Otitis media (OM) is one of the most common early childhood infections, resulting in an enormous economic burden to the health care system through unscheduled doctor visits and antibiotic prescriptions.
The objective of this study was to investigate the potential association between ambient air pollution exposure and emergency department (ED) visits for OM.
Ten years of ED data were obtained from Edmonton, Alberta, Canada, and linked to levels of air pollution: carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide, and particulate matter (PM) of median aerometric diameter
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Cites: Vaccine. 2008 Dec 23;26 Suppl 7:G5-1019094935
Temperature, a key climate change indicator, is expected to increase substantially in the Northern Hemisphere, with potentially grave implications for human health. This study is the first to investigate the association between the daily 3-hour maximum apparent temperature (Tapp(max)), and respiratory, cardiovascular and cerebrovascular mortality in Copenhagen (1999-2006) using a case-crossover design. Susceptibility was investigated for age, sex, socio-economic status and place of death. For an inter-quartile range (7 °C) increase in Tapp(max), an inverse association was found with cardiovascular mortality (-7% 95% CI -13%; -1%) and none with respiratory and cerebrovascular mortality. In the cold period all associations were inverse, although insignificant.
Cites: Epidemiology. 2008 Sep;19(5):711-918520615
Cites: Scand J Public Health. 2008 Jul;36(5):516-2318567653
Cites: J Occup Environ Med. 2009 Jan;51(1):13-2519136869
Cites: Am J Respir Crit Care Med. 2009 Mar 1;179(5):383-919060232
Self-reported data on the municipality of residence were used to assess long-term exposure to outdoor air pollution from 1980 to 2002 in the longitudinal Canadian National Population Health Survey. Exposure to carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide, and particulate matter was determined using data obtained from fixed-site air pollution monitors operated principally in urban areas. Four different methods of attributing pollution exposure were used based on residence in (1) 1980, (2) 1994, (3) 1980 and 1994, and (4) at all locations between 1980 and 2002. Between 1,693 and 4,274 of 10,515 members of the cohort could be assigned exposures to individual pollutants using these methods. On average, subjects spent 71.4% of the 1980-2002 period in the census subdivision where they lived in 1980. A single exposure measure in 1980 or 1994 or a mean of the two measures was highly correlated (r>0.7, P
This study was undertaken to determine whether variations in concentrations of particles in the ambient air of Montreal, Quebec, during the period 1984 to 1993, were associated with daily variations in nonaccidental mortality. Fixed-site air pollution monitors in Montreal provided daily mean levels of various measures of particulates and gaseous pollutants. Total sulfates were also measured daily (1986-1993) at a monitoring station 150 km southeast of the city (Sutton, Quebec). We estimated associations for PM(2.5), PM(10), total suspended particles, coefficient of haze (COH), extinction coefficient, and sulfates. We used coefficient of haze, extinction coefficient, and Sutton sulfates to predict fine particles and sulfates for days that were missing. To estimate the associations between nonaccidental mortality and ambient air particles, we regressed the logarithm of daily counts of nonaccidental mortality on the daily mean levels for the above measures of particulates, after accounting for seasonal and subseasonal fluctuations in the mortality time series, non-Poisson dispersion, weather variables, and gaseous pollutants. There were 140,939 residents of Montreal who died during the study period. We found evidence of associations between daily nonaccidental deaths and most measures of particulate air pollution. For example, the mean percentage increase (MPC) for an increase of total suspended particles of 28.57 microg/m(3) (interquartile range, IQ), evaluated at lag 0 days, was 1.86% (95% confidence interval (CI): 0.00-3.76%), and for an increase of coefficient of haze (IQ=18.5 COH units per 327.8 linear m) the MPC was 1.44% (95% CI: 0.75-2.14%). These results are similar to findings from other studies (the mean percentage increase in nonaccidental deaths for a 100 microg/m(3) increase in daily total suspended particles was 6.7%). We also found increases for fine particles and for inhalable particles, but the confidence intervals included unity. All measures of sulfates showed increased daily mortality; e.g., the MPC for sulfates from fine particles (IQ=3.51 microg/m(3)) was 1.86% (95% CI: 0.40-3.35%). We generally found higher excesses in daily mortality for persons 65 years of age and for exposures averaged across lags 0, 1, and 2 days. The slope of the association between daily mortality and ambient air particles in Montreal, which has lower levels of pollution than most major urban centers, is similar to that reported in most other industrialized cities. This study therefore provides further evidence that the association is linear and that any threshold effect, should it exist, would be found at lower levels of air pollution than those found in Montreal.
This study was undertaken to determine whether variations in concentrations of particulates in the ambient air of Montreal, Quebec, during the period 1984 to 1993, were associated with daily variations in cause-specific daily mortality. Fixed-site air pollution monitors in Montreal provided daily mean levels of various measures of particles and gaseous pollutants. Total sulfate was also measured daily (1986-1993) at a monitoring station 150 km southeast of the city (Sutton, Quebec). We used coefficient of haze (COH), extinction coefficient, and sulfate from the Sutton station to predict fine particles and sulfate from fine particles for days that were missing. We estimated associations between cause-specific mortality and PM(2.5), PM(10), predicted fine particles and fine sulfate particles, total suspended particles, coefficient of haze, extinction coefficient, and total sulfate measured at the Sutton station. We selected a set of underlying causes of death, as recorded on the death certificates, as the endpoint and then regressed the logarithm of daily counts of cause-specific mortality on the daily mean levels for the above measures of particulates, after accounting for seasonal and subseasonal fluctuations in the mortality time series, non-Poisson dispersion, weather variables, and gaseous pollutants. We found positive and statistically significant associations between the daily measures of ambient particle mass and sulfate mass and the deaths from respiratory diseases and diabetes. The mean percentage change in daily mortality (MPC), evaluated at the interquartile range for pollutants averaged over the day of death and the preceding 2 days, for deaths from respiratory diseases was MPC(COH)=6.90% (95% CI: 3.69-10.21%), MPC(Predicted PM2.5)= 9.03% (95% CI: 5.83- 12.33%), and MPC(Sutton sulfate)=4.64% (95% CI: 2.46-6.86%). For diabetes, the corresponding estimates were MPC(COH)=7.50% (95% CI: 1.96-13.34%), MPC(Predicted PM2.5)=7.59% (95% CI: 2.36-13.09%), and MPC(Sutton sulfate)=4.48% (95% CI: 1.08-7.99%). Among individuals older than 65 years at time of death, we found consistent associations across our metrics of particles for neoplasms and coronary artery diseases. Associations with sulfate mass were also found among elderly persons who died of cardiovascular diseases and of lung cancer. These associations were consistent with linear relationships. The associations found for respiratory diseases and for cardiovascular diseases, especially in the elderly, are in line with some of the current hypotheses regarding mechanisms by which ambient particles may increase daily mortality. The positive associations found for cancer and for diabetes may be understood through a general hypothesis proposed by Frank and Tankersley, who suggested that persons in failing health may be at higher risk for external insults through the failure of regulating physiological set points. The association with diabetes may be interpreted in light of recent toxicological findings that inhalation of urban particles in animals increases blood pressure and plasmatic levels of endothelins that enhance vasoconstriction and alter electrophysiology. Further research to confirm these findings and to determine whether they are causal is warranted.
Swedish foundries have a long tradition of legally required surveys in the workplace that, from the late 1960s onwards, included measurements of quartz. The availability of exposure data spanning almost 40 years presents a unique opportunity to study trends over that time and to evaluate the validity of exposure models based on data from shorter time spans. The aims of this study were (i) to investigate long-term trends in quartz exposure over time, (ii) using routinely collected quartz exposure measurements to develop a mathematical model that could predict both historical and current exposure patterns, and (iii) to validate this exposure model with up-to-date measurements from a targeted survey of the industry.
Eleven foundries, representative of the Swedish iron foundry industry, were divided into three groups based on the size of the companies, i.e. the number of employees. A database containing 2333 quartz exposure measurements for 11 different job descriptions was used to create three models that covered time periods which reflected different work conditions and production processes: a historical model (1968-1989), a development model (1990-2004), and a validation model (2005-2006). A linear mixed model for repeated measurements was used to investigate trends over time. In all mixed models, time period, company size, and job title were included as fixed (categorical) determinants of exposure. The within- and between-worker variances were considered to be random effects. A linear regression analysis was performed to investigate agreement between the models. The average exposure was estimated for each combination of job title and company size.
A large reduction in exposure (51%) was seen between 1968 and 1974 and between 1975 and 1979 (28%). In later periods, quartz exposure was reduced by 8% per 5 years at best. In the first period, employees at smaller companies experienced ~50% higher exposure levels than those at large companies, but these differences became much smaller in later years. The furnace and ladle repair job were associated with the highest exposure, with 3.9-8.0 times the average exposure compared to the lowest exposed group. Without adjusting for this autonomous trend over time, predicting early historical exposures using our development model resulted in a statistically significant regression coefficient of 2.42 (R(2) = 0.81), indicating an underestimation of historical exposure levels. Similar patterns were seen for other historical time periods. Comparing our development model with our validation model resulted in a statistically significant regression coefficient of 0.31, indicating an overestimation of current exposure levels.
To investigate long-term trends in quartz exposure over time, overall linear trends can be determined by using mixed model analysis. To create individual exposure measures to predict historical exposures, it is necessary to consider factors such as the time period, type of job, type of company, and company size. The mixed model analysis showed systematic changes in concentration levels, implying that extrapolation of exposure estimates outside the range of years covered by measurements may result in underestimation or overestimation of exposure.
The standard approach to government-mandated aerometric monitoring of airborne particulates across North America is to sample every sixth day year round. However, such data are inadequate for epidemiological studies which aim to examine daily time series relationships of particulate air pollution to respiratory health responses. The aim of the present study was to estimate missing daily particulate matter
Historical records show that the A.D. 1783-1784 Laki eruption in Iceland caused severe environmental stress and posed a health hazard far beyond the borders of Iceland. Given the reasonable likelihood of such an event recurring, it is important to assess the scale on which a future eruption could impact society. We quantify the potential health effects caused by an increase in air pollution during a future Laki-style eruption using a global aerosol model together with concentration-response functions derived from current epidemiological studies. The concentration of particulate matter with diameters smaller than 2.5 µm is predicted to double across central, western, and northern Europe during the first 3 mo of the eruption. Over land areas of Europe, the current World Health Organization 24-h air quality guideline for particulate matter with diameters smaller than 2.5 µm is exceeded an additional 36 d on average over the course of the eruption. Based on the changes in particulate air pollution, we estimate that approximately 142,000 additional cardiopulmonary fatalities (with a 95% confidence interval of 52,000-228,000) could occur in Europe. In terms of air pollution, such a volcanic eruption would therefore be a severe health hazard, increasing excess mortality in Europe on a scale that likely exceeds excess mortality due to seasonal influenza.
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Cites: J Air Waste Manag Assoc. 2006 Jun;56(6):709-4216805397
To evaluate exposure estimation methods such as spatially resolved land-use regression models and ambient monitoring data in the context of epidemiological studies of the impact of air pollution on pregnancy outcomes.
The study measured personal 48 h exposures (NO, NO(2), PM(2.5) mass and absorbance) and mobility (time activity and GPS) for 62 pregnant women during 2005-2006 in Vancouver, Canada, one to three times during pregnancy. Measurements were compared to modelled (using land-use regression and interpolation of ambient monitors) outdoor concentrations at subjects' home and work locations.
Personal NO and absorbance (ABS) measurements were moderately correlated (NO: r = 0.54, ABS: r = 0.29) with monitor interpolations and explained primarily within-subject (temporal) variability. Land-use regression estimates including work location improved correlations for NO over those based on home postal code (for NO: r = 0.49 changed to NO: r = 0.55) and explained more between-subject variance (4-20%); limiting to a subset of samples (n = 61) when subjects spent >65% time at home also improved correlations (NO: r = 0.72). Limitations of the GPS equipment precluded assessment of including complete GPS-based mobility information.
The study found moderate agreement between short-term personal measurements and estimates of ambient air pollution at home based on interpolation of ambient monitors and land-use regression. These results support the use of land-use regression models in epidemiological studies, as the ability of such models to characterise high resolution spatial variability is "reflected" in personal exposure measurements, especially when mobility is characterised.
A majority of occupants of a newly renovated historic courthouse in Calgary, Alberta, Canada, reported multiple (3 or more) health-related symptoms, and several reported more than 10 persistent symptoms. Most required at least 1 day outside of the building to recover from their symptoms. Molds that produce mycotoxins, such as Stachybotrys chartarum and Emericella nidulans, were identified in the building, along with fungal organisms of the genera Aspergillus, Penicillium, Streptomyces, Cladosporium, Chaetomium, Rhizopus/Mucor, Alternaria, Ulocladium, and Basidiomycetes. Renovations to this historic had building failed to provide adequate thermal and vapor barriers, thus allowing moist indoor air to migrate into the building enclosure, causing condensation to develop. Mold grew on the condensation and was dispersed throughout the courthouse, including on furniture and files. The courthouse was closed and a new facility was modified with low-offgassing materials, better ventilation and air filtration, and strict building maintenance to accommodate those occupants of the older building who had developed multiple chemical sensitivities.