Acute effects of ambient air pollution on clinic visits of college students for upper respiratory tract infection in Wuhan, China

Zhang, Faxue; Zhang, Han; Wu, Chuanlong; Zhang, Miaoxuan; Feng, Hongqing; Li, Dejia; Zhu, Wei

doi:10.1007/s11356-021-12828-7

Cited by 28 publications

(21 citation statements)

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“…4) The hospital of Wuhan University had set up four branches in four academic departments to facilitate college students with different majors and faculties to seek basic medical treatment. In addition, bene t by the medical insurance policy of Wuhan University, the medical expenses of our college students in the Hospital of Wuhan University are all reduced 90%, which greatly avoids the bias of not choosing to seek medical treatment due to the cost (Zhang et al 2021), and makes the exposure-response relationship of DTR and the daily outpatient visits of URTI in this study more genuine and believable.…”

Section: Discussionmentioning

confidence: 92%

The association between diurnal temperature range and clinic visits for upper respiratory tract infection among college students in Wuhan, China

Zhang

et al. 2021

Environ Sci Pollut Res

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The effects of daily mean temperature on health outcomes have been discussed in many previous studies, but few have considered the adverse impacts due to variance of temperature in one day. Diurnal temperature range (DTR) was a novel indicator calculated as maximum temperature minus minimum temperature in the same day. In this study, generalized additive model (GAM) with quasi-Poisson distribution was used to investigate the association between DTR and the number of daily outpatient visits for upper respiratory tract infection (URTI) among college students. Data about meteorological factors and air pollutants were provided by Hubei Meteorological Bureau and Wuhan Environmental Protection Bureau, respectively. Outpatient visits data were provided by the Hospital of Wuhan University from January 1, 2016 to November 31, 2018. Short-term exposure to DTR was associated with the increased risk of outpatient for URTI among all college students. Per 1 ℃ increased in DTR was associated with 0.89% (95%CI: 0.40, 1.38) increased in outpatient visits of all college students for URTI at lag 0 day. The greatest effect values were observed in males [1.83% (95%CI: 0.81, 2.86)], and in females [1.44% (95%CI: 0.51, 2.38)] at lag 0-6 days. DTR had more adverse health impact in the warm season than that in the cold season. Public health departments should consider the negative effect of DTR to formulate more effective preventive and control measures for protecting vulnerable people.

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Section: Discussionmentioning

confidence: 92%

The association between diurnal temperature range and clinic visits for upper respiratory tract infection among college students in Wuhan, China

Zhang

et al. 2021

Environ Sci Pollut Res

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“…15,16 Search strategies referred to these 2 previous systematic reviews with modifications as listed in Table S1. Health outcomes considered in the systematic review were: mortality from (1) all causes (AC, ICD9: 001-799, ICD10: A00-R99); (2) all respiratory diseases (RESP, ICD9: 460-519, ICD10: J00-J98); (3) chronic obstructive pulmonary diseases and allied conditions (COPD, ICD9: 490-496, ICD10: J19-J46); (4) all cardiovascular diseases (CVD, ICD9: 390-459, ICD10:I00-I98); (5) all cerebrovascular diseases (CEVD, ICD9: 430-438, ICD10: I60-I69); (6) ischaemic heart disease (IHD, ICD9: 410-414, ICD10: I20-I25); (7) congestive heart failure (CHF, ICD9: 428, ICD10: I50); (8) ischaemic stroke (ICD9: 434, ICD10: I61-I64); (9) pneumonia (ICD9: 480-487, ICD10: J12-J18); and (10) lung cancer (LC, ICD9: 162, ICD10: C33-C34).…”

Section: Search Strategymentioning

confidence: 99%

“…Short-term (i.e. hours to days) exposure to high-level O3 can cause a series of acute symptoms like asthma, respiratory tract infection, myocardial infarction, and cardiac arrest; [5][6][7][8] and long-term (i.e. over years) exposure can lead to chronic health outcomes including but not limited to preterm delivery, stroke, chronic obstructive pulmonary diseases, and cerebrovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Long-term ozone exposure associated cause-specific mortality risks with adjusted metrics by cohort studies: A systematic review and meta-analysis

Sun

Pei

Lan

et al. 2021

Preprint

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BACKGROUNDLong-term ozone (O3) exposure could lead to a series of non-communicable diseases and increase the mortality risks. However, cohort-based studies were still rather rare, and inconsistent exposure metrics might impair the credibility of epidemiological evidence synthetisation. To provide more accurate meta-estimation, this review updated the systematic review with inclusion of recent studies and summarised the quantitative associations between O3 exposure and cause-specific mortality risks based on unified exposure metrics.METHODSResearch articles reporting relative risks between incremental long-term O3 exposure and causes of mortality covering all-cause, cardiovascular diseases, respiratory diseases, chronic obstructive pulmonary disease, pneumonia, ischaemic heart diseases, ischaemic stroke, congestive heart failure, cerebrovascular diseases, and lung cancer, estimated from cohort studies were identified through systematic searches in MEDLINE, Embase and Web of Science. Cross-metric conversion factors were estimated linearly by decadal of observations during 1990-2019. DerSimonian and Laird random effect meta-regression was applied to pool the relative risks.RESULTSA total of 20 studies involving 97,766,404 participants were included in the systematic review. After linearly adjusting the inconsistent O3 exposure metrics into congruity, the pooled relative risks (RR) associated with every 10 nmol mol-1 (ppbV) incremental O3 exposure, by mean of warm-season daily maximum 8-hour average metric, was: 1.010 with 95% confidence interval (CI) ranging 1.005–1.015 for all-cause mortality; 1.027 (95% CI: 1.004–1.049) for respiratory mortality; 1.061 (95% CI: 1.006– 1.119) for COPD mortality; 1.028 (95% CI: 1.001–1.058) for cardiovascular mortality; and 1.102 (95% CI: 1.046–1.162) for congestive heart failure mortality. Positive but insignificant mortality risk associations were found for ischaemic heart diseases, stroke, pneumonia, and lung cancer.DISCUSSIONSThis review covered up-to-date studies, expanded the O3-exposure associated mortality causes into wider range of categories, and firstly highlighted the issue of inconsistency in O3 exposure metrics. Non-intercept linear regression-based cross-metric RR conversion was another innovation, but limitation lay in the observation reliance, indicating further calibration with more credible observations available. Large uncertainties in the multi-study pooled RRs would inspire more future studies to corroborate or contradict the results from this review.CONCLUSIONSAdjustment for exposure metrics laid more solid foundation for multi-study meta-analysis, the results of which revealed unneglectable cardiopulmonary hazards from long-term O3 exposure.REGISTRATIONThe review was registered in PROSPERO (CRD42021270637).FUNDINGThis study is mainly funded by UK Natural Environment Research Council, UK National Centre for Atmospheric Science, Australian Research Council and Australian National Health and Medical Research Council.HighlightsUpdated evidence for O3-mortality associations from 20 cohorts has been provided.Adjusted various O3exposure metrics can provide more accurate risk estimations.Long-term O3-exposure was associated with increased mortality from all-causes, respiratory disease, COPD, cardiovascular disease and congestive heart failure.

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“…Different-sized PM fractions have distinct penetration depths: Coarse PM (PM 10 or PM 2.5–10 having aerodynamic diameter between 2.5 and 10 µm) are retained in the upper airways, while fine PM (PM 2.5 or PM 0.1–2.5 having aerodynamic diameter between 0.1 and 2.5 µm) reaches the alveoli, and ultrafine PM (PM 0,1 having aerodynamic diameter ≤0.1 µm) might trespass the blood–air barrier and enter the circulation [ 42 ]. Accordingly, PM 0.1–2.5 is predominant in the lungs and is mainly responsible for pneumonia [ 29 , 30 ] and chronic obstructive pulmonary disease [ 43 , 44 , 45 ], while PM 2.5–10 is primarily associated with upper respiratory tract infections [ 46 , 47 ]. Despite the well-defined role of PM in respiratory diseases, the role of hospital PM as a vehicle for bacterial and viral agents causing HCAIs has been largely neglected to date, albeit the critical reviews suggested the potential importance of ventilation system contamination in the spread of HCAIs [ 48 , 49 ].…”

Section: Introductionmentioning

confidence: 99%

Ventilation-Associated Particulate Matter Is a Potential Reservoir of Multidrug-Resistant Organisms in Health Facilities

Чезганова

Ефимова

Сахарова

et al. 2021

Life

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Most healthcare-associated infections (HCAIs) develop due to the colonisation of patients and healthcare workers by multidrug-resistant organisms (MDRO). Here, we investigated whether the particulate matter from the ventilation systems (Vent-PM) of health facilities can harbour MDRO and other microbes, thereby acting as a potential reservoir of HCAIs. Dust samples collected in the ventilation grilles and adjacent air ducts underwent a detailed analysis of physicochemical properties and biodiversity. All Vent-PM samples included ultrafine PM capable of reaching the alveoli. Strikingly, >70% of Vent-PM samples were contaminated, mostly by viruses (>15%) or multidrug-resistant and biofilm-producing bacterial strains (60% and 48% of all bacteria-contaminated specimens, respectively). Total viable count at 1 m from the ventilation grilles was significantly increased after opening doors and windows, indicating an association between air flow and bacterial contamination. Both chemical and microbial compositions of Vent-PM considerably differed across surgical vs. non-surgical and intensive vs. elective care units and between health facilities located in coal and chemical districts. Reduced diversity among MDRO and increased prevalence ratio in multidrug-resistant to the total Enterococcus spp. in Vent-PM testified to the evolving antibiotic resistance. In conclusion, we suggest Vent-PM as a previously underestimated reservoir of HCAI-causing pathogens in the hospital environment.

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Acute effects of ambient air pollution on clinic visits of college students for upper respiratory tract infection in Wuhan, China

Cited by 28 publications

References 50 publications

The association between diurnal temperature range and clinic visits for upper respiratory tract infection among college students in Wuhan, China

The association between diurnal temperature range and clinic visits for upper respiratory tract infection among college students in Wuhan, China

Long-term ozone exposure associated cause-specific mortality risks with adjusted metrics by cohort studies: A systematic review and meta-analysis

Ventilation-Associated Particulate Matter Is a Potential Reservoir of Multidrug-Resistant Organisms in Health Facilities

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