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Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with no cure. Although the etiology of sporadic ALS is largely unknown, environmental exposures may affect ALS risk., Objective: We investigated relationships between exposure to long-term ambient particulate matter (PM) and gaseous air pollution (AP) and ALS mortality., Methods: Within the Women's Health Initiative (WHI) cohort of 161,808 postmenopausal women aged 50-79 years at baseline (1993-1998), we performed a nested case-control study of 256 ALS deaths and 2486 matched controls with emphasis on PM constituents (PM 2.5 , PM 10 , and coarse PM [PM 10 - 2.5 ]) and gaseous pollutants (NO x , NO 2 , SO 2 , and ozone). Time-varying AP exposures estimates were averaged 5, 7.5, and 10 years prior to ALS death using both a GIS-based spatiotemporal generalized additive mixed model and ordinary kriging (empirical and multiple imputation, MI). Conditional logistic regression was used to estimate the relative risk of ALS death., Results: In general, PM 2.5 and PM 10 -related risks were not significantly elevated using either method. However, for PM 10-2.5 , odds ratios (ORs) were >1.0 for both methods at all time periods using MI and empirical data for PM 10-2.5 (coarse) except for 5 and 7.5 years using the kriging method with covariate adjustment., Conclusion: This investigation adds to the body of information on long-term ambient AP exposure and ALS mortality. Specifically, the 2019 US Environmental Protection Agency (EPA) Integrated Science Assessment summarized the neurotoxic effects of PM 2.5 , PM 10, and PM 10 - 2.5. The conclusion was that evidence of an effect of coarse PM is suggestive but the data is presently not sufficient to infer a causal relationship. Further research on AP and ALS is warranted. As time from symptom onset to death in ALS is ∼2-4 years, earlier AP measures may also be of interest to ALS development. This is the first study of ALS and AP in postmenopausal women controlling for individual-level confounders., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier Inc.)

Background/objective: Poor air quality is implicated as a risk factor for cognitive impairment and dementia. Few studies have examined these associations longitudinally in well-characterized population-based cohorts with standardized annual assessment of both mild cognitive impairment (MCI) and dementia. We investigated the association between estimated ambient fine particulate matter (PM 2.5 ) and risk of incident MCI and dementia in a post-industrial region known for historically poor air quality., Setting/participants: Adults aged 65+ years in a population-based cohort (n = 1572)., Measurements: Census tract level PM 2.5 from Environmental Protection Agency (EPA) air quality monitors; Clinical Dementia Rating (CDR)®., Design: We estimated ambient PM 2.5 exposure (μg/m 3 , single-year and 5-year averages) by geocoding participants' residential addresses to census tracts with daily EPA PM 2.5 measurements from 2002 to 2014. Using Bayesian spatial regression modeling adjusted for age, sex, education, smoking history, and household income, we examined the association between estimated PM 2.5 exposure and risk of incident MCI (CDR = 0.5) and incident dementia (CDR ≥ 1.0)., Results: Modeling estimated single-year exposure, each 1 μg/m 3 higher ambient PM 2.5 was associated with 67% higher adjusted risk of incident dementia (hazard ratio [HR] = 1.669, 95% credible interval [CI]: 1.298, 2.136) and 75% higher adjusted risk of incident MCI (HR = 1.746, 95% CI: 1.518, 2.032). Estimates were higher when modeling 5-year ambient PM 2.5 exposure for incident dementia (HR = 2.082, 95% CI: 1.528, 3.015) and incident MCI (HR = 3.419, 95% CI: 2.806, 4.164)., Conclusions: Higher estimated ambient PM 2.5 was associated with higher risk of incident MCI and dementia, particularly when considering longer-term exposure, and independent of demographic characteristics and smoking history. Targeting poor air quality may be a reasonable population-wide intervention to reduce the risk of cognitive impairment in older adults, particularly in regions exceeding current recommendations for safe exposure to PM 2.5 ., (© 2021 The American Geriatrics Society.)

Evidence is growing on the adverse neurodevelopmental effects of exposure to combustion-related air pollution. Project TENDR (Targeting Environmental Neurodevelopmental Risks), a unique collaboration of leading scientists, health professionals, and children's and environmental health advocates, has identified combustion-related air pollutants as critical targets for action to protect healthy brain development. We present policy recommendations for maintaining and strengthening federal environmental health protections, advancing state and local actions, and supporting scientific research to inform effective strategies for reducing children's exposures to combustion-related air pollution. Such actions not only would improve children's neurological development but also would have the important co-benefit of climate change mitigation and further improvements in other health conditions.

Although short-term exposure to ambient ozone (O 3 ) can cause poor respiratory health outcomes, the shape of the concentration-response (C-R) between O 3 and respiratory morbidity has not been widely investigated. We estimated the effect of daily O 3 on emergency department (ED) visits for selected respiratory outcomes in 5 US cities under various model assumptions and assessed model fit. Population-weighted average 8-h maximum O 3 concentrations were estimated in each city. Individual-level data on ED visits were obtained from hospitals or hospital associations. Poisson log-linear models were used to estimate city-specific associations between the daily number of respiratory ED visits and 3-day moving average O 3 levels controlling for long-term trends and meteorology. Linear, linear-threshold, quadratic, cubic, categorical, and cubic spline O 3 C-R models were considered. Using linear C-R models, O 3 was significantly and positively associated with respiratory ED visits in each city with rate ratios of 1.02-1.07 per 25 ppb. Models suggested that O 3 -ED C-R shapes were linear until O 3 concentrations of roughly 60 ppb at which point risk continued to increase linearly in some cities for certain outcomes while risk flattened in others. Assessing C-R shape is necessary to identify the most appropriate form of the exposure for each given study setting.

Determining how associations between ambient air pollution and health vary by specific outcome is important for developing public health interventions. We estimated associations between twelve ambient air pollutants of both primary (e.g. nitrogen oxides) and secondary (e.g. ozone and sulfate) origin and cardiorespiratory emergency department (ED) visits for 8 specific outcomes in five U.S. cities including Atlanta, GA; Birmingham, AL; Dallas, TX; Pittsburgh, PA; St. Louis, MO. For each city, we fitted overdispersed Poisson time-series models to estimate associations between each pollutant and specific outcome. To estimate multicity and posterior city-specific associations, we developed a Bayesian multicity multi-outcome (MCM) model that pools information across cities using data from all specific outcomes. We fitted single pollutant models as well as models with multipollutant components using a two-stage chemical mixtures approach. Posterior city-specific associations from the MCM models were somewhat attenuated, with smaller standard errors, compared to associations from time-series regression models. We found positive associations of both primary and secondary pollutants with respiratory disease ED visits. There was some indication that primary pollutants, particularly nitrogen oxides, were also associated with cardiovascular disease ED visits. Bayesian models can help to synthesize findings across multiple outcomes and cities by providing posterior city-specific associations building on variation and similarities across the multiple sources of available information., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: There has been no investigation to date of adults with metabolic syndrome examining the association of short and long-term exposure to fine particulate matter (PM 2.5 ) air pollution with cardiovascular-disease related inflammatory marker (WBC and CRP) levels in a nationally representative sample. The goal of this study is to assess the susceptibility of adults with metabolic syndrome to PM 2.5 exposure as suggested by increased cardiovascular-disease related inflammatory marker levels., Methods: A cross sectional analysis of adult National Health and Nutrition Examination Survey (NHANES) participants (2000-2008) was carried out with linkage of CDC WONDER meteorological data and downscaler modeled USEPA air pollution data for census tracts in the continental United States. Participants were non-pregnant NHANES adults (2000-2008) with complete data for evaluating presence of metabolic syndrome and laboratory data on WBC and CRP. Exposures studied included short (lags 0-3 days and their averages), long-term (30 and 60 day moving and annual averages) PM 2.5 exposure levels at the census tract level in the continental United States. The main outcomes included CRP and WBC levels the day of NHANES study visit analyzed using multiple linear regression, adjusting for age, gender, race, education, smoking status, history of any cardiovascular disease, maximum apparent temperature and ozone level, for participants with and without metabolic syndrome., Results: A total of 7134 NHANES participants (35% with metabolic syndrome) met the inclusion criteria. After adjusting for confounders, we observed a significant effect of PM 2.5 acutely at lag day 0 on CRP level; a 10µg/m 3 rise in lag day 0 PM 2.5 level was associated with a 10.1% increase (95% CI: 2.2-18.6%) in CRP levels for participants with metabolic syndrome. For those without metabolic syndrome, the change in CRP was -1.3% (95% CI -8.8%, 6.8%). There were no significant associations for WBC count. In this first national study of the effect of PM 2.5 air pollution on levels of cardiovascular-disease related inflammatory markers in adults with metabolic syndrome, CRP levels were found to be significantly increased in those with this condition with increased fine particulate matter levels at lag day 0. With one third of US adults with metabolic syndrome, the health impact of PM 2.5 in this sensitive population may be significant., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Although regulation of emissions is the primary strategy to reduce air pollution-related morbidity, individual-level interventions are also helpful in mitigating health impacts. We used data from 2007-2008 National Health and Nutrition Examination Survey to study the prevalence of individual-level action among the US adult population if informed of air pollution, and to see if this differed by demographic and health factors. Only 13.5% (95% confidence interval [CI]: 11.6-15.4%) of participants aware of air quality reported changing their individual behaviors. Males (adjusted odds ratio [AOR]: 0.66, 95% CI: 0.56-0.77) and those without cardiovascular disease (AOR: 0.58, 95% CI: 0.47-0.71) were least likely to take action. Results show that individual action was infrequent among the population. Health promotion of individual intervention is necessary, and this effort may need to target specific subgroups of the population. Further studies on effective individual interventions are needed.

Background: Amyotrophic lateral sclerosis (ALS) is a serious and rapidly fatal neurodegenerative disorder with an annual incidence of 1-2.6/100,000 persons. Few known risk factors exist although gene-environment interaction is suspected. We investigated the relationship between suspected neurotoxicant hazardous air pollutants (HAPs) exposure and ALS., Methods: A case-control study involving sporadic ALS cases (n = 51) and matched controls (n = 51) was conducted from 2008 to 2011. Geocoded residential addresses were linked to U.S. EPA NATA data (1999, 2002, and 2005) by census tract. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression., Results: Residential exposure to aromatic solvents significantly elevated the risk of ALS among cases compared to controls in 2002 (OR = 5.03, 95% CI: 1.29, 19.53) and 1999 (OR = 4.27, 95% CI: 1.09, 16.79) following adjustment for education, smoking, and other exposure groups. Metals, pesticides, and other HAPs were not associated with ALS., Conclusions: A potential relationship is suggested between residential ambient air aromatic solvent exposure and risk of ALS in this study., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background and Objective: High concentrations of air pollutants have been linked to increased incidence of stroke in North America and Europe but not yet assessed in mainland China. The aim of this study is to evaluate the association between stroke hospitalization and short-term elevation of air pollutants in Wuhan, China., Methods: Daily mean NO2, SO2 and PM10 levels, temperature and humidity were obtained from 2006 through 2008. Data on stroke hospitalizations (ICD 10: I60-I69) at four hospitals in Wuhan were obtained for the same period. A time-stratified case-crossover design was performed by season (April-September and October-March) to assess effects of pollutants on stroke hospital admissions., Results: Pollution levels were higher in October-March with averages of 136.1 µg/m(3) for PM10, 63.6 µg/m(3) for NO2 and 71.0 µg/m(3) for SO2 than in April-September when averages were 102.0 µg/m(3), 41.7 µg/m(3) and 41.7 µg/m(3), respectively (p<.001). During the cold season, every 10 µg/m(3) increase in NO2 was associated with a 2.9% (95%C.I. 1.2%-4.6%) increase in stroke admissions on the same day. Every 10 ug/m(3) increase in PM10 daily concentration was significantly associated with an approximate 1% (95% C.I. 0.1%-1.4%) increase in stroke hospitalization. A two-pollutant model indicated that NO2 was associated with stroke admissions when controlling for PM10. During the warm season, no significant associations were noted for any of the pollutants., Conclusions: Exposure to NO2 is significantly associated with stroke hospitalizations during the cold season in Wuhan, China when pollution levels are 50% greater than in the warm season. Larger and multi-center studies in Chinese cities are warranted to validate our findings.

Despite numerous studies of air pollution and adverse birth outcomes, few studies have investigated preeclampsia and gestational hypertension, two pregnancy disorders with serious consequences for both mother and infant. Relying on hospital birth records, we conducted a cohort study identifying 34,705 singleton births delivered at Magee-Women's Hospital in Pittsburgh, PA between 1997 and 2002. Particle (<10 μm-PM10; <2.5 μm-PM2.5) and ozone (O3) exposure concentrations in the first trimester of pregnancy were estimated using the space-time ordinary Kriging interpolation method. We employed multiple logistic regression estimate associations between first trimester exposures and preeclampsia, gestational hypertension, preterm delivery, and small for gestational age (SGA) infants. PM2.5 and O3 exposures were associated with preeclampsia (adjusted OR = 1.15, 95% CI = 0.96-1.39 per 4.0 μg/m(3) increase in PM2.5; adjusted OR = 1.12, 95% CI = 0.89-1.42 per 16.8 ppb increase in O3), gestational hypertension (for PM2.5 OR = 1.11, 95 % CI = 1.00-1.23; for O3 OR = 1.12, 95 % CI = 0.97-1.29), and preterm delivery (for PM2.5 ORs = 1.10, 95% CI = 1.01-1.20; for O3 ORs = 1.23, 95% CI = 1.01-1.50). Smaller 5-8 % increases in risk were also observed for PM10 with gestational hypertension and SGA, but not preeclampsia. Our data suggest that first trimester exposure to particles, mostly PM2.5, and ozone, may increase the risk of developing preeclampsia and gestational hypertension, as well as preterm delivery and SGA.

Background: Epidemiological studies have shown adverse short-term effects of air pollution on health including cardiovascular morbidity and mortality. However, air pollution-related stroke has received less attention., Methods: In this study, we performed a time-stratified case-crossover analysis to evaluate the relationships between stroke hospital admissions and O3, among patients aged 65 years and older in Allegheny County, Pa., USA, between 1994 and 2000. We also examined whether the effects of air pollutants differed across strata defined by patient demographic characteristics and ambient temperature., Results: Exposures to O3 on the current day increase the risk of total stroke hospitalization by 1.9% (95% CI: 0.01-3.8) per interquartile range increase in concentration. Furthermore, the results suggest that males were more sensitive to adverse health effects of O3 on stroke hospitalization than females., Conclusion: These results suggest that O3 has an adverse effect on stroke hospitalization. Specific patient subgroups, such as males, may be at increased risk., (Copyright © 2013 S. Karger AG, Basel.)

Background: It is not well understood how air pollution leads to adverse pregnancy outcomes. One pathway may be through C-reactive protein, a biomarker of systemic inflammation that has been reported to increase the risk of preterm delivery. We examined whether air pollution influences serum concentrations of C-reactive protein in early pregnancy., Methods: We studied 1696 pregnant women in Allegheny County, PA, from 1997 through 2001. C-reactive protein concentrations were assayed in blood collected before the 22nd week of gestation. We estimated levels of particles of less than 10 μm (PM10) and less than 2.5 μm diameter (PM2.5), carbon monoxide, nitrogen dioxide, sulfur dioxide, and ozone at the maternal zip code using Kriging interpolation for measurements obtained from ambient stations. Associations between air pollution and high C-reactive protein concentrations (≥ 8 ng/mL) were evaluated using logistic regression., Results: Among nonsmokers, an observed 9.2 μg/m increase in PM10 (averaged over 28 days prior to the blood sample) was associated with an odds ratios of 1.41 for high C-reactive protein concentrations (95% confidence interval = 0.99-2.00). Similarly, a 4.6 μg/m increase in PM2.5 was associated with an odds ratio of 1.47 (1.05-2.06). The odds ratio was 1.49 (0.75-2.96) per 7.9 ppb increase in ozone during summer. There were no associations in smokers or for other air pollutants, and there was no evidence for effect-measure modification by obesity., Conclusions: PM10, PM2.5, and ozone exposures were associated with increased C-reactive protein concentrations in early pregnancy, suggesting that these air pollutants contribute to inflammation and thereby possibly to adverse pregnancy outcomes.

Objectives: To assess the temporal and spatial relationship of risk for total leukemia and AML (acute myelogenous leukemia) among community residents of an area in northeastern (NE) Pennsylvania (PA) affected by the Tranguch Gasoline Spill which occurred in the early 1990s., Methods: Standardized incidence ratios (SIR) were calculated for total leukemia and AML among 625 residents affected by the gasoline spill in relation to both PA and local county cancer incidence rates. The risk of total leukemia and AML among the gasoline exposed population was evaluated for the period prior to the spill, 1985-1989; during the time surrounding the spill, 1990-1994; and for a period subsequent to the spill, 1995-2001., Results: The incidence of total leukemia and AML was significantly elevated subsequent to the spill for the entire period 1990-2001 and was highest for the period 1995-2001, whether comparison was made to PA or local county leukemia rates. Based on comparison to PA rates, the SIRs for total leukemia and AML were 7.69 (95% CI=1.58-22.46) and 11.54 (95% CI=2.38-33.69) for the 1995-2001 period, respectively. Prior to the spill, 1985-1989, and during the period of the spill, 1990-1994, no cases of leukemia were identified among the affected residents., Conclusions: These results suggest a possible association between chronic low level benzene exposure and increased risk of leukemia among residents of the Tranguch Spill Site in NE PA. Our study provides additional support to the growing body of evidence implicating low level benzene exposure and cancer risk. We recommend that other communities contaminated with gasoline vapor through leaking underground storage vessels be monitored for elevated risk of leukemia., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Purpose: Low birth weight has been associated with increased risks of mortality and/or morbidity in childhood and adulthood. Epidemiological studies suggest that maternal exposure to air pollution, especially particulate matter during pregnancy, is associated with an increased risk of delivering a low birth weight infant. The aim of this study is to explore the association between exposure to particulate matter (PM10) during pregnancy and term low birth weight (LBW: birth weight <2,500 g and gestation age ≥ 37 weeks)., Methods: Birth data from the Allegheny County Health Department, Pittsburgh, PA, USA and PM10 air data generated with inverse-distance interpolation by RAND's Center for Population Health and Health Disparities, were obtained. The study population consisted of all term singleton live births (gestational age ≥ 37 weeks) born between January 1, 1994 to December 31, 2000. Infants with birth weight <2,500 g were classified as LBW. Logistic regression with robust variance estimation was performed to estimate the odds ratios of LBW per inter-quartile range increase in PM10., Results: The results showed that the odds ratios of term LBW per inter-quartile range increase in PM10 were 1.13 (95% CI: 1.02-1.25) during the first trimester and 1.10 (95% CI: 1.00-1.22) during the second trimester after adjustment for other important covariates, respectively., Conclusion: The findings of the study support the hypothesis that exposure to PM10 is associated with increased levels of term LBW. Further studies are warranted to corroborate these findings.

Background: From the early 1900s until its closure in February 1998, a Steel coke oven in Pittsburgh, Pennsylvania, was a key source of air pollution. A case-crossover study was performed to assess the associations between daily air pollution and cardiorespiratory (International Classification of Disease Ninth Revision [ICD-9]: 390-519) hospitalizations before and after plant closure and to evaluate how closure influenced these associations., Methods: Air pollution data, climatic data, and cardiorespiratory hospitalizations among residents ages 65 years and older were obtained for the period of 1996 through 2000 for the study area. Data were analyzed using a case-crossover design and conditional logistical regression. Two distinct referent-sampling approaches were compared., Results: Significant associations were observed between the fourth quartile in PM10 and cardiorespiratory hospitalizations (odds ratio [OR]: 1.12; 95% CI: 1.02-1.23) and cardiovascular hospitalizations only (ICD-9: 390-459) (OR: 1.13; 95% CI: 1.01-1.26) before the plant closure. After closure of the plant, PM10 was not significantly associated with cardiorespiratory or cardiovascular disease hospitalizations. Moreover, the referent sampling approaches did not greatly alter the estimations in the case-crossover analysis., Conclusions: Existing secondary data are an economical source to assess the impact of point source pollution on the environmental landscape. The findings suggest that closure of the steel coke plant was associated with a reduction risk of the cardiovascular hospitalizations.