially in the presence of specific weather conditions. Although genetic factors are important in the development of asthma and allergic diseases, their rising trend can be explained only by changes occurring in the environment and urban air pollution by motor vehicles has been indicated as one of the major risk factors responsible for this increase. Despite some differences in the air pollution profile and decreasing trends of some key air pollutants, air quality is an important concern for public health in the cities throughout the world. Due to climate change, air pollution patterns are changing in several urbanized areas of the world with a significant effect on respiratory health. The underlying mechanisms of all these interactions are not well known yet. The consequences on health vary from decreases in lung function to allergic diseases, new onset of diseases, and exacerbation of chronic respiratory diseases. In addition, it is important to recall that an individual’s response to pollution exposure depends on the source and components of air pollution, as well as meteorological conditions. Indeed, some air pollution-related incidents with asthma aggravation do not depend only on the increased production of air pollution, but rather on atmospheric factors that favor the accumulation of air pollutants at ground level. Associations between thunderstorms and asthma morbidity of pollinosis-affected people have also been identified in multiple locations around the world (Fig.1). Cite this as D’Amato G, Bergmann KC, Cecchi L, Annesi-Maesano I, Sanduzzi A, Liccardi G, Vitale C, Stanziola A, D’Amato M. Climate change and air pollution — Effects on pollen allergy and other allergic respiratory diseases. Allergo J Int 2014; 23: 17–23 DOI 10.1007/s40629-014-0003-7 A factor clouding the problem is that laboratory evaluations do not reflect what happens during natural exposition. Considering these aspects, governments worldwide, international organizations, and cooperations such as the World Health Organization (WHO) and the European Health Policy of the European Union (EU) are facing a growing problem of the respiratory effects induced by gaseous and particulate pollutants arising from motor vehicle emissions

In utero and childhood exposure to parental tobacco smoke, and allergies in schoolchildren

SummaryAmong early-life environmental factors, parental smoking (ETS) has been associated with adverse respiratory outcomes in children. The aim of the study was to evaluate whether parental smoking might lead to asthma and allergies taking into account family history of asthma, personal atopy, breast feeding as confounders and owing pets and day-care during the first 6 months of life as modifiers. About 9000 children of fourth and fifth grade were selected in six cities of France. About 7798 answered an epidemiological questionnaire, underwent a medical examination including skin prick test positivity to common allergens, skin examination for eczema, and run test to assess exercise-induced asthma (EIA). Prevalence of allergies was, respectively, 25.2% for eczema, 12.9% for rhinitis, 9.9% for asthma and 25% for atopy. About 8.3% had an EIA. About 21.6% of children were exposed to maternal tobacco smoking during pregnancy. Maternal smoking, in utero and later, was significantly related to lifetime wheezing (odds ratio (OR): 1.24[1.10–1.56]) and asthma (OR: 1.22[1.04–1.66]). There was no association between atopy, rhinitis, eczema and parental smoking, respectively. ETS remains a risk factor of wheezing in childhood. Counselling parents of children to quit smoking still remains a public health policy

COVID-19 lockdown related to decrease in premature birth rate and increase in birth weight in metropolitan France

IntroductionThe worldwide rate of preterm birth (PTB) has been increasing over the last two decades. COVID-19 lockdowns provide a unique opportunity to assess the effects of socioenvironmental and lifestyle factors on premature birth and birth weight. We explored the effects of COVID-19 lockdowns on the PTB rate and birth weight at a nationwide scale in France until one year after their occurrence.Material and MethodsThis national retrospective observational study evaluated the rate of PTB and birth weight in France from January 2016 to December 2020. Data were obtained from the national Programme Médicalisé des Systèmes d'Information database. The rates of global and sub-categories of PTB were tested. The birth weight was studied before and after lockdown for all live births, for term and premature neonates, and for each category of low birth weight (LBW) by a stratified analysis.ResultsData from 2,949,372 births from January 2016 to December 2019, including 228,857 PTB, were compared to those of 699,344 births and 51,886 PTB from January to December 2020. The national rate of PTB decreased significantly from 7.7% to 7.3%, when compared with the 2016–2019 period. This decrease was persistent up to 9 months later. It was observed only for moderate PTB, whereas very PTB and extremely PTB remained stable. The national mean birth weight for full-term babies increased after the lockdown and was still observable up to 8 months later (+0.16%, p < 0.0001). The proportion of children with LBW also decreased 2 months after lockdown (−0.15%; p = 0.02). For VLBW, the difference only appeared over the 6-month post-lockdown period (−0.06%; p = 0.006).ConclusionThis nationwide study shows a significant reduction in prematurity and a significant increase in birth weight in France after the lockdown for a period of time not limited to the lockdown itself. A more in-depth study of the factors determining these variations may help to drive PTB prevention policies

Climate Change, Migration, and Allergic Respiratory Diseases: An Update for the Allergist

Local climate changes can impact on a number of factors, including air pollution, that have been shown to influence both the development and attacks of allergic respiratory diseases, and they thus represent an important consideration for the allergist. Migration involves exposure to a new set of pollutants and allergens and changes in housing conditions, diet and accessibility to medical services, all of which are likely to affect migrants' health. This review provides an update on climate change, migration, and allergy and discusses factors for consideration when making recommendations for local allergy service provision, and for assessing an individual patient's environmental exposures