BACKGROUND: Evidence on the combined effects of air pollutants and greenspace exposure on pulmonary tuberculosis (PTB) treatment is limited, particularly in developing countries with high levels of air pollution. OBJECTIVE: We aimed to examine the individual and combined effects of long-term exposure to air pollutants on PTB treatment outcomes while also investigating the potential modifying effect of greenspace. METHODS: This population-based study included 82,784 PTB cases notified in Zhejiang Province, China, from 2015 to 2019. The 24-month average concentrations of particulate matter with an aerodynamic diameter ≤2.5 µm (PM_2.5), ozone (O₃), nitrogen dioxide (NO₂), and sulfur dioxide (SO₂) before PTB diagnosis were estimated using a dataset derived from satellite-based machine learning models and monitoring stations. Greenspace exposure was assessed using the annual China Land Cover Dataset. We conducted analyses using time-varying Cox proportional hazards models and cumulative risk indices. RESULTS: In individual effect models, each 10 µg/m³ increase in PM_2.5, NO₂, O₃, and SO₂ concentrations was associated with hazard ratios for PTB treatment success of 0.95 (95% confidence interval (CI): 0.93-0.97), 0.92 (95% CI: 0.91-0.94), 0.98 (95% CI: 0.97-0.99), and 1.52 (95% CI: 1.49-1.56), respectively. In combined effect models, long-term exposure to the combination of air pollutants was negatively associated with PTB treatment success, with a joint hazard ratio (JHR) of 0.79 (95% CI: 0.63-0.96). Among the pollutants examined, O₃ contributed the most to the increased risks, followed by PM_2.5 and NO₂. Additionally, areas with moderate levels of greenspace showed a reduced risk (JHR = 0.81, 95% CI: 0.62-0.98) compared with the estimate from the third quantile model (JHR = 0.68, 95% CI: 0.52-0.83). CONCLUSIONS Combined air pollutants significantly impede successful PTB treatment outcomes, with O₃ and PM_2.5 accounting for nearly 75% of this detrimental effect. Moderate levels of greenspace can mitigate the adverse effects associated with combined air pollutants, leading to improved treatment success for patients with PTB.
Humans ; China/epidemiology* ; Air Pollutants/analysis* ; Tuberculosis, Pulmonary/drug therapy* ; Particulate Matter/adverse effects* ; Male ; Female ; Middle Aged ; Environmental Exposure/analysis* ; Ozone/adverse effects* ; Adult ; Sulfur Dioxide/adverse effects* ; Treatment Outcome ; Air Pollution/adverse effects* ; Aged ; Nitrogen Dioxide/adverse effects* ; Young Adult ; Adolescent

BACKGROUND: The effect of air pollution on annual change rates in grip strength and body composition in the elderly is unknown. OBJECTIVES: This study evaluated the effects of long-term exposure to ambient air pollution on change rates of grip strength and body composition in the elderly. METHODS: In the period 2016-2020, grip strength and body composition were assessed and measured 1-2 times per year in 395 elderly participants living in the Taipei basin. Exposure to ambient fine particulate matters (PM_2.5), nitric dioxide (NO₂), and ozone (O₃) from 2015 to 2019 was estimated using a hybrid Kriging/Land-use regression model. In addition, long-term exposure to carbon monoxide (CO) was estimated using an ordinary Kriging approach. Associations between air pollution exposures and annual changes in health outcomes were analyzed using linear mixed-effects models. RESULTS: An inter-quartile range (4.1 µg/m³) increase in long-term exposure to PM_2.5 was associated with a faster decline rate in grip strength (-0.16 kg per year) and skeletal muscle mass (-0.14 kg per year), but an increase in body fat mass (0.21 kg per year). The effect of PM_2.5 remained robust after adjustment for NO₂, O₃ and CO exposure. In subgroup analysis, the PM_2.5-related decline rate in grip strength was greater in participants with older age (>70 years) or higher protein intake, whereas in skeletal muscle mass, the decline rate was more pronounced in participants having a lower frequency of moderate or strenuous exercise. The PM_2.5-related increase rate in body fat mass was higher in participants having a lower frequency of strenuous exercise or soybean intake. CONCLUSIONS Among the elderly, long-term exposure to ambient PM_2.5 is associated with a faster decline in grip strength and skeletal muscle mass, and an increase in body fat mass. Susceptibility to PM_2.5 may be influenced by age, physical activity, and dietary protein intake; however, these modifying effects vary across different health outcomes, and further research is needed to clarify their mechanisms and consistency.
Humans ; Hand Strength ; Aged ; Male ; Female ; Environmental Exposure/adverse effects* ; Follow-Up Studies ; Taiwan ; Air Pollution/adverse effects* ; Particulate Matter/adverse effects* ; Muscle, Skeletal/drug effects* ; Air Pollutants/adverse effects* ; Ozone/adverse effects* ; Aged, 80 and over ; Adipose Tissue/drug effects* ; Body Composition/drug effects* ; Nitrogen Dioxide/adverse effects*

To analyze the association between exposure to air pollution and respiratory disease of primary school students in Chongqing City. Eight districts and counties were randomly selected based on the air pollution situation in Chongqing City. In each selected district and county, one primary school was randomly selected. A questionnaire survey was conducted on all primary school students in Grades 3-5 by the end of 2019. Air quality data from the nearest environmental monitoring sites were collected. A logistic regression model was used to analyze the impact of the living environment, lifestyle and air pollution on the respiratory disease of surveyed students. This study included 5 918 primary school students, with a prevalence rate of respiratory disease of 21.54%. The prevalence rates of boys and girls were 23.38% and 19.59%, respectively. The average Air quality index (AQI) of the surveyed school was 67, and the rates of exceeding standards of PM₁₀, PM_2.5, NO₂ and O₃ were 1.16%, 6.92%, 0.99% and 5.65%, respectively. The level of SO₂ and CO did not exceed the standard. After adjusting for relevant factors, logistic regression analysis showed that primary school students in areas with high exposure to air pollution (OR=2.52), using air pollution related-chemicals at home (OR=1.47), passive smoking (OR=1.27), and keeping pets at home (OR=1.18) had a higher risk of respiratory disease (all P<0.05). In addition, the average annual values of AQI (OR=1.18), PM₁₀ (OR=1.20), PM_2.5 (OR=1.35), and NO₂ (OR=1.11) increased the risk of respiratory diseases in primary school students (all P<0.05). In conclusion, the respiratory disease of primary school students in Chongqing City is related to the living environment, behavior habits and ambient air quality. The increased exposure concentration of PM₁₀, PM_2.5 and NO₂ in air pollutants can lead to an increased risk of respiratory disease among primary school students.
Female ; Humans ; Male ; Air Pollution/adverse effects* ; Nitrogen Dioxide ; Particulate Matter ; Respiratory Tract Diseases/epidemiology* ; Schools ; Students ; Child

Nitrogen dioxide (NO₂) is an important indoor air pollutant, with both outdoor and indoor sources contributing to indoor NO₂ exposure levels. Considering the association of high NO₂ exposure with adverse health effects, the Standards for indoor air quality (GB/T 18883-2022) have been revised to further restrict indoor NO₂ limit values. The 1-h average concentration limit value for NO₂ has been reduced from 0.24 mg/m³ to 200 μg/m³.This study analyzed the technical contents related to the determination of the limits of indoor NO₂ in Standards for Indoor Air Quality (GB/T 18883-2022), including source, exposure level, health effects, and the process and evidence basis for determining the limit value. It also proposed prospects for the direction for the implementation of the indoor NO₂ standard.
Humans ; Air Pollution, Indoor/adverse effects* ; Nitrogen Dioxide ; Air Pollutants/analysis* ; China ; Air Pollution/adverse effects*

To analyze the association between exposure to air pollution and respiratory disease of primary school students in Chongqing City. Eight districts and counties were randomly selected based on the air pollution situation in Chongqing City. In each selected district and county, one primary school was randomly selected. A questionnaire survey was conducted on all primary school students in Grades 3-5 by the end of 2019. Air quality data from the nearest environmental monitoring sites were collected. A logistic regression model was used to analyze the impact of the living environment, lifestyle and air pollution on the respiratory disease of surveyed students. This study included 5 918 primary school students, with a prevalence rate of respiratory disease of 21.54%. The prevalence rates of boys and girls were 23.38% and 19.59%, respectively. The average Air quality index (AQI) of the surveyed school was 67, and the rates of exceeding standards of PM₁₀, PM_2.5, NO₂ and O₃ were 1.16%, 6.92%, 0.99% and 5.65%, respectively. The level of SO₂ and CO did not exceed the standard. After adjusting for relevant factors, logistic regression analysis showed that primary school students in areas with high exposure to air pollution (OR=2.52), using air pollution related-chemicals at home (OR=1.47), passive smoking (OR=1.27), and keeping pets at home (OR=1.18) had a higher risk of respiratory disease (all P<0.05). In addition, the average annual values of AQI (OR=1.18), PM₁₀ (OR=1.20), PM_2.5 (OR=1.35), and NO₂ (OR=1.11) increased the risk of respiratory diseases in primary school students (all P<0.05). In conclusion, the respiratory disease of primary school students in Chongqing City is related to the living environment, behavior habits and ambient air quality. The increased exposure concentration of PM₁₀, PM_2.5 and NO₂ in air pollutants can lead to an increased risk of respiratory disease among primary school students.
Female ; Humans ; Male ; Air Pollution/adverse effects* ; Nitrogen Dioxide ; Particulate Matter ; Respiratory Tract Diseases/epidemiology* ; Schools ; Students ; Child

Nitrogen dioxide (NO₂) is an important indoor air pollutant, with both outdoor and indoor sources contributing to indoor NO₂ exposure levels. Considering the association of high NO₂ exposure with adverse health effects, the Standards for indoor air quality (GB/T 18883-2022) have been revised to further restrict indoor NO₂ limit values. The 1-h average concentration limit value for NO₂ has been reduced from 0.24 mg/m³ to 200 μg/m³.This study analyzed the technical contents related to the determination of the limits of indoor NO₂ in Standards for Indoor Air Quality (GB/T 18883-2022), including source, exposure level, health effects, and the process and evidence basis for determining the limit value. It also proposed prospects for the direction for the implementation of the indoor NO₂ standard.
Humans ; Air Pollution, Indoor/adverse effects* ; Nitrogen Dioxide ; Air Pollutants/analysis* ; China ; Air Pollution/adverse effects*

OBJECTIVE: To investigate the potential effect of modification of antihypertensive medications on the association of nitrogen dioxide (NO₂) long-term exposure and chronic kidney disease (CKD). METHODS: Data of the national representative sample of adult population from the China National Survey of Chronic Kidney Disease (2007-2010) were included in the analyses, and exposure data of NO₂ were collected and matched. Generalized mixed-effects models were used to analyze the associations between NO₂ and CKD, stratified by the presence of hypertension and taking antihypertensive medications. The stratified exposure-response curves of NO₂ and CKD were fitted using the natural spine smoothing function. The modifying effects of antihypertensive medications on the association and the exposure-response curve of NO₂ and CKD were analyzed. RESULTS: Data of 45 136 participants were included, with an average age of (49.5±15.3) years. The annual average exposure concentration of NO₂ was (7.2±6.4) μg/m³. Altogether 6 517 (14.4%) participants were taking antihypertensive medications, and 4 833 (10.7%) participants were identified as having CKD. After adjustment for potential confounders, in the hypertension population not using antihypertensive medications, long-term exposure to NO₂ was associated with a significant increase risk of CKD (OR: 1.38, 95%CI: 1.24-1.54, P < 0.001); while in the hypertension population using antihypertensive medications, no significant association between long-term exposure to NO₂ and CKD (OR: 0.96, 95%CI: 0.86-1.07, P=0.431) was observed. The exposure-response curve of NO₂ and CKD suggested that there was a non-linear trend in the association between NO₂ and CKD. The antihypertension medications showed significant modifying effects both on the association and the exposure-response curve of NO₂ and CKD (interaction P < 0.001). CONCLUSION The association between long-term exposure to NO₂ and CKD was modified by antihypertensive medications. Taking antihypertensive medications may mitigate the effect of long-term exposure to NO₂ on CKD.
Adult ; Air Pollutants/analysis* ; Air Pollution/analysis* ; Antihypertensive Agents/adverse effects* ; Environmental Exposure/analysis* ; Humans ; Hypertension/epidemiology* ; Middle Aged ; Nitrogen Dioxide/analysis* ; Particulate Matter ; Renal Insufficiency, Chronic/epidemiology*

OBJECTIVE: To construct mesoporous nano-bioactive glass (MNBG) microspheres load-release minocycline as an antibacterial drug delivery system. METHODS: Sol-gel method was used to synthesze MNBG microspheres as drug carrier. The MNBG consisted of SiO2, CaO, and P2O5. According to the content of silicon, MNBG microspheres were divided into four groups (60S, 70S, 80S and 90S). Scanning electron microscopy (SEM) was used to observe the surface characteristic and particle size of MNBG; Nitrogen adsorption-desorption experiment was performed to calculate the MNBG's specific surface area and the pore sizes; The Fourier transform infrared spectrum (FT-IR) and the thermogravimetric analysis were conducted to calculate the loading efficiencies of minocycline hydrochloride; UV spectrophotometric was used to determine the cumulative release of minocycline from drug-loaded particles in PBS solution within 21 d. Agar diffusion test (ADT) was performed to evaluate the antibacterial properties on Enterococcus faecalis. The inhibition zone was observed and the diameter was measured. RESULTS: The MNBG microspheres had good dispersion, large surface area, and even particle size. The pore sizes ranged from 4.77 nm to 7.33 nm. The loading experiment results showed that the minocycline hydrochloride loading efficiency of MNBG was related to the pore size of the microspheres. Among 60S, 70S, 80S and 90S, 60S MNBG had the highest loading efficiency of 16.33% due to its high calcium content and large pore sizes. A slow minocycline release rate from MNBG particles in PBS solution until d 21 was observed. It was showed that a burst release of 28% of the total drug for the first 24 h. A cumulative release of 35% was found, and the final concentration of minocycline maintained at about 47 mg/L. ADT showed that mino-MNBG had inhibitory effect on the growth of Enterococcus faecalis. 1 g/L minocycline, 1 g/L mino-MNBG, and 0.1 g/L minocycline presented inhibition zone, however, PBS and 1 g/L MNBG didn't. The diameter of the inhibition zone of minocycline groups was significant larger than that of mino-MNBG group (P<0.05), which was also significant larger than those of PBS and MNBG groups (P<0.05). It showed that mino-MNBG drug delivery system had antibacterial properties on Enterococcus faecalis. CONCLUSION The 60S MNBG that can effectively load and release minocycline may be an ideal drug carrier.
Adsorption ; Anti-Bacterial Agents/administration & dosage* ; Drug Carriers ; Drug Delivery Systems ; Glass ; Microscopy, Electron, Scanning ; Microspheres ; Minocycline/adverse effects* ; Nitrogen ; Particle Size ; Porosity ; Silicon Dioxide ; Spectroscopy, Fourier Transform Infrared

Air pollution in China comes from multiple sources, including coal consumption, construction and industrial dust, and vehicle exhaust. Coal consumption in particular directly determines the emissions of three major air pollutants: dust, sulfur dioxide (SO(2)), and nitrogen oxide (NOx). The rapidly increasing number of civilian vehicles is expected to bring NOx emission to a very high level. Contrary to expectations, however, existing data show that the concentrations of major pollutants [particulate matter-10 (PM10), SO(2), and nitrogen dioxide (NO(2))] in several large Chinese cities have declined during the past decades, though they still exceed the national standards of ambient air quality. Archived data from China does not fully support that the concentrations of pollutants directly depend on local emissions, but this is likely due to inaccurate measurement of pollutants. Analyses on the cancer registry data show that cancer burden related to air pollution is on the rise in China and will likely increase further, but there is a lack of data to accurately predict the cancer burden. Past experience from other countries has sounded alarm of the link between air pollution and cancer. The quantitative association requires dedicated research as well as establishment of needed monitoring infrastructures and cancer registries. The air pollution-cancer link is a serious public health issue that needs urgent investigation.
Air Pollutants ; toxicity ; Air Pollution ; adverse effects ; Carcinogens, Environmental ; toxicity ; China ; Coal ; Humans ; Neoplasms ; etiology ; Nitrogen Dioxide ; toxicity ; Particulate Matter ; toxicity ; Sulfur Dioxide ; toxicity ; Vehicle Emissions ; toxicity

OBJECTIVETo study the present situations of lung cancer in Wuhan and to explore the relationship between the potential years of life lost of lung cancer and air pollution, especially vehicle emissions.

METHODSData gathered between 1986 and 1995 in Wuhan city, including air pollution and tobacco production and data on lung cancer between 1991 and 2000 were collected extensively. Simple Correlation and Grey Relational Analysis were used to analyze the relationship of them.

RESULTSThere was a ascending tendency in variance of oxides of nitrogen (NOx). The degree of grey incidence (DGI) between the concentration of air pollutants and the male's or female's potential years of life lost of lung cancer (PYLL) were calculated respectively. In males, the values of DGI were 0.6702, 0.7071, 0.6199 on sulfur dioxide (SO2), NOx, total suspensions (TSP) respectively. In females,the values of DGI were 0.6188, 0.8555, 0.5842 according to the same order as listed above. Significant positive correlation was found between the concentration of NOx and with lung cancer in both males and females by spearman correlation test (rmale = 0.63523, P = 0.0484; rfemale = 0.76396, P = 0.0101).

CONCLUSIONWith the fast growing speed of the quantity of vehicles, pollution of vehicle emission-caused air pollution posed an important risk factor for lung cancer, despite the fact that tobacco smoking still played the leading role.

Air Pollution ; adverse effects ; China ; Female ; Humans ; Lung Neoplasms ; mortality ; Male ; Nitrogen Oxides ; analysis ; Sulfur Dioxide ; analysis ; Vehicle Emissions ; analysis