Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions

Particulate air pollution is known to be associated with cardiovascular disease. The relation of particulate air pollution with cerebrovascular disease (CVD) has not been extensively studied, particularly in relation to different subtypes of stroke. A time-series study was conducted to evaluate the association between daily air pollution and acute stroke unit hospitalizations in Mantua, Italy. We analyzed 781 CVD consecutive patients living in Mantua county admitted between 2006-08. Data on stroke types, demographic variables, risk factors were available from the Lombardia Stroke Registry. Daily mean value of particulate matter with a diameter <10 mm (PM10), carbon monoxide, nitric oxide, nitrogen dioxide, sulphur dioxide, benzene and ozone were used in the analysis. The association between CVD, ischemic strokes subtypes and pollutants was investigated with a case-crossover design, using conditional logistic regression analysis, adjusting for temperature, humidity, barometric pressure and holidays. Among the 781 subjects admitted 75.7% had ischemic stroke, 11.7% haemorrhagic stroke 12.6% transient ischemic attack. In men admission for stroke was associated with PM10 [odds ratio (OR) 1.01, 95%; confidence interval (CI) 1.00-1.02; P<0.05]. According to the clinical classification, lacunar anterior circulation syndrome stroke type was related to PM10 level registered on the day of admission for both genders (OR: 1.01, 95%; CI: 1.00-1.02; P<0.05) while for total anterior circulation syndrome stroke only in men (OR: 1.04, 95%; CI 1.01-1.07; P<0.05). In conclusion, our study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke.

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Abstract 15837: Particulate Matter 2.5 Exposure Increases Risk of Subsequent Myocardial Infarction

Circulation ◽

10.1161/circ.142.suppl_3.15837 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

John K Maxi ◽

Matthew Herzog ◽

Jonathan Entwisle ◽

Jonathan K Wilt ◽

Richard V Milani

Keyword(s):

Myocardial Infarction ◽

Particulate Matter ◽

Air Quality ◽

Conditional Logistic Regression ◽

Significant Risk ◽

Significant Risk Factor ◽

Daily Average ◽

History Of ◽

Particulate Matter 2.5 ◽

Southeastern Louisiana

Introduction: Particulate matter 2.5 (PM 2.5 ) are airborne particles small enough to be inhaled into the pulmonary alveoli, and are associated with increased hospitalization rates, morbidity, and mortality. The purpose of this study was to evaluate the levels of PM 2.5 in southeastern Louisiana and describe associated cardiovascular outcomes in patients with a history of myocardial infarction (MI). Methods: Air quality monitoring stations were placed around southeastern Louisiana and were analyzed from March 1 st , 2019 to March 1 st , 2020. Samples were collected every 80 seconds, and values were aggregated at the hourly and daily level. We used conditional logistic regression models to determine the risk of MI. Control observations per patient were created using PM 2.5 exposure on the same day of the week for the two weeks before and after the event. Temperature, pressure, humidity, and their interactions with PM 2.5 were included in the model. Results: The average PM 2.5 exposure for the year was 10.41 ug/m 3 +/- 5.57 ug/m 3 , with a daily low of 1.93 ug/m 3 and a daily high of 31.32 ug/m 3 . Peaks from individual sensors reached PM 2.5 concentrations greater than 100 ug/m 3 . PM 2.5 concentration showed a significant, weakly positive correlation with daily average temperature and a significant, weakly negative correlation with daily average barometric pressure. Among patients (n=263) with history of MI, risk of subsequent MI increased by 24.3% per 10 ug/m 3 increase in PM 2.5 exposure with a lag of three days after exposure. (Figure) No significant risk associated with PM 2.5 exposure was observed at shorter lag times. Conclusion: Although the average PM 2.5 levels in southeastern Louisiana were within the WHO guidelines of air quality, PM 2.5 exposure remained a significant risk factor for MI among a those with previous MI.

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The Short-Term Effects of Ambient Air Pollutants on Childhood Asthma Hospitalization in Taiwan: A National Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16020203 ◽

2019 ◽

Vol 16 (2) ◽

pp. 203 ◽

Cited By ~ 15

Author(s):

Ching-Yen Kuo ◽

Chin-Kan Chan ◽

Chiung-Yi Wu ◽

Dinh-Van Phan ◽

Chien-Lung Chan

Keyword(s):

Air Pollution ◽

Particulate Matter ◽

Childhood Asthma ◽

Air Pollutants ◽

Linear Regression Analysis ◽

Significant Risk ◽

Ambient Air ◽

National Study ◽

Relative Risks ◽

Asthma Hospitalization

This investigation determined the effects of air pollution on childhood asthma hospitalization in regions with differing air pollution levels in Taiwan over a long time period. Data of childhood hospital admissions for asthma in patients aged 0–18 years and air quality in eight regions for the period 2001–2012 in Taiwan were collected. Poisson generalized linear regression analysis was employed to identify the relative risks of hospitalization due to asthma in children associated with exposure to varying levels of air pollutants with a change in the interquartile range after adjusting for temperature and relative humidity. Particulate matter ≤2.5 μm (PM2.5), particulate matter ≤10 μm (PM10), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2), were positively associated with childhood asthma hospitalization, while O3 was negatively associated with childhood asthma hospitalization. SO2 was identified as the most significant risk factor. The relative risks for asthma hospitalization associated with air pollutants were higher among children aged 0–5 years than aged 6–18 years and were higher among males than females. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while no association was observed in the lower-level air pollution regions. These findings may prove important for policymakers involved in implementing policies to reduce air pollution.

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Surgical Clipping of Very Small Unruptured Intracranial Aneurysms

Neurosurgery ◽

10.1227/neu.0000000000000991 ◽

2015 ◽

Vol 78 (1) ◽

pp. 47-52 ◽

Cited By ~ 19

Author(s):

Michaël Bruneau ◽

Sepideh Amin-Hanjani ◽

Päivi Koroknay-Pal ◽

Philippe Bijlenga ◽

Behnam Rezai Jahromi ◽

...

Keyword(s):

Neurological Deficit ◽

Intracranial Aneurysms ◽

Significant Risk ◽

Perioperative Period ◽

Significant Risk Factor ◽

Posterior Circulation ◽

Morbidity Rate ◽

Surgical Clipping ◽

Anterior Circulation ◽

Unruptured Intracranial Aneurysms

Abstract BACKGROUND: Treatment of very small unruptured intracranial aneurysms (VSUIAs, defined as ⩽3 mm) can be indicated in selected circumstances. The feasibility and outcomes of endovascular therapy for VSUIAs have been recently published; however, the efficacy and complication rate of surgical clipping has not been reported in any large series to date. OBJECTIVE: We conducted a multicenter study to examine surgical outcomes for VSUIAs. METHODS: All consecutive patients undergoing surgery for a VSUIA in 4 neurosurgical centers between October 2001 and December 2012 were retrospectively analyzed. RESULTS: In the study, 183 patients (128 women, mean age 51.3 years) were treated with 190 procedures for a total of 228 aneurysms. Most were anterior circulation aneurysms (n = 215). The majority were directly clipped (n = 222, 97.4%), with coagulation or wrapping in the remainder. After 1 reoperation for incomplete clipping, postoperative imaging of 225 aneurysms confirmed complete occlusion in 221 (98.2%), 1 neck remnant (0.44%), and 3 partial occlusions (1.3%). Mortality was 0%. Early postoperative neurological deficit developed in 12 patients (6.6%); posterior circulation location was a significant risk factor for early neurological deficit (P < .001). Middle cerebral artery aneurysms had the lowest rate of postoperative deficits at 1.5% (P = .023). After the initial 30-day perioperative period, all deficits related to treatment of posterior circulation aneurysms recovered; overall neurological morbidity decreased to 2.7% with no mortality. CONCLUSION: VSUIA clipping is highly effective and is associated with a low morbidity rate. For VSUIAs selected for treatment, our data support surgical clipping as the modality of choice.

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The effect of short term exposure to outdoor air pollution on fertility

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00838-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Mireia González-Comadran ◽

Bénédicte Jacquemin ◽

Marta Cirach ◽

Rafael Lafuente ◽

Thomas Cole-Hunter ◽

...

Keyword(s):

Air Pollution ◽

Sensitivity Analysis ◽

Particulate Matter ◽

Significant Risk ◽

Acute Exposure ◽

Reproductive Outcomes ◽

Short Term ◽

Short Term Exposure ◽

The Impact ◽

Subacute Exposure

Abstract Background There is evidence to suggest that long term exposure to air pollution could be associated with decreased levels of fertility, although there is controversy as to how short term exposure may compromise fertility in IVF patients and what windows of exposure during the IVF process patients could be most vulnerable. Methods This prospective cohort study aimed to evaluate the impact of acute exposure that air pollution have on reproductive outcomes in different moments of the IVF process. Women undergoing IVF living in Barcelona were recruited. Individual air pollution exposures were modelled at their home address 15 and 3 days before embryo transfer (15D and 3D, respectively), the same day of transfer (D0), and 7 days after (D7). The pollutants modelled were: PM2.5 [particulate matter (PM) ≤2.5 μm], PMcoarse (PM between 2.5 and 10μm), PM10 (PM≤10 μm), PM2.5 abs, and NO2 and NOx. Outcomes were analyzed using multi-level regression models, with adjustment for co-pollutants and confouding factors. Two sensitivity analyses were performed. First, the model was adjusted for subacute exposure (received 15 days before ET). The second analysis was based on the first transfer performed on each patient aiming to exclude patients who failed previous transfers. Results One hundred ninety-four women were recruited, contributing with data for 486 embryo transfers. Acute and subacute exposure to PMs showed a tendency in increasing miscarriage rate and reducing clinical pregnancy rate, although results were not statistically significant. The first sensitivity analysis, showed a significant risk of miscarriage for PM2.5 exposure on 3D after adjusting for subacute exposure, and an increased risk of achieving no pregnancy for PM2.5, PMcoarse and PM10 on 3D. The second sensitivity analysis showed a significant risk of miscarriage for PM2.5 exposure on 3D, and a significant risk of achieving no pregnancy for PM2.5, PMcoarse and PM10 particularly on 3D. No association was observed for nitrogen dioxides on reproductive outcomes. Conclusions Exposure to particulate matter has a negative impact on reproductive outcomes in IVF patients. Subacute exposure seems to increase the harmful effect of the acute exposure on miscarriage and pregnancy rates. Nitrogen dioxides do not modify significantly the reproductive success.

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Covid-19 Lockdown in Spring 2020 in France Provided Unexpected Opportunity to Assess Health Impacts of Falls in Air Pollution

Frontiers in Sustainable Cities ◽

10.3389/frsc.2021.643821 ◽

2021 ◽

Vol 3 ◽

Author(s):

Lucie Adélaïde ◽

Sylvia Medina ◽

Vérène Wagner ◽

Perrine de Crouy-Chanel ◽

Elsa Real ◽

...

Keyword(s):

Air Pollution ◽

Significant Risk ◽

Significant Risk Factor ◽

Ambient Air ◽

Health Impact ◽

Ambient Air Pollution ◽

Health Impacts ◽

Long Term Effects ◽

Pollution Levels

Lockdown measures to limit the spread of Covid-19 in France in spring 2020 sharply reduced activities and lowered air-pollution concentrations. This study sought to determine the short- and long-term impacts on mortality in metropolitan France resulting from the temporary decrease in the population's exposure to air pollution. The reduction in exposure to air pollution was estimated by calculating the difference between modeled exposure of the population during the strict lockdown and the gradual lifting, and the simulated exposure that would have been observed in the absence of lockdown. A quantitative health impact assessment was used to estimate both the short-term impact of PM10 and NO2 reductions, and the long-term impact of PM2.5 and NO2 reductions on mortality. Reduced activities during the lockdown lowered NO2 and PM concentrations, resulting in about 2,300 deaths postponed for PM2.5 and nearly 1,200 for NO2, mainly due to avoided long-term effects. This study shows that, even in an unprecedented context that is certainly neither realistic nor desirable to improve air quality in the long run, public interventions appear to have a significant impact on health through reductions in air-pollution levels. In a long-term perspective, the study also reminds us that the total burden of air pollution on health remains a significant risk factor in France. Efforts to reduce ambient air pollution must thus be pursued sustainably for all sources of air pollution with suitably adapted but ambitious policies. Finally, the lockdown restrictions had other consequences, both positive and negative, on the population's health. These consequences highlight the need to conduct more integrated assessments of health impacts that include the multisectoral consequences of interventions, particularly in terms of population compliance with mitigating restrictions, behavior and mental health and, more broadly, climate change.

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Meteorological Factors Affecting Particulate Air Pollution of a City

Bulletin of the American Meteorological Society ◽

10.1175/1520-0477-42.8.556 ◽

1961 ◽

Vol 42 (8) ◽

pp. 556-560 ◽

Cited By ~ 3

Author(s):

R. R. Dickson

Keyword(s):

Air Pollution ◽

Particulate Matter ◽

Meteorological Factors ◽

Absolute Error ◽

Graphical Analysis ◽

Factors Affecting ◽

Particulate Air Pollution ◽

Day Of The Week ◽

Matter Concentration ◽

Pollution Concentrations

Due to its utility in handling joint functions, the method of coaxial graphical correlation is used to relate particulate air pollution at Nashville, Tennessee to various meteorological factors. The derived relationship applied to test data yielded an average absolute error of 38.3 micrograms per cubic meter and root-mean-square error of 59.3; these results are clearly superior to a climatological control forecast using seasonal average concentrations. Graphical analysis and supporting correlation-ratio computations suggest that small amounts of precipitation may be very effective in cleansing particulate matter from the atmosphere, rendering further precipitation of little consequence. The analysis emphasizes the importance of wind direction in governing air-pollution concentrations at a point, suggesting that point measurement of particulate concentrations may have little representativeness when applied to an area the size of a city. Particulate-matter concentration is found significantly correlated with day of the week (weekday-weekend groupings), offering an avenue for improvement of results.

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Particulate Matter and Respiratory Symptoms among Adults Living in Windhoek, Namibia; a Cross Sectional Descriptive Study

10.20944/preprints201610.0030.v1 ◽

2016 ◽

Author(s):

Ndinomholo Hamatui ◽

Caryl Beynon

Keyword(s):

Particulate Matter ◽

Respiratory Symptoms ◽

Respiratory Health ◽

Significant Risk ◽

Reference Method ◽

Significant Risk Factor ◽

Cross Sectional ◽

Particulate Pollution ◽

Related Data ◽

Health Related

The study aimed to estimate the prevalence of respiratory symptoms and to assess respiratory health risks associated with Particulate Matter (PM) exposure among the residents of Windhoek, Namibia. Objectives: To measure particulate pollution concentration in Windhoek through monitoring of particulate matter concentration and to identify any associations between particulate pollution, individual location and respiratory health among the Windhoek resident’s. Methods: an adapted standardized self-administered questionnaire was used to collect respiratory health related data as well as previous exposure, while PM monitoring was done using ASTM D1739 reference method. Results: A high prevalence was observed for cough (43%), breathlessness (25%), and Asthma (11.2%). PM was found to be a significant risk factor for episode of cough and phlegm, while high PM exposure category had increased odds ratio for episode of phlegm and cough (OR: 2.5, 95% CI: 0.8-8.0). No association was observed between location and respiratory health outcomes. Conclusion: The study found high levels of PM concentration across all Windhoek suburbs which were above the German, American and EPA. Enactment of legislation relating to the control and monitoring of PM related emissions at point of generation is required at country and city level.

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Risk Factors for COVID-19 versus non-COVID-19 related in-hospital and community deaths by Local Authority District in Great Britain

10.1101/2020.05.21.20108936 ◽

2020 ◽

Author(s):

Samuel Paul Leighton ◽

Danielle Jane Leighton ◽

James Herron ◽

Rachel Upthegrove ◽

Jonathan Cavanagh ◽

...

Keyword(s):

Public Health ◽

Risk Factors ◽

Air Pollution ◽

Great Britain ◽

Public Health Policy ◽

Hospital Care ◽

Local Authority ◽

Significant Risk ◽

Significant Risk Factor ◽

Care Homes

Objectives: To undertake a preliminary hypothesis-generating analysis exploring putative risk factors for coronavirus diseae 2019 (COVID-19) population-adjusted deaths, compared with non-COVID-19 related deaths, at a local authority district (LAD) level in hospital, care homes and at home. Design: Ecological retrospective cohort study Setting Local authority districts (LADs) in England, Scotland and Wales (Great Britain (GB)). Participants All LAD deaths registered by week 16 of 2020. Main Outcome Measures Death registration where COVID-19 is mentioned as a contributing factor per 100,000 people in all settings, and in i) cares homes, ii) hospitals or iii) home only, in comparison to non-COVID-19 related deaths. Results Across GB by week 16 of 2020, 20,684 deaths had been registered mentioning COVID-19, equivalent to 25.6 per 100,000 people. Significant risk factors for LAD COVID-19 death in comparison to non-COVID-19 related death were air pollution and proportion of the population who were female. Significant protective factors were higher air temperature and proportion of the population who were ex-smokers. Conversely, for all COVID-19 unrelated deaths in comparison to COVID-19 deaths, higher rates of communal living, higher population rates of chronic kidney disease, chronic obstructive pulmonary disease, cerebrovascular disease deaths under 75 and dementia were predictive of death, whereas, higher rates of flight passengers was protective. Looking at individual setttings, the most notable findings in care homes was Scotland being a significant risk factor for COVID-19 related deaths compared to England. For hospital setting, the proportion of the population who were from black and Asian minority ethnic (BAME) groups significantly predicted COVID-19 related death. Conclusions This is the first study within GB to assess COVID-19 related deaths in comparison to COVID-19 unrelated deaths across hospital, care homes and home combined. As an ecological study, the results cannot be directly extrapolated to individuals. However, the analysis may be informative for public health policy and protective measures. From our hypothesis-generating analysis, we propose that air pollution is a significant risk factor and high temperature a significant protective factor for COVID-19 related deaths. These factors cannot readily be modelled at an individual level. Scottish local authorities and local authorities with a higher proportion of individuals of BAME origin are potential risk factors for COVID-19 related deaths in care homes and in hospitals, respectively. Altogether, this analysis shows the benefits of access to high quality open data for public information, public health policy and further research.

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Recreational physical activity and the problem of particulate matter air pollution

Przeglad Epidemiologiczny ◽

10.32394/pe.73.22 ◽

2019 ◽

pp. 349-360 ◽

Cited By ~ 1

Author(s):

Krzysztof Kocot

Keyword(s):

Physical Activity ◽

Air Pollution ◽

Particulate Matter ◽

Health Effects ◽

Negative Impact ◽

Pollution Level ◽

Review Author ◽

Recreational Physical Activity ◽

Positive Effects ◽

Particulate Air Pollution

Studies reveal the negative impact of exposure to particulate air pollution on human health, especially on respiratory and circulatory systems. At the same time the beneficial effects of maintaining adequate level of physical activity are well known. In this review author presents analysis of chosen current articles about health effects of recreational physical activity in the environment of high level of ambient particulate matter air pollution. Available data suggests that there are complex relations between physical activity and exposure to air pollution. The direct positive effects of recreational physical activity include decrease of diastolic blood pressure and bronchial dilatation. It is proven that particulate air pollution show contrary impact on respiratory and cardiovascular systems. The mechanisms of this influence consist of induction of inflammation in respiratory epithelial cells, increase of oxidative stress and alterations in autonomic nervous system regulation. Changes induced by air pollution, expressed by the decrease of spirometry parameters (most commonly FEV1 decrease) were observed even in young and healthy adults doing recreational physical activity. Nevertheless, several studies suggest modulatory impact of physical exercises, which may limit the pro-inflammatory influence of particulate air pollution. Less expressed short-term negative effects of exposure have been observed in people doing physical exercise in comparison to those being inactive at the same time. In addition, apart from direct health effects, air pollution may also discourage exposed people from doing physical activity. Therefore, balanced choices regarding physical activity are needed, in order to decrease the negative impact of exposure to air pollution, without limiting the positive impact of physical activity. Still, new research is needed in order to fully explain relations between physical activity and exposure to air pollution. This will allow to elaborate physical activity guidelines including current air pollution level, better risk communication and promotion of safe ways of exercise.

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