Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases:A prospective cohort study in Australia

Background: Short- and long-term spatiotemporal variation in exposure to air pollution is associated with respiratory morbidity in areas with moderate-to-high level of air pollution, but very few studies have examined whether these associations also exist in areas with low level exposure. Objectives: We assessed the association between spatial variation in long-term exposure to PM and NO and hospitalisation for all respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), and pneumonia, in older adults residing in Sydney, Australia, a city with low-level concentrations. Methods: We recorded data on hospitalisations for 100,084 participants, who were aged >45 years at entry in 2006–2009 until June 2014. Annual NO and PM concentrations were estimated for the participants’ residential addresses and Cox proportional hazards regression was used to model the association between exposure to air pollutants and first episode of hospitalisation, controlling for personal and area level covariates. We further investigated the shape of the exposure-response association and potential effect modification by age, sex, education level, smoking status, and BMI. Results: NO and PM annual mean exposure estimates were 17.5 μg·m and 4.5 μg·m respectively. NO and PM was positively, although not significantly, associated with asthma. The adjusted hazard ratio for a 1 μg·m increase in PM was 1.08, 95% confidence interval 0.89–1.30. The adjusted hazard ratio for a 5 μg·m increase in NO was 1.03, 95% confidence interval 0.88–1.19. We found no positive statistically significant associations with hospitalisation for all respiratory diseases, and pneumonia while negative associations were observed with COPD. Conclusions: We found weak positive associations of exposure to air pollution with hospitalisation for asthma while there was no evidence of an association for all respiratory diseases

“Supposing that truth is a woman, what then?” The Lie Detector, The Love Machine and the Logic of Fantasy

One of the consequences of the public outcry over the 1929 St Valentine’s Day massacre was the establishment of a Scientific Crime Detection Laboratory at Northwestern University. The photogenic “Lie Detector Man”, Leonarde Keeler, was the Laboratory’s poster boy and his instrument the jewel in the crown of forensic science. The press often depicted Keeler gazing at a female suspect attached to his “sweat box”; a galvanometer electrode in her hand, a sphygmomanometer cuff on her arm and a rubber pneumograph tube strapped across her breasts. Keeler’s fascination with the deceptive charms of the female body was one he shared with his fellow lie detector pioneers, all of whom met their wives – and in William Marston’s case his mistress too – through their engagement with the instrument. Marston employed his own “Love Meter”, as the press dubbed it, to prove that “brunettes react far more violently to amatory stimuli than blondes”. In this paper I draw on the psychoanalytic concepts of fantasy and pleasure to argue that the female body played a pivotal role in establishing the lie detector’s reputation as an infallible and benign mechanical technology of truth

Mortality burden attributable to exceptional PM2.5 air pollution events in Australian cities: A health impact assessment

Background: People living in Australian cities face increased mortality risks from exposure to extreme air pollution events due to bushfires and dust storms. However, the burden of mortality attributable to exceptional PM2.5 levels has not been well characterised. We assessed the burden of mortality due to PM2.5 pollution events in Australian capital cities between 2001 and 2020. Methods: For this health impact assessment, we obtained data on daily counts of deaths for all non-accidental causes and ages from the Australian National Vital Statistics Register. Daily concentrations of PM2.5 were estimated at a 5 km grid cell, using a Random Forest statistical model of data from air pollution monitoring sites combined with a range of satellite and land use-related data. We calculated the exceptional PM2.5 levels for each extreme pollution exposure day using the deviation from a seasonal and trend loess decomposition model. The burden of mortality was examined using a relative risk concentration-response function suggested in the literature. Findings: Over the 20-year study period, we estimated 1454 (95 % CI 987, 1920) deaths in the major Australian cities attributable to exceptional PM2.5 exposure levels. The mortality burden due to PM2.5 exposure on extreme pollution days was considerable. Variations were observed across Australia. Despite relatively low daily PM2.5 levels compared to global averages, all Australian cities have extreme pollution exposure days, with PM2.5 concentrations exceeding the World Health Organisation Air Quality Guideline standard for 24-h exposure. Our analysis results indicate that nearly one-third of deaths from extreme air pollution exposure can be prevented with a 5 % reduction in PM2.5 levels on days with exceptional pollution. Interpretation: Exposure to exceptional PM2.5 events was associated with an increased mortality burden in Australia's cities. Policies and coordinated action are needed to manage the health risks of extreme air pollution events due to bushfires and dust storms under climate change

Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases: A prospective cohort study in Australia

Background: Short-and long-term spatiotemporal variation in exposure to air pollution is associated with respiratory morbidity in areas with moderate-to-high level of air pollution, but very few studies have examined whether these associations also exist in areas with low level exposure. Objectives: We assessed the association between spatial variation in long-term exposure to PM2.5 and NO2 and hospitalisation for all respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), and pneumonia, in older adults residing in Sydney, Australia, a city with low-level concentrations. Methods: We recorded data on hospitalisations for 100,084 participants, who were aged > 45 years at entry in 2006-2009 until June 2014. Annual NO2 and PM2.5 concentrations were estimated for the participants’ residential addresses and Cox proportional hazards regression was used to model the association between exposure to air pollutants and first episode of hospitalisation, controlling for personal and area level covariates. We further investigated the shape of the exposure-response association and potential effect modification by age, sex, education level, smoking status, and BMI. Results: NO2 and PM2.5 annual mean exposure estimates were 17.5 mu g.m(-3) and 4.5 mu g.m(-3) respectively. NO2 and PM2.5 was positively, although not significantly, associated with asthma. The adjusted hazard ratio for a 1 mu g.m(-3) increase in PM2.5 was 1.08, 95% confidence interval 0.89-1.30. The adjusted hazard ratio for a 5 mu g.m(-3) increase in NO2 was 1.03, 95% confidence interval 0.88-1.19. We found no positive statistically significant associations with hospitalisation for all respiratory diseases, and pneumonia while negative associations were observed with COPD. Conclusions: We found weak positive associations of exposure to air pollution with hospitalisation for asthma while there was no evidence of an association for all respiratory diseases

Avoidable Mortality Attributable to Anthropogenic Fine Particulate Matter (PM2.5) in Australia

Ambient fine particulate matter <2.5 _m(PM2.5) air pollution increases premature mortality globally. Some PM2.5 is natural, but anthropogenic PM2.5 is comparatively avoidable. We determined the impact of long-term exposures to the anthropogenic PM component on mortality in Australia. PM2.5-attributable deaths were calculated for all Australian Statistical Area 2 (SA2; n = 2310) regions. All-cause death rates from Australian mortality and population databases were combined with annual anthropogenic PM2.5 exposures for the years 2006–2016. Relative risk estimates were derived from the literature. Population-weighted average PM2.5 concentrations were estimated in each SA2 using a satellite and land use regression model for Australia. PM2.5-attributable mortality was calculated using a health-impact assessment methodology with life tables and all-cause death rates. The changes in life expectancy (LE) from birth, years of life lost (YLL), and economic cost of lost life years were calculated using the 2019 value of a statistical life. Nationally, long-term populationweighted average total and anthropogenic PM2.5 concentrations were 6.5 _g/m3 (min 1.2–max 14.2) and 3.2 _g/m3 (min 0–max 9.5), respectively. Annually, anthropogenic PM2.5-pollution is associated with 2616 (95% confidence intervals 1712, 3455) deaths, corresponding to a 0.2-year (95% CI 0.14, 0.28) reduction in LE for children aged 0–4 years, 38,962 (95%CI 25,391, 51,669) YLL and an average annual economic burden of $6.2 billion (95$4.0 billion, $8.1 billion). We conclude that the anthropogenic PM2.5-related costs of mortality in Australia are higher than community standards should allow, and reductions in emissions are recommended to achieve avoidable mortality