Estimated Excess Morbidity and Mortality Associated with Air Pollution above American Thoracic Society–recommended Standards, 2013–2015. American Thoracic Society and Marron Institute Report

Cromar, Kevin; Gladson, Laura A.; Ghazipura, Marya; Ewart, Gary

doi:10.1513/annalsats.201710-785eh

Cited by 18 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the nationwide analysis, we found significant positive associations between SO 2 concentrations and IHD and CVD mortality, PM 10 concentrations and CVD mortality, and O 3 concentrations and PN and CLRD mortality, which were consistent with those reported in previous studies [ 1 , 5 , 9 , 16 ]; however, direct comparisons of the effect sizes are not appropriate because of differences in the study design, area, and period (Fig. 1 ).…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Association between long-term exposure to air pollutants and cardiopulmonary mortality rates in South Korea

Hwang

Kwon

et al. 2020

BMC Public Health

View full text Add to dashboard Cite

Background The association between long-term exposure to air pollutants, including nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), ozone (O3), and particulate matter 10 μm or less in diameter (PM10), and mortality by ischemic heart disease (IHD), cerebrovascular disease (CVD), pneumonia (PN), and chronic lower respiratory disease (CLRD) is unclear. We investigated whether living in an administrative district with heavy air pollution is associated with an increased risk of mortality by the diseases through an ecological study using South Korean administrative data over 19 years. Methods A total of 249 Si-Gun-Gus, unit of administrative districts in South Korea were studied. In each district, the daily concentrations of CO, SO2, NO2, O3, and PM10 were averaged over 19 years (2001–2018). Age-adjusted mortality rates by IHD, CVD, PN and CLRD for each district were averaged for the same study period. Multivariate beta-regression analysis was performed to estimate the associations between air pollutant concentrations and mortality rates, after adjusting for confounding factors including altitude, population density, higher education rate, smoking rate, obesity rate, and gross regional domestic product per capita. Associations were also estimated for two subgrouping schema: Capital and non-Capital areas (77:172 districts) and urban and rural areas (168:81 districts). Results For IHD, higher SO2 concentrations were significantly associated with a higher mortality rate, whereas other air pollutants had null associations. For CVD, SO2 and PM10 concentrations were significantly associated with a higher mortality rate. For PN, O3 concentrations had significant positive associations with a higher mortality rate, while SO2, NO2, and PM10 concentrations had significant negative associations. For CLRD, O3 concentrations were associated with an increased mortality rate, while CO, NO2, and PM10 concentrations had negative associations. In the subgroup analysis, positive associations between SO2 concentrations and IHD mortality were consistently observed in all subgroups, while other pollutant-disease pairs showed null, or mixed associations. Conclusion Long-term exposure to high SO2 concentration was significantly and consistently associated with a high mortality rate nationwide and in Capital and non-Capital areas, and in urban and rural areas. Associations between other air pollutants and disease-related mortalities need to be investigated in further studies.

show abstract

Section: Discussionsupporting

confidence: 90%

“…There is increasing evidence on the harmful associations between air pollution and cardiopulmonary mortality [ 1 – 9 ]. Many short-term studies have reported compelling evidence on such associations [ 2 , 3 , 5 , 6 , 9 ]; however, relatively limited number of long-term studies were performed.…”

Section: Introductionmentioning

confidence: 99%

Association between long-term exposure to air pollutants and cardiopulmonary mortality rates in South Korea

Hwang

Kwon

et al. 2020

BMC Public Health

View full text Add to dashboard Cite

show abstract

“…Ozone (O 3 ) is a common gaseous air pollutant formed through the photochemical interaction of sunlight with nitrogen oxides and volatile organic compounds commonly produced by combustion sources such as motor vehicles. Exposures to elevated ambient concentrations of O 3 have been associated with increases in morbidity and mortality (Cohen et al 2017;Cromar et al 2018). In 2015, Cohen et al (2017) estimated 254,000 deaths and 4.1 million disability-adjusted life years were attributed to global ambient O 3 exposures.…”

Section: Introductionmentioning

confidence: 99%

Repetitive Ozone Exposures and Evaluation of Pulmonary Inflammation and Remodeling in Diabetic Mouse Strains

Wagner

Barkauskas

Vose

et al. 2020

Environ Health Perspect

View full text Add to dashboard Cite

BACKGROUND: Epidemiological studies support the hypothesis that diabetes alters pulmonary responses to air pollutants like ozone (O 3). The mechanism(s) underlying these associations and potential links among diabetes, O 3 , and lung inflammation and remodeling are currently unknown. OBJECTIVES: The goal was to determine whether pulmonary responses to repetitive ozone exposures are exacerbated in murine strains that are hyperglycemic and insulin resistant. METHODS: Normoglycemic and insulin-sensitive C57BL/6J mice; hyperglycemic, but mildly insulin-resistant, KK mice; and hyperglycemic and markedly insulin-resistant KKAy mice were used for ozone exposure studies. All animals were exposed to filtered air (FA) or repetitive ozone (0:5 ppm O 3 , 4 h/d, for 13 consecutive weekdays). Tissue analysis was performed 24 h following the final exposure. This analysis included bronchoalveolar lavage (BAL) for cell and fluid analysis, and tissue for pathology, immunohistology, mRNA, and hydroxyproline. RESULTS: Following repetitive O 3 exposure, higher bronchoalveolar lavage fluid inflammatory cells were observed in all mice (KKAy >KK >C57BL=6), with a notable influx of neutrophils and eosinophils in KK and KKAy mice. Although the lungs of O 3-exposed C57BL/6J and KK mice had minimal centriacinar histological changes without fibrosis, the lungs of O 3-exposed KKAy mice contained marked epithelial hyperplasia in proximal alveolar ducts and adjacent alveoli with associated centriacinar fibrosis. Fibrosis in O 3-exposed KKAy lungs was confirmed with immunohistochemistry, tissue hydroxyproline content, and tissue mRNA expression of fibrosis-associated genes (Ccl11, Il13, and Mmp12). Immunofluorescence staining and confocal microscopy revealed alterations in the structure and composition of the airway and alveolar epithelium in regions of fibrosis. DISCUSSION: Our results demonstrate that in diabetic animal strains repetitive ambient ozone exposure led to early and exaggerated pulmonary inflammation and remodeling. Changes in distal and interstitial airspaces and the activation of Th2 inflammatory and profibrotic pathways in experimental animals provide a preliminary, mechanistic framework to support the emerging epidemiological associations among air pollution, diabetes, and lung disease.

show abstract

“…Ground level ozone is a colorless and odorless gaseous pollutant for which a threshold of safe exposure has not yet been identified, 10,11 although a recent review suggests that levels greater than 33–42 parts per billion (ppb) are harmful to human health 8 . Compared to stratospheric ozone (a.k.a.…”

Section: Basics Of Ozone Pollution and Regulation In The United Statesmentioning

confidence: 99%

“…96 Taken together, these studies provide evidence that the current EPA standard does not provide an adequate margin of protection for children and, in particular, children with asthma. Indeed, since 2007 the American Thoracic Society (ATS) has endorsed a primary NAAQS of 60 ppb, 97,98 which approximately 80% of monitored US counties would exceed if instituted 11,99 (Figure 1).…”

Section: Current Ozone Naaqs Is Not Adequatementioning

confidence: 99%

Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard

Rosser

Balmes

2023

Pediatric Pulmonology

View full text Add to dashboard Cite

Ground level ozone is a potent respiratory toxicant with decades of accumulated data demonstrating respiratory harms to children. Despite the ubiquity of ozone in the United States, impacting both urban and rural communities, the associated harms of exposure to this important air pollutant are often infrequently or inadequately covered during medical training including pulmonary specialization. Thus, many providers caring for children's respiratory health may have limited knowledge of the harms which may result in reduced discussion of ozone pollution during clinical encounters. Further, the current US air quality standard for ozone does not adequately protect children. In this nonsystematic review, we present basic background information for healthcare providers caring for children's respiratory health, review the US process for setting air quality standards, discuss the respiratory harms of ozone for healthy children and those with underlying respiratory disease, highlight the urgent need for a more protective ozone standard to adequately protect children's respiratory health, review impacts of climate change on ozone levels, and provide information for discussion in clinical encounters.

show abstract

Estimated Excess Morbidity and Mortality Associated with Air Pollution above American Thoracic Society–recommended Standards, 2013–2015. American Thoracic Society and Marron Institute Report

Cited by 18 publications

References 29 publications

Association between long-term exposure to air pollutants and cardiopulmonary mortality rates in South Korea

Association between long-term exposure to air pollutants and cardiopulmonary mortality rates in South Korea

Repetitive Ozone Exposures and Evaluation of Pulmonary Inflammation and Remodeling in Diabetic Mouse Strains

Ozone and childhood respiratory health: A primer for US pediatric providers and a call for a more protective standard

Contact Info

Product

Resources

About