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PubMed2005

Air pollution exposure assessment for epidemiologic studies of pregnant women and children: lessons learned from the Centers for Children's Environmental Health and Disease Prevention Research.

The National Children's Study is considering a wide spectrum of airborne pollutants that are hypothesized to potentially influence pregnancy outcomes, neurodevelopment, asthma, atopy, immune development, obesity, and pubertal development. In this article we summarize six applicable exposure assessment lessons learned from the Centers for Children's Environmental Health and Disease Prevention Research that may enhance the National Children's Study: a) Selecting individual study subjects with a wide range of pollution exposure profiles maximizes spatial-scale exposure contrasts for key pollutants of study interest. b) In studies with large sample sizes, long duration, and diverse outcomes and exposures, exposure assessment efforts should rely on modeling to provide estimates for the entire cohort, supported by subject-derived questionnaire data. c) Assessment of some exposures of interest requires individual measurements of exposures using snapshots of personal and microenvironmental exposures over short periods and/or in selected microenvironments. d) Understanding issues of spatial-temporal correlations of air pollutants, the surrogacy of specific pollutants for components of the complex mixture, and the exposure misclassification inherent in exposure estimates is critical in analysis and interpretation. e) "Usual" temporal, spatial, and physical patterns of activity can be used as modifiers of the exposure/outcome relationships. f) Biomarkers of exposure are useful for evaluation of specific exposures that have multiple routes of exposure. If these lessons are applied, the National Children's Study offers a unique opportunity to assess the adverse effects of air pollution on interrelated health outcomes during the critical early life period.

Air Pollutants↗
PubMed1981

Effect of air pollution on chronic respiratory disease in the New York city metropolitan area, 1972.

The effect of air pollution on chronic respiratory diseases (CRD) was examined in a study in the New York metropolitan area in 1972. Four study communities, sites A, B, C and D, were selected for the similarity of socioeconomic and demographic characteristics. Historically, these communities represented an increasing gradient of air pollution levels. However, after air quality improvement in the metropolitan area, Site A had only slightly lower pollution levels than sites B, C and D. In the examination of chronic respiratory symptoms, study hypotheses were established to correspond with historical levels of air pollution. The study population was drawn from parents of children attending elementary school in each site. Information was obtained by means of a questionnaire modified from the 1966 BMRC questionnaire. The analysis was based on 5416 white long-term residents without occupational exposure to irritant dust and fumes. Confounding factors, including smoking status, age, level of education of head-of-household and crowding within the home, were examined. Smoking was found to be the most important factor in determining the level of severity of CRD. The effect of air pollution showed differential patterns among the smokers and nonsmokers. Among the smokers, no air pollution effect was observed. However, among nonsmokers, a statistically significant difference was observed among females. Further, among male nonsmokers a similar pattern was observed, but the effect was not statistically significant. Other possible factors that could contribute to the difference are discussed.

Adolescent↗
PubMed2006

Dog ownership enhances symptomatic responses to air pollution in children with asthma.

BACKGROUND: Experimental data suggest that asthma exacerbation by ambient air pollutants is enhanced by exposure to endotoxin and allergens; however, there is little supporting epidemiologic evidence. METHODS: We evaluated whether the association of exposure to air pollution with annual prevalence of chronic cough, phlegm production, or bronchitis was modified by dog and cat ownership (indicators of allergen and endotoxin exposure). The study population consisted of 475 Southern California children with asthma from a longitudinal cohort of participants in the Children's Health Study. We estimated average annual ambient exposure to nitrogen dioxide, ozone, particulate matter < 10, 2.5, and 10-2.5 microm in aerodynamic diameter (PM10, PM2.5, and PM10-2.5, respectively), elemental and organic carbon, and acid vapor from monitoring stations in each of the 12 study communities. Multivariate models were used to examine the effect of yearly variation of each pollutant. Effects were scaled to the variability that is common for each pollutant in representative communities in Southern California. RESULTS: Among children owning a dog, there were strong associations between bronchitic symptoms and all pollutants examined. Odds ratios ranged from 1.30 per 4.2 microg/m3 for PM10-2.5 [95% confidence interval (CI), 0.91-1.87) to 1.91 per 1.2 microg/m3 for organic carbon (95% CI, 1.34-2.71). Effects were somewhat larger among children who owned both a cat and dog. There were no effects or small effects with wide CIs among children without a dog and among children who owned only a cat. CONCLUSION: Our results suggest that dog ownership, a source of residential exposure to endotoxin, may worsen the relationship between air pollution and respiratory symptoms in asthmatic children.

Adolescent↗
PubMed2006

Gaseous air pollutants and hospitalization for respiratory disease in the neonatal period.

OBJECTIVE: Current levels of ambient air pollution are associated with morbidity and mortality in the general population. To determine the influence of gaseous air pollutants on neonatal respiratory morbidity, we tested the association between daily respiratory hospitalizations and daily concentrations of ambient air pollution gases: ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide, in 11 large Canadian cities. STUDY DESIGN: Daily time-series analyses were employed and results were adjusted for day of the week, temperature, barometric pressure, and relative humidity. RESULTS: The percent increases in hospitalization associated with an increase in air pollution equivalent to its interquartile range were 3.35 [95% confidence interval (CI), 1.73-4.77] for O3, 2.85 (95% CI, 1.68-4.02) for NO2, 1.66 (95% CI, 0.63-2.69) for SO2, and 1.75 (95% CI, 0.48-3.02) for CO. The independent effect of all pollutants combined was 9.61% (95% CI, 4.52-14.7%). CONCLUSION: Our results suggest that neonates are experiencing adverse effects of air pollution at current levels in Canada, and that accounts for a significant proportion of hospitalizations in this subgroup.

Air Pollutants↗
PubMed1990

Prevalence of respiratory conditions among schoolchildren exposed to different levels of air pollutants in the Haifa Bay area, Israel.

During spring 1984, 2334 second and 2000 fifth-grade schoolchildren living in three Haifa Bay areas on the eastern Mediterranean coast with different levels of air pollution were studied. The parents of these children filled out American Thoracic Society and National Heart and Lung Institute health questionnaires, and the children performed the following pulmonary function tests (PFT); FVC, FEV1, FEV1/FEV, PEF, FEF50, and FEF75. A trend of higher prevalence of most reported respiratory symptoms was found for schoolchildren growing up in the medium and high pollution areas as compared with the low pollution area. Part of the reported respiratory diseases were significantly more common among children from the high pollution area. Models fitted for the respiratory conditions that differed significantly among the three areas of residence also included background variables that could be responsible for these differences. Relative risk values, which were calculated from the logistic models, were in the range of 1.38 for sputum with cold and 1.81 for sputum without cold for children from the high pollution area as compared with 1.00 for children from the low pollution area. All the measured values of PFT were within the normal range. There was no consistent trend of reduced pulmonary function that characterized any residential area.

Air Pollutants↗
PubMed1993

Epidemiologic study design for investigating respiratory health effects of complex air pollution mixtures.

Epidemiologic studies of the respiratory health effects of air pollution are intrinsically difficult because exposure is common, expected effects at concentrations found in developed countries are weak, random misclassification of exposure is common, and the respiratory health indicators have multiple etiologies. Exposures to air pollutants also are multidimensional, generally consisting of a mixture of gases and particles. In this paper, epidemiologic study designs are described, and their potential for evaluating effects of complex pollutant mixtures are discussed. Power to detect the independent effects of individual pollutants in a complex pollutant mixture or to measure their interactions is in general very weak unless the study is specifically designed to test such hypotheses. However, with innovative and creative design, the independent and joint effects of multiple pollutants should be estimable in epidemiologic studies.

Air Pollutants↗
PubMed1995

Health effects of particulate air pollution: time for reassessment?

Numerous studies have observed health effects of particulate air pollution. Compared to early studies that focused on severe air pollution episodes, recent studies are more relevant to understanding health effects of pollution at levels common to contemporary cities in the developed world. We review recent epidemiologic studies that evaluated health effects of particulate air pollution and conclude that respirable particulate air pollution is likely an important contributing factor to respiratory disease. Observed health effects include increased respiratory symptoms, decreased lung function, increased hospitalizations and other health care visits for respiratory and cardiovascular disease, increased respiratory morbidity as measured by absenteeism from work or school or other restrictions in activity, and increased cardiopulmonary disease mortality. These health effects are observed at levels common to many U.S. cities including levels below current U.S. National Ambient Air Quality Standards for particulate air pollution.

Acute Disease↗
PubMed1998

Association between air pollution and intrauterine mortality in São Paulo, Brazil.

The associations among daily counts of intrauterine mortality and pollutant concentrations (NO2, SO2, CO, O3, and particulate matter (3/4)10 microm) were investigated for the period ranging from January 1991 to December 1992 in the city of São Paulo, Brazil. We used Poisson regression techniques, adjusted for season and weather. The association between intrauterine mortality and air pollution was strong for NO2 (coefficient = 0.0013/ microg/m3; p<0.01) but lesser for SO2 (coefficient = 0.0005/ microg/m3; p<0.10) and CO (coefficient = 0.0223/ppm; p<0.10). A significant association was observed when an index that combined these three pollutants was considered in the models instead of considering each pollutant individually (p<0.01). These associations exhibited a short time lag, not over 5 days. In addition, some evidence of fetal exposure to air pollution was obtained by disclosing a significant association between the levels of carboxyhemoglobin of blood sampled from the umbilical cord and ambient CO levels in children delivered by nonsmoking pregnant women in the period from May to July 1995. Our results suggest that air pollution in São Paulo may promote adverse health effects on fetuses.

Adult↗
PubMed1999

Reanalysis of the effects of air pollution on daily mortality in Seoul, Korea: A case-crossover design.

We used the case-crossover design to identify any increase in mortality in Seoul, Korea, when there were higher levels of ambient air pollution on case-days than would be expected solely as a result of chance. This empirical study showed that either unidirectional retrospective (selecting only control days prior to death) or prospective (selecting only control days after death) control sampling could cause risk estimates to be confounded by seasonal waves as well as time trends in air pollution levels. In bidirectional control sampling in which exposures at death were compared with exposures both before and after death, the estimated mortality was resistant to confounding by time patterns of air pollution. Using a bidirectional control sampling approach, the results from a conditional logistic regression model controlling for weather conditions showed that the nonaccidental mortality associated with a 50-ppb increment over a 3-day moving average of SO(2) concentrations, including the concurrent day and preceding 2 days, was 1.023 [95% confidence interval (CI), 1.016-1.084]. The relative risk of death was 1.023 (CI, 0.999-1.048) per 50 ppb for 1-hr maximum O(3) and 1.010 (CI, 0.988-1.032) per 100 microg/m(3 )or total suspended particulates. In conclusion, the findings of this study were 2-fold: given the consistency of the observed association between SO(2) and daily mortality across different analysis methods, the association reported here indicates that air pollution is a probable contributor to premature death; and bidirectional control sampling is needed in a case-crossover design applied to air pollution epidemiologic studies to control confounding by seasonal patterns of air pollution as well as time trends.

Adolescent↗
PubMedDate not supplied

Particulate air pollution and asthma: a review of epidemiological and biological studies.

The link between exposure to air pollution and exacerbation of asthma symptoms has been investigated by epidemiological study and by direct biological experimentation. In asthmatics, epidemiological studies generally show a positive correlation between the particulate fraction of air pollution and increased morbidity, although roles for other co-pollutants (for example, ozone) are implicated as well. Direct experimentation using air pollutants, especially particles, to investigate their effects on humans or on animal models of asthma provides corroboration of the epidemiology and has begun to identify the pathophysiological mechanisms involved. We begin this review with an overview of air pollution, followed by a survey of the epidemiological and experimental data regarding air pollution particles and asthma. We finish with a discussion of directions for future research.

Adolescent↗
PubMed2005

[Relationship between low birthweight and air pollution in the city of Sao Paulo, Brazil].

OBJECTIVE: Air pollution has been investigated as a potential determinant for low birthweight. The aim of the present study was to study the effect of air pollution on birthweight. METHODS: We analyzed all deliveries by mothers living in the municipality of Sao Paulo, Southeastern Brazil, between 1998 and 2000. We estimated the prevalence of low birthweight according to newborn, mother, and delivery characteristics. Only births occurring in the most central districts of the city were analyzed, totaling 311.735 events. For the evaluation of the effects of air pollution, we excluded preterm and multiple deliveries. Pollutants analyzed were ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), suspended particles (PM10), and carbon monoxide (CO). The effect of maternal exposure to air pollution on birthweight was evaluated using linear and logistic regression. RESULTS: A total of 4.6% of newborns weighed less than 2,500 g at birth. Maternal exposure to CO, PM10, and NO2 during the first trimester of pregnancy was significantly associated with decreased birthweight. CONCLUSIONS: Our results reinforce the notion that maternal exposure to air pollution during the first trimester of pregnancy may contribute to lesser weight gain in the fetus.

Adult↗
PubMedDate not supplied

[Air pollution and living conditions: a geographical analysis of health risk in Volta Redonda, Rio de Janeiro, Brazil].

Air pollution is a widely recognized hazard to human health. In industrial cities the emission of toxic gases and particulate matter into the atmosphere compounds the pollution problem caused by circulation of vehicles, often creating hazardous public health situations. The goal of this study was to analyze patterns in pollution and living conditions in Volta Redonda and identify more vulnerable areas and population groups. Volta Redonda is a city near Rio de Janeiro with 250,000 inhabitants and Brazil's main steel industrial complex. The presence of several factories in the city, especially the huge CSN steel plant, contributes to increased air pollution levels, to the point that this city is one of the most heavily polluted in the country. The methodology applied to identify areas and groups of people most vulnerable to this sort of pollution utilized a GIS software. The study showed that the northwestern area of Volta Redonda had the worst environmental and living conditions.

Adult↗
PubMedDate not supplied

Phenols and flavonoids in Aleppo pine needles as bioindicators of air pollution.

The aim of the present study is to assess whether certain ecophysiological responses (contents of total phenols, total proanthocyanidins, and total and simple flavonols), in the needles of Aleppo pines (Pinus halepensis Mill.) may be valid bioindicators for the assessment of the air quality. Samples were taken at five natural sites polluted by various pollutants (NO, NO2, other NOx, SO2, and O3). The results show a decrease in total phenol concentrations with levels of nitrogen oxide pollutions (significant negative correlations between the total phenol concentrations and concentrations of NO, NO2, and other NOx). Total flavonoids (total flavonols and proanthocyanidins) are useful bioindicators for ozone pollution (significant negative correlations between total proanthocyanidins and the concentrations of ozone and significant positive correlations between total flavonols and the ozone pollution). Sulfur dioxide pollution is distinguished by low concentrations in quercetin, isorhamnetin, and kaempferol (significant negative correlations between these simple flavonols and the concentrations of SO2). This work confirms the strong interest of using the phenolic compounds of Pinus halepensis as biological indicators of air quality.

Air Pollutants↗
PubMed2006

Spatial estimates of stormwater-pollutant loading using Bayesian networks and geographic information systems.

Stormwater runoff has become the primary source of many pollutants to the Santa Monica Bay watershed (California), and managing stormwater inputs to the bay has become the primary objective of new regulatory efforts. Empirical methods to estimate stormwater pollution have been developed using land-use data; however, land-use data collected from traditional ground surveys are expensive and time consuming and may not be available. This study used an alternative approach and estimated land use from satellite-image classification using Bayesian networks. The results were converted to thematic maps using a geographic information system to visualize spatial estimates of runoff coefficients of the given area, event-mean concentrations (EMCs) of target pollutants, and their pollutant loads. The stormwater-pollutant-loading maps identified areas of high annual-mass loads, which were more affected by impervious areas, because of their high runoff coefficients, rather than their EMCs. In this watershed, the major sources of nonpoint-source pollution are the multiple-family-residential (14%), commercial (7%), public (6%), industrial (3%), and transportation (7%) land uses adjacent to Marina del Rey and the Ballona wetlands. The contributions of single-family-residential (30%) and open (33%) land uses are less important.

Bayes Theorem↗
PubMed1999

Daily changes in oxygen saturation and pulse rate associated with particulate air pollution and barometric pressure.

Epidemiologic studies have linked fine particulate air pollution with increases in morbidity and mortality rates from cardiopulmonary complications. Although the underlying biologic mechanisms responsible for this increase remain largely unknown, potential pathways include transient declines in blood oxygenation and changes in pulse rate following exposures to particulate air pollution episodes. This study evaluated potential associations between daily measures of respirable particulate matter (PM) with pulse rate and oxygen saturation of the blood. Pulse rate and oxygen saturation (Spo2) using pulse oximetry were measured daily in 90 elderly subjects living near air pollution monitors during the winter of 1995-96 in Utah Valley. We also evaluated potential associations of oxygen saturation and pulse rate with barometric pressure. Small but statistically significant positive associations between day-to-day changes in Spo2 and barometric pressure were observed. Pulse rate was inversely associated with barometric pressure. Exposure to particulate pollution was not significantly associated with Spo2 except in male participants 80 years of age or older. Increased daily pulse rate, as well as the odds of having a pulse rate 5 or 10 beats per minute (bpm) above normal (normal is defined as the individual's mean pulse rate throughout the study period), were significantly associated with exposure to particulate pollution on the previous 1 to 5 days. The medical or biologic relevance of these increases in pulse rate following exposure to particulate air pollution requires further study.

Aged↗
PubMedDate not supplied

[Bronchial asthma, atmospheric pollution, and weather conditions. Guadalajara, Jal].

BACKGROUND: In the last year it has been an increase in the prevalence of asthma, as well as in the air pollution. The effect of air pollution on the respiratory health is still controversial. OBJECTIVE: To determine the relationship between the income to the Emergency Room for asthmatic crisis and the air pollution or weather conditions. MATERIAL AND METHOD: An observational, descriptive, retrospective survey was made with children and adult patients who had an income to the Emergency Room of the Dr. Valentín Gómez Farías Regional Hospital due to an asthmatic crisis, during period between January 1st and December 31 the of 1994, being related to weekly measures of ozone, nitrogen dioxide, carbon monoxide, sulfur dioxide and particulate matter as air pollution, and minimal temperature, minimal percentage of humidity and wind speed, as weather conditions. They was related by autoregression technique using the Epi Info 5 computing system. RESULTS: An amount of 406 incomes to the Emergency Room for asthmatic crisis was recorded, observing an increase during the period between September and November. When compared to the air pollutants and weather conditions measurement, it has found a moderate relation between the increase of income and the nitrogen dioxide quantification, as the highest value. CONCLUSIONS: Air pollution and weather conditions by themselves seem to have a minimal to moderate influence on the incidence of incomes to the Emergency Room for asthmatic crisis.

Adult↗
PubMedDate not supplied

[The short-term effects of air pollution on mortality. The results of the EMECAM project in the city of Vigo, 1991-94. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica y la Mortalidad].

BACKGROUND: In the Autonomous Region of Galicia, no study has been made of the impacts of air pollution on human health, despite the fact that several of its major cities have moderate levels of pollution. Therefore, we have considered the need of making this study in the city of Vigo. The main objective of this analysis is that of analyzing the short-term impact of air pollution on the daily death rate for all reasons in the city of Vigo throughout the 1991-1994 period, by using the procedure for analysis set out as part of the EMECAM Project. METHOD: The daily fluctuations in the number of deaths for all causes with the exception of the external ones are listed with the daily fluctuations of sulfur dioxide and particles using Poisson regression models. A non-parametric model is also used in order to better control the confusion variables. RESULTS: Using the Poisson regression model, no significant relationships have been found to exist between the pollutants and the death rate. In the non-parametric model, a relationship was found between the concentration of particles on the day immediately prior to the date of death and the death rate, an effect which remains unchanged on including the autoregressive terms. CONCLUSIONS: Particle-based air pollution is a health risk despite the average levels of this pollutant falling within the air quality guideline levels in the city of Vigo.

Air Pollution↗
PubMedDate not supplied

Environmental risk factors (outdoor air pollution and climatic changes) and increased trend of respiratory allergy.

A wealth of evidence suggests that allergic respiratory diseases such as rhinosinusitis and bronchial asthma have become more common worldwide in recent years and a great deal of etiological and pathogenic research has been carried out to evaluate the possible causes of this increasing trend. There is also some evidence that increased atmospheric concentrations of pollutants such as ozone (O3), nitric oxides (NOx), respirable particulate (PM10) and volatile organic chemicals (VOC5), which result from increased use of liquid petroleum gas or kerosene, may be linked to the increased prevalence of allergic diseases which develop more frequently in urban areas of developed countries. Since bronchial asthma is a syndrome which can be aggravated by inhaled compounds, the effects of air pollutants on health have been the focus of attention. In fact, various studies have demonstrated that inhalation of air pollutants such as O3, nitrogen dioxide (NO2) and sulfur dioxide (SO2), either individually or in combination, can enhance the airway response to inhaled allergens in atopic subjects, thus inducing asthma exacerbations. Moreover, experimental studies have shown that diesel exhaust particulate causes respiratory symptoms and is able also to modulate the immune response by increasing IgE synthesis in predisposed animals and humans. There is also some evidence that air pollutants can interact with aeroallergens in the atmosphere and/or on human airways, potentiating their effects. In fact, by inducing airway inflammation which increases epithelial permeability, some pollutants overcome the mucosal barrier and lead to allergen-induced responses. However, air pollution and climatic changes should also have an indirect effect on allergic response by influencing quantitatively and qualitatively the pollen production by allergenic plants.

Air Pollution↗