Air pollutants and health outcomes: Assessment of confounding by influenza

We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996–2002.Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus <2% of the annual positive isolates for ≥2 consecutive weeks. We examined effects of influenza on associations between nitrogen dioxide (NO₂), sulfur dioxide (SO₂), particulate matter with aerodynamic diameter ≤10 μm (PM₁₀) and ozone (O₃) and health outcomes including all natural causes mortality, cardiorespiratory mortality and hospitalization. Generalized additive Poisson regression model with natural cubic splines was fitted to control for time-varying covariates to estimate air pollution health effects. Confounding with influenza was assessed using an absolute difference of >0.1% between unadjusted and adjusted excess risks (ER%).Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO₂ and stroke hospitalization with O₃. Following adjustment, changes in ER% for all pollutants were <0.1% for all natural causes mortality, but >0.1% for mortality from stroke with NO₂ and SO₂, cardiac or heart disease with NO₂, PM₁₀ and O₃, lower respiratory infections with NO₂ and O₃ and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO₂, SO₂ and O₃ and acute lower respiratory infections hospitalization with PM₁₀. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants and subgroups of cardiorespiratory mortality and respiratory hospitalization there was evidence to suggest confounding by influenza.     

The Association between Ambient Carbon Monoxide Levels and Daily Mortality in Toronto,Canada

ABSTRACT

The role of ambient levels of carbon monoxide (CO) in the exacerbation of heart problems in individuals with both cardiac and other diseases was examined by comparing daily variations in CO levels and daily fluctuations in nonaccidental mortality in metropolitan Toronto for the 15-year period 1980–1994. After adjusting the mortality time series for day-of-the-week effects, nonparametic smoothed functions of day of study and weather variables, statistically significant positive associations were observed between daily fluctuations in mortality and ambient levels of carbon monoxide, nitrogen dioxide, sulfur dioxide, coefficient of haze, total suspended particulate matter, sulfates, and estimated PM_2.5 and PM₁₀. However, the effects of this complex mixture of air pollutants could be almost completely explained by the levels of CO and total suspended particulates (TSP). Of the 40 daily nonaccidental deaths in metropolitan Toronto, 4.7% (95% confidence interval of 3.4%–6.1%) could be attributable to CO while TSP contributed an additional 1.0% (95% confidence interval of 0.2–1.9%), based on changes in CO and TSP equivalent to their average concentrations. Statistically significant positive associations were observed between CO and mortality in all seasons, age, and disease groupings examined. Carbon monoxide should be considered as a potential public health risk to urban populations at current ambient exposure levels.     

Daily Mortality and Air Pollution in the Netherlands

ABSTRACT

We studied the association of daily mortality with short-term variations in the ambient concentrations of major gaseous pollutants and PM in the Netherlands. The magnitude of the association in the four major urban areas was compared with that in the remainder of the country. Daily cause-specific mortality counts, air quality, temperature, relative humidity, and influenza data were obtained from 1986 to 1994. The relationship between daily mortality and air pollution was modeled using Poisson regression analysis. We adjusted for potential confounding due to long-term and seasonal trends, influenza epidemics, ambient temperature and relative humidity, day of the week, and holidays, using generalized additive models.

Influenza episodes were associated with increased mortality up to 3 weeks later. Daily mortality was significantly associated with the concentration of all air pollutants. An increase in the PM₁₀ concentration by 100 u.g/m³ was associated with a relative risk (RR) of 1.02 for total mortality. The largest RRs were found for pneumonia deaths. Ozone had the most consistent, independent association with mortality. Particulate air pollution (e.g., PM₁₀, black smoke [BS]) was not more consistently associated with mortality than were the gaseous pollutants SO₂ and NO₂. Aerosol SO₄ ^-2, NO₃ ^-, and BS were more consistently associated with total mortality than was PM₁₀. The RRs for all pollutants were substantially larger in the summer months than in the winter months. The RR of total mortality for PM₁₀ was 1.10 for the summer and 1.03 for the winter. There was no consistent difference between RRs in the four major urban areas and the more rural areas.     

Extended effects of air pollution on cardiopulmonary mortality in Vienna

BackgroundCurrent standards for fine particulates and nitrogen dioxide are under revision. Patients with cardiovascular disease have been identified as the largest group which need to be protected from effects of urban air pollution.MethodsWe sought to estimate associations between indicators of urban air pollution and daily mortality using time series of daily TSP, PM₁₀, PM_2.5, NO₂, SO₂, O₃ and nontrauma deaths in Vienna (Austria) 2000–2004. We used polynomial distributed lag analysis adjusted for seasonality, daily temperature, relative humidity, atmospheric pressure and incidence of influenza as registered by sentinels.ResultsAll three particulate measures and NO₂ were associated with mortality from all causes and from ischemic heart disease and COPD at all ages and in the elderly. The magnitude of the effect was largest for PM_2.5 and NO₂. Best predictor of mortality increase lagged 0–7 days was PM_2.5 (for ischemic heart disease and COPD) and NO₂ (for other heart disease and all causes). Total mortality increase, lagged 0–14 days, per 10 μg m⁻³ was 2.6% for PM_2.5 and 2.9% for NO₂, mainly due to cardiopulmonary and cerebrovascular causes.ConclusionAcute and subacute lethal effects of urban air pollution are predicted by PM_2.5 and NO₂ increase even at relatively low levels of these pollutants. This is consistent with results on hospital admissions and the lack of a threshold. While harvesting (reduction of mortality after short increase due to premature deaths of most sensitive persons) seems to be of minor importance, deaths accumulate during 14 days after an increase of air pollutants. The limit values for PM_2.5 and NO₂ proposed for 2010 in the European Union are unable to prevent serious health effects.     

Association between Levels of Fine Particulate and Emergency Visits for Pneumonia and other Respiratory Illnesses among Children in Santiago,Chile

ABSTRACT

Recent evidence has implicated the fine fraction of particulate as the major contributor to the increase in mortality and morbidity related to particulate ambient levels. We therefore evaluated the impact of daily variation of ambient PM_2.5 and other pollutants on the number of daily respiratory-related emergency visits (REVs) to a large pediatric hospital of Santiago, Chile. The study was conducted from February 1995 to August 1996. Four monitoring stations from the network of Santiago provided air pollution data. The PM2.5 24-hr average ranged from 10 to 111 μg/m³ during September to April (warm months) and from 10 to 156 μg/m³ during May to August (cold months). Other contaminants (ozone (O₃), nitrogen dioxide (NO₂), and sulfur dioxide (SO₂)) were, in general, low during the study period. The increase in REVs was significantly related to PM₁₀ and PM_2.5 ambient levels, with the relationship between PM_2.5 levels and the number of REVs the stronger. During the cold months, an increase of 45 ìg/m³ in the PM_2.5 24-hr average was related to a 2.7% increase in the number of REVs (95% CI, 1.1–4.4%) with a two-day lag, and to an increase of 6.7% (95% CI, 1.7–12.0%) in the number of visits for pneumonia with a three-day lag. SO₂ and NO₂ were also related to REVs. We conclude that urban air pollutant mixture, particularly fine particulates, adversely affect the respiratory health of children residing in Santiago.     

Assessment of ambient air quality in the port of Naples

Two experimental monitoring campaigns were carried out in 2012 to investigate the air quality in the port of Naples, the most important in southern Italy for traffic of passengers and one of the most important for goods. Therefore, it represents an important air pollution source located close to the city of Naples. The concentrations of sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and BTEX (benzene, toluene, ethylbenzene, and xylenes) in the air were measured at 15 points inside the Naples port area through the use of passive samplers. In addition, a mobile laboratory was positioned in a fixed point inside the port area to measure continuous concentration of pollutants together with particulate matter, ambient parameters, and wind direction and intensity. The pollution levels monitored were compared with those observed in the urban area of Naples and in other Mediterranean ports. Even though the observation time was limited, measured concentrations were also compared with limit values established by European legislation. All the measured pollutants were below the limits with the exception of nitrogen dioxide: its average concentration during the exposition time exceeded the yearly limit value. A spatial analysis of data, according to the measured wind direction and intensity, provided information about the effects that ship emissions have on ambient air quality in the port area. The main evidence indicates that ship emissions influence sulfur dioxide concentration more than any other pollutants analyzed.

Implications: Two monitoring campaigns were carried out to measure BTEX, SO₂, NO₂, and PM₁₀ (particulate matter with an aerodynamic diameter <10 μm) air concentrations in the port of Naples. NO₂ hourly average and PM₁₀ daily average comply with European legislative standards. Spatial variation of pollutants long the axis corresponding to the prevailing wind direction seems to indicate a certain influence of ship emissions for SO₂. For NO₂ and PM₁₀, a correlation between concentrations in the harbor and those measured by the air quality monitoring stations sited in the urban area of Naples was observed, indicating a possible contribution of the near road traffic to the air pollution in the port of Naples.     

Daily Mortality in the Philadelphia Metropolitan Area and Size-Classified Particulate Matter

ABSTRACT

Time-series of daily mortality data from May 1992 to September 1995 for various portions of the seven-county Philadelphia, PA, metropolitan area were analyzed in relation to weather and a variety of ambient air quality parameters. The air quality data included measurements of size-classified PM, SO₄ ^2-, and H+ that had been collected by the Harvard School of Public Health, as well as routine air pollution monitoring data. Because the various pollutants of interest were measured at different locations within the metropolitan area, it was necessary to test for spatial sensitivity by comparing results for different combinations of locations. Estimates are presented for single pollutants and for multiple-pollutant models, including gaseous pollutants and mutually exclusive components of PM (PM_2.5 and coarse particles, SO₄ ^2- and non-SO₄ ^2- portions of total suspended particulate [TSP] and PM₁₀), measured on the day of death and the previous day.

We concluded that associations between air quality and mortality were not limited to data collected in the same part of the metropolitan area; that is, mortality for one part may be associated with air quality data from another, not necessarily neighboring, part. Significant associations were found for a wide variety of gaseous and particulate pollutants, especially for peak O₃. Using joint regressions on peak O₃ with various other pollutants, we found that the combined responses were insensitive to the specific other pollutant selected. We saw no systematic differences according to particle size or chemistry. In general, the associations between daily mortality and air pollution depended on the pollutant or the PM metric, the type of collection filter used, and the location of sampling. Although peak O₃ seemed to exhibit the most consistent mortality responses, this finding should be confirmed by analyzing separate seasons and other time periods.     

Predicting residential indoor concentrations of nitrogen dioxide,fine particulate matter,and elemental carbon using questionnaire and geographic information system based data

Previous studies have identified associations between traffic-related air pollution and adverse health effects. Most have used measurements from a few central ambient monitors and/or some measure of traffic as indicators of exposure, disregarding spatial variability and factors influencing personal exposure-ambient concentration relationships. This study seeks to utilize publicly available data (i.e., central site monitors, geographic information system, and property assessment data) and questionnaire responses to predict residential indoor concentrations of traffic-related air pollutants for lower socioeconomic status (SES) urban households.As part of a prospective birth cohort study in urban Boston, we collected indoor and outdoor 3–4 day samples of nitrogen dioxide (NO₂) and fine particulate matter (PM_2.5) in 43 low SES residences across multiple seasons from 2003 to 2005. Elemental carbon (EC) concentrations were determined via reflectance analysis. Multiple traffic indicators were derived using Massachusetts Highway Department data and traffic counts collected outside sampling homes. Home characteristics and occupant behaviors were collected via a standardized questionnaire. Additional housing information was collected through property tax records, and ambient concentrations were collected from a centrally located ambient monitor.The contributions of ambient concentrations, local traffic and indoor sources to indoor concentrations were quantified with regression analyses. PM_2.5 was influenced less by local traffic but had significant indoor sources, while EC was associated with traffic and NO₂ with both traffic and indoor sources. Comparing models based on covariate selection using p-values or a Bayesian approach yielded similar results, with traffic density within a 50 m buffer of a home and distance from a truck route as important contributors to indoor levels of NO₂ and EC, respectively. The Bayesian approach also highlighted the uncertanity in the models. We conclude that by utilizing public databases and focused questionnaire data we can identify important predictors of indoor concentrations for multiple air pollutants in a high-risk population.     

Air pollution and hospital visits for acute upper and lower respiratory infections among children in Ningbo,China: A time-series analysis

Acute upper and lower respiratory infections are main causes of mortality and morbidity in children. Air pollution has been recognized as an important contributor to development and exacerbation of respiratory infections. However, few studies are available in China. In this study, we investigated the short-term effect of air pollution on hospital visits for acute upper and lower respiratory infections among children under 15 years in Ningbo, China. Poisson generalized models were used to estimate the associations between air pollution and hospital visits for acute upper and lower respiratory infections adjusted for temporal, seasonal, and meteorological effects. We found that four pollutants (PM_2.5, PM₁₀, NO₂, and SO₂) were significantly associated with hospital visits for acute upper and lower respiratory infections. The effect estimates for acute upper respiratory infections tended to be higher (PM_2.5 ER = 3.46, 95% CI 2.18, 4.76; PM₁₀ ER = 2.81, 95% CI 1.93, 3.69; NO₂ ER = 11.27, 95% CI 8.70, 13.89; SO₂ ER = 15.17, 95% CI 11.29, 19.19). Significant associations for gaseous pollutants (NO₂ and SO₂) were observed after adjustment for particular matter. Stronger associations were observed among older children and in the cold period. Our study suggested that short-term exposure to outdoor air pollution was associated with hospital visits for acute upper and lower respiratory infections in Ningbo.     

Association between particulate matter air pollution and cardiovascular disease mortality in Lanzhou,China

Ambient particulate matter (PM) pollution has been linked to elevated mortality, especially from cardiovascular diseases. However, evidence on the effects of particulate matter pollution on cardiovascular mortality is still limited in Lanzhou, China. This research aimed to examine the associations of daily mean concentrations of ambient air pollutants (PM_2.5, PM_C, and PM₁₀) and cardiovascular mortality due to overall and cause-specific diseases in Lanzhou. Data representing daily cardiovascular mortality rates, meteorological factors (daily average temperature, daily average humidity, and atmospheric pressure), and air pollutants (PM_2.5, PM₁₀, SO₂, NO₂) were collected from January 1, 2014, to December 31, 2017, in Lanzhou. A quasi-Poisson regression model combined with a distributed lag non-linear model (DLNM) was used to estimate the associations. Stratified analyses were also performed by different cause-specific diseases, including cerebrovascular disease (CD), ischemic heart disease (IHD), heart rhythm disturbances (HRD), and heart failure (HF). The results showed that elevated concentration of PM_2.5, PM_C, and PM₁₀ had different effects on mortality of different cardiovascular diseases. Only cerebrovascular disease showed a significant positive association with elevated PM_2.5. Positive associations were identified between PM_C and daily mortality rates from total cardiovascular diseases, cerebrovascular diseases, and ischemic heart diseases. Besides, increased concentration of PM₁₀ was correlated with increased death of cerebrovascular diseases and ischemic heart diseases. For cerebrovascular disease, each 10 μg/m³ increase in PM_2.5 at lag4 was associated with increments of 1.22% (95% CI 0.11–2.35%). The largest significant effects for PM_C on cardiovascular diseases and ischemic heart diseases were both observed at lag0, and a 10 μg/m³ increment in concentration of PM_C was associated with 0.47% (95% CI 0.06–0.88%) and 0.85% (95% CI 0.18–1.52%) increases in cardiovascular mortality and ischemic heart diseases. In addition, it exhibited a lag effect on cerebrovascular mortality as well, which was most significant at lag6d, and an increase of 10 μg/m³ in PM_C was associated with a 0.76% (95% CI 0.16–1.37%) increase in cerebrovascular mortality. The estimates of percentage change in daily mortality rates per 10 μg/m³ increase in PM₁₀ were 0.52% (95% CI 0.05–1.02%) for cerebrovascular disease at lag6 and 0.53% (95% CI 0.01–1.05%) for ischemic heart disease at lag0, respectively. Our study suggests that elevated concentration of atmospheric PM (PM_2.5, PM_C, and PM₁₀) in Lanzhou is associated with increased mortality of cardiovascular diseases and that the health effect of elevated concentration of PM_2.5 is more significant than that of PM_C and PM₁₀.

     

Effect of the Fine Fraction of Particulate Matter versus the Coarse Mass and Other Pollutants on Daily Mortality in Santiago,Chile

ABSTRACT

Daily counts of non-accidental deaths in Santiago, Chile, from 1988 to 1996 were regressed on six air pollutants— fine particles (PM_2.5), coarse particles (PM_10–2.5), CO, SO₂, NO₂, and O₃. Controlling for seasonal and meteorological conditions was done using three different models— a generalized linear model, a generalized additive model, and a generalized additive model on previously filtered data. Single- and two-pollutant models were tested for lags of 1-5 days and the average of the previous 2-5 days.

The increase in mortality associated with the mean levels of air pollution varied from 4 to 11%, depending on the pollutants and the way season of the year was considered. The results were not sensitive to the modeling approaches, but different effects for warmer and colder months were found. Fine particles were more important than coarse particles in the whole year and in winter, but not in summer. NO₂ and CO were also significantly associated with daily mortality, as was O₃ in the warmer months. No consistent effect was observed for SO₂. Given particle composition in Santiago, these results suggest that combustion-generated pollutants, especially from motor vehicles, may be associated with increased mortality. Temperature was closely associated with mortality. High temperatures led to deaths on the same day, while low temperatures lead to deaths from 1 to 4 days later.     

A Statistical Assessment of Saturation and Mobile Sampling Strategies to Estimate Long-Term Average Concentrations across Urban Areast

Abstract

The objectives of this study were: (1) to quantify the errors associated with saturation air quality monitoring in estimating the long-term (i.e., annual and 5 yr) mean at a given site from four 2-week measurements, once per season; and (2) to develop a sampling strategy to guide the deployment of mobile air quality facilities for characterizing intraurban gradients of air pollutants, that is, to determine how often a given location should be visited to obtain relatively accurate estimates of the mean air pollutant concentrations. Computer simulations were conducted by randomly sampling ambient monitoring data collected in six Canadian cities at a variety of settings (e.g., population-based sites, near-roadway sites). The 5-yr (1998–2002) dataset consisted of hourly measurements of nitric oxide (NO), nitrogen dioxide (NO₂), oxides of nitrogen (NO_x), sulfur dioxide (SO₂), coarse particulate matter (PM₁₀), fine particulate matter (PM_2.5)_, and CO. The strategy of randomly selecting one 2-week measurement per season to determine the annual or long-term average concentration yields estimates within 30% of the true value 95% of the time for NO₂, PM₁₀ and NO_x. Larger errors, up to 50%, are expected for NO, SO₂, PM_2.5, and CO. Combining concentrations from 85 random 1-hr visits per season provides annual and 5-yr average estimates within 30% of the true value with good confidence. Overall, the magnitude of error in the estimates was strongly correlated with the variability of the pollutant. A better estimation can be expected for pollutants known to be less temporally variable and/or over geographic areas where concentrations are less variable. By using multiple sites located in different settings, the relationships determined for estimation error versus number of measurement periods used to determine long-term average are expected to realistically portray the true distribution. Thus, the results should be a good indication of the potential errors one could expect in a variety of different cities, particularly in more northern latitudes.     

Ambient air pollution and term birth weight in Texas from 1998 to 2004

Previous studies have explored the association between air pollution levels and adverse birth outcomes such as lower birth weight. Existing literature suggests an association, although results across studies are not consistent. Additional research is needed to confirm the effect, investigate the exposure window of importance, and distinguish which pollutants cause harm.

We assessed the association between ambient pollutant concentrations and term birth weight for 1,548,904 births in TX from 1998 to 2004. Assignment of prenatal exposure to air pollutants was based on maternal county of residence at the time of delivery. Pollutants examined included particulate matter with aerodynamic diameter ≤10 and ≤2.5 µm (PM₁₀ and PM_2.5), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and ozone (O₃). We applied a linear model with birth weight as a continuous variable. The model was adjusted for known risk factors and region. We assessed pollutant effects by trimester to identify biological exposure window of concern, and explored interaction due to race/ethnicity.

An interquartile increase in ambient pollutant concentrations of SO₂ and O₃ was associated with a 4.99-g (95% confidence interval [CI], 1.87–8.11) and 2.72-g (95% CI, 1.11–4.33) decrease in birth weight, respectively. Lower birth weight was associated with exposure to O₃ in the first and second trimester, whereas results were not significant for other pollutants by trimester. A positive association was exhibited for PM_2.5 in the first trimester. Effects estimates for PM₁₀ and PM_2.5 were inconsistent across race/ethnic groups.

Current ambient air pollution levels may be increasing the risk of lower birth weight for some pollutants. These risks may be increased for certain racial/ethnic groups. Additional research including consideration of improved methodology is needed to investigate these findings. Future studies should examine the influence of residual confounding.

Implications: This is one of the most comprehensive studies examining criteria air pollutants and lower birth weight in Texas. Our findings confirm results found previously for adverse effects of the air pollutant SO₂ on lower birth weight. Results from our study suggest that adverse pregnancy outcomes such as lower birth weight can occur even while maintaining air pollution levels below regulatory standards. Future studies should incorporate the assessment of differential pollutant exposure as well as effect estimates by race/ethnicity with individual and community-level social factors in order to enhance our understanding of how physical, social, and host factors influence birth outcomes.

Supplemental Materials: Supplementary information relating to characteristics of excluded births, distribution of air pollutant monitors by pollutant, and correlation coefficients of the air pollutants is available in the publisher's online edition of the Journal of the Air & Waste Management Association.     

Impact of Covid-19 partial lockdown on PM2.5, SO2, NO2, O3, and trace elements in PM2.5 in Hanoi,Vietnam

Covid-19 lockdowns have improved the ambient air quality across the world via reduced air pollutant levels. This article aims to investigate the effect of the partial lockdown on the main ambient air pollutants and their elemental concentrations bound to PM_2.5 in Hanoi. In addition to the PM_2.5 samples collected at three urban sites in Hanoi, the daily PM_2.5, NO₂, O₃, and SO₂ levels were collected from the automatic ambient air quality monitoring station at Nguyen Van Cu street to analyze the pollution level before (March 10th–March 31st) and during the partial lockdown (April 1st–April 22nd) with “current” data obtained in 2020 and “historical” data obtained in 2014, 2016, and 2017. The results showed that NO₂, PM_2.5, O₃, and SO₂ concentrations obtained from the automatic ambient air quality monitoring station were reduced by 75.8, 55.9, 21.4, and 60.7%, respectively, compared with historical data. Besides, the concentration of PM_2.5 at sampling sites declined by 41.8% during the partial lockdown. Furthermore, there was a drastic negative relationship between the boundary layer height (BLH) and the daily mean PM_2.5 in Hanoi. The concentrations of Cd, Se, As, Sr, Ba, Cu, Mn, Pb, K, Zn, Ca, Al, and Mg during the partial lockdown were lower than those before the partial lockdown. The results of enrichment factor (EF) values and principal component analysis (PCA) concluded that trace elements in PM_2.5 before the partial lockdown were more affected by industrial activities than those during the partial lockdown.

     

Short-term effects of air pollution on daily hospital admissions for cardiovascular diseases in western China

Controlling the confounding factors on cardiovascular diseases, such as long-time trend, calendar effect, and meteorological factors, a generalized additive model (GAM) was used to investigate the short-term effects of air pollutants (PM₁₀, SO₂, and NO₂) on daily cardiovascular admissions from March 1st to May 31st during 2007 to 2011 in Lanzhou, a heavily polluted city in western China. The influences of air pollutants were examined with different lag structures, and the potential effect modification by dust storm in spring was also investigated. Significant associations were found between air pollutants and hospital admissions for cardiovascular diseases both on dust event days and non-dust event days in spring. Air pollutants had lag effects on different age and gender groups. Relative risks (RRs) and their 95% confidence intervals (CIs) associated with a 10 μg/m³ increase were 1.14 (1.04~1.26) on lag1 for PM₁₀, 1.31 (1.21~1.51) on lag01 for SO₂, and 1.96 (1.49~2.57) on lag02 for NO₂ on dust days. Stronger effects of air pollutants were observed for females and the elderly (≥60 years). Our analysis concluded that the effects of air pollutants on cardiovascular admissions on dust days were significantly stronger than non-dust days. The current study strengthens the evidence of effects of air pollution on health and dust-exacerbated cardiovascular admissions in Lanzhou.     

Effects of Instrument Precision and Spatial Variability on the Assessment of the Temporal Variation of Ambient Air Pollution in Atlanta,Georgia

Abstract

Data from the U.S. Environmental Protection Agency Air Quality System, the Southeastern Aerosol Research and Characterization database, and the Assessment of Spatial Aerosol Composition in Atlanta database for 1999 through 2002 have been used to characterize error associated with instrument precision and spatial variability on the assessment of the temporal variation of ambient air pollution in Atlanta, GA. These data are being used in time series epidemiologic studies in which associations of acute respiratory and cardiovascular health outcomes and daily ambient air pollutant levels are assessed. Modified semivariograms are used to quantify the effects of instrument precision and spatial variability on the assessment of daily metrics of ambient gaseous pollutants (SO₂, CO, NO_x, and O₃) and fine particulate matter ([PM_2.5] PM_2.5 mass, sulfate, nitrate, ammonium, elemental carbon [EC], and organic carbon [OC]). Variation because of instrument imprecision represented 7–40% of the temporal variation in the daily pollutant measures and was largest for the PM_2.5 EC and OC. Spatial variability was greatest for primary pollutants (SO₂, CO, NO_x, and EC). Population–weighted variation in daily ambient air pollutant levels because of both instrument imprecision and spatial variability ranged from 20% of the temporal variation for O₃ to 70% of the temporal variation for SO₂ and EC. Wind rose plots, corrected for diurnal and seasonal pattern effects, are used to demonstrate the impacts of local sources on monitoring station data. The results presented are being used to quantify the impacts of instrument precision and spatial variability on the assessment of health effects of ambient air pollution in Atlanta and are relevant to the interpretation of results from time series health studies that use data from fixed monitors.     

Street-level concentrations of nitrogen dioxide and suspended particulate matter in Hong Kong

The concentrations of respirable suspended particulates (PM₁₀), fine suspended particulates (PM_2.5) and nitrogen dioxide (NO₂) were measured in various locations over the territory of Hong Kong. In order to study the contributions of these pollutants from motor vehicles and their characteristics, the attention was focused on the roadside, street-level concentrations. A statistical analysis of the sampling results was conducted to obtain general characteristics of the roadside particulate and nitrogen dioxide pollution and to investigate the effects of traffic volume and meteorological factors on the pollution levels. High correlation coefficients are found between PM₁₀, PM_2.5 and NO₂ concentration.     

Understanding of regional air pollution over China using CMAQ,part I performance evaluation and seasonal variation

The U.S. EPA Models-3 Community Multiscale Air Quality (CMAQ) modeling system with the process analysis tool is applied to China to study the seasonal variations and formation mechanisms of major air pollutants. Simulations show distinct seasonal variations, with higher surface concentrations of sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and particulate matter with aerodynamic diameter less than or equal to 10 μm (PM₁₀), column mass of carbon monoxide (CO) and NO₂, and aerosol optical depth (AOD) in winter and fall than other seasons, and higher 1-h O₃ and troposphere ozone residual (TOR) in spring and summer than other seasons. Higher concentrations of most species occur over the eastern China, where the air pollutant emissions are the highest in China. Compared with surface observations, the simulated SO₂, NO₂, and PM₁₀ concentrations are underpredicted throughout the year with NMBs of up to ?51.8%, ?32.0%, and ?54.2%, respectively. Such large discrepancies can be attributed to the uncertainties in emissions, simulated meteorology, and deviation of observations based on air pollution index. Max. 1-h O₃ concentrations in Jan. and Jul. at 36-km are overpredicted with NMBs of 12.0% and 19.3% and agree well in Apr. and Oct. Simulated column variables can capture the high concentrations over the eastern China and low values in the central and western China. Underpredictions occur over the northeastern China for column CO in Apr., TOR in Jul., and AODs in both Apr. and Jul.; and overpredictions occur over the eastern China for column CO in Oct., NO₂ in Jan. and Oct., and AODs in Jan. and Oct. The simulations at 12-km show a finer structure in simulated concentrations than that at 36-km over higher polluted areas, but do not always give better performance than 36-km. Surface concentrations are more sensitive to grid resolution than column variables except for column NO₂, with higher sensitivity over mountain and coastal areas than other regions.     

Long-term associations of morbidity with air pollution: A catalog and synthesis

I searched the National Institutes of Health MEDLINE database through January 2017 for long-term studies of morbidity and air pollution and cataloged them with respect to cardiovascular, respiratory, cancer, diabetes, hospitalization, neurological, and pregnancy-birth endpoints. The catalog is presented as an online appendix. Associations with PM_2.5 (particulate matter with an aerodynamic diameter <2.5 μm), PM₁₀ (PM with an aerodynamic diameter <10 μm), and nitrogen dioxide (NO₂) were evaluated most frequently among the 417 ambient air quality studies identified. Associations with total suspended particles (TSP), carbon, ozone, sulfur, vehicular traffic, radon, and indoor air quality were also reported. I evaluated each study in terms of pollutant significance (yes, no), duration of exposure, and publication date. I found statistically significant pollutant relationships (P < 0.05) in 224 studies; 220 studies indicated adverse effects. Among 795 individual pollutant effect estimates, 396 are statistically significant. Pollutant associations with cardiovascular indicators, lung function, respiratory symptoms, and low birth weight are more likely to be significant than with disease incidence, heart attacks, diabetes, or neurological endpoints. Elemental carbon (EC), traffic, and PM_2.5 are most likely to be significant for cardiovascular outcomes; TSP, EC, and ozone (O₃) for respiratory outcomes; NO₂ for neurological outcomes; and PM₁₀ for birth/pregnancy outcomes. Durations of exposure range from 60 days to 35 yr, but I found no consistent relationships with the likelihood of statistical significance. Respiratory studies began ca. 1975; studies of diabetes, cardiovascular, and neurological effects increased after about 2005. I found 72 studies of occupational air pollution exposures; 40 reported statistically significant adverse health effects, especially for respiratory conditions. I conclude that the aggregate of these studies supports the existence of nonlethal physiological effects of various pollutants, more so for non–life-threatening endpoints and for noncriteria pollutants (TSP, EC, PM_2.5 metals). However, most studies were cross-sectional analyses over limited time spans with no consideration of lag or disease latency. Further longitudinal studies are thus needed to investigate the progress of disease incidence in association with air pollution exposure.

Implications: Relationships of air pollution with excess mortality are better known than with long-term antecedent morbidity. I cataloged 489 studies of cardiovascular, respiratory, cancer, and neurological effects, diabetes, and birth outcomes with respect to 12 air pollutants. About half of the studies reported statistically significant relationships, more frequently with noncriteria than with criteria pollutants. Indoor and cumulative exposures, coarse or ultrafine particles, and organic carbon were seldom considered. Significant relationships were more likely with less-severe endpoints such as blood pressure, lung function, or respiratory symptoms than with incidence of cancer, chronic obstructive pulmonary disease (COPD), heart failure, or diabetes. Most long-term studies are based on spatial relationships; longitudinal studies are needed to link the progression of pollution-related morbidity to mortality, especially for the cardiovascular system.