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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 30706

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Special Issue Editors

Prof. Dr. Shyamali Dharmage

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Guest Editor

Allergy and Lung Health Unit, University of Melbourne, Parkville 3010, Australia
Interests: epidemiology; respiratory medicine; chronic obstructive pulmonary disease (COPD); asthma; allergy; risk factors

Dr. Dinh Bui

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Assistant Guest Editor

Allergy and Lung Health Unit, University of Melbourne, Parkville 3010, Australia
Interests: epidemiology; respiratory medicine; chronic obstructive pulmonary disease (COPD); asthma; lung health

Dr. Gayan Bowatte

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Assistant Guest Editor

Allergy and Lung Health Unit, University of Melbourne, Parkville 3010, Australia
Interests: epidemiology; respiratory medicine; chronic obstructive pulmonary disease (COPD); asthma; air pollution

Special Issue Information

Dear Colleagues,

Allergic and chronic lung diseases, particularly asthma and chronic obstructive pulmonary disease (COPD), are now a worldwide public health problem. The complex and multifactorial features of these conditions make them a prevailing public health challenge. Advancing our understanding of the role of environmental and genetic factors and their interaction in the aetiology of these conditions is warranted to inform more effective prevention and management strategies.

This Special Issue is devoted to the consolidation of evidence of the impact of environmental factors on allergic diseases and lung health throughout the life course. We invite high-quality research that seeks to understand the epidemiology, burden, treatment and management of asthma, allergic rhinitis, COPD and lung development and decline in relation to environmental factors and their interaction with genetic traits. Environmental factors include, but are not limited to, individual non-genetic factors (e.g., smoking, infection and nutrition) as well as features of the physical environment (e.g., outdoor air pollution, indoor air pollution, greenness, the built environment, pollen and fungi). Original research papers and review articles (both systematic and narrative) are welcome.

We hope you will consider contributing to this Special Issue.

Prof. Dr. Shyamali Dharmage
Dr. Dinh Bui
Dr. Gayan Bowatte
Guest Editors

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Keywords

Allergic disease
Asthma
Chronic obstructive pulmonary disease
COPD
Chronic respiratory diseases
Respiratory health
Lung function
Lung health
Environmental exposures
Air pollution
Greenness
Pollen
Fungi
Gene-environmental interaction

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Published Papers (9 papers)

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Research

Jump to: Review

20 pages, 707 KiB

Open AccessArticle

Outpatient Department Visits and Mortality with Various Causes Attributable to Ambient Air Pollution in the Eastern Economic Corridor of Thailand

by Khanut Thongphunchung, Panita Charoensuk, Sutida U-tapan, Wassana Loonsamrong, Arthit Phosri and Wiriya Mahikul

Int. J. Environ. Res. Public Health 2022, 19(13), 7683; https://doi.org/10.3390/ijerph19137683 - 23 Jun 2022

Cited by 2 | Viewed by 2304

Abstract

The Eastern Economic Corridor in Thailand is undergoing development, but industrial activities are causing serious air pollution. This study aimed to examine the effects of particulate matter (PM₁₀), fine particulate matter (PM_2.5), SO₂, NO₂, O₃, and CO on outpatient department (OPD) visits and mortality with various causes in the Eastern Economic Corridor, Thailand between 2013 and 2019 using a case-crossover design and conditional Poisson model. The corresponding burden of disease due to air pollution exposure was calculated. A 1 µg/m³ increase in the PM₁₀ was associated with significant increases in OPD visits for circulatory diseases (0.22, 95% CI 0.01, 0.34), respiratory diseases (0.21, 95% CI 0.13, 0.28), and skin and subcutaneous tissue diseases (0.18, 95% CI 0.10, 0.26). By contrast, a 1 µg/m³ increase in the PM₁₀ was associated with significant increases in mortality from skin and subcutaneous tissue diseases (0.79, 95% CI 0.04, 1.56). A 1 µg/m³ increase in PM_2.5 was associated with significant increases in mortality from circulatory diseases (0.75, 95% CI 0.20, 1.34), respiratory diseases (0.82, 95% CI 0.02, 1.63), and skin and subcutaneous tissue diseases (2.91, 95% CI 0.99, 4.86). The highest OPD burden was for circulatory diseases. Respiratory effects were attributed to PM₁₀ exceeding the national ambient air quality standards (NAAQS) of Thailand (120 μg/m³). The highest morbidity burden was for skin and subcutaneous tissue diseases attributed to PM_2.5 concentrations that exceeded the NAAQs (50 μg/m³). PM pollution in the EEC could strongly contribute to OPD visits and morbidity from various diseases. Preventing PM₁₀ concentrations from being higher than 60 µg/m³ could decrease OPD visits by more than 33,265 and 29,813 for circulatory and respiratory diseases, respectively. Our study suggests that such pollution increases the risks of OPD visits and mortality in various causes in the Thai EEC. Reducing the ambient air pollution concentration of NAAQSs in Thailand could reduce the health effect on the Thai population. Full article

(This article belongs to the Special Issue Environmental Risk Factors, Allergic Diseases and Lung Health)

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10 pages, 1644 KiB

Open AccessArticle

Ambient Air Pollution and Risk of Admission Due to Asthma in the Three Largest Urban Agglomerations in Poland: A Time-Stratified, Case-Crossover Study

by Piotr Dąbrowiecki, Andrzej Chciałowski, Agata Dąbrowiecka and Artur Badyda

Int. J. Environ. Res. Public Health 2022, 19(10), 5988; https://doi.org/10.3390/ijerph19105988 - 14 May 2022

Cited by 12 | Viewed by 2500

Abstract

Ambient air pollution in urban areas may trigger asthma exacerbations. We carried out a time-series analysis of the association between the concentrations of various air pollutants and the risk of hospital admission due to asthma over 7 days from exposure. We used distributed lag nonlinear models to analyze data gathered between 2010 and 2018 in the three largest urban agglomerations in Poland. Overall, there were 31,919 asthma hospitalizations. Over 7 days since exposure, the rate ratio (95%CI) for admission per 10 µg/m³ was 1.013 (1.002–1.024) for PM₁₀; 1.014 (1.000–1.028) for PM_2.5; 1.054 (1.031–1.078) for NO₂; and 1.044 for SO₂ (95%CI: 0.986–1.104). For all pollutants, the risk of admission was the greatest on the day of exposure (day 0), decreased below baseline on days 1 and 2, and then increased gradually up to day 6. The proportions (95%CI) of hospitalizations attributable to air pollution were 4.52% (0.80%–8.14%) for PM₁₀; 3.74% (0.29%–7.11%) for PM_2.5; 16.4% (10.0%–21.8%) for NO₂; and 2.50% (−0.75%–5.36%) for SO₂. In conclusion, PM_2.5, PM₁₀, NO₂, and SO₂ pollution was associated with an increased risk of hospital admission due to asthma in the three largest urban agglomerations in Poland over nine years. Full article

(This article belongs to the Special Issue Environmental Risk Factors, Allergic Diseases and Lung Health)

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13 pages, 574 KiB

Open AccessArticle

Relationship Between Air Pollution and the Concentration of Nitric Oxide in the Exhaled Air (FeNO) in 8–9-Year-Old School Children in Krakow

by Marta Czubaj-Kowal, Ryszard Kurzawa, Henryk Mazurek, Michał Sokołowski, Teresa Friediger, Maciej Polak and Grzegorz Józef Nowicki

Int. J. Environ. Res. Public Health 2021, 18(13), 6690; https://doi.org/10.3390/ijerph18136690 - 22 Jun 2021

Cited by 4 | Viewed by 2705

Abstract

The consequences of air pollution pose one of the most serious threats to human health, and especially impact children from large agglomerations. The measurement of nitric oxide concentration in exhaled air (FeNO) is a valuable biomarker in detecting and monitoring airway inflammation. However, only a few studies have assessed the relationship between FeNO and the level of air pollution. The study aims to estimate the concentration of FeNO in the population of children aged 8–9 attending the third grade of public primary schools in Krakow, as well as to determine the relationship between FeNO concentration and dust and gaseous air pollutants. The research included 4580 children aged 8–9 years who had two FeNO measurements in the winter–autumn and spring–summer periods. The degree of air pollution was obtained from the Regional Inspectorate of Environmental Protection in Krakow. The concentration of pollutants was obtained from three measurement stations located in different parts of the city. The FeNO results were related to air pollution parameters. The study showed weak but significant relationships between FeNO and air pollution parameters. The most significant positive correlations were found for CO8h (r = 0.1491, p < 0.001), C₆H₆ (r = 0.1420, p < 0.001), PM₁₀ (r = 0.1054, p < 0.001) and PM_2.5 (r = 0.1112, p < 0.001). We suggest that particulate and gaseous air pollutants impact FeNO concentration in children aged 8–9 years. More research is needed to assess the impact of air pollution on FeNO concentration in children. The results of such studies could help to explain the increase in the number of allergic and respiratory diseases seen in children in recent decades. Full article

(This article belongs to the Special Issue Environmental Risk Factors, Allergic Diseases and Lung Health)

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9 pages, 299 KiB

Open AccessArticle

Impact of a Positive Viral Polymerase Chain Reaction on Outcomes of Chronic Obstructive Pulmonary Disease (COPD) Exacerbations

by Kulothungan Gunasekaran, Mudassar Ahmad, Sana Rehman, Bright Thilagar, Kavitha Gopalratnam, Sathish Ramalingam, Vijayakumar Paramasivam, Ashish Arora and Arul Chandran

Int. J. Environ. Res. Public Health 2020, 17(21), 8072; https://doi.org/10.3390/ijerph17218072 - 2 Nov 2020

Cited by 8 | Viewed by 2408

Abstract

Introduction: More than 15 million adults in the USA have chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD) places a high burden on the healthcare system. Many hospital admissions are due to an exacerbation, which is suspected to be from a viral cause. The purpose of this analysis was to compare the outcomes of patients with a positive and negative respiratory virus panel who were admitted to the hospital with COPD exacerbations. Methods: This retrospective cohort study was conducted in the Geisinger Healthcare System. The dataset included 2729 patient encounters between 1 January 2006 and 30 November 2017. Hospital length of stay was calculated as the discrete number of calendar days a patient was in the hospital. Patient encounters with a positive and negative respiratory virus panel were compared using Pearson’s chi-square or Fisher’s exact test for categorical variables and Student’s t-test or Wilcoxon rank-sum tests for continuous variables. Results: There were 1626 patients with a total of 2729 chronic obstructive pulmonary disease exacerbation encounters. Nineteen percent of those encounters (n = 524) had a respiratory virus panel performed during their admission. Among these encounters, 161 (30.7%) had positive results, and 363 (69.3%) had negative results. For encounters with the respiratory virus panel, the mean age was 64.5, 59.5% were female, 98.9% were white, and the mean body mass index was 26.6. Those with a negative respiratory virus panel had a higher median white blood cell count (11.1 vs. 9.9, p = 0.0076). There were no other statistically significant differences in characteristics between the two groups. Respiratory virus panel positive patients had a statistically significant longer hospital length of stay. There were no significant differences with respect to being on mechanical ventilation or ventilation-free days. Conclusion: This study shows that a positive respiratory virus panel is associated with increased length of hospital stay. Early diagnosis of chronic obstructive pulmonary disease exacerbation patients with positive viral panel would help identify patients with a longer length of stay. Full article

(This article belongs to the Special Issue Environmental Risk Factors, Allergic Diseases and Lung Health)

Review

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16 pages, 1917 KiB

Open AccessReview

A Review of the Respiratory Health Burden Attributable to Short-Term Exposure to Pollen

by Nur Sabrina Idrose, Caroline J. Lodge, Bircan Erbas, Jo A. Douglass, Dinh S. Bui and Shyamali C. Dharmage

Int. J. Environ. Res. Public Health 2022, 19(12), 7541; https://doi.org/10.3390/ijerph19127541 - 20 Jun 2022

Cited by 17 | Viewed by 3875

Abstract

Respiratory diseases such as asthma, allergic rhinitis (AR) and chronic obstructive pulmonary disease (COPD) affect millions worldwide and pose a significant global public health burden. Over the years, changes in land use and climate have increased pollen quantity, allergenicity and duration of the pollen season, thus increasing its impact on respiratory disease. Many studies have investigated the associations between short-term ambient pollen (i.e., within days or weeks of exposure) and respiratory outcomes. Here, we reviewed the current evidence on the association between short-term outdoor pollen exposure and thunderstorm asthma (TA), asthma and COPD hospital presentations, general practice (GP) consultations, self-reported respiratory symptoms, lung function changes and their potential effect modifiers. The literature suggests strong evidence of an association between ambient pollen concentrations and almost all respiratory outcomes mentioned above, especially in people with pre-existing respiratory diseases. However, the evidence on sub-clinical lung function changes, COPD, and effect modifiers other than asthma, hay fever and pollen sensitisation are still scarce and requires further exploration. Better understanding of the implications of pollen on respiratory health can aid healthcare professionals to implement appropriate management strategies. Full article

(This article belongs to the Special Issue Environmental Risk Factors, Allergic Diseases and Lung Health)

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24 pages, 550 KiB

Open AccessReview

The Effect of Outdoor Environmental Exposure on Readmission Rates for Children and Adolescents with Asthma—A Systematic Review

by Lisa Smaller, Mehak Batra and Bircan Erbas

Int. J. Environ. Res. Public Health 2022, 19(12), 7457; https://doi.org/10.3390/ijerph19127457 - 17 Jun 2022

Cited by 2 | Viewed by 2248

Abstract

The burden of asthma readmission for children and adolescents is approximately 10% worldwide. Research has been synthesised for behavioural and indoor impacts; however, no such synthesis has been conducted for outdoor environmental exposures. This systematic review aims to evaluate and synthesise the impact the outdoor environment has on readmission rates for children or adolescents with asthma. We conducted a systematic search of seven databases and hand searched reference lists of articles published up until 18 January 2021. There were 12 out of 392 studies eligible for inclusion. Overall, most studies showed that outdoor environments impact on readmission; however, the strength of association is seen to be stronger in a particular subpopulation of each study depending on the exposure investigated. The evidence for the association between outdoor environmental exposure and readmission rates for children or adolescents with asthma is increasing; however, it is complicated by potential confounders such as socioeconomic factors, ethnicity, indoor air pollutants, and other behavioural factors. Further research is required to differentiate between them. Additionally, further studies need to be undertaken in further countries other than the United States of America to understand the full relationship. Full article

(This article belongs to the Special Issue Environmental Risk Factors, Allergic Diseases and Lung Health)

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12 pages, 1477 KiB

Open AccessReview

An Overview of Environmental Risk Factors for Food Allergy

by Rachel L. Peters, Suzanne Mavoa and Jennifer J. Koplin

Int. J. Environ. Res. Public Health 2022, 19(2), 722; https://doi.org/10.3390/ijerph19020722 - 10 Jan 2022

Cited by 34 | Viewed by 6214

Abstract

IgE-mediated food allergy is an increasing public health concern in many regions around the world. Although genetics play a role in the development of food allergy, the reported increase has occurred largely within a single generation and therefore it is unlikely that this can be accounted for by changes in the human genome. Environmental factors must play a key role. While there is strong evidence to support the early introduction of allergenic solids to prevent food allergy, this is unlikely to be sufficient to prevent all food allergy. The purpose of this review is to summarize the evidence on risk factors for food allergy with a focus the outdoor physical environment. We discuss emerging evidence of mechanisms that could explain a role for vitamin D, air pollution, environmental greenness, and pollen exposure in the development of food allergy. We also describe the recent extension of the dual allergen exposure hypothesis to potentially include the respiratory epithelial barrier in addition to the skin. Few existing studies have examined the relationship between these environmental factors with objective measures of IgE-mediated food allergy and further research in this area is needed. Future research also needs to consider the complex interplay between multiple environmental factors. Full article

(This article belongs to the Special Issue Environmental Risk Factors, Allergic Diseases and Lung Health)

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20 pages, 653 KiB

Open AccessFeature PaperReview

The Exposome Approach in Allergies and Lung Diseases: Is It Time to Define a Preconception Exposome?

by Juan Pablo López-Cervantes, Marianne Lønnebotn, Nils Oskar Jogi, Lucia Calciano, Ingrid Nordeide Kuiper, Matthew G. Darby, Shyamali C. Dharmage, Francisco Gómez-Real, Barbara Hammer, Randi Jacobsen Bertelsen, Ane Johannessen, Anne Mette Lund Würtz, Toril Mørkve Knudsen, Jennifer Koplin, Kathrine Pape, Svein Magne Skulstad, Signe Timm, Gro Tjalvin, Susanne Krauss-Etschmann, Simone Accordini, Vivi Schlünssen, Jorunn Kirkeleit and Cecilie Svanes Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2021, 18(23), 12684; https://doi.org/10.3390/ijerph182312684 - 1 Dec 2021

Cited by 13 | Viewed by 4089

Abstract

Emerging research suggests environmental exposures before conception may adversely affect allergies and lung diseases in future generations. Most studies are limited as they have focused on single exposures, not considering that these diseases have a multifactorial origin in which environmental and lifestyle factors are likely to interact. Traditional exposure assessment methods fail to capture the interactions among environmental exposures and their impact on fundamental biological processes, as well as individual and temporal factors. A valid estimation of exposure preconception is difficult since the human reproductive cycle spans decades and the access to germ cells is limited. The exposome is defined as the cumulative measure of external exposures on an organism (external exposome), and the associated biological responses (endogenous exposome) throughout the lifespan, from conception and onwards. An exposome approach implies a targeted or agnostic analysis of the concurrent and temporal multiple exposures, and may, together with recent technological advances, improve the assessment of the environmental contributors to health and disease. This review describes the current knowledge on preconception environmental exposures as related to respiratory health outcomes in offspring. We discuss the usefulness and feasibility of using an exposome approach in this research, advocating for the preconception exposure window to become included in the exposome concept. Full article

(This article belongs to the Special Issue Environmental Risk Factors, Allergic Diseases and Lung Health)

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16 pages, 2010 KiB

Open AccessReview

Environmental and Endogenous Acids Can Trigger Allergic-Type Airway Reactions

by Giuliano Molinari, Laura Molinari and Elsa Nervo

Int. J. Environ. Res. Public Health 2020, 17(13), 4688; https://doi.org/10.3390/ijerph17134688 - 29 Jun 2020

Cited by 1 | Viewed by 2948

Abstract

Inflammatory allergic and nonallergic respiratory disorders are spreading worldwide and often coexist. The root cause is not clear. This review demonstrates that, from a biochemical point of view, it is ascribable to protons (H⁺) released into cells by exogenous and endogenous acids. The hypothesis of acids as the common cause stems from two considerations: (a) it has long been known that exogenous acids present in air pollutants can induce the irritation of epithelial surfaces, particularly the airways, inflammation, and bronchospasm; (b) according to recent articles, endogenous acids, generated in cells by phospholipases, play a key role in the biochemical mechanisms of initiation and progression of allergic-type reactions. Therefore, the intracellular acidification and consequent Ca²⁺ increase, induced by protons generated by either acid pollutants or endogenous phospholipases, may constitute the basic mechanism of the multimorbidity of these disorders, and environmental acidity may contribute to their spread. Full article

(This article belongs to the Special Issue Environmental Risk Factors, Allergic Diseases and Lung Health)

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