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1. PM2.5 and cardiovascular diseases: State-of-the-Art review

Author

Chayakrit Krittanawong, Yusuf Kamran Qadeer, Richard B. Hayes, Zhen Wang, George D. Thurston, Salim Virani, and Carl J. Lavie

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Air pollution, especially exposure to particulate matter 2.5 (PM2.5), has been associated with an increase in morbidity and mortality around the world. Specifically, it seems that PM2.5 promotes the development of cardiovascular risk factors such as hypertension and atherosclerosis, while being associated with an increased risk of cardiovascular diseases, including myocardial infarction (MI), stroke, heart failure, and arrhythmias. In this review, we seek to elucidate the pathophysiological mechanisms by which exposure to PM2.5 can result in adverse cardiovascular outcomes, in addition to understanding the link between exposure to PM2.5 and cardiovascular events. It is hypothesized that PM2.5 functions via 3 mechanisms: increased oxidative stress, activation of the inflammatory pathway of the immune system, and stimulation of the autonomic nervous system which ultimately promote endothelial dysfunction, atherosclerosis, and systemic inflammation that can thus lead to cardiovascular events. It is important to note that the various cardiovascular associations of PM2.5 differ regarding the duration of exposure (short vs long) to PM2.5, the source of PM2.5, and regulations regarding air pollution in the area where PM2.5 is prominent. Current strategies to reduce PM2.5 exposure include personal strategies such as avoiding high PM2.5 areas such as highways or wearing masks outdoors, to governmental policies restricting the amount of PM2.5 produced by organizations. This review, by highlighting the significant impact between PM2.5 exposure and cardiovascular health will hopefully bring awareness and produce significant change regarding dealing with PM2.5 levels worldwide.

Published
2023
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4. Mapping urban air quality using mobile sampling with low-cost sensors and machine learning in Seoul, South Korea

Author

Chris C. Lim, Ho Kim, M.J. Ruzmyn Vilcassim, George D. Thurston, Terry Gordon, Lung-Chi Chen, Kiyoung Lee, Michael Heimbinder, and Sun-Young Kim

Subjects
Environmental sciences, GE1-350
Abstract

Recent studies have demonstrated that mobile sampling can improve the spatial granularity of land use regression (LUR) models. Mobile sampling campaigns deploying low-cost (

Published
2019
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7. Respiratory Emergency Department Visit Associations with Exposures to Fine Particulate Matter Mass, Constituents, and Sources in Dhaka, Bangladesh Air Pollution

Author

Mostafijur Rahman, George D. Thurston, Philip K. Hopke, Kamrun Nahar, and Bilkis A. Begum

Subjects
Pulmonary and Respiratory Medicine, Air Pollutants, Bangladesh, medicine.medical_specialty, South asia, business.industry, Air pollution, MEDLINE, Emergency department, medicine.disease_cause, complex mixtures, Air Pollution, Environmental health, Epidemiology, medicine, Humans, Particulate Matter, Respiratory system, Child, Emergency Service, Hospital, business, Respiratory health, Aged
Abstract

Rationale: To date, there is no published local epidemiological evidence documenting the respiratory health effects of source specific air pollution in South Asia, where PM2.5 composition is differ...

Published
2022
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8. PM2.5 and Cardiovascular Health Risks

Author

Chayakrit Krittanawong, Yusuf Kamran Qadeer, Richard B. Hayes, Zhen Wang, Salim Virani, George D. Thurston, and Carl J. Lavie

Subjects
General Medicine, Cardiology and Cardiovascular Medicine
Published
2023
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9. Effects of Home Particulate Air Filtration on Blood Pressure

Author

Jonathan D. Newman, Judith S. Hochman, George D. Thurston, Lorna E. Thorpe, Yuhe Xia, Hua Zhong, Timothy T. Roberts, Dalia Walzer, and Terry Gordon

Subjects
Air filtration, Fine particulate, Air pollution, 030204 cardiovascular system & hematology, 010501 environmental sciences, Particulates, medicine.disease_cause, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, Blood pressure, Environmental chemistry, Internal Medicine, medicine, Environmental science, Risk factor, 0105 earth and related environmental sciences
Abstract

Air pollution is a major contributor to cardiovascular morbidity and mortality. Fine particulate matter P =0.01) but a nonsignificant difference in mean diastolic BP (−0.95 mm Hg [95% CI, −2.81 to 0.91]; P =0.32). Subgroup analyses indicated no heterogeneity of effect by age, level of particulate exposure, or study duration. Given the variation in study design, additional study is warranted to confirm and better quantify the observed benefits in systolic BP found with personal air cleaner use.

Published
2020
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10. Outdoor Air Pollution and New-Onset Airway Disease. An Official American Thoracic Society Workshop Report

Author

Isabella Annesi-Maesano, Urmila P. Kodavanti, Frank D. Gilliland, Esteban G. Burchard, Christopher Carlsten, Haneen Khreis, Carl W. White, Rob McConnell, George D. Thurston, Steven R. Kleeberger, Erika Garcia, Joan Reibman, Laura S. Van Winkle, John R. Balmes, Jack R. Harkema, Kent E. Pinkerton, Mary B. Rice, Dave B Peden, Tamara Schikowski, and Stephanie J. London

Subjects
Traffic-Related Pollution, Respiratory System, air pollution, Air pollution, medicine.disease_cause, Pulmonary Disease, Chronic Obstructive, Epidemiology, 2.2 Factors relating to the physical environment, 2.1 Biological and endogenous factors, Child, Lung, Societies, Medical, media_common, Pediatric, Air Pollutants, COPD, Incidence (epidemiology), Age Factors, Causality, Airway disease, Respiratory, Adult, Pulmonary and Respiratory Medicine, Pollution, Chronic Obstructive, medicine.medical_specialty, Chronic Obstructive Pulmonary Disease, media_common.quotation_subject, Clinical Sciences, Pulmonary Disease, Ozone, new-onset airway disease, Medical, Environmental health, medicine, Humans, Climate-Related Exposures and Conditions, Asthma, American Thoracic Society Documents, business.industry, Environmental Exposure, asthma, medicine.disease, United States, respiratory tract diseases, Particulate Matter, Societies, Airway, business
Abstract

Although it is well accepted that air pollution exposure exacerbates preexisting airway disease, it has not been firmly established that long-term pollution exposure increases the risk of new-onset asthma or chronic obstruction pulmonary disease (COPD). This Workshop brought together experts on mechanistic, epidemiological, and clinical aspects of airway disease to review current knowledge regarding whether air pollution is a causal factor in the development of asthma and/or COPD. Speakers presented recent evidence in their respective areas of expertise related to air pollution and new airway disease incidence, followed by interactive discussions. A writing committee summarized their collective findings. The Epidemiology Group found that long-term exposure to air pollution, especially metrics of traffic-related air pollution such as nitrogen dioxide and black carbon, is associated with onset of childhood asthma. However, the evidence for a causal role in adult-onset asthma or COPD remains insufficient. The Mechanistic Group concluded that air pollution exposure can cause airway remodeling, which can lead to asthma or COPD, as well as asthma-like phenotypes that worsen with long-term exposure to air pollution, especially fine particulate matter and ozone. The Clinical Group concluded that air pollution is a plausible contributor to the onset of both asthma and COPD. Available evidence indicates that long-term exposure to air pollution is a cause of childhood asthma, but the evidence for a similar determination for adult asthma or COPD remains insufficient. Further research is needed to elucidate the exact biological mechanism underlying incident childhood asthma, and the specific air pollutant that causes it.

Published
2020
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12. Contributors

Author

Jan Aaseth, Peter Aggett, Antero Aitio, Agneta Åkesson, Maria Albin, Jan Alexander, Christian B.I. Andersen, Ole Andersen, Pietro Apostoli, Michael Aschner, Rowa Bakadlag, Lars Barregard, David C. Bellinger, Ingvar A. Bergdahl, Balazs Berlinger, Alfred Bernard, Carolina Bigert, Poul Bjerregaard, Robyn Blain, Lennart K. Blomqvist, Beatrice Bocca, Stephan Bose-O'Reilly, Karin Broberg, Ronald P. Brown, Esben Budtz-Jørgensen, Samuel W. Caito, Tiffany Carle, Chien-Jen Chen, Xiao Chen, Lung-Chi Chen, C.-H. Selene J. Chou, Mitchell D. Cohen, Max Costa, Giuseppe De Palma, Alison Elder, Carl-Gustaf Elinder, Bengt Fadeel, Obaid M. Faroon, Bruce A. Fowler, Hitomi Fujishiro, Silvia Fustinoni, Lars Gerhardsson, Philippe Grandjean, Per Gustavsson, Yolanda Hedberg, Seiichiro Himeno, Xi Huang, Per A. Hultman, Ivo Iavicoli, Taiyi Jin, Robert L. Jones, Hanna L. Karlsson, Larry S. Keith, Yangho Kim, Catherine B. Klein, Michael Kleinman, David Kotelchuck, Yukinori Kusaka, Philip J. Landrigan, Per E. Leffler, Veruscka Leso, Alex Heng Li, Dominique Lison, Shan Liu, Roberto G. Lucchini, Polina Maciejczyk, Koren K. Mann, Nikki Maples-Reynolds, Michael J. Maroney, Airton C. Martins, Mary S. Matsui, Daphne B. Moffett, Lisbeth Birk Møller, M. Moiz Mumtaz, Makiko Nakano, Benoit Nemery, Koji Nogawa, Gunnar F. Nordberg, Monica Nordberg, Angelica Ortiz, Agneta Oskarsson, Elena A. Ostrakhovitch, Cezary M. Pałczyński, Natalia Pawlas, Daniela Pelclova, Maria Pesonen, K. Michael Pollard, Lothar Rink, Flavia Ruggieri, Patricia Ruiz, Harold H. Sandstead, Tiina Santonen, Kazuhiro Sato, Hiroshi Satoh, Deepak Saxena, Greet Schoeters, Bengt Sjögren, Staffan Skerfving, Donald R. Smith, Dexter W. Sullivan, Daigo Sumi, Hong Sun, Hille Suojalehto, Akiyo Tanaka, Milton Tenenbein, George D. Thurston, Francisco A. Tomei Torres, Muhammet S. Toprak, Carolyn A. Tylenda, Julian F. Tyson, Tomohiro Umemura, Margaret H. Whittaker, Jana Wolf, Wenbo Yan, Robert A. Yokel, and Rudolfs K. Zalups

Published
2022
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13. Long-Term Exposure to Source-Specific Fine Particles and Mortality-A Pooled Analysis of 14 European Cohorts within the ELAPSE Project

Author

Jie Chen, Gerard Hoek, Kees de Hoogh, Sophia Rodopoulou, Zorana J. Andersen, Tom Bellander, Jørgen Brandt, Daniela Fecht, Francesco Forastiere, John Gulliver, Ole Hertel, Barbara Hoffmann, Ulla Arthur Hvidtfeldt, W. M. Monique Verschuren, Karl-Heinz Jöckel, Jeanette T. Jørgensen, Klea Katsouyanni, Matthias Ketzel, Diego Yacamán Méndez, Karin Leander, Shuo Liu, Petter Ljungman, Elodie Faure, Patrik K. E. Magnusson, Gabriele Nagel, Göran Pershagen, Annette Peters, Ole Raaschou-Nielsen, Debora Rizzuto, Evangelia Samoli, Yvonne T. van der Schouw, Sara Schramm, Gianluca Severi, Massimo Stafoggia, Maciej Strak, Mette Sørensen, Anne Tjønneland, Gudrun Weinmayr, Kathrin Wolf, Emanuel Zitt, Bert Brunekreef, and George D. Thurston

Subjects
Technology, SOURCE-APPORTIONMENT, Medizin, Environmental Sciences & Ecology, fine particulate matter (PM), HEART-DISEASE, NO2, complex mixtures, Cohort Studies, Engineering, absolute principal component analysis (APCA), USE REGRESSION-MODELS, PARTICULATE MATTER, Air Pollution, Environmental Chemistry, Humans, SPATIAL VARIATION, Air Pollutants, Science & Technology, COMPONENTS, Engineering, Environmental, source apportionment, General Chemistry, Environmental Exposure, AIR-POLLUTION, fine particulate matter (PM2.5), mortality, Absolute Principal Component Analysis (apca), Fine Particulate Matter (pm2.5), Mortality, Source Apportionment, RISK-FACTORS, HEALTH, Life Sciences & Biomedicine, Environmental Sciences
Abstract

We assessed mortality risks associated with source-specific fine particles (PM2.5) in a pooled European cohort of 323,782 participants. Cox proportional hazard models were applied to estimate mortality hazard ratios (HRs) for source-specific PM2.5identified through a source apportionment analysis. Exposure to 2010 annual average concentrations of source-specific PM2.5components was assessed at baseline residential addresses. The source apportionment resulted in the identification of five sources: traffic, residual oil combustion, soil, biomass and agriculture, and industry. In single-source analysis, all identified sources were significantly positively associated with increased natural mortality risks. In multisource analysis, associations with all sources attenuated but remained statistically significant with traffic, oil, and biomass and agriculture. The highest association per interquartile increase was observed for the traffic component (HR: 1.06; 95% CI: 1.04 and 1.08 per 2.86 μg/m3increase) across five identified sources. On a 1 μg/m3basis, the residual oil-related PM2.5had the strongest association (HR: 1.13; 95% CI: 1.05 and 1.22), which was substantially higher than that for generic PM2.5mass, suggesting that past estimates using the generic PM2.5exposure response function have underestimated the potential clean air health benefits of reducing fossil-fuel combustion. Source-specific associations with cause-specific mortality were in general consistent with findings of natural mortality.

Published
2022
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16. Scientist Civic Engagement and the US EPA’s 'Strengthening Transparency in Regulatory Science' Rule

Author

George D. Thurston

Subjects
Data access, Political science, General Earth and Planetary Sciences, Civic engagement, Regulatory science, Public administration, Transparency (behavior), General Environmental Science, Health data
Abstract

BACKGROUND AND AIM: For decades, vested interests, including tobacco and oil companies, have sought access to data used by observational epidemiologists, even when involving private health data. Th...

Published
2021
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17. The Role of Fossil Fuel Combustion Metals in PM2.5 Air Pollution Health Associations

Author

Lung Chi Chen, Polina Maciejczyk, and George D. Thurston

Subjects
Ammonium bisulfate, particulate matter, Atmospheric Science, Ammonium sulfate, fossil fuel combustion, air pollution, Air pollution, chemistry.chemical_element, particulate matter associated metals, Sulfuric acid, Environmental Science (miscellaneous), Particulates, medicine.disease_cause, Redox, Sulfur, chemistry.chemical_compound, chemistry, Environmental chemistry, Meteorology. Climatology, medicine, ambient metals, Particle, Environmental science, inhalation metals, QC851-999
Abstract

In this review, we elucidate the central role played by fossil fuel combustion in the health-related effects that have been associated with inhalation of ambient fine particulate matter (PM2.5). We especially focus on individual properties and concentrations of metals commonly found in PM air pollution, as well as their sources and their adverse health effects, based on both epidemiologic and toxicological evidence. It is known that transition metals, such as Ni, V, Fe, and Cu, are highly capable of participating in redox reactions that produce oxidative stress. Therefore, particles that are enriched, per unit mass, in these metals, such as those from fossil fuel combustion, can have greater potential to produce health effects than other ambient particulate matter. Moreover, fossil fuel combustion particles also contain varying amounts of sulfur, and the acidic nature of the resulting sulfur compounds in particulate matter (e.g., as ammonium sulfate, ammonium bisulfate, or sulfuric acid) makes transition metals in particles more bioavailable, greatly enhancing the potential of fossil fuel combustion PM2.5 to cause oxidative stress and systemic health effects in the human body. In general, there is a need to further recognize particulate matter air pollution mass as a complex source-driven mixture, in order to more effectively quantify and regulate particle air pollution exposure health risks.

Published
2021

18. Land use regression study in Lanzhou, China: A pilot sampling and spatial characteristics of pilot sampling sites

Author

Jesse D. Berman, George D. Thurston, Michelle L. Bell, Yawei Zhang, Yaqun Zhang, and Lan Jin

Subjects
Atmospheric Science, 010504 meteorology & atmospheric sciences, Elevation, Air pollution, Sampling (statistics), Land cover, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Spatial heterogeneity, Kriging, Statistics, Linear regression, medicine, Environmental science, Spatial analysis, 0105 earth and related environmental sciences, General Environmental Science
Abstract

Background Land use regression (LUR) has been widely used to estimate air pollution exposure in recent epidemiology studies. However, few LUR studies were conducted in China, and even fewer used purposefully designed monitoring networks. The objectives of this study are to obtain preliminary understanding of fine-scale air pollution distributions, and to provide a foundation for a future extended study in Lanzhou, China, a major industrial city. Methods A pilot monitoring network was designed using stratified-random sampling, and purposeful selection in gaps of spatial predictor distributions. Based on this network, NO2 were measured using Palmes tubes for 2 weeks in summer 2015, which were used to develop a pilot LUR model considering spatial information of traffic and population densities, elevation, land cover, and land use. We developed linear regression, kriging models, including ordinary kriging, universal kriging, and compared them using AIC. Results The sampling sites of the pilot monitoring network represented wide ranges of spatial predictors (N = 47). The pilot LUR model explained 71% of the variance in the measured NO2 at the sampling sites. The spatial predictors in the model included road densities, elevation, and district indicator. Predicted NO2 concentrations were higher in the east of the city, which is more developed and has dense road networks. Linear regression model performed better than the kriging models due to the lowest AIC. Conclusions This study developed a pilot monitoring network that can effectively capture variability in spatial characteristics and developed a robust LUR model capturing small-scale spatial variations of air pollution in an understudied area. The predicted and measured NO2 showed substantial spatial heterogeneity that was not captured by the limited government monitors. A future study with extended monitoring network and measurements from more seasons is needed to fully understand the distribution of air pollution in Lanzhou, China.

Published
2019
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19. PM2.5 air pollution and cause-specific cardiovascular disease mortality

Author

Chris C. Lim, George D. Thurston, Yongzhao Shao, Debra T. Silverman, Richard B. Hayes, Yilong Zhang, Kevin R. Cromar, Yikyung Park, Rena R. Jones, Michael Jerrett, Jiyoung Ahn, and Harmony R. Reynolds

Subjects
Male, Epidemiology, 010501 environmental sciences, 01 natural sciences, National Death Index, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Air Pollution, Environmental health, Humans, Medicine, 030212 general & internal medicine, Risk factor, Stroke, Aged, Proportional Hazards Models, 0105 earth and related environmental sciences, Exposure assessment, Air Pollutants, business.industry, Proportional hazards model, Hazard ratio, Environmental Exposure, General Medicine, Middle Aged, medicine.disease, United States, Confidence interval, Cardiovascular Diseases, Relative risk, Female, Particulate Matter, business
Abstract

Background Ambient air pollution is a modifiable risk factor for cardiovascular disease, yet uncertainty remains about the size of risks at lower levels of fine particulate matter (PM2.5) exposure which now occur in the USA and elsewhere. Methods We investigated the relationship of ambient PM2.5 exposure with cause-specific cardiovascular disease mortality in 565 477 men and women, aged 50 to 71 years, from the National Institutes of Health-AARP Diet and Health Study. During 7.5 x 106 person-years of follow up, 41 286 cardiovascular disease deaths, including 23 328 ischaemic heart disease (IHD) and 5894 stroke deaths, were ascertained using the National Death Index. PM2.5 was estimated using a hybrid land use regression (LUR) geostatistical model. Multivariate Cox regression models were used to estimate relative risks (RRs) and 95% confidence intervals (CI). Results Each increase of 10 μg/m3 PM2.5 (overall range, 2.9–28.0 μg/m3) was associated, in fully adjusted models, with a 16% increase in mortality from ischaemic heart disease [hazard ratio (HR) 1.16; 95% CI 1.09-1.22] and a 14% increase in mortality from stroke (HR 1.14; CI 1.02-1.27). Compared with PM2.5 exposure Conclusions Long-term exposure to fine particulate air pollution is associated with ischaemic heart disease and stroke mortality, with excess risks occurring in the range of and below the present US long-term standard for ambient exposure to PM2.5 (12 µg/m3), indicating the need for continued improvements in air pollution abatement for CVD prevention.

Published
2019
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20. Air Pollution and Noncommunicable Diseases

Author

Clayton T. Cowl, Rogelio Pérez-Padilla, Anessa Vanker, Kevin Mortimer, Soon Hee Jung, Akshay Sood, Teresa To, Mary B. Rice, John R. Balmes, Dean E. Schraufnagel, Donald J. Wuebbles, George D. Thurston, Horacio Riojas-Rodríguez, and Sara De Matteis

Subjects
Pulmonary and Respiratory Medicine, Passive smoking, Childhood leukemia, Air pollution, Critical Care and Intensive Care Medicine, medicine.disease_cause, Social support, 03 medical and health sciences, Indoor air quality, 0302 clinical medicine, Environmental health, medicine, 030212 general & internal medicine, Respiratory system, Lung cancer, Air quality index, Pollutant, COPD, Lung, business.industry, respiratory system, Particulates, medicine.disease, respiratory tract diseases, Harm, medicine.anatomical_structure, 030228 respiratory system, Cardiology and Cardiovascular Medicine, business
Abstract

Air pollution poses a great environmental risk to health. Outdoor fine particulate matter (particulate matter with an aerodynamic diameter 103 million disability-adjusted life years lost according to the Global Burden of Disease Report. The World Health Organization attributes 3.8 million additional deaths to indoor air pollution. Air pollution can harm acutely, usually manifested by respiratory or cardiac symptoms, as well as chronically, potentially affecting every organ in the body. It can cause, complicate, or exacerbate many adverse health conditions. Tissue damage may result directly from pollutant toxicity because fine and ultrafine particles can gain access to organs, or indirectly through systemic inflammatory processes. Susceptibility is partly under genetic and epigenetic regulation. Although air pollution affects people of all regions, ages, and social groups, it is likely to cause greater illness in those with heavy exposure and greater susceptibility. Persons are more vulnerable to air pollution if they have other illnesses or less social support. Harmful effects occur on a continuum of dosage and even at levels below air quality standards previously considered to be safe.

Published
2019
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21. Air Pollution Monitoring for Health Research and Patient Care. An Official American Thoracic Society Workshop Report

Author

Erika N Sasser, Steven Pawson, Sean Khan, Edmund Seto, Yang Liu, George D. Thurston, Jennifer K Quint, Kristen Benedict, Alena Bartonova, Rima Habre, Michael Brauer, Kevin R. Cromar, John Volckens, Mary B. Rice, Bryan N. Duncan, John Haynes, David B. Peden, Susan L. Stone, Gayle S.W. Hagler, and Vasu Kilaru

Subjects
Pulmonary and Respiratory Medicine, Satellite Imagery, Emerging technologies, Air pollution, medicine.disease_cause, Patient care, 03 medical and health sciences, 0302 clinical medicine, Air Pollution, Environmental monitoring, Agency (sociology), Medicine, Risk communication, Humans, 030212 general & internal medicine, Environmental planning, Air quality index, Societies, Medical, American Thoracic Society Documents, Air Pollutants, business.industry, United States, 030228 respiratory system, Particulate Matter, Global citizenship, Patient Care, business, Environmental Monitoring
Abstract

Air quality data from satellites and low-cost sensor systems, together with output from air quality models, have the potential to augment high-quality, regulatory-grade data in countries with in situ monitoring networks and provide much-needed air quality information in countries without them. Each of these technologies has strengths and limitations that need to be considered when integrating them to develop a robust and diverse global air quality monitoring network. To address these issues, the American Thoracic Society, the U.S. Environmental Protection Agency, the National Aeronautics and Space Administration, and the National Institute of Environmental Health Sciences convened a workshop in May 2017 to bring together global experts from across multiple disciplines and agencies to discuss current and near-term capabilities to monitor global air pollution. The participants focused on four topics: 1) current and near-term capabilities in air pollution monitoring, 2) data assimilation from multiple technology platforms, 3) critical issues for air pollution monitoring in regions without a regulatory-quality stationary monitoring network, and 4) risk communication and health messaging. Recommendations for research and improved use were identified during the workshop, including a recognition that the integration of data across monitoring technology groups is critical to maximizing the effectiveness (e.g., data accuracy, as well as spatial and temporal coverage) of these monitoring technologies. Taken together, these recommendations will advance the development of a global air quality monitoring network that takes advantage of emerging technologies to ensure the availability of free, accessible, and reliable air pollution data and forecasts to health professionals, as well as to all global citizens.

Published
2019

22. PM2.5 Concentration and Composition in Subway Systems in the Northeastern United States

Author

Jade Hess, George D. Thurston, Colin Gordon, M J Ruzmyn Vilcassim, Amna Raja, Maria Katsigeorgis, Terry Gordon, Rebecca S. Kim, David G. Luglio, Jonathan M. Fine, and John Adragna

Subjects
Transport engineering, 03 medical and health sciences, 0302 clinical medicine, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health, Environmental science, 030212 general & internal medicine, Transit (astronomy), 010501 environmental sciences, 01 natural sciences, Composition (language), Air quality index, 0105 earth and related environmental sciences
Abstract

Objectives: The goals of this study were to assess the air quality in subway systems in the northeastern United States and estimate the health risks for transit workers and commuters. Methods: We r...

Published
2021
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23. Evidence of air pollution exposure and new asthma onset: further justification for cleaner air

Author

George D. Thurston and Alison Lee

Subjects
Pulmonary and Respiratory Medicine, business.industry, Air pollution exposure, Air pollution, medicine.disease, medicine.disease_cause, Asthma, New onset, Environmental health, Air Pollution, medicine, Humans, business, Air quality index
Abstract

Further evidence that new onset asthma can occur from air pollution, even below prevailing air quality standards. It is time the ERS and ATS release a formal statement on the evidence for the link between long-term air pollution and new incident asthma.https://bit.ly/30uAjNN

Published
2021

24. Contributors

Author

Jan Aaseth, Peter Aggett, Antero Aitio, Agneta Åkesson, Maria Albin, Jan Alexander, Christian B.I. Andersen, Ole Andersen, Pietro Apostoli, Michael Aschner, Rowa Bakadlag, Lars Barregard, David C. Bellinger, Ingvar A. Bergdahl, Balazs Berlinger, Alfred Bernard, Carolina Bigert, Poul Bjerregaard, Robyn Blain, Lennart K. Blomqvist, Beatrice Bocca, Stephan Bose-O'Reilly, Karin Broberg, Ronald P. Brown, Esben Budtz-Jørgensen, Samuel W. Caito, Tiffany Carle, Chien-Jen Chen, Xiao Chen, Lung-Chi Chen, C.-H. Selene J. Chou, Mitchell D. Cohen, Max Costa, Giuseppe De Palma, Alison Elder, Carl-Gustaf Elinder, Bengt Fadeel, Obaid M. Faroon, Bruce A. Fowler, Hitomi Fujishiro, Silvia Fustinoni, Lars Gerhardsson, Philippe Grandjean, Per Gustavsson, Yolanda Hedberg, Seiichiro Himeno, Xi Huang, Per A. Hultman, Ivo Iavicoli, Taiyi Jin, Robert L. Jones, Hanna L. Karlsson, Larry S. Keith, Yangho Kim, Catherine B. Klein, Michael Kleinman, David Kotelchuck, Yukinori Kusaka, Philip J. Landrigan, Per E. Leffler, Veruscka Leso, Alex Heng Li, Dominique Lison, Shan Liu, Roberto G. Lucchini, Polina Maciejczyk, Koren K. Mann, Nikki Maples-Reynolds, Michael J. Maroney, Airton C. Martins, Mary S. Matsui, Daphne B. Moffett, Lisbeth Birk Møller, M. Moiz Mumtaz, Makiko Nakano, Benoit Nemery, Koji Nogawa, Gunnar F. Nordberg, Monica Nordberg, Angelica Ortiz, Agneta Oskarsson, Elena A. Ostrakhovitch, Cezary M. Pałczyński, Natalia Pawlas, Daniela Pelclova, Maria Pesonen, K. Michael Pollard, Lothar Rink, Flavia Ruggieri, Patricia Ruiz, Harold H. Sandstead, Tiina Santonen, Kazuhiro Sato, Hiroshi Satoh, Deepak Saxena, Greet Schoeters, Bengt Sjögren, Staffan Skerfving, Donald R. Smith, Dexter W. Sullivan, Daigo Sumi, Hong Sun, Hille Suojalehto, Akiyo Tanaka, Milton Tenenbein, George D. Thurston, Francisco A. Tomei Torres, Muhammet S. Toprak, Carolyn A. Tylenda, Julian F. Tyson, Tomohiro Umemura, Margaret H. Whittaker, Jana Wolf, Wenbo Yan, Robert A. Yokel, and Rudolfs K. Zalups

Published
2021
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26. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author

Soufiane Boufous, Yousef Veisani, Mehran Asadi-Aliabadi, Sharath Burugina Nagaraja, Maziar Moradi-Lakeh, Getachew Mullu Kassa, Edward J Mills, Dimas Ria Angga Pribadi, William James Dangel, Mohamad-Hani Temsah, Catherine O. Johnson, Gregory A. Roth, Giuseppe Gorini, Fariborz Mansour-Ghanaei, Alberto Ortiz, Samad Azari, Assefa Ayalew Ayalew Ayalew Gebreslassie, Salime Goharinezhad, Stephanie R. M. Zimsen, Peng Zheng, Michael Assmus, Elisabetta Pupillo, Bach Xuan Tran, Lal B. Rawal, Narayanaswamy Venketasubramanian, Noushin Mohammadifard, Stephen S Lim, Ata Rafiee, Maria Inês Schmidt, Vincent C. Iannucci, Suzanne Lyn Barker-Collo, Leah E. Cahill, Tauseef Ahmad, Platon D. Lopukhov, Kazumasa Yamagishi, Abdullah Al Mamun, Iqbal R. F. Elyazar, Giovanni Damiani, Mohammad Hossein Bakhshaei, Mehdi Fazlzadeh, Virginia Núñez-Samudio, Alyssa Pennini, Dietrich Plass, Atkilt Esaiyas Etisso, Gebre Teklemariam Demoz, Alexandrea Watson, Arvin Haj-Mirzaian, Paul S Briant, Frank B. Osei, Blair R. Bumgarner, Maciej Banach, Ravensara S. Travillian, Kai-Lan Chang, Shirin Djalalinia, Hasan Yusefzadeh, Silvano Gallus, Seyyed Meysam Mousavi, Bernhard T. Baune, Aaron van Donkelaar, Azeem Majeed, Hans Kromhout, Robert Ancuceanu, Blessing J. Akombi, Pushpendra Singh, Nayu Ikeda, William M. Gardner, Zahid A Butt, Mohammad Abdollahi, Temesgen Yihunie Akalu, Rahman Shiri, Benn Sartorius, Ai-Min Wu, Bing Fang Hwang, Flavia M. Cicuttini, Hiroyasu Iso, Luis Camera, Amin Soheili, Félix Carvalho, Yun Jin Kim, Caleb Mackay Salpeter Irvine, Mehdi Mirzaei-Alavijeh, Iman Halvaei, Saqib Ali, Giulio Castelpietra, Catalina Liliana Andrei, Ali Kazemi Karyani, Parkes J Kendrick, Hamidreza Haririan, Lucas Guimarães Abreu, Mukhammad David Naimzada, Jeff T. Zhao, Samiah Alam, Sorin Hostiuc, Shaun Wen Huey Lee, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Takahiro Tabuchi, Manu Raj Mathur, Søren Thorgaard Skou, Thomas Khaled Dwayne Classen, Reza Heidari-Soureshjani, Massimo Cirillo, Nikita Otstavnov, Mehdi Bohluli, Ruth W. Kimokoti, Animut Tagele Tamiru, Masoumeh Sadeghi, Mohammad Ali Jahani, Itamar S. Santos, Mekdes Tigistu Yilma, Lars Johansson, Arielle Wilder Eagan, Nevine El Nahas, Silvia Schiavolin, Kevin D. Shield, Dinh-Toi Chu, Shiva Borzouei, Paul S. F. Yip, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Deanna Anderlini, Giuseppe Remuzzi, Khalid A Altirkawi, Farahnaz Joukar, Aso Mohammad Darwesh, Ratilal Lalloo, Panniyammakal Jeemon, Rohollah Kalhor, Daniel Youngwhan Cho, Weijia Fu, João Pedro Silva, Rodrigo Sarmiento-Suarez, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Jacob Olusegun Olusanya, José Neves, Gaorui Guo, Tomas Y. Yeheyis, John S. Ji, Charles D. H. Parry, Maryam Ghadimi, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Anna E. Torre, Vinod C Nayak, Jamileh Shadid, Susanne Breitner, Mohammad Khammarnia, Mathilde Touvier, Ensiyeh Jenabi, Hosna Janjani, Floriane Ausloos, Irmina Maria Michalek, Alexandra S. Boon-Dooley, Jessica A. Cruz, Syed Mohamed Aljunid, Abiodun M. Adeoye, André Faro, Bartosz Miazgowski, Jobert Richie Nansseu, Erin C Mullany, Giannina Ferrara, Martin McKee, Emmanuel Peprah, Oommen John, Reza Saeedi, Yasser Vasseghian, Dragos Virgil Davitoiu, Sarah Wulf Hanson, Yingxi Zhao, Omid Shafaat, Ali Rajabpour-Sanati, Farid Najafi, Ana Maria Mantilla Herrera, Fatemeh Rajati, Tarun Gupta, Łukasz Szumowski, Mohammed Ibrahim Mohialdeen Gubari, Peter Njenga Keiyoro, Dharmesh Kumar Lal, Zhi Jiang Zhang, Osayomwanbo Osarenotor, Tanvir M. Huda, Perminder S. Sachdev, Farhad Ghamari, Era Upadhyay, Vivek Kumar, Guoqing Hu, Vinay Nangia, Vladimir Andreevich Korshunov, Saeed Shahabi, Golnaz Heidari, Ashraf Nabhan, Robert C. Reiner, Aziz Rezapour, Justin J. Lang, Rakhi Dandona, Josephine W. Ngunjiri, Anna-Karin Danielsson, André Karch, Filippo Ariani, Ahmed Abdelalim, Masih Tajdini, Stefanos Tyrovolas, Mohamed Hsairi, Jae Il Shin, Jasvinder A. Singh, Meghan D. Mooney, Fiona B. Bennitt, Hesam Alizade, Segun Emmanuel Ibitoye, Pradhum Ram, Soraya Siabani, Evanson Z. Sambala, Reza Malekzadeh, Falk Schwendicke, Lalit Dandona, Masoud Moradi, Molly R Nixon, Roya Mirzaei, Rachel Feldman, Hosni Salem, Alberto L. García-Basteiro, Lorainne Tudor Car, Sharareh Eskandarieh, Ramesh Holla, Ritesh G. Menezes, Taraneh Yousefinezhadi, Hai Quang Pham, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Ali Bijani, Harvey Whiteford, Shanshan Li, Aleksandr Y. Aravkin, Joshua A. Salomon, Franz Castro, Lisa M. Force, Abdilahi Yousuf Yousuf, Mina Anjomshoa, Ken Takahashi, Maigeng Zhou, Telma Zahirian Moghadam, Maseer Khan, Irina Filip, Santi Martini, Randah R. Hamadeh, Somayeh Bohlouli, Joana Morgado-da-Costa, Tim Driscoll, Jingkai Wei, Hermann Brenner, Reza Rawassizadeh, Radoslaw Sierpinski, Saman Esmaeilnejad, Emmanuel Wandera Okunga, Marisa Freitas, Srikanta Banerjee, Feleke Mekonnen Demeke, Shahin Soltani, Naser Mohammad Gholi Mezerji, Reed J D Sorensen, Elena V. Gnedovskaya, Johan Ärnlöv, Ivo Rakovac, Reza Mohammadpourhodki, Hussain Jafari, Atte Meretoja, Yasir Waheed, Fahad Alanezi, Arya Haj-Mirzaian, Sezer Kisa, Jaifred Christian F. Lopez, Khalid F. Alhabib, Basema Saddik, Michael R. Phillips, Vishnu Renjith, Yafeng Wang, Kevan R. Polkinghorne, Liliana G Ciobanu, Jacek Jerzy Jozwiak, Gelin Xu, Richard C. Franklin, Junjie Wu, Thomas R. Hird, Mohammad Zamani, Diana Silva, Fotis Topouzis, Irena Ilic, Jeffrey D. Stanaway, Hadi Pourjafar, Huong Lan Thi Nguyen, Khaled Khatab, Ammas Siraj Mohammed, Ziyad Al-Aly, A. A. Fomenkov, Charlie Ashbaugh, Mowafa Househ, Paul I. Dargan, Endalkachew Worku Mengesha, Shaimaa I. El-Jaafary, Ernoiz Antriyandarti, Iffat Elbarazi, Dara K. Mohammad, Naznin Hossain, Reza Shirkoohi, João M. Furtado, Arash Ziapour, Morteza Jafarinia, M. Mofizul Islam, Anamika Pandey, Ahmed I. Hasaballah, Tanuj Kanchan, Lee Ling Lim, Muktar Omer Omer, Charles D.A. Wolfe, Ulrich O Mueller, Helen Bitew, V. Prakash, Fereshteh Mehri, Randall V. Martin, Claudiu Herteliu, Constance D. Pond, Min Jeong Shin, Morteza Oladnabi, Antonio Maria Borzì, Yousef Mohammad, Yuichiro Yano, Luke D. Knibbs, Kevin S Ikuta, Maryam Mirzaei, Andreea Mirica, Sofia Boston Redford, Siamak Sabour, Mariya Vladimirovna Titova, Davood Anvari, Ghobad Moradi, Jordi Alonso, Shiwei Liu, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Owen R. Cooper, Seyed Sina Naghibi Irvani, Kejia Hu, Hannah J. Henrikson, Sanni Yaya, Robert P. Dellavalle, Chidozie Declan Iwu, Sergey Soshnikov, Jee-Young Jasmine Choi, Satinath Mukhopadhyay, Zabihollah Yousefi, Iman El Sayed, Biresaw Wassihun Alemu, Neeti Kapoor, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nuno Taveira, Masoud Foroutan, Fatemeh Amiri, Mariam Molokhia, Songhomitra Panda-Jonas, Amy E. Peden, Rufus Akinyemi, Ejaz Ahmad Khan, Mostafa Amini-Rarani, J. Becker, Hamidreza Pazoki Toroudi, Ben Lacey, Kidanemaryam Berhe, Simon Yadgir, Spencer L. James, Cory N. Spencer, Aletta E. Schutte, Mu'awiyyah Babale Sufiyan, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Rixing Xu, Jonathan F. Mosser, Josep Maria Haro, Enrico Rubagotti, Anurag Agrawal, Zahiruddin Quazi Syed, Hoa Thi Do, Ettore Beghi, Seyed Mohammad Kazem Aghamir, Abraham Geremew, Alireza Esteghamati, Paramjit Gill, Farzad Jalilian, J. Jason West, Mikhail Sergeevich Zastrozhin, Albertino Damasceno, Bruce Bartholow Duncan, Nazir Fattahi, Daniel Cury Ribeiro, Michael Brauer, Mark A. Stokes, Veincent Christian Filipino Pepito, Lidia Morawska, Fiona J Charlson, Babak Moazen, Dejana Braithwaite, Jonathan M. Kocarnik, Sergio I. Prada, Andrea Farioli, Zahra Atafar, Heather Orpana, Daniela Balzi, Marco Vacante, Rahmatollah Moradzadeh, Jacek A. Kopec, Iván Landires, Robert G. Weintraub, Leonardo Roever, Yannick Béjot, Markus P. Schlaich, Hamed Zandian, Subramanian Senthilkumaran, Klara Dokova, Vahid Alipour, Sowmya J. Rao, Rakesh Ghosh, Omar Mukhtar Salman, Faris Lami, Marcos Roberto Tovani-Palone, Hamid Reza Tohidinik, Seyed Mohammad Riahi, Adnan Kisa, Ghasem Azarian, Caroline Stein, Zulfiqar A. Bhutta, Sinead Langan, Kunihiro Matsushita, Lauren E. Schaeffer, Kathryn H. Jacobsen, Mehdi Naderi, Mehdi Hosseinzadeh, Nizal Sarrafzadegan, Bahram Armoon, Dan J. Stein, Jessica Fanzo, Morenike Oluwatoyin Folayan, Luca Ronfani, Phetole Walter Mahasha, Nicholas J K Breitborde, Adrian Oţoiu, Arash Sarveazad, Marc L. Serre, Mostafa Hosseini, Nicolas Cherbuin, George D. Thurston, Jalal Arabloo, Mokhtar Mahdavi, Andre Rodrigues Duraes, Ana Laura Manda, Ahmed Abualhasan, Nima Rezaei, Yuan-Pang Wang, Theodore Patrick Younker, Alireza Ansari-Moghaddam, Borhan Mansouri, Adam E. Berman, Khezar Hayat, Rosario Cárdenas, Bolajoko O. Olusanya, Tommi Vasankari, Simon I. Hay, Fatemeh Ghaffarifar, Leo Stockfelt, Ai Koyanagi, Giorgia Giussani, Yuming Guo, Sonia Saxena, Deborah Carvalho Malta, Mehedi Hasan, Negar Rezaei, Maja Pasovic, Jukka Takala, Bogdan Oancea, Sare Safi, A. Werdecker, Florian Fischer, Beatriz Paulina Ayala Quintanilla, Muhammad Shahdaat Bin Sayeed, Takeshi Fukumoto, Maha Atout, Brijesh Sathian, Cristina Bosetti, Mitchell T. Wallin, Agegnehu Bante, Helen Ippolito, Anthony Masaka, Chantal Huynh, Justin Lo, Jordan Weiss, Joemer C. Maravilla, Alberto Raggi, Peter W. Gething, Cristiana Abbafati, Daniela Ribeiro, Mohammad Farahmand, Yetunde O. John-Akinola, Isabela M. Benseñor, Emilie R Maddison, John J. McGrath, Salman Khazaei, Scott B. Patten, Jean Jacques Noubiap, Emmanuela Gakidou, Celine M. Barthelemy, Ashish Badiye, George C. Patton, Obinna Onwujekwe, Peter Allebeck, Victor Aboyans, Olayinka Stephen Ilesanmi, Mousa Yaminfirooz, Neeraj Bedi, Nicholas L S Roberts, Joht Singh Chandan, Hans W. Hoek, Usman Iqbal, Nima Hafezi-Nejad, Haley Lescinsky, Naohiro Yonemoto, Ahmad Ghashghaee, Anders Larsson, David C. Schwebel, Milena Ilic, Richard T. Burnett, Yang Liu, Carlo La Vecchia, Felix Akpojene Ogbo, Morteza Naserbakht, Sangram Kishor Patel, Melanie S. Hammer, Prasanna Mithra, Mohammad Amin Bahrami, Kanyin L. Ong, Mona Pathak, Afshin Maleki, Saeid Safiri, Masood Ali Shaikh, Kate Causey, Michael R.M. Abrigo, Jost B. Jonas, Dian Kusuma, Jagadish Rao Padubidri, Mihajlo Jakovljevic, Ali S. Shalash, Abdiwahab Hashi, Ionut Negoi, Nataliya A. Foigt, Andrey Nikolaevich Briko, François Alla, Giuseppe Grosso, Houman Goudarzi, Di H. Cross, Vera Marisa Costa, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Odgerel Chimed-Ochir, Sonia Rodríguez-Ramírez, Bo Norrving, Kerem Shuval, Jacob L. Stubbs, Muhammad Ali, Shuhei Nomura, Man Mohan Mehndiratta, Chisom Joyqueenet Akunna, Abdollah Mohammadian-Hafshejani, Navid Rabiee, Dana Bryazka, Hussen Mohammed, Asadollah Gholamian, Ashley Marks, Rizwan Kalani, Molly E. Herbert, Islam Y. Elgendy, Moritz U. G. Kraemer, Chuanhua Yu, Suzanne Polinder, Pascual R. Valdez, Jennifer Rickard, Kylie Ball, Turki Alanzi, Mohsen Bayati, Hamed Mirzaei, Christopher M Odell, Amira Shaheen, Ziad A. Memish, Thirunavukkarasu Sathish, Michael A. Piradov, Hamed Kalani, Lorenzo Monasta, Christopher S Yilgwan, Desalegn Getnet Demsie, Riaz Uddin, Rizwan Suliankatchi Abdulkader, Vinay Srinivasan, Hamid Ahmadieh, Claudio Alberto Dávila-Cervantes, Raffaele Palladino, Chukwudi A Nnaji, Mika Shigematsu, Stein Emil Vollset, Abbas Sheikhtaheri, Paulo A. Lotufo, Nasir Salam, Binyam Minuye Birihane, Mohammad Ali Mansournia, Tomislav Mestrovic, Samer Hamidi, Rajesh Sagar, Mayowa O. Owolabi, Kara Estep, Ester Cerin, Michael T. Chung, Simon Øverland, Amir Taherkhani, Sheng Chia Chung, Martin Amogre Ayanore, Nikolaos Dervenis, Joan B. Soriano, Tahereh Javaheri, Victor Adekanmbi, Seid Tiku Mereta, Gbenga A. Kayode, Christopher R. Cederroth, Razique Anwer, Rajan Nikbakhsh, Kaja Abbas, Fatemeh Heydarpour, Louisa Degenhardt, Tahiya Alam, Mohammad Miri, Alibek Mereke, David Laith Rawaf, Ippazio Cosimo Antonazzo, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Desta Debalkie Atnafu, Davide Sattin, Moslem Soofi, Edris Hasanpoor, Krittika Bhattacharyya, Mika Kivimäki, Nikolay Ivanovich Briko, Joanna L Whisnant, Christopher J L Murray, Simin Mouodi, Alize J. Ferrari, Damian Santomauro, Katrin Burkart, Tudorel Andrei, Alberto Baldasseroni, Hafiz Ansar Rasul Suleria, Valery L. Feigin, Nauman Khalid, Ewerton Cousin, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Themba G.G. Ginindza, Sadaf G. Sepanlou, Sheikh Mohammed Shariful Islam, Sanjay Basu, Getinet Ayano, Paula Moraga, Soheil Hassanipour, Jason A. Anderson, Catherine Bisignano, Iyad Sultan, Deepak Kumar Pasupula, Keivan Ahmadi, Fariba Dorostkar, Rajeev Gupta, David M. Pereira, Mustafa Z. Younis, Adel Spotin, Rasmus Havmoeller, Yeshambel T. Nigatu, Barthelemy Kuate Defo, Mithila Faruque, Alan D. Lopez, Shailesh Advani, Behshad Naghshtabrizi, Shane D. Morrison, Inga Dora Sigfusdottir, Konrad Pesudovs, Anna Gershberg Hayoon, Raaj Kishore Biswas, Reshmi Bhageerathy, H. Dean Hosgood, Giulia Carreras, Sarika Chaturvedi, James L. Fisher, In-Hwan Oh, G Anil Kumar, Christoph Nowak, Vijay Kumar Chattu, Puja C Rao, Marcel Ausloos, Ali Kabir, Rannveig Sigurvinsdottir, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Rafael Tabarés-Seisdedos, Minh Nguyen, Ashkan Afshin, Payman Salamati, Colin Angus, Mona M. Khater, Ehsan Sadeghi, Mahalaqua Nazli Khatib, Antonio Biondi, Valentin Yurievich Skryabin, Mohsen Abbasi-Kangevari, Andrew T Olagunju, Amir Radfar, Laith J. Abu-Raddad, Marcello Tonelli, Hesam Ghiasvand, Hanne Christensen, Juan Jesus Carrero, Maryam Adabi, Saravanan Muthupandian, Kurt Straif, Hossein Samadi Kafil, Lope H Barrero, Harish Chander Gugnani, Mohammad Fareed, Morteza Shamsizadeh, Jemal Abdu Mohammed, Juan A Rivera, Shai Linn, Saad M.A. Dahlawi, Janni Leung, Shokofeh Maleki, Mohd Anisul Karim, Kamarul Imran Musa, Farshad Pourmalek, Dietrich Rothenbacher, Kiomars Sharafi, Alessandra C. Goulart, Leila Doshmangir, Gabriele Nagel, Helena Manguerra, Olatunji O. Adetokunboh, Srinivasa Vittal Katikireddi, Nermin Ghith, Maha El Tantawi, Awoke Misganaw, Yunquan Zhang, Carl Abelardo T. Antonio, Vahid Rashedi, Mehran Shams-Beyranvand, Bhaskaran Unnikrishnan, Holly E. Erskine, Ann Kristin Knudsen, Marissa B Reitsma, Getayeneh Antehunegn Tesema, Javad Javidnia, Ismael R. Campos-Nonato, Biniyam Sahiledengle Geberemariyam, Godfrey Mutashambara Rwegerera, Alaa Badawi, James Leigh, Morteza Arab-Zozani, Kyle E. Simpson, Muluken Bekele Sorrie, Roghiyeh Faridnia, Vivekanand Jha, Tomasz Miazgowski, Aaron J Cohen, Chukwuma David Umeokonkwo, Alessandra Lugo, Adhanom Gebreegziabher Baraki, Akshaya Srikanth Bhagavathula, Caitlyn Steiner, Gholamreza Roshandel, Cuong Tat Nguyen, Tania G Sánchez-Pimienta, Ahamarshan Jayaraman Nagarajan, Laura Kemmer, Ihoghosa Osamuyi Iyamu, Seyedeh Zahra Masoumi, Vivian Chia-Rong Hsieh, Kris J. Krohn, Phoebe Anne Rhinehart, Sarah Wozniak, Sahar Saeedi Moghaddam, Kate E. LeGrand, Christian Kieling, Vahid Yazdi-Feyzabadi, Robin Room, Zelalem Nigussie Azene, Kelly Cercy, Paul H. Lee, Stanislav S. Otstavnov, Dinesh Bhandari, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Aziz Sheikh, Michellr L. Bell, Marwa Rashad Salem, Kirsten E. Wiens, Emma U.R. Smith, Hassan Abolhassani, Cristiano Piccinelli, Kedir Hussein Abegaz, G.K. Mini, Christian Razo, Manuela L. Ferreira, Diego De Leo, Francesco Saverio Violante, Aristidis Tsatsakis, Zahra Sadat Dibaji Forooshani, Tea Lallukka, Dickson A. Amugsi, Anna Poznańska, Graeme J. Hankey, Kewal Krishan, Maryam Zamanian, Eirini Skiadaresi, Jai K Das, Felix Greaves, Tessa M. Pilz, Sameer Vali Gopalani, Mansour Ghafourifard, M. DeLang, Morteza Mahmoudi, Alton Lu, Brian J. Hall, Ravi Prakash Jha, David Edvardsson, Xiu Ju George Zhao, Farshad Farzadfar, Hadi Hassankhani, Samuel M. Ostroff, Gerhard Sulo, Keyghobad Ghadiri, Neeraj Bhala, Stefan Lorkowski, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Rashid Abdi Guled, Abdallah M. Samy, Roman Topor-Madry, Michal Grivna, Afsaneh Arzani, Ayesha Humayun, Simin Liu, Maryam Khayamzadeh, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Paolo Lauriola, Abbas Mosapour, Sophia Emmons-Bell, Khurshid Alam, Rajat Das Gupta, Matilde Leonardi, Muktar Beshir Ahmed, Jeffrey V. Lazarus, Mohamed M. Gad, Kelly Compton, Leila R Kalankesh, Abdelrahman Ibrahim Abushouk, Mikk Jürisson, Catherine M. Antony, Ali A. Asadi-Pooya, Daniel Diaz, Salman Rawaf, Gina Agarwal, Ted R. Miller, Rebecca Ivers, João Vasco Santos, Savita Lasrado, Abdul Moiz Hafiz, Amir Almasi-Hashiani, Praveen Hoogar, Fares Alahdab, Om P Kurmi, Anbissa Muleta Senbeta, Tomi Akinyemiju, Boris Bikbov, Muhammad Aziz Rahman, Amin Mousavi Khaneghah, Yahya Safari, Guilherme Borges, Carlos A Castañeda-Orjuela, Kenji Shibuya, Bahman Yousefi, Berrin Serdar, Karen M. Tabb, Sonali Kochhar, Till Bärnighausen, Kala M. Mehta, Mostafa Dianatinasab, Arash Etemadi, Melissa Y. Wei, Kiana Ramezanzadeh, Lingkan Barua, Zubair Kabir, Rade Vukovic, Hesham M. Al-Mekhlafi, Shoshana H. Ballew, Miriam Levi, Zainab Samad, Florentino Luciano Caetano dos Santos, Juan Sanabria, Ramu Rawat, Chinwe Juliana Iwu, Gabrielle B. Britton, Colm McAlinden, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Jalil Jaafari, Walter Mendoza, Mahesh P A, Pallab K. Maulik, Ali H. Mokdad, Andre M. N. Renzaho, Milena Santric-Milicevic, Parvaiz A Koul, Foad Abd-Allah, Mihaela Hostiuc, Richard G. Cowden, Ronny Westerman, Meghdad Pirsaheb, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Tampere University, Tays Research Services, Health Sciences, Murray, C. J. L., Aravkin, A. Y., Zheng, P., Abbafati, C., Abbas, K. M., Abbasi-Kangevari, M., Abd-Allah, F., Abdelalim, A., Abdollahi, M., Abdollahpour, I., Abegaz, K. H., Abolhassani, H., Aboyans, V., Abreu, L. G., Abrigo, M. R. M., Abualhasan, A., Abu-Raddad, L. J., Abushouk, A. I., Adabi, M., Adekanmbi, V., Adeoye, A. M., Adetokunboh, O. O., Adham, D., Advani, S. M., Agarwal, G., Aghamir, S. M. K., Agrawal, A., Ahmad, T., Ahmadi, K., Ahmadi, M., Ahmadieh, H., Ahmed, M. B., Akalu, T. Y., Akinyemi, R. O., Akinyemiju, T., Akombi, B., Akunna, C. J., Alahdab, F., Al-Aly, Z., Alam, K., Alam, S., Alam, T., Alanezi, F. M., Alanzi, T. M., Alemu, B. W., Alhabib, K. F., Ali, M., Ali, S., Alicandro, G., Alinia, C., Alipour, V., Alizade, H., Aljunid, S. M., Alla, F., Allebeck, P., Almasi-Hashiani, A., Al-Mekhlafi, H. M., Alonso, J., Altirkawi, K. A., Amini-Rarani, M., Amiri, F., Amugsi, D. A., Ancuceanu, R., Anderlini, D., Anderson, J. A., Andrei, C. L., Andrei, T., Angus, C., Anjomshoa, M., Ansari, F., Ansari-Moghaddam, A., Antonazzo, I. C., Antonio, C. A. T., Antony, C. M., Antriyandarti, E., Anvari, D., Anwer, R., Appiah, S. C. Y., Arabloo, J., Arab-Zozani, M., Ariani, F., Armoon, B., Arnlov, J., Arzani, A., Asadi-Aliabadi, M., Asadi-Pooya, A. A., Ashbaugh, C., Assmus, M., Atafar, Z., Atnafu, D. D., Atout, M. M. W., Ausloos, F., Ausloos, M., Ayala Quintanilla, B. P., Ayano, G., Ayanore, M. A., Azari, S., Azarian, G., Azene, Z. N., Badawi, A., Badiye, A. D., Bahrami, M. A., Bakhshaei, M. H., Bakhtiari, A., Bakkannavar, S. M., Baldasseroni, A., Ball, K., Ballew, S. H., Balzi, D., Banach, M., Banerjee, S. K., Bante, A. B., Baraki, A. G., Barker-Collo, S. L., Barnighausen, T. W., Barrero, L. H., Barthelemy, C. M., Barua, L., Basu, S., Baune, B. T., Bayati, M., Becker, J. S., Bedi, N., Beghi, E., Bejot, Y., Bell, M. L., Bennitt, F. B., Bensenor, I. M., Berhe, K., Berman, A. E., Bhagavathula, A. S., Bhageerathy, R., Bhala, N., Bhandari, D., Bhattacharyya, K., Bhutta, Z. A., Bijani, A., Bikbov, B., Bin Sayeed, M. S., Biondi, A., Birihane, B. M., Bisignano, C., Biswas, R. K., Bitew, H., Bohlouli, S., Bohluli, M., Boon-Dooley, A. S., Borges, G., Borzi, A. M., Borzouei, S., Bosetti, C., Boufous, S., Braithwaite, D., Breitborde, N. J. K., Breitner, S., Brenner, H., Briant, P. S., Briko, A. N., Briko, N. I., Britton, G. B., Bryazka, D., Bumgarner, B. R., Burkart, K., Burnett, R. T., Burugina Nagaraja, S., Butt, Z. A., Caetano dos Santos, F. L., Cahill, L. E., Camera, L. L. A., Campos-Nonato, I. R., Cardenas, R., Carreras, G., Carrero, J. J., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Castro, F., Causey, K., Cederroth, C. R., Cercy, K. M., Cerin, E., Chandan, J. S., Chang, K. -L., Charlson, F. J., Chattu, V. K., Chaturvedi, S., Cherbuin, N., Chimed-Ochir, O., Cho, D. Y., Choi, J. -Y. J., Christensen, H., Chu, D. -T., Chung, M. T., Chung, S. -C., Cicuttini, F. M., Ciobanu, L. G., Cirillo, M., Classen, T. K. D., Cohen, A. J., Compton, K., Cooper, O. R., Costa, V. M., Cousin, E., Cowden, R. G., Cross, D. H., Cruz, J. A., Dahlawi, S. M. A., Damasceno, A. A. M., Damiani, G., Dandona, L., Dandona, R., Dangel, W. J., Danielsson, A. -K., Dargan, P. I., Darwesh, A. M., Daryani, A., Das, J. K., Das Gupta, R., das Neves, J., Davila-Cervantes, C. A., Davitoiu, D. V., De Leo, D., Degenhardt, L., Delang, M., Dellavalle, R. P., Demeke, F. M., Demoz, G. T., Demsie, D. G., Denova-Gutierrez, E., Dervenis, N., Dhungana, G. P., Dianatinasab, M., Dias da Silva, D., Diaz, D., Dibaji Forooshani, Z. S., Djalalinia, S., Do, H. T., Dokova, K., Dorostkar, F., Doshmangir, L., Driscoll, T. R., Duncan, B. B., Duraes, A. R., Eagan, A. W., Edvardsson, D., El Nahas, N., El Sayed, I., El Tantawi, M., Elbarazi, I., Elgendy, I. Y., El-Jaafary, S. I., Elyazar, I. R., Emmons-Bell, S., Erskine, H. E., Eskandarieh, S., Esmaeilnejad, S., Esteghamati, A., Estep, K., Etemadi, A., Etisso, A. E., Fanzo, J., Farahmand, M., Fareed, M., Faridnia, R., Farioli, A., Faro, A., Faruque, M., Farzadfar, F., Fattahi, N., Fazlzadeh, M., Feigin, V. L., Feldman, R., Fereshtehnejad, S. -M., Fernandes, E., Ferrara, G., Ferrari, A. J., Ferreira, M. L., Filip, I., Fischer, F., Fisher, J. L., Flor, L. S., Foigt, N. A., Folayan, M. O., Fomenkov, A. A., Force, L. M., Foroutan, M., Franklin, R. C., Freitas, M., Fu, W., Fukumoto, T., Furtado, J. M., Gad, M. M., Gakidou, E., Gallus, S., Garcia-Basteiro, A. L., Gardner, W. M., Geberemariyam, B. S., Gebreslassie, A. A. A. A., Geremew, A., Gershberg Hayoon, A., Gething, P. W., Ghadimi, M., Ghadiri, K., Ghaffarifar, F., Ghafourifard, M., Ghamari, F., Ghashghaee, A., Ghiasvand, H., Ghith, N., Gholamian, A., Ghosh, R., Gill, P. S., Ginindza, T. G. G., Giussani, G., Gnedovskaya, E. V., Goharinezhad, S., Gopalani, S. V., Gorini, G., Goudarzi, H., Goulart, A. C., Greaves, F., Grivna, M., Grosso, G., Gubari, M. I. M., Gugnani, H. C., Guimaraes, R. A., Guled, R. A., Guo, G., Guo, Y., Gupta, R., Gupta, T., Haddock, B., Hafezi-Nejad, N., Hafiz, A., Haj-Mirzaian, A., Hall, B. J., Halvaei, I., Hamadeh, R. R., Hamidi, S., Hammer, M. S., Hankey, G. J., Haririan, H., Haro, J. M., Hasaballah, A. I., Hasan, M. M., Hasanpoor, E., Hashi, A., Hassanipour, S., Hassankhani, H., Havmoeller, R. J., Hay, S. I., Hayat, K., Heidari, G., Heidari-Soureshjani, R., Henrikson, H. J., Herbert, M. E., Herteliu, C., Heydarpour, F., Hird, T. R., Hoek, H. W., Holla, R., Hoogar, P., Hosgood, H. D., Hossain, N., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Hsairi, M., Hsieh, V. C. -R., Hu, G., Hu, K., Huda, T. M., Humayun, A., Huynh, C. K., Hwang, B. -F., Iannucci, V. C., Ibitoye, S. E., Ikeda, N., Ikuta, K. S., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Inbaraj, L. R., Ippolito, H., Iqbal, U., Irvani, S. S. N., Irvine, C. M. S., Islam, M. M., Islam, S. M. S., Iso, H., Ivers, R. Q., Iwu, C. C. D., Iwu, C. J., Iyamu, I. O., Jaafari, J., Jacobsen, K. H., Jafari, H., Jafarinia, M., Jahani, M. A., Jakovljevic, M., Jalilian, F., James, S. L., Janjani, H., Javaheri, T., Javidnia, J., Jeemon, P., Jenabi, E., Jha, R. P., Jha, V., Ji, J. S., Johansson, L., John, O., John-Akinola, Y. O., Johnson, C. O., Jonas, J. B., Joukar, F., Jozwiak, J. J., Jurisson, M., Kabir, A., Kabir, Z., Kalani, H., Kalani, R., Kalankesh, L. R., Kalhor, R., Kanchan, T., Kapoor, N., Karami Matin, B., Karch, A., Karim, M. A., Kassa, G. M., Katikireddi, S. V., Kayode, G. A., Kazemi Karyani, A., Keiyoro, P. N., Keller, C., Kemmer, L., Kendrick, P. J., Khalid, N., Khammarnia, M., Khan, E. A., Khan, M., Khatab, K., Khater, M. M., Khatib, M. N., Khayamzadeh, M., Khazaei, S., Kieling, C., Kim, Y. J., Kimokoti, R. W., Kisa, A., Kisa, S., Kivimaki, M., Knibbs, L. D., Knudsen, A. K. S., Kocarnik, J. M., Kochhar, S., Kopec, J. A., Korshunov, V. A., Koul, P. A., Koyanagi, A., Kraemer, M. U. G., Krishan, K., Krohn, K. J., Kromhout, H., Kuate Defo, B., Kumar, G. A., Kumar, V., Kurmi, O. P., Kusuma, D., La Vecchia, C., Lacey, B., Lal, D. K., Lalloo, R., Lallukka, T., Lami, F. H., Landires, I., Lang, J. J., Langan, S. M., Larsson, A. O., Lasrado, S., Lauriola, P., Lazarus, J. V., Lee, P. H., Lee, S. W. H., Legrand, K. E., Leigh, J., Leonardi, M., Lescinsky, H., Leung, J., Levi, M., Li, S., Lim, L. -L., Linn, S., Liu, S., Liu, Y., Lo, J., Lopez, A. D., Lopez, J. C. F., Lopukhov, P. D., Lorkowski, S., Lotufo, P. A., Lu, A., Lugo, A., Maddison, E. R., Mahasha, P. W., Mahdavi, M. M., Mahmoudi, M., Majeed, A., Maleki, A., Maleki, S., Malekzadeh, R., Malta, D. C., Mamun, A. A., Manda, A. L., Manguerra, H., Mansour-Ghanaei, F., Mansouri, B., Mansournia, M. A., Mantilla Herrera, A. M., Maravilla, J. C., Marks, A., Martin, R. V., Martini, S., Martins-Melo, F. R., Masaka, A., Masoumi, S. Z., Mathur, M. R., Matsushita, K., Maulik, P. K., Mcalinden, C., Mcgrath, J. J., Mckee, M., Mehndiratta, M. M., Mehri, F., Mehta, K. M., Memish, Z. A., Mendoza, W., Menezes, R. G., Mengesha, E. W., Mereke, A., Mereta, S. T., Meretoja, A., Meretoja, T. J., Mestrovic, T., Miazgowski, B., Miazgowski, T., Michalek, I. M., Miller, T. R., Mills, E. J., Mini, G. K., Miri, M., Mirica, A., Mirrakhimov, E. M., Mirzaei, H., Mirzaei, M., Mirzaei, R., Mirzaei-Alavijeh, M., Misganaw, A. T., Mithra, P., Moazen, B., Mohammad, D. K., Mohammad, Y., Mohammad Gholi Mezerji, N., Mohammadian-Hafshejani, A., Mohammadifard, N., Mohammadpourhodki, R., Mohammed, A. S., Mohammed, H., Mohammed, J. A., Mohammed, S., Mokdad, A. H., Molokhia, M., Monasta, L., Mooney, M. D., Moradi, G., Moradi, M., Moradi-Lakeh, M., Moradzadeh, R., Moraga, P., Morawska, L., Morgado-da-Costa, J., Morrison, S. D., Mosapour, A., Mosser, J. F., Mouodi, S., Mousavi, S. M., Mousavi Khaneghah, A., Mueller, U. O., Mukhopadhyay, S., Mullany, E. C., Musa, K. I., Muthupandian, S., Nabhan, A. F., Naderi, M., Nagarajan, A. J., Nagel, G., Naghavi, M., Naghshtabrizi, B., Naimzada, M. D., Najafi, F., Nangia, V., Nansseu, J. R., Naserbakht, M., Nayak, V. C., Negoi, I., Ngunjiri, J. W., Nguyen, C. T., Nguyen, H. L. T., Nguyen, M., Nigatu, Y. T., Nikbakhsh, R., Nixon, M. R., Nnaji, C. A., Nomura, S., Norrving, B., Noubiap, J. J., Nowak, C., Nunez-Samudio, V., Otoiu, A., Oancea, B., Odell, C. M., Ogbo, F. A., Oh, I. -H., Okunga, E. W., Oladnabi, M., Olagunju, A. T., Olusanya, B. O., Olusanya, J. O., Omer, M. O., Ong, K. L., Onwujekwe, O. E., Orpana, H. M., Ortiz, A., Osarenotor, O., Osei, F. B., Ostroff, S. M., Otstavnov, N., Otstavnov, S. S., Overland, S., Owolabi, M. O., P A, M., Padubidri, J. R., Palladino, R., Panda-Jonas, S., Pandey, A., Parry, C. D. H., Pasovic, M., Pasupula, D. K., Patel, S. K., Pathak, M., Patten, S. B., Patton, G. C., Pazoki Toroudi, H., Peden, A. E., Pennini, A., Pepito, V. C. F., Peprah, E. K., Pereira, D. M., Pesudovs, K., Pham, H. Q., Phillips, M. R., Piccinelli, C., Pilz, T. M., Piradov, M. A., Pirsaheb, M., Plass, D., Polinder, S., Polkinghorne, K. R., Pond, C. D., Postma, M. J., Pourjafar, H., Pourmalek, F., Poznanska, A., Prada, S. I., Prakash, V., Pribadi, D. R. A., Pupillo, E., Quazi Syed, Z., Rabiee, M., Rabiee, N., Radfar, A., Rafiee, A., Raggi, A., Rahman, M. A., Rajabpour-Sanati, A., Rajati, F., Rakovac, I., Ram, P., Ramezanzadeh, K., Ranabhat, C. L., Rao, P. C., Rao, S. J., Rashedi, V., Rathi, P., Rawaf, D. L., Rawaf, S., Rawal, L., Rawassizadeh, R., Rawat, R., Razo, C., Redford, S. B., Reiner, R. C., Reitsma, M. B., Remuzzi, G., Renjith, V., Renzaho, A. M. N., Resnikoff, S., Rezaei, N., Rezapour, A., Rhinehart, P. -A., Riahi, S. M., Ribeiro, D. C., Ribeiro, D., Rickard, J., Rivera, J. A., Roberts, N. L. S., Rodriguez-Ramirez, S., Roever, L., Ronfani, L., Room, R., Roshandel, G., Roth, G. A., Rothenbacher, D., Rubagotti, E., Rwegerera, G. M., Sabour, S., Sachdev, P. S., Saddik, B., Sadeghi, E., Sadeghi, M., Saeedi, R., Saeedi Moghaddam, S., Safari, Y., Safi, S., Safiri, S., Sagar, R., Sahebkar, A., Sajadi, S. M., Salam, N., Salamati, P., Salem, H., Salem, M. R. R., Salimzadeh, H., Salman, O. M., Salomon, J. A., Samad, Z., Samadi Kafil, H., Sambala, E. Z., Samy, A. M., Sanabria, J., Sanchez-Pimienta, T. G., Santomauro, D. F., Santos, I. S., Santos, J. V., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarmiento-Suarez, R., Sarrafzadegan, N., Sartorius, B., Sarveazad, A., Sathian, B., Sathish, T., Sattin, D., Saxena, S., Schaeffer, L. E., Schiavolin, S., Schlaich, M. P., Schmidt, M. I., Schutte, A. E., Schwebel, D. C., Schwendicke, F., Senbeta, A. M., Senthilkumaran, S., Sepanlou, S. G., Serdar, B., Serre, M. L., Shadid, J., Shafaat, O., Shahabi, S., Shaheen, A. A., Shaikh, M. A., Shalash, A. S., Shams-Beyranvand, M., Shamsizadeh, M., Sharafi, K., Sheikh, A., Sheikhtaheri, A., Shibuya, K., Shield, K. D., Shigematsu, M., Shin, J. I., Shin, M. -J., Shiri, R., Shirkoohi, R., Shuval, K., Siabani, S., Sierpinski, R., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, J. P., Simpson, K. E., Singh, J. A., Singh, P., Skiadaresi, E., Skou, S. T. S., Skryabin, V. Y., Smith, E. U. R., Soheili, A., Soltani, S., Soofi, M., Sorensen, R. J. D., Soriano, J. B., Sorrie, M. B., Soshnikov, S., Soyiri, I. N., Spencer, C. N., Spotin, A., Sreeramareddy, C. T., Srinivasan, V., Stanaway, J. D., Stein, C., Stein, D. J., Steiner, C., Stockfelt, L., Stokes, M. A., Straif, K., Stubbs, J. L., Sufiyan, M. B., Suleria, H. A. R., Suliankatchi Abdulkader, R., Sulo, G., Sultan, I., Szumowski, Tabares-Seisdedos, R., Tabb, K. M., Tabuchi, T., Taherkhani, A., Tajdini, M., Takahashi, K., Takala, J. S., Tamiru, A. T., Taveira, N., Tehrani-Banihashemi, A., Temsah, M. -H., Tesema, G. A., Tessema, Z. T., Thurston, G. D., Titova, M. V., Tohidinik, H. R., Tonelli, M., Topor-Madry, R., Topouzis, F., Torre, A. E., Touvier, M., Tovani-Palone, M. R. R., Tran, B. X., Travillian, R., Tsatsakis, A., Tudor Car, L., Tyrovolas, S., Uddin, R., Umeokonkwo, C. D., Unnikrishnan, B., Upadhyay, E., Vacante, M., Valdez, P. R., van Donkelaar, A., Vasankari, T. J., Vasseghian, Y., Veisani, Y., Venketasubramanian, N., Violante, F. S., Vlassov, V., Vollset, S. E., Vos, T., Vukovic, R., Waheed, Y., Wallin, M. T., Wang, Y., Wang, Y. -P., Watson, A., Wei, J., Wei, M. Y. W., Weintraub, R. G., Weiss, J., Werdecker, A., West, J. J., Westerman, R., Whisnant, J. L., Whiteford, H. A., Wiens, K. E., Wolfe, C. D. A., Wozniak, S. S., Wu, A. -M., Wu, J., Wulf Hanson, S., Xu, G., Xu, R., Yadgir, S., Yahyazadeh Jabbari, S. H., Yamagishi, K., Yaminfirooz, M., Yano, Y., Yaya, S., Yazdi-Feyzabadi, V., Yeheyis, T. Y., Yilgwan, C. S., Yilma, M. T., Yip, P., Yonemoto, N., Younis, M. Z., Younker, T. P., Yousefi, B., Yousefi, Z., Yousefinezhadi, T., Yousuf, A. Y., Yu, C., Yusefzadeh, H., Zahirian Moghadam, T., Zamani, M., Zamanian, M., Zandian, H., Zastrozhin, M. S., Zhang, Y., Zhang, Z. -J., Zhao, J. T., Zhao, X. -J. G., Zhao, Y., Zhou, M., Ziapour, A., Zimsen, S. R. M., Brauer, M., Afshin, A., Lim, S. S., Lacey, B, Sartorius, B, Abbafati, C, Abbas, K, Abbasi-Kangevari, M, Abd-Allah, F, Abdelalim, A, Abdollahi, M, Abdollahpour, I, Abegaz, K, Abolhassani, H, Aboyans, V, Abreu, L, Abrigo, M, Abualhasan, A, Abu-Raddad, L, Abushouk, A, Adabi, M, Adekanmbi, V, Adeoye, A, Adetokunboh, O, Adham, D, Advani, S, Afshin, A, Agarwal, G, Aghamir, S, Agrawal, A, Ahmad, T, Ahmadi, K, Ahmadi, M, Ahmadieh, H, Ahmed, M, Akalu, T, Akinyemi, R, Akinyemiju, T, Akombi, B, Akunna, C, Alahdab, F, Al-Aly, Z, Alam, K, Alam, S, Alam, T, Alanezi, F, Alanzi, T, Alemu, B, Alhabib, K, Ali, M, Ali, S, Alicandro, G, Alinia, C, Alipour, V, Alizade, H, Aljunid, S, Alla, F, Allebeck, P, Almasi-Hashiani, A, Al-Mekhlafi, H, Alonso, J, Altirkawi, K, Amini-Rarani, M, Amiri, F, Amugsi, D, Ancuceanu, R, Anderlini, D, Anderson, J, Andrei, C, Andrei, T, Angus, C, Anjomshoa, M, Ansari, F, Ansari-Moghaddam, A, Antonazzo, I, Antonio, C, Antony, C, Antriyandarti, E, Anvari, D, Anwer, R, Appiah, S, Arabloo, J, Arab-Zozani, M, Aravkin, A, Ariani, F, Armoon, B, Arnlov, J, Arzani, A, Asadi-Aliabadi, M, Asadi-Pooya, A, Ashbaugh, C, Assmus, M, Atafar, Z, Atnafu, D, Atout, M, Ausloos, F, Ausloos, M, Ayala Quintanilla, B, Ayano, G, Ayanore, M, Azari, S, Azarian, G, Azene, Z, Badawi, A, Badiye, A, Bahrami, M, Bakhshaei, M, Bakhtiari, A, Bakkannavar, S, Baldasseroni, A, Ball, K, Ballew, S, Balzi, D, Banach, M, Banerjee, S, Bante, A, Baraki, A, Barker-Collo, S, Barnighausen, T, Barrero, L, Barthelemy, C, Barua, L, Basu, S, Baune, B, Bayati, M, Becker, J, Bedi, N, Beghi, E, Bejot, Y, Bell, M, Bennitt, F, Bensenor, I, Berhe, K, Berman, A, Bhagavathula, A, Bhageerathy, R, Bhala, N, Bhandari, D, Bhattacharyya, K, Bhutta, Z, Bijani, A, Bikbov, B, Bin Sayeed, M, Biondi, A, Birihane, B, Bisignano, C, Biswas, R, Bitew, H, Bohlouli, S, Bohluli, M, Boon-Dooley, A, Borges, G, Borzi, A, Borzouei, S, Bosetti, C, Boufous, S, Braithwaite, D, Brauer, M, Breitborde, N, Breitner, S, Brenner, H, Briant, P, Briko, A, Briko, N, Britton, G, Bryazka, D, Bumgarner, B, Burkart, K, Burnett, R, Burugina Nagaraja, S, Butt, Z, Caetano Dos Santos, F, Cahill, L, Camera, L, Campos-Nonato, I, Cardenas, R, Carreras, G, Carrero, J, Carvalho, F, Castaldelli-Maia, J, Castaneda-Orjuela, C, Castelpietra, G, Castro, F, Causey, K, Cederroth, C, Cercy, K, Cerin, E, Chandan, J, Chang, K, Charlson, F, Chattu, V, Chaturvedi, S, Cherbuin, N, Chimed-Ochir, O, Cho, D, Choi, J, Christensen, H, Chu, D, Chung, M, Chung, S, Cicuttini, F, Ciobanu, L, Cirillo, M, Classen, T, Cohen, A, Compton, K, Cooper, O, Costa, V, Cousin, E, Cowden, R, Cross, D, Cruz, J, Dahlawi, S, Damasceno, A, Damiani, G, Dandona, L, Dandona, R, Dangel, W, Danielsson, A, Dargan, P, Darwesh, A, Daryani, A, Das, J, Das Gupta, R, das Neves, J, Davila-Cervantes, C, Davitoiu, D, De Leo, D, Degenhardt, L, Delang, M, Dellavalle, R, Demeke, F, Demoz, G, Demsie, D, Denova-Gutierrez, E, Dervenis, N, Dhungana, G, Dianatinasab, M, Dias da Silva, D, Diaz, D, Dibaji Forooshani, Z, Djalalinia, S, Do, H, Dokova, K, Dorostkar, F, Doshmangir, L, Driscoll, T, Duncan, B, Duraes, A, Eagan, A, Edvardsson, D, El Nahas, N, El Sayed, I, El Tantawi, M, Elbarazi, I, Elgendy, I, El-Jaafary, S, Elyazar, I, Emmons-Bell, S, Erskine, H, Eskandarieh, S, Esmaeilnejad, S, Esteghamati, A, Estep, K, Etemadi, A, Etisso, A, Fanzo, J, Farahmand, M, Fareed, M, Faridnia, R, Farioli, A, Faro, A, Faruque, M, Farzadfar, F, Fattahi, N, Fazlzadeh, M, Feigin, V, Feldman, R, Fereshtehnejad, S, Fernandes, E, Ferrara, G, Ferrari, A, Ferreira, M, Filip, I, Fischer, F, Fisher, J, Flor, L, Foigt, N, Folayan, M, Fomenkov, A, Force, L, Foroutan, M, Franklin, R, Freitas, M, Fu, W, Fukumoto, T, Furtado, J, Gad, M, Gakidou, E, Gallus, S, Garcia-Basteiro, A, Gardner, W, Geberemariyam, B, Ayalew Gebreslassie, A, Geremew, A, Gershberg Hayoon, A, Gething, P, Ghadimi, M, Ghadiri, K, Ghaffarifar, F, Ghafourifard, M, Ghamari, F, Ghashghaee, A, Ghiasvand, H, Ghith, N, Gholamian, A, Ghosh, R, Gill, P, Ginindza, T, Giussani, G, Gnedovskaya, E, Goharinezhad, S, Gopalani, S, Gorini, G, Goudarzi, H, Goulart, A, Greaves, F, Grivna, M, Grosso, G, Gubari, M, Gugnani, H, Guimaraes, R, Guled, R, Guo, G, Guo, Y, Gupta, R, Gupta, T, Haddock, B, Hafezi-Nejad, N, Hafiz, A, Haj-Mirzaian, A, Hall, B, Halvaei, I, Hamadeh, R, Hamidi, S, Hammer, M, Hankey, G, Haririan, H, Haro, J, Hasaballah, A, Hasan, M, Hasanpoor, E, Hashi, A, Hassanipour, S, Hassankhani, H, Havmoeller, R, Hay, S, Hayat, K, Heidari, G, Heidari-Soureshjani, R, Henrikson, H, Herbert, M, Herteliu, C, Heydarpour, F, Hird, T, Hoek, H, Holla, R, Hoogar, P, Hosgood, H, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hsairi, M, Hsieh, V, Hu, G, Hu, K, Huda, T, Humayun, A, Huynh, C, Hwang, B, Iannucci, V, Ibitoye, S, Ikeda, N, Ikuta, K, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Ippolito, H, Iqbal, U, Irvani, S, Irvine, C, Islam, M, Islam, S, Iso, H, Ivers, R, Iwu, C, Iyamu, I, Jaafari, J, Jacobsen, K, Jafari, H, Jafarinia, M, Jahani, M, Jakovljevic, M, Jalilian, F, James, S, Janjani, H, Javaheri, T, Javidnia, J, Jeemon, P, Jenabi, E, Jha, R, Jha, V, Ji, J, Johansson, L, John, O, John-Akinola, Y, Johnson, C, Jonas, J, Joukar, F, Jozwiak, J, Jurisson, M, Kabir, A, Kabir, Z, Kalani, H, Kalani, R, Kalankesh, L, Kalhor, R, Kanchan, T, Kapoor, N, Matin, B, Karch, A, Karim, M, Kassa, G, Katikireddi, S, Kayode, G, Kazemi Karyani, A, Keiyoro, P, Keller, C, Kemmer, L, Kendrick, P, Khalid, N, Khammarnia, M, Khan, E, Khan, M, Khatab, K, Khater, M, Khatib, M, Khayamzadeh, M, Khazaei, S, Kieling, C, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Kivimaki, M, Knibbs, L, Knudsen, A, Kocarnik, J, Kochhar, S, Kopec, J, Korshunov, V, Koul, P, Koyanagi, A, Kraemer, M, Krishan, K, Krohn, K, Kromhout, H, Kuate Defo, B, Kumar, G, Kumar, V, Kurmi, O, Kusuma, D, La Vecchia, C, Lal, D, Lalloo, R, Lallukka, T, Lami, F, Landires, I, Lang, J, Langan, S, Larsson, A, Lasrado, S, Lauriola, P, Lazarus, J, Lee, P, Lee, S, Legrand, K, Leigh, J, Leonardi, M, Lescinsky, H, Leung, J, Levi, M, Li, S, Lim, L, Linn, S, Liu, S, Liu, Y, Lo, J, Lopez, A, Lopez, J, Lopukhov, P, Lorkowski, S, Lotufo, P, Lu, A, Lugo, A, Maddison, E, Mahasha, P, Mahdavi, M, Mahmoudi, M, Majeed, A, Maleki, A, Maleki, S, Malekzadeh, R, Malta, D, Mamun, A, Manda, A, Manguerra, H, Mansour-Ghanaei, F, Mansouri, B, Mansournia, M, Mantilla Herrera, A, Maravilla, J, Marks, A, Martin, R, Martini, S, Martins-Melo, F, Masaka, A, Masoumi, S, Mathur, M, Matsushita, K, Maulik, P, Mcalinden, C, Mcgrath, J, Mckee, M, Mehndiratta, M, Mehri, F, Mehta, K, Memish, Z, Mendoza, W, Menezes, R, Mengesha, E, Mereke, A, Mereta, S, Meretoja, A, Meretoja, T, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, I, Miller, T, Mills, E, Mini, G, Miri, M, Mirica, A, Mirrakhimov, E, Mirzaei, H, Mirzaei, M, Mirzaei, R, Mirzaei-Alavijeh, M, Misganaw, A, Mithra, P, Moazen, B, Mohammad, D, Mohammad, Y, Mohammad Gholi Mezerji, N, Mohammadian-Hafshejani, A, Mohammadifard, N, Mohammadpourhodki, R, Mohammed, A, Mohammed, H, Mohammed, J, Mohammed, S, Mokdad, A, Molokhia, M, Monasta, L, Mooney, M, Moradi, G, Moradi, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morawska, L, Morgado-Da-Costa, J, Morrison, S, Mosapour, A, Mosser, J, Mouodi, S, Mousavi, S, Khaneghah, A, Mueller, U, Mukhopadhyay, S, Mullany, E, Musa, K, Muthupandian, S, Nabhan, A, Naderi, M, Nagarajan, A, Nagel, G, Naghavi, M, Naghshtabrizi, B, Naimzada, M, Najafi, F, Nangia, V, Nansseu, J, Naserbakht, M, Nayak, V, Negoi, I, Ngunjiri, J, Nguyen, C, Nguyen, H, Nguyen, M, Nigatu, Y, Nikbakhsh, R, Nixon, M, Nnaji, C, Nomura, S, Norrving, B, Noubiap, J, Nowak, C, Nunez-Samudio, V, Oancea, B, Odell, C, Ogbo, F, Oh, I, Okunga, E, Oladnabi, M, Olagunju, A, Olusanya, B, Olusanya, J, Omer, M, Ong, K, Onwujekwe, O, Orpana, H, Ortiz, A, Osarenotor, O, Osei, F, Ostroff, S, Otoiu, A, Otstavnov, N, Otstavnov, S, Overland, S, Owolabi, M, Mahesh, P, Padubidri, J, Palladino, R, Panda-Jonas, S, Pandey, A, Parry, C, Pasovic, M, Pasupula, D, Patel, S, Pathak, M, Patten, S, Patton, G, Toroudi, H, Peden, A, Pennini, A, Pepito, V, Peprah, E, Pereira, D, Pesudovs, K, Pham, H, Phillips, M, Piccinelli, C, Pilz, T, Piradov, M, Pirsaheb, M, Plass, D, Polinder, S, Polkinghorne, K, Pond, C, Postma, M, Pourjafar, H, Pourmalek, F, Poznanska, A, Prada, S, Prakash, V, Pribadi, D, Pupillo, E, Syed, Z, Rabiee, M, Rabiee, N, Radfar, A, Rafiee, A, Raggi, A, Rahman, M, Rajabpour-Sanati, A, Rajati, F, Rakovac, I, Ram, P, Ramezanzadeh, K, Ranabhat, C, Rao, P, Rao, S, Rashedi, V, Rathi, P, Rawaf, D, Rawaf, S, Rawal, L, Rawassizadeh, R, Rawat, R, Razo, C, Redford, S, Reiner, R, Reitsma, M, Remuzzi, G, Renjith, V, Renzaho, A, Resnikoff, S, Rezaei, N, Rezapour, A, Rhinehart, P, Riahi, S, Ribeiro, D, Rickard, J, Rivera, J, Roberts, N, Rodriguez-Ramirez, S, Roever, L, Ronfani, L, Room, R, Roshandel, G, Roth, G, Rothenbacher, D, Rubagotti, E, Rwegerera, G, Sabour, S, Sachdev, P, Saddik, B, Sadeghi, E, Sadeghi, M, Saeedi, R, Saeedi Moghaddam, S, Safari, Y, Safi, S, Safiri, S, Sagar, R, Sahebkar, A, Sajadi, S, Salam, N, Salamati, P, Salem, H, Salem, M, Salimzadeh, H, Salman, O, Salomon, J, Samad, Z, Samadi Kafil, H, Sambala, E, Samy, A, Sanabria, J, Sanchez-Pimienta, T, Santomauro, D, Santos, I, Santos, J, Santric-Milicevic, M, Saraswathy, S, Sarmiento-Suarez, R, Sarrafzadegan, N, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Saxena, S, Schaeffer, L, Schiavolin, S, Schlaich, M, Schmidt, M, Schutte, A, Schwebel, D, Schwendicke, F, Senbeta, A, Senthilkumaran, S, Sepanlou, S, Serdar, B, Serre, M, Shadid, J, Shafaat, O, Shahabi, S, Shaheen, A, Shaikh, M, Shalash, A, Shams-Beyranvand, M, Shamsizadeh, M, Sharafi, K, Sheikh, A, Sheikhtaheri, A, Shibuya, K, Shield, K, Shigematsu, M, Shin, J, Shin, M, Shiri, R, Shirkoohi, R, Shuval, K, Siabani, S, Sierpinski, R, Sigfusdottir, I, Sigurvinsdottir, R, Silva, J, Simpson, K, Singh, J, Singh, P, Skiadaresi, E, Skou, S, Skryabin, V, Smith, E, Soheili, A, Soltani, S, Soofi, M, Sorensen, R, Soriano, J, Sorrie, M, Soshnikov, S, Soyiri, I, Spencer, C, Spotin, A, Sreeramareddy, C, Srinivasan, V, Stanaway, J, Stein, C, Stein, D, Steiner, C, Stockfelt, L, Stokes, M, Straif, K, Stubbs, J, Sufiyan, M, Suleria, H, Suliankatchi Abdulkader, R, Sulo, G, Sultan, I, Tabares-Seisdedos, R, Tabb, K, Tabuchi, T, Taherkhani, A, Tajdini, M, Takahashi, K, Takala, J, Tamiru, A, Taveira, N, Tehrani-Banihashemi, A, Temsah, M, Tesema, G, Tessema, Z, Thurston, G, Titova, M, Tohidinik, H, Tonelli, M, Topor-Madry, R, Topouzis, F, Torre, A, Touvier, M, Tovani-Palone, M, Tran, B, Travillian, R, Tsatsakis, A, Tudor Car, L, Tyrovolas, S, Uddin, R, Umeokonkwo, C, Unnikrishnan, B, Upadhyay, E, Vacante, M, Valdez, P, van Donkelaar, A, Vasankari, T, Vasseghian, Y, Veisani, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vos, T, Vukovic, R, Waheed, Y, Wallin, M, Wang, Y, Watson, A, Wei, J, Wei, M, Weintraub, R, Weiss, J, Werdecker, A, West, J, Westerman, R, Whisnant, J, Whiteford, H, Wiens, K, Wolfe, C, Wozniak, S, Wu, A, Wu, J, Wulf Hanson, S, Xu, G, Xu, R, Yadgir, S, Yahyazadeh Jabbari, S, Yamagishi, K, Yaminfirooz, M, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yeheyis, T, Yilgwan, C, Yilma, M, Yip, P, Yonemoto, N, Younis, M, Younker, T, Yousefi, B, Yousefi, Z, Yousefinezhadi, T, Yousuf, A, Yu, C, Yusefzadeh, H, Moghadam, T, Zamani, M, Zamanian, M, Zandian, H, Zastrozhin, M, Zhang, Y, Zhang, Z, Zhao, J, Zhao, X, Zhao, Y, Zheng, P, Zhou, M, Ziapour, A, Zimsen, S, Lim, S, Murray, C, GBD 2019 Risk Factors Collaborator, Violante FS, Biosciences, Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Sub Foundations&PhilosophyofNaturSc begr, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Public Health, Bin Sayeed, M. S. B., Caetano Dos Santos, F. L., Camera, L. A., Elyazar, I. R. F., Ayalew Gebreslassie, A. A. A., Ginindza, T. G., Matin, B. K., Morgado-Da-Costa, J., Khaneghah, A. M., Mahesh, P. A., Toroudi, H. P., Syed, Z. Q., Salem, M. R., Skou, S. T., Tovani-Palone, M. R., Tudor Car, L. T., and Moghadam, T. Z.

Subjects
Male, Nutritional Sciences, Specific risk, Contaminación del Aire Interior, 030204 cardiovascular system & hematology, Socioeconomic Factor, systematic analysis, Global Health, Body Mass Index, Global Burden of Disease, Health Risk Behavior, Health Risk Behaviors, Disease studies, 0302 clinical medicine, Risk Factors, METABOLIC RISKS, 030212 general & internal medicine, 11 Medical and Health Sciences, Factores de Riesgo, 2. Zero hunger, education.field_of_study, Public health, Injuries, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, GBD, risck factors, attributable burden of disease, 3142 Public health care science, environmental and occupational health, 3. Good health, Relative risk, Environmental health, Health, Hypertension, Global Burden of Diseases, Injuries, Risk Factors, A990 Medicine and Dentistry not elsewhere classified, Female, Leading risk factors, Global Health Metrics, Cohort study, Human, medicine.medical_specialty, Substance-Related Disorders, Population, UNITED-STATES, Risk Assessment, DIET, ITC-HYBRID, 03 medical and health sciences, Life Expectancy, MORTALITY, DISABILITY, POLLUTION, CLUSTERS, SDG 3 - Good Health and Well-being, General & Internal Medicine, medicine, Humans, Global Burden of Disease Study, Risk factor, education, Global burden, business.industry, Risk Factor, Malnutrition, Klinisk medicin, Global Burden of Diseases, Environmental Exposure, medicine.disease, Enfermedades, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Years of potential life lost, Socioeconomic Factors, Risk factors, Disease study, Hyperglycemia, ITC-ISI-JOURNAL-ARTICLE, NA, Clinical Medicine, business, RA
Abstract

Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10.8 million (95% uncertainty interval [UI] 9.51-12.1) deaths (19.2% [16.9-21.3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8.71 million (8.12-9.31) deaths (15.4% [14.6-16.2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11.6% [10.3-13.1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. Interpretation Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.

Published
2020
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27. Application of data science methods to identify school and home risk factors for asthma and allergy-related symptoms among children in New York

Author

Connie Jiang, Xiaobo Xue Romeiko, Ian Ryan, Tia Marks, Wangjian Zhang, George D. Thurston, Bo Ye, Xinlei Deng, Haider A. Khwaja, Shao Lin, and Yanji Qu

Subjects
Allergy, Environmental Engineering, 010504 meteorology & atmospheric sciences, New York, 010501 environmental sciences, Multiple risk factors, 01 natural sciences, Tobacco smoke, Indoor air quality, Risk Factors, Environmental health, Environmental Chemistry, Medicine, Humans, Child, Waste Management and Disposal, Socioeconomic status, 0105 earth and related environmental sciences, Asthma, Schools, business.industry, Data Science, Environmental Exposure, medicine.disease, Pollution, Young age, Air Pollution, Indoor, business, Bedroom
Abstract

Objectives Few studies have comprehensively assessed multiple environmental exposures affecting children's health. This study applied machine-learning methods to evaluate how indoor environmental conditions at home and school contribute to asthma and allergy-related symptoms. Methods We randomly selected 10 public schools representing different socioeconomic statuses in New York State (2017–2019) and distributed questionnaires to students to collect health status and home-and school-environmental exposures. Indoor air quality was measured at school, and ambient particle exposures (PM2.5 and components) were measured using real-time personal monitors for 48 h. We used random forest model to identify the most important risk factors for asthma and allergy-related symptoms, and decision tree for visualizing the inter-relationships among the multiple risk factors with the health outcomes. Results The top contributing factors identified for asthma were family rhinitis history (relative importance: 10.40%), plant pollen trigger (5.48%); bedroom carpet (3.58%); environmental tobacco smoke (ETS) trigger symptom (2.98%); and ETS exposure (2.56%). For allergy-related symptoms, plant pollen trigger (10.88%), higher paternal education (7.33%), bedroom carpet (5.28%), family rhinitis history (4.78%), and higher maternal education (4.25%) were the strongest contributing factors. Conversely, primary heating with hot water radiator was negatively (−6.86%) associated with asthma symptoms. Younger children ( Conclusion Family rhinitis history, bedroom carpet, and pollen triggers were the most important risk factors for both asthma and allergy-related symptoms. Our new findings included that hot-water radiator was related to reduced asthma symptoms, and the combination of young age, rhinitis history, and bedroom carpeting was related to increased asthma symptoms. Further studies are needed to confirm our findings.

Published
2020

28. Outdoor air pollution and cancer: An overview of the current evidence and public health recommendations

Author

Michelle C. Turner, Aaron J Cohen, George D. Thurston, Zorana Jovanovic Andersen, Diddier Prada, Jonathan M. Samet, Susan M. Gapstur, W. Ryan Diver, C. Arden Pope, and Andrea A. Baccarelli

Subjects
medicine.medical_specialty, Psychological intervention, Air pollution, medicine.disease_cause, Article, 03 medical and health sciences, Global population, 0302 clinical medicine, breast cancer, Environmental health, Health care, Epidemiology, Medicine, 030212 general & internal medicine, cancer survival, particulate matter, business.industry, Public health, Cancer, Cancer survival, Hematology, medicine.disease, lung cancer, Oncology, 030220 oncology & carcinogenesis, business
Abstract

Outdoor air pollution is a major contributor to the burden of disease worldwide. Most of the global population resides in places where air pollution levels, because of emissions from industry, power generation, transportation, and domestic burning, considerably exceed the World Health Organization's health-based air-quality guidelines. Outdoor air pollution poses an urgent worldwide public health challenge because it is ubiquitous and has numerous serious adverse human health effects, including cancer. Currently, there is substantial evidence from studies of humans and experimental animals as well as mechanistic evidence to support a causal link between outdoor (ambient) air pollution, and especially particulate matter (PM) in outdoor air, with lung cancer incidence and mortality. It is estimated that hundreds of thousands of lung cancer deaths annually worldwide are attributable to PM air pollution. Epidemiological evidence on outdoor air pollution and the risk of other types of cancer, such as bladder cancer or breast cancer, is more limited. Outdoor air pollution may also be associated with poorer cancer survival, although further research is needed. This report presents an overview of outdoor air pollutants, sources, and global levels, as well as a description of epidemiological evidence linking outdoor air pollution with cancer incidence and mortality. Biological mechanisms of air pollution-derived carcinogenesis are also described. This report concludes by summarizing public health/policy recommendations, including multilevel interventions aimed at individual, community, and regional scales. Specific roles for medical and health care communities with regard to prevention and advocacy and recommendations for further research are also described.

Published
2020
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29. Exposure assessment of emissions from mobile food carts on New York City streets

Author

George D. Thurston, Kamrun Nahar, Mostafijur Rahman, Terry Gordon, and Amna Raja

Subjects
Pollution, 010504 meteorology & atmospheric sciences, Health, Toxicology and Mutagenesis, media_common.quotation_subject, Air pollution, 010501 environmental sciences, Toxicology, medicine.disease_cause, 01 natural sciences, Indoor air quality, Environmental protection, medicine, Cooking, Cities, Charcoal, Air quality index, 0105 earth and related environmental sciences, media_common, Exposure assessment, Air Pollutants, Commerce, General Medicine, Particulates, Food, visual_art, North America, visual_art.visual_art_medium, Environmental science, Food preparation, New York City
Abstract

Food carts are common along streets in cities throughout the world. In North America, food cart vendors generally use propane, charcoal, or both propane and charcoal (P and C) for food preparation. Although cooking emissions are known to be a major source of indoor air pollution, there is limited knowledge on outdoor cooking’s impact on the ambient environment and, in particular, the relative contribution of the different cooking fuels. This field study investigated the air pollution the public is exposed to in the micro-environment around 19 food carts classified into 3 groups: propane, charcoal, and P and C carts. Concentrations near the food carts were measured using both real-time and filter-based methods. Mean real-time concentrations of PM2.5, BC2.5, and particle counts were highest near the charcoal food carts: 196 μg/m3, 5.49 μg/m3, and 69,000 particles/cm3, respectively, with peak exposures of 1520 μg/m3, 67.9 μg/m3, and 235,000 particles/cm3, respectively. In order of pollution emission impacts: charcoal > P and C > propane carts. Thus, significant differences in air pollution emissions occurred in the vicinity of mobile food carts, depending on the fuel used in food preparation. Local air pollution polices should consider these emission factors in regulating food cart vendor operations.

Published
2020

31. Realizing the Paris Climate Agreement to Improve Cardiopulmonary Health. Where Science Meets Policy

Author

Nganda Motto Malea, Carol M Browner, Sheldon Whitehouse, George D. Thurston, Joel Schwartz, Kari C. Nadeau, Mary B. Rice, and Kent E. Pinkerton

Subjects
Lung Diseases, Pulmonary and Respiratory Medicine, Paris, business.industry, Climate Change, Health Policy, MEDLINE, 010501 environmental sciences, Public relations, 01 natural sciences, Environmental Policy, 03 medical and health sciences, 0302 clinical medicine, Cardiovascular Diseases, Humans, Medicine, 030212 general & internal medicine, business, Environmental Health, Health policy, 0105 earth and related environmental sciences
Published
2018
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32. Association of Cardiovascular Responses in Mice with Source-apportioned PM2.5 Air Pollution in Beijing

Author

Lan Jin, Junfeng Zhang, Mianhua Zhong, Xinbiao Guo, Jing-Shiang Hwang, Qingshan Qu, Lung Chi Chen, George D. Thurston, Polina Maciejczyk, and Qinghua Sun

Subjects
Decreased heart rate, 010504 meteorology & atmospheric sciences, Fine particulate, Lag, Air pollution, Acute effect, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Pollution, Toxicology, Beijing, Heart rate, medicine, Environmental Chemistry, Heart rate variability, Environmental science, 0105 earth and related environmental sciences
Abstract

In this study, factor analysis and mass regression were used to identify four fine particulate matter sources and estimate their contributions to the ambient air pollution in Beijing. The identified sources were traffic re-suspended soil, mixed industrial sources, oil combustion, and secondary sulfate. The estimated source contributions were then introduced into two models as exposure variables to explore the relationships between cardiovascular responses in mice and PM exposures. We observed that PM2.5 has a small negative acute effect on heart rate, but the individual source factors showed much more significant effects. Traffic re-suspended soil had the most significant effect on heart rate, with a positive contribution on the day of exposure and a negative one on day lag 1. Acute heart rate variability outcomes were better explained by the total PM2.5 than by the source components. Chronic effects were observed as a decreased heart rate but an increased number of heart rate variability outcomes.

Published
2018
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33. An evaluation of the health benefits achieved at the time of an air quality intervention in three Israeli cities

Author

Lital Yinon and George D. Thurston

Subjects
Male, Pollution, Time Factors, media_common.quotation_subject, Air pollution, Psychological intervention, 010501 environmental sciences, Health benefits, medicine.disease_cause, 01 natural sciences, Article, 03 medical and health sciences, 0302 clinical medicine, Air Pollution, Environmental health, medicine, Humans, Sulfur Dioxide, 030212 general & internal medicine, Cities, Israel, Mortality, Air quality index, lcsh:Environmental sciences, 0105 earth and related environmental sciences, General Environmental Science, media_common, lcsh:GE1-350, Air Pollutants, business.industry, Regression analysis, Models, Theoretical, Intervention (law), Cardiovascular Diseases, Particulate Matter, Seasons, Biological plausibility, business
Abstract

Background The statistical association between increased exposure to air pollution and increased risk of morbidity and mortality is well established. However, documentation of the health benefits of lowering air pollution levels, which would support the biological plausibility of those past statistical associations, are not as well developed. A better understanding of the aftereffects of interventions to reduce air pollution is needed in order to: 1) better document the benefits of lowered air pollution; and, 2) identify the types of reductions that most effectively provide health benefits. Methods This study analyzes daily health and pollution data from three major cities in Israel that have undergone pollution control interventions to reduce sulfur emissions from combustion sources. In this work, the hypothesis tested is that transitions to cleaner fuels are accompanied by a decreased risk of daily cardiovascular and respiratory mortalities. Interrupted time series regression models are applied in order to test whether the cleaner air interventions are associated with a statistically significant reduction in mortality. Results In the multi-city meta-analysis we found statistically significant reductions of 13.3% [CI − 21.9%, − 3.8%] in cardiovascular mortality, and a borderline significant (p = 0.06) reduction of 19.0% [CI − 35.1%, 1.1%] in total mortality. Conclusions Overall, new experiential evidence is provided consistent with human health benefits being associated with interventions to reduce air pollution. The methods employed also provide an approach that may be applied elsewhere in the future to better document and optimize the health benefits of clean air interventions.

Published
2017

34. Identifying and evaluating school environmental health indicators

Author

Yi Lu, Wangjian Zhang, Shao Lin, Ziqiang Lin, Guang-Hui Dong, Tia Marks, George D. Thurston, Haider A. Khwaja, and Xiaobo Xue Romeiko

Subjects
Schools, Home environment, Health, Toxicology and Mutagenesis, education, Attendance, New York, Feature selection, General Medicine, Environmental Exposure, 010501 environmental sciences, Health Services, 01 natural sciences, Pollution, Ambient ozone, Data quality, Environmental health, Environmental Chemistry, Humans, Research questions, School environment, Psychology, Child, Environmental Health, 0105 earth and related environmental sciences
Abstract

Children's health, attendance, and academic performance may be affected by school environmental hazards. While prior studies evaluated home environment and health, few have evaluated indicators of school in-/outdoor environment and health. This study addresses this knowledge gap by systematically reviewing and evaluating outdoor and indoor indicators of school environment and student's health and performance in New York State (NYS). We also evaluate statistical methodologies to address highly correlated indicators and integrate multiple exposures. Multiple school environmental indicators were identified from various existing NYS datasets. We summarized data sources, completeness, geographic and temporal coverage, and data quality for each indicator. Each indicator was evaluated by scientific basis/relevance, analytic soundness/feasibility, and interpretation/utility, and validated using objective NYS data. Finally, advanced variable selection methods were described and discussed. We have identified and evaluated multiple school environmental health indicators. It was found that mold and moisture problems, ventilation problems, ambient ozone, and PM2.5 levels are among the top priorities of school environmental issues/indicators in NYS, which were also consistent while using NYS data. Choice of best variable selection method should be made based on the research questions and data characteristics. The school environmental health indicators identified, and variable selection methods evaluated, in this study could be used by other researchers to help school officials and policy makers initiate prevention programs.

Published
2019

35. Air Pollution, Oxidative Stress, and Diabetes: a Life Course Epidemiologic Perspective

Author

George D. Thurston and Chris C. Lim

Subjects
0301 basic medicine, Diabetes risk, Offspring, Endocrinology, Diabetes and Metabolism, Air pollution, 030209 endocrinology & metabolism, medicine.disease_cause, Article, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Air Pollution, Environmental health, Diabetes mellitus, Internal Medicine, medicine, Humans, Air Pollutants, business.industry, Environmental Exposure, medicine.disease, Gestational diabetes, Diabetes, Gestational, Oxidative Stress, 030104 developmental biology, Life course approach, Female, business, Oxidative stress
Abstract

PURPOSE OF REVIEW: Ambient air pollution is strongly linked to cardiovascular and respiratory diseases. We summarize available published evidence regarding similar associations with diabetes across the life course. RECENT FINDINGS: We performed a life-course survey of the recent literature, including prenatal, gestational, childhood/adolescence, and adult exposures to air pollution. Oxidative stress is identified as a key factor in both metabolic dysfunction and the effects of air pollution exposure, especially from fossil fuel combustion products, providing a plausible mechanism for air pollution-diabetes associations. The global burden of diabetes attributed to air pollution exposure is substantial, with a recent estimate that ambient fine particulate matter (PM(2.5)) exposure contributes to more than 200,000 deaths from diabetes annually. SUMMARY: There is a growing body of literature linking air pollution exposure during childhood and adulthood with diabetes etiology and related cardiometabolic biomarkers. A small number of studies found that exposure to air pollution during pregnancy is associated with elevated gestational diabetes risk among mothers. Studies examining prenatal air pollution exposure and diabetes risk among the offspring, as well as potential transgenerational effects of air pollution exposure, are very limited thus far. This review provides insight into how air pollutants affect diabetes and other metabolic dysfunction-related diseases across the different life stages.

Published
2019
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36. A land use regression model of nitrogen dioxide and fine particulate matter in a complex urban core in Lanzhou, China

Author

George D. Thurston, Yaqun Zhang, Jesse D. Berman, Jonathan I. Levy, Lan Jin, Yawei Zhang, Shuxiao Wang, Michelle L. Bell, Xibao Xu, and Joshua L. Warren

Subjects
China, Population, Nitrogen Dioxide, Air pollution, Land cover, 010501 environmental sciences, Urban area, Atmospheric sciences, medicine.disease_cause, 01 natural sciences, Biochemistry, Cross-validation, 03 medical and health sciences, 0302 clinical medicine, Air Pollution, medicine, 030212 general & internal medicine, Cities, education, 0105 earth and related environmental sciences, General Environmental Science, Exposure assessment, geography, education.field_of_study, Air Pollutants, geography.geographical_feature_category, Land use, Elevation, Environmental science, Particulate Matter, Environmental Monitoring
Abstract

Background Land use regression (LUR) models have been widely used to estimate air pollution exposures at high spatial resolution. However, few LUR models were developed for rapidly developing urban cores, which have substantially higher densities of population and built-up areas than the surrounding areas within a city’s administrative boundary. Further, few studies incorporated vertical variations of air pollution in exposure assessment, which might be important to estimate exposures for people living in high-rise buildings. Objective A LUR model was developed for the urban core of Lanzhou, China, along with a model of vertical concentration gradients in high-rise buildings. Methods In each of four seasons in 2016–2017, NO2 was measured using Ogawa badges for 2 weeks at 75 ground-level sites. PM2.5 was measured using DataRAM for shorter time intervals at a subset (N = 38) of the 75 sites. Vertical profile measurements were conducted on 9 stories at 2 high-rise buildings (N = 18), with one building facing traffic and another facing away from traffic. The average seasonal concentrations of NO2 and PM2.5 at ground level were regressed against spatial predictors, including elevation, population, road network, land cover, and land use. The vertical variations were investigated and linked to ground-level predictions with exponential models. Results We developed robust LUR models at the ground level for estimated annual averages of NO2 (R2: 0.71, adjusted R2: 0.67, and Leave-One-Out Cross Validation (LOOCV) R2: 0.64) and PM2.5 (R2: 0.77, adjusted R2: of 0.73, and LOOCV R2: 0.67) in the urban core of Lanzhou, China. The LUR models for the estimated seasonal averages of NO2 showed similar patterns. Vertical variation of NO2 and PM2.5 differed by windows orientation with respect to traffic, by season or by time of a day. Vertical variation functions incorporated the ground-level LUR predictions, in a form that could allow for exposure assessment in future epidemiological investigations. Conclusions Ground-level NO2 and PM2.5 showed substantial spatial variations, explained by traffic and land use patterns. Further, vertical variation of air pollution levels is significant under certain conditions, suggesting that exposure misclassification could occur with traditional LUR that ignores vertical variation. More studies are needed to fully characterize three-dimensional concentration patterns to accurately estimate air pollution exposures for residents in high-rise buildings, but our LUR models reinforce that concentration heterogeneity is not captured by the limited government monitors in the Lanzhou urban area.

Published
2019

37. Long-Term Exposure to Ozone and Cause-Specific Mortality Risk in the United States

Author

Jiyoung Ahn, Michelle L. Bell, Rena R. Jones, Yongzhao Shao, Debra T. Silverman, Cynthia Garcia, George D. Thurston, Richard B. Hayes, and Chris C. Lim

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, Ozone, Adolescent, Respiratory Tract Diseases, Air pollution, Critical Care and Intensive Care Medicine, medicine.disease_cause, Risk Assessment, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, Young Adult, 0302 clinical medicine, Oxidants, Photochemical, Risk Factors, Environmental health, Air Pollution, Cause of Death, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Aged, Proportional Hazards Models, Aged, 80 and over, business.industry, Editorials, Cause specific mortality, Environmental Exposure, Middle Aged, United States, Term (time), 030228 respiratory system, chemistry, Female, business
Abstract

Rationale: Many studies have linked short-term exposure to ozone (O3) with morbidity and mortality, but epidemiologic evidence of associations between long-term O3 exposure and mortality is more li...

Published
2019

38. Deliberating performance targets workshop: Potential paths for emerging PM2.5 and O3 air sensor progress

Author

Anthony S. Wexler, N.A. Martin, Michael H. Bergin, L. Hassinger, Grant R. Allen, D. Jack, Michael P. Hannigan, R. Subramanian, Jay R. Turner, James J. Schauer, Gayle S.W. Hagler, Zhi Ning, George D. Thurston, Peter K.K. Louie, Vasu Kilaru, Edmund Seto, G. Pierce, Robert Judge, Michele Penza, Rima Habre, Ron Williams, Rachelle M. Duvall, K. Ray, Joann Rice, Andrea Polidori, Amanda Kaufman, Katherine B. Benedict, M. Gerboles, Ronald C. Cohen, P. Fransioli, Williams, R., Duvall, R., Kilaru, V., Hagler, G., Hassinger, L., Benedict, K., Rice, J., Kaufman, A., Judge, R., Pierce, G., Allen, G., Bergin, M., Cohen, R. C., Fransioli, P., Gerboles, M., Habre, R., Hannigan, M., Jack, D., Louie, P., Martin, N. A., Penza, M., Polidori, A., Subramanian, R., Ray, K., Schauer, J., Seto, E., Thurston, G., Turner, J., Wexler, A. S., and Ning, Z.

Subjects
Atmospheric Science, Process management, PM, Computer science, Best practice, Certification, PM2.5, lcsh:QC851-999, Performance target, Ozone, Documentation, lcsh:Environmental pollution, Climate-Related Exposures and Conditions, Performance targets, General Environmental Science, Government, business.industry, Low-cost air quality sensor, Usability, Subject-matter expert, 2.5, Data quality, lcsh:TD172-193.5, lcsh:Meteorology. Climatology, Performance indicator, Low-cost air quality sensors, business
Abstract

The United States Environmental Protection Agency held an international two-day workshop in June 2018 to deliberate possible performance targets for non-regulatory fine particulate matter (PM2.5) and ozone (O3) air sensors. The need for a workshop arose from the lack of any market-wide manufacturer requirement for documented sensor performance evaluations, the lack of any independent third party or government-based sensor performance certification program, and uncertainty among all users as to the general usability of air sensor data. A multi-sector subject matter expert panel was assembled to facilitate an open discussion on these issues with multiple stakeholders. This summary provides an overview of the workshop purpose, key findings from the deliberations, and considerations for future actions specific to sensors. Important findings concerning PM2.5 and O3 sensors included the lack of consistent performance indicators and statistical metrics as well as highly variable data quality requirements depending on the intended use. While the workshop did not attempt to yield consensus on any topic, a key message was that a number of possible future actions would be beneficial to all stakeholders regarding sensor technologies. These included documentation of best practices, sharing quality assurance results along with sensor data, and the development of a common performance target lexicon, performance targets, and test protocols. Keywords: Low-cost air quality sensors, Performance targets, PM2.5, Ozone

Published
2019

39. Mediterranean Diet and the Association between Air Pollution and Cardiovascular Disease Mortality Risk

Author

George D. Thurston, Yongzhao Shao, Richard B. Hayes, Rena R. Jones, Chris C. Lim, Debra T. Silverman, and Jiyoung Ahn

Subjects
Male, medicine.medical_specialty, Time Factors, Nutritional Supplementation, Mediterranean diet, 030204 cardiovascular system & hematology, 010501 environmental sciences, Diet, Mediterranean, 01 natural sciences, Article, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Physiology (medical), Environmental health, Epidemiology, medicine, Humans, Prospective Studies, Stroke, Air quality index, 0105 earth and related environmental sciences, Aged, Air Pollutants, business.industry, Environmental Exposure, Middle Aged, Protective Factors, medicine.disease, Prognosis, Obesity, United States, Cardiovascular Diseases, Female, Particulate Matter, Diet, Healthy, Cardiology and Cardiovascular Medicine, business, Risk assessment, Body mass index, Nutritive Value
Abstract

Background: Recent experimental evidence suggests that nutritional supplementation can blunt adverse cardiopulmonary effects induced by acute air pollution exposure. However, whether usual individual dietary patterns can modify the association between long-term air pollution exposure and health outcomes has not been previously investigated. We assessed, in a large cohort with detailed diet information at the individual level, whether a Mediterranean diet modifies the association between long-term exposure to ambient air pollution and cardiovascular disease mortality risk. Methods: The National Institutes of Health–American Association for Retired Persons Diet and Health Study, a prospective cohort (N=548 845) across 6 states and 2 cities in the United States and with a follow-up period of 17 years (1995–2011), was linked to estimates of annual average exposures to fine particulate matter and nitrogen dioxide at the residential census-tract level. The alternative Mediterranean Diet Index, which uses a 9-point scale to assess conformity with a Mediterranean-style diet, was constructed for each participant from information in cohort baseline dietary questionnaires. We evaluated mortality risks for cardiovascular disease, ischemic heart disease, cerebrovascular disease, or cardiac arrest associated with long-term air pollution exposure. Effect modification of the associations between exposure and the mortality outcomes by alternative Mediterranean Diet Index was examined via interaction terms. Results: For fine particulate matter, we observed elevated and significant associations with cardiovascular disease (hazard ratio [HR] per 10 μg/m 3 , 1.13; 95% CI, 1.08–1.18), ischemic heart disease (HR, 1.16; 95% CI, 1.10–1.23), and cerebrovascular disease (HR, 1.15; 95% CI, 1.03–1.28). For nitrogen dioxide, we found significant associations with cardiovascular disease (HR per 10 ppb, 1.06; 95% CI, 1.04–1.08) and ischemic heart disease (HR, 1.08; 95% CI, 1.05–1.11). Analyses indicated that Mediterranean diet modified these relationships, as those with a higher alternative Mediterranean Diet Index score had significantly lower rates of cardiovascular disease mortality associated with long-term air pollution exposure ( P -interaction Conclusions: A Mediterranean diet reduced cardiovascular disease mortality risk related to long-term exposure to air pollutants in a large prospective US cohort. Increased consumption of foods rich in antioxidant compounds may aid in reducing the considerable disease burden associated with ambient air pollution.

Published
2019

40. Advancing environmental exposure assessment science to benefit society

Author

Masoud Ghandehari, George D. Thurston, Paul W. Glimcher, Chris C. Lim, and Andrew Caplin

Subjects
0301 basic medicine, Health Knowledge, Attitudes, Practice, Health Status, Science, Air pollution, General Physics and Astronomy, Review Article, 02 engineering and technology, Global Health, medicine.disease_cause, General Biochemistry, Genetics and Molecular Biology, Local policy, 03 medical and health sciences, Human health, Air pollutants, Adverse health effect, Air Pollution, medicine, Global health, Humans, Environmental planning, Air Pollutants, Multidisciplinary, Environmental Exposure, General Chemistry, Environmental exposure, 021001 nanoscience & nanotechnology, Environmental Policy, 030104 developmental biology, Socioeconomic Factors, Particulate Matter, Business, Disadvantaged populations, 0210 nano-technology, Environmental Monitoring
Abstract

Awareness of the human health impacts of exposure to air pollution is growing rapidly. For example, it has become evident that the adverse health effects of air pollution are more pronounced in disadvantaged populations. Policymakers in many jurisdictions have responded to this evidence by enacting initiatives that lead to lower concentrations of air pollutants, such as urban traffic restrictions. In this review, we focus on the interplay between advances in environmental exposure assessment and developments in policy. We highlight recent progress in the granular measurement of air pollutants and individual-level exposures, and how this has enabled focused local policy actions. Finally, we detail an illustrative study designed to link individual-level health-relevant exposures with economic, behavioral, biological, familial, and environmental variables., How can scientists and policymakers work together to reduce the health impacts of air pollution? In this review paper, the authors discuss the interplay between advances in environmental exposure assessment and policy advances to tackle pollution in a focused way.

Published
2019
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41. Exposure to Greater Air Pollution when Traveling Abroad Is Associated with Decreased Lung Function

Author

Lung Chi Chen, George D. Thurston, M J Ruzmyn Vilcassim, Terry Gordon, and Chris C. Lim

Subjects
Pulmonary and Respiratory Medicine, Adult, Aged, 80 and over, Lung Diseases, Male, Air Pollutants, Travel, business.industry, Air pollution, Environmental Exposure, Middle Aged, Critical Care and Intensive Care Medicine, medicine.disease_cause, Decreased lung function, Respiratory Function Tests, Environmental health, Correspondence, Medicine, Humans, Female, Particulate Matter, business, Aged
Published
2019

42. Water Pipe (Hookah) Smoking and Cardiovascular Disease Risk: A Scientific Statement From the American Heart Association

Author

Wasim Maziak, Mary Rezk-Hanna, Kenneth D. Ward, George D. Thurston, Aruni Bhatnagar, Thomas Eissenberg, Caroline O. Cobb, Brian A King, Merlyn A. Griffiths, Erin L. Sutfin, and Larry B. Goldstein

Subjects
Risk, medicine.medical_treatment, education, Water Pipe Smoking, Hookah Smoking, 030204 cardiovascular system & hematology, Article, Nicotine, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Environmental health, Smoking Water Pipes, Medicine, Water pipe, Humans, 030212 general & internal medicine, Smoke, business.industry, American Heart Association, United States, Cardiovascular Diseases, Practice Guidelines as Topic, Disease risk, Smoking cessation, Smoking Cessation, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Tobacco smoking with a water pipe or hookah is increasing globally. There are millions of water pipe tobacco smokers worldwide, and in the United States, water pipe use is more common among youth and young adults than among adults. The spread of water pipe tobacco smoking has been abetted by the marketing of flavored tobacco, a social media environment that promotes water pipe smoking, and misperceptions about the addictive potential and potential adverse health effects of this form of tobacco use. There is growing evidence that water pipe tobacco smoking affects heart rate, blood pressure regulation, baroreflex sensitivity, tissue oxygenation, and vascular function over the short term. Long-term water pipe use is associated with increased risk of coronary artery disease. Several harmful or potentially harmful substances present in cigarette smoke are also present in water pipe smoke, often at levels exceeding those found in cigarette smoke. Water pipe tobacco smokers have a higher risk of initiation of cigarette smoking than never smokers. Future studies that focus on the long-term adverse health effects of intermittent water pipe tobacco use are critical to strengthen the evidence base and to inform the regulation of water pipe products and use. The objectives of this statement are to describe the design and operation of water pipes and their use patterns, to identify harmful and potentially harmful constituents in water pipe smoke, to document the cardiovascular risks of water pipe use, to review current approaches to water pipe smoking cessation, and to offer guidance to healthcare providers for the identification and treatment of individuals who smoke tobacco using water pipes.

Published
2019

43. Exposure to air pollution is associated with adverse cardiopulmonary health effects in international travellers

Author

Eric Saunders, George D. Thurston, Chris C. Lim, M J Ruzmyn Vilcassim, Lung Chi Chen, Terry Gordon, and Yixin Yao

Subjects
Adult, Male, Evening, New York, Air pollution, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Pulmonary function testing, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Air Pollution, Forced Expiratory Volume, Environmental health, Heart rate, medicine, Humans, 030212 general & internal medicine, Cities, 0105 earth and related environmental sciences, Morning, Travel, business.industry, Environmental Exposure, General Medicine, Metropolitan area, Healthy Volunteers, Megacity, Blood pressure, Heart Function Tests, Female, Particulate Matter, Original Article, Travel-Related Illness, business
Abstract

Background With the number of annual global travellers reaching 1.2 billion, many individuals encounter greater levels of air pollution when they travel abroad to megacities around the world. This study’s objective was to determine if visits to cities abroad with greater levels of air pollution adversely impact cardiopulmonary health. Methods A total of 34 non-smoking healthy adult participants who travelled abroad to selected cities from the New York City (NYC) metropolitan area were pre-trained to measure lung function, blood pressure and heart rate (HR)/HR variability (HRV) and record symptoms before, during and after travelling abroad. Outdoor particulate matter (PM)2.5 concentrations were obtained from central monitors in each city. Associations between PM exposure concentrations and cardiopulmonary health endpoints were analysed using a mixed effects statistical design. Results East and South Asian cities had significantly higher PM2.5 concentrations compared with pre-travel NYC PM2.5 levels, with maximum concentrations reaching 503 μg/m3. PM exposure–related associations for lung function were statistically significant and strongest between evening Forced Expiratory Volume in the first second (FEV1) and same-day morning PM2.5 concentrations; a 10-μg/m3 increase in outdoor PM2.5 was associated with a mean decrease of 7 mL. Travel to a highly polluted city (PM2.5 > 100 μg/m3) was associated with a 209-ml reduction in evening FEV1 compared with a low polluted city (PM2.5 Conclusions Exposure to increased levels of PM2.5 in cities abroad caused small but statistically significant acute changes in cardiopulmonary function and respiratory symptoms in healthy young adults. These data suggest that travel-related exposure to increased PM2.5 adversely impacts cardiopulmonary health, which may be particularly important for travellers with pre-existing respiratory or cardiac disease.

Published
2019
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44. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Gregory A Roth, Degu Abate, Kalkidan Hassen Abate, Solomon M Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Haftom Temesgen Abebe, Molla Abebe, Zegeye Abebe, Ayenew Negesse Abejie, Semaw F Abera, Olifan Zewdie Abil, Haftom Niguse Abraha, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Beyene Meressa Adhena, Mina G Adib, Amha Admasie, Ashkan Afshin, Gina Agarwal, Kareha M Agesa, Anurag Agrawal, Sutapa Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Muktar Beshir Ahmed, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Mohammad Esmaeil Akbari, Rufus Olusola Akinyemi, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Rajaa M Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Animut Alebel, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Jordi Alonso, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T Amare, Leopold N Aminde, Erfan Amini, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Hossein Ansari, Mustafa Geleto Ansha, Carl Abelardo T Antonio, Palwasha Anwari, Olatunde Aremu, Johan Ärnlöv, Amit Arora, Monika Arora, Al Artaman, Krishna K Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Zerihun Ataro, Suleman Atique, Sachin R Atre, Marcel Ausloos, Euripide F G A Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Yohanes Ayele, Rakesh Ayer, Peter S Azzopardi, Arefeh Babazadeh, Umar Bacha, Hamid Badali, Alaa Badawi, Ayele Geleto Bali, Katherine E Ballesteros, Maciej Banach, Kajori Banerjee, Marlena S Bannick, Joseph Adel Mattar Banoub, Miguel A Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Simon Barquera, Lope H Barrero, Quique Bassat, Sanjay Basu, Bernhard T Baune, Habtamu Wondifraw Baynes, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Béjot, Bayu Begashaw Bekele, Abate Bekele Belachew, Ezra Belay, Yihalem Abebe Belay, Michelle L Bell, Aminu K Bello, Derrick A Bennett, Isabela M Bensenor, Adam E Berman, Eduardo Bernabe, Robert S Bernstein, Gregory J Bertolacci, Mircea Beuran, Tina Beyranvand, Ashish Bhalla, Suraj Bhattarai, Soumyadeeep Bhaumik, Zulfiqar A Bhutta, Belete Biadgo, Molly H Biehl, Ali Bijani, Boris Bikbov, Ver Bilano, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Donal Bisanzio, Tuhin Biswas, Brigette F Blacker, Berrak Bora Basara, Rohan Borschmann, Cristina Bosetti, Kayvan Bozorgmehr, Oliver J Brady, Luisa C Brant, Carol Brayne, Alexandra Brazinova, Nicholas J K Breitborde, Hermann Brenner, Paul Svitil Briant, Gabrielle Britton, Traolach Brugha, Reinhard Busse, Zahid A Butt, Charlton S K H Callender, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Mate Car, Rosario Cárdenas, Giulia Carreras, Juan J Carrero, Austin Carter, Félix Carvalho, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Chris D Castle, Clara Castro, Franz Castro, Ferrán Catalá-López, Ester Cerin, Yazan Chaiah, Jung-Chen Chang, Fiona J Charlson, Pankaj Chaturvedi, Peggy Pei-Chia Chiang, Odgerel Chimed-Ochir, Vesper Hichilombwe Chisumpa, Abdulaal Chitheer, Rajiv Chowdhury, Hanne Christensen, Devasahayam J Christopher, Sheng-Chia Chung, Flavia M Cicuttini, Liliana G Ciobanu, Massimo Cirillo, Aaron J Cohen, Leslie Trumbull Cooper, Paolo Angelo Cortesi, Monica Cortinovis, Ewerton Cousin, Benjamin C Cowie, Michael H Criqui, Elizabeth A Cromwell, Christopher Stephen Crowe, John A Crump, Matthew Cunningham, Alemneh Kabeta Daba, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Paul I Dargan, Ahmad Daryani, Siddharth K Das, Rajat Das Gupta, José Das Neves, Tamirat Tesfaye Dasa, Aditya Prasad Dash, Adrian C Davis, Nicole Davis Weaver, Dragos Virgil Davitoiu, Kairat Davletov, Fernando Pio De La Hoz, Jan-Walter De Neve, Meaza Girma Degefa, Louisa Degenhardt, Tizta T Degfie, Selina Deiparine, Gebre Teklemariam Demoz, Balem Betsu Demtsu, Edgar Denova-Gutiérrez, Kebede Deribe, Nikolaos Dervenis, Don C Des Jarlais, Getenet Ayalew Dessie, Subhojit Dey, Samath D Dharmaratne, Daniel Dicker, Mesfin Tadese Dinberu, Eric L Ding, M Ashworth Dirac, Shirin Djalalinia, Klara Dokova, David Teye Doku, Christl A Donnelly, E Ray Dorsey, Pratik P Doshi, Dirk Douwes-Schultz, Kerrie E Doyle, Tim R Driscoll, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B Duncan, Andre R Duraes, Hedyeh Ebrahimi, Soheil Ebrahimpour, Dumessa Edessa, David Edvardsson, Anne Elise Eggen, Charbel El Bcheraoui, Maysaa El Sayed Zaki, Ziad El-Khatib, Hajer Elkout, Christian Lycke Ellingsen, Matthias Endres, Aman Yesuf Endries, Benjamin Er, Holly E Erskine, Babak Eshrati, Sharareh Eskandarieh, Reza Esmaeili, Alireza Esteghamati, Mahdi Fakhar, Hamed Fakhim, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Carla Sofia E sá Farinha, Andre Faro, Maryam S Farvid, Farshad Farzadfar, Mohammad Hosein Farzaei, Valery L Feigin, Andrea B Feigl, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C Fernandes, Alize J Ferrari, Garumma Tolu Feyissa, Irina Filip, Samuel Finegold, Florian Fischer, Christina Fitzmaurice, Nataliya A Foigt, Kyle J Foreman, Carla Fornari, Tahvi D Frank, Takeshi Fukumoto, John E Fuller, Nancy Fullman, Thomas Fürst, João M Furtado, Neal D Futran, Silvano Gallus, Alberto L Garcia-Basteiro, Miguel A Garcia-Gordillo, William M Gardner, Abadi Kahsu Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Bereket Gebremichael, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M Geleijnse, Ricard Genova-Maleras, Yilma Chisha Dea Geramo, Peter W Gething, Kebede Embaye Gezae, Mohammad Rasoul Ghadami, Reza Ghadimi, Khalil Ghasemi Falavarjani, Maryam Ghasemi-Kasman, Mamata Ghimire, Katherine B Gibney, Paramjit Singh Gill, Tiffany K Gill, Richard F Gillum, Ibrahim Abdelmageed Ginawi, Maurice Giroud, Giorgia Giussani, Shifalika Goenka, Ellen M Goldberg, Srinivas Goli, Hector Gómez-Dantés, Philimon N Gona, Sameer Vali Gopalani, Taren M Gorman, Atsushi Goto, Alessandra C Goulart, Elena V Gnedovskaya, Ayman Grada, Giuseppe Grosso, Harish Chander Gugnani, Andre Luiz Sena Guimaraes, Yuming Guo, Prakash C Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Reyna Alma Gutiérrez, Bishal Gyawali, Juanita A Haagsma, Nima Hafezi-Nejad, Tekleberhan B Hagos, Tewodros Tesfa Hailegiyorgis, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Alexis J Handal, Graeme J Hankey, Hilda L Harb, Sivadasanpillai Harikrishnan, Josep Maria Haro, Mehedi Hasan, Hadi Hassankhani, Hamid Yimam Hassen, Rasmus Havmoeller, Roderick J Hay, Simon I Hay, Yihua He, Akbar Hedayatizadeh-Omran, Mohamed I Hegazy, Behzad Heibati, Mohsen Heidari, Delia Hendrie, Andualem Henok, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Pouria Heydarpour, Sousan Heydarpour, Desalegn Tsegaw Hibstu, Hans W Hoek, Michael K Hole, Enayatollah Homaie Rad, Praveen Hoogar, H Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Peter J Hotez, Damian G Hoy, Thomas Hsiao, Guoqing Hu, John J Huang, Abdullatif Husseini, Mohammedaman Mama Hussen, Susan Hutfless, Bulat Idrisov, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Nazrul Islam, Sheikh Mohammed Shariful Islam, Farhad Islami, Kathryn H Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Moti Tolera Jalu, Spencer L James, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Kathy J Jenkins, Ravi Prakash Jha, Vivekanand Jha, Catherine O Johnson, Sarah C Johnson, Jost B Jonas, Ankur Joshi, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Manoochehr Karami, Behzad Karami Matin, André Karch, Corine Karema, Hamidreza Karimi-Sari, Amir Kasaeian, Dessalegn H Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Zhila Kazemi, Ali Kazemi Karyani, Dhruv Satish Kazi, Adane Teshome Kefale, Peter Njenga Keiyoro, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Nauman Khalid, Ibrahim A Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young-Ho Khang, Mona M Khater, Abdullah T Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Jagdish Khubchandani, Aliasghar A Kiadaliri, Getiye D Kibret, Zelalem Teklemariam Kidanemariam, Daniel N Kiirithio, Daniel Kim, Young-Eun Kim, Yun Jin Kim, Ruth W Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimäki, Ann Kristin Skrindo Knudsen, Jonathan M Kocarnik, Sonali Kochhar, Yoshihiro Kokubo, Tufa Kolola, Jacek A Kopec, Parvaiz A Koul, Ai Koyanagi, Michael A Kravchenko, Kewal Krishan, Barthelemy Kuate Defo, Burcu Kucuk Bicer, G Anil Kumar, Manasi Kumar, Pushpendra Kumar, Michael J Kutz, Igor Kuzin, Hmwe Hmwe Kyu, Deepesh P Lad, Sheetal D Lad, Alessandra Lafranconi, Dharmesh Kumar Lal, Ratilal Lalloo, Tea Lallukka, Jennifer O Lam, Faris Hasan Lami, Van C Lansingh, Sonia Lansky, Heidi J Larson, Arman Latifi, Kathryn Mei-Ming Lau, Jeffrey V Lazarus, Georgy Lebedev, Paul H Lee, James Leigh, Mostafa Leili, Cheru Tesema Leshargie, Shanshan Li, Yichong Li, Juan Liang, Lee-Ling Lim, Stephen S Lim, Miteku Andualem Limenih, Shai Linn, Shiwei Liu, Yang Liu, Rakesh Lodha, Chris Lonsdale, Alan D Lopez, Stefan Lorkowski, Paulo A Lotufo, Rafael Lozano, Raimundas Lunevicius, Stefan Ma, Erlyn Rachelle King Macarayan, Mark T Mackay, Jennifer H MacLachlan, Emilie R Maddison, Fabiana Madotto, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Dhaval P Maghavani, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Ana-Laura Manda, Luiz Garcia Mandarano-Filho, Helena Manguerra, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Dadi Marami, Joemer C Maravilla, Wagner Marcenes, Laurie Marczak, Ashley Marks, Guy B Marks, Gabriel Martinez, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Winfried März, Melvin B Marzan, Joseph R Masci, Benjamin Ballard Massenburg, Manu Raj Mathur, Prashant Mathur, Richard Matzopoulos, Pallab K Maulik, Mohsen Mazidi, Colm McAlinden, John J McGrath, Martin McKee, Brian J McMahon, Suresh Mehata, Man Mohan Mehndiratta, Ravi Mehrotra, Kala M Mehta, Varshil Mehta, Tefera C Mekonnen, Addisu Melese, Mulugeta Melku, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Desalegn Tadese Mengistu, Getnet Mengistu, George A Mensah, Seid Tiku Mereta, Atte Meretoja, Tuomo J Meretoja, Tomislav Mestrovic, Haftay Berhane Mezgebe, Bartosz Miazgowski, Tomasz Miazgowski, Anoushka I Millear, Ted R Miller, Molly Katherine Miller-Petrie, G K Mini, Parvaneh Mirabi, Mojde Mirarefin, Andreea Mirica, Erkin M Mirrakhimov, Awoke Temesgen Misganaw, Habtamu Mitiku, Babak Moazen, Karzan Abdulmuhsin Mohammad, Moslem Mohammadi, Noushin Mohammadifard, Mohammed A Mohammed, Shafiu Mohammed, Viswanathan Mohan, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Ghobad Moradi, Maziar Moradi-Lakeh, Mehdi Moradinazar, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Joana Morgado-Da-Costa, Shane Douglas Morrison, Marilita M Moschos, Simin Mouodi, Seyyed Meysam Mousavi, Kindie Fentahun Muchie, Ulrich Otto Mueller, Satinath Mukhopadhyay, Kate Muller, John Everett Mumford, Jonah Musa, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Jean B Nachega, Gabriele Nagel, Aliya Naheed, Azin Nahvijou, Gurudatta Naik, Sanjeev Nair, Farid Najafi, Luigi Naldi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Bruno Ramos Nascimento, Gopalakrishnan Natarajan, Nahid Neamati, Ionut Negoi, Ruxandra Irina Negoi, Subas Neupane, Charles R J Newton, Frida N Ngalesoni, Josephine W Ngunjiri, Anh Quynh Nguyen, Grant Nguyen, Ha Thu Nguyen, Huong Thanh Nguyen, Long Hoang Nguyen, Minh Nguyen, Trang Huyen Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Yirga Legesse Nirayo, Molly R Nixon, Nomonde Nolutshungu, Shuhei Nomura, Ole F Norheim, Mehdi Noroozi, Bo Norrving, Jean Jacques Noubiap, Hamid Reza Nouri, Malihe Nourollahpour Shiadeh, Mohammad Reza Nowroozi, Peter S Nyasulu, Christopher M Odell, Richard Ofori-Asenso, Felix Akpojene Ogbo, In-Hwan Oh, Olanrewaju Oladimeji, Andrew T Olagunju, Pedro R Olivares, Helen Elizabeth Olsen, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Kanyin L Ong, Sok King Sk Ong, Eyal Oren, Heather M Orpana, Alberto Ortiz, Justin R Ortiz, Stanislav S Otstavnov, Simon Øverland, Mayowa Ojo Owolabi, Raziye Özdemir, Mahesh P A, Rosana Pacella, Smita Pakhale, Abhijit P Pakhare, Amir H Pakpour, Adrian Pana, Songhomitra Panda-Jonas, Jeyaraj Durai Pandian, Andrea Parisi, Eun-Kee Park, Charles D H Parry, Hadi Parsian, Shanti Patel, Sanghamitra Pati, George C Patton, Vishnupriya Rao Paturi, Katherine R Paulson, Alexandre Pereira, David M Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Michael R Phillips, Frédéric B Piel, David M Pigott, Julian David Pillay, Meghdad Pirsaheb, Farhad Pishgar, Suzanne Polinder, Maarten J Postma, Akram Pourshams, Hossein Poustchi, Ashwini Pujar, Swayam Prakash, Narayan Prasad, Caroline A Purcell, Mostafa Qorbani, Hedley Quintana, D Alex Quistberg, Kirankumar Waman Rade, Amir Radfar, Anwar Rafay, Alireza Rafiei, Fakher Rahim, Kazem Rahimi, Afarin Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Rajesh Kumar Rai, Sasa Rajsic, Usha Ram, Chhabi Lal Ranabhat, Prabhat Ranjan, Puja C Rao, David Laith Rawaf, Salman Rawaf, Christian Razo-García, K Srinath Reddy, Robert C Reiner, Marissa B Reitsma, Giuseppe Remuzzi, Andre M N Renzaho, Serge Resnikoff, Satar Rezaei, Shahab Rezaeian, Mohammad Sadegh Rezai, Seyed Mohammad Riahi, Antonio Luiz P Ribeiro, Maria Jesus Rios-Blancas, Kedir Teji Roba, Nicholas L S Roberts, Stephen R Robinson, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Dietrich Rothenbacher, Ambuj Roy, Enrico Rubagotti, Perminder S Sachdev, Basema Saddik, Ehsan Sadeghi, Hosein Safari, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Nasir Salam, Joseph S Salama, Payman Salamati, Raphael De Freitas Saldanha, Zikria Saleem, Yahya Salimi, Sundeep Santosh Salvi, Inbal Salz, Evanson Zondani Sambala, Abdallah M Samy, Juan Sanabria, Maria Dolores Sanchez-Niño, Damian Francesco Santomauro, Itamar S Santos, João Vasco Santos, Milena M Santric Milicevic, Bruno Piassi Sao Jose, Abdur Razzaque Sarker, Rodrigo Sarmiento-Suárez, Nizal Sarrafzadegan, Benn Sartorius, Shahabeddin Sarvi, Brijesh Sathian, Maheswar Satpathy, Arundhati R Sawant, Monika Sawhney, Sonia Saxena, Mehdi Sayyah, Elke Schaeffner, Maria Inês Schmidt, Ione J C Schneider, Ben Schöttker, Aletta Elisabeth Schutte, David C Schwebel, Falk Schwendicke, James G Scott, Mario Sekerija, Sadaf G Sepanlou, Edson Serván-Mori, Seyedmojtaba Seyedmousavi, Hosein Shabaninejad, Katya Anne Shackelford, Azadeh Shafieesabet, Mehdi Shahbazi, Amira A Shaheen, Masood Ali Shaikh, Mehran Shams-Beyranvand, Mohammadbagher Shamsi, Morteza Shamsizadeh, Kiomars Sharafi, Mehdi Sharif, Mahdi Sharif-Alhoseini, Rajesh Sharma, Jun She, Aziz Sheikh, Peilin Shi, Mekonnen Sisay Shiferaw, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, Ivy Shiue, Farhad Shokraneh, Mark G Shrime, Si Si, Soraya Siabani, Tariq J Siddiqi, Inga Dora Sigfusdottir, Rannveig Sigurvinsdottir, Donald H Silberberg, Diego Augusto Santos Silva, João Pedro Silva, Natacha Torres Da Silva, Dayane Gabriele Alves Silveira, Jasvinder A Singh, Narinder Pal Singh, Prashant Kumar Singh, Virendra Singh, Dhirendra Narain Sinha, Karen Sliwa, Mari Smith, Badr Hasan Sobaih, Soheila Sobhani, Eugène Sobngwi, Samir S Soneji, Moslem Soofi, Reed J D Sorensen, Joan B Soriano, Ireneous N Soyiri, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Vinay Srinivasan, Jeffrey D Stanaway, Vladimir I Starodubov, Vasiliki Stathopoulou, Dan J Stein, Caitlyn Steiner, Leo G Stewart, Mark A Stokes, Michelle L Subart, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Patrick John Sur, Ipsita Sutradhar, Bryan L Sykes, P N Sylaja, Dillon O Sylte, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Santosh Kumar Tadakamadla, Ken Takahashi, Nikhil Tandon, Segen Gebremeskel Tassew, Nuno Taveira, Arash Tehrani-Banihashemi, Tigist Gashaw Tekalign, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Omar Temsah, Abdullah Sulieman Terkawi, Manaye Yihune Teshale, Belay Tessema, Gizachew Assefa Tessema, Kavumpurathu Raman Thankappan, Sathish Thirunavukkarasu, Nihal Thomas, Amanda G Thrift, George D Thurston, Binyam Tilahun, Quyen G To, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Anna E Torre, Miguel Tortajada-Girbés, Mathilde Touvier, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Khanh Bao Tran, Suryakant Tripathi, Christopher E Troeger, Thomas Clement Truelsen, Nu Thi Truong, Afewerki Gebremeskel Tsadik, Derrick Tsoi, Lorainne Tudor Car, E Murat Tuzcu, Stefanos Tyrovolas, Kingsley N Ukwaja, Irfan Ullah, Eduardo A Undurraga, Rachel L Updike, Muhammad Shariq Usman, Olalekan A Uthman, Selen Begüm Uzun, Muthiah Vaduganathan, Afsane Vaezi, Gaurang Vaidya, Pascual R Valdez, Elena Varavikova, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Santos Villafaina, Francesco S Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Stein Emil Vollset, Theo Vos, Gregory R Wagner, Fasil Shiferaw Wagnew, Yasir Waheed, Mitchell Taylor Wallin, Judd L Walson, Yanping Wang, Yuan-Pang Wang, Molla Mesele Wassie, Elisabete Weiderpass, Robert G Weintraub, Fitsum Weldegebreal, Kidu Gidey Weldegwergs, Andrea Werdecker, Adhena Ayaliew Werkneh, T Eoin West, Ronny Westerman, Harvey A Whiteford, Justyna Widecka, Lauren B Wilner, Shadrach Wilson, Andrea Sylvia Winkler, Charles Shey Wiysonge, Charles D A Wolfe, Shouling Wu, Yun-Chun Wu, Grant M A Wyper, Denis Xavier, Gelin Xu, Simon Yadgir, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Bereket Yakob, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Gökalp Kadri Yentür, Alex Yeshaneh, Ebrahim M Yimer, Paul Yip, Biruck Desalegn Yirsaw, Engida Yisma, Naohiro Yonemoto, Gerald Yonga, Seok-Jun Yoon, Marcel Yotebieng, Mustafa Z Younis, Mahmoud Yousefifard, Chuanhua Yu, Vesna Zadnik, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Zohreh Zare, Ayalew Jejaw Zeleke, Zerihun Menlkalew Zenebe, Anthony Lin Zhang, Kai Zhang, Maigeng Zhou, Sanjay Zodpey, Liesl Joanna Zuhlke, Mohsen Naghavi, and Christopher J L Murray., Rubagotti, Enrico, Abay, Solomon M., Roth, Gregory, Abd Allah, Foad, Abdela, Jemal, Abbastabar, Hedayat, and Abbasi, Nooshin

Subjects
Overview, Disease, Territory, Causes of death, humanities
Abstract

Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. The Lancet Publishing Group

Published
2019

45. Evaluation of a commercial database to estimate residence histories in the los angeles ultrafines study

Author

Mary H. Ward, Rena R. Jones, Danielle N. Medgyesi, Linda M. Liao, George D. Thurston, Richard B. Hayes, Abigail R. Flory, Jared A. Fisher, and Debra T. Silverman

Subjects
Male, medicine.medical_specialty, Population, Air pollution, 010501 environmental sciences, medicine.disease_cause, computer.software_genre, 01 natural sciences, Biochemistry, Article, 03 medical and health sciences, 0302 clinical medicine, Air Pollution, Epidemiology, medicine, Humans, Prospective Studies, 030212 general & internal medicine, education, Prospective cohort study, 0105 earth and related environmental sciences, General Environmental Science, Estimation, Air Pollutants, education.field_of_study, Database, Environmental Exposure, Environmental exposure, Los Angeles, Geography, Population study, Female, Particulate Matter, Residence, computer
Abstract

Background Commercial databases can be used to identify participant addresses over time, but their quality and impact on environmental exposure assessment is uncertain. Objective To evaluate the performance of a commercial database to find residences and estimate environmental exposures for study participants. Methods We searched LexisNexis® for participant addresses in the Los Angeles Ultrafines Study, a prospective cohort of men and women aged 50–71 years. At enrollment (1995–1996) and follow-up (2004–2005), we evaluated attainment (address found for the corresponding time period) and match rates to survey addresses by participant characteristics. We compared geographically-referenced predictors and estimates of ultrafine particulate matter (UFP) exposure from a land use regression model using LexisNexis and survey addresses at enrollment. Results LexisNexis identified an address for 69% of participants at enrollment (N = 50,320) and 95% of participants at follow-up (N = 24,432). Attainment rate at enrollment modestly differed (≥5%) by age, smoking status, education, and residential mobility between surveys. The match rate at both survey periods was high (82–86%) and similar across characteristics. When using LexisNexis versus survey addresses, correlations were high for continuous values of UFP exposure and its predictors (rho = 0.86–0.92). Significance Time period and population characteristics influenced the attainment of addresses from a commercial database, but accuracy and subsequent estimation of specific air pollution exposures were high in our older study population.

Published
2021
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46. The clear and persistent impact of air pollution on chronic respiratory diseases: a call for interventions

Author

Francesco Forastiere, Laura S. Van Winkle, John R. Balmes, Isabella Annesi-Maesano, Jack R. Harkema, Kent E. Pinkerton, Cara Nichole Maesano, Rob McConnell, David B. Peden, Barbara Hoffmann, Stephen T. Holgate, George D. Thurston, Frank J. Kelly, Christopher Carlsten, Tamara Schikowski, Erika Garcia, and Haneen Khreis

Subjects
Pulmonary and Respiratory Medicine, Air Pollutants, medicine.medical_specialty, business.industry, Air pollution exposure, Public health, Respiratory Tract Diseases, Air pollution, Psychological intervention, Fossil fuel combustion, Environmental Exposure, Respiration Disorders, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Biomass combustion, Air Pollution, Environmental health, medicine, Humans, Particulate Matter, 030212 general & internal medicine, business
Abstract

Air pollution is responsible for chronic respiratory symptoms and diseases. Efforts to reduce air pollution exposure to protect public health, especially from emissions from both fossil fuel combustion and biomass combustion, are needed urgently.https://bit.ly/3hJtCze

Published
2021
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47. Ischemic Heart Disease Mortality and Long-Term Exposure to Source-Related Components of U.S. Fine Particle Air Pollution

Author

Michelle C. Turner, Daniel Krewski, Susan M. Gapstur, George D. Thurston, Richard T. Burnett, W. Ryan Diver, Michael Jerrett, Ramona Lall, Yuanli Shi, C. Arden Pope, and Kazuhiko Ito

Subjects
Adult, Male, Fine particulate, Health, Toxicology and Mutagenesis, Air pollution exposure, Myocardial Ischemia, Air pollution, Particle (ecology), Coronary Artery Disease, 010501 environmental sciences, Toxicology, medicine.disease_cause, Medical and Health Sciences, complex mixtures, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, Air Pollution, Environmental health, medicine, Humans, Climate-Related Exposures and Conditions, 030212 general & internal medicine, Aged, Proportional Hazards Models, 0105 earth and related environmental sciences, Air Pollutants, Prevention, Research, Disease mortality, Public Health, Environmental and Occupational Health, Environmental Exposure, Environmental exposure, Middle Aged, Particulates, United States, 3. Good health, Good Health and Well Being, 13. Climate action, Environmental science, Female, Particulate Matter, Ischemic heart, Environmental Sciences
Abstract

Background: Fine particulate matter (PM2.5) air pollution exposure has been identified as a global health threat. However, the types and sources of particles most responsible are not yet known. Objectives: We sought to identify the causal characteristics and sources of air pollution underlying past associations between long-term PM2.5 exposure and ischemic heart disease (IHD) mortality, as established in the American Cancer Society’s Cancer Prevention Study-II cohort. Methods: Individual risk factor data were evaluated for 445,860 adults in 100 U.S. metropolitan areas followed from 1982 through 2004 for vital status and cause of death. Using Cox proportional hazard models, we estimated IHD mortality hazard ratios (HRs) for PM2.5, trace constituents, and pollution source–associated PM2.5, as derived from air monitoring at central stations throughout the nation during 2000–2005. Results: Associations with IHD mortality varied by PM2.5 mass constituent and source. A coal combustion PM2.5 IHD HR = 1.05 (95% CI: 1.02, 1.08) per microgram/cubic meter, versus an IHD HR = 1.01 (95% CI: 1.00, 1.02) per microgram/cubic meter PM2.5 mass, indicated a risk roughly five times higher for coal combustion PM2.5 than for PM2.5 mass in general, on a per microgram/cubic meter PM2.5 basis. Diesel traffic–related elemental carbon (EC) soot was also associated with IHD mortality (HR = 1.03; 95% CI: 1.00, 1.06 per 0.26-μg/m3 EC increase). However, PM2.5 from both wind-blown soil and biomass combustion was not associated with IHD mortality. Conclusions: Long-term PM2.5 exposures from fossil fuel combustion, especially coal burning but also from diesel traffic, were associated with increases in IHD mortality in this nationwide population. Results suggest that PM2.5–mortality associations can vary greatly by source, and that the largest IHD health benefits per microgram/cubic meter from PM2.5 air pollution control may be achieved via reductions of fossil fuel combustion exposures, especially from coal-burning sources. Citation: Thurston GD, Burnett RT, Turner MC, Shi Y, Krewski D, Lall R, Ito K, Jerrett M, Gapstur SM, Diver WR, Pope CA III. 2016. Ischemic heart disease mortality and long-term exposure to source-related components of U.S. fine particle air pollution. Environ Health Perspect 124:785–794; http://dx.doi.org/10.1289/ehp.1509777

Published
2016
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48. Perception and reality of particulate matter exposure in New York City taxi drivers

Author

Judith T. Zelikoff, Sudha Acharya, Francesca Gany, Terry Gordon, Sehrish Bari, Jennifer Leng, Lakshmi Prasad, George D. Thurston, and Trevor Lee

Subjects
Adult, Male, Health Knowledge, Attitudes, Practice, Air sampling, Future studies, Adolescent, 010504 meteorology & atmospheric sciences, Epidemiology, Fine particulate, Air pollution, Pilot Projects, 010501 environmental sciences, Toxicology, medicine.disease_cause, 01 natural sciences, Article, Young Adult, Health problems, Soot, Air pollutants, Air Pollution, Occupational Exposure, Surveys and Questionnaires, Environmental health, Environmental monitoring, medicine, Humans, Vehicle Emissions, 0105 earth and related environmental sciences, Air Pollutants, Public Health, Environmental and Occupational Health, Emigration and Immigration, Middle Aged, Particulates, Pollution, Environmental science, Female, New York City, Particulate Matter, Perception, Automobiles, human activities, Environmental Monitoring
Abstract

Exposure to fine particulate matter (PM2.5) and black carbon (BC) have been linked to negative health risks, but exposure among professional taxi drivers is understudied. This pilot study measured drivers' knowledge, attitudes, and beliefs (KAB) about air pollution compared with direct measures of exposures. Roadside and in-vehicle levels of PM2.5 and BC were continuously measured over a single shift on each subject, and exposures compared with central site monitoring. One hundred drivers completed an air pollution KAB questionnaire, and seven taxicabs participated in preliminary in-cab air sampling. Taxicab PM2.5 and BC concentrations were elevated compared with nearby central monitoring. Average PM2.5 concentrations per 15-min interval were 4-49 μg/m3. BC levels were also elevated; reaching>10 μg/m3. Fifty-six of the 100 drivers surveyed believed they were more exposed than non-drivers; 81 believed air pollution causes health problems. Air pollution exposures recorded suggest that driver exposures would likely exceed EPA recommendations if experienced for 24 h. Surveys indicated that driver awareness of this was limited. Future studies should focus on reducing exposures and increasing awareness among taxi drivers.

Published
2016
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49. Assessing the PM2.5 impact of biomass combustion in megacity Dhaka, Bangladesh

Author

Mostafijur Rahman, Philip K. Hopke, George D. Thurston, Kamrun Nahar, and Bilkis A. Begum

Subjects
Pollution, 010504 meteorology & atmospheric sciences, Health, Toxicology and Mutagenesis, media_common.quotation_subject, Air pollution, India, Biomass, 010501 environmental sciences, Toxicology, Atmospheric sciences, medicine.disease_cause, Combustion, Monsoon, 01 natural sciences, Article, Air Pollution, medicine, 0105 earth and related environmental sciences, media_common, Aerosols, Air Pollutants, Bangladesh, General Medicine, Particulates, Aerosol, Megacity, Environmental science, Particulate Matter, Seasons, Environmental Monitoring
Abstract

In Dhaka, Bangladesh, fine particulate matter (PM(2.5)) air pollution shows strong seasonal trends, with significantly higher mean concentrations during winter than during the monsoon (winter=178.1 μg/m(3) vs. monsoon = 30.2 μg/m(3)). Large-scale open burning of post-harvest agricultural waste across the Indo-Gangetic Plain is a major source of PM(2.5) air pollution in northern India during the non-monsoon period. This study evaluates the extent to which the seasonal differences in PM(2.5) pollution concentrations in Dhaka are accounted for by biomass-burning vs. fossil-fuel combustion sources. To assess this, an index was developed based on elemental potassium (K) as a marker for biomass particulate matter, after adjusting for soil-associated K contributions. Alternatively, particulate sulfur was employed as a tracer index for fossil-fuel combustion PM(2.5). By simultaneously regressing total PM(2.5) on S and adjusted K, the PM(2.5) mass for each day was apportioned into: 1) fossil-fuels combustion associated PM(2.5); 2) biomass-burning associated PM(2.5); and, 3) all other PM(2.5). The results indicated that fossil-fuel combustion contributed 21.6% (19.5 μg/m(3)), while biomass contributed 40.2% (36.3 μg/m(3)) of overall average PM(2.5) from September 2013 to December 2017. However, the mean source contributions varied by season: PM(2.5) in Dhaka during the monsoon season was dominated by fossil-fuels sources (44.3%), whereas PM(2.5) mass was dominated by biomass-burning (41.4%) during the remainder of the year. The contribution to PM(2.5) and each of its source components by transport of pollution into Dhaka during non-monsoon time was also evaluated by: 1) Conditional bivariate (CBPF) and pollution rose plots; 2) Concentration weighted trajectories (CWT), and; 3) NASA satellite photos to identify aerosol loading and fire locations on high pollution days. The collective evidence indicates that, while the air pollution in Dhaka is contributed to by both local and transboundary sources, the highest pollution days were dominated by biomass-related PM(2.5), during periods of crop-burning in the Indo-Gangetic Plain.

Published
2020
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50. Use of Tracer Elements for Estimating Community Exposure to Marcellus Shale Development Operations

Author

James Ross, Matthew S. Varonka, William H. Orem, Maya Nye, Michael McCawley, Travis L. Knuckles, George D. Thurston, Alexandria Dzomba, and Beizhan Yan

Subjects
unconventional natural gas development, Fine particulate, Health, Toxicology and Mutagenesis, Well stimulation, lcsh:Medicine, Natural Gas, 010501 environmental sciences, 01 natural sciences, Article, 03 medical and health sciences, 0302 clinical medicine, community exposure, Natural gas, TRACER, 030212 general & internal medicine, 0105 earth and related environmental sciences, particulate matter, Hydrology, Pollutant, Air Pollutants, business.industry, lcsh:R, Marcellus shale, Public Health, Environmental and Occupational Health, Drilling, Environmental Exposure, Models, Theoretical, Particulates, source identification, tracer elements, Environmental science, pm2.5, business, Environmental Monitoring
Abstract

Since 2009, unconventional natural gas development (UNGD) has significantly increased in Appalachia&rsquo, s Marcellus Shale formation. Elevations of fine particulate matter &lt, 2.5 &micro, m (PM2.5), have been documented in areas surrounding drilling operations during well stimulation. Furthermore, many communities are experiencing increased industrial activities and probable UNGD air pollutant exposures. Recent studies have associated UNGD emissions with health effects based on distances from well pads. In this study, PM2.5 filter samples were collected on an active gas well pad in Morgantown, West Virginia, and three locations downwind during hydraulic stimulation. Fine particulate samples were analyzed for major and trace elements. An experimental source identification model was developed to determine which elements appeared to be traceable downwind of the UNGD site and whether these elements corresponded to PM2.5 measurements. Results suggest that 1) magnesium may be useful for detecting the reach of UNGD point source emissions, 2) complex surface topographic and meteorological conditions in the Marcellus Shale region could be modeled and confounding sources discounted, and 3) well pad emissions may be measurable at distances of at least 7 km. If shown to be more widely applicable, future tracer studies could enhance epidemiological studies showing health effects of UNGD-associated emissions at &ge, 15 km.

Published
2020
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