Case-Crossover Analysis of Air Pollution Health Effects: A Systematic Review of Methodology and Application

Case-crossover is one of the most used designs for analyzing the health-related effects of air pollution. Nevertheless, no one has reviewed its application and methodology in this context. Objective: We conducted a systematic review of case-crossover (CCO) designs used to study the relationship between air pollution and morbidity and mortality, from the standpoint of methodology and application.Data sources and extraction: A search was made of the MEDLINE and EMBASE databases.Reports were classified as methodologic or applied. From the latter, the following information was extracted: author, study location, year, type of population (general or patients), dependent variable(s), independent variable(s), type of CCO design, and whether effect modification was analyzed for variables at the individual level. Data synthesis: The review covered 105 reports that fulfilled the inclusion criteria. Of these, 24 addressed methodological aspects, and the remainder involved the design’s application. In the methodological reports, the designs that yielded the best results in simulation were symmetric bidirectional CCO and time-stratified CCO. Furthermore, we observed an increase across time in the use of certain CCO designs, mainly symmetric bidirectional and time-stratified CCO. The dependent variables most frequently analyzed were those relating to hospital morbidity; the pollutants most often studied were those linked to particulate matter. Among the CCO-application reports, 13.6% studied effect modification for variables at the individual level.Conclusions: The use of CCO designs has undergone considerable growth; the most widely used designs were those that yielded better results in simulation studies: symmetric bidirectional and time-stratified CCO. However, the advantages of CCO as a method of analysis of variables at the individual level are put to little use

Relation between the level of self-mutilation and theconcentration of fecal metabolites of glucocorticoids incaptive chimpanzees (Pan troglodytes)

The influence of stress in an environment, according with the behavioral and endocrine variables of primates, are increasingly being studied by a diversity of authors, and have shown that abnormal behaviors associated with increased glucocorticoids may be directly related with the impairment of their well-being. In this work were used 22 adult chimpanzees (Pan troglodytes), 11 males and 11 females, kept in captivity in three different institutions. All animals had their behavior registered by focal session using a 30 seconds sample interval, during six months, totaling 4,800 registries per each animal. During this period, fecal samples were collected 3 times a week for the extraction and measurement of the concentration of fecal metabolites of glucocorticoid by radioimmunoassay. Of the total observed, stereotypical behaviors represented 13,45±2.76%, and among them, self-mutilation represented 38.28±3.98 %. The animals were classified into three different scores, according with the percentage of body surface with alopecia due to self-mutilation. It was found a positive correlation of high intensity between the scores of alopecia due to the observed mutilation and the average concentrations of fecal metabolites of glucocorticoids. This result strongly suggests that this measurement of self-mutilation in a chimpanzee can be used as an important auxiliary tool to evaluate de conditions of adaptation of an animal in captivity, functioning as a direct indicator of the presence of chronic stress.

Effect of air pollution on pediatric respiratory emergency room visits and hospital admissions

In order to assess the effect of air pollution on pediatric respiratory morbidity, we carried out a time series study using daily levels of PM10, SO2, NO2, ozone, and CO and daily numbers of pediatric respiratory emergency room visits and hospital admissions at the Children's Institute of the University of São Paulo Medical School, from August 1996 to August 1997. In this period there were 43,635 hospital emergency room visits, 4534 of which were due to lower respiratory tract disease. The total number of hospital admissions was 6785, 1021 of which were due to lower respiratory tract infectious and/or obstructive diseases. The three health end-points under investigation were the daily number of emergency room visits due to lower respiratory tract diseases, hospital admissions due to pneumonia, and hospital admissions due to asthma or bronchiolitis. Generalized additive Poisson regression models were fitted, controlling for smooth functions of time, temperature and humidity, and an indicator of weekdays. NO2 was positively associated with all outcomes. Interquartile range increases (65.04 µg/m³) in NO2 moving averages were associated with an 18.4% increase (95% confidence interval, 95% CI = 12.5-24.3) in emergency room visits due to lower respiratory tract diseases (4-day moving average), a 17.6% increase (95% CI = 3.3-32.7) in hospital admissions due to pneumonia or bronchopneumonia (3-day moving average), and a 31.4% increase (95% CI = 7.2-55.7) in hospital admissions due to asthma or bronchiolitis (2-day moving average). The study showed that air pollution considerably affects children's respiratory morbidity, deserving attention from the health authorities.

Quantification of fecal estradiol and progesterone metabolites in Syrian hamsters (Mesocricetus auratus)

Alternative methods to the utilization of laboratory animal blood and its by-products are particularly attractive, especially regarding hamsters due to their small size and difficulties in obtaining serial blood samples. Steroid hormone metabolite quantification in feces, widely used in studies of free-ranging or intractable animals, is a non-invasive, non-stressor, economical, and animal saving technique which allows longitudinal studies by permitting frequent sampling of the same individual. The present study was undertaken to determine the suitability of this method for laboratory animals. Estradiol and progesterone metabolites were quantified by radioimmunoassay in feces of intact, sexually mature female Syrian hamsters during the estrous cycle (control) and in feces of superovulated females. Metabolites were extracted by fecal dilution in ethanol and quantified by solid phase radioimmunoassay. Median estrogen and progesterone concentrations were 9.703 and 180.74 ng/g feces in the control group, respectively. Peaks of estrogen (22.44 ± 4.54 ng/g feces) and progesterone (655.95 ± 129.93 ng/g feces) mean fecal concentrations respectively occurred 12 h before and immediately after ovulation, which is easily detected in this species by observation of a characteristic vaginal postovulatory discharge. Median estrogen and progesterone concentrations (28.159 and 586.57 ng/g feces, respectively) were significantly higher in superovulated animal feces (P < 0.0001). The present study demonstrated that it is possible to monitor ovarian activity in Syrian hamsters non-invasively by measuring fecal estradiol and progesterone metabolites. This technique appears to be a quite encouraging method for the development of new endocrinologic studies on laboratory animals.

Effect of air pollution on diabetes and cardiovascular diseases in São Paulo, Brazil

Type 2 diabetes increases the risk of cardiovascular mortality and these patients, even without previous myocardial infarction, run the risk of fatal coronary heart disease similar to non-diabetic patients surviving myocardial infarction. There is evidence showing that particulate matter air pollution is associated with increases in cardiopulmonary morbidity and mortality. The present study was carried out to evaluate the effect of diabetes mellitus on the association of air pollution with cardiovascular emergency room visits in a tertiary referral hospital in the city of São Paulo. Using a time-series approach, and adopting generalized linear Poisson regression models, we assessed the effect of daily variations in PM10, CO, NO2, SO2, and O3 on the daily number of emergency room visits for cardiovascular diseases in diabetic and non-diabetic patients from 2001 to 2003. A semi-parametric smoother (natural spline) was adopted to control long-term trends, linear term seasonal usage and weather variables. In this period, 45,000 cardiovascular emergency room visits were registered. The observed increase in interquartile range within the 2-day moving average of 8.0 µg/m³ SO2 was associated with 7.0% (95%CI: 4.0-11.0) and 20.0% (95%CI: 5.0-44.0) increases in cardiovascular disease emergency room visits by non-diabetic and diabetic groups, respectively. These data indicate that air pollution causes an increase of cardiovascular emergency room visits, and that diabetic patients are extremely susceptible to the adverse effects of air pollution on their health conditions.

Economic Impacts Of Air Pollution on Human Health and Property Values

The objectives of the present study are to provide a systematic descriptive documentation of the nature of air pollution of the Cochin industrial agglomeration, estimate the willingness to pay for morbidity reduction due to air pollution in observed and hypothetical markets and to estimate the value of welfare loss in the purchase of property due to reduced air quality. This study is an attempt to examine economic impacts of air pollution on the human health and property values in the industrial capital of Kerala. The process of industrialization in Kerala and the increase in air pollution created damages to human, natural and economic resources in the state. The study documents the extent of air pollution and applied econometric approaches to estimate economic impacts of air pollution on human health and property values. The Important sources of air pollution identified in Cochin are emissions from industries and automobiles.

Legal Control of Industrial Pollution

Industries constitute the main spring of development. Without industrial development no country could reach a stage in which a decent living for its citizens would be achieved. Increasing production to meet the basic needs of society augmented scientific invention and machine oriented industrial order.Environmental pollution ls a burning global issue. It is more serious and dangerous than terrorism. Started with the discovery of fire and development of civilization. Pollution went unnoticed throughout the centuries of human growth until its adverse effects on human environment become explicit.National concern tor environment started in our country only atter the cause of protection of environment received global attention. At present legal control ot industrial pollution is in a scattered framework of piece meal processes with overlapping provisions and authorities.Environmental protection- should be an item not only in the concurrent list of schedule 7 to the Constitution but also in the list of matters entrusted to the panchayati institutions in the Schedule 11. It is heartening to note that so far as municipalities are concerned the Constitution of India lives up to the expectation. In the wake of New Industrial Policy based on liberalisation a long list of small scale industries fall outside the purview of environmental clearance. The Indian concept of environmental im»act assessment introduced under the Environment Act by notification excludes the entire gamut of small scale industries and r.elates only to scheduled industries covered by the notifica~ion. Most of them are subjected to ETA only it the investment goes above ~.50 crores. This provision dilutes the impact assessment considerably A mandatory impact assessment with public partiCipation and with provision for a review by specialized environmental courts will eliminate the possible evils of this judicial passiveness.

Studies on the meteriological aspects of air pollution over Cochin

Pollutants that once enter into the earth’s atmosphere become part of the atmosphere and hence their dispersion, dilution, direction of transportation etc. are governed by the meteorological conditions. The thesis deals with the study of the atmospheric dispersion capacity, wind climatology, atmospheric stability, pollutant distribution by means of a model and the suggestions for a comprehensive planning for the industrially developing city, Cochin. The definition, sources, types and effects of air pollution have been dealt with briefly. The influence of various meteorological parameters such as vector wind, temperature and its vertical structure and atmospheric stability in relation to pollutant dispersal have been studied. The importance of inversions, mixing heights, ventilation coefficients were brought out. The spatial variation of mixing heights studies for the first time on a microscale region, serves to delineate the regions of good and poor dispersal capacity. A study of wind direction fluctuation, σθ and its relation to stability and mixing heights were shown to be much useful. It was shown that there is a necessity to look into the method of σθ computation. The development of Gausssian Plume Model along with the application for multiple sources was presented. The pollutant chosen was sulphur dioxide and industrial sources alone were considered. The percentage frequency of occurrence of inversions and isothermals are found to be low in all months during the year. The spatial variation of mixing heights revealed that a single mixing height cannot be taken as a representative for the whole city have low mixing heights and monsoonal months showed lowest mixing heights. The study of ventilation co-efficients showed values less than the required optimum value 6000m2/5. However, the low values may be due to the consideration of surface wind alone instead of the vertically averaged wind. Relatively more calm conditions and light winds during night and strong winds during day time were observed. During the most of the year westerlies during day time and northeasterlies during night time are the dominant winds. Unstable conditions with high values of σθ during day time and stable conditions with lower values of σθ during night time are the prominent features. Monsoonal months showed neutral stability for most of the time. A study σθ of and Pasquill Stability category has revealed the difficulty in giving a unique value of for each stability category. For the first time regression equations have been developed relating mixing heights and σθ. A closer examination of σθ revealed that half of the range of wind direction fluctuations is to be taken, instead of one by sixth, to compute σθ. The spatial distribution of SO2 showed a more or less uniform distribution with a slight intrusion towards south. Winter months showed low concentrations contrary to the expectations. The variations of the concentration is found to be influenced more by the mixing height and the stack height rather than wind speed. In the densely populated areas the concentration is more than the threshold limit value. However, the values reported appear to be high, because no depletion of the material is assumed through dry or wet depositions and also because of the inclusion of calm conditions with a very light wind speed. A reduction of emission during night time with a consequent rise during day time would bring down the levels of pollution. The probable locations for the new industries could be the extreme southeast parts because the concentration towards the north falls off very quickly resulting low concentrations. In such a case pollutant spread would be towards south and west, thus keeping the city interior relatively free from pollution. A more detailed examination of the pollutant spread by means of models that would take the dry and wet depositions may be necessary. Nevertheless, the present model serves to give the trend of the distribution of pollutant concentration with which one can suggest the optimum locations for the new industries

Environomics - A Financial Estimate of Environmental Pollution Control and Abatement Schemes in Eloor-Edayar Industrial Belt

The present study consists of nine chapters including the introductory chapter. Chapter II makes a brief review of environmental literature and examines various measures adopted at the global level to protect the environment. The environmental problems often transgress national sovereignity and geographical boundaries. Therefore, attempts must be made at the national and international levels to protect the environment, the resources of which are the common property of mankind. The protection of the national environment from the ancient till the present forms the content of Chapter III. These chapters together provide a background to understand the issues analysed in the subsequent chapters. Carefully worked out theoretical framework is a pre-requisite for the successful study of a complex subject. Some of the theoretical issues of ‘environomics’ are examined in Chapter IV. The theoretical issues involved in estimating the costs and benefits of environmental protection constitute the theme of Chapter V. The state of environment in Eloor-Edayar Industrial belt andthe impact analysis of pollution of the area are discussed in Chapter VI and VII respectively. Chapter VIII makes the financial estimate of environmental protection of the project And finally, Chapter IX presents the findings of the study

Effect of industrial pollution on the benthic communities of a tropical estuary

Cochin backwaters, a tropical barbuilt estuary is well known for its prawn, molluscan and demersal fisheries. Also it formed the dumping area for sewage,235 retting of husks and discharge of effluents from industries located on either side of it. As a result the fishery is being gradually dwindled year after year due to the lowering of the water quality. The effect of industrial polution on the benthic community of this tropical estuary was worked out. An area extending over 21 km from the mouth of the estuary to upstream of industrial belt was selected. Temporal and spatial variations of 16 environmental parameters at 9 stations along the area were monitored monthly during 1981. Benthic fauna of these 9 stations consisted of amphipods , polychaetes, isopods, tanaidaceans, molluscs and other crustaceans (Decapods, Acetes, Alpheids, Balanus, insect larvae, chironomid larvae, cumacea and some fresh water forms ). Apart from these, sea anemone, flat worms, nematodes, sipunculoids, echinoderms and fishes were also encountered. 75 species belonging to 31 faunal groups were identified. Of these 31 groups, amphipods, polychaedes, isopods, tanaidaceans and molluscs were numerically abundant. Rest of the 26 groups (including 13 riverine forms) were found less significant due to their rare occurrence/low numerical abundance. Polychaetes and molluscs were the only major groups present at all the stations.