Long term effects of air pollution on hospital admissions. Results from the Italian cohort in the LIFE MED HISS project. (LIFE12 ENV/IT/000834)

We hypothesize that analyzing individual-level secondary data with instrumental variable (IV) methods can advance knowledge of the long-term effects of air pollution on dementia. We discuss issues in measurement using secondary data and how IV estimation can overcome biases due to measurement error and unmeasured variables. We link air-quality data from the Environmental Protection Agency’s monitors with Medicare claims data to illustrate the use of secondary data to document associations. Additionally, we describe results from a previous study that uses an IV for pollution and finds that PM2.5’s effects on dementia are larger than non-causal associations.

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Long-term Effects of Air Pollution and Amyotrophic Lateral Sclerosis Risk

Annals of Epidemiology ◽

10.1016/j.annepidem.2021.07.015 ◽

2021 ◽

Keyword(s):

Air Pollution ◽

Amyotrophic Lateral Sclerosis ◽

Long Term Effects ◽

Lateral Sclerosis

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Anthropogenic Effects on Forest Ecosystems at Various Spatio-Temporal Scales

The Scientific World JOURNAL ◽

10.1100/tsw.2002.129 ◽

2002 ◽

Vol 2 ◽

pp. 827-841 ◽

Cited By ~ 1

Author(s):

Michael Bredemeier

Keyword(s):

Air Pollution ◽

Long Range ◽

Acid Deposition ◽

Soil Degradation ◽

Forest Ecosystems ◽

Global Scale ◽

Soil Productivity ◽

Long Term Effects ◽

The World

The focus in this review of long-term effects on forest ecosystems is on human impact. As a classification of this differentiated and complex matter, three domains of long-term effects with different scales in space and time are distinguished: 1- Exploitation and conversion history of forests in areas of extended human settlement 2- Long-range air pollution and acid deposition in industrialized regions 3- Current global loss of forests and soil degradation.There is an evident link between the first and the third point in the list. Cultivation of primary forestland — with its tremendous effects on land cover — took place in Europe many centuries ago and continued for centuries. Deforestation today is a phenomenon predominantly observed in the developing countries, yet it threatens biotic and soil resources on a global scale. Acidification of forest soils caused by long-range air pollution from anthropogenic emission sources is a regional to continental problem in industrialized parts of the world. As a result of emission reduction legislation, atmospheric acid deposition is currently on the retreat in the richer industrialized regions (e.g., Europe, U.S., Japan); however, because many other regions of the world are at present rapidly developing their polluting industries (e.g., China and India), “acid rain” will most probably remain a serious ecological problem on regional scales. It is believed to have caused considerable destabilization of forest ecosystems, adding to the strong structural and biogeochemical impacts resulting from exploitation history.Deforestation and soil degradation cause the most pressing ecological problems for the time being, at least on the global scale. In many of those regions where loss of forests and soils is now high, it may be extremely difficult or impossible to restore forest ecosystems and soil productivity. Moreover, the driving forces, which are predominantly of a demographic and socioeconomic nature, do not yet seem to be lessening in strength. It can only be hoped that a wise policy of international cooperation and shared aims can cope with this problem in the future.

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Effect of the COVID-19 lockdown on disease recognition and utilisation of healthcare services in the older population in German: a cross-sectional study

Age and Ageing ◽

10.1093/ageing/afaa260 ◽

2020 ◽

Author(s):

Bernhard Michalowsky ◽

Wolfgang Hoffmann ◽

Jens Bohlken ◽

Karel Kostev

Keyword(s):

Hospital Admissions ◽

Healthcare Services ◽

Routine Care ◽

Cross Sectional Study ◽

Age Group ◽

Sectional Study ◽

Long Term Effects ◽

Older Population ◽

Cross Sectional

Abstract Background There is little evidence about the utilisation of healthcare services and disease recognition in the older population, which was urged to self-isolate during the COVID-19 lockdown. Objectives We aimed to describe the utilisation of physician consultations, specialist referrals, hospital admissions and the recognition of incident diseases in Germany for this age group during the COVID-19 lockdown. Design Cross-sectional observational study. Setting 1,095 general practitioners (GPs) and 960 specialist practices in Germany. Subjects 2.45 million older patients aged 65 or older. Methods The number of documented physician consultations, specialist referrals, hospital admissions and incident diagnoses during the imposed lockdown in 2020 was descriptively analysed and compared to 2019. Results Physician consultations decrease slightly in February (−2%), increase before the imposed lockdown in March (+9%) and decline in April (−18%) and May (−14%) 2020 compared to the same periods in 2019. Volumes of hospital admissions decrease earlier and more intensely than physician consultations (−39 versus −6%, respectively). Overall, 15, 16 and 18% fewer incident diagnoses were documented by GPs, neurologists and diabetologists, respectively, in 2020. Diabetes, dementia, depression, cancer and stroke were diagnosed less frequently during the lockdown (−17 to −26%), meaning that the decrease in the recognition of diseases was greater than the decrease in physician consultations. Conclusion The data suggest that organisational changes were adopted quickly by practice management but also raise concerns about the maintenance of routine care. Prospective studies should evaluate the long-term effects of lockdowns on patient-related outcomes.

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