Objectives
Due to their small size, ultrafine particles (UFP) are believed to exert higher toxicity than larger particles. As numerous studies on health effects of UFP have been published since the ...last systematic review in 2013, we aim to systematically review the new literature.
Methods
We searched MEDLINE and the specialized LUDOK database for studies published between 01.01.2011 and 11.05.2017 investigating health effects of ambient air pollution-related UFP. We included epidemiologic studies containing UFP measures and quantifiable measures of associations. Relevant data were extracted on the basis of previously developed evaluation criteria.
Results
We identified 85 original studies, conducting short-term (
n
= 75) and long-term (
n
= 10) investigations. Panel (
n
= 32), scripted exposure with predefined settings (
n
= 16) or time series studies (
n
= 11) were most frequent. Thirty-four studies adjusted for at least one other pollutant. Most consistent associations were identified for short-term effects on pulmonary/systemic inflammation, heart rate variability and blood pressure.
Conclusions
The evidence suggests adverse short-term associations with inflammatory and cardiovascular changes, which may be at least partly independent of other pollutants. For the other studied health outcomes, the evidence on independent health effects of UFP remains inconclusive or insufficient.
Air pollution and climate change have a significant impact on human health and well‐being and contribute to the onset and aggravation of allergic rhinitis and asthma among other chronic respiratory ...diseases. In Westernized countries, households have experienced a process of increasing insulation and individuals tend to spend most of their time indoors. These sequelae implicate a high exposure to indoor allergens (house dust mites, pets, molds, etc), tobacco smoke, and other pollutants, which have an impact on respiratory health. Outdoor air pollution derived from traffic and other human activities not only has a direct negative effect on human health but also enhances the allergenicity of some plants and contributes to global warming. Climate change modifies the availability and distribution of plant‐ and fungal‐derived allergens and increases the frequency of extreme climate events. This review summarizes the effects of indoor air pollution, outdoor air pollution, and subsequent climate change on asthma and allergic rhinitis in children and adults and addresses the policy adjustments and lifestyle changes required to mitigate their deleterious effects.
To investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines.
...Pooled analysis of eight cohorts.
Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries.
325 367 adults from the general population recruited mostly in the 1990s or 2000s with detailed lifestyle data. Stratified Cox proportional hazard models were used to analyse the associations between air pollution and mortality. Western Europe-wide land use regression models were used to characterise residential air pollution concentrations of ambient fine particulate matter (PM
), nitrogen dioxide, ozone, and black carbon.
Deaths due to natural causes and cause specific mortality.
Of 325 367 adults followed-up for an average of 19.5 years, 47 131 deaths were observed. Higher exposure to PM
, nitrogen dioxide, and black carbon was associated with significantly increased risk of almost all outcomes. An increase of 5 µg/m
in PM
was associated with 13% (95% confidence interval 10.6% to 15.5%) increase in natural deaths; the corresponding figure for a 10 µg/m
increase in nitrogen dioxide was 8.6% (7% to 10.2%). Associations with PM
, nitrogen dioxide, and black carbon remained significant at low concentrations. For participants with exposures below the US standard of 12 µg/m
an increase of 5 µg/m
in PM
was associated with 29.6% (14% to 47.4%) increase in natural deaths.
Our study contributes to the evidence that outdoor air pollution is associated with mortality even at low pollution levels below the current European and North American standards and WHO guideline values. These findings are therefore an important contribution to the debate about revision of air quality limits, guidelines, and standards, and future assessments by the Global Burden of Disease.
Summary Background Ambient air pollution is suspected to cause lung cancer. We aimed to assess the association between long-term exposure to ambient air pollution and lung cancer incidence in ...European populations. Methods This prospective analysis of data obtained by the European Study of Cohorts for Air Pollution Effects used data from 17 cohort studies based in nine European countries. Baseline addresses were geocoded and we assessed air pollution by land-use regression models for particulate matter (PM) with diameter of less than 10 μm (PM10 ), less than 2·5 μm (PM2·5 ), and between 2·5 and 10 μm (PMcoarse ), soot (PM2·5absorbance ), nitrogen oxides, and two traffic indicators. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses. Findings The 312 944 cohort members contributed 4 013 131 person-years at risk. During follow-up (mean 12·8 years), 2095 incident lung cancer cases were diagnosed. The meta-analyses showed a statistically significant association between risk for lung cancer and PM10 (hazard ratio HR 1·22 95% CI 1·03–1·45 per 10 μg/m3 ). For PM2·5 the HR was 1·18 (0·96–1·46) per 5 μg/m3 . The same increments of PM10 and PM2·5 were associated with HRs for adenocarcinomas of the lung of 1·51 (1·10–2·08) and 1·55 (1·05–2·29), respectively. An increase in road traffic of 4000 vehicle-km per day within 100 m of the residence was associated with an HR for lung cancer of 1·09 (0·99–1·21). The results showed no association between lung cancer and nitrogen oxides concentration (HR 1·01 0·95–1·07 per 20 μg/m3 ) or traffic intensity on the nearest street (HR 1·00 0·97–1·04 per 5000 vehicles per day). Interpretation Particulate matter air pollution contributes to lung cancer incidence in Europe. Funding European Community's Seventh Framework Programme.
In order to investigate associations between air pollution and adverse health effects consistent fine spatial air pollution surfaces are needed across large areas to provide cohorts with comparable ...exposures. The aim of this paper is to develop and evaluate fine spatial scale land use regression models for four major health relevant air pollutants (PM2.5, NO2, BC, O3) across Europe.
We developed West-European land use regression models (LUR) for 2010 estimating annual mean PM2.5, NO2, BC and O3 concentrations (including cold and warm season estimates for O3). The models were based on AirBase routine monitoring data (PM2.5, NO2 and O3) and ESCAPE monitoring data (BC), and incorporated satellite observations, dispersion model estimates, land use and traffic data. Kriging was performed on the residual spatial variation from the LUR models and added to the exposure estimates. One model was developed using all sites (100%). Robustness of the models was evaluated by performing a five-fold hold-out validation and for PM2.5 and NO2 additionally with independent comparison at ESCAPE measurements. To evaluate the stability of each model's spatial structure over time, separate models were developed for different years (NO2 and O3: 2000 and 2005; PM2.5: 2013).
The PM2.5, BC, NO2, O3 annual, O3 warm season and O3 cold season models explained respectively 72%, 54%, 59%, 65%, 69% and 83% of spatial variation in the measured concentrations. Kriging proved an efficient technique to explain a part of residual spatial variation for the pollutants with a strong regional component explaining respectively 10%, 24% and 16% of the R2 in the PM2.5, O3 warm and O3 cold models. Explained variance at fully independent sites vs the internal hold-out validation was slightly lower for PM2.5 (65% vs 66%) and lower for NO2 (49% vs 57%). Predictions from the 2010 model correlated highly with models developed in other years at the overall European scale.
We developed robust PM2.5, NO2, O3 and BC hybrid LUR models. At the West-European scale models were robust in time, becoming less robust at smaller spatial scales. Models were applied to 100 × 100 m surfaces across Western Europe to allow for exposure assignment for 35 million participants from 18 European cohorts participating in the ELAPSE study.
•Robust PM2.5, NO2, BC and O3 hybrid LUR models at a 100x100 m resolution for Western Europe were developed•Models included large scale SAT and CTM estimates and fine scale traffic and land use and were further improved with kriging•Models were robust in time at European scale, becoming less robust at smaller spatial scales.
Objective Venous diseases are among the most frequent diseases in the general population of industrialized countries. The aim of this article is to investigate the population-based prevalence of ...pathologic reflux in superficial and deep leg veins, taking into account factors as gender, age, and clinical classification of venous disease. Methods In a population-based cross-sectional study, 3072 subjects aged 18 to 79 years (1350 male, 1722 female, response 59%) were enrolled from October 2000 through November 2001. A standardized interview was conducted to document phlebological history and clinical examinations including duplex sonography of selected superficial and deep leg veins. Pathological reflux was defined as being >500 ms. All participants where classified according to the CEAP classification. Results Using the highest clinical stage per participant, 9.6% where classified C0, 59.0% C1, 14.3% C2, 13.5% C3, 2.9% C4, and 0.7% C5-C6. A pathological reflux (>500 ms) was found in 35.3% (95% confidence interval CI 33.6-37.1) of subjects with 21.0% (95% CI 19.5-22.5) showing reflux in at least one superficial vein and 20.0% (95% CI 18.6-21.5) showing reflux in at least one deep vein. We observed significantly higher reflux prevalence for the superficial veins in women while for the deep veins reflux prevalence were significantly higher in men. Prevalence of reflux in the superficial veins markedly increases with age. In the deep venous system, no clear changes in reflux prevalence with age can be observed. For superficial veins, reflux prevalence is markedly higher with higher C-stages. For the deep veins, the proportion of refluxes is relatively constant in stages C0-C3 with a distinct increase of prevalence from stage C4 onward. Conclusion Our results show a high prevalence of reflux both for the superficial and the deep venous system. Reflux prevalence is associated with gender, age, and the clinical stage as measured by the CEAP classification. Further longitudinal studies are needed to clarify the relevance of pathological reflux in subjects with otherwise healthy veins.
Empirical spatial air pollution models have been applied extensively to assess exposure in epidemiological studies with increasingly sophisticated and complex statistical algorithms beyond ordinary ...linear regression. However, different algorithms have rarely been compared in terms of their predictive ability.
This study compared 16 algorithms to predict annual average fine particle (PM2.5) and nitrogen dioxide (NO2) concentrations across Europe. The evaluated algorithms included linear stepwise regression, regularization techniques and machine learning methods. Air pollution models were developed based on the 2010 routine monitoring data from the AIRBASE dataset maintained by the European Environmental Agency (543 sites for PM2.5 and 2399 sites for NO2), using satellite observations, dispersion model estimates and land use variables as predictors. We compared the models by performing five-fold cross-validation (CV) and by external validation (EV) using annual average concentrations measured at 416 (PM2.5) and 1396 sites (NO2) from the ESCAPE study. We further assessed the correlations between predictions by each pair of algorithms at the ESCAPE sites.
For PM2.5, the models performed similarly across algorithms with a mean CV R2 of 0.59 and a mean EV R2 of 0.53. Generalized boosted machine, random forest and bagging performed best (CV R2~0.63; EV R2 0.58–0.61), while backward stepwise linear regression, support vector regression and artificial neural network performed less well (CV R2 0.48–0.57; EV R2 0.39–0.46). Most of the PM2.5 model predictions at ESCAPE sites were highly correlated (R2 > 0.85, with the exception of predictions from the artificial neural network). For NO2, the models performed even more similarly across different algorithms, with CV R2s ranging from 0.57 to 0.62, and EV R2s ranging from 0.49 to 0.51. The predicted concentrations from all algorithms at ESCAPE sites were highly correlated (R2 > 0.9). For both pollutants, biases were low for all models except the artificial neural network. Dispersion model estimates and satellite observations were two of the most important predictors for PM2.5 models whilst dispersion model estimates and traffic variables were most important for NO2 models in all algorithms that allow assessment of the importance of variables.
Different statistical algorithms performed similarly when modelling spatial variation in annual average air pollution concentrations using a large number of training sites.
•Multiple statistical algorithms with very different assumptions were compared.•Despite the difference in modeling frameworks, predictions among the models exhibit generally good agreement.•The use of an external evaluation dataset strengthens evaluation by cross-validation.
Previous published analyses have focused on the effect of air pollution on asthma and rhinoconjunctivitis throughout early and middle childhood. However, the role of exposure to air pollution in the ...development of childhood and adolescent asthma and rhinoconjunctivitis remains unclear. We aimed to assess the longitudinal associations between exposure to air pollution and development of asthma and rhinoconjunctivitis throughout childhood and adolescence.
We did a population-based birth cohort study of 14 126 participants from four prospective birth cohort studies from Germany, Sweden, and the Netherlands with 14–16 years of follow-up. We linked repeated questionnaire reports of asthma and rhinoconjunctivitis with annual average air pollution concentrations (nitrogen dioxide NO2, particulate matter PM with a diameter of less than 2·5 μm PM2·5, less than 10 μm PM10, and between 2·5 μm and 10 μm PMcoarse, and PM2·5 absorbance indicator of soot) at the participants' home addresses. We analysed longitudinal associations of air pollution exposure at participants' birth addresses and addresses at the time of follow-up with asthma and rhinoconjunctivitis incidence and prevalence in cohort-specific analyses, with subsequent meta-analysis and pooled analyses.
Overall, the risk of incident asthma up to age 14–16 years increased with increasing exposure to NO2 (adjusted meta-analysis odds ratio OR 1·13 per 10 μg/m3 95% CI 1·02–1·25) and PM2·5 absorbance (1·29 per 1 unit 1·00–1·66) at the birth address. A similar, albeit non-significant, trend was shown for PM2·5 and incident asthma (meta-analysis OR 1·25 per 5 μg/m3 95% CI 0·94–1·66). These associations with asthma were more consistent after age 4 years than before that age. There was no indication of an adverse effect of air pollution on rhinoconjunctivitis.
Exposure to air pollution early in life might contribute to the development of asthma throughout childhood and adolescence, particularly after age 4 years, when asthma can be more reliably diagnosed. Reductions in levels of air pollution could help to prevent the development of asthma in children.
The European Union.
It has been hypothesized that air pollution and ambient noise might impact neurocognitive function. Early studies mostly investigated the associations of air pollution and ambient noise exposure with ...cognitive development in children. More recently, several studies investigating associations with neurocognitive function, mood disorders, and neurodegenerative disease in adult populations were published, yielding inconsistent results. The purpose of this review is to summarize the current evidence on air pollution and noise effects on mental health in adults. We included studies in adult populations (≥18 years old) published in English language in peer-reviewed journals. Fifteen articles related to long-term effects of air pollution and eight articles on long-term effects of ambient noise were extracted. Both exposures were separately shown to be associated with one or several measures of global cognitive function, verbal and nonverbal learning and memory, activities of daily living, depressive symptoms, elevated anxiety, and nuisance. No study considered both exposures simultaneously and few studies investigated progression of neurocognitive decline or psychological factors. The existing evidence generally supports associations of environmental factors with mental health, but does not suffice for an overall conclusion about the independent effect of air pollution and noise. There is a need for studies investigating simultaneously air pollution and noise exposures in association mental health, for longitudinal studies to corroborate findings from cross-sectional analyses, and for parallel toxicological and epidemiological studies to elucidate mechanisms and pathways of action.
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