Dietary patterns related to total mortality and cancer mortality in the United States.

PURPOSE: This study investigated the association between dietary patterns, total mortality, and cancer mortality in the United States. METHODS: We identified the four major dietary patterns at baseline from 13,466 participants of the NHANES III cohort using principal component analysis (PCA). Dietary patterns were categorized into 'prudent' (fruits and vegetables), 'western' (red meat, sweets, pastries, oils), 'traditional' (red meat, legumes, potatoes, bread), and 'fish and alcohol'. We estimated hazard ratios for total mortality, and cancer mortality using Cox regression models. RESULTS: A total of 4,963 deaths were documented after a mean follow-up of 19.59 years. Higher adherence to the 'prudent' pattern was associated with the lowest risk of total mortality (5th vs. 1st quintile HR 0.90, 95% CI 0.82-0.98), with evidence that all-cause mortality decreased as consumption of the pattern increased. No evidence was found that the 'prudent' pattern reduced cancer mortality. The 'western' and the 'traditional' patterns were associated with up to 22% and 16% increased risk for total mortality (5th vs. 1st quintile HR 1.22, 95% CI 1.11-1.34; and 5th vs. 1st quintile HR 1.16, 95% CI 1.06-1.27, respectively), and up to 33% and 15% increased risk for cancer mortality (5th vs. 1st quintile HR 1.33, 95% CI 1.10-1.62; and 5th vs. 1st quintile HR 1.15, 95% CI 1.06-1.24, respectively). The associations between adherence to the 'fish and alcohol' pattern and total mortality, and cancer mortality were not statistically significant. CONCLUSION: Higher adherence to the 'prudent' diet decreased the risk of all-cause mortality but did not affect cancer mortality. Greater adherence to the 'western' and 'traditional' diet increased the risk of total mortality and mortality due to cancer.

Nitrogen dioxide and asthma emergency department visits in California, USA during cold season (November to February) of 2005 to 2015: A time-stratified case-crossover analysis.

Nitrogen dioxide (NO2) is responsible for aggravating respiratory diseases, particularly asthma. The aim of this study is to investigate the association between NO2 exposure and asthma emergency department (ED) visits during the cold season (November-February) in five populated locations (Sacramento, San Francisco, Fresno, Los Angeles, and San Diego) of California from 2005 to 2015 (1320 Days). Conditional logistic regression models were used to obtain the odds ratio (OR) and 95% confidence interval (CI) associated with a 5 ppb increase in NO2 concentration for the 19,735 ED visits identified. An increase in NO2 exposure increased the odds of having asthma ED visits for the studied population. The potential effect modification by sex (female and male), race (White, Black, Hispanic, and Asian), and age (2-5, 6-18, 19-40, 41-64, and ≥65) was explored. A 5 ppb increase in the concentration of NO2 during lag 0-30 was associated with a 56% increase in the odds of having an asthma ED visit (OR = 1.560, CI: 1.428-1.703). Sex was not found to be a modifier. Asthma ED visits among all the races/ethnicities (except Asians) were associated with NO2 exposure. Whites had the highest OR 75% (OR = 1.750, CI: 1.417-2.160) at lag 0-30 in response to NO2 exposure. The association between NO2 exposure and asthma ED visits was positive among all age groups except for 19 to 40 years old; the OR was higher among 2 to 18 year old (at lag 0-30: age group 2-5 (OR = 1.699, CI: 1.399-2.062), and age group 6-18 (OR = 1.568, CI 1.348-1.825)). For stratification by location, San Diego and Fresno were found to have the highest OR, compared to the other studied locations.

Electronic cigarette (e-cigarette) use and frequency of asthma symptoms in adult asthmatics in California.

INTRODUCTION: Electronic cigarettes use is increasing in the United States. One motive for e-cigarette's popularity is that they wean from combustible cigarettes. Smokers perceive electronic cigarette products as healthier than cigarette smoking and as a useful tool for smoking cessation. However, research has indicated the use of electronic cigarettes may have harmful effects on respiratory function even with short-term use. Respiratory effects of e-cigarette use among asthmatics are little understood. OBJECTIVE: The aim of this study was to determine the association between e-cigarette use and frequency of asthma symptoms among adult asthmatics in California from 2015-2016. METHODS: This cross-sectional study included a total of 1277 adult asthmatics. The presence of asthma was based on an adult's self-reported doctor diagnosis. The analysis was controlled for age, education, sex, race, body mass index, and smoking status. RESULTS: E-cigarette use was associated with increased odds of having more frequent asthma symptoms (OR = 1.69, CI: 1.20-2.39, p = 0.002; ORadj = 1.65, CI: 1.09-2.49, p = 0.016). Male e-cigarette users were more likely to have more frequent asthma symptoms compared to male nonusers (OR = 1.90, CI: 1.13-3.19, p = 0.015; ORadj = 2.42, CI: 1.28-4.55, p = 0.006). No differences were found between female e-cigarette users and nonusers (OR = 1.43, CI: 0.86-2.37, p = 0.162; ORadj = 1.26, CI: 0.72-2.18, p = 0.162). CONCLUSION: Our findings suggest that e-cigarette use is associated with more frequent asthma symptoms and disproportionally affects male asthmatics.

Methyl-bromide and asthma emergency department visits in California, USA from 2005 to 2011.

Objective: Urban monitors of Methyl bromide (MBr), not typically near application sites, are used to investigate the impact of ambient concentrations on asthma Emergency Department (ED) visits.Methods: 4262 ED visits from August to February of 2005 to 2011 in Central and Southern California were selected from California's Office of Statewide Health Planning and Development (OSHPD). A bidirectional-symmetric case-crossover study design using conditional logistic regression model was used to obtain the odds ratio (OR) and 95% confidence interval associated with a 0.01 ppb (interquartile range) increase in MBr.Results: The population sample was comprised of 46.0% male and 53.9% females. Ethnic groups included 32.0% Non-Hispanic White, 23.5% Non-Hispanic Black, and 44.4% Hispanic. Age distribution was between 2 and 5 years old (11.6%), 6 and 18 years old (23.5%), 19 and 40 years old (29.3%), 41 and 64 years old (24.1%), and 65 or older (6.9%). There was a positive association between MBr and asthma ED visits among Non-Hispanic Blacks [OR: 1.065 (95% confidence intervals: 1.019, 1.108)] and Hispanics [OR: 1.107 (95% confidence intervals: 1.043, 1.173)], while Non-Hispanic Whites did not have an association with asthma ED visits. Positive association between MBr and asthma ED visits was found only among 6 to 18 [OR: 1.071 (95% confidence intervals: 1.016, 1.125)] years old.Conclusion: An increase in MBr concentration was found to be associated with an increase of the odds of having asthma ED visits in California among 6 to 18 years old and disproportionately affects Non-Hispanic Blacks and Hispanics over Non-Hispanic Whites.

The association between 1,3-dichloropropene and asthma emergency department visits in California, USA from 2005 to 2011: a bidirectional-symmetric case crossover study.

Objective: The ever-increasing rate of pesticide use in California farmlands is of great concern due to its potential toxicity on human health. In this study, the association between short term exposure to 1,3-dichloropropene (1,3-D) and asthma emergency department (ED) visits in central and southern California from 2005 to 2011 is investigated.Methods: 3878 ED visits were identified from 2005 to 2011 (1064 days). Conditional logistic regression models were used to obtain the odds ratio (OR) associated with 0.01 ppb increase in 1,3-D. Potential effect modification by sex, race/ethnicity (Non-Hispanic White, Non-Hispanic Black, or Hispanic), and age (2-5, 6-18, 19-40, 41-64 or ≥ 65) are investigated.Results: It was found that a 0.01 ppb increase in 1,3-D at the event day is associated with 13.5% [OR = 1.135, 95% CI: 1.123, 1.149] increase in the odds of having asthma ED visits in central and southern California during October to February of 2005 to 2011. Race had a positive association between 1,3-D and asthma ED visits among Non-Hispanic Black [OR= 1.095 95% CI: 1.035, 1.155] and Hispanic [OR= 1.121 95% CI: 1.064, 1.179]; while Non-Hispanic Whites had no association. Positive association for age was found between 1,3-D and asthma ED visits among patients 2 to 5 [OR= 1.065 95% CI: 1.020, 1.133], 6 to 18 [OR= 1.142 95% CI: 1.086, 1.196], and 19 to 40 [OR= 1.023 95% CI: 1.015, 1.073] years old.Conclusion: These findings suggest a 0.01 ppb increase in 1,3-D concentration increases the odds of having asthma ED visits.

Laboratory and field evaluation of real-time and near real-time PM2.5 smoke monitors.

Increases in large wildfire frequency and intensity and a longer fire season in the western United States are resulting in a significant increase in air pollution, including concentrations of PM2.5 (particulate matter <2.5 µm in aerodynamic diameter) that pose significant health risks to nearby communities. During wildfires, government agencies monitor PM2.5 mass concentrations providing information and actions needed to protect affected communities; this requires continuously measuring instruments. This study assessed the performance of seven candidate instruments: (1) Met One Environmental beta attenuation monitor (EBAM), (2) Met One ES model 642 (ES642), (3) Grimm Environmental Dust Monitor 164 (EDM), (4) Thermo ADR 1500 (ADR), (5) TSI DRX model 8543 (DRX), (6) Dylos 1700 (Dylos), and (7) Purple Air II (PA-II) in comparison with a BAM 1020 (BAM) reference instrument. With the exception of the EBAM, all candidates use light scattering to determine PM2.5 mass concentrations. Our comparison study included environmental chamber and field components, with two of each candidate instrument operating next to the reference instrument. The chamber component involved 6 days of comparisons for biomass combustion emissions. The field component involved operating all instruments in an air monitoring station for 39.5 days with hourly average relative humidity (RH) ranging from 19% to 98%. Goals were to assess instrument precision and accuracy and effects of RH, elemental carbon (EC), and organic carbon (OC) concentrations. All replicate candidate instruments showed high hourly correlations (R2 ≥ 0.80) and higher daily average correlations (R2 ≥ 0.90), where all instruments correlated well (R2 ≥ 0.80) with the reference. The DRX and Purple Air overestimated PM2.5 mass concentrations by a factor of ~two. Differences between candidates and reference were more pronounced at higher PM2.5 concentrations. All optical instruments were affected by high RH and by the EC/OC ratio. Equations to convert candidate instruments data to FEM BAM type data are provided to enhance the usability of data from candidate instruments.Implications: This study tested the performance of seven candidate PM2.5 mass concentration measuring instruments in two settings - environmental chamber and field. The instruments were tested to determine their suitability for use during biomass combustion events and the effects of RH, PM mass concentrations, and concentrations of EC and OC on their performance. The accuracy and precision of each monitor and effect of RH, PM concentration, EC and OC concentrations are varied. The data show that most of these candidate instruments are suitable for measuring PM2.5 concentration during biomass combustions with a proper correction factor for each instrument type.

Incident command post exposure to polycyclic aromatic hydrocarbons and particulate matter during a wildfire.

Wildland firefighters engaged in fire suppression activities are often exposed to hazardous air pollutants such as polycyclic aromatic hydrocarbons (PAHs) and particulate matter (PM2.5) during wildfires with no respiratory protection. Although the most significant exposures to smoke likely occur on the fireline, wildland firefighters may also be exposed at the incident command post (ICP), an area designated for wildfire suppression support operations. Our objective was to characterize exposures of PAHs and PM2.5 near an ICP during a wildfire event in California. We collected area air samples for PAHs and PM2.5, during the first 12 days of a wildfire event. PAH area air samples were actively collected in 12-hr shifts (day and night) using XAD4-coated quartz fiber filters and XAD2 sorbent tubes and analyzed for 17 individual PAHs. Hourly area PM2.5 concentrations were measured with an Environmental Beta Attenuation Monitor. Most PAH concentrations generally had similar concentrations during the day and night. PM2.5 concentrations were higher during the day, due to increased fire activity, than at night. The highest concentrations of the 17 PAHs measured were for naphthalene, phenanthrene, and retene. The location of an ICP may be a critical factor in reducing these potential exposures to firefighters during wildfire events. Additionally, exposures could be reduced by utilizing clean air tents or sleeping trailers with HEPA filtration or setting up smaller camps in less smokey areas closer to the fireline for firefighters. Although measured exposures to PAHs for firefighters from smoke are lower at an ICP, these exposures still contribute to the overall cumulative work exposures.

Ozone pollution and asthma emergency department visits in the Central Valley, California, USA, during June to September of 2015: a time-stratified case-crossover analysis.

Objective: The San Joaquin Valley (SJV) exceeds the state and national standards for ozone (O3). This study investigates whether short-term exposure to O3 is associated with asthma emergency department (ED) visits. Methods: We identified 1,101 ED visits in June-September of 2015 in SJV, California, who lived within 15 km of active air monitors. Conditional logistic regression models were used to obtain the odds ratio (OR) and 95% confidence interval (CI) associated with an interquartile (IQR) increase in ozone. We explored the potential effect modification by sex (female and male), race (White, Black and Hispanic), age (2-5, 6-18, 19-40, 41-64 and > = 65) and county (Merced, Madera, Kings, Fresno and Kern). Results: An IQR range (18.1 ppb) increase in O3 exposure three days before an asthma attack (lag 3) was associated with a 6.6% [OR: 1.066 (95% CI: 1.032, 1.082)] increase in the odds of having an asthma ED visit. The overall ORs differed across age groups and races/ethnicities, with strongest for children aged 6-18 years [OR: 1.219 (95% CI: 1.159, 1.280)], adults 19-40 years [OR: 1.102 (95% CI: 1.053, 1.154)] and Blacks [OR: 1.159 (95% CI: 1.088, 1.236)], respectively. O3 exposure was not positively associated with asthma ED visits for Whites, while it was for other underrepresented groups. Fresno had the highest number of asthma ED visits and positive association among all five counties. Conclusion: We found that O3 exposure is associated with asthma ED visits in the SJV.

Nitrogenous air pollutants and ozone exposure in the central Sierra Nevada and White Mountains of California - Distribution and evaluation of ecological risks.

Ammonia (NH3), nitric oxide (NO), nitrogen dioxide (NO2), nitric acid (HNO3), and ozone (O3) were measured in summers of 2012 and 2013 with passive samplers. Nine monitoring sites were on W-E transect (511 to 3490 m) across central Sierra Nevada Mountains (SNM), and five sites on elevational gradient (1237 to 4346 m) in White Mountains (WM) of California. Levels of pollutants were similar in 2012 and 2013 in all sites. NH3, NO2, and HNO3 were highest near highly polluted Central Valley of California (CVC): maximum summer season means 7.8 µg m-3, 3.0 ppb, and 3.0 µg m-3, respectively. Regional background for NH3, NO2, and HNO3 in SNM occurred >20 km from CVC and >1500 m with seasonal averages: 2.1-4.8 µg m-3; 0.8-1.7 ppb; 1.0-1.8 µg m-3, respectively, during two seasons. Levels of NH3, NO2, and HNO3 in WM remote locations were similar: 1.2-3.3 µg m-3, 0.6-1.1 ppb, and 1.0-1.3 µg m-3, respectively. Seasonal mean O3 (38-60 ppb) in SNM did not change with distance from CVC nor elevation. In WM, O3 and NO mixing ratios were 41-61 ppb and 2.3-4.1 ppb, respectively, increasing with elevation. Even the lowest NH3 concentrations determined in this study were higher than NH3 continental background. This fact, as well as high values of Nreduced/Noxidized near CVC of 1.9 in 2012 and 2.0 in 2013, decreasing with distance to 0.7 in 2012 and 0.8 in 2013, show importance of NH3 emissions from CVC as a contributor to N deposition and ecological impacts in SNM. The phytotoxic O3 indices, AOT40 and W126, for selected sites on SNM and WM transects, showed high potential for negative O3 impacts on vegetation, including forest trees. CAPSULE: Elevated NH3, NO2, and HNO3 on the western slopes of the Sierra Nevada Mountains (SNM) near the Central Valley of California (CVC) decreased with distance from CVC and elevation to regional background levels also recorded at high elevation sites of the White Mountains (WM).

A statistical model for determining impact of wildland fires on Particulate Matter (PM2.5) in Central California aided by satellite imagery of smoke.

As the climate in California warms and wildfires become larger and more severe, satellite-based observational tools are frequently used for studying impact of those fires on air quality. However little objective work has been done to quantify the skill these satellite observations of smoke plumes have in predicting impacts to PM2.5 concentrations at ground level monitors, especially those monitors used to determine attainment values for air quality under the Clean Air Act. Using PM2.5 monitoring data from a suite of monitors throughout the Central California area, we found a significant, but weak relationship between satellite-observed smoke plumes and PM2.5 concentrations measured at the surface. However, when combined with an autoregressive statistical model that uses weather and seasonal factors to identify thresholds for flagging unusual events at these sites, we found that the presence of smoke plumes could reliably identify periods of wildfire influence with 95% accuracy.

Ozone, nitric acid, and ammonia air pollution is unhealthy for people and ecosystems in southern Sierra Nevada, California.

Two-week average concentrations of ozone (O3), nitric acid vapor (HNO3) and ammonia (NH3) were measured with passive samplers during the 2002 summer season across the central Sierra Nevada Mountains, California, along the San Joaquin River drainage. Elevated concentrations of the pollutants were determined with seasonal means for individual sites ranging between 62 and 88 ppb for O3, 1.0-3.8 microg m(-3) for HNO3, and 2.6-5.2 microg m(-3) for NH3. Calculated O3 exposure indices were very high, reaching SUM00-191 ppm h, SUM60-151 ppm h, and W126-124 ppm h. Calculated nitrogen (N) dry deposition ranged from 1.4 to 15 kg N ha(-1) for maximum values, and 0.4-8 kg N ha(-1) for minimum values; potentially exceeding Critical Loads (CL) for nutritional N. The U.S., California, and European 8 h O3 human health standards were exceeded during 104, 108, and 114 days respectively, indicating high risk to humans from ambient O3.