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Combustion related particulate matter air pollution (PM) is associated with an increased risk of respiratory infections in adults. The exact mechanism underlying this association has not been determined. We hypothesized that increased concentrations of combustion related PM would result in dysregulation of the innate immune system. This epidemiological study includes 111 adult patients hospitalized with respiratory infections who underwent transcriptional analysis of their peripheral blood. We examined the association between gene expression at the time of hospitalization and ambient measurements of particulate air pollutants in the 28 days prior to hospitalization. For each pollutant and time lag, gene-specific linear models adjusting for infection type were fit using LIMMA (Linear Models For Microarray Data), and pathway/gene set analyses were performed using the CAMERA (Correlation Adjusted Mean Rank) program. Comparing patients with viral and/or bacterial infection, the expression patterns associated with air pollution exposure differed. Adjusting for the type of infection, increased concentrations of Delta-C (a marker of biomass smoke) and other PM were associated with upregulation of iron homeostasis and protein folding. Increased concentrations of black carbon (BC) were associated with upregulation of viral related gene pathways and downregulation of pathways related to antigen presentation. The pollutant/pathway associations differed by lag time and by type of infection. This study suggests that the effect of air pollution on the pathogenesis of respiratory infection may be pollutant, timing, and infection specific.

Background: Previous work reported increased rates of acute cardiovascular hospitalizations associated with increased PM2.5 concentrations in the previous few days across urban centers in New York State from 2005 to 2016. These relative rates were higher after air quality policies and economic changes resulted in decreased PM2.5 concentrations and changes in PM composition (e.g. increased secondary organic carbon), compared to before and during these changes. Changes in PM composition and sources may explain this difference. Objectives: To estimate the rate of acute cardiovascular hospitalizations associated with increases in source specific PM2.5 concentrations. Methods: Using source apportioned PM2.5 concentrations at the same NYS urban sites, a time-stratified case-crossover design, and conditional logistic regression models adjusting for ambient temperature and relative humidity, we estimated the rate of these acute cardiovascular hospitalizations associated with increases in mean source specific PM2.5 concentrations in the previous 1, 4, and 7 days. Results: Interquartile range (IQR) increases in spark-ignition emissions (GAS) concentrations were associated with increased excess rates of cardiac arrhythmia hospitalizations (2.3%; 95% CI = 0.4%, 4.2%; IQR = 2.56 μg/m3) and ischemic stroke hospitalizations (3.7%; 95% CI = 1.1%, 6.4%; 2. 73 μg/m3) over the next day. IQR increases in diesel (DIE) concentrations were associated with increased rates of congestive heart failure hospitalizations (0.7%; 95% CI = 0.2% 1.3%; 0.51 μg/m3) and ischemic heart disease hospitalizations (0.8%; 95% CI = 0.3%, 1.3%; 0.60 μg/m3) over the next day, as hypothesized. However, secondary sulfate PM2.5 (SS) was not. Increased acute cardiovascular hospitalization rates were also associated with IQR increases in concentrations of road dust (RD), residual oil (RO), and secondary nitrate (SN) over the previous 1, 4, and 7 days, but not other sources. Conclusions: These findings suggest a role of several sources of PM2.5 in New York State (i.e. traffic emissions, non-traffic emissions such as brake and tire wear, residual oil, and nitrate that may also reflect traffic emissions) in the triggering of acute cardiovascular events. Keywords: Cardiovascular hospitalizations, Air pollution, Source apportionment, Traffic emissions

Increased ambient air pollutant concentrations during pregnancy have been associated with reduced birth weight, but the etiologically relevant pregnancy time window(s) is/are unclear. In 76,500 singleton births in Monroe County, NY (2005–2016), who were 37–42 gestational weeks at delivery, we used generalized linear models to regress term birth weight against mean gestational month pollutant concentrations, adjusting for mean temperature, and maternal, infant, and medical service use characteristics. Overall, there were no clear patterns of term birth weight change associated with increased concentrations of any pollutant across gestational months. However, among Hispanic women only, increases in all pollutants, except O3, in multiple gestational months, were associated with decreased term birth weight. Each 3.25 µg/m3 increase in PM2.5 concentration in the 6th gestational month was associated with a −20.4 g (95% CI = −34.0, −6.8) reduction in term birth weight among Hispanic women, but a 4.1 g (95% CI = −2.5, 10.8) increase among non-Hispanic mothers (p for interaction

PURPOSE: Long-term exposure to ambient fine particle (PM(2.5)) concentrations has been associated with an increased rate or risk of neurodegenerative conditions but individual PM sources have not been previously examined in relation to neurodegenerative diseases. METHODS: Using the Statewide Planning and Research Cooperative System database, we studied 63,287 hospital admissions with a primary diagnosis of either Alzheimer’s disease (AD), dementia, or Parkinson’s disease (PD) for New York State (NYS) residents living within 15 miles from six PM(2.5) monitoring sites. In addition to PM(2.5) concentrations, we studied seven specific PM(2.5) sources: secondary sulfate, secondary nitrate, biomass burning, diesel, spark-ignition emissions, pyrolyzed organic rich, and road dust. We estimated the rate of neurodegenerative hospital admissions associated with increased concentration of PM(2.5) and individual PM(2.5) sources average concentrations in the previous 0–29, 0–179, and 0–364 days. RESULTS: Increases in ambient PM(2.5) concentrations were not consistently associated with increased hospital admissions rates. Increased source-specific PM2.5 concentrations were associated with both increased (e.g., secondary sulfates and diesel emissions) and decreased rates (e.g., secondary nitrate and spark-ignition vehicular emissions) of neurodegenerative admissions. CONCLUSIONS: We did not observe clear associations between overall ambient PM(2.5) concentrations or source apportioned ambient PM(2.5) contributions and rates of neurologic disease hospitalizations.

Prior work found increased rates for emergency department (ED) visits for asthma and hospitalizations for chronic obstructive pulmonary disease per unit mass of PM2.5 across New York State (NYS) during 2014–2016 after significant reductions in ambient PM2.5 concentrations had occurred following implementation of various policy actions and major economic disruptions. The associations of source-specific PM2.5 concentrations with these respiratory diseases were assessed with a time-stratified case-cossover design and logistic regression models to identify the changes in the PM2.5 that have led to the apparently increased toxicity per unit mass. The rates of ED visits and hospitalizations for asthma and COPD associated with increases in source-specific PM2.5 concentrations in the prior 1, 4, and 7 days were estimated for 6 urban sites in New York State. Overall, there were similar numbers of significantly increased (n = 9) and decreased rates (n = 8) of respiratory events (asthma and COPD hospitalizations and ED visits) associated with increased source-specific PM2.5 concentrations in the previous 1, 4, and 7 days. Associations of source-specific PM2.5 concentrations with excess rates of hospitalizations for COPD for spark- and compression ignition vehicles increased in the 2014–2016 period, but the values were not statistically significant. Other source types showed inconsistent patterns of excess rates. For asthma ED visits, only biomass burning and road dust showed consistent positive associations with road dust having significant values for most lag times. Secondary nitrate also showed significant positive associations with asthma ED visits in the AFTER period compared to no associations in the prior periods. These results suggest that the relationships of asthma and COPD exacerbation with source-specific PM2.5 are not well defined and further work will be needed to determine the causes of the apparent increases in the per unit mass toxicity of PM2.5 in New York State in the 2014-16 period.

Increased ambient air pollutant concentrations during pregnancy have been associated with reduced birth weight, but the etiologically relevant pregnancy time window(s) is/are unclear. In 76,500 singleton births in Monroe County, NY (2005-2016), who were 37-42 gestational weeks at delivery, we used generalized linear models to regress term birth weight against mean gestational month pollutant concentrations, adjusting for mean temperature, and maternal, infant, and medical service use characteristics. Overall, there were no clear patterns of term birth weight change associated with increased concentrations of any pollutant across gestational months. However, among Hispanic women only, increases in all pollutants, except O

The northeastern United States has experienced significant emissions reductions in the last two decades leading to a decrease in PM2.5, major gaseous pollutants (SO2, CO, NOx) and ultrafine particles (UFPs) concentrations. Emissions controls were implemented for coal-fired power plants, and new heavy-duty diesel trucks were equipped with particle traps and NOx control systems, and ultralow sulfur content is mandatory for both road and non-road diesel as well as residual oil for space heating. At the same time, economic changes also influenced the trends in air pollutants. Investigating the influence of these changes on ultrafine particle sources is fundamental to determine the success of the mitigation strategies and to plan future actions. Particle size distributions have been measured in Rochester, NY since January 2002. The particle sources were investigated with positive matrix factorization (PMF) of the size distributions (11&ndash, 470 nm) and measured criteria pollutants during five periods (2002&ndash, 2003, 2004&ndash, 2007, 2008&ndash, 2010, 2011&ndash, 2013, and 2014&ndash, 2016) and three seasons (winter, summer, and transition). Monthly, weekly, and hourly source contributions patterns were evaluated.

Rationale: Fine particulate matter air pollution of 2.5 μm or less in diameter (PM2.5) has been associated with an increased risk of respiratory disease, but assessments of specific respiratory infections in adults are lacking. Objectives: To estimate the rate of respiratory infection healthcare encounters in adults associated with acute increases in PM2.5 concentrations. Methods: Using case–crossover methods, we studied 498,118 adult New York State residents with a primary diagnosis of influenza, bacterial pneumonia, or culture-negative pneumonia upon hospitalization or emergency department (ED) visit (2005–2016). We estimated the relative rate of healthcare encounters associated with increases in PM2.5 in the previous 1–7 days and explored differences before (2005–2007), during (2008–2013), and after (2014–2016) implementation of air quality policies and economic changes. Results: Interquartile range increases in PM2.5 over the previous 7 days were associated with increased excess rates (ERs) of culture-negative pneumonia hospitalizations (2.5%; 95% confidence interval [CI], 1.7–3.2%) and ED visits (2.5%; 95% CI, 1.4–3.6%), and increased ERs of influenza ED visits (3.9%; 95% CI, 2.1–5.6%). Bacterial pneumonia hospitalizations, but not ED visits, were associated with increases in PM2.5 and, though imprecise, were of a similar magnitude to culture-negative pneumonia (Lag Day 6 ER, 2.3%; 95% CI, 0.3–4.3). Increased relative rates of influenza ED visits and culture-negative pneumonia hospitalizations were generally larger in the “after” period (P

The United States has experienced substantial air pollutant emissions reductions in the last two decades. Among others, emissions produced by electricity generation plants and industries were significantly lowered. Ultralow (

Prior studies reported that exposure to increased concentrations of fine particulate matter (PM2.5) were associated with increased rates of hospitalization and emergency department (ED) visits for asthma and chronic obstructive pulmonary disease (COPD). In this study, rates were examined from 2005 to 2016 using a case-crossover design to ascertain if there have been changes in the rates per unit mass exposure given substantial reductions in PM2.5 concentration and changes in its composition. PM2.5 concentrations were reduced through a combination of policies designed to improve air quality and economic drivers, including the 2008 economic recession and shifts in the relative costs of coal and natural gas. The study period was split into three periods reflecting that much of the emissions changes occurred between 2008 and 2013. Thus, the three periods were defined as: BEFORE (2005 to 2007), DURING (2008–2013), and AFTER (2014–2016). In general, the number of hospitalizations and ED visits declined with the decreased concentration of PM2.5. However, the rate of COPD hospitalizations and asthma ED visits associated with each interquartile range increase in ambient PM2.5 concentration was larger in the AFTER period than the DURING and BEFORE periods. For example, each 6.8 μg/m3 increase in PM2.5 on the same day was associated with 0.4% (0.0%, 0.8%), 0.3% (−0.2%, 0.7%), and 2.7% (1.9%, 3.5) increases in the rate of asthma emergency department visits in the BEFORE, DURING, and AFTER periods, respectively, suggesting the same mass concentration of PM2.5 was more toxic in the AFTER period.

Conditional probability functions are commonly used for source identification purposes in air pollution studies. CBPF (conditional bivariate probability function) categorizes the probability of high concentrations being observed at a location by wind direction/speed and investigate the directionality of local sources. PSCF (potential source contribution function), a trajectory-ensemble method, identifies the source regions most likely to be associated with high measured concentrations. However, these techniques do not allow the direct identification of areas where changes in emissions have occurred. This study presents an extension of conditional probability methods in which the differences between conditional probability values for temporally different sets of data can be used to explore changes in emissions from source locations. The differential CBPF and differential PSCF were tested using a long-term series of air quality data (12 years; 2005/2016) collected in Rochester, NY. The probability functions were computed for each of 4 periods that represent known changes in emissions. Correlation analyses were also performed on the results to find pollutants undergoing similar changes in local and regional sources. The differential probability functions permitted the identification of major changes in local and regional emission location. In Rochester, changes in local air pollution were related to the shutdown of a large coal power plant (SO2) and to the abatement measures applied to road and off-road traffic (primary pollutants). The concurrent effects of these changes in local emissions were also linked to reduced concentrations of nucleation mode particles. Changes in regional source areas were related to the decreases in secondary inorganic aerosol and organic carbon. The differential probabilities for sulfate, nitrate, and organic aerosol were consistent with differences in the available National Emission Inventory annual emission values. Changes in the source areas of black carbon and PM2.5 mass concentrations were highly correlated.

Previous studies have reported increased risks of myocardial infarction in association with elevated ambient particulate matter (PM) in the previous hour(s). However, whether PM can trigger mechanisms that act on this time scale is still unclear. We hypothesized that increases in PM are associated with rapid changes in measures of heart rate variability and repolarization. We used data from panel studies in Augsburg, Germany, and Rochester, New York, USA, and two controlled human exposure studies in Rochester. Data included ECG recordings from all four studies, controlled exposures to (concentrated) ultrafine particles (UFP; particles with an aerodynamic diameter 2.5, aerodynamic diameter 2.5 concentrations in the preceding six hours in both panel studies. We did not find consistent associations between particle metrics and T-wave complexity. This study provided consistent evidence that recent exposures to UFP and PM2.5 can induce acute pathophysiological responses.

Background Previous studies have reported that fine particle (PM2.5) concentrations triggered ST elevation myocardial infarctions (STEMI). In Rochester, NY, multiple air quality policies and economic changes/influences from 2008 to 2013 led to decreased concentrations of PM2.5 and its major constituents (SO42−, NO3−, elemental and primary organic carbon). This study examined whether the rate of STEMI associated with increased ambient gaseous and PM component concentrations was different AFTER these air quality policies and economic changes (2014–2016), compared to DURING (2008–2013) and BEFORE these polices and changes (2005–2007). Methods Using 921 STEMIs treated at the University of Rochester Medical Center (2005–2016) and a case-crossover design, we examined whether the rate of STEMI associated with increased PM2.5, ultrafine particles (UFP

BACKGROUND: Previous studies have reported associations between ambient fine particle (PM(2.5)) concentrations and hypertensive disorders of pregnancy (HDP). However, none have examined whether ultrafine particles (UFP

Significant changes in emission sources have occurred in the northeastern United States over the past decade, due in part to the implementation of emissions standards, the introduction and addition of abatement technologies for road transport, changes in fuel sulfur content for road and non-road transport, as well as economic impacts of a major recession and differential fuel prices. These changes in emission scenarios likely affected the concentrations of airborne submicron particles. This study investigated the characteristics of 11-500nm particle number concentrations and their size spectra in Rochester, NY during the past 15years (2002 to 2016). The modal structure, diurnal, weekly and monthly patterns of particle number concentrations are analyzed. Long-term trends are quantified using seasonal-trend decomposition procedures based on "Loess", Mann-Kendall regression with Theil-Sen slope and piecewise regression. Particle concentrations underwent significant (p0.05) downward trends. An annual decrease of -323particles/cm

To compare grocery costs between relatively high energy density foods and sugar-sweetened/high-fat beverages and lower energy density foods and more healthful beverages in children's diets.Sixty foods were divided into high and low energy density baskets. Fourteen beverages were designated to either basket based on fat and added-sugar content. Prices were collected at 60 grocery stores and composite costs compared between baskets using Wilcoxon tests.The cost per kilogram of high energy density foods was greater, but the cost per quart of sugar-sweetened/high-fat beverages was lower than more healthful beverages. The cost per 1000 calories and the cost per serving of the high energy density basket were lower.The relative cost of high and low energy density foods in children's diets depends on how cost is quantified. "Pound-for-pound," lower energy density foods and more healthful beverages are generally less expensive, but high energy density foods and less healthful beverages are cheaper per serving. Cost metrics including other factors (e.g. time cost) may further clarify the role of grocery prices in children's diets.

Previously, we reported that increased PM concentrations triggered ST elevation myocardial infarction (STEMI), with the largest rate of MI when pollutant mixtures were high in secondary particles. ...

The development and implementation of effective policies for controlling PM2.5 mass concentrations and protecting human health depend upon the identification and apportionment of its sources. In this study, the PM2.5 sources affecting 6 urban and 2 rural sites across New York State during the period 2005–2016 were determined. The extracted profiles were compared to identify state-wide common profiles. The source contributions provide detailed, long-term quantification of the emission sources across the state during the investigated period (2005–2016). Seven factors were common to all sites: secondary sulfate, secondary nitrate, spark-ignition emissions, diesel emissions, road dust, biomass burning, and pyrolyzed organic (OP) rich. The largest contributors were secondary sulfate, secondary nitrate, spark-ignition (gasoline), diesel, and OP-rich. Secondary sulfate concentrations ranged from 2.3 μg m−3 at Whiteface to 3.2 μg m−3 at Buffalo and the Bronx. The highest secondary sulfate fractional contributions were found at the rural sites (∼46% of PM2.5 mass) also showed the highest OP-rich contributions (∼19%). Secondary nitrate showed the highest concentrations at the urban sites representing ∼17% of PM2.5 mass (1.6 ± 0.3 μg m−3 on average). Urban sites also showed the highest average spark-ignition concentrations (1.7 ± 0.2 μg m−3, ∼18%) and diesel emissions (1.0 ± 0.2 μg m−3, ∼10%). During this period, secondary sulfate concentrations declined likely related to the implementation of mitigation strategies for controlling SO2 emissions and the changing economics of electricity generation. Similarly, diesel and secondary nitrate showed decreases in concentrations likely associated with the introduction of emissions controls and improved quality fuels for heavy-duty diesel on-road trucks and buses. Spark-ignition concentrations showed an increase across the state during 2014–2016 associated with the increase of registered vehicles in New York State.

The performance of a low cost ozone monitor (Aeroqual Series 500 portable gas monitors using a metal oxide sensor for ozone; model OZL) was assessed under field conditions. Ten ozone monitors were calibrated under clean-air laboratory conditions and controlled ozone concentrations of 5 to 100 ppb. Good linearity and response were obtained relative to a research-grade ozone monitor. One monitor was co-located at a regulatory air quality monitoring station that uses a U.S. federal equivalent method (FEM) ozone analyzer. Raw data from the Aeroqual monitor collected over 4 months (June-October) at a 10-minute time-resolution, showed good agreement (r(2)=0.83) with the FEM values but with an overestimation of ~12%. Data were averaged to different time resolutions; 1 h time averaged concentrations showed the best fit with the FEM results (r(2)=0.87). Data analyses suggested the potential of interferences due to temperature, relative humidity, nitrogen oxides, and volatile organic compounds. Correction models using temperature, humidity, and nitrogen dioxide (NO(2)) were tested to relate the monitor concentrations to the FEM values. Temperature and humidity were two readily available variables. The model (#3) that added NO(2) did not provide a substantial improvement in the fit. Thus, the models with only temperature and humidity can be easily developed by any user. The best model explained 91% of the variance and showed statistically significant improvement of the goodness of fits as well as decreased influence of the interfering variables on the diurnal and weekly patterns. The correction models were also able to lower the effect of seasonal temperature changes, allowing the use of the monitors over long-term sampling campaigns. Thus, the Aeroqual ozone monitor can return “FEM-like” concentrations after appropriate corrections. Data provided by a network of monitors could provide intra-urban spatial variations in ozone concentrations and provide more accurate human exposure assessments by reducing exposure misclassification.

Introduction Carboplatin is widely used to treat lung cancer in the United States as an alternative to cisplatin. Several studies have demonstrated that cisplatin-based regimen is associated with a high frequency of thromboembolic complications. However, there has been limited investigation directly comparing the risk of thromboembolic events (TEEs) between cisplatin- and carboplatin-treated patients with lung cancer. Methods All lung cancer patients treated with cisplatin or carboplatin at Wilmot Cancer Center, University of Rochester between 2011 and 2014 were included. Patient characteristics including exposure (cisplatin vs. carboplatin) and outcome (TEEs between the time of the first dose of cisplatin or carboplatin and 4 weeks after the last dose) were collected by reviewing electronic medical records. A Fisher’s exact test was used to compare the proportion of incident TEEs between cisplatin and carboplatin groups. The risk of TEE associated with carboplatin compared to cisplatin was assessed using multiple logistic regression. Results Among 415 subjects, 317 patients (76.4%) received carboplatin and 98 (23.6%) patients received cisplatin. In the carboplatin group, 10.9% (33/302) of evaluable patients developed treatment-related TEEs vs. 14.7% (14/95) in the cisplatin group. There was no significant difference in the risk of developing TEEs between the two groups (P = 0.32). However, 15.2% of carboplatin-related TEEs were arterial thromboses compared to none in the cisplatin group. Conclusions The incidence of carboplatin-related TEEs was high in lung cancer patients without significant difference in the risk of developing TEEs between cisplatin and carboplatin groups. Potential use of prophylactic anticoagulation in all platinum-treated patients should be further investigated.

Objectives We explored the association between acute changes in daily mean pulmonary artery (PA) and right ventricular (RV) pressures and concentrations of ambient fine particulate matter [PM with aerodynamic diameter ≤2.5 μm (PM2.5)] as an explanation for previous associations between congestive heart failure (HF) hospital admissions and PM. Materials and methods In the Chronicle Offers Management to Patients with Advanced Signs and Symptoms of Heart Failure (COMPASS-HF) trial, to see whether management of ambulatory HF could be improved by providing continuous right heart pressure monitoring to physicians, the Chronicle Implantable Hemodynamic Monitor (Medtronic, Inc., Minneapolis, MN, USA) continuously measured multiple right heart hemodynamic parameters, heart rate, and activity trends in subjects with moderate/severe HF. Using these trial data, we calculated daily mean pressures, using only those time intervals where the subject was not physically active (n = 5,807 person-days; n = 11 subjects). We then studied the association between mean daily PA/RV pressures and mean ambient PM2.5 concentrations on the same day and previous 6 days. Results Each 11.62-μg/m3 increase in same-day mean PM2.5 concentration was associated with small but significant increases in estimated PA diastolic pressure [0.19 mmHg; 95% confidence interval (CI), 0.05–0.33] and RV diastolic pressure (0.23 mmHg; 95% CI, 0.11–0.34). Although we saw considerable differences in the magnitude of response by COMPASS-HF randomization group (total data access for physicians vs. blocked clinician access), season, left ventricular ejection fraction, and obesity, these effects were not significantly different. Conclusions These pilot study findings provide a potential mechanism for previous findings of increased risk of HF associated with ambient PM. However, because of the small number of subjects, a larger study is needed for confirmation.

Taking advantage of the natural experiment of the 2008 Beijing Olympics (August 8 to September 24), when air pollution levels decreased by 13% to 60%, the authors assessed whether having ≥1 pregnancy month during the Olympics was associated with decreased risks of hypertensive disorders (HDs) and/or fetal-placental conditions (FPCs). Singleton births to mothers with ≥1 pregnancy month in 2008 or 2009 (N = 56,155) were included. Using generalized additive models, the authors estimated the risk of HDs and FPCs associated with (1) the 2008 Olympics compared with the same dates in 2009, and (2) increased mean ambient PM10 (particulate matter with an aerodynamic diameter

Epidemiologic studies have demonstrated a consistent link between sudden cardiac deaths and particulate air pollution. We used implanted cardioverter defibrillator (ICD) records of ventricular tachyarrhythmias to assess the role of air pollution as a trigger of these potentially life-threatening events. The study cohort consisted of 203 cardiac patients with ICD devices in the Boston metropolitan area who were followed for an average of 3.1 years between 1995 and 2002. Fine particle mass and gaseous air pollution plus temperature and relative humidity were measured on almost all days, and black carbon, sulfate, and particle number on a subset of days. Date, time, and intracardiac electrograms of ICD-detected arrhythmias were downloaded at the patients' regular follow-up visits (about every 3 months). Ventricular tachyarrhythmias were identified by electrophysiologist review. Risk of ventricular arrhythmias associated with air pollution was estimated with logistic regression, adjusting for season, temperature, relative humidity, day of the week, patient, and a recent prior arrhythmia. We found increased risks of ventricular arrhythmias associated with 2-day mean exposure for all air pollutants considered, although these associations were not statistically significant. We found statistically significant associations between air pollution and ventricular arrhythmias for episodes within 3 days of a previous arrhythmia. The associations of ventricular tachyarrhythmias with fine particle mass, carbon monoxide, nitrogen dioxide, and black carbon suggest a link with motor vehicle pollutants. The associations with sulfate suggest a link with stationary fossil fuel combustion sources.

Both increases and decreases in ambient temperature have been associated with increased cardiovascular mortality and morbidity. However, the mechanism(s) remain unclear.We examined associations between biomarkers of pathways thought to, in part, explain these associations and changes in ambient temperature in a panel of predominantly post-myocardial infarction or post-stent patients.We studied 76 subjects who had a recent coronary event and were participating in a cardiac rehabilitation program. In these patients, we measured heart rate variability, repolarization, and baroreflex sensitivity parameters using Holter ECG recordings before and during supervised, graded, twice weekly, exercise sessions. Hourly temperature measurements were made at a monitoring site near the rehabilitation center.Using linear mixed models, we observed decreases in rMSSD (square root of the mean of the sum of the squared differences between adjacent NN intervals) and deceleration capacity, associated with increases in ambient temperature in the previous four days. Additionally, decreased rMSSD was associated with both increasing temperature (mean in previous 6 hours) in the summer and decreasing temperature (mean in the previous 3 weeks) in the winter.In a panel of cardiac rehabilitation patients, changes in ambient temperature were associated with decreases in markers of heart rate variability and baroreflex sensitivity, which may lead to increased risk of arrhythmic events and sudden death in post-infarction patients.

Background: A growing body of evidence has associated maternal exposure to air pollution with adverse effects on fetal growth; however, the existing literature is inconsistent. Objectives: We aimed to quantify the association between maternal exposure to particulate air pollution and term birth weight and low birth weight (LBW) across 14 centers from 9 countries, and to explore the influence of site characteristics and exposure assessment methods on between-center heterogeneity in this association. Methods: Using a common analytical protocol, International Collaboration on Air Pollution and Pregnancy Outcomes (ICAPPO) centers generated effect estimates for term LBW and continuous birth weight associated with PM10 and PM2.5 (particulate matter ≤ 10 and 2.5 µm). We used meta-analysis to combine the estimates of effect across centers (~ 3 million births) and used meta-regression to evaluate the influence of center characteristics and exposure assessment methods on between-center heterogeneity in reported effect estimates. Results: In random-effects meta-analyses, term LBW was positively associated with a 10-μg/m3 increase in PM10 [odds ratio (OR) = 1.03; 95% CI: 1.01, 1.05] and PM2.5 (OR = 1.10; 95% CI: 1.03, 1.18) exposure during the entire pregnancy, adjusted for maternal socioeconomic status. A 10-μg/m3 increase in PM10 exposure was also negatively associated with term birth weight as a continuous outcome in the fully adjusted random-effects meta-analyses (–8.9 g; 95% CI: –13.2, –4.6 g). Meta-regressions revealed that centers with higher median PM2.5 levels and PM2.5:PM10 ratios, and centers that used a temporal exposure assessment (compared with spatiotemporal), tended to report stronger associations. Conclusion: Maternal exposure to particulate pollution was associated with LBW at term across study populations. We detected three site characteristics and aspects of exposure assessment methodology that appeared to contribute to the variation in associations reported by centers.

The purpose of the present study was to examine the risk of stillbirth associated with ambient air pollution during pregnancy. Using live birth and fetal death data from New Jersey from 1998 to 2004, the authors assigned daily concentrations of air pollution to each birth or fetal death. Generalized estimating equation models were used to estimate the relative odds of stillbirth associated with interquartile range increases in mean air pollutant concentrations in the first, second, and third trimesters and throughout the entire pregnancy. The relative odds of stillbirth were significantly increased with each 10-ppb increase in mean nitrogen dioxide concentration in the first trimester (odds ratio (OR) = 1.16, 95% confidence interval (CI): 1.03, 1.31), each 3-ppb increase in mean sulfur dioxide concentration in the first (OR = 1.13, 95% CI: 1.01, 1.28) and third (OR = 1.26, 95% CI: 1.03, 1.37) trimesters, and each 0.4-ppm increase in mean carbon monoxide concentration in the second (OR = 1.14, 95% CI: 1.01, 1.28) and third (OR = 1.14, 95% CI: 1.06, 1.24) trimesters. Although ambient air pollution during pregnancy appeared to increase the relative odds of stillbirth, further studies are needed to confirm these findings and examine mechanistic explanations.

Background: It has previously been reported that the risk of ventricular arrhythmias is positively associated with ambient air pollution among patients with implantable cardioverter defibrillators (ICD) in Boston. Aims: To assess the association of community exposures to air pollution with ventricular arrhythmias in a cohort of ICD patients in metropolitan St Louis, Missouri. Methods: ICD detected episodes reported during clinical follow up were abstracted and reviewed by an electrophysiologist to identify ventricular arrhythmias. A total of 139 ventricular arrhythmias were identified among 56 patients. A case-crossover design was used with control periods matched on weekday and hour of the day within the same calendar month. Conditional logistic regression models were adjusted for temperature, barometric pressure, and relative humidity in the 24 hours preceding the event. Results: There was a significant (24%, 95% CI 7% to 44%) increase in risk of ventricular arrhythmias associated with each 5 ppb increase in mean sulphur dioxide and non-significantly increased risk (22%, 95% CI −6% to 60%; and 18%, 95% CI −7% to 50%) associated with increases in nitrogen dioxide (6 ppb) and elemental carbon (0.5 μg/m3), respectively in the 24 hours before the arrhythmia. Conclusions: These results provide evidence of an association between ventricular arrhythmias and ambient air pollutants in St Louis. This is consistent with previous results from Boston, although the pollutants responsible for the increased risk are different.