Epidemiological studies of the respiratory effects of air pollution

Lebowitz, Michael D.

doi:10.1183/09031936.96.09051029

Cited by 112 publications

(65 citation statements)

References 210 publications

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“…It appears from these studies that CAPS may be acting to alter lung antibacterial defense mechanisms important in the handling of ongoing pneumococcal infections. This scenario fits temporally with the epidemiologic data that indicate that deaths among exposed individuals occur relatively quickly following a PM episode, and that individuals with chronic respiratory disease were less likely than healthy individuals to recover from pulmonary infections following PM exposure (1,24,25).…”

Section: Discussionsupporting

confidence: 54%

A role for associated transition metals in the immunotoxicity of inhaled ambient particulate matter.

Zelikoff

Schermerhorn

Fang

et al. 2002

Environ Health Perspect

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Epidemiologic studies demonstrate that infection, specifically pneumonia, contributes substantially to the increased morbidity and mortality among elderly individuals following exposure to ambient particulate matter (PM). This laboratory has previously demonstrated that a single inhalation exposure of Streptococcus pneumoniae-infected rats to concentrated ambient PM 2.5 (particulate matter with aerodynamic diameter ≤ 2.5 µm) from New York City (NYC) air exacerbates the infection process and alters pulmonary and systemic immunity. Although these results provide some basis for explaining the epidemiologic findings, the identity of specific PM constituents that might have been responsible for the worsening pneumonia in exposed hosts remains unclear. Thus, studies were performed to correlate the physicochemical attributes of ambient PM 2.5 with its in vivo immunotoxicity to identify and characterize the role of constitutive transition metals in exacerbating an ongoing streptococcal infection. Uninfected or previously infected rats were exposed in the laboratory to soluble divalent Fe, Mn, or Ni chloride salts. After exposure, uninfected rats were sacrificed and their lungs were lavaged. Lungs from infected hosts were used to evaluate changes in bacterial clearance and effects of exposure on the extent/severity of infection. Results demonstrated that inhalation of Fe altered innate and adaptive immunity in uninfected hosts, and both Fe and Ni reduced pulmonary bacterial clearance in previously infected rats. The effects on clearance produced in infected Fe-exposed rats were similar to those seen in infected rats exposed to ambient NYC PM. Taken together, these studies demonstrate that inhaled ambient PM can worsen the outcome of an ongoing pulmonary infection and that associated Fe may play some role in the immunotoxicity.

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Section: Discussionsupporting

confidence: 54%

A role for associated transition metals in the immunotoxicity of inhaled ambient particulate matter.

Zelikoff

Schermerhorn

Fang

et al. 2002

Environ Health Perspect

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“…However, smoking might be considered as an effect modifier, although it is unclear whether smokers are more or less susceptible to the effects of air pollution than nonsmokers. It has been reported that smokers are less responsive than nonsmokers due to altered lung function and an increase in mucus, both of which could influence dose in the different regions of the lung [31]. It has also been suggested that smokers are more responsive than nonsmokers: in a study reported by DUSSELDORP et al [32], separate analyses in a small group of smokers (n=9) suggested a greater susceptibility of smokers to PM10 pollution.…”

Section: Discussionmentioning

confidence: 99%

Acute effects of air pollution on respiratory health of 50-70 yr old adults

et al. 2000

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The aim of this study was to investigate the association between daily changes in respiratory health and air pollution in 489 adults, aged 50±70 yrs, with and without chronic respiratory symptoms, living in urban and nonurban areas in the Netherlands.Subjects were selected from the general population with a screening questionnaire. During three consecutive winters starting in 1992/1993, peak expiratory flow (PEF) and respiratory symptoms were registered in a daily diary. Daily measurements of particles with a 50% cut-off aerodynamic diameter of 10 mm (PM10), black smoke (BS), sulphate, sulphur dioxide (SO 2 ) and nitrogen dioxide (NO 2 ) were conducted. The difference in PM10, BS and sulphate concentrations between urban and nonurban areas was small, but there was more contrast in the concentrations of SO 2 and NO 2 .In symptomatic subjects from urban areas, PM10, BS, sulphate and SO 2 concentrations were associated with the prevalence of large decrements in morning PEF (>20% below the median). BS in particular was also associated with upper respiratory symptoms (URS). The magnitude of the effect estimates was in the order of an 80% increase in PEF decrements and a 20% increase in URS for a 40 mg . m -3 increase of the same day BS concentration. In symptomatic subjects from nonurban areas, no consistent associations between air pollution and health indicators were observed. However, the differences in effect estimates between urban and nonurban symptomatic panels were small and nonsignificant. In nonsymptomatic adults from both areas, no consistent pattern of associations with air pollution was found.In conclusion, air pollution effects were only found in symptomatic adults in the urban areas. Eur Respir J 2000; 15: 700±709.

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“…Epidemiological studies indicate that exposure to fine particles is associated with tens of thousands of hospital admissions and premature deaths annually ( Dockery and Pope, 1994;Lebowitz, 1996;Lippmann and Thurston, 1996 ). These studies have demonstrated consistent associations, with coherence across various health endpoints (Bates, 1992 ).…”

Section: Introductionmentioning

confidence: 99%

Particulate matter and heart rate variability among elderly retirees: the Baltimore 1998 PM study

Creason

Neas

Walsh

et al. 2001

J Expo Sci Environ Epidemiol

149

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This study investigates the relationship between ambient fine particle pollution and impaired cardiac autonomic control in the elderly. Heart rate variability ( HRV ) among 56 elderly ( mean age 82 ) nonsmoking residents of a retirement center in Baltimore County, Maryland, was monitored for 4 weeks, from July 27 through August 22, 1998. The weather was seasonally mild ( 63 ± 848F mean daily temperature ) with low to moderate levels of fine particles ( PM 2.5 < 50 g / m 3 ) . Two groups of approximately 30 subjects were examined on alternate days. A spline mixed -effects model revealed a negative relationship between outdoor 24 -h average fine particulate matter ( PM 2.5 ) and high -frequency ( HF ) HRV that was consistent with our earlier Baltimore study for all but 2 days. These 2 days were the only days with significant precipitation in combination with elevated PM 2.5 . They were also unusual in that back -trajectory of their air masses was distinctly different from those on the other study days, emanating from the direction of rural Pennsylvania. Mixed -effects analysis for all 24 study days showed a small negative association of outdoor PM 2.5 with HF HRV ( À 0.03 change in log [ HF HRV ] for a 10 g / m 3 increment in PM 2.5 ) after adjustment for age, sex, cardiovascular status, trend, maximum temperature, average dew point temperature, random subject intercepts, and autocorrelated residuals. After excluding study days 4 and 5, this association was strengthened ( À 0.07 change in log [ HF HRV ] for 10 g / m 3 PM 2.5 , 95% CI À 0.13 to À 0.02 ) and was similar to that obtained in an earlier study ( À 0.12 change in log [ HF HRV ] for a 10 g / m 3 increment in outdoor PM 2.5 , 95% CI À 0.24 to À 0.00 ) [ Liao D., Cai J., Rosamond W.D., Barnes R.W., Hutchinson R.G., Whitsel E.A., Rautaharju P., and Heiss G. Cardiac autonomic function and incident coronary heart disease: a population -based case -cohort study. The ARIC Study. Atherosclerosis Risk in Communities Study. Am J Epidemiol 1997: 145 ( 8 ) : 696 ± 706 ] . Acute ( 1 to 4 h ) previous PM 2.5 exposure did not have a stronger impact than the 24 -h measure. A distributed lag model incorporating the six preceding 4 -h means also did not indicate any effect greater than that observed in the 24 -h measure. This study is consistent with earlier findings that exposures to PM 2.5 are associated with decreased HRV in the elderly.

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Epidemiological studies of the respiratory effects of air pollution

Cited by 112 publications

References 210 publications

A role for associated transition metals in the immunotoxicity of inhaled ambient particulate matter.

A role for associated transition metals in the immunotoxicity of inhaled ambient particulate matter.

Acute effects of air pollution on respiratory health of 50-70 yr old adults

Particulate matter and heart rate variability among elderly retirees: the Baltimore 1998 PM study

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