Faculty of Nursing, University of Thessaly, GAIOPOLIS, Thessaly, Greece
PM 2.5 Pollution Strongly Predicted COVID-19 Incidence in Four High-Polluted Urbanized Italian Cities during the Pre-Lockdown and Lockdown Periods
Background: The coronavirus disease in 2019 (COVID-19) heavily hit Italy, one of Europe's most polluted countries. The extent to which PM pollution contributed to COVID-19 diffusion is needing further clarification. We aimed to investigate the particular matter (PM) pollution and its correlation with COVID-19 incidence across four Italian cities: Milan, Rome, Naples, and Salerno, during the pre-lockdown and lockdown periods.
Methods: We performed a comparative analysis followed by correlation and regression analyses of the daily average PM10, PM2.5 concentrations, and COVID-19 incidence across four cities from 1 January 2020 to 8 April 2020, adjusting for several factors, taking a two-week time lag into account.
Results: Milan had significantly higher average daily PM10 and PM2.5 levels than Rome, Naples, and Salerno. Rome, Naples, and Salerno maintained safe PM10 levels. The daily PM2.5 levels exceeded the legislative standards in all cities during the entire period. PM2.5 pollution was related to COVID-19 incidence. The PM2.5 levels and sampling rate were strong predictors of COVID-19 incidence during the pre-lockdown period. The PM2.5 levels, population's age, and density strongly predicted COVID-19 incidence during lockdown.
Conclusions: Italy serves as a noteworthy paradigm illustrating that PM2.5 pollution impacts COVID-19 spread. Even in lockdown, PM2.5 levels negatively impacted COVID-19 incidence.
Assistance Publique des Hôpitaux de Paris, APHP, Hôpital Saint Antoine, Neurology Department, Paris, France
Fine Particulate Matter Related to Multiple Sclerosis Relapse in Young Patients
Objective: Particulate matter (PM) of aerodynamic diameter smaller than 10 μm (PM10) has been associated with multiple sclerosis (MS) relapse. However, the impact of smaller PM with a greater ability to penetrate human organism has never been assessed. We evaluated the impact of PM smaller than 2.5 μm (PM2.5) on the risk of MS relapse. Material and Methods: In a case-crossover study, we included 2,109 consecutive hospitalizations likely due to MS relapse in day hospital in 5 MS centers in the Paris area from January 2009 to December 2013. For each hospitalization, the natural logarithm of the average weekly PM2.5 concentrations (μg/m3) at the patient's residence address during each of the 6 weeks (week to week[-5]) preceding admission was compared with the concentration during the previous week, using a conditional logistic regression adjusted on temperature, flu-like syndrome rate, pollen count, and holiday period. Results: PM2.5 average concentration during week[-3] was significantly associated with the risk of hospitalization for MS relapse [OR = 1.21 (CI 1.01;1.46)]. The association was stronger in patients younger than 30 years [OR=1.77 (CI 1.10; 2.83)]. Conclusion: Our study demonstrates an association between exposure to PM2.5 and MS relapse, particularly in young people.
Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Multiple sclerosis in Iran: An epidemiological update with focus on air pollution debate
Background: Multiple sclerosis (MS), as the most common neurologic disorder of the central nervous system, with growing incidence and prevalence worldwide and in the Middle East. This article aimed to find out the potential relationship between MS and air pollution in Iran.
Methods: By assessing the published articles on MS and air pollution in Iran, the situation of MS as well as air/soil pollution in Iran was clarified. Then, studies on air pollution and its potential effect on Iranian MS patients were checked until 2020.
Results: The MS prevalence is distributed across Iran Provinces with highest rates in Isfahan, located in the center of Iran. The higher rates of MS in Isfahan and Tehran (the Metropolitan) might be due to industrial pollution of these cities, but this hypothesis is not true for non-industrial provinces. Based on the published atlas of MS in Iran, it seems that there is a high-risk "belt" from northwest to southeast.
Conclusion: There are many risk factors of MS in Iran including age, gender, Vitamin D deficiency, smoking, and air pollution. The potential main risk factor of MS might be air pollution considering Isfahan and Tehran provinces. However, Chahar Mahal and Bakhtiary Province, with non-industrial nature, has the second highest MS rates which does not follow this hypothesis.
Relevance for patients: By finding the air pollution as the main potential risk factor of MS in big provinces including Isfahan and Tehran, its effect of this factor can also be considered during diagnosis and treatment.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Province Laboratory of Inflammation and Immune Mediated Diseases, Anhui Medical University, China
Association between ambient air pollution and multiple sclerosis: a systemic review and meta-analysis
Recently, increasing attention has been paid to the effects of air pollutants on autoimmune diseases. The results of relationship between ambient air pollution and multiple sclerosis (MS) showed a variety of differences. Thus, the purpose of this study is to further clarify and quantify the relationship between ambient air pollutants and MS through meta-analysis. Through electronic literature search, literature related to our research topic was collected in Cochrane Library, Embase, and PubMed till August 18, 2020, according to certain criteria. Pooled risk estimate and 95% confidence intervals (95%CI) were calculated by random-effect model analysis. After removing copies, browsing titles and abstracts, and reading full text, 6 studies were finally included. The results showed that only particulate matter (PM) with aerodynamic diameter ≤ 10 (PM10) was related to MS (pooled HR = 1.058, 95% CI = 1.050-1.066), and no correlation was found between PM with aerodynamic diameter < 2.5 (PM2.5), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), benzene (C6H6), major road < 50 m, and MS. There was no publication bias, and the heterogeneity analysis results were stable. PM10 is correlated with the disease MS, while other pollution is not connected with MS. Therefore, it is important for MS patients to take personal protection against particulate pollution and avoid exposure to higher levels of PM.
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, China
Particulate matter pollution associated with schizophrenia hospital re-admissions: a time-series study in a coastal Chinese city
Schizophrenia (SCZ) hospital re-admissions constitute a serious disease burden worldwide. Some studies have reported an association between air pollutants and hospital admissions for SCZ. However, evidence is scarce regarding the effects of ambient particulate matter (PM) on SCZ hospital re-admissions, especially in coastal cities in China. The purpose of this study was to examine whether PM affects the risk of SCZ hospital re-admission in the coastal Chinese city of Qingdao. Daily SCZ hospital re-admissions, daily air pollutants, and meteorological factors from 2015 to 2019 were collected. A quasi-Poisson generalized linear regression model combined with distributed lag non-linear model (DLNM) was applied to model the exposure-lag-response relationship between PM and SCZ hospital re-admissions. The relative risks (RRs) were estimated for an inter-quartile range (IQR) increase in PM concentrations. Subgroup analyses by age and gender were conducted to identify the vulnerable subgroups. There were 6220 SCZ hospital re-admissions during 2015-2019. The results revealed that PM, including PM10 (particles with an aerodynamic diameter ≤10 μm), PMc (particles >2.5 μm but <10 μm), and PM2.5 (particles ≤2.5 μm), was positively correlated with SCZ hospital re-admissions. The strongest single-day effects all occurred on lag3 day, and the corresponding RRs were 1.07 (95% CI: 1.02-1.11) for PM10, 1.03 (95% CI: 1.00-1.07) for PMc, and 1.05 (95% CI: 1.01-1.09) for PM2.5 per IQR increase. Stronger associations were observed in males and younger individuals (<45 years). Our findings suggest that PM exposure is associated with increased risk of SCZ hospital re-admission. Active intervention measures against PM exposure should be taken to reduce the risk of SCZ hospital re-admission, especially for males and younger individuals.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
An impact of air pollution on moderate to severe relapses among multiple sclerosis patients
Background: Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system with both a genetic and environmental component.
Objective: In the current study, we examined an association between incidence of MS moderate to severe relapses and exposure to air pollutants and meteorological exposures.
Methods: We enrolled MS patients in Southern Israel during 2000-2017. Exposure assessment relied on satellite-based model of exposure to particulate matter of size <2.5 and 10 microns (PM2.5, PM10) and temperature at a spatial resolution of 1 km (Kloog et al., 2015). The information on exposure to nitrogen dioxide (NO2), sulfur dioxide (SO2) and ozone (O3) levels was completed from the database of the monitoring stations. We analyzed the data using a semi-ecological approach. The monthly incidence of MS-related relapses requiring hospitalization as a function of environmental factors was analyzed by time-series technique, adjusting to sex, age and smoking. We also used a case-crossover approach to compare environmental exposure of a patient on the day of the relapse with the exposure on the relapse-free days. All estimates were adjusted to the heat index and were divided by IQR.
Results: There were 287 MS patients in the study, with an average age of 52.8 ± 16.7 years, 37% of them (107) being under 40. Mostly female (66.2%), and 13.6% of the patients smoking (47% non-smoking and 39.4% unknown). PM2.5 was independently associated with MS relapses within the non-smoking population [Relative Risk (RR)=1.28, 95%CI:1.01-1.62]. O3 was found adversely associated with MS relapses among patients younger than 40 [RR=1.58, 95%CI 1.03-4.43]. Based on the case-crossover approach, relapses were associated with elevated levels of PM10 and NO2 in all subjects [Odds Ratio (OR)=1.05, 95%CI:1.00-1.11; OR=1.85, 95%CI: 1.28-2.68, respectively]. An adverse association with PM2.5 was observed in non-smokers [OR 1.12, 95%CI 1.00-1.25].
Conclusions: The findings show that MS relapses are adversely associated with an ambient exposure to PM and NO2.
Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Association of Exposure to Particulate Matters and Multiple Sclerosis: A Systematic Review and Meta-Analysis
..Collectively, we found that PM exposure (PM10 and PM2.5) in MS patients associates with the occurrence and relapse of disease.
University of Oviedo, Department of Economics, Campus del Cristo s/n, Spain
Air pollution and life expectancy in Europe: Does investment in renewable energy matter?
This study examines the relationship between health and air pollution using a novel approach that allows differentiation between potential and observed health. It also permits an analysis of those factors that may contribute towards reducing any differences between the latter concepts. To this end, a panel data from 29 European countries for the periods 2005 and 2018 is used. Results indicate that the main pollutants affecting European countries, namely NOx, PM10 and PM2.5 have a negative impact on life expectancy at birth, while investment in renewable energies has a positive effect. Several conclusions can be drawn from these results. Firstly, if the aim is to minimize the detrimental effects of the global production of goods and services on air quality, a greater investment in renewable energies as compared to other more polluting ones, is called for. In turn, this would contribute to an improvement in the general health of citizens and the planet thereby increasing overall potential life expectancy. Secondly, NOx gases seem to be the ones that most affect the population's mean potential life expectancy. Results indicate that with regard to particulate matters, those with a diameter of less than 2.5 μm, are the ones that have the greatest impact on the health of European citizens, more so than larger particles (with a diameter between 10 and 2.5 μm).
Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan, Kuala Lumpur, Malaysia
Particulate Air Pollution and Osteoporosis: A Systematic Review
Air pollution is associated with inflammation and oxidative stress, which predispose to several chronic diseases in human. Emerging evidence suggests that the severity and progression of osteoporosis are directly associated with inflammation induced by air pollutants like particulate matter (PM). This systematic review examined the relationship between PM and bone health or fractures. A comprehensive literature search was conducted from January until February 2021 using the PubMed, Scopus, Web of Science, Google Scholar and Cochrane Library databases. Human cross-sectional, cohort and case-control studies were considered. Of the 1500 papers identified, 14 articles were included based on the inclusion and exclusion criteria. The air pollution index investigated by most studies were PM2.5 and PM10. Current studies demonstrated inconsistent associations between PM and osteoporosis risk or fractures, which may partly due to the heterogeneity in subjects' characteristics, study design and analysis. In conclusion, there is an inconclusive relationship between osteoporosis risk and fracture and PM exposures which require further validation.
Centre for Environmental Magnetism & Palaeomagnetism, Lancaster Environment Centre, Lancaster University, United Kingdom
Size-resolved, quantitative evaluation of the magnetic mineralogy of airborne brake-wear particulate emissions
Exposure to particulate air pollution has been associated with a variety of respiratory, cardiovascular and neurological problems, resulting in increased morbidity and mortality worldwide. Brake-wear emissions are one of the major sources of metal-rich airborne particulate pollution in roadside environments. Of potentially bioreactive metals, Fe (especially in its ferrous form, Fe2+) might play a specific role in both neurological and cardiovascular impairments. Here, we collected brake-wear particulate emissions using a full-scale brake dynamometer, and used a combination of magnetic measurements and electron microscopy to make quantitative evaluation of the magnetic composition and particle size of airborne emissions originating from passenger car brake systems. Our results show that the concentrations of Fe-rich magnetic grains in airborne brake-wear emissions are very high (i.e., ~100-10,000 × higher), compared to other types of particulate pollutants produced in most urban environments. From magnetic component analysis, the average magnetite mass concentration in total PM10 of brake emissions is ~20.2 wt% and metallic Fe ~1.6 wt%. Most brake-wear airborne particles (>99 % of particle number concentration) are smaller than 200 nm. Using low-temperature magnetic measurements, we observed a strong superparamagnetic signal (indicative of ultrafine magnetic particles, < ~30 nm) for all of the analysed size fractions of airborne brake-wear particles. Transmission electron microscopy independently shows that even the larger size fractions of airborne brake-wear emissions dominantly comprise agglomerates of ultrafine (<100 nm) particles (UFPs). Such UFPs likely pose a threat to neuronal and cardiovascular health after inhalation and/or ingestion. The observed abundance of ultrafine magnetite particles (estimated to constitute ~7.6 wt% of PM0.2) might be especially hazardous to the brain, contributing both to microglial inflammatory action and excess generation of reactive oxygen species.
Students Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, Iran
Air pollution and multiple sclerosis: a comprehensive review
Multiple sclerosis (MS) is an inflammatory, autoimmune demyelinating disorder of the central nervous system (CNS), leading to progressive functional impairments, and many intrinsic and acquired factors are believed to be associated with its development and relapse. In terms of environmental factors, air pollution has gained much attention during recent decades, as chronic exposure to ambient air pollution seems to increase the level of some pro-inflammatory markers in the human brain, which can lead to neuroinflammation, neurodegeneration, and blood-brain barrier (BBB) breakdown. These events may also be associated with the risk of MS development and relapse. In this review, we aimed to summarize recent findings around the impact of air pollutants, including particulate matter (PM10, PM2.5, and ultra-fine particles), gaseous pollutants (carbon monoxide [CO], nitrogen oxides [NOx], sulfur dioxide [SO2], and ozone [O3]), and heavy metals, on MS development and relapse.
Institute of Chemistry and Chemical Technology SB RAS, Federal Research Center "Krasnoyarsk Science Center,Krasnoyarsk, Russia
Magnetic Fractions of PM 2.5, PM 2.5-10, and PM 10 from Coal Fly Ash as Environmental Pollutants
Characterization of magnetic particulate matter (PM) in coal fly ashes is critical to assessing the health risks associated with industrial coal combustion and for future applications of fine fractions that will minimize solid waste pollution. In this study, magnetic narrow fractions of fine ferrospheres related to environmentally hazardous PM2.5, PM2.5-10, and PM10 were for the first time separated from fly ash produced during combustion of Ekibastuz coal. It was determined that the average diameter of globules in narrow fractions is 1, 2, 3, and 7 μm. The major components of chemical composition are Fe2O3 (57-60) wt %, SiO2 (25-28 wt %), and Al2O3 (10-12 wt %). The phase composition is represented by crystalline phases, including ferrospinel, α-Fe2O3, ε-Fe2O3, mullite, and quartz, as well as the amorphous glass phase. Mössbauer spectroscopy and magnetic measurements confirmed the formation of nanoscale particles of ε-Fe2O3. Stabilization of the ε-Fe2O3 metastable phase, with quite ideal distribution of iron cations, occurs in the glass matrix due to the rapid cooling of fine globules during their formation from mineral components of coal.
Laboratory of Toxicology and Environmental Health, Universitat Rovira i Virgili, School of Medicine, Sant Llorens 21, 43201, Reus, Catalonia, Spain
Positive association between outdoor air pollution and the incidence and severity of COVID-19. A review of the recent scientific evidences
In June 2020, we published a review focused on assessing the influence of various air pollutants on the transmission of SARS-CoV-2, and the severity of COVID-19 in patients infected by the coronavirus. The results of most of those reviewed studies suggested that chronic exposure to certain air pollutants might lead to more severe and lethal forms of COVID-19, as well as delays/complications in the recovery of the patients. Since then, a notable number of studies on this topic have been published, including also various reviews. Given the importance of this issue, we have updated the information published since our previous review. Taking together the previous results and those of most investigations now reviewed, we have concluded that there is a significant association between chronic exposure to various outdoor air pollutants: PM2.5, PM10, O3, NO2, SO2 and CO, and the incidence/risk of COVID-19 cases, as well as the severity/mortality of the disease. Unfortunately, studies on the potential influence of other important air pollutants such as VOCs, dioxins and furans, or metals, are not available in the scientific literature. In relation to the influence of outdoor air pollutants on the transmission of SARS-CoV-2, although the scientific evidence is much more limited, some studies point to PM2.5 and PM10 as potential airborne transmitters of the virus. Anyhow, it is clear that environmental air pollution plays an important negative role in COVID-19, increasing its incidence and mortality.
Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellin, Colombia
Viral respiratory infections and air pollutants
Air pollution is a public health issue of global importance and a risk factor for developing cardiorespiratory diseases. These contaminants induce reactive oxygen species (ROS) and increased pro-inflammatory cytokines such as IL-1β, IL-6, and IL-8, triggering the inflammatory response that alters cell and tissue homeostasis and facilitates the development of diseases. The effects of air pollutants such as ozone, particulate matter (PM10, PM2.5, and PM0.1), and indoor air pollutants on respiratory health have been widely reported. For instance, epidemiological and experimental studies have shown associations between hospital admissions for individual diseases and increased air pollutant levels. This review describes the association and relationships between exposure to air pollutants and respiratory viral infections, especially those caused by the respiratory syncytial virus and influenza virus. The evidence suggests that exposure to air contaminants induces inflammatory states, modulates the immune system, and increases molecules' expression that favors respiratory viruses' pathogenesis and affects the respiratory system. However, the mechanisms underlying these interactions have not yet been fully elucidated, so it is necessary to develop new studies to obtain information that will allow health and policy decisions to be made for the adequate control of respiratory infections, especially in the most vulnerable population, during periods of maximum air pollution.
Ingham Institute for Applied Medical Research, University of New South Wales, Australia
Ambient Air Pollution and Stillbirths Risk in Sydney, Australia
We aimed to determine the associations between ambient air pollution, specifically particulate matter less than or equal to 10 microns and 2.5 microns (PM10 and PM2.5 respectively) and ozone (O3), and stillbirths. We analysed all singleton births between 20-42 weeks gestation in metropolitan Sydney, Australia, from 1997 to 2012. We implemented logistic regression to assess the associations between air pollutants and stillbirth for each trimester and for the entire pregnancy. Over the study period, there were 967,694 live births and 4287 stillbirths. Mean levels of PM10, PM2.5 and O3 for the entire pregnancy were 17.9 µg/m3, 7.1 µg/m3 and 3.2 ppb, respectively. Adjusted odds ratios were generally greater than unity for associations between PM and stillbirths, but none were statistically significant. There were no significant associations between O3 and stillbirths. There was potential effect modification of the PM10 and O3 association by maternal age. We did not find consistent evidence of associations between PM and O3 and stillbirths in Sydney, Australia. More high quality birth cohort studies are required to clarify associations between air pollution and stillbirths.
2021 Sep 26
Time trends of chronic immune diseases by year of birth in Danish registries