Ambient air pollutants relate to hospital admissions for chronic obstructive pulmonary disease in Ganzhou, China

ABSTRACT OBJECTIVE To evaluate the relationship between ambient air pollutants and chronic obstructive pulmonary disease in relatively low-polluted areas in China. METHODS Atmospheric pollutants levels and meteorological data were obtained from January 2016 to December 2020. The medical database including daily hospital admissions for chronic obstructive pulmonary disease (ICD10: J44) was derived from the First Affiliated Hospital of Gannan Medical University. The generalized additive model was used to analyze the percentage change with 95% confidence interval in daily hospital admissions for chronic obstructive pulmonary disease associated with a 10 µg/m3 increase in atmospheric pollutants levels. RESULTS In total, occurred 4,980 chronic obstructive pulmonary disease hospital admissions (not including emergency department visits) during 2016-2020. The mean concentrations of daily PM2.5, PM10, SO2, NO2, O3, and CO were 37.5 μg/m3, 60.1 μg/m3, 18.7 μg/m3, 23.5 μg/m3, 70.0 μg/m3, and 1.2 mg/m3 in Ganzhou. Each 10 µg/m3 increment of PM2.5, PM10, NO2, and O3 were significantly associated with 2.8% (95%CI: 1.0-4.7), 1.3% (95%CI: 0.3-2.4), 2.8% (95%CI: 0.4-5.4), and 1.5% (95%CI: 0.2-2.7) elevation in daily chronic obstructive pulmonary disease hospital admissions. The estimates of delayed effects of PM2.5, PM10, NO2, and O3 were observed at lag6, lag6, lag8, lag1, respectively. The health effects of particulate pollutants (PM2.5 and PM10) may be independent of other pollutants. The adverse effects of air pollutants were more evident in the warm season (May-Oct) than in the cold season (Nov-Apr). CONCLUSION Our study demonstrated that elevated concentrations of atmospheric pollutant (PM2.5, PM10, NO2, and O3), especially particulate pollutants, can be associated with increased daily count of hospital admissions for chronic obstructive pulmonary disease , which may promote further understanding of the potential hazards of relatively low levels of air pollution on chronic obstructive pulmonary disease and other respiratory disorders.

O envolvimento do estresse oxidativo e nitrosativo em modelo de doença pulmonar obstrutiva crônica (DPOC) induzido por elastase / The involvement of oxidative and nitrosative stress in model of chronic obstructive pulmonary disease (COPD) induced by elastase

Este estudo buscou investigar o papel do estresse oxidativo e nitrosativo no enfisema pulmonar induzido por elastase. Foram utilizados camundongos machos C57BL/6 submetidos a dois modelos de indução do enfisema por elastase pancreática suína (PPE): intratraqueal (i.t.) e intranasal (i.n.). No modelo intratraqueal a PPE foi instilada nas doses de 0,05 U ou 0,05 U/camundongo para avaliação temporal do enfisema 7, 14 e 21 dias após instilação de PPE. Em outra etapa, o papel da iNOS foi avaliado através da sua inibição farmacológica por aminoguanidina (AMG) 1% na água de beber ou pela sua exclusão genética em camundongos deficientes em iNOS que tiveram o enfisema induzido por 0,5 U PPE i.t. após 21 dias. No modelo intranasal a dose de PPE foi 3 U/camundongo para avaliação temporal do enfisema (1, 7, 14 e 21 dias após PPE). O papel do estresse oxidativo e nitrosativo foi avaliado com diferentes tratamentos antioxidantes na água de beber: tempol, apocinina+alopurinol, n-acetilcisteína, vitamina C+E, e aminoguanidina durante os 21 dias de indução do enfisema. Os grupos controles foram submetidos à instilação de salina. Lavado broncoalveolar, imunoensaios, análises bioquímicas de estresse oxidativo e ensaios morfométricos foram realizados nos pulmões dos animais. O enfisema foi histologicamente alcançado em 21 dias após 0,5 U PPE i.t., evidenciado pelo aumento do diâmetro alveolar médio - Lm e da densidade de volume dos espaços alveolares - Vvair em comparação ao grupo controle. TNF-a foi aumentado em 7 e 14 dias após 0,05 U PPE comparados ao controle, concomitante com a redução de IL-10 nos mesmos períodos, comparados ao controle. O estresse oxidativo foi observado na fase inicial do enfisema, com aumento dos níveis de nitrito, TBARS e superóxido dismutase no grupo 7 dias após 0,5 U PPE (i.t.) quando comparados ao controle ao passo que no modelo intranasal as alterações típicas do estresse foram vistas no grupo 1 dia após 3 U de PPE. Atividade da glutationa ...

This study investigated the role of oxidative and nitrosative stress in elastase-induced pulmonary emphysema. C57BL/6 male mice were used submitted to two models of emphysema induced by porcine pancreatic elastase (PPE): intratracheal (i.t.) and intranasal (i.n.). In the intratracheal model PPE was instilled at doses of 0.05 U or 0.5 U/mouse (i.t.) to temporal evaluation of emphysema 7, 14 and 21 days post-PPE instillation. Others sets of experiments, the role of iNOS was evaluated through its pharmacology inhibition by 1% aminoguanidine (AMG) into the drinking water or bt iNOS genetic exclusion in iNOS-deficient mice which had induced emphysema by 0.5 U PPE i.t. after 21 days. In the intranasal model the PPE dose was 3 U/mouse to temporal evaluation of emphysema (1, 7, 14 and 21 days after PPE). The role of oxidative and nitrosative stress was evaluated using different antioxidant treatments into the drinking water: tempol, apocynin+allopurinol, N-acetylcysteine, vitamin C+E and aminoguanidine during the 21 days of emphysema induction. Control groups were instilled with saline. Bronchoalveolar lavage, immunoassays, biochemical analysis of oxidative stress and morphometric tests were performed in the lungs of animals. The emphysema was histologically reached 21 days after 0.5 U PPE, as evidenced by an increase in alveolar diameter - Lm and volume density of the alveolar spaces - Vvair compared to the control group. TNF-a was increased in 7 and 14 days after 0.5 U PPE compared to the control, concomitant with reduction of IL-10 at the same time-points compared to the control. Oxidative stress was observed in the early stages of emphysema, with increased levels of nitrite, TBARS and superoxide dismutase in group 7 days after 0.5 U PPE (i.t.) compared to the control, while in the intranasal model the typical stress alterations were seen in group 1 day after 3 U PPE. Glutathione peroxidase activity was increased in all PPE groups (i.t.). Exposure to 0.5 U PPE ...

Diagnóstico precoz de enfermedades pulmonares por tabaquismo / Early diagnose of smoking lung diseases

El tabaquismo es una epidemia y en Chile la prevalencia no ha disminuido. Entre las causas más importantes de muerte por tabaquismo están el cáncer pulmonar y la enfermedad pulmonar obstructiva crónica (EPOC). La erradicación del tabaquismo es la mejor estrategia de prevención de estas enfermedades. La segunda estrategia es la detección precoz de ellas. Sin embargo la EPOC está sub diagnosticada en todo el mundo. No está claro si la solución es hacer más espirometrías en población de riesgo. Es posible que otros métodos diagnósticos como la tomografía axial computada de tórax (TAC) y la difusión pulmonar, puedan mejorar la capacidad de diagnóstico precoz de esta enfermedad. El cáncer pulmonar es el más mortal de los cánceres. El diagnóstico en etapas tempranas mejora significativamente su pronóstico. Hay varios estudios en curso que evalúan el beneficio de hacer pesquisa de cáncer pulmonar con TAC

Cigarette smoking is worldwide epidemic and in Chile its prevalence is not decreasing. Lung cancer and COPD are important causes of smoking related mortality. Primary prevention of smoking is the best way to avoid these diseases. The second best strategy is an early detection of them. However COPD is under diagnosed all over the world and it is not clear if the solution is doing spirometry in risk population. CT scan of the chest and DLCO could increase the early diagnose. Lung cancer is a deadly disease. Its prognosis is much better in early stages. Currently there are some studies in progress evaluating the benefit of doing screening for lung cancer with CT of the chest

Exceso de morbilidad respiratoria en niños y adultos mayores en una comuna de Santiago con alta contaminación atmosférica por partículas / Excess respiratory diseases in children and elderly people in a community of Santiago with high particulate air pollution

Background: The relationship between air pollution and health damage has been sufficiently documented. In station "R" of the air quality monitoring system, located in a community of Metropolitan Santiago (Cerro Navia), the Chilean standard of 150 æg/m³, averaged in 24 hours, for particles with a diameter of 10 micrometers or less (PM10), has been exceeded more days than in the rest of the city stations. Aim: To investigate if the population living near that station has a higher proportion of lower respiratory infections than the Metropolitan Region (MR) as a whole. Material and methods: An outpatient clinic located near station "R" (Centro Albertz), was implemented as a sentinel center according to UNICEF methodology, used since 1992 by the Acute Respiratory Infections National Program. Daily information was collected between May and December 2004. Monitoring data included total number of consults by children less than 15 years old for lower respiratory tract infections, pneumonia, obstructive bronchitis syndrome in children and by adults over 64 years old for lower airway disease, chronic obstructive pulmonary disease (COPD), and pneumonia. Results were compared with those of the rest of MR. Results: Compared with the MR, children from the sentinel clinic had a significantly higher proportion of consults for obstructive bronchial syndrome (20.1 percent and 26.4 percent respectively, in p <0.01) and pneumonia (1.3 and 2.7 percent respectively, p <0.01). In the elderly, the average consults for lower airway disease were 17 percent in the sentinel clinic and 12.2 percent in MR (p <0.04). Conclusions: Children and elderly subjects at the sentinel clinic had a significantly higher proportion of respiratory infections (pneumonia and obstructive bronchial syndrome in children and lower airway disease in the elderly) as compared to the Metropolitan Region.