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Li J, Zuo Y, Feng L, et al., 2024, Association of blood eosinophils with corticosteroid treatment failure stratified by smoking status among inpatients with AECOPD., BMJ Open Respir Res, Vol: 11
BACKGROUND: Recent studies have suggested elevated blood eosinophils are independent predictors of response to corticosteroid therapy in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Smoking status has been shown to affect corticosteroid response. Whether the association between high blood eosinophils and corticosteroid treatment failure is modified by smoking has not been fully investigated so far. OBJECTIVES: This study aimed to assess whether the association between high blood eosinophils and corticosteroid treatment failure is modified by smoking. METHODS: We included 3402 inpatients with AECOPD treated with corticosteroids at Beijing Chao-Yang Hospital from July 2013 to June 2021. Blood eosinophil counts were measured within 24 hours of admission. An eosinophil percentage ≥2% was considered as high eosinophilic. Smokers in this study were defined as current or former smokers. Treatment failure was defined as a worsening of AECOPD that led to adverse clinical outcomes or required further treatment or an extended hospital stay or hospitalisation following the exacerbation. Multivariate-adjusted logistic models were used to estimate the OR and 95% CI associated with treatment failure. RESULTS: There were 958 (28.2%) treatment failure events occurring. Patients with high eosinophils had a lower risk of treatment failure (OR 0.74, 95% CI 0.63 to 0.87) than patients with low eosinophils. Compared with never smoking and low eosinophilic group, the ORs for treatment failure were 0.70 (95% CI 0.52 to 0.96) for never smoking and high eosinophilic group, 0.82 (95% CI 0.64 to 1.05) for smoking and low eosinophilic group and 0.62 (95% CI 0.47 to 0.81) for smoking and high eosinophilic group. Furthermore, there was no significant interaction between eosinophils and smoking status in relation to treatment failure (p for interaction=0.73). Similar results were obtained from multiple secondary outcomes and subgroup analyses. CONCLUSION:
Wang J, Yang T, Hu X, et al., 2024, Association of Road Traffic Noise with Obesity and the Role of Meat Intake: A Prospective Study from UK Biobank, Environment & Health, ISSN: 2833-8278
Guyatt AL, Cai YS, Doiron D, et al., 2024, Air pollution, lung function and mortality: survival and mediation analyses in UK Biobank., ERJ Open Res, Vol: 10, ISSN: 2312-0541
BACKGROUND: Air pollution is associated with lower lung function, and both are associated with premature mortality and cardiovascular disease (CVD). Evidence remains scarce on the potential mediating effect of impaired lung function on the association between air pollution and mortality or CVD. METHODS: We used data from UK Biobank (n∼200 000 individuals) with 8-year follow-up to mortality and incident CVD. Exposures to particulate matter <10 µm (PM10), particulate matter <2.5 µm (PM2.5) and nitrogen dioxide (NO2) were assessed by land-use regression modelling. Lung function (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and the FEV1/FVC ratio) was measured between 2006 and 2010 and transformed to Global Lung Function Initiative (GLI) z-scores. Adjusted Cox proportional hazards and causal proportional hazards mediation analysis models were fitted, stratified by smoking status. RESULTS: Lower FEV1 and FVC were associated with all-cause and CVD mortality, and incident CVD, with larger estimates in ever- than never-smokers (all-cause mortality hazard ratio per FEV1 GLI z-score decrease 1.29 (95% CI 1.24-1.34) for ever-smokers and 1.16 (95% CI 1.12-1.21) for never-smokers). Long-term exposure to PM2.5 or NO2 was associated with incident CVD, with similar effect sizes for ever- and never-smokers. Mediated proportions of the air pollution-all-cause mortality estimates driven by FEV1 were 18% (95% CI 2-33%) for PM2.5 and 27% (95% CI 3-51%) for NO2. Corresponding mediated proportions for incident CVD were 9% (95% CI 4-13%) for PM2.5 and 16% (95% CI 6-25%) for NO2. CONCLUSIONS: Lung function may mediate a modest proportion of associations between air pollution and mortality and CVD outcomes. Results likely reflect the extent of either shared mechanisms or direct effects relating to lower lung function caused by air pollution.
Feng L, Li J, Qian Z, et al., 2024, Comprehensive Nomograms Using Routine Biomarkers Beyond Eosinophil Levels: Enhancing Predictability of Corticosteroid Treatment Outcomes in AECOPD., J Inflamm Res, Vol: 17, Pages: 1511-1526, ISSN: 1178-7031
PURPOSE: Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) exhibit heterogeneous responses to corticosteroid treatment. We aimed to determine whether combining eosinophil levels with other routine clinical indicators can enhance the predictability of corticosteroid treatment outcomes and to come up with a scoring system. PATIENTS AND METHODS: Consecutive patients admitted with AECOPD receiving corticosteroid treatment between July 2013 and March 2022 at Beijing Chao-Yang Hospital were retrospectively analyzed. Data on patients' demographics, smoking status, hospitalization for AECOPD in the previous year, comorbidities, blood laboratory tests, in-hospital treatment and clinical outcomes were collected. Least absolute shrinkage and selection operator (LASSO) regression and backward logistic regression were used for predictor selection, and predictive nomograms were developed. The discrimination and calibration of the nomograms were assessed using the area under the receiver operating curve (AUC) and calibration plots. Internal validation was performed using the 500-bootstrap method, and clinical utility was evaluated using decision curve analysis (DCA). RESULTS: Among the 3254 patients included, 804 (24.7%) had treatment failure. A nomogram of eosinophils, platelets, C-reactive protein (CRP), low density lipoprotein cholesterol, prognostic nutritional index (PNI), hospitalization for AECOPD in the previous year, ischemic heart diseases and chronic hepatic disease was developed to predict treatment failure for patients with a smoking history. For patients without a smoking history, a nomogram of CRP, PNI, ischemic heart diseases and chronic hepatic disease was developed. Although the AUCs of these two nomograms were only 0.644 and 0.647 respectively, they were significantly superior to predictions based solely on blood eosinophil levels. CONCLUSION: We developed easy-to-use comprehensive nomograms utilizing readily available clinical b
Li J, Liang L, Lyu B, et al., 2023, Double trouble: The interaction of PM2.5 and O3 on respiratory hospital admissions., Environ Pollut, Vol: 338
The co-occurrence of fine particulate matter (PM2.5) and ozone (O3) pollution during the warm season has become a growing public health concern. The interaction between PM2.5 and O3 and its contribution to disease burden associated with co-pollution has not been thoroughly examined. We collected data on hospital admissions for respiratory diseases from a city-wide hospital discharge database in Beijing between 2013 and 2019. City-wide 24-h mean PM2.5 and daily maximum 8-h mean O3 were averaged from 35 monitoring stations across Beijing. Conditional Poisson regression was employed to estimate the interaction between warm-season PM2.5 and O3 on respiratory admissions. A model incorporating a tensor product term was used to fit the non-linear interaction and estimate the number of respiratory admissions attributable to PM2.5 and O3 pollution. From January 18, 2013 to December 31, 2019, 1,191,308 respiratory admissions were recorded. We observed multiplicative interactions between warm-season PM2.5 and O3 on upper respiratory infections (P = 0.004), pneumonia (P = 0.002), chronic obstructive pulmonary disease (P = 0.041), and total respiratory disease (P < 0.001). PM2.5-O3 co-pollution during warm season exhibited a super-additive effect on respiratory admissions, with a relative excess risk due to interaction of 1.65% (95%CI: 0.46%-2.84%). There was a non-linear pattern of the synergistic effect between PM2.5 and O3 on respiratory admissions. Based on the World Health Organization global air quality guidelines, 12,421 respiratory admissions would be reduced if both daily PM2.5 and O3 concentrations had not exceeded the target (PM2.5 15 μg/m3, O3 100 μg/m3). The number of respiratory admissions attributable to either PM2.5 or O3 pollution decreased by 48.7% from 2013 to 2019. Prioritizing O3 control during the warm season is a cost-effective strategy for Beijing. These findings underscore the significance of con
Eminson K, Cai YS, Chen Y, et al., 2023, Does air pollution confound associations between environmental noise and cardiovascular outcomes?-A systematic review, ENVIRONMENTAL RESEARCH, Vol: 232, ISSN: 0013-9351
Cai YS, Mustapha A, 2023, Editorial: Environmental health in informal settlements: current progress, challenges and perspectives, FRONTIERS IN PUBLIC HEALTH, Vol: 11
Yang T, Hu X, Wang J, et al., 2023, Long-Term Exposure to Road Traffic Noise and Incident Heart Failure Evidence From UK Biobank, JACC-HEART FAILURE, Vol: 11, Pages: 986-996, ISSN: 2213-1779
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Hu X, Yang T, Xu Z, et al., 2023, Mediation of metabolic syndrome in the association between long-term co-exposure to road traffic noise, air pollution and incident type 2 diabetes, ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY, Vol: 258, ISSN: 0147-6513
Savoure M, Eminson K, Sese L, et al., 2023, The exposome in respiratory diseases: multiple preventable risk factors from early life to adulthood, BREATHE, Vol: 19, ISSN: 1810-6838
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Gao D, Cai YS, Pan Y, et al., 2023, Editorial: Epidemiology and clinical researches in atherosclerosis and cardiovascular disease, FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol: 10, ISSN: 2297-055X
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Liang L, Lin Y, Feng L, et al., 2023, Multicentre double-blind randomised controlled trial of systematic corticosteroid therapy in patients with acute exacerbations of chronic obstructive pulmonary disease admitted to hospital with higher eosinophil levels: the ECHO protocol, BMJ OPEN, Vol: 13, ISSN: 2044-6055
Yang L, Yang Z, Zhao Z, et al., 2023, Exposure to greenness, air pollution and respiratory health among pre-school children in northern China, ATMOSPHERIC ENVIRONMENT, Vol: 298, ISSN: 1352-2310
Huang J, Yang T, Gulliver J, et al., 2023, Road Traffic Noise and Incidence of Primary Hypertension: A Prospective Analysis in UK Biobank., JACC Adv, Vol: 2
BACKGROUND: The quality of evidence regarding the associations between road traffic noise and hypertension is low due to the limitations of cross-sectional study design, and the role of air pollution remains to be further clarified. OBJECTIVES: The purpose of this study was to evaluate the associations of long-term road traffic noise exposure with incident primary hypertension; we conducted a prospective population-based analysis in UK Biobank. METHODS: Road traffic noise was estimated at baseline residential address using the common noise assessment method model. Incident hypertension was ascertained through linkage with medical records. Cox proportional hazard models were used to estimate hazard ratios (HRs) for association in an analytical sample size of over 240,000 participants free of hypertension at baseline, adjusting for covariates determined via directed acyclic graph. RESULTS: During a median of 8.1 years follow-up, 21,140 incident primary hypertension (International Classification of Diseases-10th Revision [ICD-10]: I10) were ascertained. The HR for a 10 dB[A] increment in mean weighted average 24-hour road traffic noise level (L den ) exposure was 1.07 (95% CI: 1.02-1.13). A dose-response relationship was found, with HR of 1.13 (95% CI: 1.03-1.25) for L den >65 dB[A] vs ≤55 dB[A] (P for trend <0.05). The associations were all robust to adjustment for fine particles (PM2.5) and nitrogen dioxide (NO2). Furthermore, high exposure to both road traffic noise and air pollution was associated with the highest hypertension risk. CONCLUSIONS: Long-term exposure to road traffic noise was associated with increased incidence of primary hypertension, and the effect estimates were stronger in presence of higher air pollution.
Xie W, Zhong B, Liang L, et al., 2023, Editorial: Epidemiology and clinical researches on neuropsychiatric disorders in aging, FRONTIERS IN PSYCHIATRY, Vol: 14, ISSN: 1664-0640
Chen Y, Hansell AL, Clark SN, et al., 2023, Environmental noise and health in low-middle-income-countries: A systematic review of epidemiological evidence, ENVIRONMENTAL POLLUTION, Vol: 316, ISSN: 0269-7491
Li J, Cai YS, Kelly FJ, et al., 2023, Landscape fire smoke enhances the association between fine particulate matter exposure and acute respiratory infection among children under 5 years of age: findings of a case-crossover study for 48 low- and middle-income countries, Environment International, Vol: 171, ISSN: 0160-4120
BackgroundFine particulate matter (PM2.5) produced by landscape fires is thought to be more toxic than that from non-fire sources. However, the effects of “fire-sourced” PM2.5 on acute respiratory infection (ARI) are unknown.MethodsWe combined Demographic and Health Survey (DHS) data from 48 countries with gridded global estimates of PM2.5 concentrations from 2003 to 2014. The proportions of fire-sourced PM2.5 were assessed by a chemical transport model using a variety of PM2.5 source data. We tested for associations between ARI and short-term exposure to fire- and “non-fire-sourced” PM2.5 using a bidirectional case-crossover analysis. The robustness and homogeneity of the associations were examined by sensitivity analyses. We also established a nonlinear exposure–response relationship between fire- and non-fire-sourced PM2.5 and ARI using a two-dimensional spline function.ResultsThe study included 36,432 children under 5 years who reported ARI symptoms. Each 1 µg/m3 increment of fire-sourced PM2.5 was associated with a 3.2 % (95 % confidence interval [CI] 0.2, 6.2) increment in the risk of ARI. This effect was comparable to that of each ∼5 µg/m3 increment in PM2.5 from non-fire sources (3.1 %; 95 % CI 2.4, 3.7). The association between ARI and total PM2.5 concentration was significantly mediated by the proportion of fire-sourced particles. Nonlinear analysis showed that the risk of ARI was increased by both fire- and non-fire-sourced PM2.5, but especially by the former.ConclusionsPM2.5 produced by landscape fire was more strongly associated to ARI among children under 5 years than that from non-fire sources.
Li C, Gao D, Cai YS, et al., 2023, Relationships of Residential Distance to Major Traffic Roads with Dementia Incidence and Brain Structure Measures: Mediation Role of Air Pollution, Health Data Science, Vol: 3
<jats:p> <jats:bold>Background:</jats:bold> Uncertainty exists regarding the operating pathways between near-roadway exposure and dementia incidence. We intend to examine relationships between proximity to major roadways with dementia incidence and brain MRI structure measures, and potential mediation roles of air and noise pollution. <jats:bold>Methods:</jats:bold> The cohort study was based on the UK Biobank. Baseline survey was conducted from 2006 to 2010, with linkage to electronic health records conducted for follow-up. Residential distance to major roadways was ascertained residential address postcode. A land use regression model was applied for estimating traffic-related air pollution at residence. Dementia incidence was ascertained using national administrative databases. Brain MRI measures were derived as image-derived phenotypes, including total brain, white matter, gray matter, and peripheral cortical gray matter. <jats:bold>Results:</jats:bold> We included 460,901 participants [mean (SD) age: 57.1 (8.1) years; men: 45.7%]. Compared with individuals living >1,000 m from major traffic roads, living ≤1,000 m was associated with a 13% to 14% higher dementia risk, accounting for 10% of dementia cases. Observed association between residential distance and dementia was substantially mediated by traffic-related air pollution, mainly nitrogen dioxide (proportion mediated: 63.6%; 95% CI, 27.0 to 89.2%) and PM <jats:sub>2.5</jats:sub> (60.9%, 26.8 to 87.0%). The shorter residential distance was associated with smaller volumes of brain structures, which was also mediated by traffic-related air pollutants. No significant mediation role was observed of noise pollution. <jats:bold>Conclusions:</jats:bold> The shorter residential distance to major roads was associated with elevated demen
Li J, Liang L, Feng L, et al., 2023, The Prognostic Value of Blood Eosinophil Level in AECOPD is Influenced by Corticosteroid Treatment During Hospitalization, JOURNAL OF INFLAMMATION RESEARCH, Vol: 16, Pages: 3233-3243
Zhang H, Fan Y, Han Y, et al., 2022, Partitioning indoor-generated and outdoor-generated PM2.5 from real-time residential measurements in urban and peri-urban Beijing, Science of the Total Environment, Vol: 845, ISSN: 0048-9697
Limited number of projects have attempted to partition and quantify indoor- and outdoor-generated PM2.5 (PM2.5ig and PM2.5og) where strong indoor sources (e.g., solid fuel, tobacco smoke, or kerosene) exist. This study aimed to apply and refine a previous recursive model used to derive infiltration efficiency (Finf) to additionally partition pollution concentrations into indoor and outdoor origins within residences challenged by elevated ambient and indoor combustion-related sources. During the winter of 2016 and summer of 2017 we collected residential measurements in 72 homes in urban and peri-urban Beijing, 12 of which had additional paired residential outdoor measurements during the summer season. Local ambient measurements were collected throughout. We then compared the calculated PM2.5ig and using (i) outdoor and (ii) ambient measurements as model inputs. The results from outdoor and ambient measurements were not significantly different, which suggests that ambient measurements can be used as a model input for pollution origin partitioning when paired outdoor measurements are not available. From the results calculated using ambient measurements, the mean percentage contribution of indoor-generated PM2.5 was 19 % (σ = 22 %), and 7 % (11 %) of the total indoor PM2.5 for peri-urban and urban homes respectively during the winter; and 18 % (18 %) and 6 % (10 %) of the total indoor PM2.5 during the summer. Partitioning pollution into PM2.5ig and PM2.5og is important to allow investigation of distinct associations between health outcomes and particulate mixes, often with different physiochemical composition and toxicity. It will also inform targeted interventions that impact indoor and outdoor sources of pollution (e.g., domestic fuel switching vs. power generation), which are typically radically different in design and implementation.
Roscoe C, Mackay C, Gulliver J, et al., 2022, Associations of private residential gardens versus other greenspace types with cardiovascular and respiratory disease mortality: observational evidence from UK Biobank, Environment International, Vol: 167, ISSN: 0160-4120
BackgroundLongitudinal evidence linking urban greenspace to reduced rates of all-cause and cause-specific mortality has mostly been established using greenness measures of limited specificity such as vegetation indices. Evidence on specific green space types, including private residential gardens is less well established.MethodsWe examined associations of greenspace with all-cause, non-injury, cardiovascular disease (CVD) and respiratory disease deaths in UK Biobank – a national prospective cohort of adults with linked Office for National Statistics mortality records. We included private residential gardens and other greenspace types e.g. public parks, sport facilities, using categories from Ordnance Survey MasterMap™ Greenspace. We used Cox proportional hazards models, adjusted for individual and area-level covariates, and stratified analyses by sex, household income, and area-level deprivation. In sensitivity analyses, we further adjusted for air pollution, road-traffic noise, indirect tobacco smoke exposure, and physical activity, and restricted analyses to non-movers.ResultsIn 232,926 participants, we observed 13,586 all-cause, 13,159 non-injury, 2,796 cardiovascular (CVD), and 968 respiratory disease deaths. Private residential garden cover showed inverse associations with all-cause, non-injury, CVD, and chronic respiratory disease mortality, after adjustment for covariates and other types of greenspace, with hazard ratios and 95% confidence intervals of 0.94 (0.91, 0.97), 0.95 (0.92, 0.97), 0.92 (0.86, 0.98) and 0.87 (0.78, 0.98), respectively, per interquartile range (IQR) increase in private residential garden cover (IQR = 21.6% increase within 100 m buffer). Other greenspace types showed weaker inverse associations with CVD and chronic respiratory disease mortality than private residential gardens. Sex, household income, and area level deprivation modified associations. Findings were robust to sensitivity analyses.ConclusionOur finding that priv
Belt RV, Rahimi K, Cai S, 2022, Researching the hard-to-reach: a scoping review protocol of digital health research in hidden, marginal and excluded populations, BMJ OPEN, Vol: 12, ISSN: 2044-6055
Fisher T, Gibson H, Liu Y, et al., 2022, Uncertainty-Aware Interpretable Deep Learning for Slum Mapping and Monitoring, REMOTE SENSING, Vol: 14
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Mamouei M, Zhu Y, Nazarzadeh M, et al., 2022, Investigating the association of environmental exposures and all-cause mortality in the UK Biobank using sparse principal component analysis, SCIENTIFIC REPORTS, Vol: 12, ISSN: 2045-2322
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Liang L, Cai Y, Lyu B, et al., 2022, Air pollution and hospitalization of patients with idiopathic pulmonary fibrosis in Beijing: a time-series study, RESPIRATORY RESEARCH, Vol: 23
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Lyu B, Cai Y, Sun Z, et al., 2022, Evaluating temporally decomposed associations between PM<sub>2.5</sub> and hospitalisation risks of AECOPD: A case study in Beijing from 2010 to 2019, ATMOSPHERIC POLLUTION RESEARCH, Vol: 13, ISSN: 1309-1042
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Cai YS, Gibson H, Ramakrishnan R, et al., 2021, Ambient Air Pollution and Respiratory Health in Sub-Saharan African Children: A Cross-Sectional Analysis, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 18
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Cai Y, 2021, Ambient pollen and air quality on children's lung function: is there a synergy?, THORAX, Vol: 76, Pages: 858-859, ISSN: 0040-6376
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Kupcikova Z, Fecht D, Ramakrishnan R, et al., 2021, Road traffic noise and cardiovascular disease risk factors in UK Biobank, European Heart Journal, Vol: 42, Pages: 2072-2084, ISSN: 0195-668X
Aims: The aim of this study was to investigate the cross-sectional associations of modelled residential road traffic noise with cardiovascular disease risk factors [systolic (SBP) and diastolic blood pressure (DBP), C-reactive protein, triglycerides, glycated haemoglobin, and self-reported hypertension] in UK Biobank.Methods and results: The UK Biobank recruited 502 651 individuals aged 40–69 years across the UK during 2006–10. Road traffic noise (Lden and Lnight) exposure for 2009 was estimated at baseline address using a simplified version of the Common Noise Assessment Methods model. We used multivariable linear and logistic regression models, adjusting for age, sex, body mass index (BMI), smoking, alcohol intake, area- and individual-level deprivation, season of blood draw, length of time at residence, and nitrogen dioxide (main model), in an analytical sample size of over 370 000 participants. Exposure to road-traffic Lden >65 dB[A], as compared to ≤55 dB[A], was associated with 0.77% [95% confidence interval (CI) 0.60%, 0.95%], 0.49% (95% CI 0.32%, 0.65%), 0.79% (95% CI 0.11%, 1.47%), and 0.12% (95% CI −0.04%, 0.28%) higher SBP, DBP, triglycerides, and glycated haemoglobin, respectively. Removing BMI from the main model yielded significant positive associations with all five markers with elevated percent changes. The associations with SBP or DBP did not appear to be impacted by hypertension medication while a positive association with prevalent self-reported hypertension was seen in the non-medicated group who exposed to a Lden level of 60–65 dB[A] (odds ratio 1.07, 95% CI 1.00, 1.15).Conclusion: Exposure to road traffic noise >65 dB[A], independent of nitrogen dioxide, was associated with small but adverse changes in blood pressure and cardiovascular biochemistry.
Zheng F, Cai Y, Han X, et al., 2021, Reduced Lung Function and Cognitive Decline in Aging: A Longitudinal Cohort Study, ANNALS OF THE AMERICAN THORACIC SOCIETY, Vol: 18, Pages: 373-376, ISSN: 1546-3222
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