Effect modification of the short-term effects of air pollution on morbidity by season: A systematic review and meta-analysis

Studies of the health effects of air pollution have traditionally controlled for ambient temperature as a confounder, and vice versa. However, season might be an important factor contributing to adverse health effects of air pollution. Given the current inconsistencies in results of previous studies on the effect modification of air pollution on morbidity by season, a systematic review and meta-analysis was conducted to synthesize the current evidence on effects of season on air pollution and morbidity. The electronic databases including PubMed, Web of Science, Embase, CNKI, and Wanfang were used to identify papers published up to the 30st of November in 2019. We identified 4284 articles, after screening, eighty papers met the inclusion criteria. Significant effect modification of CO, O3, SO2 and NO2 on morbidity by season was observed, with corresponding ratio of relative risk of 1.0009 (95% CI: 1.0001–1.0018), 1.0080 (95% CI: 1.0021–1.0138), 0.9828 (95% CI: 0.9697–0.9962) and 0.9896 (95% CI: 0.9824–0.9968), respectively. Season significantly modified the effect of CO on pneumonia, the effect of SO2 on cardiovascular disease, the effect of PM10 on stroke, and the effect of O3 on stroke, asthma and pneumonia. The effect modifications of air pollution by season were similar among males and females, while the effect estimates seem to be higher among children under 18 years old and the elderly aged 75 or over. Further research is needed to better understand the mechanisms underlying the seasonal variance of the effect of air pollutants on morbidity

Global Associations of Air Pollution and Conjunctivitis Diseases: A Systematic Review and Meta-Analysis

(1) Background: As the most common eye disease diagnosed in emergency departments, conjunctivitis has caused serious health and economic burdens worldwide. However, whether air pollution may be a risk factor for conjunctivitis is still inconsistent among current evidence. (2) Methods: We searched the literature on the relationship between air pollution and conjunctivitis in multiple English databases before 18 March 2019. Meta-analysis, meta-regression, and funnel plots were used to integrate the data, identify the sources of bias, and determine the publication bias, respectively. (3) Results: A total of 2450 papers were found, 12 of which were finally included. The pooled relative risk for each 10 μg/m3 increase of air pollution on conjunctivitis was 1.0006 (95%CI: 0.9993–1.0019) for CO, 1.0287 (1.0120–1.0457) for NO2, 1.0089 (1.0030–1.0149) for O3, 1.0004 (0.9976–1.0032) for PM2.5, 1.0033 (0.9982–1.0083) for PM10, and 1.0045 (0.9908–1.0185) for SO2. In the subgroup, PM2.5 and O3 had a greater impact on conjunctivitis risk in women than in men, and people <18 years old than those ≥18 years old. Relative humidity significantly modified the risk of O3 on conjunctivitis (p = 0.023), explaining 45% of the between-study heterogeneity. (4) Conclusion: Globally, air pollution has considerable health risks for conjunctivitis. Females and the youth were more vulnerable to PM2.5, NO2, and O3. Reductions of air pollution levels are still warranted to protect the vulnerable populations

Ammonia emissions from a representative in-use fleet of vehicles in Guangzhou

Emission rates of ammonia (NH3) are reported for a fleet of 130 light-, medium-, and heavy-duty vehicles recruited in Guangzhou, China. NH3 measurements were performed using Nessler's Reagents spectrophotometry and nationwide standard chassis dynamometer test cycles required by Chinese EPA. Emissions of CO and NOx were also measured during these test cycles. Emission factors of NH3 were calculated for each type of vehicle and used to estimate the total emissions of NH3 from motor vehicles in Guangzhou (GZ) in 2009. Emission factors of NH3 show large variations among different categories of vehicles, with a range from 4 to 138 mg km-1. The average emissions of NH3 in Guangzhou in 2009 were estimated to be 983 t, with a range from 373 to 2136 t. In addition, it was found that vehicles with the highest NH3 emission rates possess the following characteristics: mediumand heavy-duty vehicles, certified with out-of-date emission standards, mid-range odometer readings, and higher CO and NOx emission rates. The results of this study will be useful for developing NH3 emissions inventories in Guangzhou and other urban areas in China

Heatwave and mortality in 31 major Chinese cities: Definition, vulnerability and implications

Few data are available on the health impacts of heatwaves in China, and in particular, the heatwave definition and vulnerable populations remain to be identified. We collected data on daily maximum temperature and mortality from 31 Chinese capital cities during 2007–2013. A Poisson regression model allowing for over-dispersion was applied to estimate the short-term effects of heatwaves on mortality in hot season (May–September). 15 heatwave definitions combining five heat thresholds (90.0th, 92.5th, 95th, 97.5th and 99th percentiles of daily maximum temperature) and three durations (≥2, ≥3 and ≥4 days) were compared. The pooled effects were then computed using random effect meta-analysis based on the residual maximum likelihood estimation. Effect modification of heatwave-mortality association by individual-level characteristics was tested using a stratified analysis. Potential effect modification by city-level characteristics was examined by meta-regression analysis. Totally, 259 million permanent residents were covered and 4,481,090 non-accidental deaths occurred during the study period. Generally, the magnitude of heatwave impacts increased by intensities and durations of the heatwaves. Heatwave definition using daily maximum temperature ≥ 92.5th percentile with duration ≥3 days produced the best model fit. The pooled relative risks of heatwaves on non-accidental mortality at lag 0, lag 0–2 and lag 0–10 days were 1.06 (95%CI: 1.03–1.09), 1.09 (1.05–1.13) and 1.10 (1.05–1.15), respectively. Compared with non-accidental mortality, higher effect estimates of heatwaves were observed among deaths from ischemic heart diseases, stroke and respiratory diseases, although the differences were not statistically significant. Females, those ≥75 years old and the illiterates were more vulnerable to heatwaves. Cities with higher concentrations of PM2.5, higher latitudes, and lower numbers of hospital beds per 10,000 populations had higher mortality risks during heatwaves. These findings may have important implications for developing heat alert systems and early response actions on protecting the vulnerable populations from adverse health effects of heatwave in China.</p

Mortality Risk and Burden From a Spectrum of Causes in Relation to Size-Fractionated Particulate Matters: Time Series Analysis

BackgroundThere is limited evidence regarding the adverse impact of particulate matters (PMs) on multiple body systems from both epidemiological and mechanistic studies. The association between size-fractionated PMs and mortality risk, as well as the burden of a whole spectrum of causes of death, remains poorly characterized. ObjectiveWe aimed to examine the wide range of susceptible diseases affected by different sizes of PMs. We also assessed the association between PMs with an aerodynamic diameter less than 1 µm (PM1), 2.5 µm (PM2.5), and 10 µm (PM10) and deaths from 36 causes in Guangzhou, China. MethodsDaily data were obtained on cause-specific mortality, PMs, and meteorology from 2014 to 2016. A time-stratified case-crossover approach was applied to estimate the risk and burden of cause-specific mortality attributable to PMs after adjusting for potential confounding variables, such as long-term trend and seasonality, relative humidity, temperature, air pressure, and public holidays. Stratification analyses were further conducted to explore the potential modification effects of season and demographic characteristics (eg, gender and age). We also assessed the reduction in mortality achieved by meeting the new air quality guidelines set by the World Health Organization (WHO). ResultsPositive and monotonic associations were generally observed between PMs and mortality. For every 10 μg/m3 increase in 4-day moving average concentrations of PM1, PM2.5, and PM10, the risk of all-cause mortality increased by 2.00% (95% CI 1.08%-2.92%), 1.54% (95% CI 0.93%-2.16%), and 1.38% (95% CI 0.95%-1.82%), respectively. Significant effects of size-fractionated PMs were observed for deaths attributed to nonaccidental causes, cardiovascular disease, respiratory disease, neoplasms, chronic rheumatic heart diseases, hypertensive diseases, cerebrovascular diseases, stroke, influenza, and pneumonia. If daily concentrations of PM1, PM2.5, and PM10 reached the WHO target levels of 10, 15, and 45 μg/m3, 7921 (95% empirical CI [eCI] 4454-11,206), 8303 (95% eCI 5063-11,248), and 8326 (95% eCI 5980-10690) deaths could be prevented, respectively. The effect estimates of PMs were relatively higher during hot months, among female individuals, and among those aged 85 years and older, although the differences between subgroups were not statistically significant. ConclusionsWe observed positive and monotonical exposure-response curves between PMs and deaths from several diseases. The effect of PM1 was stronger on mortality than that of PM2.5 and PM10. A substantial number of premature deaths could be preventable by adhering to the WHO’s new guidelines for PMs. Our findings highlight the importance of a size-based strategy in controlling PMs and managing their health impact

Hydroxyapatite Crystal Formation in the Presence of Polysaccharide

Natural polysaccharides play an important role in the formation of nanohydroxyapatite (nHA) crystals in biological systems. In this study, we synthesized nHA crystals in the presence of four polysaccharides, i.e., pectin, carrageenan, chitosan, and amylose, referred as PeHA, CaHA, CsHA, and AmHA, respectively. X-ray diffraction, Fourier transform infrared spectroscopy, transmission electron microscopy, scanning electron microscope, and thermogravimetric analysis were used to investigate the formation of nHA crystals. The shape of prepared nHA crystals is needle/rod-like in all cases, whereas the size increases in the order of PeHA, CaHA, CsHA, and AmHA. The presence of polysaccharides induces the heterogeneous nucleation of nHA and further modulates the crystal growth. Our data suggest that the interaction intensity between nHA and polysaccharides is in the decreasing order of PeHA, CaHA, CsHA, and AmHA, resulting in the smallest nHA crystals with pectin. It is also demonstrated that a high polysaccharide concentration and short reaction time are adverse to nHA crystals, especially for the polysaccharides with carboxyl groups. This study can provide insight into the effects of polysaccharides with different chemical functional groups (−COOH, −OSO₃H, −NH₂, −OH) on the formation of nHA crystals