The association between long-term exposure to ambient fine particulate matter with aerodynamic diameter
(
) and lung function in young people remains uncertain, particularly in Asia, where air ...pollution is generally a serious problem.
This study investigated the association between long-term exposure to ambient
and lung function in Taiwanese children, adolescents, and young adults.
This study comprised 24,544 participants 6-24 years of age, with 33,506 medical observations made between 2000 and 2014. We used a spatiotemporal model to estimate
concentrations at participants' addresses. Spirometry parameters, i.e., forced vital capacity (FVC), forced expiratory volume in 1 s (
), and maximum midexpiratory flow (MMEF), were determined. A generalized linear mixed model was used to examine the associations between long-term exposure to ambient
and lung function. The odds ratios (ORs) of poor lung function were also calculated after adjusting for a range of covariates.
Every
increase in the 2-y average
concentration was associated with decreases of 2.22% 95% confidence interval (CI):
,
, 2.94 (95% CI:
,
), and 2.79% (95% CI:
,
) in the FVC,
, and MMEF, respectively. Furthermore, it was associated with a 20% increase in the prevalence of poor lung function (OR: 1.20; 95% CI: 1.12, 1.29).
Two-year ambient
concentrations were inversely associated with lung function and positively associated with the prevalence of poor lung function in children, adolescents, and young adults in Taiwan. https://doi.org/10.1289/EHP5220.
Chronic kidney disease (CKD) is a serious global public health challenge, but there is limited information on the connection between air pollution and risk of CKD.
The aim of this study was to ...investigate the association between long-term exposure to particulate matter (PM) with an aerodynamic diameter of less than Formula: see text (Formula: see text) and the development of CKD in a large cohort.
A total of 100,629 nonCKD Taiwanese residents age 20 y or above were included in this study between 2001 and 2014. Ambient Formula: see text concentration was estimated at each participant's address using a satellite-based spatiotemporal model. Incident CKD cases were identified by an estimated glomerular filtration rate (eGFR) of less than Formula: see text. We collected information on a wide range of potential confounders/modifiers during the medical examinations. Cox proportional hazard regression was applied to calculate hazard ratios (HRs).
During the follow-up, 4,046 incident CKD cases were identified, and the incidence rate was 6.24 per 1,000 person-years. In contrast with participants with the first quintile exposure of Formula: see text, participants with the fourth and fifth quintiles exposure of Formula: see text had increased risk of CKD development, adjusting for age, sex, educational level, smoking, drinking, body mass index, systolic blood pressure, fasting glucose, total cholesterol, and self-reported heart disease or stroke, with an HR 95% confidence interval (CI) of 1.11 (1.02, 1.22) and 1.15 (1.05, 1.26), respectively. A significant concentration-response trend was observed (Formula: see text). Every Formula: see text increment in the Formula: see text concentration was associated with a 6% higher risk of developing CKD (HR: 1.06, 95% CI: 1.02, 1.10). Sensitivity and stratified analyses yielded similar results.
Long-term exposure to ambient Formula: see text was associated with an increased risk of CKD development. Our findings reinforce the urgency to develop global strategies of air pollution reduction to prevent CKD. https://doi.org/10.1289/EHP3304.
Physical activity (PA) increases a person's inhalation of air pollutants due to greater ventilation, possibly leading to larger adverse health effects. This study aims to investigate the combined ...effects of long-term exposure to fine particulate matter (PM
) and habitual PA on lung function in adults.
This was a longitudinal cohort study that included 278,065 Taiwan residents with an age of 20 years old or above who joined a standard medical screening programme between 2001 and 2014. Each participant received at least one medical examination (including spirometric, blood, and urinary tests and a standard self-administered questionnaire survey) during the study period. We estimated the 2-year average PM
concentrations at each participant's address using a new physical model based on observational data. Information on the participants' PA was collected using the standard self-administrated questionnaire. Generalised linear mixed models were used to investigate the combined effects of PM
and PA on pulmonary function. We also performed stratified analyses by different levels of PM
exposure and habitual PA.
Each 10 MET-h increase in PA was associated with a higher level of 0.20%, 0.16%, and 0.19% in forced vital capacity (FVC), forced expiratory volume in the first second (FEV
), and maximum mid-expiratory flow (MMEF), respectively, after adjusting for PM
exposure and a wide range of covariates including age, sex education, body mass index, lifestyles, and health conditions. Each 10 μg/m
increase in PM
was associated with a lower FVC, FEV
, and MMEF (2.43%, 2.78% and 3.10%, respectively). Negative interactions were observed, and PM
exposure was associated with a greater reduction in lung function among the participants with higher PA levels.
We found significant negative interaction effects between long-term exposure to PM
and habitual PA, suggesting that the increased intake of PM
due to PA may attenuate the benefits of habitual PA on lung function. However, the PA benefits generally remained stable at different stratum of PM
in the stratified analyses, and habitual PA may still be recommended to people residing in relatively polluted regions.
Information on the effects of long-term exposure to fine particulate matter with an aerodynamic diameter of 2·5 μm or less (PM2·5) on lung health is scarce. We aimed to investigate the associations ...between long-term exposure to PM2·5, lung function, and chronic obstructive pulmonary disease (COPD) in a large-scale longitudinal cohort.
We included 285 046 participants aged 20 years or older from the Taiwan MJ Health Management Institution cohort, who were recruited between 2001 and 2014 and had spirometric tests during the medical examination visit. We used a satellite-based spatiotemporal model to estimate the 2-year average ground concentration of PM2·5 (for the calendar year of each participant's medical examination and for the previous year) at each participant's address. We used the generalised linear mixed model to examine the associations between PM2·5 concentrations and lung function and the Cox proportional hazard regression model with time-dependent covariates to investigate the PM2·5 effects on COPD development.
Every 5 μg/m3 increment in PM2·5 was associated with a decrease of 1·18% for forced vital capacity (FVC), 1·46% for forced expiratory volume in 1 s (FEV1), 1·65% for maximum mid-expiratory flow (MMEF), and 0·21% for FEV1:FVC ratio. The decrease accelerated over time. Additional annual declines were observed for FVC (0·14%), FEV1 (0·24%), MMEF (0·44%), and FEV1:FVC ratio (0·09%). Compared with the participants exposed to the first quartile of PM2·5, participants exposed to the fourth, third, and second quartiles of PM2·5 had a hazard ratio of 1·23 (95% CI 1·09–1·39), 1·30 (1·16–1·46), and 1·39 (1·24–1·56) for COPD development, respectively.
Long-term exposure to ambient PM2·5 is associated with reduced, and faster declines in, lung function. Long-term exposure to ambient PM2·5 is also associated with an increased risk of the incidence of COPD. This study reinforces the urgency of global strategies to mitigate air pollution for improvement of pulmonary health and prevention of COPD.
Environmental Health Research Fund of the Chinese University of Hong Kong and PhD Studentship of the Chinese University of Hong Kong.
Long-term exposure to particulate matter (PM) air pollution may increase blood pressure and the risk of hypertension. However, epidemiological evidence is scarce and inconsistent.
We investigated the ...associations between long-term exposure to PM with an aerodynamic diameter <2.5μm (PM
), blood pressure, and incident hypertension in a large Taiwanese cohort.
We studied 361,560 adults ≥18y old from a large cohort who participated in a standard medical examination program during 2001 to 2014. Among this group, 125,913 nonhypertensive participants were followed up. A satellite-based spatiotemporal model was used to estimate the 2-y average PM
concentrations at each participant's address. Multivariable linear regression was used in the cross-sectional data analysis with the 361,560 participants to investigate the associations between PM
and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP), and Cox proportional hazard regression was used in the cohort data analysis with the 125,913 participants to investigate the associations between PM
and incident hypertension.
Each 10-μg/m
increment in the 2-y average PM
concentration was associated with increases of 0.45 mmHg 95% confidence interval (CI): 0.40, 0.50, 0.07 mmHg (95% CI: 0.04, 0.11), and 0.38 mmHg (95% CI: 0.33, 0.42) in SBP, DBP, and PP, respectively, after adjusting for a wide range of covariates and possible confounders. Each 10-μg/m
increment in the 2-y average PM
concentration was associated with an increase of 3% in the risk of developing hypertension hazard ratio=1.03 (95% CI: 1.01, 1.05). Stratified and sensitivity analyses yielded similar results.
Long-term exposure to PM
air pollution is associated with higher blood pressure and an increased risk of hypertension. These findings reinforce the importance of air pollution mitigation strategies to reduce the risk of cardiovascular disease. https://doi.org/10.1289/EHP2466.
Aims/hypothesis
Information on the associations of long-term exposure to fine particulate matter (with an aerodynamic diameter less than 2.5 μm; PM
2.5
) with the development of type 2 diabetes is ...scarce, especially for south-east Asia, where most countries are experiencing serious air pollution. This study aimed to investigate the long-term effects of exposure to ambient PM
2.5
on the incidence of type 2 diabetes in a population of Taiwanese adults.
Methods
A total of 147,908 participants without diabetes, at least 18 years of age, were recruited in a standard medical examination programme between 2001 and 2014. They were encouraged to take medical examinations periodically and underwent at least two measurements of fasting plasma glucose (FPG). Incident type 2 diabetes was identified as FPG ≥7 mmol/l or self-reported physician-diagnosed diabetes in the subsequent medical visits. The PM
2.5
concentration at each participant’s address was estimated using a satellite-based spatiotemporal model with a resolution of 1 × 1 km
2
. The 2 year average of PM
2.5
concentrations (i.e. the year of and the year before the medical examination) was treated as an indicator of long-term exposure to ambient PM
2.5
air pollution. We performed Cox regression models with time-dependent covariates to analyse the long-term effects of exposure to PM
2.5
on the incidence of type 2 diabetes. A wide range of covariates were introduced in the models to control for potential effects, including age, sex, education, season, year, smoking status, alcohol drinking, physical activity, vegetable intake, fruit intake, occupational exposure, BMI, hypertension and dyslipidaemia (all were treated as time-dependent covariates except for sex).
Results
Compared with the participants exposed to the first quartile of ambient PM
2.5
, participants exposed to the second, third and fourth quartiles of ambient PM
2.5
had HRs of 1.28 (95% CI 1.18, 1.39), 1.27 (95% CI 1.17, 1.38) and 1.16 (95% CI 1.07, 1.26), respectively, for the incidence of type 2 diabetes. Participants who drank occasionally or regularly (more than once per week) or who had a lower BMI (<23 kg/m
2
) were more sensitive to the long-term effects of exposure to ambient PM
2.5
.
Conclusions/interpretation
Long-term exposure to ambient PM
2.5
appears to be associated with a higher risk of developing type 2 diabetes in this Asian population experiencing high levels of air pollution.
•The PM2.5 levels in Taiwan peaked around 2004 and began to decrease since 2005.•Improvements in ambient PM2.5 were associated with a better lung function.•Reduced in ambient PM2.5 were associated ...with a decreased risk of COPD development.
Several studies reported that long-term exposure to fine particulate matter (PM2.5) was associated with an increased risk of chronic obstructive pulmonary disease (COPD). It remains unclear whether reduced PM2.5 can decrease the risk of COPD development.
To investigate the associations of dynamic changes (including deterioration and improvement) in long-term exposure to ambient PM2.5 with changes in lung function and the incidence of COPD.
A total of 133,119 adults (aged 18 years or older) were recruited in Taiwan between 2001 and 2014. All participants underwent at least two standard medical examinations including spirometry test. We estimated PM2.5 concentrations using a high-resolution (1 km2) satellite-based spatio-temporal model. The change in PM2.5 (ΔPM2.5) was defined as the difference in concentration of PM2.5 between the respective visit and the previous visit. We used a multivariable mixed linear model and time-varying Cox model to investigate the associations of change in PM2.5 with annual change of lung function and the incidence of COPD, respectively.
The PM2.5 concentration in Taiwan increased during 2002–2004 and began to decrease around 2005. Every 5-µg/m3/year decrease in the annual change of PM2.5 (i.e., ΔPM2.5/year of 5 µg/m3/year) was associated with an average increase of 19.93 mL/year (95 %CI: 17.42,22.43) in forced expiratory volume in 1 s (FEV1), 12.76 mL/year (95 %CI: 9.84,15.66) in forced vital capacity (FVC), 70.22 mL/s/year (95 %CI: 64.69,76.16) in midexpiratory flow between 25 and 75% of the forced vital capacity (MEF25-75), 0.27%/year (95 %CI: 0.21%, 0.32%) in FEV1/FVC/year. Every 5 µg/m3 decrease in PM2.5 (i.e., ΔPM2.5 of 5 µg/m3) was associated with a 12% (95 %CI: 7%, 17%) reduced risk of COPD development. The stratified and sensitivity analyses generally yielded similar results.
An improvement in PM2.5 pollution exposure was associated with an attenuated decline in lung function parameters of FEV1, FVC, MEF25-75, and FEV1/FVC, and a decreased risk of COPD development. Our findings suggest that strategies aimed at reducing air pollution may effectively combat the risk of COPD development.
Aims/hypothesis
Physical activity may increase a person’s inhalation of air pollutants and exacerbate the adverse health effects. This study aimed to investigate the combined associations of chronic ...exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM
2.5
) and habitual physical activity with the incidence of type 2 diabetes in Taiwan.
Methods
We selected 156,314 non-diabetic adults (≥18 years old) who joined an ongoing longitudinal cohort between 2001 and 2016. Incident type 2 diabetes was identified at the follow-up medical examinations. Two-year mean PM
2.5
exposure was estimated at each participant’s address using a satellite-based spatiotemporal model. Information on physical activity and a wide range of covariates was collected using a standard self-administered questionnaire. We analysed the data using a Cox regression model with time-varying covariates. An interaction term between PM
2.5
and physical activity was included to examine the overall interaction effects.
Results
Compared with high physical activity, moderate and inactive/low physical activity were associated with a higher risk of diabetes (HR 95% CI 1.31 1.22, 1.41 and 1.56 1.46, 1.68, respectively). Participants with moderate/high PM
2.5
had a higher risk of type 2 diabetes than the participants exposed to low PM
2.5
(HR 1.31 1.22, 1.40 and 1.94 1.76, 2.14, respectively). The participants with high physical activity and low PM
2.5
had a 64% lower risk of type 2 diabetes than those with inactive/low physical activity and high PM
2.5
.
Conclusions/interpretation
Higher physical activity and lower PM
2.5
exposure are associated with lower risk of type 2 diabetes. Habitual physical activity can reduce the risk of diabetes regardless of the levels of PM
2.5
exposure. Our results indicate that habitual physical activity is a safe diabetes prevention strategy for people residing in relatively polluted regions.
Graphical abstract
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are inflammatory rheumatic diseases common in people over the age of 50 years. Seasonal influenza vaccination (IV) is strongly recommended ...in this population, among whom it is considered to be effective and well tolerated. IV-induced GCA or PMR are thought to be exceptional.
We retrieved all post-IV cases from an inception cohort of patients with newly diagnosed GCA. We also included two patients with post-IV PMR and reviewed all published reports of post-IV GCA or PMR, with selection of cases demonstrating disease onset within 1 month following IV. We compared the results of HLA-DRB1 typing, performed in seven patients with post-IV GCA or PMR, with those of 11 GCA patients with familial aggregation and 16 randomly selected GCA patients without a reported trigger.
Of 358 GCA recruited since 2002, 10 (2.8%) qualified for post-IV GCA, of whom two also showed familial aggregation. Thirty-two patients (19 with GCA and 13 with PMR) including our patients were reviewed; their mean age was 71.8 ± 7.4 years and the M/F ratio was 0.8. Six patients (19%) had a history of PMR. Patients with post-IV GCA/PMR had the DRB1*13:01 haplotype more frequently compared to those with familial GCA (5/7 vs. 2/11, p = 0.048) or with GCA without a known trigger (3/16, p = 0.026). Post-IV PMR generally appeared self-limited, whereas post-IV GCA often displayed a more protracted course (chronic relapsing disease in one-third of the patients).
Post-IV onset of GCA/PMR is not an exceptional occurrence and may be part of the spectrum of the autoimmune syndrome induced by adjuvants (ASIA). IV can trigger GCA or PMR, especially in persons at higher spontaneous risk, such as those with a personal or familial history of GCA/PMR. Whether the presence of the DRB1*13:01 allele further increases the risk of post-IV GCA/PMR through a stronger vaccine-induced immune reaction deserves further investigation. Unlike PMR, GCA can be a serious complication of IV.
•Giant cell arteritis and/or polymyalgia rheumatic may occur following influenza vaccination.•Up to 3% of incident cases of GCA could be triggered by a seasonal influenza vaccination.•HLA DRB1*13:01 could be implicated in the development of post-influenza vaccination.•Unlike PMR, GCA can be a serious complication of IV.•GCA and PMR may be both part of the so-called autoimmune/inflammatory syndrome induced by adjuvants (ASIA).
The 3D printed bulk samples fabricated by selective laser melting (SLM) of the additive manufacturing technique are usually considered to be 3D isotropic in microstructures and mechanical responses. ...This study systematically investigates the anisotropic responses in terms of hardness and electrochemical resistance for the X-, Y- and Z-planes of the SLM Ti-6Al-4V bulk samples fabricated with the zigzag laser path strategy. Results show that all SLM planes exhibit no significant difference in Young's modulus compared to the mechanically rolled plate. However, the X-plane, referred to the cross-sectional plane perpendicular to the laser moving direction, is found ~20% lower hardness and the lowest corrosion resistance compared to the Y- and Z-planes. The underlying reasoning is researched and discussed. The microstructure observations indicate that artifact holes are induced in the X-plane due to un-uniform laser intensity distribution between two neighboring printing lines. Alternatively, the Y- and Z-planes exhibit dense morphology due to multiple heating while zigzag scanning. Experimental results also indicate that the SLM materials exhibit higher corrosion resistance than the commercial rolled materials.
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