Urban versus rural health impacts attributable to PM2.5 and O3 in northern India

Ambient air pollution in India contributes to negative health impacts and early death. Ground-based monitors often used to quantify health impacts are located in urban regions, yet approximately 70% of India's population lives in rural communities. We simulate high-resolution concentrations of fine particulate matter (PM) and ozone from the regional Community Multi-scale Air Quality model over northern India, including updated estimates of anthropogenic emissions for transportation, residential combustion and location-based industrial and electrical generating emissions in a new anthropogenic emissions inventory. These simulations inform seasonal air quality and health impacts due to anthropogenic emissions, contrasting urban versus rural regions. For our northern India domain, we estimate 463 200 (95% confidence interval: 444 600–482 600) adults die prematurely each year from PM2.5 and that 37 800 (28 500–48 100) adults die prematurely each year from O3. This translates to 5.8 deaths per 10 000 attributable to air pollution out of an annual rate of 72 deaths per 10 000 (8.1% of deaths) using 2010 estimates. We estimate that the majority of premature deaths resulting from PM2.5 and O3 are in rural (383 600) as opposed to urban (117 200) regions, where we define urban as cities and towns with populations of at least 100 000 people. These findings indicate the need for rural monitoring and appropriate health studies to understand and mitigate the effects of ambient air pollution on this population in addition to supporting model evaluation

Integrated genomic approaches implicate osteoglycin (Ogn) in the regulation of left ventricular mass

Left ventricular mass (LVM) and cardiac gene expression are complex traits regulated by factors both intrinsic and extrinsic to the heart. To dissect the major determinants of LVM, we combined expression quantitative trait locus1 and quantitative trait transcript (QTT) analyses of the cardiac transcriptome in the rat. Using these methods and in vitro functional assays, we identified osteoglycin (Ogn) as a major candidate regulator of rat LVM, with increased Ogn protein expression associated with elevated LVM. We also applied genome-wide QTT analysis to the human heart and observed that, out of 22,000 transcripts, OGN transcript abundance had the highest correlation with LVM. We further confirmed a role for Ogn in the in vivo regulation of LVM in Ogn knockout mice. Taken together, these data implicate Ogn as a key regulator of LVM in rats, mice and humans, and suggest that Ogn modifies the hypertrophic response to extrinsic factors such as hypertension and aortic stenosi

Urban versus rural health impacts attributable to PM2.5 and O3 in northern India

Ambient air pollution in India contributes to negative health impacts and early death. Ground-based monitors often used to quantify health impacts are located in urban regions, yet approximately 70% of India's population lives in rural communities. We simulate high-resolution concentrations of fine particulate matter (PM) and ozone from the regional Community Multi-scale Air Quality model over northern India, including updated estimates of anthropogenic emissions for transportation, residential combustion and location-based industrial and electrical generating emissions in a new anthropogenic emissions inventory. These simulations inform seasonal air quality and health impacts due to anthropogenic emissions, contrasting urban versus rural regions. For our northern India domain, we estimate 463 200 (95% confidence interval: 444 600–482 600) adults die prematurely each year from PM2.5 and that 37 800 (28 500–48 100) adults die prematurely each year from O3. This translates to 5.8 deaths per 10 000 attributable to air pollution out of an annual rate of 72 deaths per 10 000 (8.1% of deaths) using 2010 estimates. We estimate that the majority of premature deaths resulting from PM2.5 and O3 are in rural (383 600) as opposed to urban (117 200) regions, where we define urban as cities and towns with populations of at least 100 000 people. These findings indicate the need for rural monitoring and appropriate health studies to understand and mitigate the effects of ambient air pollution on this population in addition to supporting model evaluation

Modelling street level PM10 concentrations across Europe: source apportionment and possible futures

Despite increasing emission controls, particulate matter (PM) has remained a critical issue for European air quality in recent years. The various sources of PM, both from primary particulate emissions as well as secondary formation from precursor gases, make this a complex issue to tackle. In order to allow for credible predictions of future concentrations under policy assumptions, a modelling approach is needed that considers all chemical processes and spatial dimensions involved, from hemispheric background to local street canyons. Here we describe a modelling scheme which has been implemented in the GAINS integrated assessment model to assess compliance with PM10 limit values at individual air quality monitoring stations. The modelling approach relies on a combination of bottom up modelling of emissions, simplified atmospheric chemistry and dispersion calculations, and a traffic increment calculation wherever applicable. At each monitoring station fulfilling a few data coverage criteria, measured concentrations in the base year 2009 are explained to the extent possible and then modelled for the past and future. More than 1850 monitoring stations are covered, including more than 300 traffic stations and 80 % of the stations which violated the limit values in 2009. As a validation, we compare modelled trends in the period 2000–2008 to observations, which are well reproduced. The station modelling scheme is applied here to quantify explicitly source contributions to ambient concentrations at a subset of monitoring stations, and we undertake an outlook on the predicted evolution of PM10 concentrations until 2030 under different policy scenarios. Significant improvements in ambient PM10 concentrations are expected already under the assumption of successful implementation of already agreed legislation; however, these will not be large enough to ensure attainment of PM10 standards in hot spot locations such as Southern Poland and major European cities. Remaining issues are largely eliminated in a scenario applying to the maximal technically feasible extent the best available emission control technologies.JRC.H.2-Air and Climat

Cardiac defibrillation therapy for at risk patients with systemic right ventricular dysfunction secondary to atrial redirection surgery for dextro-transposition of the great arteries

AIM: To review techniques of implantable cardioverter-defibrillators (ICD) in patients after Mustard surgery for arterial transposition. METHODS AND RESULTS: Retrospective analysis of all Mustard patients receiving ICDs at our institution. Five patients (median age 24 years, range 19-35, 3 male) with systemic right ventricular dysfunction (sRV) dysfunction and New York Heart Association (NYHA) II and III, received ICDs. Implantation was performed transvenously in three patients, epicardial patches and subcutaneous arrays at surgery in two patients. Two patients required lead extraction and baffle stent angioplasty before ICD implantation. Defibrillation vectors incorporating the anterior sRV mass [i.e., sub-pulmonary left ventricle (pLV) to generator can, and between epicardial defibrillator patches], consistently achieved a minimum 10 joule(J) safety margin during defibrillation threshold (DFT) testing. Subcutaneous arrays and endocardial vectors that included a superior vena cava (SVC) electrode were less effective. One patient developed pulmonary oedema post-procedure. At a median 20 months, all patients were alive and in NYHA class II. Follow-up over 24 months documented multiple non-sustained ventricular tachycardia (VT) in the group and one patient had recurrent VT with aborted device therapy. CONCLUSION: Defibrillator implantation in Mustard patients is challenging. Sub-optimal defibrillation should be anticipated and can be overcome using vectors which integrate the RV mass and high-energy devices. A staged procedure involving pre-implant interventions or separate DFT tests, where indicated, may be better tolerated by patients

Managing future air quality in megacities: A case study for Delhi

Abstract Megacities in Asia rank high in air pollution at the global scale. In many cities, ambient concentrations of fine particulate matter (PM2.5) have been exceeding both the WHO interim targets as well as respective national air quality standards. This paper presents a systems analytical perspective on management options that could efficiently improve air quality at the urban scale, having Delhi as a case study. We employ the newly developed GAINS-City policy analysis framework, consisting of a bottom up emission calculation combined with atmospheric chemistry-transport calculation, to derive innovative insights into the current sources of pollution and their impacts on ambient PM2.5, both from emissions of primary PM as well as precursors of secondary inorganic and organic aerosols. We outline the likely future development of these sources, quantify the related ambient PM2.5 concentrations and health impacts, and explore potential policy interventions that could effectively reduce environmental pollution and resulting health impacts in the coming years. The analysis demonstrates that effective improvement of Delhi's air quality requires collaboration with neighboring States and must involve sources that are less relevant in industrialized countries. At the same time, many of the policy interventions will have multiple co-benefits on development targets in Delhi and its neighboring States. Outcomes of this study, as well as the modelling tools used herein, are applicable to other urban areas and fast growing metropolitan zones in the emerging Asian regions