Special Issue "Morbidity and Mortality Related to Air Pollution and Extreme Temperatures"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (31 August 2019).

Special Issue Editor

Prof. Dr. Youn-Hee Lim
Website
Guest Editor
Institute of Environmental Medicine, Seoul National University College of Medicine, Seoul, Korea
Interests: health effects of air pollution and extreme temperatures

Special Issue Information

Dear Colleagues,

Air pollution and extreme temperatures are the most common consequences of climate change. The health effects of climate change have appeared in many areas, regardless of their location, whether in the south or in the north hemisphere. Therefore, more studies are needed to estimate the health effects and impacts of the exposure to these factors. Novel methods to study health effects may consider new definitions of exposure, additional health outcomes, and novel analytical methods. Previous studies used absolute values of exposure to different factors (e.g., absolute temperature or lagged temperature). However, the variance related to these values in those studies was small. Developing new methods to predict mortality and morbidity will improve the preventive strategies. Defining susceptible populations—by evaluating pre-exiting health conditions, socioeconomic status, or other factors—and newly identified diseases due to air pollution and extreme temperatures may be considered. In addition, more studies are needed to develop novel methods to assess the health impact of the exposure to air pollution and extreme temperatures. A comparison with traditional techniques may be carried out. Various approaches, including disability-adjusted life expectancy (DALY) and attributable mortality counts or fraction, may be employed. Papers addressing novel methods for the study of the health effects of air pollution and extreme temperatures are invited for this Special Issue.

Prof. Dr. Youn-Hee Lim
Guest Editor

Manuscript Submission Information

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Keywords

  • Air pollution
  • Health impact assessment
  • Health effects
  • Meteorology
  • Mortality
  • Morbidity
  • Temperature

Published Papers (9 papers)

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Research

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Open AccessArticle
The Value of Local Heatwave Impact Assessment: A Case-Crossover Analysis of Hospital Emergency Department Presentations in Tasmania, Australia
Int. J. Environ. Res. Public Health 2019, 16(19), 3715; https://doi.org/10.3390/ijerph16193715 - 02 Oct 2019
Cited by 3
Abstract
Heatwaves have been identified as a threat to human health, with this impact projected to rise in a warming climate. Gaps in local knowledge can potentially undermine appropriate policy and preparedness actions. Using a case-crossover methodology, we examined the impact of heatwave events [...] Read more.
Heatwaves have been identified as a threat to human health, with this impact projected to rise in a warming climate. Gaps in local knowledge can potentially undermine appropriate policy and preparedness actions. Using a case-crossover methodology, we examined the impact of heatwave events on hospital emergency department (ED) presentations in the two most populous regions of Tasmania, Australia, from 2008–2016. Using conditional logistic regression, we analyzed the relationship between ED presentations and severe/extreme heatwaves for the whole population, specific demographics including age, gender and socio-economic advantage, and diagnostic conditions that are known to be impacted in high temperatures. ED presentations increased by 5% (OR 1.05, 95% CI 1.01–1.09) across the whole population, by 13% (OR 1.13, 95% CI 1.03–1.24) for children 15 years and under, and by 19% (OR 1.19, 95% CI 1.04–1.36) for children 5 years and under. A less precise association in the same direction was found for those over 65 years. For diagnostic subgroups, non-significant increases in ED presentations were observed for asthma, diabetes, hypertension, and atrial fibrillation. These findings may assist ED surge capacity planning and public health preparedness and response activities for heatwave events in Tasmania, highlighting the importance of using local research to inform local practice. Full article
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Open AccessArticle
Spatial Variability in the Effect of High Ambient Temperature on Mortality: An Analysis at Municipality Level within the Greater Athens Area
Int. J. Environ. Res. Public Health 2019, 16(19), 3689; https://doi.org/10.3390/ijerph16193689 - 30 Sep 2019
Cited by 2
Abstract
Spatial variability in temperature exists within metropolitan areas but very few studies have investigated intra-urban differentiation in the temperature-mortality effects. We investigated whether local characteristics of 42 Municipalities within the Greater Athens Area lead to modified temperature effects on mortality and if effect [...] Read more.
Spatial variability in temperature exists within metropolitan areas but very few studies have investigated intra-urban differentiation in the temperature-mortality effects. We investigated whether local characteristics of 42 Municipalities within the Greater Athens Area lead to modified temperature effects on mortality and if effect modifiers can be identified. Generalized Estimating Equations models were used to assess the effect of high ambient temperature on the total and cause-specific daily number of deaths and meta-regression to investigate effect modification. We found significant effects of daily temperature increases on all-cause, cardiovascular, and respiratory mortality (e.g., for all ages 4.16% (95% CI: 3.73,4.60%) per 1 °C increase in daily temperature (lags 0–3). Heterogeneity in the effect estimates between Municipalities was observed in several outcomes and environmental and socio-economic effect modifying variables were identified, such as % area coverage of buildings, length of roads/km2, population density, % unemployed, % born outside the EU countries and mean daily temperature. To further examine the role of temperature, we alternatively used modelled temperature per Municipality and calculated the effects. We found that heterogeneity was reduced but not eliminated. It appears that there are socioeconomic status and environmental determinants of the magnitude of heat-related effects on mortality, which are detected with some consistency and should be further investigated. Full article
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Open AccessArticle
Cold Weather Conditions and Risk of Hypothermia Among People Experiencing Homelessness: Implications for Prevention Strategies
Int. J. Environ. Res. Public Health 2019, 16(18), 3259; https://doi.org/10.3390/ijerph16183259 - 05 Sep 2019
Cited by 3
Abstract
Hypothermia is a preventable condition that disproportionately affects individuals who experience homelessness, yet limited data exist to inform the response to cold weather. To fill this gap, we examined the association between meteorological conditions and the risk of hypothermia among homeless individuals. Hypothermic [...] Read more.
Hypothermia is a preventable condition that disproportionately affects individuals who experience homelessness, yet limited data exist to inform the response to cold weather. To fill this gap, we examined the association between meteorological conditions and the risk of hypothermia among homeless individuals. Hypothermic events were identified from emergency department charts and coroner’s records between 2004 and 2015 in Toronto, Canada. A time-stratified case-crossover design with conditional logistic regression was used to assess the relationship between the meteorological conditions (minimum temperature and precipitation) and the risk of hypothermia. There were 97 hypothermic events identified: 79 injuries and 18 deaths. The odds of experiencing a hypothermic event increased 1.64-fold (95% CI: 1.30–2.07) with every 5 °C decrease in the minimum daily temperature and 1.10-fold (95% CI: 1.03–1.17) with every 1 mm increase in precipitation. The risk of hypothermia among individuals experiencing homelessness increased with declining temperature; however, most cases occurred during periods of low and moderate cold stress. 72% occurred when the minimum daily temperatures were warmer than −15 °C. These findings highlight the importance of providing a seasonal cold weather response to prevent hypothermia, complemented by an alert-based response on extremely cold days. Full article
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Open AccessArticle
Short-Term Effects of Carbonaceous Components in PM2.5 on Pulmonary Function: A Panel Study of 37 Chinese Healthy Adults
Int. J. Environ. Res. Public Health 2019, 16(13), 2259; https://doi.org/10.3390/ijerph16132259 - 26 Jun 2019
Cited by 1
Abstract
Objectives: To explore the health effects of indoor/outdoor carbonaceous compositions in PM2.5 on pulmonary function among healthy students living in the local university campus. Methods: Daily peak expiratory flow (PEF) and forced expiratory volume in 1 second (FEV1) were measured [...] Read more.
Objectives: To explore the health effects of indoor/outdoor carbonaceous compositions in PM2.5 on pulmonary function among healthy students living in the local university campus. Methods: Daily peak expiratory flow (PEF) and forced expiratory volume in 1 second (FEV1) were measured among 37 healthy students in the morning and evening for four two-week periods. Concurrent concentrations of indoor and outdoor PM2.5 (particulate matter with an aerodynamic diameter ≤ 2.5μm), carbonaceous components in PM2.5, ambient temperature, and relative humidity in the study area were also obtained. Mixed-effects model was applied to evaluate the associations between carbonaceous components and lung function. Different lags for the carbonaceous components were investigated. Results: In single-pollutant model, a 10 μg/m3 increase of indoor and outdoor EC (elemental carbon) associated with −3.93 (95%CI: −6.89, −0.97) L/min and −3.21 (95%CI: −5.67, −0.75) L/min change in evening PEF at lag 0 day, respectively. Also, a 10 μg/m3 increase of indoor and outdoor POC (primary organic carbon) concentration was significantly associated with −5.82 (95%CI: −10.82, −0.81) L/min and −7.32 (95%CI: −12.93, −1.71) L/min change of evening PEF at lag 0 day. After adjusting total mass of PM2.5, indoor EC consistently had a significant adverse impact on evening PEF and FEV1 at lag3 day and a cumulative effect at lag0-3 day. Conclusions: This study suggests that carbonaceous components in PM2.5 indeed have impacts on pulmonary function among healthy young adults especially on evening PEF. Thus, the local mitigation strategies on pollution are needed. Full article
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Open AccessArticle
Particulate Matter Mortality Rates and Their Modification by Spatial Synoptic Classification
Int. J. Environ. Res. Public Health 2019, 16(11), 1904; https://doi.org/10.3390/ijerph16111904 - 29 May 2019
Cited by 3
Abstract
Air pollution levels are highly correlated with temperature or humidity, so we investigated the relationship between PM10 and the spatial synoptic classification (SSC) scheme on daily mortality, according to age group and season. Daily death data for 2000–2014 from Seoul, Korea, were [...] Read more.
Air pollution levels are highly correlated with temperature or humidity, so we investigated the relationship between PM10 and the spatial synoptic classification (SSC) scheme on daily mortality, according to age group and season. Daily death data for 2000–2014 from Seoul, Korea, were acquired, and time-series analysis was applied with respect to season and to each of seven distinct SSC types: dry moderate (DM); dry polar (DP); dry tropical (DT); moist moderate (MM); moist polar (MP); moist tropical (MT); and transition (T). Modification effects were estimated for daily, non-accidental, cardiovascular, and respiratory mortality between PM10 and SSC types. The following SSC-type-specific increased mortalities were observed, by cause of death: non-accidental mortality: DT (1.86%) and MT (1.86%); cardiovascular mortality: DT (2.83%) and MM (3.00%); respiratory mortality: MT (3.78%). Based on simplified weather types, increased PM10 effects in non-accidental mortality rates were observed in dry (1.54%) and moist (2.32%) conditions among those aged 40–59 years and were detected regardless of conditions in other age groups: 60–74 (1.11%), 75–84 (1.55%), and 85+ (1.75%). The effects of particulate air pollution, by SSC, suggest the applicability of SSC to the comparison and understanding of acute effects of daily mortality based on weather type. Full article
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Open AccessArticle
Value Assessment of Health Losses Caused by PM2.5 Pollution in Cities of Atmospheric Pollution Transmission Channel in the Beijing–Tianjin–Hebei Region, China
Int. J. Environ. Res. Public Health 2019, 16(6), 1012; https://doi.org/10.3390/ijerph16061012 - 20 Mar 2019
Cited by 6
Abstract
A set of exposure–response coefficients between fine particulate matter (PM2.5) pollution and different health endpoints were determined through the meta-analysis method based on 2254 studies collected from the Web of Science database. With data including remotely-sensed PM2.5 concentration, demographic data, [...] Read more.
A set of exposure–response coefficients between fine particulate matter (PM2.5) pollution and different health endpoints were determined through the meta-analysis method based on 2254 studies collected from the Web of Science database. With data including remotely-sensed PM2.5 concentration, demographic data, health data, and survey data, a Poisson regression model was used to assess the health losses and their economic value caused by PM2.5 pollution in cities of atmospheric pollution transmission channel in the Beijing–Tianjin–Hebei region, China. The results showed the following: (1) Significant exposure–response relationships existed between PM2.5 pollution and a set of health endpoints, including all-cause death, death from circulatory disease, death from respiratory disease, death from lung cancer, hospitalization for circulatory disease, hospitalization for respiratory disease, and outpatient emergency treatment. Each increase of 10 μg/m3 in PM2.5 concentration led to an increase of 5.69% (95% CI (confidence interval): 4.12%, 7.85%), 6.88% (95% CI: 4.94%, 9.58%), 4.71% (95% CI: 2.93%, 7.57%), 9.53% (95% CI: 6.84%, 13.28%), 5.33% (95% CI: 3.90%, 7.27%), 5.50% (95% CI: 4.09%, 7.38%), and 6.35% (95% CI: 4.71%, 8.56%) for above-mentioned health endpoints, respectively. (2) PM2.5 pollution posed a serious threat to residents’ health. In 2016, the number of deaths, hospitalizations, and outpatient emergency visits induced by PM2.5 pollution in cities of atmospheric pollution transmission channel in the Beijing–Tianjin–Hebei region reached 309,643, 1,867,240, and 47,655,405, respectively, accounting for 28.36%, 27.02% and 30.13% of the total number of deaths, hospitalizations, and outpatient emergency visits, respectively. (3) The economic value of health losses due to PM2.5 pollution in the study area was approximately $28.1 billion, accounting for 1.52% of the gross domestic product. The economic value of health losses was higher in Beijing, Tianjin, Shijiazhuang, Zhengzhou, Handan, Baoding, and Cangzhou, but lower in Taiyuan, Yangquan, Changzhi, Jincheng, and Hebi. Full article
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Open AccessArticle
Comparison of Frequentist and Bayesian Generalized Additive Models for Assessing the Association between Daily Exposure to Fine Particles and Respiratory Mortality: A Simulation Study
Int. J. Environ. Res. Public Health 2019, 16(5), 746; https://doi.org/10.3390/ijerph16050746 - 01 Mar 2019
Cited by 1
Abstract
Objective: To compare the performance of frequentist and Bayesian generalized additive models (GAMs) in terms of accuracy and precision for assessing the association between daily exposure to fine particles and respiratory mortality using simulated data based on a real time-series study. Methods: [...] Read more.
Objective: To compare the performance of frequentist and Bayesian generalized additive models (GAMs) in terms of accuracy and precision for assessing the association between daily exposure to fine particles and respiratory mortality using simulated data based on a real time-series study. Methods: In our study, we examined the estimates from a fully Bayesian GAM using simulated data based on a genuine time-series study on fine particles with a diameter of 2.5 μm or less (PM2.5) and respiratory deaths conducted in Shanghai, China. The simulation was performed by multiplying the observed daily death with a random error. The underlying priors for Bayesian analysis are estimated using the real world time-series data. We also examined the sensitivity of Bayesian GAM to the choice of priors and to true parameter. Results: The frequentist GAM and Bayesian GAM show similar means and variances of the estimates of the parameters of interest. However, the estimates from Bayesian GAM show relatively more fluctuation, which to some extent reflects the uncertainty inherent in Bayesian estimation. Conclusions: Although computationally intensive, Bayesian GAM would be a better solution to avoid potentially over-confident inferences. With the increasing computing power of computers and statistical packages available, fully Bayesian methods for decision making may become more widely applied in the future. Full article
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Open AccessArticle
Effects of Cardiorespiratory Exercise on Cognition in Older Women Exposed to Air Pollution
Int. J. Environ. Res. Public Health 2019, 16(2), 245; https://doi.org/10.3390/ijerph16020245 - 16 Jan 2019
Cited by 3
Abstract
The aim was to analyze the effects of cardiorespiratory exercise and air pollution on cognition and cardiovascular markers in four groups of older women: the active/clean air group (AC), the active/polluted air group (AP), the sedentary/clean air group (SC), and the sedentary/polluted air [...] Read more.
The aim was to analyze the effects of cardiorespiratory exercise and air pollution on cognition and cardiovascular markers in four groups of older women: the active/clean air group (AC), the active/polluted air group (AP), the sedentary/clean air group (SC), and the sedentary/polluted air group (SP). Active groups performed a training task based on progressive walking. Prior to and after the experiment, the following parameters were assessed: cognition, by Mini Mental State Examination (MMSE); maximum oxygen uptake (VO2max), estimated by the Six-Minute Walk Test (6mWT); heart rate (HR); and oxygen saturation (SpO2). There were significant differences (p < 0.05) between the AC and the SP in all the MMSE dimensions except “Registration”, and in all the physiological variables (VO2max, SpO2, HR). Aerobic exercise may be a protective factor against the effects that pollution have on cognition and on the mechanisms of oxygen transport. Full article
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Review

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Open AccessReview
Global Associations of Air Pollution and Conjunctivitis Diseases: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2019, 16(19), 3652; https://doi.org/10.3390/ijerph16193652 - 28 Sep 2019
Cited by 2
Abstract
(1) Background: As the most common eye disease diagnosed in emergency departments, conjunctivitis has caused serious health and economic burdens worldwide. However, whether air pollution may be a risk factor for conjunctivitis is still inconsistent among current evidence. (2) Methods: We searched the [...] Read more.
(1) Background: As the most common eye disease diagnosed in emergency departments, conjunctivitis has caused serious health and economic burdens worldwide. However, whether air pollution may be a risk factor for conjunctivitis is still inconsistent among current evidence. (2) Methods: We searched the literature on the relationship between air pollution and conjunctivitis in multiple English databases before 18 March 2019. Meta-analysis, meta-regression, and funnel plots were used to integrate the data, identify the sources of bias, and determine the publication bias, respectively. (3) Results: A total of 2450 papers were found, 12 of which were finally included. The pooled relative risk for each 10 μg/m3 increase of air pollution on conjunctivitis was 1.0006 (95%CI: 0.9993–1.0019) for CO, 1.0287 (1.0120–1.0457) for NO2, 1.0089 (1.0030–1.0149) for O3, 1.0004 (0.9976–1.0032) for PM2.5, 1.0033 (0.9982–1.0083) for PM10, and 1.0045 (0.9908–1.0185) for SO2. In the subgroup, PM2.5 and O3 had a greater impact on conjunctivitis risk in women than in men, and people <18 years old than those ≥18 years old. Relative humidity significantly modified the risk of O3 on conjunctivitis (p = 0.023), explaining 45% of the between-study heterogeneity. (4) Conclusion: Globally, air pollution has considerable health risks for conjunctivitis. Females and the youth were more vulnerable to PM2.5, NO2, and O3. Reductions of air pollution levels are still warranted to protect the vulnerable populations. Full article
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