Health impacts of wildfire-related air pollution in Brazil: a nationwide study of more than 2 million hospital admissions between 2008 and 2018
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ABSTRACT:
SUBMITTER: Requia W
PROVIDER: S-EPMC8589982 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Summary Background Air pollution exposure has been associated with critical neonatal morbidities, including low birth weight (LBW). However, little is known on short-term exposure to wildfire smoke and LBW. In this study, we estimated the association between birth weight following pregnancy and wildfire smoke exposure in more than 1.5 million newborns in Brazil (considered as a very fire-prone region worldwide). Methods We applied a logistic regression model to estimate the percent variation in newborns with low birth weight when exposed to wildfire in different trimesters of the pregnancy. Findings After adjusting the model with relevant covariates, we found that an increase of 100 wildfire records in Brazil was associated with an increase in low birth weight in the Midwest region [0.98% (95%CI:0.34; 1.63)] and in the South region [18.55% (95%CI:13.66; 23.65)] when the exposure occurred in the first trimester of pregnancy. Interpretation Wildfires were associated with LBW and this should be of public health concern for policymakers. Funding Brazilian Agencies National Council for Scientific and Technological Development (CNPq); Ministry of Science, Technology and Innovation in Brazil (MCTI); and Novo Nordisk Foundation Challenge Programme.
| S-EPMC9903686 | biostudies-literature
Project description:BACKGROUND:Evidence of the short-term effects of ambient air pollution on the risk of ischemic stroke in low- and middle-income countries is limited and inconsistent. We aimed to examine the associations between air pollution and daily hospital admissions for ischemic stroke in China. METHODS AND FINDINGS:We identified hospital admissions for ischemic stroke in 2014-2016 from the national database covering up to 0.28 billion people who received Urban Employee Basic Medical Insurance (UEBMI) in China. We examined the associations between air pollution and daily ischemic stroke admission using a two-stage method. Poisson time-series regression models were firstly fitted to estimate the effects of air pollution in each city. Random-effects meta-analyses were then conducted to combine the estimates. Meta-regression models were applied to explore potential effect modifiers. More than 2 million hospital admissions for ischemic stroke were identified in 172 cities in China. In single-pollutant models, increases of 10 ?g/m3 in particulate matter with aerodynamic diameter <2.5 ?m (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) and 1 mg/m3 in carbon monoxide (CO) concentrations were associated with 0.34% (95% confidence interval [CI], 0.20%-0.48%), 1.37% (1.05%-1.70%), 1.82% (1.45%-2.19%), 0.01% (-0.14%-0.16%), and 3.24% (2.05%-4.43%) increases in hospital admissions for ischemic stroke on the same day, respectively. SO2 and NO2 associations remained significant in two-pollutant models, but not PM2.5 and CO associations. The effect estimates were greater in cities with lower air pollutant levels and higher air temperatures, as well as in elderly subgroups. The main limitation of the present study was the unavailability of data on individual exposure to ambient air pollution. CONCLUSIONS:As the first national study in China to systematically examine the associations between short-term exposure to ambient air pollution and ischemic stroke, our findings indicate that transient increase in air pollution levels may increase the risk of ischemic stroke, which may have significant public health implications for the reduction of ischemic stroke burden in China.
| S-EPMC6171821 | biostudies-literature
Project description: Not available
| S-EPMC9857436 | biostudies-literature
Project description: Not available
| S-EPMC5711265 | biostudies-literature
Project description:RationaleThere are unexplained geographical and seasonal differences in the short-term effects of fine particulate matter (PM(2.5)) on human health. The hypothesis has been advanced to include the possibility that such differences might be due to variations in the PM(2.5) chemical composition, but evidence supporting this hypothesis is lacking.ObjectivesTo examine whether variation in the relative risks (RR) of hospitalization associated with ambient exposure to PM(2.5) total mass reflects differences in PM(2.5) chemical composition.MethodsWe linked two national datasets by county and by season: (1) long-term average concentrations of PM(2.5) chemical components for 2000-2005 and (2) RRs of cardiovascular and respiratory hospitalizations for persons 65 years or older associated with a 10-microg/m(3) increase in PM(2.5) total mass on the same day for 106 U.S. counties for 1999 through 2005.Measurements and main resultsWe found a positive and statistically significant association between county-specific estimates of the short-term effects of PM(2.5) on cardiovascular and respiratory hospitalizations and county-specific levels of vanadium, elemental carbon, or nickel PM(2.5) content.ConclusionsCommunities with higher PM(2.5) content of nickel, vanadium, and elemental carbon and/or their related sources were found to have higher risk of hospitalizations associated with short-term exposure to PM(2.5).
| S-EPMC2695497 | biostudies-literature
Project description:Indoor and outdoor number concentrations of fine particulate matter (PM2.5), black carbon (BC), carbon monoxide (CO), and nitrogen dioxide (NO2) were monitored continuously for two to seven days in 28 low-income homes in Denver, Colorado, during the 2016 and 2017 wildfire seasons. In the absence of indoor sources, all outdoor pollutant concentrations were higher than indoors except for CO. Results showed that long-range wildfire plumes elevated median indoor PM2.5 concentrations by up to 4.6 times higher than outdoors. BC, CO, and NO2 mass concentrations were higher indoors in homes closer to roadways compared to those further away. Four of the homes with mechanical ventilation systems had 18% higher indoor/outdoor (I/O) ratios of PM2.5 and 4% higher I/O ratios of BC compared to other homes. Homes with exhaust stove hoods had PM2.5 I/O ratios 49% less than the homes with recirculating hoods and 55% less than the homes with no stove hoods installed. Homes with windows open for more than 12 hours a day during sampling had indoor BC 2.4 times higher than homes with windows closed. This study provides evidence that long-range wildfire plumes, road proximity, and occupant behavior have a combined effect on indoor air quality in low-income homes.
| S-EPMC6801919 | biostudies-literature
Project description:BackgroundIn the United States, both cannabis use disorder (CUD) and opioid use disorder (OUD) have increased in prevalence. The prevalence, demographics, and costs of CUD and OUD are not well known in heart failure (HF) admissions. This study aimed to use a national database to examine the prevalence, demographics, and costs associated with CUD and OUD in HF.MethodsThis study used the National Inpatient Sample from 2008 to 2018 to identify all primary HF admissions with and without the co-diagnosis of OUD or CUD using International Classification for Diagnosis, diagnosis codes. Demographics, costs, and trends were examined.ResultsBetween 2008 and 2018, we identified 11,692,995 admissions for HF of which 84,796 (0.8%) had a co-diagnosis of CUD only, and 67,137 (0.6%) had a co-diagnosis of OUD only. The proportion of HF admissions with CUD significantly increased from 0.3% in 2008 to 1.3% in 2018 (p<0.001). The proportion of HF admissions with OUD significantly increased from 0.2% in 2008 to 1.1% in 2018 (p<0.001). Patients admitted with HF and either CUD or OUD were younger, more likely to be Black, and from lower socioeconomic backgrounds (p<0.001, all). HF admissions with OUD or CUD had higher median costs compared to HF admissions without associated substance abuse diagnoses ($8,611 vs. $8,337 for CUD HF and $10,019 vs. $8,337 for OUD HF, p<0.001 for both).ConclusionsAmong discharge records for HF, CUD and OUD are increasing in prevalence, significantly affect underserved populations and are associated with higher costs of stay. Future research is essential to better delineate the cause of these increased costs and create interventions, particularly in underserved populations.
| S-EPMC8483306 | biostudies-literature
Project description:BACKGROUND:While many studies reported the association between long-term exposure to particulate matter air pollution (PM) and cardiovascular disease (CVD), few studies focused on incidence with relatively high-dose exposure using a nationwide cohort. This study aimed to investigate the association between long-term exposure to PM10 and PM2.5 and incidence of CVD in a nationwide and population-based cohort in South Korea where the annual average concentration of PM2.5 is above 20??g/m3. METHODS:We selected 196,167 adults in the National Health Insurance Service-National Sample Cohort (NHIS-NSC) constructed based on the entire South Korean population. Incidence of four CVD subtypes including ischemic heart disease (IHD), myocardial infarction, heart failure, and stroke, and total CVD including all four was identified as the first diagnosis for 2007-2015. To assess individual exposures, we used annually-updated district-level residential addresses and district-specific PM concentrations predicted by a previously developed universal kriging prediction model. We computed individual-level long-term PM concentrations for four exposure windows: previous 1, 3, and 5?year(s) and 5?years before baseline. We applied time-dependent Cox proportional hazards models to estimate hazard ratios (HRs) of incident CVDs per 10??g/m3 increase in PM10 and PM2.5 after adjusting for individual- and area-level characteristics. RESULTS:During 1,578,846 person-year, there were 33,580 cases of total incident CVD. Average PM10 and PM2.5 concentrations for the previous 5?years were 52.3 and 28.1??g/m3, respectively. A 10??g/m3 increase in PM2.5 exposed for the previous 5?years was associated with 4 and 10% increases in the incidence of total CVD (95% confidence interval: 0-9%) and IHD (4-16%), respectively. HRs tended to be higher with earlier exposure for IHD and more recent exposure for stroke. The estimated shape of the concentration-response relationship showed non-linear patterns. We did not find evidence of the association for PM10. CONCLUSIONS:Using a population-based nationwide cohort exposed to relatively high PM concentration, this study confirmed the association between PM2.5 and CVD incidence that was reported in previous studies mostly with low-dose environments. The magnitude and the shape of the association were generally consistent with previous findings.
| S-EPMC7653702 | biostudies-literature
Project description:ImportanceAir pollution is a worldwide public health issue that has been exacerbated by recent wildfires, but the relationship between wildfire-associated air pollution and inflammatory skin diseases is unknown.ObjectiveTo assess the associations between wildfire-associated air pollution and clinic visits for atopic dermatitis (AD) or itch and prescribed medications for AD management.Design, setting, and participantsThis cross-sectional time-series study assessed the associations of air pollution resulting from the California Camp Fire in November 2018 and 8049 dermatology clinic visits (4147 patients) at an academic tertiary care hospital system in San Francisco, 175 miles from the wildfire source. Participants included pediatric and adult patients with AD or itch from before, during, and after the time of the fire (October 2018 through February 2019), compared with those with visits in the same time frame of 2015 and 2016, when no large wildfires were near San Francisco. Data analysis was conducted from November 1, 2019, to May 30, 2020.ExposuresWildfire-associated air pollution was characterized using 3 metrics: fire status, concentration of particulate matter less than 2.5 μm in diameter (PM2.5), and satellite-based smoke plume density scores.Main outcomes and measuresWeekly clinic visit counts for AD or itch were the primary outcomes. Secondary outcomes were weekly numbers of topical and systemic medications prescribed for AD in adults.ResultsVisits corresponding to a total of 4147 patients (mean [SD] age, 44.6 [21.1] years; 2322 [56%] female) were analyzed. The rates of visits for AD during the Camp Fire for pediatric patients were 1.49 (95% CI, 1.07-2.07) and for adult patients were 1.15 (95% CI, 1.02-1.30) times the rate for nonfire weeks at lag 0, adjusted for temperature, relative humidity, patient age, and total patient volume at the clinics for pediatric patients. The adjusted rate ratios for itch clinic visits during the wildfire weeks were 1.82 (95% CI, 1.20-2.78) for the pediatric patients and 1.29 (95% CI, 0.96-1.75) for adult patients. A 10-μg/m3 increase in weekly mean PM2.5 concentration was associated with a 7.7% (95% CI, 1.9%-13.7%) increase in weekly pediatric itch clinic visits. The adjusted rate ratio for prescribed systemic medications in adults during the Camp Fire at lag 0 was 1.45 (95% CI, 1.03-2.05).Conclusions and relevanceThis cross-sectional study found that short-term exposure to air pollution due to the wildfire was associated with increased health care use for patients with AD and itch. These results may provide a better understanding of the association between poor air quality and skin health and guide health care professionals' counseling of patients with skin disease and public health practice.
| S-EPMC8060890 | biostudies-literature
Project description:One of our era's greatest scourges is air pollution, on account not only of its impact on climate change but also its impact on public and individual health due to increasing morbidity and mortality. There are many pollutants that are major factors in disease in humans. Among them, Particulate Matter (PM), particles of variable but very small diameter, penetrate the respiratory system via inhalation, causing respiratory and cardiovascular diseases, reproductive and central nervous system dysfunctions, and cancer. Despite the fact that ozone in the stratosphere plays a protective role against ultraviolet irradiation, it is harmful when in high concentration at ground level, also affecting the respiratory and cardiovascular system. Furthermore, nitrogen oxide, sulfur dioxide, Volatile Organic Compounds (VOCs), dioxins, and polycyclic aromatic hydrocarbons (PAHs) are all considered air pollutants that are harmful to humans. Carbon monoxide can even provoke direct poisoning when breathed in at high levels. Heavy metals such as lead, when absorbed into the human body, can lead to direct poisoning or chronic intoxication, depending on exposure. Diseases occurring from the aforementioned substances include principally respiratory problems such as Chronic Obstructive Pulmonary Disease (COPD), asthma, bronchiolitis, and also lung cancer, cardiovascular events, central nervous system dysfunctions, and cutaneous diseases. Last but not least, climate change resulting from environmental pollution affects the geographical distribution of many infectious diseases, as do natural disasters. The only way to tackle this problem is through public awareness coupled with a multidisciplinary approach by scientific experts; national and international organizations must address the emergence of this threat and propose sustainable solutions.
| S-EPMC7044178 | biostudies-literature