Publications by authors named "Randall V Martin"

134 Publications

Ambient air pollution and the risk of acute myocardial infarction and stroke: A national cohort study.

Environ Res 2021 Aug 31;204(Pt A):111975. Epub 2021 Aug 31.

ICES, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada; Public Health Ontario, Toronto, Ontario, M5G 1V5, Canada; Population Studies Division, Environmental Health and Research Bureau, Health Canada, Ottawa, Ontario K1A 0T6, Canada. Electronic address:

We used a large national cohort in Canada to assess the incidence of acute myocardial infarction (AMI) and stroke hospitalizations in association with long-term exposure to fine particulate matter (PM), nitrogen dioxide (NO), and ozone (O). The study population comprised 2.7 million respondents from the 2006 Canadian Census Health and Environment Cohort (CanCHEC), followed for incident hospitalizations of AMI or stroke between 2006 and 2016. We estimated 10-year moving average estimates of PM, NO, and O, annually. We used Cox proportional hazards models to examine the associations adjusting for various covariates. For AMI, each interquartile range (IQR) increase in exposure was found to be associated with a hazard ratio of 1.026 (95% CI: 1.007-1.046) for PM, 1.025 (95% CI: 1.001-1.050) for NO, and 1.062 (95% CI: 1.041-1.084) for O, respectively. Similarly, for stroke, an IQR increase in exposure was associated with a hazard ratio of 1.078 (95% CI: 1.052-1.105) for PM, 0.995 (95% CI: 0.965-1.030) for NO, and 1.055 (95% CI: 1.028-1.082) for O, respectively. We found consistent evidence of positive associations between long-term exposures to PM, and O, and to a lesser degree NO, with incident AMI and stroke hospitalizations.
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http://dx.doi.org/10.1016/j.envres.2021.111975DOI Listing
August 2021

Predicting Spatial Variations in Multiple Measures of Oxidative Burden for Outdoor Fine Particulate Air Pollution across Canada.

Environ Sci Technol 2021 07 9;55(14):9750-9760. Epub 2021 Jul 9.

Air Health Science Division, Health Canada, 269 Laurier Avenue West, Ottawa, Ontario K1A 0K0, Canada.

Fine particulate air pollution (PM) is a leading contributor to the overall global burden of disease. Traditionally, outdoor PM has been characterized using mass concentrations which treat all particles as equally harmful. Oxidative potential (OP) (per μg) and oxidative burden (OB) (per m) are complementary metrics that estimate the ability of PM to cause oxidative stress, which is an important mechanism in air pollution health effects. Here, we provide the first national estimates of spatial variations in multiple measures (glutathione, ascorbate, and dithiothreitol depletion) of annual median outdoor PM OB across Canada. To do this, we combined a large database of ground-level OB measurements collected monthly prospectively across Canada for 2 years (2016-2018) with PM components estimated using a chemical transport model (GEOS-Chem) and satellite aerosol observations. Our predicted ground-level OB values of all three methods were consistent with ground-level observations (cross-validation = 0.63-0.74). We found that forested regions and urban areas had the highest OB, predicted primarily by black carbon and organic carbon from wildfires and transportation sources. Importantly, the dominant components associated with OB were different than those contributing to PM mass concentrations (secondary inorganic aerosol); thus, OB metrics may better indicate harmful components and sources on health than the bulk PM mass, reinforcing that OB estimates can complement the existing PM data in future national-level epidemiological studies.
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http://dx.doi.org/10.1021/acs.est.1c01210DOI Listing
July 2021

Fine particulate matter constituents and infant mortality in Africa: A multicountry study.

Environ Int 2021 11 30;156:106739. Epub 2021 Jun 30.

School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai 200030, China. Electronic address:

Background: Few studies have investigated the association between exposure to fine particulate matter (PM) and infant mortality in developing countries, especially for the health effects of specific PM constituents.

Objective: We aimed to examine the association of long-term exposure to specific PM constituents with infant mortality in 15 African countries from 2005 to 2015.

Methods: Based on the Demographic and Health Surveys (DHS) dataset, we included birth history records from 15 countries in Africa and conducted a multicountry cross-sectional study to examine the associations between specific PM constituents and infant mortality. We estimated annual residential exposure using satellite-derived PM for mass and a chemical transport model (GEOS-Chem) for its six constituents, including organic matter (OM), black carbon (BC), sulfate (SO), nitrate (NO), ammonium (NH), and soil dust (DUST). Multivariable logistic regression analysis was employed by fitting single-constituent models, the constituent-PM models, and the constituent-residual models. We also conducted stratified analyses by potential effect modifiers and examined the specific associations for each country.

Results: We found positive and significant associations between PM total mass and most of its constituents with infant mortality. In the single-constituent model, for an IQR increase in pollutant concentrations, the odds ratio (OR) of infant mortality was 1.03 (95 %CI; 1.01, 1.06) for PM total mass, and was 1.04 (95 %CI: 1.02, 1.06), 1.04 (95 %CI: 1.02, 1.05), 1.02 (95 %CI: 1.00, 1.03), 1.04 (1.01, 1.06) for BC, OM, SO, and DUST, respectively. The associations of BC, OM, and SO remained significant in the other two models. We observed larger estimates in subgroups with older maternal age, living in urban areas, using unclean cooking energy, and with access to piped water. The associations varied among countries, and by different constituents.

Conclusions: The carbonaceous fractions and sulfate play a major important role among PM constituents on infant mortality. Our findings have certain policy implications for implementing effective measures for targeted reduction in specific sources (fossil fuel combustion and biomass burning) of PM constituents against the risk of infant mortality.
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http://dx.doi.org/10.1016/j.envint.2021.106739DOI Listing
November 2021

Association of fine particulate matter air pollution and its constituents with lung function: The China Pulmonary Health study.

Environ Int 2021 11 26;156:106707. Epub 2021 Jun 26.

Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, China; National Center of Gerontology, Beijing, China.

The associations of long-term exposure to various constituents of fine particulate matter (≤2.5 μm in aerodynamic diameter, PM) air pollution with lung function were not clearly elucidated in developing countries. The aim was to evaluate the associations of long-term exposure to main constituents of PM with lung function in China. This is a nationwide, cross-sectional analysis among 50,991 study participants from the China Pulmonary Health study. Multivariable linear regression models were used to obtain differences of forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), FEV/FVC, peak expiratory flow (PEF), and forced expiratory flow at 25-75% of exhaled FVC (FEF) associated with an interquartile range (IQR) change of PM or its constituents. Residential annual PM levels varied from 26 μg/m to 92 μg/m (average: 53 μg/m). An IQR increase of PM concentrations was associated with lower FEV (19.82 mL, 95% CI: 11.30-28.33), FVC (17.45 mL, 95% CI: 7.16-27.74), PEF (86.64 mL/s, 95% CI: 59.77-113.52), and FEF (31.93 mL/s, 95% CI: 16.64-47.22). Black carbon, organic matter, ammonium, sulfate, and nitrate were negatively associated with most lung function indicators, with organic matter and nitrate showing consistently larger magnitude of associations than PM mass. This large-scale study provides first-hand epidemiological evidence that long-term exposure to ambient PM and some constituents, especially organic matter and nitrate, were associated with lower large- and small- airway function.
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http://dx.doi.org/10.1016/j.envint.2021.106707DOI Listing
November 2021

Parkinson's disease aggravation in association with fine particle components in New York State.

Environ Res 2021 Jun 25;201:111554. Epub 2021 Jun 25.

Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.

Background: Long-term exposure to fine particulate matter (PM) has been associated with neurodegenerative diseases, including disease aggravation in Parkinson's disease (PD), but associations with specific PM components have not been evaluated.

Objective: To characterize the association between specific PM components and PD first hospitalization, a surrogate for disease aggravation.

Methods: We obtained data on hospitalizations from the New York Department of Health Statewide Planning and Research Cooperative System (2000-2014) to calculate annual first PD hospitalization counts in New York State per county. We used well-validated prediction models at 1 km resolution to estimate county level population-weighted annual black carbon (BC), organic matter (OM), nitrate, sulfate, sea salt (SS), and soil particle concentrations. We then used a multi-pollutant mixed quasi-Poisson model with county-specific random intercepts to estimate rate ratios (RR) of one-year exposure to each PM component and PD disease aggravation. We evaluated potential nonlinear exposure-outcome relationships using penalized splines and accounted for potential confounders.

Results: We observed a total of 197,545 PD first hospitalizations in NYS from 2000 to 2014. The annual average count per county was 212 first hospitalizations. The RR (95% confidence interval) for PD aggravation was 1.06 (1.03, 1.10) per one standard deviation (SD) increase in nitrate concentrations and 1.06 (1.04, 1.09) for the corresponding increase in OM concentrations. We also found a nonlinear inverse association between PD aggravation and BC at concentrations above the 96th percentile. We found a marginal association with SS and no association with sulfate or soil exposure.

Conclusion: In this study, we detected associations between the PM components OM and nitrate with PD disease aggravation. Our findings support that PM adverse effects on PD may vary by particle composition.
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http://dx.doi.org/10.1016/j.envres.2021.111554DOI Listing
June 2021

Effects of COVID-19 lockdowns on fine particulate matter concentrations.

Sci Adv 2021 Jun 23;7(26). Epub 2021 Jun 23.

Earth Sciences Division, NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA.

Lockdowns during the COVID-19 pandemic provide an unprecedented opportunity to examine the effects of human activity on air quality. The effects on fine particulate matter (PM) are of particular interest, as PM is the leading environmental risk factor for mortality globally. We map global PM concentrations for January to April 2020 with a focus on China, Europe, and North America using a combination of satellite data, simulation, and ground-based observations. We examine PM concentrations during lockdown periods in 2020 compared to the same periods in 2018 to 2019. We find changes in population-weighted mean PM concentrations during the lockdowns of -11 to -15 μg/m across China, +1 to -2 μg/m across Europe, and 0 to -2 μg/m across North America. We explain these changes through a combination of meteorology and emission reductions, mostly due to transportation. This work demonstrates regional differences in the sensitivity of PM to emission sources.
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http://dx.doi.org/10.1126/sciadv.abg7670DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221629PMC
June 2021

The prospective effects of long-term exposure to ambient PM and constituents on mortality in rural East China.

Chemosphere 2021 Oct 4;280:130740. Epub 2021 May 4.

School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China. Electronic address:

Few cohort studies explored the associations of long-term exposure to ambient fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM) and its chemical constituents with mortality risk in rural China. We conducted a 12-year prospective study of 28,793 adults in rural Deqing, China from 2006 to 2018. Annual mean PM and its constituents, including black carbon (BC), organic carbon (OC), ammonium (NH), nitrate (NO), sulfate (SO), and soil dust were measured at participants' addresses at enrollment from a satellite-based exposure predicting model. Cox proportional hazard model was used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs) of long-term exposure to PM for mortality. A total of 1960 deaths were identified during the follow-up. We found PM, BC, OC, NH, NO, and SO were significantly associated with an increased risk of non-accidental mortality. The HR for non-accidental mortality was 1.17 (95%CI: 1.07, 1.28) for each 10 μg/m increase in PM. As for constituents, the strongest association was found for BC (HR = 1.21, 95%CI: 1.11, 1.33), followed by NO, NH, SO, and OC (HR = 1.14-1.17 per interquartile range). A non-linear relationship was found between PM and non-accidental mortality. Similar associations were found for cardio-cerebrovascular and cancer mortality. Associations were stronger among men and ever smokers. Conclusively, we found long-term exposure to ambient PM and its chemical constituents (especially BC and NO) increased mortality risk. Our results suggested the importance of adopting effective targeted emission control to improve air quality for health protection in rural East China.
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http://dx.doi.org/10.1016/j.chemosphere.2021.130740DOI Listing
October 2021

Source sector and fuel contributions to ambient PM and attributable mortality across multiple spatial scales.

Nat Commun 2021 06 14;12(1):3594. Epub 2021 Jun 14.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Ambient fine particulate matter (PM) is the world's leading environmental health risk factor. Reducing the PM disease burden requires specific strategies that target dominant sources across multiple spatial scales. We provide a contemporary and comprehensive evaluation of sector- and fuel-specific contributions to this disease burden across 21 regions, 204 countries, and 200 sub-national areas by integrating 24 global atmospheric chemistry-transport model sensitivity simulations, high-resolution satellite-derived PM exposure estimates, and disease-specific concentration response relationships. Globally, 1.05 (95% Confidence Interval: 0.74-1.36) million deaths were avoidable in 2017 by eliminating fossil-fuel combustion (27.3% of the total PM burden), with coal contributing to over half. Other dominant global sources included residential (0.74 [0.52-0.95] million deaths; 19.2%), industrial (0.45 [0.32-0.58] million deaths; 11.7%), and energy (0.39 [0.28-0.51] million deaths; 10.2%) sectors. Our results show that regions with large anthropogenic contributions generally had the highest attributable deaths, suggesting substantial health benefits from replacing traditional energy sources.
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http://dx.doi.org/10.1038/s41467-021-23853-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203641PMC
June 2021

Does exposure to air pollution increase the risk of acute care in young children with asthma? An Ontario, Canada study.

Environ Res 2021 08 19;199:111302. Epub 2021 May 19.

Environmental Health Science and Research Bureau, Health Canada, Canada.

Owing to their greater outdoor activity and ongoing lung development, children are particularly vulnerable to the harmful effects of exposure to fine particulate matter (PM) However, the effects of PM components are poorly understood. This study aimed to use a longitudinal birth cohort of children with physician-diagnosed incident asthma to investigate the effect of PM components at birth on morbidity measured by health services utilization. Of 1277 Toronto Child Health Evaluation Questionnaire (T-CHEQ) participants, the study population included 362 children diagnosed with asthma who were followed for a mean of 13 years from birth until March 31, 2016, or loss-to-follow-up. Concentrations of PM and its components were assigned based on participants' postal codes at birth. Study outcomes included counts of asthma, asthma-related, and all-cause health services use. Poisson regression in single-, two-, and multi-pollutant models was used to estimate rate ratios (RR) per interquartile range (IQR) increase of exposures. Covariates were included in all models to further adjust for potential confounding. The adjusted RR for sulfate (SO) and all-cause hospitalizations was statistically significant with RR = 2.23 (95% confidence interval [CI]: 1.25-3.96) in a multi-pollutant model with nitrogen dioxide (NO) and ozone (O). In multi-pollutant models with oxidants, the adjusted RRs for SO of all-cause hospitalizations and emergency department (ED) visits were also statistically significant with RR = 2.31 (95% CI: 1.32-4.03) and RR = 1.39 (95% CI: 1.02-1.90), respectively. While unadjusted single-pollutant RRs for asthma-specific and asthma-related health services use with the SO component of PM were above one, none were statistically significant. This study found significant associations with exposure to SO in PM and all-cause acute care, chiefly for hospitalizations, in children with asthma.
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http://dx.doi.org/10.1016/j.envres.2021.111302DOI Listing
August 2021

Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19 positive individuals: Cohort study.

Environ Int 2021 09 9;154:106564. Epub 2021 Apr 9.

Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Veterans Research & Education Foundation of Saint Louis, 501 N Grand Blvd, Suite 300, Saint Louis, MO 63103, United States; Department of Medicine, Washington University in Saint Louis, 4921 Parkview Pl, Saint Louis, MO 63110, United States; Nephrology Section, Medicine Service, VA Saint Louis Health Care System, 915 N Grand Blvd, Saint Louis, MO 63106, United States; Institute for Public Health, Washington University in Saint Louis, 600 S Taylor Ave, Saint Louis, MO 63110, United States. Electronic address:

Background: Ecologic analyses suggest that living in areas with higher levels of ambient fine particulate matter air pollution (PM) is associated with higher risk of adverse COVID-19 outcomes. Studies accounting for individual-level health characteristics are lacking.

Methods: We leveraged the breadth and depth of the US Department of Veterans Affairs national healthcare databases and built a national cohort of 169,102 COVID-19 positive United States Veterans, enrolled between March 2, 2020 and January 31, 2021, and followed them through February 15, 2021. Annual average 2018 PM exposure, at an approximately 1 km resolution, was linked with residential street address at the year prior to COVID-19 positive test. COVID-19 hospitalization was defined as first hospital admission between 7 days prior to, and 15 days after, the first COVID-19 positive date. Adjusted Poisson regression assessed the association of PM with risk of hospitalization.

Results: There were 25,422 (15.0%) hospitalizations; 5,448 (11.9%), 5,056 (13.0%), 7,159 (16.1%), and 7,759 (19.4%) were in the lowest to highest PM quartile, respectively. In models adjusted for State, demographic and behavioral factors, contextual characteristics, and characteristics of the pandemic a one interquartile range increase in PM (1.9 µg/m) was associated with a 10% (95% CI: 8%-12%) increase in risk of hospitalization. The association of PM and risk of hospitalization among COVID-19 individuals was present in each wave of the pandemic. Models of non-linear exposure-response suggested increased risk at PM concentrations below the national standard 12 µg/m. Formal effect modification analyses suggested higher risk of hospitalization associated with PM in Black people compared to White people (p = 0.045), and in those living in socioeconomically disadvantaged neighborhoods (p < 0.001).

Conclusions: Exposure to higher levels of PM was associated with increased risk of hospitalization among COVID-19 infected individuals. The risk was evident at PM levels below the regulatory standards. The analysis identified those of Black race and those living in disadvantaged neighborhoods as population groups that may be more susceptible to the untoward effect of PM on risk of hospitalization in the setting of COVID-19.
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http://dx.doi.org/10.1016/j.envint.2021.106564DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040542PMC
September 2021

Prenatal exposure to residential PM and its chemical constituents and weight in preschool children: A longitudinal study from Shanghai, China.

Environ Int 2021 09 24;154:106580. Epub 2021 Apr 24.

NHC Key Lab. Of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Old Hu Min Road, Shanghai 200237, China.

Background: Studies have reported that prenatal exposure to fine particulate matter (PM) might be associated with adverse birth outcomes in offspring. However, evidence with regard to the effects of prenatal exposure to PM and, especially, its main chemical constituents on offspring's weight in childhood is limited and inconsistent.

Objectives: The present study aimed to examine associations of prenatal exposure to PM total mass and its chemical constituents in each trimester with children's weight from birth to 6 years of age using data from Shanghai-Minhang Birth Cohort Study.

Methods: A total of 1,084 mother-infant pairs were included with both PM exposure data and at least one measurement of weight and height. Weight-for-Length (WLZ), BMI-for-Age (BMIz), and Weight-for-Age (WAZ) z-scores were generated according to the World Health Organization guidelines. Exposure to PM total mass and its chemical constituents [organic carbon (OC), black carbon (BC), ammonium (NH), nitrate (NO), sulfate (SO), and soil dust (SOIL)] during pregnancy was estimated from a satellite based modelling framework. We used multiple informant model to estimate the associations of trimester-specific PM total mass and its specific constituents concentrations with WLZ/BMIz and WAZ of offspring at birth and 1, 4, and 6 years of age.

Results: In multiple informant model, we observed consistent patterns of associations between exposure to PM total mass, OC, BC, NH, NO, and SO during the 2 and 3 trimesters and decreased WLZ/BMIz and WAZ at 1, 4, and 6 years of age in boys. We observed associations between prenatal exposure to PM total mass, NH, and NO during the 1 and 2 trimesters and increased WLZ/BMIz and WAZ in girls at birth. However, there were null associations at 1 and 4 years of age and inverse associations at 6 years of age.

Conclusions: Prenatal exposure to PM total mass and its main chemical constituents was associated with decreased weight in boys from 1 to 6 years of age, with increased weight at birth and decreased weight at 6 years of age in girls. Our findings suggest that prenatal exposure to PM and its chemical constituents may have a lasting effect on offspring's weight in childhood.
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http://dx.doi.org/10.1016/j.envint.2021.106580DOI Listing
September 2021

Long-term exposure to air pollution and mortality in a prospective cohort: The Ontario Health Study.

Environ Int 2021 09 23;154:106570. Epub 2021 Apr 23.

Public Health Ontario, Toronto, ON, Canada; ICES, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada. Electronic address:

Background: Air pollution has been associated with increased mortality. However, updated evidence from cohort studies with detailed information on various risk factors is needed, especially in regions with low air pollution levels. We investigated the associations between long-term exposure to air pollution and mortality in a prospective cohort.

Methods: We studied 88,615 participants aged ≥30 years from an ongoing cohort study in Ontario, Canada from 2009 to 2017. Exposure to ambient fine particulate matter (PM) and nitrogen dioxide (NO) was estimated at participants' residence. Cox proportional hazard models were used to investigate the associations between air pollution and non-accidental, cardiovascular, and respiratory mortality, adjusted for a wide array of individual-level and contextual covariates. Potential effect modification by socio-demographic and behavioral factors was also examined in exploratory stratified analyses.

Results: The fully adjusted hazard ratios (HRs) per 1 µg/m increment in PM were 1.037 [95% confidence interval (CI): 1.018, 1.057]¸ 1.083 (95% CI: 1.040, 1.128) and 1.109 (95% CI: 1.035, 1.187) for non-accidental, cardiovascular, and respiratory mortality, respectively. Positive associations were also found for NO; the corresponding HRs per 1 ppb increment were 1.027 (95% CI: 1.021, 1.034), 1.032 (95% CI: 1.019, 1.046) and 1.044 (95% CI: 1.020, 1.068). We found suggestive evidence of stronger associations in physically active participants, smokers, and those with lower household income.

Conclusions: Long-term exposure to PM and NO was associated with increased risks for non-accidental, cardiovascular, and respiratory mortality, suggesting potential benefits of further improvement in air quality even in low-exposure environments.
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http://dx.doi.org/10.1016/j.envint.2021.106570DOI Listing
September 2021

Ambient Fine Particulate Matter Air Pollution and Risk of Weight Gain and Obesity in United States Veterans: An Observational Cohort Study.

Environ Health Perspect 2021 Apr 1;129(4):47003. Epub 2021 Apr 1.

Clinical Epidemiology Center, Research and Development Service, Veterans Affairs Saint Louis Health Care System, Saint Louis, Missouri, USA.

Background: Experimental evidence and studies of children and adolescents suggest that ambient fine particulate matter [particulate matter in aerodynamic diameter ()] air pollution may be obesogenic, but the relationship between and the risk of body weight gain and obesity in adults is uncertain.

Objectives: Our goal was to characterize the association between and the risks of weight gain and obesity.

Methods: We followed 3,902,440 U.S. Veterans from 2010 to 2018 (median 8.1 y, interquartile range: 7.3-8.4) and assigned time-updated exposures by linking geocoded residential street addresses with satellite-based estimates of surface-level mass (at resolution). Associations with were estimated using Cox proportional hazards models for incident obesity [body mass index (] and a increase in weight relative to baseline and linear mixed models for associations with intra-individual changes in BMI and weight.

Results: A higher average annual concentration was associated with risk of incident obesity [; (95% CI: 1.06, 1.11)] and the risk of a () increase in weight [ (95% CI: 1.06, 1.08)] and with higher intra-individual changes in BMI [ (95% CI: 0.139, 0.142)] and weight [ (95% CI: 0.955, 0.981)]. Nonlinear exposure-response models indicated associations at concentrations below the national standard of . As expected, a negative exposure control (ambient air sodium) was not associated with obesity or weight gain. Associations were consistent in direction and magnitude across sensitivity analyses that included alternative outcomes and exposures assigned at different spatial resolutions.

Discussion: air pollution was associated with the risk of obesity and weight gain in a large predominantly male cohort of U.S. Veterans. Discussions about health effects of should include its association with obesity, and deliberations about the epidemiology of obesity should consider its association with . Investigation in other cohorts will deepen our understanding of the relationship between and weight gain and obesity. https://doi.org/10.1289/EHP7944.
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http://dx.doi.org/10.1289/EHP7944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016176PMC
April 2021

Assessing the Distribution of Air Pollution Health Risks within Cities: A Neighborhood-Scale Analysis Leveraging High-Resolution Data Sets in the Bay Area, California.

Environ Health Perspect 2021 Mar 31;129(3):37006. Epub 2021 Mar 31.

Environmental Defense Fund, San Francisco, California, USA.

Background: Air pollution-attributable disease burdens reported at global, country, state, or county levels mask potential smaller-scale geographic heterogeneity driven by variation in pollution levels and disease rates. Capturing within-city variation in air pollution health impacts is now possible with high-resolution pollutant concentrations.

Objectives: We quantified neighborhood-level variation in air pollution health risks, comparing results from highly spatially resolved pollutant and disease rate data sets available for the Bay Area, California.

Methods: We estimated mortality and morbidity attributable to nitrogen dioxide (), black carbon (BC), and fine particulate matter [PM in aerodynamic diameter ()] using epidemiologically derived health impact functions. We compared geographic distributions of pollution-attributable risk estimates using concentrations from ) mobile monitoring of and BC; and ) models predicting annual , BC and concentrations from land-use variables and satellite observations. We also compared results using county vs. census block group (CBG) disease rates.

Results: Estimated pollution-attributable deaths per 100,000 people at the grid-cell level ranged across the Bay Area by a factor of 38, 4, and 5 for [ (95% CI: 9, 50)], BC [ (95% CI: 1, 2)], and , [ (95% CI: 33, 64)]. Applying concentrations from mobile monitoring and land-use regression (LUR) models in Oakland neighborhoods yielded similar spatial patterns of estimated grid-cell-level mortality rates. Mobile monitoring concentrations captured more heterogeneity [mobile monitoring (95% CI: 19, 107) deaths per 100,000 people; (95% CI: 30, 167)]. Using CBG-level disease rates instead of county-level disease rates resulted in 15% larger attributable mortality rates for both and , with more spatial heterogeneity at the grid-cell-level [ CBG deaths per 100,000 people (95% CI: 12, 68); (95% CI: 11, 64); (95% CI: 40, 77); and (95% CI: 37, 71)].

Discussion: Air pollutant-attributable health burdens varied substantially between neighborhoods, driven by spatial variation in pollutant concentrations and disease rates. https://doi.org/10.1289/EHP7679.
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http://dx.doi.org/10.1289/EHP7679DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011332PMC
March 2021

Fine particulate matter concentration and composition and the incidence of childhood asthma.

Environ Int 2021 07 5;152:106486. Epub 2021 Mar 5.

Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada; Population Studies Division, Health Canada, Ottawa, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

Background: Several studies have found positive associations between outdoor fine particulate air pollution (≤2.5 μm, PM) and childhood asthma incidence. However, the impact of PM composition on children's respiratory health remains uncertain.

Objective: We examined whether joint exposure to PM mass concentrations and its major chemical components was associated with childhood asthma development.

Methods: We conducted a population-based cohort study by identifying 1,130,855 singleton live births occurring between 2006 and 2014 in the province of Ontario, Canada. Concentrations of PM and its seven major chemical components were assigned to participants based on their postal codes using chemical transport models and remote sensing. The joint impact of outdoor PM concentrations and its major components and childhood asthma incidence (up to age 6) were estimated using Cox proportional hazards models, allowing for potential nonlinearity.

Results: We identified 167,080 children who developed asthma before age 6. In adjusted models, outdoor PM mass concentrations during childhood were associated with increased incidence of childhood asthma (Hazard Ratio (HR) for each 1 μg/m increase = 1.026, 95% CI: 1.021-1.031). We found that the joint effects of PM and its components on childhood asthma incidence may be 24% higher than the conventional approach. Specific components/source markers such as black carbon, ammonium, and nitrate appeared to play an important role.

Conclusions: Early life exposure to PM and its chemical components is associated with an increased risk of asthma development in children. The heterogeneous nature of PM should be considered in future health risk assessments.
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http://dx.doi.org/10.1016/j.envint.2021.106486DOI Listing
July 2021

A Population-Based Cohort Study of Respiratory Disease and Long-Term Exposure to Iron and Copper in Fine Particulate Air Pollution and Their Combined Impact on Reactive Oxygen Species Generation in Human Lungs.

Environ Sci Technol 2021 03 5;55(6):3807-3818. Epub 2021 Mar 5.

Public Health Ontario, Toronto, ON M5G 1V2, Canada.

Metal components in fine particulate matter (PM) from nontailpipe emissions may play an important role in underlying the adverse respiratory effects of PM. We investigated the associations between long-term exposure to iron (Fe) and copper (Cu) in PM and their combined impact on reactive oxygen species (ROS) generation in human lungs, and the incidence of asthma, chronic obstructive pulmonary disease (COPD), COPD mortality, pneumonia mortality, and respiratory mortality. We conducted a population-based cohort study of ∼0.8 million adults in Toronto, Canada. Land-use regression models were used to estimate the concentrations of Fe, Cu, and ROS. Outcomes were ascertained using validated health administrative databases. We found positive associations between long-term exposure to Fe, Cu, and ROS and the risks of all five respiratory outcomes. The associations were more robust for COPD, pneumonia mortality, and respiratory mortality than for asthma incidence and COPD mortality. Stronger associations were observed for ROS than for either Fe or Cu. In two-pollutant models, adjustment for nitrogen dioxide somewhat attenuated the associations while adjustment for PM had little influence. Long-term exposure to Fe and Cu in PM and estimated ROS concentration in lung fluid was associated with increased incidence of respiratory diseases, suggesting the adverse respiratory effects of nontailpipe emissions.
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http://dx.doi.org/10.1021/acs.est.0c05931DOI Listing
March 2021

Fine Particle Exposure and Clinical Aggravation in Neurodegenerative Diseases in New York State.

Environ Health Perspect 2021 Feb 8;129(2):27003. Epub 2021 Feb 8.

Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA.

Background: Adult-onset neurodegenerative diseases affect millions and negatively impact health care systems worldwide. Evidence suggests that air pollution may contribute to aggravation of neurodegeneration, but studies have been limited.

Objective: We examined the potential association between long-term exposure to particulate matter in aerodynamic diameter [fine particulate matter ()] and disease aggravation in Alzheimer's (AD) and Parkinson's (PD) diseases and amyotrophic lateral sclerosis (ALS), using first hospitalization as a surrogate of clinical aggravation.

Methods: We used data from the New York Department of Health Statewide Planning and Research Cooperative System (SPARCS 2000-2014) to construct annual county counts of first hospitalizations with a diagnosis of AD, PD, or ALS (total, urbanicity-, sex-, and age-stratified). We used annual concentrations estimated by a prediction model at a resolution, which we aggregated to population-weighted county averages to assign exposure to cases based on county of residence. We used outcome-specific mixed quasi-Poisson models with county-specific random intercepts to estimate rate ratios (RRs) for a 1-y exposure. We allowed for nonlinear exposure-outcome relationships using penalized splines and accounted for potential confounders.

Results: We found a positive nonlinear association that plateaued above (, 95% CI: 1.04, 1.14 for a increase from 8.1 to ). We also found a linear positive association (, 95% CI: 1.01, 1.09 per increase), and suggestive evidence of an association with AD. We found effect modification by age for PD and ALS with a stronger positive association in patients of age but found insufficient evidence of effect modification by sex or urbanization level for any of the outcomes.

Conclusion: Our findings suggest that annual increase in county-level concentrations may contribute to clinical aggravation of PD and ALS. Importantly, the average annual concentration in our study was , below the current American national standards, suggesting the standards may not adequately protect the aging population. https://doi.org/10.1289/EHP7425.
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http://dx.doi.org/10.1289/EHP7425DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869948PMC
February 2021

Long-term exposure to iron and copper in fine particulate air pollution and their combined impact on reactive oxygen species concentration in lung fluid: a population-based cohort study of cardiovascular disease incidence and mortality in Toronto, Canada.

Int J Epidemiol 2021 05;50(2):589-601

Public Health Ontario, Toronto, ON, Canada.

Background: Exposure to fine particulate (PM2.5) air pollution is associated with increased cardiovascular disease (CVD), but less is known about its specific components, such as metals originating from non-tailpipe emissions. We investigated the associations of long-term exposure to metal components [iron (Fe) and copper (Cu)] in PM2.5 with CVD incidence.

Methods: We conducted a population-based cohort study in Toronto, Canada. Exposures to Fe and Cu in PM2.5 and their combined impact on the concentration of reactive oxygen species (ROS) in lung fluid were estimated using land use regression models. Incidence of acute myocardial infarction (AMI), congestive heart failure (CHF) and CVD death was ascertained using health administrative datasets. We used mixed-effects Cox regression models to examine the associations between the exposures and health outcomes. A series of sensitivity analyses were conducted, including indirect adjustment for individual-level cardiovascular risk factors (e.g. smoking), and adjustment for PM2.5 and nitrogen dioxide (NO2).

Results: In single-pollutant models, we found positive associations between the three exposures and all three outcomes, with the strongest associations detected for the estimated ROS. The associations of AMI and CHF were sensitive to indirect adjustment, but remained robust for CVD death in all sensitivity analyses. In multi-pollutant models, the associations of the three exposures generally remained unaltered. Interestingly, adjustment for ROS did not substantially change the associations between PM2.5 and CVD, but attenuated the associations of NO2.

Conclusions: Long-term exposure to Fe and Cu in PM2.5 and their combined impact on ROS were consistently associated with increased CVD death.
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http://dx.doi.org/10.1093/ije/dyaa230DOI Listing
May 2021

Large global variations in measured airborne metal concentrations driven by anthropogenic sources.

Sci Rep 2020 12 11;10(1):21817. Epub 2020 Dec 11.

Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka, 1000, Bangladesh.

Globally consistent measurements of airborne metal concentrations in fine particulate matter (PM) are important for understanding potential health impacts, prioritizing air pollution mitigation strategies, and enabling global chemical transport model development. PM filter samples (N ~ 800 from 19 locations) collected from a globally distributed surface particulate matter sampling network (SPARTAN) between January 2013 and April 2019 were analyzed for particulate mass and trace metals content. Metal concentrations exhibited pronounced spatial variation, primarily driven by anthropogenic activities. PM levels of lead, arsenic, chromium, and zinc were significantly enriched at some locations by factors of 100-3000 compared to crustal concentrations. Levels of metals in PM and PM exceeded health guidelines at multiple sites. For example, Dhaka and Kanpur sites exceeded the US National Ambient Air 3-month Quality Standard for lead (150 ng m). Kanpur, Hanoi, Beijing and Dhaka sites had annual mean arsenic concentrations that approached or exceeded the World Health Organization's risk level for arsenic (6.6 ng m). The high concentrations of several potentially harmful metals in densely populated cites worldwide motivates expanded measurements and analyses.
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http://dx.doi.org/10.1038/s41598-020-78789-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733447PMC
December 2020

Satellite-based estimates of decline and rebound in China's CO emissions during COVID-19 pandemic.

Sci Adv 2020 12 2;6(49). Epub 2020 Dec 2.

Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing, China.

Changes in CO emissions during the COVID-19 pandemic have been estimated from indicators on activities like transportation and electricity generation. Here, we instead use satellite observations together with bottom-up information to track the daily dynamics of CO emissions during the pandemic. Unlike activity data, our observation-based analysis deploys independent measurement of pollutant concentrations in the atmosphere to correct misrepresentation in the bottom-up data and can provide more detailed insights into spatially explicit changes. Specifically, we use TROPOMI observations of NO to deduce 10-day moving averages of NO and CO emissions over China, differentiating emissions by sector and province. Between January and April 2020, China's CO emissions fell by 11.5% compared to the same period in 2019, but emissions have since rebounded to pre-pandemic levels before the coronavirus outbreak at the beginning of January 2020 owing to the fast economic recovery in provinces where industrial activity is concentrated.
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http://dx.doi.org/10.1126/sciadv.abd4998DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7821878PMC
December 2020

Ambient PM exposure and rapid spread of COVID-19 in the United States.

Sci Total Environ 2021 Mar 9;760:143391. Epub 2020 Nov 9.

Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA.

It has been posited that populations being exposed to long-term air pollution are more susceptible to COVID-19. Evidence is emerging that long-term exposure to ambient PM (particulate matter with aerodynamic diameter 2.5 μm or less) associates with higher COVID-19 mortality rates, but whether it also associates with the speed at which the disease is capable of spreading in a population is unknown. Here, we establish the association between long-term exposure to ambient PM in the United States (US) and COVID-19 basic reproduction ratio R- a dimensionless epidemic measure of the rapidity of disease spread through a population. We inferred state-level R values using a state-of-the-art susceptible, exposed, infected, and recovered (SEIR) model initialized with COVID-19 epidemiological data corresponding to the period March 2-April 30. This period was characterized by a rapid surge in COVID-19 cases across the US states, implementation of strict social distancing measures, and a significant drop in outdoor air pollution. We find that an increase of 1 μg/m in PM levels below current national ambient air quality standards associates with an increase of 0.25 in R (95% CI: 0.048-0.447). A 10% increase in secondary inorganic composition, sulfate-nitrate-ammonium, in PM associates with ≈10% increase in R by 0.22 (95% CI: 0.083-0.352), and presence of black carbon (soot) in the ambient environment moderates this relationship. We considered several potential confounding factors in our analysis, including gaseous air pollutants and socio-economical and meteorological conditions. Our results underscore two policy implications - first, regulatory standards need to be better guided by exploring the concentration-response relationships near the lower end of the PM air quality distribution; and second, pollution regulations need to be continually enforced for combustion emissions that largely determine secondary inorganic aerosol formation.
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http://dx.doi.org/10.1016/j.scitotenv.2020.143391DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7651233PMC
March 2021

Development of Europe-Wide Models for Particle Elemental Composition Using Supervised Linear Regression and Random Forest.

Environ Sci Technol 2020 12 25;54(24):15698-15709. Epub 2020 Nov 25.

Institute for Risk Assessment Sciences (IRAS), Utrecht University, Postbus 80125, 3508 TC Utrecht, The Netherlands.

We developed Europe-wide models of long-term exposure to eight elements (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc) in particulate matter with diameter <2.5 μm (PM) using standardized measurements for one-year periods between October 2008 and April 2011 in 19 study areas across Europe, with supervised linear regression (SLR) and random forest (RF) algorithms. Potential predictor variables were obtained from satellites, chemical transport models, land-use, traffic, and industrial point source databases to represent different sources. Overall model performance across Europe was moderate to good for all elements with hold-out-validation -squared ranging from 0.41 to 0.90. RF consistently outperformed SLR. Models explained within-area variation much less than the overall variation, with similar performance for RF and SLR. Maps proved a useful additional model evaluation tool. Models differed substantially between elements regarding major predictor variables, broadly reflecting known sources. Agreement between the two algorithm predictions was generally high at the overall European level and varied substantially at the national level. Applying the two models in epidemiological studies could lead to different associations with health. If both between- and within-area exposure variability are exploited, RF may be preferred. If only within-area variability is used, both methods should be interpreted equally.
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http://dx.doi.org/10.1021/acs.est.0c06595DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745532PMC
December 2020

Ambient PM and its chemical constituents on lifetime-ever pneumonia in Chinese children: A multi-center study.

Environ Int 2021 01 18;146:106176. Epub 2020 Nov 18.

Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China. Electronic address:

The long-term effects of ambient PM and chemical constituents on childhood pneumonia were still unknown. A cross-sectional study was conducted in 30,315 children in the China Children, Homes, Health (CCHH) project, involving 205 preschools in six cities in China, to investigate the long-term effects of PM constituents on lifetime-ever diagnosed pneumonia. Information on the lifetime-ever pneumonia and demographics were collected by validated questionnaires. The lifetime annual average ambient PM, ozone and five main PM constituents, including SO, NO, NH, organic matter (OM) and black carbon (BC), were estimated according to preschool addresses by a combination of satellite remote sensing, chemical transport modeling and ground-based monitors. The prevalence of lifetime-ever diagnosed pneumonia was 34.5% across six cities and differed significantly among cities (p = 0.004). The two-level logistic regression models showed that the adjusted odds ratio for PM (per 10 µg/m) and its constituents (per 1 µg/m)-SO, NO, NH, and OM were 1.12 (95% CI:1.07-1.18), 1.02 (1.00-1.04), 1.06 (1.04-1.09), 1.05 (1.03-1.07) and 1.09 (1.06-1.12), respectively. Children in urban area, aged < 5 years and breastfeeding time < 6 months enhanced the risks of pneumonia. Our study provided robust results that long-term levels of ambient PM and its constituents increased the risk of childhood pneumonia, especially NH, NO and OM.
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http://dx.doi.org/10.1016/j.envint.2020.106176DOI Listing
January 2021

Fine particulate matter constituents and sub-clinical outcomes of cardiovascular diseases: A multi-center study in China.

Sci Total Environ 2021 Mar 6;759:143555. Epub 2020 Nov 6.

China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.

Background: Limited evidence is available on the associations of long-term exposure to various fine particulate matter (PM) constituents with sub-clinical outcomes of cardiovascular disease (CVD) in China.

Objectives: We aimed to explore the associations of PM and its constituents with blood pressure (BP), fasting glucose, and cardiac electrophysiological (ECG) properties based on a national survey of 5852 Chinese adults, who participated in the Sub-Clinical Outcome of Polluted Air study, from July 2017 to March 2019.

Methods: Annual residential exposure to PM and its constituents of each subject was predicted by a satellite-based mode. We assessed the associations between five main constituents [organic matter (OM), black carbon (BC), sulfate (SO), nitrate (NO), ammonium (NH)] of PM and systolic BP (SBP), diastolic BP (DBP), fasting glucose, and ECG measurements (PR, QRS, QT, and QTc interval) using multivariable linear regression models.

Results: Long-term PM exposure was significantly associated with increased levels of fasting glucose, DBP, and ECG measurements. An IQR increase in OM (8.2 μg/m) showed considerably stronger associations with an elevated fasting glucose of 0.39 mmol/L (95%CI confidence interval: 0.28, 0.49) compared with other PM constituents. Meanwhile, an IQR increase in NO, NH and OM had stronger associations with DBP and ECG parameters compared with BC and SO.

Conclusions: This nationwide multi-center study in China indicated that some constituents (i.e., OM, NO, and NH) might be mainly responsible for the association of PM with sub-clinical outcomes of CVD including BP, fasting glucose, and ECG measurements.
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http://dx.doi.org/10.1016/j.scitotenv.2020.143555DOI Listing
March 2021

Examining PM concentrations and exposure using multiple models.

Environ Res 2021 05 7;196:110432. Epub 2020 Nov 7.

School of the Environment, Yale University, New Haven, CT, USA.

Epidemiologic studies have found associations between fine particulate matter (PM) exposure and adverse health effects using exposure models that incorporate monitoring data and other relevant information. Here, we use nine PM concentration models (i.e., exposure models) that span a wide range of methods to investigate i) PM concentrations in 2011, ii) potential changes in PM concentrations between 2011 and 2028 due to on-the-books regulations, and iii) PM exposure for the U.S. population and four racial/ethnic groups. The exposure models included two geophysical chemical transport models (CTMs), two interpolation methods, a satellite-derived aerosol optical depth-based method, a Bayesian statistical regression model, and three data-rich machine learning methods. We focused on annual predictions that were regridded to 12-km resolution over the conterminous U.S., but also considered 1-km predictions in sensitivity analyses. The exposure models predicted broadly consistent PM concentrations, with relatively high concentrations on average over the eastern U.S. and greater variability in the western U.S. However, differences in national concentration distributions (median standard deviation: 1.00 μg m) and spatial distributions over urban areas were evident. Further exploration of these differences and their implications for specific applications would be valuable. PM concentrations were estimated to decrease by about 1 μg m on average due to modeled emission changes between 2011 and 2028, with decreases of more than 3 μg m in areas with relatively high 2011 concentrations that were projected to experience relatively large emission reductions. Agreement among models was closer for population-weighted than uniformly weighted averages across the domain. About 50% of the population was estimated to experience PM concentrations less than 10 μg m in 2011 and PM improvements of about 2 μg m due to modeled emission changes between 2011 and 2028. Two inequality metrics were used to characterize differences in exposure among the four racial/ethnic groups. The metrics generally yielded consistent information and suggest that the modeled emission reductions between 2011 and 2028 would reduce absolute exposure inequality on average.
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http://dx.doi.org/10.1016/j.envres.2020.110432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102649PMC
May 2021

Air Pollution as a Risk Factor for Incident Chronic Obstructive Pulmonary Disease and Asthma. A 15-Year Population-based Cohort Study.

Am J Respir Crit Care Med 2021 05;203(9):1138-1148

Public Health Ontario, Toronto, Ontario, Canada.

Current evidence on the relationship between long-term exposure to air pollution and new onset of chronic lung disease is inconclusive. To examine associations of incident chronic obstructive pulmonary disease (COPD) and adult-onset asthma with past exposure to fine particulate matter ≤ 2.5 μm in diameter (PM), nitrogen dioxide (NO), ozone (O), and the redox-weighted average of NO and O (O) and characterize the concentration-response relationship. We conducted a population-based cohort study of all Ontarians, aged 35-85 years, from 2001 to 2015. A 3-year moving average of residential exposures to selected pollutants with a 1-year lag were estimated during follow-up. We used Cox proportional hazard models and Aalen additive-hazard models to quantify the pollution-disease associations and characterized the shape of these relationships using newly developed nonlinear risk models. Among 5.1 million adults, we identified 340,733 and 218,005 incident cases of COPD and asthma, respectively. We found positive associations of COPD with PM per interquartile-range (IQR) increase of 3.4 μg/m (hazard ratio, 1.07; 95% confidence interval, 1.06-1.08), NO per IQR increase of 13.9 ppb (1.04; 1.02-1.05), O per IQR increase of 6.3 ppb (1.04; 1.03-1.04), and O per IQR increase of 4.4 ppb (1.03; 1.03-1.03). By contrast, we did not find strong evidence linking these pollutants to adult-onset asthma. In addition, we quantified that each IQR increase in pollution exposure yielded 3.0 (2.4-3.6), 3.2 (2.0-4.3), 1.9 (1.3-2.5), and 2.3 (1.7-2.9) excess cases of COPD per 100,000 adults for PM, NO, O, and O, respectively. Furthermore, most pollutant-COPD relationships exhibited supralinear shapes. Air pollution was associated with a higher incidence of COPD but was not associated with a higher incidence of adult-onset asthma.
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http://dx.doi.org/10.1164/rccm.201909-1744OCDOI Listing
May 2021

Prenatal exposure to fine particles, premature rupture of membranes and gestational age: A prospective cohort study.

Environ Int 2020 12 26;145:106146. Epub 2020 Sep 26.

State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China. Electronic address:

Background: The associations between maternal exposure to fine particles with aerodynamic diameter ≤ 2.5 μm (PM) and gestational age as well as premature rupture of membranes (PROM) remain unclear. Few studies have focused on preconception exposure and components of fine particles in China.

Methods: A total of 1715 pregnant women were enrolled at hospitals affiliated with Nanjing Medical University from 2014 to 2015. Personal exposure to PM was estimated from preconception to the first trimester. Gestational age and PROM were investigated to explore their associations with PM and its components.

Results: From 12 weeks before conception to the end of the first trimester, the gestational age was reduced by 0.89 days (95% CI: -1.37, -0.40) per 10 μg/m increment in PM exposure. After the exposure period was separated into two groups, PM exposure reduced the gestational age by 0.35 days (95% CI: -0.59, -0.11) in the 12 weeks before pregnancy. With maternal exposure to PM early in the first trimester, gestational age was reduced by 0.62 days (95% CI: -1.09, -0.14). After mediation analysis, we found that PROM mediated the association between PM and gestational age from preconception to the first trimester. Components analysis indicated that exposure to black carbon, organic matter, and nitrate increased the risk of PROM and decreased gestational age.

Conclusion: Exposure to PM as well as some components of PM before and during early pregnancy was associated with PROM and gestational age. PROM might be a potential mediator in associations between PM as well as various components and gestational age.
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http://dx.doi.org/10.1016/j.envint.2020.106146DOI Listing
December 2020

Ambient ultrafine particle concentrations and incidence of childhood cancers.

Environ Int 2020 12 23;145:106135. Epub 2020 Sep 23.

Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.

Background: Ambient air pollution has been associated with childhood cancer. However, little is known about the possible impact of ambient ultrafine particles (<0.1 μm) (UFPs) on childhood cancer incidence.

Objective: This study aimed to evaluate the association between prenatal and childhood exposure to UFPs and development of childhood cancer.

Methods: We conducted a population-based cohort study of within-city spatiotemporal variations in ambient UFPs across the City of Toronto, Canada using 653,702 singleton live births occurring between April 1, 1998 and March 31, 2017. Incident cases of 13 subtypes of paediatric cancers among children up to age 14 were ascertained using a cancer registry. Associations between ambient air pollutant concentrations and childhood cancer incidence were estimated using random-effects Cox proportional hazards models. We investigated both single- and multi-pollutant models accounting for co-exposures to PM and NO.

Results: A total of 1,066 childhood cancers were identified. We found that first trimester exposure to UFPs (Hazard Ratio (HR) per 10,000/cm increase = 1.13, 95% CI: 1.03-1.22) was associated with overall cancer incidence diagnosed before 6 years of age after adjusting for PM, NO, and for personal and neighborhood-level covariates. Association between UFPs and overall cancer incidence exhibited a linear shape. No statistically significant associations were found for specific cancer subtypes.

Conclusion: Ambient UFPs may represent a previously unrecognized risk factor in the aetiology of cancers in children. Our findings reinforce the importance of conducting further research on the effects of UFPs given their high prevalence of exposure in urban areas.
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http://dx.doi.org/10.1016/j.envint.2020.106135DOI Listing
December 2020

Residential Greenness and Cardiovascular Disease Incidence, Readmission, and Mortality.

Environ Health Perspect 2020 08 25;128(8):87005. Epub 2020 Aug 25.

College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA.

Background: Living in greener areas of cities was linked to increased physical activity levels, improved mental well-being, and lowered harmful environmental exposures, all of which may affect human health. However, whether living in greener areas may be associated with lower risk of cardiovascular disease incidence, progression, and premature mortality is unclear.

Objectives: We conducted a cohort study to examine the associations between residential green spaces and the incidence of acute myocardial infarction (AMI) and heart failure (HF), post-AMI and HF hospital readmissions, and mortality.

Methods: We simultaneously followed four large population-based cohorts in Ontario, Canada, including the entire adult population, adults free of AMI and HF, and survivors of AMI or HF from 2000 to 2014. We estimated residential exposure to green spaces using satellite-derived observations and ascertained health outcomes using validated disease registries. We estimated the associations using spatial random-effects Cox proportional hazards models. We conducted various sensitivity analyses, including further adjusting for property values and performing exploratory mediation analysis.

Results: Each interquartile range increase in residential greenness was associated with a 7% [95% confidence interval (CI): 4%, 9%] decrease in incident AMI and a 6% (95% CI: 4%, 7%) decrease in incident HF. Residential greenness was linked to a decrease in cardiovascular mortality in both adults free of AMI and HF and the entire adult population. These associations remained consistent in sensitivity analyses and were accentuated among younger adults. Additionally, we estimated that the decreases in AMI and HF incidence associated with residential greenness explained of the protective association between residential greenness and cardiovascular mortality. Conversely, residential greenness was not associated with any delay in readmission or mortality among AMI and HF patients.

Conclusions: Living in urban areas with more green spaces was associated with improved cardiovascular health in people free of AMI and HF but not among individuals who have already developed these conditions. https://doi.org/10.1289/EHP6161.
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http://dx.doi.org/10.1289/EHP6161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446772PMC
August 2020

Self-rated stress, distress, mental health, and health as modifiers of the association between long-term exposure to ambient pollutants and mortality.

Environ Res 2020 12 15;191:109973. Epub 2020 Aug 15.

Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.

Background: Individual and neighbourhood-scale socioeconomic characteristics modify associations between exposure to air pollution and mortality. The role of stress, which may integrate effects of social and environmental exposures on health, is unknown. We examined whether an individual's perspective on their own well-being, as assessed using self-rated measures of stress and health, modifies the pollutant-mortality relationship.

Methods: The Canadian Community Health Survey (CCHS)-mortality cohort includes respondents from surveys administered between 2001 and 2012 linked to vital statistics and postal codes from 1981 until 2016. Annual fine particulate matter (PM), nitrogen dioxide (NO), and ozone (O) exposure estimates were attached to a sample of cohort members aged 30-89 years (n = 398,300 respondents/3,848,400 person-years). We examined whether self-rated stress, distress, mental health, and general health modified associations between long-term exposure to each pollutant (three-year moving average with one-year lag) and non-accidental mortality using Cox survival models, adjusted for individual- (i.e. socioeconomic and behavioural) and neighbourhood-scale covariates.

Results: In fully-adjusted models, the relationship between exposure to pollutants and mortality was stronger among those with poor self-rated mental health, including a significant difference for NO (hazard ratio (HR) = 1.15, 95% CI 1.06-1.25 per IQR) compared to those with very good/excellent mental health (HR = 1.05, 95% CI 1.01-1.08; Cochran's Q = 4.01; p < 0.05). Poor self-rated health was similarly associated with higher pollutant-associated HRs, but only in unadjusted models. Stress and distress did not modify pollutant-mortality associations.

Conclusions: Poor self-rated mental and general health were associated with increased mortality attributed to exposure to ambient pollutants.
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http://dx.doi.org/10.1016/j.envres.2020.109973DOI Listing
December 2020
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