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Associations between outdoor air pollution and hospital admissions in Brisbane, Australia.

The authors investigated the effects of ambient air pollution on hospital admissions in Brisbane, Australia. The authors used the Air Pollution on Health: European Approach protocol to examine the effects of particles, ozone, sulfur dioxide, and nitrogen dioxide on daily hospital admissions for asthma and respiratory, cardiovascular, and digestive disorders (control diagnosis) that occurred during the period 1987-1994. Ozone was consistently associated with admissions for asthma and respiratory disease-with little evidence of a threshold. In two-pollutant models, the ozone effect was relatively unaffected by the control for high levels of other pollutants. Particulate pollution (measured by nephelometry) was associated positively with admissions for respiratory disease and admissions for asthma in summer, whereas a negative association was observed for cardiovascular admissions. Although sulfur dioxide was associated significantly with admissions for respiratory and cardiovascular disese, a significant association was also found for the control diagnosis of digestive disorders. No significant associations were found for nitrogen dioxide over the study period, although significantly positive seasonal interactions were found for asthma and respiratory disease in autumn, winter, and spring. It was concluded that current levels of ambient air pollution in Brisbane make a significant contribution to the variation in daily hospital admissions for asthma and respiratory disease.

Adolescent↗

Respiratory function changes from inhalation of polluted air.

Exposure to polluted air may trigger respiratory symptoms in certain subjects. Maximal expiratory flow volume measurements and methacholine bronchial challenges were conducted in 25 asthmatics and 30 healthy volunteers, before and after breathing bagged polluted air for 30 min, to determine whether exposures to polluted air influence respiratory function and bronchial reactivity. No differences in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), total respiratory resistance (Rrs), and bronchial reactivity were noted for normal subjects after they inhaled polluted air and ambient air. Significant decreases in FEV1.0 and FEV1.0/FVC, an increase in airway reactivity, and elevation of baseline Rrs values occurred in the asthmatic subjects, after exposure to polluted air. These findings suggest that asthmatic patients are more vulnerable to the adverse effects of polluted air.

Adult↗

Associations between outdoor air pollution and daily mortality in Brisbane, Australia.

The results of several studies have indicated significant associations between daily mortality and air pollution, with little evidence of a threshold. In the current study, the authors examined daily mortality during the period 1987-1993 for the Brisbane region, which is the fastest-growing urban region in Australia (annual average concentration of particulate matter less than 10 microm in diameter = 27 microg/m3, maximum hourly sulfur dioxide level = 60 ppb, and maximum daily ozone hourly level = 118 ppb). The authors conducted a general estimating equation analysis, and they used autoregressive Poisson models for daily mortality to examine associations with air pollution variables. The authors used research methods developed in the Air Pollution on Health, European Approach (APHEA), project to control confounding effects of weather and temporal trends. The air pollutants examined included particulate pollution (measured by nephelometry [bsp data]), sulfur dioxide, ozone, and nitrogen dioxide. The results indicated that the associations between total daily mortality and particulate levels found in studies in the United States and other countries may be applicable in Brisbane, Australia. Ozone levels were also associated significantly with total daily mortality. There was little evidence of interaction between the ozone effects (mainly in summer) and particulates or with sulfur dioxide and nitrogen dioxide. The associations between pollutants (ozone, bsp) and daily mortality were significant only for individuals who were older than 65 y of age; positive associations were also found with cardiovascular disease categories, and the regression coefficients--when significant--were higher than those for total mortality. The results indicated a possible threshold for ozone levels, but a similar result for particulate levels was not apparent.

Age Factors↗

Seasonality in adult asthma admissions, air pollutant levels, and climate: a population-based study.

OBJECTIVE AND BACKGROUND: Most studies of asthma seasonal variations have not examined associations of environmental risk factors and climatic changes associated with seasonality in asthma hospitalizations. This study used population-based data to examine seasonality in asthma admissions and the associated seasonality in levels of air pollutants and climatic factors during a 4-year period in Taiwan. METHODS: A total of 126,671 asthma hospitalizations in Taiwan during 1998-2001 operationalized as monthly admissions per 100,000 population and monthly mean levels of criterion air pollutants and meteorological factors were subjected to Auto-Regressive Integrated Moving Average to test for seasonality and association between asthma admission rates and the pollutant and climatic factor levels. Owing to significant differences in seasonality between pediatric and adult age groups, this study was limited to 99,591 adult asthma cases to examine the seasonality issue as related to the criterion air pollutants and climatic factors using Spearman rank correlations. RESULTS: Seasonal trends showed a hospitalization peak in January through March and a sharp decline beginning in April to a trough in June for both sexes. Seasonal variations in adult asthma admissions were significantly positively correlated with levels of PM10, SO2, CO, NO2, and atmospheric pressure and negatively correlated with temperature and hours of sunshine. CONCLUSIONS: Adult asthma hospitalization propensity is highest in spring and is significantly correlated with air pollution and climate. Air quality control programs and early public warning systems on pollution and atmospheric factors are needed to enable predisposed individuals and their physicians to preempt attacks through primary and secondary preventive measures.

Adolescent↗

Effects of pollution on humic substances.

To assess effects of industrial and environmental pollution on analytical characteristics of humic substances, we isolated humic acids (HA's) and fulvic acids (FA's) from unpolluted and polluted soils and sediments. Following purification, the HA's and FA's were characterized by elemental (C, H, O, N, S) and functional group (CO2H, phenolic OH, total acidity) analyses, infrared (IR) spectrophotometry, differential thermal analysis (DTA) and by metal (Fe, Al, Cu, Mn, Pb, Ni, Co, Zn, Cr, Cd, Hg, Ca and Mg) analyses. Si was also determined in all samples. Polluted HA's and FA's contained more N and S but less O and were richer in all metals and Si than were unpolluted ones. IR spectra showed that polluted humic materials were enriched in COO- groups, secondary non-cyclic amides and possible also in SO3H groups. DTA curves indicated that polluted HA's and FA's were more thermostable than unpolluted HA's and FA's. Unusually high N, S, Cu, Cr, Zn and Hg contents of humic materials appear to be useful indicators of soil and sediment pollution.

Benzopyrans↗

Use of residence time distribution for evaluation of gaseous pollutant volatilization from stored swine manure.

A quantification analysis for evaluation of gaseous pollutant volatilization as a result of mass transfer from stored swine manure is presented from the viewpoint of residence time distribution. The method is based on evaluating the moments of concentration vs. time curves of both air and gaseous pollutants. The concept of moments of concentration histories is applicable to characterize the dispersal of the supplied air or gaseous pollutant in a ventilated system. The mean age or residence time of airflow can be calculated from an inverse system state matrix [B]-1 of a linear dynamic equation describing the dynamics of gaseous pollutant in a ventilated airspace. The sum elements in an arbitrary row i in matrix [B]-1 is equal to the mean age of airflow in airspace i. The mean age of gaseous pollutant in airspace i can be obtained from the area under the concentration profile divided by the equilibrium concentration reading in that space caused by gaseous pollutant sources. Matrix [B]-1 can also be represented in terms of the inverse local airflow rate matrix ([W]-1), transition probability matrix ([P]), and air volume matrix ([V]) as, [B]-1 = [W]-1[P][V]. Finally the mean age of airflow in a ventilated airspace can be interpreted by the physical characteristics of matrices [W] and [P]. The practical use of the concepts is also applied in a typical pig unit.

Air Pollutants↗

An objective definition of air mass types affecting Athens, Greece; the corresponding atmospheric pressure patterns and air pollution levels.

This work aims at defining characteristic air mass types that dominate in the region of Athens, Greece during the cold (November-March) and the warm (May-September) period of the year and also at evaluating the corresponding concentration levels of the main air pollutants. For each air mass type, the mean atmospheric pressure distribution (composite maps) over Europe and the Mediterranean is estimated in order to reveal the association of atmospheric circulation with air pollution levels in Athens. The data basis for this work consists of daily values of thirteen meteorological and six pollutant parameters covering the period 1993-97. The definition of the characteristic air mass types is attempted objectively by using the methods of Factor Analysis and Cluster Analysis. The results show that during the cold period of the year there are six prevailing air mass types (at least 3% of the total number of days) and six infrequent ones. The examination of the corresponding air pollution concentration levels shows that the primary air pollutants appear with increased concentrations when light or southerly winds prevail. This is usually the case when a high pressure system is located over the central Mediterranean or a low pressure system lays over south Italy, respectively. Low levels of the primary pollutants are recorded under northeasterly winds, mainly caused by a high pressure system over Ukraine. During the warm period of the year, the southwestern Asia thermal low and the subtropical anticyclone of the Atlantic Ocean affect Greece. Though these synoptic systems cause almost stagnant conditions, four main air mass types are dominant and ten others, associated with extreme weather, are infrequent. Despite the large amounts of total solar radiation characterizing this period, ozone concentrations remain at low levels in central Athens because of its destruction by nitric oxide.

Air Movements↗

Determination and parameterization of some air pollutants as a function of meteorological parameters in Kayseri, Turkey.

In this paper, the statistical relations between meteorological parameters and some pollutant ground level concentrations are presented. The daily average sulfur dioxide and smoke values were measured at five stations in Kayseri over 20 months. The model adopted for analysis differed from the power-law form selected by former investigators. Wind speed, degree-day temperature, the percentage of relative humidity, the previous day's pollution concentrations, and the amount of global solar radiation were the variables of multiple regression equations that were derived to calculate pollutant concentrations. The amount of cloud cover, however, had no important effect on the pollutant concentrations. The average variances of these regression equations were found as 84 and 75% for sulfur dioxide and smoke concentrations, respectively. The calculated pollutant concentrations utilizing forecast meteorological parameters reflected that the occurrence of high pollutant concentrations can be predicted.

Air Pollutants↗

Concentration of atmospheric pollutants in the gaseous emissions of medical waste incinerators.

The purpose of this paper is to quantify the production of medical waste from a general hospital and to evaluate the atmospheric pollutant concentrations in gaseous emissions associated with its incineration. A 3.8 kg (bed.day)-1 production of medical waste was estimated for 1998; its incineration is related with an ash production of 0.3-0.4 kg (bed.day)-1. The concentrations of atmospheric pollutants were estimated using emission factors, comparing the effluents with and without control of atmospheric pollutants. The calculated concentrations were compared with the emission limits established by Portuguese legislation. The results indicate that, if there is no control of atmospheric pollutants, their concentrations exceed the established limits. This is observed even if correct operation and maintenance procedures are used. The emission concentrations of dioxins are higher than the Portuguese emission limit, which is particularly worrying due to the high toxicity of some of these compounds. Generally, it is possible to reduce pollutant concentrations if appropriate control equipment is used. The conclusions obtained clearly justify the great concern regarding air pollution associated with medical waste incinerators currently operating in Portugal.

Air Pollutants, Occupational↗

Validity of ambient levels of fine particles as surrogate for personal exposure to outdoor air pollution--results of the European EXPOLIS-EAS Study (Swiss Center Basel).

To evaluate the validity of fixed-site fine particle levels as exposure surrogates in air pollution epidemiology, we considered four indicator groups: (1) PM2.5 total mass concentrations, (2) sulfur and potassium for regional air pollution, (3) lead and bromine for traffic-related particles, and (4) calcium for crustal particles. Using data from the European EXPOLIS (Air Pollution Exposure Distribution within Adult Urban Populations in Europe) study, we assessed the associations between 48-hr personal exposures and home outdoor levels of the indicators. Furthermore, within-city variability of fine particle levels was evaluated. Personal exposures to PM2.5 mass were not correlated to corresponding home outdoor levels (n = 44, rSpearman (Sp) = 0.07). In the group reporting neither relevant indoor sources nor relevant activities, personal exposures and home outdoor levels of sulfur were highly correlated (n = 40, rSp = 0.85). In contrast, the associations were weaker for traffic (Pb: n = 44, rSp = 0.53; Br: n = 44, rSp = 0.21) and crustal (Ca: n = 44, rSp = 0.12) indicators. This contrast is consistent with spatially homogeneous regional pollution and higher spatial variability of traffic and crustal indicators observed in Basel, Switzerland. We conclude that for regional air pollution, fixed-site fine particle levels are valid exposure surrogates. For source-specific exposures, however, fixed-site data are probably not the optimal measure. Still, in air pollution epidemiology, ambient PM2.5 levels may be more appropriate exposure estimates than total personal PM2.5 exposure, since the latter reflects a mixture of indoor and outdoor sources.

Adult↗

Daily mortality and air pollution in The Netherlands.

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 micrograms/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.

Adolescent↗

Relationship between air pollution and daily mortality in a tropical city: Kaohsiung, Taiwan.

Air pollution has been associated with daily mortality in numerous studies over the past decade. However, most of these studies were conducted in the United States and Europe, with relatively few done in Asia. In this study, the association between ambient air pollution and daily mortality in Kaohsiung, Taiwan, a large industrial city with a tropical climate, was investigated for the period 1994-2000 using a case-crossover analysis. This design is an alternative to Poisson time-series regression for studying the short-term adverse health effects of air pollution. The air pollutants examined included particulate matter (PM10), sulfur dioxide (SO2), ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO). No significant effects were found between PM10 and SO2 exposure levels and respiratory-related mortality. The well-established link between air pollution levels and daily mortality may not be as strong in cities in tropical areas, although other factors such as differences in pollutant mixtures or underlying health of the population may explain the lack of a strong association in this study. Further studies of this type in cities with varying climates and cultures are needed.

Air Pollution↗

Correlation between air pollution and postneonatal mortality in a subtropical city: Taipei, Taiwan.

With growing evidence of the association between daily mortality and air pollution exposure in adults, it is important to investigate whether infants are also susceptible. The purpose of this study was to examine the relationship between air pollution exposure and postneonatal, defined as infant of more than 27 d and less than 1 yr old, mortality in Taipei, Taiwan's largest city, which has a subtropical climate, for the period 1994-2000, using a case-crossover analysis. This design is an alternative to Poisson time-series regression for studying the short-term adverse health effects of air pollution. The air pollutants examined included particulate matter (PM10), sulfur dioxide (SO2), ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO). The risk of postneonatal deaths was estimated to increase by 3.1% for PM10, 4.1% for SO2, 1.7% for NO2, 3.8% for CO, and 0.1% for O3 for each interquartile range change, respectively. However, the associations were without statistical significance. The established link between air pollution levels and infant mortality may not be as strong in cities with subtropical climates, although other factors such as differences in pollutant component composition or the underlying health of the postneonates may explain the lack of a strong association in this study. Further studies of this type in cities with varying climates and cultures are needed.

Air Pollutants↗

Association of higher levels of ambient criteria pollutants with impaired cardiac autonomic control: a population-based study.

An association between air pollution and increased cardiovascular disease (CVD) mortality has been reported, but underlying mechanisms are unknown. The authors examined short-term associations between ambient pollutants (particulate matter less than 10 microm in aerodynamic diameter (PM10), ozone, carbon monoxide, nitrogen dioxide, and sulfur dioxide) and cardiac autonomic control using data from the fourth cohort examination (1996-1998) of the population-based Atherosclerosis Risk in Communities Study. For each participant, the authors calculated PM10 and gaseous pollutant exposures as 24-hour averages and ozone exposure as an 8-hour average 1 day prior to the randomly allocated examination date. They calculated 5-minute heart rate variability indices and used logarithmically transformed data on high-frequency (0.15-0.40 Hz) and low-frequency (0.04-0.15 Hz) power, standard deviation of normal R-R intervals, and mean heart rate. Linear regression was used to adjust for CVD risk factors and demographic, socioeconomic, and meteorologic variables. Regression coefficients for a one-standard-deviation increase in PM10 (11.5 microg/m3) were -0.06 ms2 (standard error (SE), 0.018), -1.03 ms (SE, 0.31), and 0.32 beats/minute (SE, 0.158) for log-transformed high-frequency power, standard deviation of normal R-R intervals, and heart rate, respectively. Similar results were found for gaseous pollutants. These cross-sectional findings suggest that higher ambient pollutant concentrations are associated with lower cardiac autonomic control, especially among persons with existing CVD, and highlight a putative mechanism through which air pollution is associated with CVD.

Air Pollutants↗

Seasonal analyses of air pollution and mortality in 100 US cities.

Time series models relating short-term changes in air pollution levels to daily mortality counts typically assume that the effects of air pollution on the log relative rate of mortality do not vary with time. However, these short-term effects might plausibly vary by season. Changes in the sources of air pollution and meteorology can result in changes in characteristics of the air pollution mixture across seasons. The authors developed Bayesian semiparametric hierarchical models for estimating time-varying effects of pollution on mortality in multisite time series studies. The methods were applied to the database of the National Morbidity and Mortality Air Pollution Study, which includes data for 100 US cities, for the period 1987-2000. At the national level, a 10-microg/m(3) increase in particulate matter less than 10 microm in aerodynamic diameter at a 1-day lag was associated with 0.15% (95% posterior interval (PI): -0.08, 0.39), 0.14% (95% PI: -0.14, 0.42), 0.36% (95% PI: 0.11, 0.61), and 0.14% (95% PI: -0.06, 0.34) increases in mortality for winter, spring, summer, and fall, respectively. An analysis by geographic region found a strong seasonal pattern in the Northeast (with a peak in summer) and little seasonal variation in the southern regions of the country. These results provide useful information for understanding particle toxicity and guiding future analyses of particle constituent data.

Air Pollution↗

Ambient air pollution and health.

The adverse health effects of air pollution became widely acknowledged after severe pollution episodes occurred in Europe and North America before the 1960s. In these areas, pollutant levels have decreased. During the last 15 years, however, consistent results, mainly from epidemiological studies, have provided evidence that current air pollutant levels have been associated with adverse long- and short-term health effects, including an increase in mortality. These effects have been better studied for ambient particle concentrations but there is also substantial evidence concerning gaseous pollutants such as ozone, NO(2) and CO. Attempts to estimate the impact of air pollution effects on health in terms of the attributable number of events indicate that the ubiquitous nature of the exposure results in a considerable public health burden from relatively weak relative risks.

Air Pollutants↗

A longitudinal study of ambient air pollutants and the lung peak expiratory flow rates among asthmatic children in Hungary.

BACKGROUND: We conducted this study in Budapest, Hungary, to better characterize the effects of exposure to ambient air pollutants on the lung function of asthmatic children. METHODS: The 60 study participants were 9-14 years old, had physician-diagnosed asthma, and were symptomatic during the previous year. Their ambient air pollutant exposures to total suspended particulates (TSP) and sulphur dioxide (SO2) were estimated from measurements made at the air monitor nearest their residence. We used analysis of variance and a fixed-effects model to assess the impact of the pollutants upon their morning and evening peak expiratory flow rates (PEFR) from 13 September to 5 December 1993. RESULTS: Total suspended particulates and SO2 concentrations exceeded World Health Organization guideline limits on several days. Pollutant concentrations and PEFR increased during the study period. After adjusting for temperature, humidity, weekend/weekday, and the time trend, we found no consistent association between air pollutant concentrations and PEFR. CONCLUSIONS: Fall to winter seasonal changes had a large influence on PEFR and may have overshadowed the effects of the air pollutants during the study period. Seasonal influences should be carefully considered when planning future studies.

Adolescent↗

Causality and temporality in the study of short-term effects of air pollution on health.

BACKGROUND: The relationship between air pollution and health is usually analysed by time series analysis. However, temporality (i.e. looking to see whether the cause precedes the effect) is rarely examined in detail. METHODS: Models were fitted to daily levels of black smoke, nitrogen dioxide, sulphur dioxide, ozone and mortality from Barcelona 1986-1995 to account for seasonality, environmental temperature, days of the week and influenza epidemics. Cross-correlations of the residuals were plotted for different lags. RESULTS: Clear evidence of a temporal relationship between mortality and air pollution found for all four pollutants in that changes in the pollutant preceded changes in mortality, implying causality. However the pattern of dependence was different for each pollutant. CONCLUSION: The cross-correlation plot is a useful tool in the analysis of air pollution time series.

Air Pollution↗