Air pollution: Sources and health effects

Air pollution: Sources and health effects
Sabit Cakmak
1 Environmental
Health Sciences Research Bureau, Population Studies Division,
HECSB, Health Canada, Ottawa, ON
Date: March 2015
Collaborators
• Bob Dales
• Maria Angelica Rubio
• Claudia Blanco Vidal
• Pedro Oyala
• Ling Liu
• Judith Leech
• Mamun Mahmud
• Brad Mills
• Amanda Wheeler
• Alice Grgicak-Mannion
• Sara Martin
• Chris Hebbern
• Jennifer Vanos
• Corben Bristow
• Vladislav Brion
• Scott Sheridan
2
Air pollution: Sources and health effects
•
•
•
•
•
Air pollution effect on
neurological diseases

Epilepsy

Headache
Venous thrombosis and
pulmonary embolism
Diabetes
Exercise capacity
•
•
•
Does traffic counts reflects
more accurately traffic
related pollution?
Does health effects
modified by socioeconomics?
Which source produce most
toxic component of
particulate matter?
Interaction with
aeroallergens
3
Adjusted relative risk estimates and 95% CI in
hospitalization for epilepsy at IQR, Santiago Province, 2001
through 2005.
Environment International 36 (2010) 501–505
•
1.4% of adults in US
had seizures and less
edu and empl. And
more unhappiness
(2002 US Nat. H. S)
•
In Ontario, 0.6% of
population reported
epilepsy.(1990 health
survey)
•
In Santiago, daily 2.9
hospitalization
•
Almost 3 million
people in the United
States suffer from
epilepsy
Adjusted RR estimates for Migraine Headache, Santiago
Province, 2001 through 2005.
•
More common in
neighborhood with a
pulp mill
•
In Ottawa, Between
1992 and 2000 daily
headache visits to
emergency dept.
visits increased by
4.9%.
•
In Santiago, daily
2.48 hospitalization
•
Almost 28 million
people in the United
States suffer from
headache
Adjusted RR estimates for Specific Cause Headache,
Santiago Province, 2001 through 2005
Adjusted RR estimates for Cause not specified Headache,
Santiago Province, 2001 through 2005
American Journal of Epidemiol
2009
Air pollution: Sources and health effects
•
•
•
•
•
Air pollution effect on
neurological diseases

Epilepsy

Headache
Venous thrombosis and
pulmonary embolism
Diabetes
Exercise capacity
•
•
•
Does traffic counts reflects
more accurately traffic
related pollution?
Does health effects
modified by socioeconomics?
Which source produce most
toxic component of
particulate matter?
Interaction with
aeroallergens
8
Pooled city estimates of relative risk and 95% CI of hospitalization associated with
changes in pollutant concentrations equivalent to their IQR, Santiago 2001-2005
O3
O3
SO2
CO
NO2
CO
SO2
PM10
PM2.5
5
6
1.00
1.00
PM10
PM2.5
1.10
1.10
NO2
1
2
3
4
5
6
1
2
Venous thrombosis
O3
NO2
PM2.5
SO2
PM10
4
5
NO2
CO
PM10
PM2.5
5
6
SO2
0.96
0.98
1.02
1.02
CO
4
Pulmonary embolism
1.06
1.08
O3
3
1
2
3
Venous thrombosis Multi
6
1
2
3
4
Pulmonary embolism Multi
• Daily 2.3
admissions
• In USA
600,000
hospitalized
each year
Journal of
Thrombosis
and
Haemostasis,
8: 669–674,
2011
Air pollution: Sources and health effects
•
•
•
•
•
Air pollution effect on
neurological diseases

Epilepsy

Headache
Venous thrombosis and
pulmonary embolism
Diabetes
Exercise capacity
•
•
•
Does traffic counts reflects
more accurately traffic
related pollution?
Does health effects
modified by socioeconomics?
Which source produce most
toxic component of
particulate matter?
Interaction with
aeroallergens
10
PM2.5
NO2
SO2
PM10
PM2.5
5
6
1.0
2
3
4
5
6
1
2
3
Males
1.4
PM10
4
5
6
2
3
4
5
6
Age 75-84
1.8
1.6
1.4
1.3
1.4
PM2.5
PM10
CO
SO2
1.0
1.0
1.1
1.2
1.2
PM2.5
1
2
3
4
Apr-Sep
5
6
O3
4
5
NO2
PM2.5
1
2
1
2
3
6
Environment International 2012, 46,
1–5
O3
PM10
PM10
CO
Age > 85
NO2
SO2
SO2
6
• Daily 1.79
hosp.
• In Chile, 11%
of population
between age
of 45-64
• In USA, 25.8
million
people have
diabetes
1.0
1
O3
NO2
5
1.2
1.2
CO
1.0
3
4
3
PM2.5
SO2
NO2
Age 65-64
CO
2
1.6
PM2.5
1.0
2
PM10
1.4
1.2
PM10
0.8
1
1
1.8
1.8
O3
SO2
NO2
SO2
Age < 64
1.6
1.4
4
Females
O3
CO
O3
PM2.5
1.0
1.1
1.0
0.9
1
NO2
CO
1.1
O3
1.3
O3
CO
1.2
PM10
1.2
SO2
1.3
NO2
CO
1.1
1.2
1.3
Pooled estimates of RR of hospitalization for diabetic ketoacidosis and coma
associated with IQR changes of air pollution. Santiago Province 2001 through
2008.
3
4
Oct-Mar
5
6
Air pollution: Sources and health effects
•
•
•
•
•
Air pollution effect on
neurological diseases

Epilepsy

Headache
Venous thrombosis and
pulmonary embolism
Diabetes
Exercise capacity
•
•
•
Does traffic counts reflects
more accurately traffic
related pollution?
Does health effects
modified by socioeconomics?
Which source produce most
toxic component of
particulate matter?
Interaction with
aeroallergens
12
Change in physiologic characteristic for an IQR change in ambient air pollution
concentration. Results are adjusted for smoking, income, age, sex and education,
5011 people in CHMS.
1.0
NO2
2.0
NO2
2.0
Ozone
1.5
NO2
1.0
PM2.5
Ozone
1.0
1.5
2.0
2.5
3.0
0.5
1.0
Resting Heart rate (per minute)
1.5
2.0
2.5
3.0
NO2
0.5
0.5
2.0
2.5
PM2.5
Ozone
-0.2
-0.6
0.0
PM2.5
-1.0
1.0
1.5
2.0
2.5
3.0
1.0
1.5
2.0
2.5
3.0
1.0
3.0
1.5
2.0
2.5
3.0
FEV1/FVC (% predicted)
NO2
Ozone
Ozone
-6
-4
Ozone
1.5
2.0
2.5
Immediate post-exercise heart rate/min (n=3789)
3.0
-8
0.95
1.0
PM2.5
-2
NO2
PM2.5
1.00
PM2.5
0
1.05
2
4
1.10
FVC (% predicted)
-1.0
0.0 0.5 1.0 1.5 2.0
FEV1 (% predicted)
NO2
• 15 of 257
sites are
selected
• Total of 5604
people were
enrolled
• 5011
NO2
spirometry
and 3789 ha
exercise
-1.0
-1.5
-0.5
-0.5
NO2
1.5
Resting Diastolic blood pressure (mmHg)
Ozone
PM2.5
1.0
Resting Systolic blood pressure (mmHg)
Ozone
PM2.5
0.0
-0.5
0.0
0.5
0.0
1.0
PM2.5
0.2
0.5
1.5
Ozone
1.0
1.5
2.0
2.5
Final stepping stage (n=3789)
3.0
1.0
1.5
2.0
2.5
Aerobic fitness score (n=3789)
3.0
Environmental
Research 2011
1309–1312
Air pollution: Sources and health effects
•
•
•
•
•
Air pollution effect on
neurological diseases

Epilepsy

Headache
Venous thrombosis and
pulmonary embolism
Diabetes
Exercise capacity
•
•
•
Does traffic counts reflects
more accurately traffic
related pollution?
Does health effects
modified by socioeconomics?
Which source produce most
toxic component of
particulate matter?
Interaction with
aeroallergens
14
Canada
Air Pollution Concentrations
mean concentrations of aeroallergens
CO
PM10
CO
NO2
SO2
High
High
Low
High
Low
Low
Low
High
Low
Basidiomycetes
Low
1.1
Low
1.0
1.1
PM10
Low
Low
1.0
PM2.5
High
Low
Ascomycetes
PM10
High
1.2
1.2
High
High
Low
SO2
High
High
Low
NO2
1.3
1.3
High
High
CO
PM10
1.4
1.4
1.5
Percent change in daily hospitalization and 95%CI with an increase in allergen
concentrations equal to their pooled IQR
Deuteromycetes
Trees Weeds
J Allergy Clin Immunol 2012;129:228-31
Air pollution: Sources and health effects
•
•
•
•
•
Air pollution effect on
neurological diseases

Epilepsy

Headache
Venous thrombosis and
pulmonary embolism
Diabetes
Exercise capacity
•
•
•
Does traffic counts reflects
more accurately traffic
related pollution?
Does health effects
modified by socioeconomics?
Which source produce most
toxic component of
particulate matter?
Interaction with
aeroallergens
18
1
2
3
1.0
1.1
1.1
1.2
Asthma
Cold.Cough
Any.Symptom
1.3
5
Turning movement Counts 0700HR-1900HR
6
7
1
2
3
1.0
1.1
1.3
Truck turning movement Counts
4
5
Turning movement counts 0700HR -1000HR
6
6
7
7
1
2
4
5
Turning movement counts 1100HR-1400HR
6
Chest.Illness
Chest.Cong
Wheeze
3
Wheeze.with.Dyspnoea
Asthma
Cold.Cough
1.3
Chest.Illness
Any.Symptom
1.2
5
Chest.Cong
Wheeze
Asthma
Cold.Cough
Any.Symptom
1.2
4
Chest.Illness
1.1
Chest.Illness
Wheeze.with.Dyspnoea
3
Chest.Cong
2
Wheeze
1
Wheeze.with.Dyspnoea
7
Asthma
Simple traffic Counts over 24-hours
Cold.Cough
6
Any.Symptom
1.0
Wheeze
5
Chest.Cong
Wheeze.with.Dyspnoea
1.3
4
1.3
1.2
Any.Symptom
3
1.2
1.1
Asthma
1.0
Cold.Cough
0.9
2
Chest.Illness
4
Chest.Cong
Wheeze
1.0
1
Wheeze.with.Dyspnoea
0.9
The odds ratios and 95% CI between traffic counts within 200 meters of the
neighboured and resp symptoms among 15128 Windsor public school students in
grades 4-6.
7
FEV1
eNO3
0.5
FVC
0.0
-0.5
-1.0
-1.0
-0.5
-0.5
0.0
FVC
FEV1
eNO3
0.5
FVC
0.0
FEV1
eNO3
0.5
1.0
1.0
Change in respiratory function for an IQR change in traffic counts.1528 children.
1.0
1.5
2.0
2.5
3.0
1.0
1.5
2.0
2.5
3.0
Turning movement counts 0700HR -1000HR
eNO3
0.4
FVC
FEV1
-0.4
-0.2
0.0
0.2
eNO3
FVC
FEV1
0.0
-0.8
-0.6
-0.5
1.0
1.5
2.0
2.5
Turning movement Counts 0700HR-1900HR
3.0
1.0
1.5
2.0
2.5
1.0
1.5
2.0
2.5
Turning movement counts 1100HR-1400HR
0.5
Simple traffic Counts over 24-hours4
3.0
Truck turning movement Counts 0700HR-1900HR
3.0
eNO3
eNO3
-2
-2
-2
FVC
FEV1
FVC
0
0
FEV1
0
FVC
FEV1
2
2
2
4
4
4
eNO3
6
6
Change in respiratory function for an IQR change in traffic counts among those
with a previous diagnosis of asthma, (275 students)
1.0
1.5
2.0
2.5
3.0
1.0
2.0
2.5
3.0
1.0
1.5
2.0
2.5
3.0
eNO3
4
Turning movement counts 1100HR-1400HR
FEV1
FVC
Environment International 2012,
39, 128–132
-2
-1
-2
0
1
FVC
FEV1
0
2
2
3
4
1.5
Turning movement counts 0700HR -1000HR
eNO3
Simple traffic Counts over 24-hours4
1.0
1.5
2.0
2.5
3.0
Turning movement Counts Counts 0700HR-1900HR
1.0
1.5
2.0
2.5
3.0
Truck turning movement Counts 0700HR-1900HR
Air pollution: Sources and health effects
•
•
•
•
•
Air pollution effect on
neurological diseases

Epilepsy

Headache
Venous thrombosis and
pulmonary embolism
Diabetes
Exercise capacity
•
•
•
Does traffic counts reflects
more accurately traffic
related pollution?
Does health effects
modified by socioeconomics?
Which source produce most
toxic component of
particulate matter?
Interaction with
aeroallergens
22
Relative Risk of Mortality from Air Pollutants by Level of
Education, Santiago,
Relative Risk of Mortality from Air Pollutants by Income
Relative Risk of Mortality from Air Pollutants by Employment
Status
Relative Risks among Lowest Income and Education
Elderly
Environmental Research 2011 388–393
Air pollution: Sources and health effects
•
•
•
•
•
Air pollution (AP) effect on
neurological diseases

Epilepsy

Headache
Venous thrombosis and
pulmonary embolism
Diabetes
Exercise capacity
•
•
•
Does traffic counts reflects
more accurately traffic
related pollution?
Does health effects
modified by socioeconomics?
Which source produce most
toxic component of
particulate matter?
Interaction with
aeroallergens
27
Mortality: Single pollutant model - Total
EC
1.08
Cu
OC
Ca
1.06
Zn
Fe
1.04
1.02
1.00
0.98
Relative risk
K
Mn
S
Si
Al
Br
Cl
Pb
Ni
Cr
Na
Se
Element loadings of the factors
Si
0.8
CO
Br
Al
Ca
NO2 EC
Pb
Mn
OC
Zn
Fe
Fe
Cl
Cu
0.0
0.2
0.4
0.6
Cr
Data from Santiago , Chile between
1998 and 2006.
Factor effects - Total
1.5
Total
TotalM
TotalF
Total<64 Tot6574 Tot7584 Total>85
Card
Resp
1.3
1.2
1
1
2 3
1
1
1.1
1
1
2 3
2 3
2 3
4
2 3
4
4
1
2 3
4
2 3
1
2
4
2 3
4
4
3
4
4
1.0
Relative risk
1.4
1
0
INT J OCCUP ENVIRON HEALTH
15:152–158
Mechanisms
• Air pollution generate inflammatory mediators in the lungs which
then circulate, influencing vascular function and blood-brain
barrier function.
• Trigeminovascular reflex may lead to peptide release, and
subsequent inflammation , vasodilation and pain from
headaches.
• Studies supporting an adverse effect of traffic-related air
pollution on hospitalization and death from stroke and heart
attack suggesting that air pollution influencing coagulation.
• AP can trigger oxidative stress and inflammation of adipose
tissue (in mice) and that might increase insulin resistance (
inhibits insulin responsiveness), and thus increasing
hospitalization for diabetes on days with higher air pollution.
31
Mechanisms
•
•
•
•
Ability to exercise depends on the ventilatory and gasexchanging capacity of lungs, and the heart and vessels
delivering oxygen to cells to produce energy. Inflammation
and oxidative stress can narrow bronchial airway and
decrease arterial oxygenation.
AP might increase mucosal permeability and thereby
penetration of allergens.
Metals might enhance the allergic response.
Traffic pollution include the mixture of motor vehicle
products, asphalt, rubber etc and traffic count may capture
this composite better than any single pollutant.
32
Summary
•
•
•
•
AP influence mortality and morbidity.
Elemental carbon (EC) had the strongest effect which
persisted despite adjustment for other elements
Elemental carbon is considered to be a marker of motor
vehicle traffic and may be more indicative of traffic than
organic carbon. This suggests that the traffic-sourced
pollution mix are toxic.
Air pollution can be modified through legislation. This
observation should be considered when calculating the
health burden and costs to society of air pollution.
33
Summary
• The burden of mortality due to short term changes in
air pollution is disproportionately experienced by those
who are elderly, have lower educational attainment,
live in areas of lower income, and especially those who
are poor and elderly.
• These findings suggest that the determination of air
quality guidelines designed to protect the general
population may be insufficient to protect the elderly
and those with lower income and educational
attainment.
• Decreasing air pollution levels might reduce the
severity of allergic asthma
Next Steps
•
We investigated Climate change and Temperature relaed mortalti in
Canada. Int J Biometeorol (2012) 56:605–619

Further investigate the relative risk of mortality (RR) due to air pollution,
and determine which combination of atmospheric conditions pose a
greater health threat in multiple age groups (weather, air pollution
interactions)

Examine by season, age, pollutant and weather type
35
Spatial Synoptic Classificationa (SSC)
• SSC = semi-automated daily air mass classification system; based on 4
daily measurements of air pressure, temperature, dew point, cloud
cover, and wind velocity
SEVEN SSC CATEGORIES:
• Dry Moderate (DM)
• Dry Polar (DP)
• Dry Tropical (DT)
•
•
•
•
Moist Moderate (MM)
Moist Polar (MP)
Moist Tropical (MT)
Transition (TR) – frontal passage
Model:
•
piece-wise Poisson General Linear Model to estimate relative risks associated
with air pollution and weather type
aSheridan
(2002), http://sheridan.geog.kent.edu/ssc.html
Age Effect Example: Nitrogen Dioxide Estimates
• In all air masses excluding MT
and DT, the elderly >85 years
are significantly more likely to
die of air pollution
• The same result was found for
Carbon Monoxide and Sulphur
Dioxide
• Ozone did not have significant
differences by age
37
VOC’s
Explanatory analysis
Date:
188 VOC’s from Windsor
Principle component
Cyan= indoor, dark
orange= outdoor.
39
By Season and garage type
Outdoor:
Skyblue= winter, orange = summer.
Indoor Summer
Red= attached garage, blue= no
garage, green= detached garage.
40
THANK YOU.
41