Short-term joint effects of PM10, NO2 and SO2 on cardio-respiratory disease hospital admissions in Cape Town, South Africa

BACKGROUND/AIM : In sub-Sahara Africa, few studies have investigated the short-term association between hospital admissions and ambient air pollution. Therefore, this study explored the association between multiple air pollutants and hospital admissions in Cape Town, South Africa. METHODS : Generalized additive quasi-Poisson models were used within a distributed lag linear modelling framework to estimate the cumulative effects of PM10, NO2 , and SO2 up to a lag of 21 days. We further conducted multi-pollutant models and stratified our analysis by age group, sex, and season. RESULTS : The overall relative risk (95% confidence interval (CI)) for PM10, NO2 , and SO2 at lag 0–1 for hospital admissions due to respiratory disease (RD) were 1.9% (0.5–3.2%), 2.3% (0.6–4%), and 1.1% (−0.2–2.4%), respectively. For cardiovascular disease (CVD), these values were 2.1% (0.6–3.5%), 1% (−0.8–2.8%), and −0.3% (−1.6–1.1%), respectively, per inter-quartile range increase of 12 µg/m3 for PM10, 7.3 µg/m3 for NO2 , and 3.6 µg/m3 for SO2 . The overall cumulative risks for RD per IQR increase in PM10 and NO2 for children were 2% (0.2–3.9%) and 3.1% (0.7–5.6%), respectively. CONCLUSION : We found robust associations of daily respiratory disease hospital admissions with daily PM10 and NO2 concentrations. Associations were strongest among children and warm season for RD.DATA AVAILABILITY STATEMENT : Exposure data are available for download on the South African Air Quality Information System (SAAQIS) https://saaqis.environment.gov.za/; (accessed on 22 April 2019) however, restrictions apply to the health outcome data.SUPPLEMENTARY MATERIAL : This document describes the air pollution data by station for each year and outlines the imputation analysis. In addition, it tabulates the estimates for age groups, sex, and season per interquartile range and 10 µg/m3.https://www.mdpi.com/journal/ijerphSchool of Health Systems and Public Health (SHSPH

Public health impacts of city policies to reduce climate change:Findings from the URGENCHE EU-China project

Climate change is a global threat to health and wellbeing. Here we provide findings of an international research project investigating the health and wellbeing impacts of policies to reduce greenhouse gas emissions in urban environments.; Five European and two Chinese city authorities and partner academic organisations formed the project consortium. The methodology involved modelling the impact of adopted urban climate-change mitigation transport, buildings and energy policy scenarios, usually for the year 2020 and comparing them with business as usual (BAU) scenarios (where policies had not been adopted). Carbon dioxide emissions, health impacting exposures (air pollution, noise and physical activity), health (cardiovascular, respiratory, cancer and leukaemia) and wellbeing (including noise related wellbeing, overall wellbeing, economic wellbeing and inequalities) were modelled. The scenarios were developed from corresponding known levels in 2010 and pre-existing exposure response functions. Additionally there were literature reviews, three longitudinal observational studies and two cross sectional surveys.; There are four key findings. Firstly introduction of electric cars may confer some small health benefits but it would be unwise for a city to invest in electric vehicles unless their power generation fuel mix generates fewer emissions than petrol and diesel. Second, adopting policies to reduce private car use may have benefits for carbon dioxide reduction and positive health impacts through reduced noise and increased physical activity. Third, the benefits of carbon dioxide reduction from increasing housing efficiency are likely to be minor and co-benefits for health and wellbeing are dependent on good air exchange. Fourthly, although heating dwellings by in-home biomass burning may reduce carbon dioxide emissions, consequences for health and wellbeing were negative with the technology in use in the cities studied.; The climate-change reduction policies reduced CO2 emissions (the most common greenhouse gas) from cities but impact on global emissions of CO2 would be more limited due to some displacement of emissions. The health and wellbeing impacts varied and were often limited reflecting existing relatively high quality of life and environmental standards in most of the participating cities; the greatest potential for future health benefit occurs in less developed or developing countries

WHO Air Quality Guidelines 2021-aiming for healthier air for all: a joint statement by medical, public health, scientific societies and patient representative organisations

[Extract] After years of intensive research and deliberations with experts across the globe, the World Health Organization (WHO) updated its 2005 Global Air Quality Guidelines (AQG) in September 2021 [1, 2]. The new air quality guidelines (WHO AQG) are ambitious and reflect the large impact that air pollution has on global health. They recommend aiming for annual mean concentrations of PM2.5 not exceeding 5 µg/m3 and NO2 not exceeding 10 µg/m3, and the peak season mean 8-hr ozone concentration not exceeding 60 µg/m3 [1]. For reference, the corresponding 2005 WHO guideline values for PM2.5 and NO2 were, respectively, 10 µg/m3 and 40 µg/m3 with no recommendation issued for long-term ozone concentrations [3]. While the guidelines are not legally binding, we hope they will influence air quality policy across the globe for many years to come

Long-term exposure to elemental constituents of particulate matter and cardiovascular mortality in 19 European cohorts: Results from the ESCAPE and TRANSPHORM projects

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Source apportionment of population representative samples of PM2.5 in three European cities using structural equation modelling

Apportionment of urban particulate matter (PM) to sources is central for air quality management and efficient reduction of the substantial public health risks associated with fine particles (PM2.5). Traffic is an important source combustion particles, but also a significant source of resuspended particles that chemically resemble Earth’s crust and that are not affected by development of cleaner motor technologies. A substantial fraction of urban ambient PM originates from long-range transport outside the immediate urban environment including secondary particles formed from gaseous emissions of mainly sulphur, nitrogen oxides and ammonia. Most source apportionment studies are based on small number of fixed monitoring sites and capture well population exposures to regional and long-range transported particles. However, concentrations from local sources are very unevenly distributed and the results from such studies are therefore poorly representative of the actual exposures. The current study uses PM2.5 data observed at population based random sampled residential locations in Athens, Basle and Helsinki with 17 elemental constituents, selected VOCs (xylenes, trimethylbenzenes, nonane and benzene) and light absorbance (black smoke). The major sources identified across the three cities included crustal, salt, long-range transported inorganic and traffic sources. Traffic was associated separately with source categories with crustal (especially Athens and Helsinki) and long-range transported chemical composition (all cities). Remarkably high fractions of the variability of elemental (R-2 >0.6 except for Ca in Basle 0.38) and chemical concentrations (R-2>0.5 except benzene in Basle 0.22 and nonane in Athens 0.39) are explained by the source factors of an SEM model. The RAINS model that is currently used as the main tool in developing European air quality management policies seems to capture the local urban fraction (the city delta term) quite well, but underestimates crustal particle levels in the three cities of the current study. Utilizing structural equation modelling parallel with traditional principal component analysis (PCA) provides an objective method to determine the number of factors to be retained in a model and allows for formal hypotheses testing. (C) 2007 Elsevier B.V. All rights reserved

Air Pollution Exposure in European Cities: The "Expolis" Study.

EXPOLIS is a European multicenter study for measurement of air pollution exposures of working age populations. The selected urban areas are Athens, Basel, Grenoble, Helsinki, Milan and Prague. The main objectives of EXPOLIS are: to assess the exposures of European urban populations to major air pollutants; to analyze the personal and environmental determinants and inter-relationshipsto these exposures; to develop an European database for simulation of air pollution exposures. These objectives are pursued by measuring the personal exposures, home indoor and outdoor workplace levels of PM2.5, VOCs and CO of approx. 500 subjects representing the urban target populations.JRC.(EI)-Environment Institut

Early detection of subjects at risk for vascular remodelling : results from the Swiss population-based study SAPALDIA

As the burden of cardiovascular disease (CVD) increases globally, its prevention and risk assessment becomes ever more important. We thus investigated the longitudinal association of the cardiovascular risk scores in the population-based cohort SAPALDIA with carotid intima media thickening (CIMT), an indicator of sub-clinical disease, and CVD incidence.; In 2,832 SAPALDIA participants, the Swiss and ESC heart risk score (AGLA, SCORE) were calculated based on 2001 data and CIMT was measured in 2010/11. We ran multi-level linear regression analyses between scores and CIMT, stratified for CVD status and gender, and logistic analyses for doctor-diagnosed CVD incidence. Path analyses investigated direct and indirect effects on CIMT.; AGLA and SCORE were positively associated with increasing CIMT in both healthy and CVD diagnosed subjects and men and women. Participants in highest risk categories showed a significant CIMT difference of 1%), even larger in CVD healthy subjects and men. With increasing risk the odds of CVD incidence increased (Ref. >1%; 10 yr. risk AGLA <10% OR 2.1, <20% OR 3.7). Path analyses yield risk factors' direct and indirect effects through blood pressure.; The positive longitudinal association between risk estimations and CIMT confirms the use of risk scores in assessing individuals and populations at risk. Systolic blood pressure appears to be a main pathological mechanism, underscoring the importance of optimal blood pressure control and the importance of prevention strategies of risk factors, indirectly affecting CIMT through the haemodynamic pathway