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Long-Term Exposure to Ambient Air Pollution and Mortality Due to Cardiovascular Disease and Cerebrovascular Disease in Shenyang, China  [PDF]
Pengfei Zhang,Guanghui Dong,Baijun Sun,Liwen Zhang,Xi Chen,Nannan Ma,Fei Yu,Huimin Guo,Hui Huang,Yungling Leo Lee,Naijun Tang,Jie Chen
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0020827
Abstract: The relationship between ambient air pollution exposure and mortality of cardiovascular and cerebrovascular diseases in human is controversial, and there is little information about how exposures to ambient air pollution contribution to the mortality of cardiovascular and cerebrovascular diseases among Chinese. The aim of the present study was to examine whether exposure to ambient-air pollution increases the risk for cardiovascular and cerebrovascular disease.
Traffic air pollution and mortality from cardiovascular disease and all causes: a Danish cohort study
Ole Raaschou-Nielsen, Zorana Andersen, Steen Jensen, Matthias Ketzel, Mette S?rensen, Johnni Hansen, Steffen Loft, Anne Tj?nneland, Kim Overvad
Environmental Health , 2012, DOI: 10.1186/1476-069x-11-60
Abstract: We followed up 52 061 participants in a Danish cohort for mortality in the nationwide Register of Causes of Death, from enrollment in 1993–1997 through 2009, and traced their residential addresses from 1971 onwards in the Central Population Registry. We used dispersion-modelled concentration of nitrogen dioxide (NO2) since 1971 as indicator of traffic air pollution and used Cox regression models to estimate mortality rate ratios (MRRs) with adjustment for potential confounders.Mean levels of NO2 at the residence since 1971 were significantly associated with mortality from cardiovascular disease (MRR, 1.26; 95% confidence interval [CI], 1.06–1.51, per doubling of NO2 concentration) and all causes (MRR, 1.13; 95% CI, 1.04–1.23, per doubling of NO2 concentration) after adjustment for potential confounders. For participants who ate?<?200 g of fruit and vegetables per day, the MRR was 1.45 (95% CI, 1.13–1.87) for mortality from cardiovascular disease and 1.25 (95% CI, 1.11–1.42) for mortality from all causes.Traffic air pollution is associated with mortality from cardiovascular diseases and all causes, after adjustment for traffic noise. The association was strongest for people with a low fruit and vegetable intake.Although several recent studies have shown associations between long-term exposure to traffic-related air pollution and mortality from cardiovascular disease and all causes [1-9], several questions remain open. Exposure to road traffic noise might explain the observed associations, as this has been associated with morbidity and mortality from cardiovascular disease [10]. Furthermore, air pollution could affect the risk for cardiovascular disease through mechanisms involving systemic oxidative stress and inflammation, which could drive atherosclerosis progression and other long-term effects as well as serve as triggers of events through changes in vascular function, thrombogenecity, plaque stability and autonomic balance [11]; the amount of fruit and vegetables
Chronic exposure to outdoor air pollution and diagnosed cardiovascular disease: meta-analysis of three large cross-sectional surveys
Lindsay JL Forbes, Minal D Patel, Alicja R Rudnicka, Derek G Cook, Tony Bush, John R Stedman, Peter H Whincup, David P Strachan, HR Anderson
Environmental Health , 2009, DOI: 10.1186/1476-069x-8-30
Abstract: We carried out a cross-sectional analysis of data on more than 19,000 white adults aged 45 and older who participated in three representative surveys of the English population in 1994, 1998 and 2003, examining the relationship between self-reported doctor-diagnosed cardiovascular disease and exposure to outdoor air pollutants using multilevel regression techniques and meta-analysis.The combined estimates suggested that an increase of 1 μg m-3 in concentration of particulate matter less than 10 microns in diameter was associated with an increase of 2.9% (95% CI -0.6% to 6.5%) in prevalence of cardiovascular disease in men, and an increase of 1.6% (95%CI -2.1% to 5.5%) in women. The year-specific analyses showed strongly positive associations in 2003 between odds of cardiovascular disease in both men and women and exposure to particulate matter but not in 1994 or 1998. We found no consistent associations between exposure to gaseous air pollutants and doctor-diagnosed cardiovascular disease.The associations of prevalent cardiovascular disease with concentration of particulate matter less than 10 microns in diameter, while only weakly positive, were consistent with the effects reported in cohort studies. The results provide evidence of the size of the association between particulate air pollution and the prevalence of cardiovascular disease but no evidence for an association with gaseous pollutants. We found strongly positive associations between particulate matter and cardiovascular disease in 2003 only, which highlights the importance of replicating findings in more than one population.Higher outdoor particulate concentration is associated with increased cardiopulmonary deaths in cohort studies[1,2]. Many studies have shown short-term associations between air pollution levels and cardiovascular events up to a few weeks later [3]. However, we have found no reports of large scale population studies of chronic exposure to air pollution and cardiovascular morbidity rather
Automatic Region-wise Spatially Varying Coefficient Regression Model: an Application to National Cardiovascular Disease Mortality and Air Pollution Association Study  [PDF]
Shuo Chen,Chengsheng Jiang,Lance Waller
Statistics , 2015,
Abstract: Motivated by analyzing a national data base of annual air pollution and cardiovascular disease mortality rate for 3100 counties in the U.S. (areal data), we develop a novel statistical framework to automatically detect spatially varying region-wise associations between air pollution exposures and health outcomes. The automatic region-wise spatially varying coefficient model consists three parts: we first compute the similarity matrix between the exposure-health outcome associations of all spatial units, then segment the whole map into a set of disjoint regions based on the adjacency matrix with constraints that all spatial units within a region are contiguous and have similar association, and lastly estimate the region specific associations between exposure and health outcome. We implement the framework by using regression and spectral graph techniques. We develop goodness of fit criteria for model assessment and model selection. The simulation study confirms the satisfactory performance of our model. We further employ our method to investigate the association between airborne particulate matter smaller than 2.5 microns (PM 2.5) and cardiovascular disease mortality. The results successfully identify regions with distinct associations between the mortality rate and PM 2.5 that may provide insightful guidance for environmental health research.
Air pollution and its impact on the cardiovascular system  [PDF]
Marjorie Paris Colombini
Einstein (S?o Paulo) , 2008,
Abstract: Despite the great medical advances, cardiovascular disease remains one of the major causes of mortality worldwide, especially in industrialized countries. It develops as a result of countless complex interactions between genetic factors such as those related to age, sex, family history, weight, and post-menopausal status in women; and to environment-related factors such as cigarette smoking, alcohol use, eating habits, physical activity, and others. For more than a decade, several epidemiological studies have demonstrated the existence of a consistent association between air pollution and increased risk for cardiovascular events, that is, not only cardiovascular death, but also acute myocardial infarction and arrhythmias. Experimental studies in different animal species, observational studies in humans, as well as in vitro cellular and acellular models attempt to elucidate the probable biological mechanisms that lend plausibility to these associations, but they fail to do it clearly, since the severity and progression of cardiovascular disease are much more affected than is its induction. However, some effects resulting from the exposure to different air pollutants have been evidenced and the most significant of which involve pulmonary and systemic inflammatory response, blood clotting disorders, promotion and potentiation of the atherosclerotic process, and cardiac autonomic dysfunction.
Effect of air pollution on diabetes and cardiovascular diseases in S?o Paulo, Brazil
Pereira Filho, M.A.;Pereira, L.A.A.;Arbex, F.F.;Arbex, M.;Concei??o, G.M.;Santos, U.P.;Lopes, A.C.;Saldiva, P.H.N.;Braga, A.L.F.;Cendon, S.;
Brazilian Journal of Medical and Biological Research , 2008, DOI: 10.1590/S0100-879X2008005000020
Abstract: type 2 diabetes increases the risk of cardiovascular mortality and these patients, even without previous myocardial infarction, run the risk of fatal coronary heart disease similar to non-diabetic patients surviving myocardial infarction. there is evidence showing that particulate matter air pollution is associated with increases in cardiopulmonary morbidity and mortality. the present study was carried out to evaluate the effect of diabetes mellitus on the association of air pollution with cardiovascular emergency room visits in a tertiary referral hospital in the city of s?o paulo. using a time-series approach, and adopting generalized linear poisson regression models, we assessed the effect of daily variations in pm10, co, no2, so2, and o3 on the daily number of emergency room visits for cardiovascular diseases in diabetic and non-diabetic patients from 2001 to 2003. a semi-parametric smoother (natural spline) was adopted to control long-term trends, linear term seasonal usage and weather variables. in this period, 45,000 cardiovascular emergency room visits were registered. the observed increase in interquartile range within the 2-day moving average of 8.0 μg/m3 so2 was associated with 7.0% (95%ci: 4.0-11.0) and 20.0% (95%ci: 5.0-44.0) increases in cardiovascular disease emergency room visits by non-diabetic and diabetic groups, respectively. these data indicate that air pollution causes an increase of cardiovascular emergency room visits, and that diabetic patients are extremely susceptible to the adverse effects of air pollution on their health conditions.
Health effects of long-term exposure to air pollution: An overview of major respiratory and cardiovascular diseases and diabetes  [PDF]
Jovanovic-Andersen Zorana
Chemical Industry and Chemical Engineering Quarterly , 2012, DOI: 10.2298/ciceq120110112j
Abstract: Large number of studies provided convincing evidence for adverse effects of exposure to outdoor air pollution on human health, and served as basis for current USA and EU Air Quality Standards and limit values. Still, new knowledge is emerging, expanding our understanding of vast effects of exposure to air pollution on human health of this ubiquitous exposure affecting millions of people in urban setting. This paper focuses on the studies of health effects of long-term (chronic) exposures to air pollution, and includes major chronic and acute diseases in adults and especially elderly, which will present increasing public health burden, due to improving longevity and projected increasing numbers of elderly. The paper gives overview over the most relevant and latest literature presented by different health outcomes: chronic obstructive pulmonary disease, asthma, pneumonia, cardiovascular disease, and diabetes.
Da o cardiovascular por material particulado del aire. Puesta al día 2008 Association between air pollution and cardiovascular risk  [cached]
Oscar Román A,María José Prieto C,Pedro Mancilla F,Pedro Astudillo O
Revista médica de Chile , 2009,
Abstract: A clear cut relationship between particulate matter air contamination and the mortality and morbidity due to respiratory disease has been observed in the last decades. However there is also a relationship between air pollution and cardiovascular diseases. In big cities, a big or small particle concentration increase of 10 xg/m3 is associated with a significantly higher risk of ischemic heart disease and myocardial infarction, both when acute or chronic exposures are considered. The risk is higher for small particles. Similar risk increases are observed in patients with hypertension, stroke or severe arrhythmias. This association is independent of environmental distracters such as weather, temperature or humidity and of classical cardiovascular risk factors such as age, diabetes, dyslipidemia and obesity. Physicians should be aware of the problem and explain their patients the increased risk that they are facing due to air pollution (Rev Méd Chile 2009; 137: 1217-24).
Influence of air pollution on hospital admissions for cardiovascular and respiratory diseases in Ni , Serbia  [PDF]
Milo?evi? Zoran,Bogdanovi? Dragan,Jovi? Sla?ana,Stankovi? Aleksandra
Vojnosanitetski Pregled , 2010, DOI: 10.2298/vsp1006473m
Abstract: Background/Aim. In studies that investigate the health effects of short-term air pollution exposure, population-wide changes in acute outcomes such as mortality, hospital admissions and healthcare visits are linked to short-term variations in ambient pollutant concentrations. The aim of this study was to estimate the association between daily outdoor black smoke and sulphur dioxide levels and hospital admissions for cardiovascular and respiratory diseases in Ni , within a period 2001-2005. Methods. A time series analysis was performed using separated regression models for each pollutant and disease group, by age groups and population as a whole. The effects of copollutant, meteorological factors and cyclic oscillations in hospitalization numbers were controlled. Results. A significant increase in hospital admissions was associated with a 10 μg/m3 increase in the concentration of black smoke, for cardiovascular diseases: 3.14% (< 0.01) in children and youth under 19 years of age, 1.85% (< 0.001) in 19-64 age group, and 0.84% (< 0.05) in all ages, and for respiratory diseases: 1.77% (< 0.05) in 19-64 age group, and 0.91% (< 0.05) in all ages. The effects on hospitalizations for respiratory diseases in children and youth under 19 years of age, and for cardiovascular and respiratory diseases in the elderly were not statistically significant. The increase of sulphur dioxide level was associated with the increased number of hospitalizations, for both cardiovascular and respiratory diseases in all age groups, but the influence was not statistically significant. Conclusion. Outdoor pollutants concentrations in urban area of Ni were below regulated limit values during most of the investigated period days but it is shown that even such a level of pollution has a significant effect on hospital admissions for cardiovascular and respiratory diseases.
Study on the Association between Ambient Air Pollution and Daily Cardiovascular and Respiratory Mortality in an Urban District of Beijing  [PDF]
Fengying Zhang,Liping Li,Thomas Krafft,Jinmei Lv,Wuyi Wang,Desheng Pei
International Journal of Environmental Research and Public Health , 2011, DOI: 10.3390/ijerph8062109
Abstract: The association between daily cardiovascular/respiratory mortality and air pollution in an urban district of Beijing was investigated over a 6-year period (January 2003 to December 2008). The purpose of this study was to evaluate the relative importance of the major air pollutants [particulate matter (PM), SO 2, NO 2] as predictors of daily cardiovascular/respiratory mortality. The time-series studied comprises years with lower level interventions to control air pollution (2003–2006) and years with high level interventions in preparation for and during the Olympics/Paralympics (2007–2008). Concentrations of PM 10, SO 2, and NO 2, were measured daily during the study period. A generalized additive model was used to evaluate daily numbers of cardiovascular/ respiratory deaths in relation to each air pollutant, controlling for time trends and meteorological influences such as temperature and relative humidity. The results show that the daily cardiovascular/respiratory death rates were significantly associated with the concentration air pollutants, especially deaths related to cardiovascular disease. The current day effects of PM 10 and NO 2 were higher than that of single lags (distributed lags) and moving average lags for respiratory disease mortality. The largest RR of SO 2 for respiratory disease mortality was in Lag02. For cardiovascular disease mortality, the largest RR was in Lag01 for PM 10, and in current day (Lag0) for SO 2 and NO 2. NO 2 was associated with the largest RRs for deaths from both cardiovascular disease and respiratory?disease.
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