Asthma affects millions of people globally and is especially concerning in populations living with poor air quality. This study examines the association of ambient outdoor air pollutants on asthma-related emergency department (ED) visits in children and adults throughout the Pittsburgh region. A time-stratified case-crossover design is used to analyze the lagged effects of fine particulate matter (PM2.5) and gaseous pollutants, e.g., ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) on asthma-related ED visits (n = 6682). Single-, double-, and multi-pollutant models are adjusted for temperature and analyzed using conditional logistic regression. In children, all models show an association between O3 and increased ED visits at lag day 1 (OR: 1.12, 95% CI, 1.03–1.22, p < 0.05) for the double-pollutant model (OR: 1.10, 95% CI: 1.01-1.20, p < 0.01). In adults, the single-pollutant model shows associations between CO and increased ED visits at lag day 5 (OR: 1.13, 95% CI, 1.00–1.28, p < 0.05) and average lag days 0–5 (OR: 1.22, 95% CI: 1.00–1.49, p < 0.05), and for NO2 at lag day 5 (OR: 1.04, 95% CI: 1.00–1.07, p < 0.05). These results show an association between air pollution and asthma morbidity in the Pittsburgh region and underscore the need for mitigation efforts to improve public health outcomes.
6 May 2023 in Journal of Allergy and Clinical Immunology
Individual components of the ambient environment, such as temperature and air pollution, exist as part of a complex mixture and have been associated with suicide; however, their interactive effects remain poorly understood. This study examined the independent and interactive effects of wet bulb globe temperature (WBGT), nitrogen dioxide (NO2), and fine particulate matter (PM2.5) on suicide mortality. We identified 7,551 suicide cases in Utah, USA, from 2000 to 2016 and assigned exposure to daily maximum WBGT (sourced from the European Center for Medium-Range Weather Forecasts) and PM2.5 and NO2 concentrations (sourced from a national spatiotemporal ensemble model) using decedent's residential address at the time of death. A case-crossover design with conditional logistic regression was used to estimate the independent and interactive effects of WBGTmax, PM2.5, and NO2 on suicide. For exposure windows, we considered single days preceding suicide (lag 0 to 6) and their averages across preceding days (lag 0-1, 0-3, and 0-6). Analyses were stratified by season. We identified a significant association between WBGTmax and suicide across all seasons (odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.01, 1.10; per 5 °C increase on lag 0-3 days). The associations were stronger in the warm season (March 22 to September 21), with ORs and 95% CIs ranging from 1.08 (1.02, 1.15) to 1.20 (1.10, 1.30) per 5 °C increase depending on the lag periods. We observed synergistic interactions between WBGTmax and PM2.5 and NO2 in the warm season, associated with higher odds of suicide. The associations of WBGTmax with suicide were most pronounced at high NO2 levels. We found evidence of synergistic interactions between WBGTmax and PM2.5 and NO2 on suicide in the warm season, emphasizing the need for considering the combined effects of heat stress and air pollution in suicide prevention strategies.