There is highly suggestive evidence for an effect of air pollution exposure on dementia-related outcomes, but evidence is not yet present to clearly pinpoint which pollutants are the probable causal ...agents. The aims of this study was to assess the longitudinal association between exposures of fine ambient particulate matter (PM2.5) from residential wood burning, and vehicle exhaust, with dementia.
We used data from the Betula study, a longitudinal study of dementia in Umeå, Northern Sweden. The study size was 1 806 and the participants were followed from study entry (1993-1995) to 2010. Modelled levels of source-specific fine particulate matter at the residential address were combined with information on wood stoves or wood boilers, and with validated data on dementia diagnosis and individual-level characteristics from the Betula study. Cox proportional hazards models were used to estimate Hazard Ratios (HRs) and their 95% CIs for dementia incidence (vascular dementia and Alzheimer's disease), adjusted for individual-level characteristics.
The emission of PM2.5 from local residential wood burning was associated with dementia incidence with a hazard ratio of 1.55 for a 1 μg/m3 increase in PM2.5 (95% Confidence Interval (CI): 1.00-2.41, p-value 0.05). Study participants with an address in an area with the highest quartile of PM2.5 from residential wood burning and who also had a wood-burning stove were more likely to develop dementia than those in the lower three quartiles without a wood-burning stove with hazard ratios of 1.74 (CI: 1.10-2.75, p-value 0.018). Particulate matter from traffic exhaust seemed to be associated with dementia incidence with hazard ratios of 1.66, (CI: 1.16-2.39), p-value 0.006, and 1.41 (CI: 0.97-2.23), p-value 0.07, in the third and fourth quartiles, respectively.
If the associations we observed are causal, then air pollution from residential wood burning, and air pollution from traffic, might be independent important risk factors for dementia.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Air pollution is one of the leading causes of mortality and morbidity worldwide. Experimental studies, and a few epidemiological studies, suggest that air pollution may cause acute exacerbation of ...psychiatric disorders, and even increase the rate of suicide attempts, but epidemiological studies on air pollution in association with psychiatric disorders are still few. Our aim was to investigate associations between daily fluctuations in air pollution concentrations and the daily number of visits to a psychiatric emergency unit.
Data from Sahlgrenska University Hospital, Gothenburg, Sweden, on the daily number of visits to the Psychiatric emergency unit were combined with daily data on monitored concentrations of respirable particulate matter(PM
), ozone(O
), nitrogen dioxides(NO
) and temperature between 1st July 2012 and 31st December 2016. We used a case-crossover design to analyze data with conditional Poisson regression models allowing for over-dispersion. We stratified data on season.
Visits increased with increasing PM
levels during the warmer season (April to September) in both single-pollutant and two-pollutant models. For example, an increase of 3.6% (95% Confidence Interval, CI, 0.4-7.0%) was observed with a 10 μg/m3 increase in PM
adjusted for NO
. In the three-pollutant models (adjusting for NO
and O
simultaneously) the increase was 3.3% (95% CI, -0.2-6.9). There were no clear associations between the outcome and NO
, O
, or PM
during the colder season (October to March).
Ambient air particle concentrations were associated with the number of visits to the Psychiatric emergency unit in the warm season. The results were only borderline statistically significant in the fully adjusted (three-pollutant) models in this small study. The observation could be interpreted as indicative of air pollution as either exacerbating an underlying psychiatric disorder, or increasing mental distress, even in areas with comparatively low levels of air pollution. In combination with the severe impact of psychiatric disorders and mental distress on society and individuals, our results are a strong warrant for future research in this area.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
Alzheimer’s disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected ...future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM
2.5
) air pollution and resulting monetary estimates are lacking.
Methods
We used data on average population-weighted exposure to ambient PM
2.5
for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish population above 60 years of age, we used the latest concentration response functions (CRF) between PM
2.5
exposure and dementia incidence, based on ten longitudinal cohort studies, for the population above 60 years of age. To estimate the monetary burden of attributable cases, we calculated total costs related to dementia, including direct and indirect lifetime costs and intangible costs by including quality-adjusted life years (QALYs) lost. Two different monetary valuations of QALYs in Sweden were used to estimate the monetary value of reduced quality-of-life from two different payer perspectives.
Results
The annual number of dementia cases attributable to PM
2.5
exposure was estimated to be 820, which represents 5% of the annual dementia cases in Sweden. Direct and indirect lifetime average cost per dementia case was estimated to correspond € 213,000. A reduction of PM
2.5
by 1 μg/m
3
was estimated to yield 101 fewer cases of dementia incidences annually, resulting in an estimated monetary benefit ranging up to 0.01% of the Swedish GDP in 2019.
Conclusion
This study estimated that 5% of annual dementia cases could be attributed to PM
2.5
exposure, and that the resulting monetary burden is substantial. These findings suggest the need to consider airborne toxic pollutants associated with dementia incidence in public health policy decisions.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Genetic and environmental factors both contribute to the development of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). One suggested environmental risk factor for ...ASD and ADHD is air pollution, but knowledge of its effects, especially in low-exposure areas, are limited. Here, we investigate risks for ASD and ADHD associated with prenatal exposure to air pollution in an area with air pollution levels generally well below World Health Organization (WHO) air quality guidelines.
We used an epidemiological database (MAPSS) consisting of virtually all (99%) children born between 1999 and 2009 (48,571 births) in the study area, in southern Sweden. MAPSS consists of data on modelled nitrogen oxide (NOx) levels derived from a Gaussian dispersion model; maternal residency during pregnancy; perinatal factors collected from a regional birth registry; and socio-economic factors extracted from Statistics Sweden. All ASD and ADHD diagnoses in our data were undertaken at the Malmö and Lund Departments of Child and Adolescent Psychiatry, using standardized diagnostic instruments. We used logistic regression analyses to obtain estimates of the risk of developing ASD and ADHD associated with different air pollution levels, with adjustments for potential perinatal and socio-economic confounders.
In this longitudinal cohort study, we found associations between air pollution exposure during the prenatal period and and the risk of developing ASD. For example, an adjusted Odds Ratio (OR) of 1.40 and its 95% Confidence Interval (CI) (95% CI: 1.02–1.93) were found when comparing the fourth with the first quartile of NOx exposure. We did not find similar associations on the risk of developing ADHD.
This study contributes to the growing evidence of a link between prenatal exposure to air pollution and autism spectrum disorders, suggesting that prenatal exposure even below current WHO air quality guidelines may increase the risk of autism spectrum disorders.
•We performed population-based research, with data on clinical diagnoses of autism and ADHD.•We had access to data on other neuro-developmental disorder, perinatal factors, and SES.•We modelled NOx with an extensive emission database and dispersion modelling.•We did not find an association of ADHD and NOx at relatively low-exposure levels.•We found a link between prenatal exposure NOx-exposure and autism.
Display omitted
•Associations of ambient NOX/2, cooking fuel and fetal/neonatal death were explored.•Overall, results were statistically insignificant and inconclusive.•A tendency towards an ...association for ambient NOX/2 and fetal death was suggested.•No associations were found for cooking fuel type and either adverse birth outcome.
Air pollution poses a threat to human health, with pregnant women and their developing fetuses being particularly vulnerable. A high dual burden of ambient and indoor air pollution exposure has been identified in Ethiopia, but studies investigating their effects on adverse birth outcomes are currently lacking. This study explores the association between ambient air pollution (NOX and NO2) and indoor air pollution (cooking fuel type) and fetal and neonatal death in Adama, Ethiopia. A prospective cohort of mothers and their babies was used, into which pregnant women were recruited at their first antenatal visit (n = 2085) from November 2015 to February 2018. Previously developed land-use regression models were utilized to assess ambient concentrations of NOX and NO2 at the residential address, whereas data on cooking fuel type was derived from questionnaires. Birth outcome data was obtained from self-reported questionnaire responses during the participant's postnatal visit or by phone if an in-person meeting was not possible. Binary logistic regression was employed to assess associations within the final study population (n = 1616) using both univariate and multivariate models; the latter of which adjusted for age, education, parity, and HIV status. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were reported. Within the cohort, 69 instances of fetal death (n = 16 miscarriages; n = 53 stillbirths) and 16 cases of neonatal death were identified. The findings suggest a tendency towards an association between ambient NOX and NO2 exposure during pregnancy and an increased risk of fetal death overall as well as stillbirth, specifically. However, statistical significance was not observed. Results for indoor air pollution and neonatal death were inconclusive. As limited evidence on the effects of exposure to ambient air pollution on adverse birth outcomes exists in Sub-Saharan Africa and Ethiopia, additional studies with larger study populations should be conducted.
Evidence of air pollution exposure, namely, ambient particulate matter (PM), during pregnancy and an increased risk of autism in children is growing; however, the unique PM sources that contribute to ...this association are currently unknown. The aim of the present study was to investigate local, source-specific ambient PM exposure during pregnancy and its associations with childhood autism, specifically, and autism spectrum disorders (ASD) as a group. A cohort of 40,245 singleton births from 2000 to 2009 in Scania, Sweden, was combined with data on locally emitted PM with an aerodynamic diameter < 2.5 µm (PM
). A flat, two-dimensional dispersion model was used to assess local PM
concentrations (all-source PM
, small-scale residential heating- mainly wood burning, tailpipe exhaust, and vehicle wear-and-tear) at the mother's residential address during pregnancy. Associations were analyzed using binary logistic regression. Exposure to local PM
during pregnancy from each of the investigated sources was associated with childhood autism in the fully adjusted models. For ASD, similar, but less pronounced, associations were found. The results add to existing evidence that exposure to air pollution during pregnancy may be associated with an increased risk of childhood autism. Further, these findings suggest that locally produced emissions from both residential wood burning and road traffic-related sources (tailpipe exhaust and vehicle wear-and-tear) contribute to this association.
•Risks of CKD were associated with long-term low level exposure to air pollution.•Risk estimates were stronger for lagging exposures during the last 1–10 years.•Risk estimates were stronger in ...never-smokers, person without hypertension or diabetes.
Associations between air pollution and chronic kidney disease (CKD) have been reported, but studies at low exposure levels and relevant exposure time windows are still warranted. This study investigated clinical CKD at low air pollution levels in the Swedish Malmö Diet and Cancer Cohort in different exposure time windows.
This study included 30,396 individuals, aged 45–74 at enrollment 1991–1996. Individual annual average residential outdoor PM2.5, PM10, nitrogen oxides (NOx), and black carbon (BC) were assigned using dispersion models from enrollment to 2016. Diagnoses of incident CKD were retrieved from national registries. Cox proportional hazards models were used to obtain hazard ratios (HRs) for CKD in relation to three time-dependent exposure time windows: exposure at concurrent year (lag 0), mean exposure in the 1–5 or 6–10 preceding years (lag 1–5 and lag 6–10), and baseline exposure.
During the study period, the average annual residential exposures were 16 μg/m3 for PM10, 11 μg/m3 for PM2.5, 26 μg/m3 for NOx, and 0.97 μg/m3 for BC. For lag 1–5 and lag 6–10 exposure, significantly elevated HRs for incident CKD were found for total PM10:1.13 (95% CI: 1.01–1.26) and 1.22 (1.06–1.41); NOx: 1.19 (1.07–1.33) and 1.13 (1.02–1.25) and BC: 1.12 (1.03–1.22) and 1.11 (1.02–1.21) per interquartile range increase in exposure. For total PM2.5 the positive associations of 1.12 (0.97–1.31) and 1.16 (0.98–1.36) were not significant. For baseline or lag 0 exposure there were significant associations only for NOx and BC, not for PM.
Residential exposure to outdoor air pollution was associated with increased risk of incident CKD at relatively low exposure levels. Average long-term exposure was more clearly associated with CKD than current exposure or exposure at recruitment. Our findings imply that the health effects of low-level air pollution on CKD are considerable.
The number of patients with Alzheimer's disease (AD) is likely to triple in a few decades as the world's population ages. Given the high personal and societal burden of this disease, it is imperative ...to identify its risk factors. The etiology of AD is still not fully understood, but environmental factors have emerged as plausible important risk factors on the population-level. In this short review, the author summarizes literature on air pollution, noise and (lack of) greenness as risk factors for AD. In conclusion, a link between air pollution and AD is supported by experimental studies as well as epidemiological studies, although a multi-exposure approach is lacking in most epidemiological studies. Although evidence is much more limited regarding noise and (lack of) greenness as risk factors for AD, future epidemiological studies should have a multi-exposure approach in order to separate potential effects of air pollution, noise and lack of greenness. Given the heavy toll of AD on individuals and society, as well as the ubiquitous nature of environmental factors, a link between environmental stressors and AD deserves special attention.
•A positive association between air pollution and AD is reported in all studies but one.•Few studies on noise and greenness in association with dementia.•Most studies lack a multi-exposure response, which makes it difficult to rule out residual confounding.•If air pollution is a risk factor for AD, then health costs attributed to air pollution have been underestimated.
•Health impact assessments of road traffic noise exposure are presented for two alternative densification scenarios.•It is possible to considerably reduce noise exposure with a more health-centred ...densification strategy.•A more health-centred strategy could help prevent annoyance and adverse sleep disturbance.•A more health-centred strategy could help prevent incidence and mortality of ischemic heart disease.•Urban planning initiatives must be more ambitious in order to create healthy, sustainable cities.
While urbanization provides many opportunities to those arriving in thriving urban areas, a greater number of residents necessitates the expansion of housing and infrastructure. This is often achieved through densification, which can lead to increased noise, particularly through increased road traffic. A key challenge of promoting healthy urban planning is to understand potential health effects, especially on the local level. The aim of the present study is, therefore, to estimate and compare the health impacts of road traffic noise exposure for various urban densification scenarios within a neighborhood (Lorensborg) in Malmö, Sweden. The three scenarios include 1) Present-day, representing the study area as it is presently organized; 2) Planned municipal strategy (the city of Malmö’s own densification plans) and 3) Health-centred, which involves major structural alterations and reflects an effort prioritize a health-centred approach. Noise was modelled using the Nordic prediction method for road traffic. Health outcomes included noise annoyance, adverse sleep disturbance, ischemic heart disease (IHD) incidence and mortality. Within all scenarios, a large proportion of the study population was exposed above the WHO’s health-based guideline value (Lden 53 dB): >80% for Present-day and Planned municipal strategy scenarios, and almost 50% in the Health-centred scenario. Still, densifying Lorensborg (population ≈9,600) according to the Health-centred scenario could prevent 549 cases of highly annoyed, 193 cases of adverse sleep disturbance, 4.7 new cases of IHD (8.9% of total cases), and 1.5 deaths due to IHD (17.8% of IHD mortality) annually. The results demonstrated that it is possible to considerably lower the health impact with a more health-centred densification strategy. Important co-benefits for public and environmental health include air pollution reduction and green space creation, although their health effects were not quantified in the present study. Urban planning initiatives must be more ambitious in order to create healthy, sustainable cities.
Asthma is one of the most common respiratory diseases in the world. Research has shown that temporal increases in air pollution concentrations can aggravate asthma symptoms. The aim of this study was ...to assess whether individuals living in areas with higher air pollution concentrations responded differently to short-term temporal exposure to air pollution than those living in lower air pollution areas.
The study was designed as a case-crossover study in Scania, Sweden. Outcome data was visits to primary health care clinics with asthma as the main complaint during the years 2007 to 2010. Nitrogen dioxide levels were obtained from 21 different air pollution monitoring stations. Short-term exposure was defined as the average concentration four days prior to the visit. Data was pooled for areas above and below a two-year average NO2 concentration of 10 μg/m3, dispersion modelled with an emission database.
The short-term association between NO2 and asthma visits seemed stronger in areas with NO2 levels below 10 μg/m3, with an odds ratio (OR) of 1.15 (95% confidence interval (CI): 1.08-1.23) associated with a 10 μg/m3 increase in NO2 compared to areas above 10 μg/m3 NO2 levels, where corresponding OR of 1.09 (95% CI: 1.02-1.17). However, this difference was not statistically significant. (p = 0.13).
The study provided some evidence, although not statistically significant, that short-term associations between air pollution and asthma may depend on background air pollution levels. However, we cannot rule out that the association is due to other spatially dependent factors in Scania. The study should be reproduced in other study areas.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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