Long-term exposure to air pollution from road traffic and cardiovascular disease with a focus on exposure modeling

Air pollution is an important environmental health factor contributing to the burden of disease. From a public health point of view cardiovascular effects of long-term exposure are predominant, primarily coronary events and stroke. However, sub-types of disease have not been well investigated and few studies have been conducted in areas with lower air pollution levels. The role of timing of exposure is also unclear. In epidemiological studies different types of models are used to estimate exposure of study participants. It is therefore important to understand if modeled levels are similar for different model types. Furthermore, there is a need to develop better modeling techniques, and it has been proposed to combine models into so called hybrid models. The aim of this thesis was to investigate the relation between individual long-term air pollution exposure from road traffic and the risk of coronary events and stroke in an area with comparatively low exposure levels, while considering timing of exposure. Furthermore a comparison of dispersion modeling (DM) and land use regression (LUR) was done in several study areas and a hybrid model based on DM and LUR was developed for Stockholm. From four cohorts in Stockholm County, 20070 individuals were followed for an average of 12 years. Information on covariates was available from questionnaires and interviews from the time of recruitment. Air pollution exposure from traffic was assessed at residential addresses during follow-up using dispersion modeled levels of nitrogen oxides (NOx), as a marker of exhaust emissions, and particles with an aerodynamic diameter of <10 μm (PM10), as a marker of road dust. A suggestive association between road traffic exposure at the recruitment address and cardiovascular disease incidence was seen. For NOx the hazard ratio for stroke and coronary events per 20μg/m3 was 1.16 (0.83 -1.61) and 1.02 (0.82-1.27), respectively. Corresponding hazard ratios for PM10 were 1.14 (0.68-1.90) and 1.14 (0.87- 1.49), respectively, per 10μg/m3. Results did not appear to be modified by covariates, disease sub-types or exposure time windows. LUR models and DMs were compared in 4 to 13 European study areas depending on the pollutant. At study addresses, the median Pearson correlation (range) for annual mean concentrations of NO2, PM10 and PM2.5 were: 0.75 (0.19–0.89), 0.39 (0.23–0.66) and 0.29 (0.22–0.81). A hybrid model was developed for Stockholm for 93 bi-weekly NOx observations using DM estimates, LUR variables, stationary monitoring and individual meteorological factors. The hybrid model explained NOx levels at monitoring stations better (R2 =89%) than the LUR and DM models (R2 =58% and R2 =68%, respectively). In conclusion, our results suggest an elevated risk of coronary events and stroke related to traffic air pollution exposures in Stockholm County, however, no modification by time window of exposure could be detected. On average, estimates from LUR and DMs correlate well for NO2 but less so for particulates. To combine DM and LUR seems promising for increasing the quality of the exposure assessment

Лечебно-диагностический алгоритм при очаговых тиреопатиях

Представлены современные данные о возможности развития тиреоидного рака на фоне доброкачественной патологии щитовидной железы, определены группы риска по развитию тиреоидных карцином. Разработан диагностический алгоритм своевременной и ранней диагностики рака щитовидной железы, предложены терапевтические подходы, направленные на предупреждение развития тиреоидного рака.Contemporary data about the possibility of thyroid carcinoma development against a background of thyroid pathology are presented. Risk groups of thyroid carcinoma development were determined. A diagnostic algorithm of timely and early diagnosis of thyroid carcinoma was worked out. Therapeutic approaches to prevention of thyroid cancer are suggested

Еволюція підходів до виділення факторів зміцнення конкурентних позицій підприємств

В статье исследовано развитие теоретической базы дисциплин, которые рассматривают конкурентное позиционирование предприятий. На основе обобщения дисциплинарных подходов к определению факторов укрепления конкурентных позиций предприятий выделено и охарактеризовано этапы развития последних. Сформулированы выводы относительно пригодности использования различных подходов для формирования адекватного современным условиям функционирования предприятий механизма достижения, поддержки и укрепления их конкурентных позиций.У статті досліджено розвиток теоретичної бази дисциплін, що розглядають конкурентне позиціонування підприємств. На основі узагальнення дисциплінарних підходів до визначення факторів зміцнення конкурентних позицій підприємств виділено та охарактеризовано етапи розвитку останніх. Сформульовано висновки відносно придатності використання різних підходів для формування адекватного сучасним умовам функціонування підприємств механізму досягнення, підтримки і зміцнення їх конкурентних позицій.Development of theoretical base of disciplines which examine the competition positioning is explored in the article. On the basis of generalization of disciplinary approaches to determination of factors of competition positions of enterprises it is selected and described the stages of development of it. Conclusions are formulated in relation to the fitness of the use of different approaches for forming of functioning of enterprises of mechanism of achievement, support and strengthening of their competition positions adequate to the modern terms

О сущности языковой компетенции

В статье даётся характеристика сущностных сторон языковой компетенции как био и социального и интеллектуального феномена.У статті подається характеристика сутнісних сторін мовної компетенції як біо та соціального та інтелектуального феномену.The characteristics of essential aspects of language competency as bio- and social and intellectual phenomenon is given in the article

Air Pollution Exposure during Pregnancy and Childhood Autistic Traits in Four European Population-Based Cohort Studies: The ESCAPE Project

Background: Prenatal exposure to air pollutants has been suggested as a possible etiologic factor for the occurrence of autism spectrum disorder. Objectives: We aimed to assess whether prenatal air pollution exposure is associated with childhood autistic traits in the general population. Methods: Ours was a collaborative study of four European population-based birth/child cohorts—CATSS (Sweden), Generation R (the Netherlands), GASPII (Italy), and INMA (Spain). Nitrogen oxides (NO2, NOx) and particulate matter (PM) with diameters of ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and between 2.5 and 10 μm (PMcoarse), and PM2.5 absorbance were estimated for birth addresses by land-use regression models based on monitoring campaigns performed between 2008 and 2011. Levels were extrapolated back in time to exact pregnancy periods. We quantitatively assessed autistic traits when the child was between 4 and 10 years of age. Children were classified with autistic traits within the borderline/clinical range and within the clinical range using validated cut-offs. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. Results: A total of 8,079 children were included. Prenatal air pollution exposure was not associated with autistic traits within the borderline/clinical range (odds ratio = 0.94; 95% CI: 0.81, 1.10 per each 10-μg/m3 increase in NO2 pregnancy levels). Similar results were observed in the different cohorts, for the other pollutants, and in assessments of children with autistic traits within the clinical range or children with autistic traits as a quantitative score. Conclusions: Prenatal exposure to NO2 and PM was not associated with autistic traits in children from 4 to 10 years of age in four European population-based birth/child cohort studies.Funding was provided as follows: ESCAPE Project— European Community’s Seventh Framework Program (FP7/2007-2011-GA#211250). CATSS, Sweden— Swedish Research Council for Health, Working Life and Welfare (FORTE), Swedish Research Council (VR) Formas, in partner hip with FORTE and VINNOVA (cross-disciplinary research program concerning children’s and young people’s mental health); VR through the Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM) framework grant 340-2013-5867; HKH Kronprinsessan Lovisas förening för barnasjukvård; and the Strategic Research Program in Epidemiology at Karolinska Institutet. Generation R, the Netherlands—The Generation R Study is conducted by the Erasmus University Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University Rotterdam; the Municipal Health Service Rotterdam area, Rotterdam; the Rotterdam Homecare foundation, Rotterdam; and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR-MDC), Rotterdam. The general design of the Generation R Study is made possible by financial support from the Erasmus University Medical Center, Rotterdam; the Erasmus University Rotterdam; the Netherlands Organization for Health Research and Development (ZonMw); the Netherlands Organization for Scientific Research (NWO); and the Ministry of Health, Welfare and Sport. The Netherlands Organisation for Applied Scientific Research (TNO) received funding from the Netherlands Ministry of Infrastructure and the Environment to support exposure assessment. GASPII, Italy—grant from the Italian Ministry of Health (ex art.12, 2001). INMA, Spain— grants from Instituto de Salud Carlos III (Red INMA G03/176 and CB06/02/0041 FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314, 09/02647, 11/01007, 11/02591, CP11/00178, FIS-PI041436, FIS-PI081151, FIS-PI06/0867, FIS-PS09/00090), PI13/1944, PI13_02032, PI14/0891, PI14/1687, MS13/00054, UE (FP7-ENV-2011 cod 282957, and HEALTH.2010.2.4.5-1); Generalitat de Catalunya-CIRIT 1999SGR 00241; La Fundació La Marató de TV3 (090430); Conselleria de Sanitat Generalitat Valenciana; Department of Health of the Basque Government (2005111093 and 2009111069); and Provincial Government of Gipuzkoa (DFG06/004 and DFG08/001). V.W.V.J. received an additional grant from the Netherlands Organization for Health Research and Development (ZonMw 90700303, 916.10159). A.G.’s work was supported by a research grant from the European Community’s 7th Framework Programme (FP7/2008–2013-GA#212652). A full roster of the INMA project investigators can be found online (http://www. proyectoinma.org/presentacion-inma/listado-investigadores/ en_listado-investigadores.html)

Particulate matter air pollution components and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts of Air Pollution Effects (ESCAPE)

© 2020 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.Introduction: Previous analysis from the large European multicentre ESCAPE study showed an association of ambient particulate matter <2.5 μm (PM2.5) air pollution exposure at residence with the incidence of gastric cancer. It is unclear which components of PM are most relevant for gastric and also upper aerodigestive tract (UADT) cancer and some of them may not be strongly correlated with PM mass. We evaluated the association between long-term exposure to elemental components of PM2.5 and PM10 and gastric and UADT cancer incidence in European adults. Methods: Baseline addresses of individuals were geocoded and exposure was assessed by land-use regression models for copper (Cu), iron (Fe) and zinc (Zn) representing non-tailpipe traffic emissions; sulphur (S) indicating long-range transport; nickel (Ni) and vanadium (V) for mixed oil-burning and industry; silicon (Si) for crustal material and potassium (K) for biomass burning. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. Results: Ten cohorts in six countries contributed data on 227,044 individuals with an average follow-up of 14.9 years with 633 incident cases of gastric cancer and 763 of UADT cancer. The combined hazard ratio (HR) for an increase of 200 ng/m3 of PM2.5_S was 1.92 (95%-confidence interval (95%-CI) 1.13;3.27) for gastric cancer, with no indication of heterogeneity between cohorts (I2 = 0%), and 1.63 (95%-CI 0.88;3.01) for PM2.5_Zn (I2 = 70%). For the other elements in PM2.5 and all elements in PM10 including PM10_S, non-significant HRs between 0.78 and 1.21 with mostly wide CIs were seen. No association was found between any of the elements and UADT cancer. The HR for PM2.5_S and gastric cancer was robust to adjustment for additional factors, including diet, and restriction to study participants with stable addresses over follow-up resulted in slightly higher effect estimates with a decrease in precision. In a two-pollutant model, the effect estimate for total PM2.5 decreased whereas that for PM2.5_S was robust. Conclusion: This large multicentre cohort study shows a robust association between gastric cancer and long-term exposure to PM2.5_S but not PM10_S, suggesting that S in PM2.5 or correlated air pollutants may contribute to the risk of gastric cancer.Peer reviewedFinal Accepted Versio

Development of West-European PM2.5 and NO2 land use regression models incorporating satellite-derived and chemical transport modelling data

Satellite-derived (SAT) and chemical transport model (CTM) estimates of PM2.5 and NO2 are increasingly used in combination with Land Use Regression (LUR) models. We aimed to compare the contribution of SAT and CTM data to the performance of LUR PM2.5 and NO2 models for Europe. Four sets of models, all including local traffic and land use variables, were compared (LUR without SAT or CTM, with SAT only, with CTM only, and with both SAT and CTM). LUR models were developed using two monitoring data sets: PM2.5 and NO2 ground level measurements from the European Study of Cohorts for Air Pollution Effects (ESCAPE) and from the European AIRBASE network. LUR PM2.5 models including SAT and SAT+CTM explained ~60% of spatial variation in measured PM2.5 concentrations, substantially more than the LUR model without SAT and CTM (adjR(2): 0.33-0.38). For NO2 CTM improved prediction modestly (adjR(2): 0.58) compared to models without SAT and CTM (adjR(2): 0.47-0.51). Both monitoring networks are capable of producing models explaining the spatial variance over a large study area. SAT and CTM estimates of PM2.5 and NO2 significantly improved the performance of high spatial resolution LUR models at the European scale for use in large epidemiological studies

Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE)

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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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Long-term exposure to ambient air pollution and traffic noise and incident hypertension in seven cohorts of the European study of cohorts for air pollution effects (ESCAPE)

We investigated whether traffic-related air pollution and noise are associated with incident hypertension in European cohorts.; We included seven cohorts of the European study of cohorts for air pollution effects (ESCAPE). We modelled concentrations of particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5), ≤10 µm (PM10), &gt;2.5, and ≤10 µm (PMcoarse), soot (PM2.5 absorbance), and nitrogen oxides at the addresses of participants with land use regression. Residential exposure to traffic noise was modelled at the facade according to the EU Directive 2002/49/EC. We assessed hypertension as (i) self-reported and (ii) measured (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or intake of BP lowering medication (BPLM). We used Poisson regression with robust variance estimation to analyse associations of traffic-related exposures with incidence of hypertension, controlling for relevant confounders, and combined the results from individual studies with random-effects meta-analysis. Among 41 072 participants free of self-reported hypertension at baseline, 6207 (15.1%) incident cases occurred within 5-9 years of follow-up. Incidence of self-reported hypertension was positively associated with PM2.5 (relative risk (RR) 1.22 [95%-confidence interval (CI):1.08; 1.37] per 5 µg/m³) and PM2.5 absorbance (RR 1.13 [95% CI:1.02; 1.24] per 10 - 5m - 1). These estimates decreased slightly upon adjustment for road traffic noise. Road traffic noise was weakly positively associated with the incidence of self-reported hypertension. Among 10 896 participants at risk, 3549 new cases of measured hypertension occurred. We found no clear associations with measured hypertension.; Long-term residential exposures to air pollution and noise are associated with increased incidence of self-reported hypertension