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.     

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.     

Time series analysis of ambient air pollution effects on daily mortality

Although the growths of ambient pollutants have been attracting public concern, the characteristic of the associations between air pollutants and mortality remains elusive. Time series analysis with a generalized additive model was performed to estimate the associations between ambient air pollutants and mortality outcomes in Shenzhen City for the period of 2012–2014. The results showed that nitrogen dioxide (NO₂)-induced excess risks (ER) of total non-accidental mortality and cardiovascular mortality were significantly increased (6.05% (95% CI 3.38%, 8.78%); 6.88% (95% CI 2.98%, 10.93%), respectively) in interquartile range (IQR) increase analysis. Also, these associations were strengthened after adjusting for other pollutants. Moreover, similar associations were estimated for sulfur dioxide (SO₂), particulate matter with an aerodynamic diameter of <10 μm (PM₁₀), and total non-accidental mortality. There were significant higher ERs of associations between PM₁₀ and mortality for men than women; while there were significant higher ERs of associations between PM₁₀/NO₂ and mortality for elders (65 or elder) than youngers (64 or younger). Season analyses showed that associations between NO₂ and total non-accidental mortality were more pronounced in hot seasons than in warm seasons. Taken together, NO₂ was positively associated with total non-accidental mortality and cardiovascular mortality in Shenzhen even when the concentrations were below the ambient air quality standard. Policy measures should aim at reducing residents’ exposure to anthropogenic NO₂ emissions.     

Effects of air pollution on lung function and symptoms of asthma, rhinitis and eczema in primary school children

Health effects of ambient air pollution were studied in three groups of schoolchildren living in areas (suburban, urban and urban-traffic) with different air pollution levels in Eski?ehir, Turkey. This study involved 1,880 students aged between 9 and 13 years from 16 public primary schools. This two-season study was conducted from January 2008 through March 2009. Symptoms of asthma, rhinitis and eczema were determined by the International Study of Asthma and Allergies in Childhood questionnaire in 2008. Two lung function tests were performed by each child for summer and winter seasons with simultaneous ambient air measurements of ozone (O₃), nitrogen dioxide (NO₂) and sulfur dioxide (SO₂) by passive sampling. Effects of air pollution on impaired lung function and symptoms in schoolchildren were estimated by multivariate logistic regression analyses. Girls with impaired lung function (only for the summer season evaluation) were more observed in suburban and urban areas when compared to urban-traffic area ([odds ratio (OR)?=?1.49; 95 % confidence interval (CI) 1.04–2.14] and [OR?=?1.69 (95 % CI 1.06–2.71)] for suburban vs. urban-traffic and urban vs. urban-traffic, respectively). Significant association between ambient ozone concentrations and impaired lung function (for an increase of 10 μg m^?3) was found only for girls for the summer season evaluation [OR?=?1.11 (95 % CI 1.03–1.19)]. No association was found for boys and for the winter season evaluation. No association was found between any of the measured air pollutants and symptoms of current wheeze, current rhinoconjunctivitis and current itchy rash. The results of this study showed that increasing ozone concentrations may cause a sub-acute impairment in lung function of school aged children.     

Particulate Air Pollution and Health Effects for Cardiovascular and Respiratory Causes in Temuco,Chile: A Wood-Smoke-Polluted Urban Area

Abstract

Temuco is one of the most highly wood-smoke-polluted cities in the world. Its population in 2004 was 340,000 inhabitants with 1587 annual deaths, of which 24% were due to cardiovascular and 11% to respiratory causes. For hospital admissions, cardiovascular diseases represented 6% and respiratory diseases 13%. Emergency room visits for acute respiratory infections represented 28%. The objective of the study presented here was to determine the relationship between air pollution from particulate matter less than or equal to 10 µm in aerodynamic diameter (PM₁₀; mostly PM_2.5, or particulate matter <2.5 µm in aerodynamic diameter) and health effects measured as the daily number of deaths, hospital admissions, and emergency room visits for cardiovascular, respiratory, and acute respiratory infection (ARI) diseases. The Air Pollution Health Effects European Approach (APHEA2) protocol was followed, and a multivariate Poisson regression model was fitted, controlling for trend, seasonality, and confounders for Temuco during 1998–2006. The results show that PM₁₀ had a significant association with daily mortality and morbidity, with the elderly (population >65 yr of age) being the group that presented the greatest risk. The relative risk for respiratory causes, with an increase of 100 µg/m³ of PM_10, was 1.163 with a 95% confidence interval (CI) of 1.057–1.279 for mortality, 1.137 (CI 1.096–1.178) for hospital admissions, and 1.162 for ARI (CI 1.144–1.181). There is evidence in Temuco of positive relationships between ambient particulate levels and mortality, hospital admissions, and ARI for cardiovascular and respiratory diseases. These results are consistent with those of comparable studies in other similar cities where wood smoke is the most important air pollution problem.     

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.     

Short-Term Effects of Gaseous Pollutants on Cause-Specific Mortality in Wuhan,China

Abstract

In Asia, limited studies have been published on the association between daily mortality and gaseous pollutants of nitrogen dioxide (NO₂), ozone (O₃), and sulfur dioxide (SO₂). Our previous studies in Wuhan, China, demonstrated long-term air pollution effects. However, no study has been conducted to determine mortality effects of air pollution in this region. This study was to determine the acute mortality effects of the gaseous pollutants in Wuhan, a city with 7.5 million permanent residents during the period from 2000 to 2004. There are approximately 4.5 million residents in Wuhan who live in the city’s core area of 201 km², where air pollution levels are highest, and pollution ranges are wider than the majority of the cities in the published literature. We used the generalized additive model to analyze pollution, mortality, and covariate data. We found consistent NO₂effects on mortality with the strongest effects on the same day. Every 10-μg/m³increase in NO₂daily concentration on the same day was associated with an increase in nonaccidental (1.43%; 95% confidence interval [CI]: 0.87–1.99%), cardiovascular (1.65%; 95% CI: 0.87–2.45%), stroke (1.49%; 95% CI: 0.56–2.43%), cardiac (1.77%; 95% CI: 0.44–3.12%), respiratory (2.23%; 95% CI: 0.52–3.96%), and cardiopulmonary mortality (1.60%; 95% CI: 0.85– 2.35%). These effects were stronger among the elderly than among the young. Formal examination of exposure-response curves suggests no-threshold linear relationships between daily mortality and NO₂, where the NO₂concentrations ranged from 19.2 to 127.4 μg/m³. SO₂and O₃were not associated with daily mortality. The exposure-response relationships demonstrated heterogeneity, with some curves showing nonlinear relationships for SO₂and O₃. We conclude that there is consistent evidence of acute effects of NO₂on mortality and suggest that a no-threshold linear relationship exists between NO₂and mortality.     

Characterization of major pollution events (dust, haze, and two festival events) at Agra, India

Total suspended particulate (TSP) samples were collected during dust, haze, and two festival events (Holi and Diwali) from February 2009 to June 2010. Pollutant gases (NO₂, SO₂, and O₃) along with the meteorological parameters were also measured during the four pollution events at Agra. The concentration of pollutant gases decreases during dust events (DEs), but the levels of the gases increase during other pollution events indicating the impact of anthropogenic emissions. The mass concentrations were about two times higher during pollution events than normal days (NDs). High TSP concentrations during Holi and Diwali events may be attributed to anthropogenic activities while increased combustion sources in addition to stagnant meteorological conditions contributed to high TSP mass during haze events. On the other hand, long-range transport of atmospheric particles plays a major role during DEs. In the dust samples, Ca²⁺, Cl^?, NO₃ ^?, and SO₄ ^2? were the most abundant ions and Ca²⁺ alone accounted for 22 % of the total ionic mass, while during haze event, the concentrations of secondary aerosols species, viz., NO₃ ^?, SO₄ ^2?, and NH₄ ⁺, were 3.6, 3.3, and 5.1 times higher than the normal days. During Diwali, SO₄ ^2? concentration (17.8 μg?m^?3) was highest followed by NO₃ ^?, K⁺, and Cl^? while the Holi samples were strongly enriched with Cl^? and K⁺ which together made up 32.7 % of the total water-soluble ions. The ion balances indicate that the haze samples were acidic. On the other hand, Holi, Diwali, and DE samples were enriched with cations. The carbonaceous aerosol shows strong variation with the highest concentration during Holi followed by haze, Diwali, DEs, and NDs. However, the secondary organic carbon concentration follows the order haze > DEs > Diwali > Holi > NDs. The scanning electron microscope/EDX results indicate that KCl and carbon-rich particles were more dominant during Holi and haze events while DE samples were enriched with particles of crustal origin.     

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 air pollution exposure and gestational diabetes mellitus in pregnant women: a retrospective cohort study

The global prevalence of gestational diabetes mellitus (GDM) is increasing annually, and previous research reports on the relationship between exposure to air pollutants and GDM are not completely consistent. We investigated the association between air pollutant exposure and GDM in pregnant women in a retrospective cohort study in Guangzhou. We found that in the first trimester, exposure to PM_2.5 and CO showed a significant association with GDM. In the second trimester, exposure to PM₁₀ was significantly associated with GDM. In the third trimester, exposure to PM_2.5, PM₁₀, NO₂, SO₂, and CO at IQR4 (odds ratio [OR]?=?1.271, 95% confidence interval [CI]: 1.179–1.370; OR?=?1.283, 95% CI: 1.191–1.383; OR?=?1.230, 95% CI: 1.145–1.322; OR?=?1.408, 95% CI: 1.303–1.522; OR?=?1.150, 95% CI: 1.067–1.240, respectively) compared with IQR1 was positively associated with GDM. However, exposure to NO₂ was negatively associated with GDM in the first and second trimesters, and O₃ was negatively associated with GDM in the second and third trimesters. We found that the correlation between air pollutants and GDM in different trimesters of pregnancy was not completely consistent in this retrospective cohort study. During pregnancy, there may be an interaction between air pollutant exposure and other factors, such as pregnant women’s age, occupation, anemia status, pregnancy-induced hypertension status, and pregnancy season.

     

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.

     

Analysis of air quality in Dire Dawa,Ethiopia

Ambient air quality was monitored and analyzed to develop air quality index and its implications for livability and climate change in Dire Dawa, Ethiopia. Using survey research design, 16 georeferenced locations, representing different land uses, were randomly selected and assessed for sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon dioxide (CO₂), carbon monoxide (CO),volatile organic compounds (VOCs), and meteorological parameters (temperature and relative humidity). The study found mean concentrations across all land uses for SO₂ of 0.37 ± 0.08 ppm, NO₂ of 0.13 ± 0.17 ppm, CO₂ of 465.65 ± 28.63 ppm, CO of 3.35 ± 2.04 ppm, and VOCs of 1850.67 ± 402 ppm. An air quality index indicated that ambient air quality for SO₂ was very poor, NO₂ ranged from moderate to very poor, whereas CO rating was moderate. Significant positive correlations existed between temperature and NO₂, CO₂, and CO and between humidity and VOCs. Significant relationships were also recorded between CO₂ and NO₂ and between CO and CO₂. Poor urban planning, inadequate pollution control measure, and weak capacity to monitor air quality have implications for energy usage, air quality, and local meteorological parameters, with subsequent feedback into global climate change. Implementation of programs to monitor and control emissions in order to reduce air pollution will provide health, economic, and environmental benefits to the city.

Implications: The need to develop and implement emission control programs to reduce air pollution in Dire Dawa City is urgent. This will provide enormous economic, health, and environmental benefits. It is expected that economic effects of air quality improvement will offset the expenditures for pollution control. Also, strategies that focus on air quality and climate change present a unique opportunity to engage different stakeholders in providing inclusive and sustainable development agenda for Dire Dawa.     

The impact of airborne particulate matter on pediatric hospital admissions for pneumonia among children in Jinan,China: A case-crossover study

This study aims to examine the effect of short-term changes in the concentration of particulate matter of diameter ≤2.5 µm (PM_2.5) and ≤10 µm (PM₁₀) on pediatric hospital admissions for pneumonia in Jinan, China. It explores confoundings factors of weather, season, and chemical pollutants. Information on pediatric hospital admissions for pneumonia in 2014 was extracted from the database of Jinan Qilu Hospital. The relative risk of pediatric hospital admissions for pneumonia was assessed using a case-crossover approach, controlling weather variables, day of the week, and seasonality. The single-pollutant model demonstrated that increased risk of pediatric hospital admissions for pneumonia was significantly associated with elevated PM_2.5 concentrations the day before hospital admission and elevated PM₁₀ concentrations 2 days before hospital admission. An increment of 10 μg/m³ in PM_2.5 and PM₁₀ was correlated with a 6% (95% CI 1.02–-1.10) and 4% (95% CI 1.00–1.08) rise in number of admissions for pneumonia, respectively. In two pollutant models, PM_2.5 and PM₁₀ remained significant after inclusion of sulfur dioxide or nitrogen dioxide but not carbon monoxide. This study demonstrated that short-term exposure to atmospheric particulate matter (PM_2.5/PM₁₀) may be an important determinant of pediatric hospital admissions for pneumonia in Jinan, China.

Implications: This study demonstrated that short-term exposure to atmospheric particulate matter (PM_2.5/PM₁₀) may be an important determinant of pediatric hospital admissions for pneumonia in Jinan, China, and suggested the relevance of pollutant exposure levels and their effects. As a specific group, children are sensitive to airborne particulate matter. This study estimated the short-term effects attribute to other air pollutants to provide references for relevant studies.     

Effects of public health interventions on industrial emissions and ambient air in Cartagena, Spain

Background, aim, and scope

Ten years of public health interventions on industrial emissions to clean air were monitored for the Mediterranean city of Cartagena. During the 1960s, a number of large chemical and non-ferrous metallurgical factories were established that significantly deteriorated the city’s air quality. By the 1970s, the average annual air concentration of sulfur dioxide (SO₂) ranged from 200 to 300 µg/m³ (standard conditions units). In 1979, the Spanish government implemented an industrial intervention plan to improve the performance of factories and industrial air pollution surveillance. Unplanned urban development led to residential housing being located adjacent to three major factories. Factory A produced lead, factory B processed zinc from ore concentrates, and factory C produced sulfuric acid and phosphates. This, in combination with the particular abrupt topography and frequent atmospheric thermal inversions, resulted in the worsening of air quality and heightening concern for public health. In 1990, the City Council authorized the immediate intervention at these factories to reduce or shut down production if ambient levels of SO₂ or total suspended particles (TSP) exceeded a time-emission threshold in pre-established meteorological contexts. The aim of this research was to assess the appropriateness and effectiveness of the intervention plan implemented from 1992 to 2001 to abate industrial air pollution.

Materials and methods

The maximum daily 1-h ambient air level of SO₂, NO₂, and TSP pollutants was selected from one of the three urban automatic stations, designed to monitor ambient air quality around industrial emissions sources. The day on which an intervention took place to reduce and/or interrupt industrial production by factory and pollutant was defined as a control day, and the day after an intervention as a post-control day. To assess the short-term intervention effect on air quality, an ecological time series design was applied, using regression analysis in generalized additive models, focusing on day-to-day variations of ambient air pollutants levels. Two indicators were estimated: (a) appropriateness, the ratio between mean levels of the pollutant for control days versus the other days, and (b) effectiveness, the ratio between mean levels of the pollutant for post-control days versus the other days. Ratios in regression analyses were adjusted for trend, seasonality, temperature, humidity and atmospheric pressure, calendar day, and special events as well as the other pollutants.

Results

A total of 702 control days were made on the factories’ industrial production during the 10-year period. Fifteen reductions and five shutdown control days took place at factory A for ambient air SO₂. At factory B, more controls were carried out for the SO₂ pollutant in the years 1992–1993 and 1997. At factory C, the control days for SO₂ decreased from 59 reductions and 14 shutdowns to a minimum from 1995 onwards, whereas the controls on TSP were more frequent, reaching a maximum of 99 reductions and 47 shutdowns in the last year. SO₂ ambient air mean levels ranged from 456 to 699 µg/m³ among factories on reduction control days and between 624 and 1,010 µg/m³ on shutdown days. The TSP ambient air mean levels were 428 and 506 µg/m³ on reduction and shutdown days, respectively. For all types of control days and factories, a mean ratio of 104% (95% confidence interval [CI] 88 to 121) in SO₂ levels was obtained and a mean ratio of 67% (95% CI 59 to 75) in TSP levels. Post-control days at all factories showed a mean ratio of ?16% (95% CI ?7 to ?24) in SO₂ levels and a mean ratio of ?13% (95% CI ?7 to ?19) in TSP levels.

Discussion

Interventions on industrial production based on the urban SO₂ and TSP ambient air levels were justified by the high concentrations detected. The best assessment of the interventions’ effectiveness would have been to utilize the ambient air pollutant concentration readings from the entire time of the production shutdowns or reductions; however, the daily hourly maximum turned out to be a useful indicator because of meteorological factors influencing the diurnal concentration profile. A substantial number of interventions were carried out from 1 to 3 am, when vehicular traffic was minimum. On the other hand, atmospheric stability undergoes diurnal cycling in the autumn–winter period due to thermal inversion, which reaches maximum levels around daybreak. Therefore, this increases the ambient air levels and justified the interventions carried out at daybreak in spite of the traffic influence.

Conclusions

All the interventions for SO₂ and TSP were carried out when the measured ambient air levels of pollutants were exceeded, which shows the appropriateness of the intervention program. This excess was greater when intervening on SO₂ than on the TSP levels. For both ambient air levels of SO₂ and TSP, significant drops in air pollution were achieved from all three factories following activity reductions. The production shutdown controls were very effective, because they returned excess levels, higher than in the reduction controls, to everyday mean values.

Recommendations and perspectives

The Cartagena City observational system of intermittent control has proven to effectively reduce industrial emissions’ impact on ambient air quality. This experienced model approach could serve well in highly polluted industrial settings. From a public health perspective, studies are needed to assess that the industrial interventions to control air pollution were related to healthier human populations. Legislation was needed to allow the public administration to take direct actions upon the polluting industries.     

Recent spatial gradients and time trends in Dhaka,Bangladesh, air pollution and their human health implications

Dhaka, the capital of Bangladesh, is among the most polluted cities in the world. This research evaluates seasonal patterns, day-of-week patterns, spatial gradients, and trends in PM_2.5 (<2.5 µm in aerodynamic diameter), PM₁₀ (<10 µm in aerodynamic diameter), and gaseous pollutants concentrations (SO₂, NO₂, CO, and O₃) monitored in Dhaka from 2013 to 2017. It expands on past work by considering multiple monitoring sites and air pollutants. Except for ozone, the average concentrations of these pollutants showed strong seasonal variation, with maximum during winter and minimum during monsoon, with the pollution concentration of PM_2.5 and PM₁₀ being roughly five- to sixfold higher during winter versus monsoon. Our comparisons of the pollutant concentrations with Bangladesh NAAQS and U.S. NAAQS limits analysis indicate particulate matter (PM_2.5 and PM₁₀) as the air pollutants of greatest concern, as they frequently exceeded the Bangladesh NAAQS and U.S. NAAQS, especially during nonmonsoon time. In contrast, gaseous pollutants reported far fewer exceedances throughout the study period. During the study period, the highest number of exceedances of NAAQS limits in Dhaka City (Darus-Salam site) were found for PM_2.5 (72% of total study days), followed by PM₁₀ (40% of total study days), O₃ (1.7% of total study days), SO₂ (0.38% of total study days), and CO (0.25% of total study days). The trend analyses results showed statistically significant positive slopes over time for SO₂ (5.6 ppb yr^?1, 95% confidence interval [CI]: 0.7, 10.5) and CO (0.32 ppm yr^?1, 95% CI: 0.01, 0.56), which suggest increase in brick kilns operation and high-sulfur diesel use. Though statistically nonsignificant annual decreasing slopes for PM_2.5 (?4.6 µg/m³ yr^?1, 95% CI: ?12.7, 3.6) and PM₁₀ (?2.7 µg/m³ yr^?1, 95% CI: ?7.9, 2.5) were observed during this study period, the PM_2.5 concentration is still too high (~ 82.0 µg/m³) and can cause severe impact on human health.

Implications: This study revealed key insights into air quality challenges across Dhaka, Bangladesh, indicating particulate matter (PM) as Dhaka’s most serious air pollutant threat to human health. The results of these analyses indicate that there is a need for immediate further investigations, and action based on those investigations, including the conduct local epidemiological PM exposure-human health effects studies for this city, in order to determine the most public health effective interventions.     

Synergistic effects of gaseous pollutants on hospital admissions for cardiovascular disease in Liuzhou,China

Previous studies demonstrated that short-term exposure to gaseous pollutants (nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and ozone (O₃)) had a greater adverse effect on cardiovascular disease. However, little evidence exists regarding the synergy between gaseous pollutants and cardiovascular disease (CVD). Therefore, we aimed to estimate the effect of individual gaseous pollutants on hospital admissions for CVD and to explore the possible synergistic effects between gaseous pollutants. Daily hospitalization counts for CVD were collected from January 1, 2014, to December 31, 2015. We also collected daily time series on gaseous pollutants from the Environment of the People’s Republic of China, including NO₂, SO₂, and O₃. We used distributed lag nonlinear models (DLNMs) to assess the association of individual gaseous pollutants on CVD hospitalization, after controlling for seasonality, day of the week, public holidays, and weather variables. Then, we explored the variability across age and sex groups. In addition, we analyzed the synergistic effects between gaseous pollutants on CVD. Extremely low NO₂ and SO₂ increase the risk of CVD in all subgroup at lag 7 days. The greatest effect of high concentration of SO₂ was observed in male and the elderly (≥ 65 years) at lag 3 days. Greater effects of high concentration of O₃ were more pronounced in the young (< 65 years) and female at lag 3 days, while the effect of low concentration of O₃ was greater in male and the young (< 65 years) at lag 0 day. We found a synergistic effect between NO₂ and SO₂ for CVD, as well as between SO₂ and O₃. The synergistic effects of NO₂ and SO₂ on CVD were stronger in the elderly (≥ 65) and female. The female was sensitive to synergistic effects of SO₂-O₃ and NO₂-O₃. Interestingly, we found that there was a risk of CVD in the susceptible population even for gaseous pollutant concentrations below the National Environmental Quality Standard. The synergy between NO₂ and SO₂ was significantly associated with cardiovascular disease hospitalization in the elderly (≥ 65). This study provides evidence for the synergistic effect of gaseous pollutants on hospital admissions for cardiovascular disease.

     

Low ambient temperature increases hospital re-admissions for systemic lupus erythematosus in humid subtropical region: a time series study

Currently, the correlation between ambient temperature and systemic lupus erythematosus (SLE) hospital admissions remains not determined. The aim of this study was to explore the correlation between ambient temperature and SLE hospital admissions in Hefei City, China. An ecological study design was adopted. Daily data on SLE hospital admissions in Hefei City, from January 1, 2007, to December 31, 2017, were obtained from the two largest tertiary hospitals in Hefei, and the daily meteorological data at the same period were retrieved from China Meteorological Data Network. The generalized additive model (GAM) combined with distributed lag nonlinear model (DLNM) with Poisson link was applied to evaluate the influence of ambient temperature on SLE hospital admissions after controlling for potential confounding factors, including seasonality, relative humidity, day of week, and long-term trend. There were 1658 SLE hospital admissions from 2007 to 2017, including 370 first admissions and 1192 re-admissions (there were 96 admissions with admission status not stated). No correlation was observed between ambient temperature and SLE first admissions, but a correlation was found between low ambient temperature and SLE re-admissions (RR: 2.53, 95% CI: 1.11, 5.77) (3.5 °C vs 21 °C). The effect of ambient temperature on SLE re-admissions remained for 2 weeks but disappeared in 3 weeks. Exposure to low ambient temperature may increase hospital re-admissions for SLE, and thus it is important for SLE patients to maintain a warm living environment and avoid exposure to lower ambient temperature.

     

The acute effects of fine particles on respiratory mortality and morbidity in Beijing, 2004–2009

Recent epidemiological and toxicological studies have shown associations between particulate matter and human health. However, the estimates of adverse health effects are inconsistent across many countries and areas. The stratification and interaction models were employed within the context of the generalized additive Poisson regression equation to examine the acute effects of fine particles on respiratory health and to explore the possible joint modification of temperature, humidity, and season in Beijing, China, for the period 2004–2009. The results revealed that the respiratory health damage threshold of the PM_2.5 concentration was mainly within the range of 20–60 μg/m³, and the adverse effect of excessively high PM_2.5 concentration maintained a stable level. In the most serious case, an increase of 10 μg/m³ PM_2.5 results in an elevation of 4.60 % (95 % CI 3.84–4.60 %) and 4.48 % (95 % CI 3.53–5.41 %) with a lag of 3 days, values far higher than the average level of 0.69 % (95 % CI 0.54–0.85 %) and 1.32 % (95 % CI 1.02–1.61 %) for respiratory mortality and morbidity, respectively. There were strong seasonal patterns of adverse effects with the seasonal variation of temperature and humidity. The growth rates of respiratory mortality and morbidity were highest in winter. And, they increased 1.4 and 1.8 times in winter, greater than in the full year as PM_2.5 increased 10 μg/m³.     

Human health risks in megacities due to air pollution

This study evaluates the health risks in megacities in terms of mortality and morbidity due to air pollution. A new spreadsheet model, Risk of Mortality/Morbidity due to Air Pollution (Ri-MAP), is used to estimate the excess numbers of deaths and illnesses. By adopting the World Health Organization (WHO) guideline concentrations for the air pollutants SO₂, NO₂ and total suspended particles (TSP), concentration-response relationships and a population attributable-risk proportion concept are employed. Results suggest that some megacities like Los Angeles, New York, Osaka Kobe, Sao Paulo and Tokyo have very low excess cases in total mortality from these pollutants. In contrast, the approximate numbers of cases is highest in Karachi (15,000/yr) characterized by a very high concentration of total TSP (～670 μg m^?3). Dhaka (7000/yr), Beijing (5500/yr), Karachi (5200/yr), Cairo (5000/yr) and Delhi (3500/yr) rank highest with cardiovascular mortality. The morbidity (hospital admissions) due to Chronic Obstructive Pulmonary Disease (COPD) follows the tendency of cardiovascular mortality. Dhaka and Karachi lead the rankings, having about 2100/yr excess cases, while Osaka-Kobe (～20/yr) and Sao Paulo (～50/yr) are at the low end of all megacities considered. Since air pollution is increasing in many megacities, and our database of measured pollutants is limited to the period up to 2000 and does not include all relevant components (e.g. O₃), these numbers should be interpreted as lower limits. South Asian megacities most urgently need improvement of air quality to prevent excess mortality and morbidity due to exceptionally high levels of air pollution. The risk estimates obtained from Ri-MAP present a realistic baseline evaluation for the consequences of ambient air pollution in comparison to simple air quality indices, and can be expanded and improved in parallel with the development of air pollution monitoring networks.     

Potential interferences in photolytic nitrogen dioxide converters for ambient air monitoring: Evaluation of a prototype

ABSTRACT

Mixing ratios of the criteria air contaminant nitrogen dioxide (NO₂) are commonly quantified by reduction to nitric oxide (NO) using a photolytic converter followed by NO-O₃ chemiluminescence (CL). In this work, the performance of a photolytic NO₂ converter prototype originally designed for continuous emission monitoring and emitting light at 395 nm was evaluated. Mixing ratios of NO₂ and NO_x (= NO + NO₂) entering and exiting the converter were monitored by blue diode laser cavity ring-down spectroscopy (CRDS). The NO₂ photolysis frequency was determined by measuring the rate of conversion to NO as a function of converter residence time and found to be 4.2 s^?1. A maximum 96% conversion of NO₂ to NO over a large dynamic range was achieved at a residence time of (1.5 ± 0.3) s, independent of relative humidity. Interferences from odd nitrogen (NO_y) species such as peroxyacyl nitrates (PAN; RC(O)O₂NO₂), alkyl nitrates (AN; RONO₂), nitrous acid (HONO), and nitric acid (HNO₃) were evaluated by operating the prototype converter outside its optimum operating range (i.e., at higher pressure and longer residence time) for easier quantification of interferences. Four mechanisms that generate artifacts and interferences were identified as follows: direct photolysis, foremost of HONO at a rate constant of 6% that of NO₂; thermal decomposition, primarily of PAN; surface promoted photochemistry; and secondary chemistry in the connecting tubing. These interferences are likely present to a certain degree in all photolytic converters currently in use but are rarely evaluated or reported. Recommendations for improved performance of photolytic converters include operating at lower cell pressure and higher flow rates, thermal management that ideally results in a match of photolysis cell temperature with ambient conditions, and minimization of connecting tubing length. When properly implemented, these interferences can be made negligibly small when measuring NO₂ in ambient air.

Implications: A new near-UV photolytic converter for measurement of the criteria pollutant nitrogen dioxide (NO₂) in ambient air by CL was characterized. Four mechanisms that generate interferences were identified and investigated experimentally: direct photolysis of HONO which occurred at a rate constant 6% that of NO₂, thermal decomposition of PAN and N₂O₅, surface promoted chemistry involving HNO₃, and secondary chemistry involving NO in the tubing connecting the converter and CL analyzer. These interferences are predicted to occur in all NO₂ P-CL systems but can be avoided by appropriate thermal management and operating at high flow rates.