Short-term effects of particle gamma radiation activities on pulmonary function in COPD patients.
ABSTRACT: BACKGROUND:It is not known whether environmental gamma radiation measured in US cities has detectable adverse health effects. We assessed whether short-term exposure to gamma radiation emitted from ambient air particles [gamma particle activity (PR?)] is associated with reduced pulmonary function in chronic obstructive pulmonary disease (COPD) patients. OBJECTIVE:We hypothesize that the inhalation of gamma radiation emitted from ambient air particles may be associated with reduced pulmonary function in individuals with COPD. METHODS:In 125 patients with COPD from Eastern Massachusetts who had up to 4 seasonal one-week assessments of particulate matter ?2.5??m (PM2.5), black carbon (BC), and sulfur followed by spirometry. The US EPA continuously monitors ambient gamma (?) radiation including ? released from radionuclides attached to particulate matter that is recorded as 9 ?-energy spectra classes (i?=?3-9) in counts per minute (CPM?) in the Boston area (USA). We analyzed the associations between ambient and indoor PR?i (up to one week) and pre and post-bronchodilator (BD) forced expiratory volume in 1?s (FEV1) and with forced vital capacity (FVC) using mixed-effects regression models. We estimated indoor PR?i using the ratio of the indoor-to-outdoor sulfur in PM2.5 as a proxy for infiltration of ambient radionuclide-associated particles. RESULTS:Overall, exposures to ambient and indoor PR?i were associated with a similar decrease in pre- and post-BD FEV1 and FVC. For example, ambient PR?3 exposure averaged from the day of pulmonary function testing through the previous 3 days [IQR of 55.1?counts per minute (CPM?)] was associated with a decrease in pre-BD FEV1 of 21.0?ml (95%CI: -38.5 to -3.0?ml; p?
Project description:BACKGROUND:Particulate matter (PM) air pollution has been associated with decreased pulmonary function, but the exposure–response relationship in chronic obstructive pulmonary disease (COPD) patients is uncertain, and most studies have only focused on exposures to ambient pollution. OBJECTIVES:We aimed to assess associations between pulmonary function and indoor and ambient PM [Formula: see text] ([Formula: see text]) and black carbon (BC). METHODS:Between November 2012 and December 2014, 125 patients with COPD (mean age, 73.4 y) who were not currently smoking and without known indoor BC sources were recruited. Indoor BC and [Formula: see text] were measured in each home for a week in each season, up to four times a year, followed by in-person spirometry pre- and post-bronchodilator. Ambient exposures were available from a central site monitor. Multivariable adjusted mixed effects regression models were used to assess associations scaled per interquartile range (IQR) of exposure. RESULTS:There were 367 study visits; the median (IQR) indoor BC and [Formula: see text] were 0.19 (0.22) [Formula: see text] and 6.67 (5.80) [Formula: see text], respectively. Increasing indoor exposures to BC were associated with decreases in pre-bronchodilator forced expiratory volume in 1 s [Formula: see text] and forced vital capacity (FVC), and [Formula: see text]. For example, in multivariable adjusted models, each IQR increase in indoor BC from the weekly integrated filter was associated with a [Formula: see text] [95% confidence interval (CI): [Formula: see text], [Formula: see text]] decrease in pre-bronchodilator [Formula: see text]. Increases in indoor [Formula: see text] were associated with decreases in [Formula: see text] and FVC of smaller magnitude than those for indoor BC; however, the results were less precise. Ambient BC was not associated with pre-bronchodilator pulmonary function, ambient [Formula: see text] was only associated with decreases in FVC and increases in [Formula: see text], and neither indoor nor ambient BC or [Formula: see text] were associated with post-bronchodilator pulmonary function. CONCLUSIONS:Low-level exposures to indoor BC and [Formula: see text], but not ambient exposures, were consistently associated with decreases in pre-bronchodilator pulmonary function. There was no association between exposures and post-bronchodilator pulmonary function. https://doi.org/10.1289/EHP3668.
Project description:Previous studies have suggested increased risk of respiratory diseases and mortality following short-term exposures to ionizing radiation. However, the short-term respiratory effects of low-level environmental radiation associated with air pollution particles have not been considered. Although ambient particulate matter (PM) has been reproducibly linked to decreased lung function and to increased respiratory related morbidity, the properties of PM promoting its toxicity are uncertain. As such, we evaluated whether lung function was associated with exposures to radioactive components of ambient PM, referred to as particle radioactivity (PR). For this, we performed a repeated-measures analysis of 839 men to examine associations between PR exposure and lung function using mixed-effects regression models, adjusting for potential confounders. We examined whether PR-lung function associations changed after adjusting for PM2.5 (particulate matter?2.5??m) or black carbon, and vice versa. PR was measured by the USEPA's radiation monitoring network. We found that higher PR exposure was associated with a lower forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). An IQR increase in 28-day PR exposure was associated with a 2.4% lower FVC [95% confidence interval (CI): 1.4, 3.4% p?<?0.001] and a 2.4% lower FEV1 (95% CI: 1.3, 3.5%, p?<?0.001). The PR-lung function associations were partially attenuated with adjustment for PM2.5 and black carbon. This is the first study to demonstrate associations between PR and lung function, which were independent of and similar in magnitude to those of PM2.5 and black carbon. If confirmed, future research should account for PR exposure in estimating respiratory health effects of ambient particles. Because of widespread exposure to low levels of ionizing radiation, our findings may have important implications for research, and environmental health policies worldwide.
Project description:This study was undertaken to investigate the associations between chronic exposure to particulate matter of medium aerodynamic diameter ?10 or ?2.5 µm (PM10 or PM2.5) and nitrogen dioxide (NO?) levels and lung function and to examine a possible change in these relationships by demographic and lifestyle factors. Chronic obstructive pulmonary disease (COPD) was defined using the Global Initiative for COPD criteria (forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70%). Associations of lung function and COPD with PM10 or PM2.5 or NO? were examined using linear and logistic regression analyses among 1264 Korean adults. The highest tertiles of PM2.5 (?37.1 ?g/m³) and NO? (?53.8 ?g/m³) exposure were significantly associated with COPD (highest versus lowest tertile of PM2.5: adjusted odds ratio (OR) = 1.79, 95% CI: 1.02-3.13; highest versus lowest tertile of NO?: adjusted OR = 1.83, 95% CI: 1.04-3.21). A 10 ?g/m³ increase in PM10 concentration was associated with a 1.85 L (95% CI -3.65 to -0.05) decrease in FEV1 and a 1.73 L (95% CI -3.35 to -0.12) decrease in FVC, with the strongest negative association among older people and those with less education. Reduced lung function was associated with PM2.5 exposure in subjects with no physical activity. This study provides evidence that exposure to ambient air pollution has adverse effects on lung function in adults.
Project description:BACKGROUND:Exposure to air pollution is associated with chronic obstructive pulmonary disease (COPD). However, findings on the effects of air pollution on lung function and systemic inflammation in Chinese COPD patients are inconsistent and scarce. This study aims to evaluate the effects of ambient air pollution on lung function parameters and serum cytokine levels in a COPD cohort in Beijing, China. METHODS:We enrolled COPD participants on a rolling basis from December 2015 to September 2017 in Beijing, China. Follow-ups were performed every 3?months for each participant. Serum levels of 20 cytokines were detected every 6?months. Hourly ambient pollutant levels over the same periods were obtained from 35 monitoring stations across Beijing. Geocoded residential addresses of the participants were used to estimate daily mean pollution exposures. A linear mixed-effect model was applied to explore the effects of air pollutants on health in the first-year of follow-up. RESULTS:A total of 84 COPD patients were enrolled at baseline. Of those, 75 COPD patients completed the first-year of follow-up. We found adverse cumulative effects of particulate matter less than 2.5??m in aerodynamic diameter (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2) and carbon monoxide (CO) on the forced vital capacity % predicted (FVC % pred) in patients with COPD. Further analyses illustrated that among COPD patients, air pollution exposure was associated with reduced levels of serum eotaxin, interleukin 4 (IL-4) and IL-13 and was correlated with increased serum IL-2, IL-12, IL-17A, interferon ? (IFN?), monocyte displacing protein 1 (MCP-1) and soluble CD40 ligand (sCD40L). CONCLUSION:Acute exposures to PM2.5, NO2, SO2 and CO were associated with a reduction in FVC % pred in COPD patients. Furthermore, short-term exposure to air pollutants increased systemic inflammation in COPD patients; this may be attributed to increased Th1 and Th17 cytokines and decreased Th2 cytokines.
Project description:<h4>Objective</h4>Ambient fine particulate matter (PM2.5) pollution is currently a major public health concern in Chinese urban areas. However, PM2.5 exposure primarily occurs indoors. Given such, we conducted this study to characterize the indoor-outdoor relationship of PM2.5 mass concentrations for urban residences in Beijing.<h4>Methods</h4>In this study, 24-h real-time indoor and ambient PM2.5 mass concentrations were concurrently collected for 41 urban residences in the non-heating season. The diurnal variation of pollutant concentrations was characterized. Pearson correlation analysis was used to examine the correlation between indoor and ambient PM2.5 mass concentrations. Regression analysis with ordinary least square was employed to characterize the influences of a variety of factors on PM2.5 mass concentration.<h4>Results</h4>Hourly ambient PM2.5 mass concentrations were 3-280 ?g/m3 with a median of 58 ?g/m3, and hourly indoor counterpart were 4-193 ?g/m3 with a median of 34 ?g/m3. The median indoor/ambient ratio of PM2.5 mass concentration was 0.62. The diurnal variation of residential indoor and ambient PM2.5 mass concentrations tracked with each other well. Strong correlation was found between indoor and ambient PM2.5 mass concentrations on the community basis (coefficients: r ? 0.90, p < 0.0001), and the ambient data explained ? 84% variance of the indoor data. Regression analysis suggested that the variables, such as traffic conditions, indoor smoking activities, indoor cleaning activities, indoor plants and number of occupants, had significant influences on the indoor PM2.5 mass concentrations.<h4>Conclusions</h4>PM2.5 of ambient origin made dominant contribution to residential indoor PM2.5 exposure in the non-heating season under the high ambient fine particle pollution condition. Nonetheless, the large inter-residence variability of infiltration factor of ambient PM2.5 raised the concern of exposure misclassification when using ambient PM2.5 mass concentrations as exposure surrogates. PM2.5 of indoor origin still had minor influence on indoor PM2.5 mass concentrations, particularly at 11:00-13:00 and 22:00-0:00. The predictive models suggested that particles from traffic emission, secondary aerosols, particles from indoor smoking, resuspended particles due to indoor cleaning and particles related to indoor plants contributed to indoor PM2.5 mass concentrations in this study. Real-time ventilation measurements and improvement of questionnaire design to involve more variables subject to built environment were recommended to enhance the performance of the predictive models.
Project description:BACKGROUND:Ambient particulate matter (PM) exposure has been associated with respiratory function decline in epidemiological studies. We hypothesize that a possible underlying mechanism is the perturbation of airway microbiome by PM exposure. METHODS:During October 2016-October 2017, on two human cohorts (n?=?115 in total) in Shanghai China, we systematically collected three categories of data: (1) respiratory functions, (2) airway microbiome from sputum, and (3) PM2.5 (PM of ? 2.5?µm in diameter) level in ambient air. We investigated the impact of PM2.5 on airway microbiome as well as the link between airway microbiome and respiratory functions using linear mixed regression models. RESULTS:The respiratory function of our primary interest includes forced vital capacity (FVC) and forced expiratory volume in 1st second (FEV1). FEV1/FVC, an important respiratory function trait and key diagnosis criterion of COPD, was significantly associated with airway bacteria load (p?=?0.0038); and FEV1 was associated with airway microbiome profile (p?=?0.013). Further, airway microbiome was significantly influenced by PM2.5 exposure (p?=?4.48E-11). CONCLUSIONS:To our knowledge, for the first time, we demonstrated the impact of PM2.5 on airway microbiome, and reported the link between airway microbiome and respiratory functions. The results expand our understanding on the scope of PM2.5 exposure's influence on human respiratory system, and point to novel etiological mechanism of PM2.5 exposure induced diseases.
Project description:Background/Objective:Wintertime thermal inversions in narrow mountain valleys create a ceiling effect, increasing concentration of small particulate matter (PM2.5). Despite potential health risks, many people continue to exercise outdoors in thermal inversions. This study measured the effects of ambient PM2.5 exposure associated with a typical thermal inversion on exercise performance, pulmonary function, and biological markers of inflammation. Methods:Healthy, active adults (5 males, 11 females) performed two cycle ergometer time trials outdoors in a counterbalanced design: 1) low ambient PM2.5 concentrations (<12??g/m3), and 2) an air quality index (AQI) ranking of "yellow." Variables of interest were exercise performance, exhaled nitric oxide (eNO), c-reactive protein (CRP), forced vital capacity (FVC), and forced expiratory volume in 1?s (FEV1). Results:Despite a significant difference in mean PM2.5 concentration of 9.3?±?3.0??g/m3 between trials (p?<?.001), there was no significant difference (p?=?.424) in the distance covered during low PM2.5 conditions (9.9?±?1.7?km) compared to high PM2.5 conditions (10.1?±?1.5?km). There were no clinically significant differences across time or between trials for eNO, CRP, FVC, or FEV1. Additionally, there were no dose-response relationships (p?>?.05) for PM2.5 concentration and the measured variables. Conclusion:An acute bout of vigorous exercise during an AQI of "yellow" did not diminish exercise performance in healthy adults, nor did it have a negative effect on pulmonary function or biological health markers. These variables might not be sensitive to small changes from acute, mild PM2.5 exposure.
Project description:A hallmark of the diagnosis of chronic obstructive pulmonary disease (COPD) is the measurement of post-bronchodilator (post-BD) airflow obstruction (AO) by spirometry, but spirometry is not enough for the provision of a clinical diagnosis. In the majority of previous epidemiological studies, COPD diagnosis has been based on spirometry and a few clinical characteristics. The aim of our study was to identify outcomes in patients newly diagnosed with airflow obstruction (AO) based on a diagnostic work-up conducted as part of a population-based cross-sectional study in North-Western Russia. Spirometry was performed before (pre-BD) and after BD administration, and AO was defined using the FEV1/FVC <0.70 and FEV1/FVC <lower limit of normal cut-off values. Relevant symptoms were recorded. Participants with AO identified at baseline were then examined by a pulmonologist, including a clinical examination and second spirometry with BD test. Of the 102 participants with post-BD AO in the initial assessment, only 60.8% still had AO identified at the second examination; among these patients, the following final diagnoses were reported: COPD (n?=?41), asthma (n?=?5), asthma-COPD overlap syndrome (ACOS) (n?=?4) and likely ACOS (n?=?5). Of the 65 participants with pre-BD AO, 23.1% had post-BD AO at the second assessment, and these patients had been diagnosed with COPD (n?=?12), asthma (n?=?1), ACOS (n?=?1), likely ACOS (n?=?1). Serial spirometric assessments complemented by a comprehensive clinical evaluation are recommended in new epidemiological studies.
Project description:BACKGROUND:Little is known about the effect of ambient fine particulate matter (PM2.5) on chronic obstructive pulmonary disease (COPD) in China. The objective of this study was to explore the short-term effects of PM2.5 on outpatient and inpatient visits for COPD in Beijing, China. METHODS:A total of 3,503,313 outpatient visits and 126,982 inpatient visits for COPD between January 1, 2010, and June 30, 2012, were identified from the Beijing Medical Claim Data for Employees. A generalized additive Poisson model was applied to estimate the percentage change with 95% confidence interval (CI) in hospital visits for COPD in relation to an interquartile range (IQR) (90.8 μg/m3) increase in PM2.5 concentrations. RESULTS:Short-term exposure to PM2.5 was significantly associated with increased use of COPD-related health services. There were clear exposure-response associations of PM2.5 with COPD outpatient and inpatient visits. An IQR increase in the concurrent day PM2.5 concentrations was significantly associated with a 2.38% (95% CI, 2.22%-2.53%) and 6.03% (95% CI, 5.19%-6.87%) increase in daily outpatient visits and inpatient visits, respectively. Elderly people were more sensitive to the adverse effects. The estimated risk was higher during the warm season compared to the cool season. CONCLUSIONS:Short-term exposure to PM2.5 was associated with increased risk of hospital visits for COPD. Our findings contributed to the limited evidence concerning the effects of ambient PM2.5 on COPD morbidity in developing countries.
Project description:RATIONALE:Dietary intake is a potential risk factor for respiratory morbidity in adult populations. Few studies capture the effect of dietary patterns, representative of the combination of nutrients consumed, on self-reported respiratory morbidity in combination with objective measures of lung function. OBJECTIVES:To evaluate patterns of dietary intake in relation to respiratory morbidity and objective measures of lung function in a U.S. POPULATION: METHODS:The ARIC (Atherosclerosis Risk in Communities) study investigators enrolled 15,792 participants from four U.S. communities between 1987 and 1989 and collected data using a validated food frequency questionnaire to assess diet. Principal component analysis was applied, and patterns representative of "Western" and "Prudent" diets emerged. We investigated cross-sectional associations between dietary patterns and pulmonary assessments that included asthma and chronic obstructive pulmonary disease (COPD) diagnosis, respiratory symptoms, and lung function. Multivariable Poisson regression models included quintiles of dietary patterns and potential confounders. Interaction of dietary patterns with obesity, sex, and smoking status was assessed in relation to all outcomes. RESULTS:Higher scores in the "Western" dietary pattern (quintile 5 vs. quintile 1) were associated with higher prevalence of COPD (prevalence ratio [PR], 1.62; 95% confidence ratio [CI], 1.33-1.97), wheeze (PR, 1.37; 95% CI, 1.11-1.69), cough (PR, 1.32; 95% CI, 1.32-1.59), and phlegm (PR, 1.27; 95% CI, 1.05-1.54) and lower percent predicted forced expiratory volume in 1 second (FEV1), percent predicted forced vital capacity (FVC), and FEV1/FVC ratio. Higher scores in the "Prudent" dietary pattern (quintile 5 vs. quintile 1) were associated with lower prevalence of COPD (PR, 0.82; 95% CI, 0.70-0.95) and cough (PR, 0.77; 95% CI, 0.67-0.89) and higher percent predicted FEV1 and FEV1/FVC ratio. The prevalence of asthma was not related to dietary intake. CONCLUSIONS:A "Western" dietary pattern was associated with respiratory symptoms, lower lung function, and COPD in ARIC participants.