Ghazawi et al provide an extensive report on spatial‐temporal patterns of incidence and mortality from acute myeloid leukemia in Canada from 1992 to 2010. We discuss the findings of this study as ...well as the methodological complications.
Climate Change, Hurricanes, and Health Woodward, Alistair J; Samet, Jonathan M
American journal of public health (1971)
108, Številka:
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Journal Article
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CAUSAL ATTRIBUTION OF EXTREME WEATHER EVENTS The broad community of atmospheric scientists has brought increasing attention to the causal attribution of extreme weather events to human activities.1 ...The underlying approaches will be familiar to those knowledgeable about causal attribution in public health, particularly the adoption of the potential outcomes framework, which compares what is observed with what is expected under an alternative scenario of no exposure to the factor of interest. Precipitation is especially difficult to simulate, because it depends on much tighter space and time scales than apply to temperature and is heavily influenced by local physical processes such as convection.4 Nonetheless, such modeling is difficult but not impossible; climate models are now capable of simulating the incidence and intensity of tropical cyclones, with and without greenhouse loading, and distinguishing to some extent the influences of natural variability (such as the occurrence of El Nino events) from anthropogenic forcing. Media accounts document many deaths from physical injury and drowning: access to clean water has been interrupted for millions as has the availability of electric power; elderly nursing home residents died in Florida from heat exposure; and needed and life-sustaining medical services were lost by many because hospitals closed and dialysis units could not operate.
The Clean Air Act of 1970 has led to reductions in air pollution in the United States, but we face new challenges in air-quality management. The Environmental Protection Agency is considering ...revisions to air-quality standards for particulate matter and ozone.
From my office, I have views of downtown Los Angeles and the San Gabriel Mountains. Air pollution infrequently obscures these views, and only rarely are my eyes and throat irritated by smog when I'm outdoors. The Los Angeles air of today is far better than that of the mid-20th century, when severe oxidant pollution, initially of unknown origins, threatened the health and welfare of the city's residents. Severe smog was a common occurrence. Today, throughout the United States, air quality has improved greatly, and the last century's severe, life-threatening episodes of air pollution, such as one that caused about 20 . . .
The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past ...statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies.This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution.
Background: Prospective cohort studies constitute the major source of evidence about the mortality effects of chronic exposure to particulate air pollution. Additional studies are needed to provide ...evidence on the health effects of chronic exposure to particulate matter ≤ 2.5 μm in aerodynamic diameter $({\rm PM}_{2.5})$ because few studies have been carried out and the cohorts have not been representative. Objectives: This study was designed to estimate the relative risk of death associated with long-term exposure to ${\rm PM}_{2.5}$ by region and age groups in a U.S. population of elderly, for the period 2000-2005. Methods: By linking ${\rm PM}_{2.5}$ monitoring data to the Medicare billing claims by ZIP code of residence of the enrollees, we have developed a new retrospective cohort study, the Medicare Cohort Air Pollution Study. The study population comprises 13.2 million participants living in 4,568 ZIP codes having centroids within 6 miles of a ${\rm PM}_{2.5}$ monitor. We estimated relative risks adjusted by socioeconomic status and smoking by fitting log-linear regression models. Results: In the eastern and central regions, a 10-μg/m³ increase in 6-year average of ${\rm PM}_{2.5}$ is associated with 6.8% 95% confidence interval (CI), 4.9-8.7% and 13.2% (95% CI, 9.5-16.9) increases in mortality, respectively. We found no evidence of an association in the western region or for persons ≥ 85 years of age. Conclusions: We established a cohort of Medicare participants for investigating air pollution and mortality on longer-term time frames. Chronic exposure to ${\rm PM}_{2.5}$ was associated with mortality in the eastern and central regions, but not in the western United States.
This 12-year prospective Korean cohort study from the National Health Insurance Corporation indicates that the relationship between the risk of death from any cause and body-mass index is J-shaped — ...higher in underweight, overweight, and obese men and women than in those of normal weight. The association between body-mass index and mortality varies according to the cause of death and is modified by age, sex, and smoking history.
This 12-year prospective study indicates that the relationship between the risk of death from any cause and body-mass index is J-shaped — higher in underweight, overweight, and obese men and women than in those of normal weight.
Although obesity is widely accepted as an important health risk, the optimal body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) and the effects of being either underweight or overweight on the risk of death are controversial. In the Cancer Prevention Study (CPS) II,
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sponsored by the American Cancer Society, the rate of death was lowest among men with a BMI of 23.5 to 24.9 and among women with a BMI of 22.0 to 23.4; above and below these levels, the risk of death increased. However, being overweight was not associated with an . . .
Studies showing that current levels of air pollution in the cities of many developed and developing countries are associated with increased rates of mortality and morbidity have heightened concern ...that air pollution continues to pose a threat to public health.
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The evidence suggests that small airborne particles are a toxic component of urban air pollution. Using this interpretation of the evidence as a rationale, the Environmental Protection Agency implemented a new standard for fine particulate matter.
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The existing standard, promulgated in 1987, specified the maximal levels allowable in a 24-hour period and on an annual basis for particulate matter . . .
Background: Environmental air pollutants are inhaled as complex mixtures, but the long dominant focus of monitoring and research on individual pollutants has provided modest insight into pollutant ...interactions that may be important to health. Trends toward managing multiple pollutants to maximize aggregate health gains place increasing value on knowing whether the effects of combinations of pollutants are greater than the sum of the effects of individual pollutants (synergy). Objective: We reviewed selected published literature to determine whether synergistic effects of combinations of pollutants on health outcomes have actually been demonstrated. Methods and results: We reviewed 36 laboratory studies of combinations of ozone with other pollutants that were reported in the recent U.S. Environmental Protection Agency Ozone Criteria Document. We examined original reports to determine whether the experimental design tested for synergy and whether synergy was demonstrated. Fourteen studies demonstrated synergism, although synergistic, additive, and antagonistic effects were sometimes observed among different outcomes or at different times after exposure. Conclusions: Synergisms involving O₃ have been demonstrated by laboratory studies of humans and animals. We conclude that the plausibility of synergisms among environmental pollutants has been established, although comparisons are limited, and most involved exposure concentrations much higher than typical of environmental pollutants. Epidemiologic research has limited ability to address the issue explicitly.
As part of the World Health Organization (WHO) Global Burden of Disease Comparative Risk Assessment, the burden of disease attributable to urban ambient air pollution was estimated in terms of deaths ...and disability-adjusted life years (DALYs). Air pollution is associated with a broad spectrum of acute and chronic health effects, the nature of which may vary with the pollutant constituents. Particulate air pollution is consistently and independently related to the most serious effects, including lung cancer and other cardiopulmonary mortality. The analyses on which this report is based estimate that ambient air pollution, in terms of fine particulate air pollution (PM
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), causes about 3% of mortality from cardiopulmonary disease, about 5% of mortality from cancer of the trachea, bronchus, and lung, and about 1% of mortality from acute respiratory infections in children under 5 yr, worldwide. This amounts to about 0.8 million (1.2%) premature deaths and 6.4 million (0.5%) years of life lost (YLL). This burden occurs predominantly in developing countries; 65% in Asia alone. These estimates consider only the impact of air pollution on mortality (i.e., years of life lost) and not morbidity (i.e., years lived with disability), due to limitations in the epidemiologic database. If air pollution multiplies both incidence and mortality to the same extent (i.e., the same relative risk), then the DALYs for cardiopulmonary disease increase by 20% worldwide.
Tracking patterns of disease incidence and mortality is fundamental to disease control. The story of lung cancer is exemplary; the 20th century epidemic of lung cancer was first detected in western ...countries as mortality rates rose; initially it affected males more than females; and rates were not uniform across regions and between countries 1. The epidemiological studies, motivated by the changing patterns of lung cancer occurrence, identified smoking, and occupational and environmental agents as causes of this highly fatal malignancy. Lung cancer mortality rates, which are very close to incidence rates because of the high case-fatality rate of lung cancer, and incidence rates, tracked through cancer registries, have now fallen in the USA and much of Europe in response to successful tobacco control and reduction of exposures to occupational and environmental carcinogens. In the example of lung cancer, tracking of occurrence is facilitated by the close correspondence of mortality with incidence, such that mortality is a reasonable index of occurrence, by the long standing surveillance of cancer through population-based cancer registries in many countries of Europe and much of the USA 2, and by improved diagnosis of lung cancer by increasingly accurate diagnostic methods.
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