Air pollution and children's health: sickle cell disease

Barbosa, Silvia Maria de Macedo; Farhat, Sylvia Costa Lima; Martins, Lourdes Conceição; Pereira, Luiz Alberto Amador; Saldiva, Paulo Hilário Nascimento; Zanobetti, Antonella; Braga, Alfésio Luı́s Ferreira

doi:10.1590/0102-311x00013214

Cited by 32 publications

(27 citation statements)

References 49 publications

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“…Such a mechanism is particularly relevant in SCD in which vasculopathy plays a central role, and there is increased risk of stroke. Exposure to increased PM 10 or PM 2.5 was associated with increased daily admissions in the short-term in Paris, 46 with PM 10 showing an equivalent effect in the Sao Paulo study; 60 however, no acute effects of PM 10 exposure were seen in London. A second study in London mapping concentrations of PM 10 to individuals' postcodes suggested that long-term exposure to increased particulate material was associated with increased blood velocity in the extracranial carotid artery, hinting that chronic exposure may increase the risk of vasculopathy.…”

Section: Particulate Mattermentioning

confidence: 79%

“…Increasing nitrogen dioxide and sulfur dioxide levels were both associated with increased hospital attendances in the studies in Brazil, 60 and France, 46 but not England. 55 In London, chronic exposure to nitrogen dioxide was nevertheless associated with increased hemolysis.…”

Section: Other Gaseous Pollutantsmentioning

confidence: 80%

“…60 However, a large French study of adults and children with all types of SCD demonstrated the opposite effect, of decreased hospital admissions with higher ozone levels. 46 There are no studies looking at potential long-term effects of exposure to increased ozone levels.…”

Section: © F E R R a T A S T O R T I F O U N D A T I O Nmentioning

confidence: 99%

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Environmental determinants of severity in sickle cell disease

et al. 2015

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Section: Particulate Mattermentioning

confidence: 79%

Section: Other Gaseous Pollutantsmentioning

confidence: 80%

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Environmental determinants of severity in sickle cell disease

et al. 2015

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“…A Spanish cohort study reported an increased prevalence of hospitalizations for sickle cell disease 50 . The exposure to the household air pollutants as discussed previously leads to exaggerated oxidative stress in patients with sickle cell disease.…”

Section: Effects Of Household Air Pollutionmentioning

confidence: 99%

Household air pollution and its effects on health

Apte¹,

Salvi²

2016

F1000Res

117

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Household air pollution is a leading cause of disability-adjusted life years in Southeast Asia and the third leading cause of disability-adjusted life years globally. There are at least sixty sources of household air pollution, and these vary from country to country. Indoor tobacco smoking, construction material used in building houses, fuel used for cooking, heating and lighting, use of incense and various forms of mosquito repellents, use of pesticides and chemicals used for cleaning at home, and use of artificial fragrances are some of the various sources that contribute to household air pollution. Household air pollution affects all stages of life with multi-systemic health effects, and its effects are evident right from pre-conception to old age. In utero exposure to household air pollutants has been shown to have health effects which resonate over the entire lifetime. Exposures to indoor air pollutants in early childhood also tend to have repercussions throughout life. The respiratory system bears the maximum brunt, but effects on the cardiovascular system, endocrine system, and nervous system are largely underplayed. Household air pollutants have also been implicated in the development of various types of cancers. Identifying household air pollutants and their health implications helps us prepare for various health-related issues. However, the real challenge is adopting changes to reduce the health effects of household air pollution and designing innovative interventions to minimize the risk of further exposure. This review is an attempt to understand the various sources of household air pollution, the effects on health, and strategies to deal with this emergent risk factor of global mortality and morbidity.

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“…International Classification of Disease 10) rather than specific hospital records; (ii) the intricate relationships between weather and air quality exposure variables; and (iii) the use of different modeling approaches to assess such interactions. 5–9 Furthermore, the impact of environmental factors on different types of SCD (HbSS versus HbSC) and on the specific clinical complications leading to hospital admissions has not been previously reported (i.e. all genotypes and clinical complications have typically been lumped together).…”

Section: Introductionmentioning

confidence: 99%

Associations between environmental factors and hospital admissions for sickle cell disease

et al. 2016

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Sickle cell disease is an increasing global health burden. This inherited disease is characterized by a remarkable phenotypic heterogeneity, which can only partly be explained by genetic factors. Environmental factors are likely to play an important role but studies of their impact on disease severity are limited and their results are often inconsistent. This study investigated associations between a range of environmental factors and hospital admissions of young patients with sickle cell disease in London and in Paris between 2008 and 2012. Specific analyses were conducted for subgroups of patients with different genotypes and for the main reasons for admissions. Generalized additive models and distributed lag non-linear models were used to assess the magnitude of the associations and to calculate relative risks. Some environmental factors significantly influence the numbers of hospital admissions of children with sickle cell disease, although the associations identified are complicated. Our study suggests that meteorological factors are more likely to be associated with hospital admissions for sickle cell disease than air pollutants. It confirms previous reports of risks associated with wind speed (risk ratio: 1.06/standard deviation; 95% confidence interval: 1.00–1.12) and also with rainfall (1.06/standard deviation; 95% confidence interval: 1.01–1.12). Maximum atmospheric pressure was found to be a protective factor (0.93/standard deviation; 95% confidence interval: 0.88–0.99). Weak or no associations were found with temperature. Divergent associations were identified for different genotypes or reasons for admissions, which could partly explain the lack of consistency in earlier studies. Advice to patients with sickle cell disease usually includes avoiding a range of environmental conditions that are believed to trigger acute complications, including extreme temperatures and high altitudes. Scientific evidence to support such advice is limited and sometimes confusing. This study shows that environmental factors do explain some of the variations in rates of admission to hospital with acute symptoms in sickle cell disease, but the associations are complex, and likely to be specific to different environments and the individual’s exposure to them. Furthermore, this study highlights the need for prospective studies with large numbers of patients and standardized protocols across Europe.

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Air pollution and children's health: sickle cell disease

Cited by 32 publications

References 49 publications

Environmental determinants of severity in sickle cell disease

Environmental determinants of severity in sickle cell disease

Household air pollution and its effects on health

Associations between environmental factors and hospital admissions for sickle cell disease

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