Ambient air pollution and lung disease in China: health effects, study design approaches and future research

doi:10.1007/s11684-015-0397-8

Front. Med.

2015, Vol. 9

Issue (3) : 392-400 https://doi.org/10.1007/s11684-015-0397-8

COMMENTARY

Ambient air pollution and lung disease in China: health effects, study design approaches and future research

Jeffrey H. Mandel¹(

), Christine Wendt², Charles Lo³, Guangbiao Zhou⁴, Marshall Hertz⁵, Gurumurthy Ramachandran¹

¹. University of Minnesota School of Public Health, Minneapolis, MN 55455, USA
². University of Minnesota Medical School, Veteran’s Administration Hospital, Minneapolis, MN 55455, USA
³. University of Minnesota, Mechanical Engineering Department, Minneapolis, MN 55455, USA
⁴. State Key Laboratory of Biomembrane and Membrane Biotechnology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
⁵. University of Minnesota Medical School, Minneapolis, MN 55455, USA

Download: PDF(223 KB) HTML
Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks

Abstract

Ambient air pollution in China has worsened following dramatic increases in industrialization, automobile use and energy consumption. Particularly bothersome is the increase in the PM_2.5 fraction of pollutants. This fraction has been associated with increasing rates of cardio-respiratory disease in China and elsewhere. Ambient pollutant levels have been described in many of China’s cities and are comparable to previous levels in southern California. Lung cancer mortality in China has increased since the 1970s and has been higher in men and in urban areas, the exact explanation for which has not been determined. The estimation of individual risk for Chinese citizens living in areas of air pollution will require further research. Occupational cohort and case-control designs each have unique attributes that could make them helpful to use in this setting. Other important future research considerations include detailed exposure assessment and the possible use of biomarkers as a means to better understand and manage the threat posed by air pollution in China.

Keywords air pollution PM_2.5 lung disease study design epidemiology

Corresponding Author(s): Jeffrey H. Mandel

Just Accepted Date: 21 May 2015 Online First Date: 19 June 2015 Issue Date: 26 August 2015

Cite this article:

Jeffrey H. Mandel,Christine Wendt,Charles Lo, et al. Ambient air pollution and lung disease in China: health effects, study design approaches and future research[J]. Front. Med., 2015, 9(3): 392-400.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-015-0397-8
https://academic.hep.com.cn/fmd/EN/Y2015/V9/I3/392

Fig.1 Daytime air pollution, Xi’an, China (May, 2014).

Tab.1 Comparison of PM_2.5 chemical component ratios for the 14 Chinese cities with ratios from selected cities in Europe, Canada, Mexico, and the United States [7]

Tab.2 Cancer incidence and mortality in China, 2006–2010

Tab.3 Lung cancer mortality by gender in urban and rural areas^a

1	Z Chen, JN Wang, GX Ma, YS Zhang. China tackles the health effects of air pollution. Lancet 2013; 382(9909): 1959–1960 https://doi.org/10.1016/S0140-6736(13)62064-4 pmid: 24332069
2	China Statistical Yearbook
3	S Cheng, L Yang, X Zhou, Z Wang, Y Zhou, X Gao, W Nie, X Wang, P Xu, W Wang. Evaluating PM2.5 ionic components and source apportionment in Jinan, China from 2004 to 2008 using trajectory statistical methods. J Environ Monit 2011; 13(6): 1662–1671 https://doi.org/10.1039/c0em00756k pmid: 21505680
4	Y Guo, Y Jia, X Pan, L Liu, HE Wichmann. The association between fine particulate air pollution and hospital emergency room visits for cardiovascular diseases in Beijing, China. Sci Total Environ 2009; 407(17): 4826–4830 https://doi.org/10.1016/j.scitotenv.2009.05.022 pmid: 19501385
5	DYH Pui, SC Chen, Z Zuo. PM2.5 in China: Measurements, sources, visibility and health effects, and mitigation. Particuology 2014; 13: 1–26 https://doi.org/10.1016/j.partic.2013.11.001
6	WHO Country profile of environmental burden of disease: China. World Health Organization 2009
7	JJ Cao, ZX Shen, JC Chow, JG Watson, SC Lee, XX Tie, KF Ho, GH Wang, YM Han. Winter and summer PM2.5 chemical compositions in fourteen Chinese cities. J Air Waste Manag Assoc 2012; 62(10): 1214–1226 https://doi.org/10.1080/10962247.2012.701193 pmid: 23155868
8	SC Chen, CJ Tsai, CY Huang, HD Chen, SJ Chen, CC Lin, JH Tsai, CCK Chou, SCC Lung, WR Huang, GD Roam, WY Wu, J Smolik, L Dzumbova. Chemical mass closure and chemical characteristics of ambient ultrafine particles and other PM fractions. Aerosol Sci Technol 2010; 44(9): 713–723 https://doi.org/10.1080/02786826.2010.486385
9	J Cao, H Xu, Q Xu, B Chen, H Kan. Fine particulate matter constituents and cardiopulmonary mortality in a heavily polluted Chinese city. Environ Health Perspect 2012; 120(3): 373–378 https://doi.org/10.1289/ehp.1103671 pmid: 22389181
10	U. S. EPA. Integrated science assessment for particulate matter (final report). Washington, D.C.: US EPA 2009
11	Y Guo, S Tong, Y Zhang, AG Barnett, Y Jia, X Pan. The relationship between particulate air pollution and emergency hospital visits for hypertension in Beijing, China. Sci Total Environ 2010; 408(20): 4446–4450 https://doi.org/10.1016/j.scitotenv.2010.06.042 pmid: 20638709
12	P Li, J Xin, Y Wang, S Wang, G Li, X Pan, Z Liu, L Wang. The acute effects of fine particles on respiratory mortality and morbidity in Beijing, 2004–2009. Environ Sci Pollut Res Int 2013; 20(9): 6433–6444 https://doi.org/10.1007/s11356-013-1688-8 pmid: 23589266
13	X Wang, R Chen, X Meng, F Geng, C Wang, H Kan. Associations between fine particle, coarse particle, black carbon and hospital visits in a Chinese city. Sci Total Environ 2013; 458–460: 1–6 https://doi.org/23639905
14	L Qiao, J Cai, H Wang, W Wang, M Zhou, S Lou, R Chen, H Dai, C Chen, H Kan. PM2.5 constituents and hospital emergency-room visits in Shanghai, China. Environ Sci Technol 2014; 48(17): 10406–10414 https://doi.org/10.1021/es501305k pmid: 25119795
15	DP Parrish. Air Pollution in Developing Mega Cities-Something Old, Something New—Lessons from Los Angeles. Cooperative Institute for Research in Environmental Sciences, University of Colorado Presentation: Bolder Colorado on August 7, 2014
16	M Franklin, A Zeka, J Schwartz. Association between PM2.5 and all-cause and specific-cause mortality in 27 US communities. J Expo Sci Environ Epidemiol 2007; 17(3): 279–287 https://doi.org/10.1038/sj.jes.7500530 pmid: 17006435
17	JD Kaufman, SD Adar, RW Allen, RG Barr, MJ Budoff, GL Burke, AM Casillas, MA Cohen, CL Curl, ML Daviglus, AV Diez Roux, DR Jacobs Jr, RA Kronmal, TV Larson, SL Liu, T Lumley, A Navas-Acien, DH O’Leary, JI Rotter, PD Sampson, L Sheppard, DS Siscovick, JH Stein, AA Szpiro, RP Tracy. Prospective study of particulate air pollution exposures, subclinical atherosclerosis, and clinical cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Am J Epidemiol 2012; 176(9): 825–837 https://doi.org/10.1093/aje/kws169 pmid: 23043127
18	T Yorifuji, E Suzuki, S Kashima. Outdoor air pollution and out-of-hospital cardiac arrest in Okayama, Japan. J Occup Environ Med 2014; 56(10): 1019–1023 https://doi.org/10.1097/JOM.0000000000000274 pmid: 25285824
19	CA Pope 3rd, RT Burnett, D Krewski, M Jerrett, Y Shi, EE Calle, MJ Thun. Cardiovascular mortality and exposure to airborne fine particulate matter and cigarette smoke: shape of the exposure-response relationship. Circulation 2009; 120(11): 941–948 https://doi.org/10.1161/CIRCULATIONAHA.109.857888 pmid: 19720932
20	SL Lee, WH Wong, YL Lau. Association between air pollution and asthma admission among children in Hong Kong. Clin Exp Allergy 2006; 36(9): 1138–1146 https://doi.org/10.1111/j.1365-2222.2006.02555.x pmid: 16961713
21	O Raaschou-Nielsen, ZJ Andersen, R Beelen, E Samoli, M Stafoggia, G Weinmayr, B Hoffmann, P Fischer, MJ Nieuwenhuijsen, B Brunekreef, WW Xun, K Katsouyanni, K Dimakopoulou, J Sommar, B Forsberg, L Modig, A Oudin, B Oftedal, PE Schwarze, P Nafstad, U De Faire, NL Pedersen, CG Östenson, L Fratiglioni, J Penell, M Korek, G Pershagen, KT Eriksen, M Sørensen, A Tjønneland, T Ellermann, M Eeftens, PH Peeters, K Meliefste, M Wang, B Bueno-de-Mesquita, TJ Key, K de Hoogh, H Concin, G Nagel, A Vilier, S Grioni, V Krogh, MY Tsai, F Ricceri, C Sacerdote, C Galassi, E Migliore, A Ranzi, G Cesaroni, C Badaloni, F Forastiere, I Tamayo, P Amiano, M Dorronsoro, A Trichopoulou, C Bamia, P Vineis, G Hoek. Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncol 2013; 14(9): 813–822 https://doi.org/10.1016/S1470-2045(13)70279-1 pmid: 23849838
22	JA Ailshire, EM Crimmins. Fine particulate matter air pollution and cognitive function among older US adults. Am J Epidemiol 2014; 180(4): 359–366 https://doi.org/10.1093/aje/kwu155 pmid: 24966214
23	DM Brown, MR Wilson, W MacNee, V Stone, K Donaldson. Size-dependent proinflammatory effects of ultrafine polystyrene particles: a role for surface area and oxidative stress in the enhanced activity of ultrafines. Toxicol Appl Pharmacol 2001; 175(3): 191–199 https://doi.org/10.1006/taap.2001.9240 pmid: 11559017
24	CL Tran, D Buchanan, RT Cullen, A Searl, AD Jones, K Donaldson. Inhalation of poorly soluble particles. II. Influence Of particle surface area on inflammation and clearance. Inhal Toxicol 2000; 12(12): 1113–1126 https://doi.org/11114784
25	RL Maynard, RL Maynard. A derived association between ambient aerosol surface area and excess mortality using historic time series data. Atmos Environ 2002; 36(36–37): 5561–5567 https://doi.org/10.1016/S1352-2310(02)00743-4
26	R Beelen, M Stafoggia, O Raaschou-Nielsen, ZJ Andersen, WW Xun, K Katsouyanni, K Dimakopoulou, B Brunekreef, G Weinmayr, B Hoffmann, K Wolf, E Samoli, D Houthuijs, M Nieuwenhuijsen, A Oudin, B Forsberg, D Olsson, V Salomaa, T Lanki, T Yli-Tuomi, B Oftedal, G Aamodt, P Nafstad, U De Faire, NL Pedersen, CG Östenson, L Fratiglioni, J Penell, M Korek, A Pyko, KT Eriksen, A Tjønneland, T Becker, M Eeftens, M Bots, K Meliefste, M Wang, B Bueno-de-Mesquita, D Sugiri, U Krämer, J Heinrich, K de Hoogh, T Key, A Peters, J Cyrys, H Concin, G Nagel, A Ineichen, E Schaffner, N Probst-Hensch, J Dratva, R Ducret-Stich, A Vilier, F Clavel-Chapelon, M Stempfelet, S Grioni, V Krogh, MY Tsai, A Marcon, F Ricceri, C Sacerdote, C Galassi, E Migliore, A Ranzi, G Cesaroni, C Badaloni, F Forastiere, I Tamayo, P Amiano, M Dorronsoro, M Katsoulis, A Trichopoulou, P Vineis, G Hoek. Long-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts. Epidemiology 2014; 25(3): 368–378 https://doi.org/10.1097/EDE.0000000000000076 pmid: 24589872
27	Y Shang, Z Sun, J Cao, X Wang, L Zhong, X Bi, H Li, W Liu, T Zhu, W Huang. Systematic review of Chinese studies of short-term exposure to air pollution and daily mortality. Environ Int 2013; 54: 100–111 https://doi.org/10.1016/j.envint.2013.01.010 pmid: 23434817
28	S Vedal, J Sullivan. Particulate matter. In: WN Rom, S Markowitz. Environmental and Occupational Medicine. 4th ed. Philadelphia, PA: Wolters Kluwer/Lippincott, Williams and Wilkins, 2007: 1487–1506
29	JM Samet, ML Bell. Air polution: epidemiology. In: WN Rom, S Markowitz. Environmental and Occupational Medicine. 4th ed. Philadelphia, PA: Wolters Kluwer/Lippincott, Williams and Wilkins, 2007: 1400–1420
30	E Kelly, CA Owen, V Pinto-Plata, BR Celli. The role of systemic inflammatory biomarkers to predict mortality in chronic obstructive pulmonary disease. Expert Rev Respir Med 2013; 7(1): 57–64 https://doi.org/10.1586/ers.12.82 pmid: 23362815
31	AM Neophytou, S Costello, DM Brown, S Picciotto, EM Noth, SK Hammond, MR Cullen, EA Eisen. Marginal structural models in occupational epidemiology: application in a study of ischemic heart disease incidence and PM2.5 in the US aluminum industry. Am J Epidemiol 2014; 180(6): 608–615 https://doi.org/10.1093/aje/kwu175 pmid: 25125691
32	S Esposito, R Tenconi, M Lelii, V Preti, E Nazzari, S Consolo, MF Patria. Possible molecular mechanisms linking air pollution and asthma in children. BMC Pulm Med 2014; 14(1): 31 https://doi.org/24581224
33	AG Barnett, GM Williams, J Schwartz, AH Neller, TL Best, AL Petroeschevsky, RW Simpson. Air pollution and child respiratory health: a case-crossover study in Australia and New Zealand. Am J Respir Crit Care Med 2005; 171(11): 1272–1278 https://doi.org/10.1164/rccm.200411-1586OC pmid: 15764722
34	P Vineis, K Husgafvel-Pursiainen. Air pollution and cancer: biomarker studies in human populations. Carcinogenesis 2005; 26(11): 1846–1855 https://doi.org/10.1093/carcin/bgi216 pmid: 16123121
35	D Palli, A Russo, G Masala, C Saieva, S Guarrera, S Carturan, A Munnia, G Matullo, M Peluso. DNA adduct levels and DNA repair polymorphisms in traffic-exposed workers and a general population sample. Int J Cancer 2001; 94(1): 121–127 https://doi.org/10.1002/ijc.1433 pmid: 11668486
36	M Ruchirawa, C Mahidol, C Tangjarukij, S Pui-ock, O Jensen, O Kampeerawipakorn, J Tuntaviroon, A Aramphongphan, H Autrup. Exposure to genotoxins present in ambient air in Bangkok, Thailand—particle associated polycylic aromatic hydrocarbons and biomarkers. Sci Total Environ 2002; 287(1-2): 121–132 pmid: 11883753
37	CA Demetriou, O Raaschou-Nielsen, S Loft, P Møller, R Vermeulen, D Palli, M Chadeau-Hyam, WW Xun, P Vineis. Biomarkers of ambient air pollution and lung cancer: a systematic review. Occup Environ Med 2012; 69(9): 619–627 https://doi.org/10.1136/oemed-2011-100566 pmid: 22773658
38	PM Ridker, CH Hennekens, JE Buring, N Rifai. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342(12): 836–843 https://doi.org/10.1056/NEJM200003233421202 pmid: 10733371
39	KJ Rothman, S Greenland, TL Lash. Modern Epidemiology. Chapters 6–12 (Study Design and Conduct). Philadelphia, PA: Wolters-Kluwer/Lippincott, Williams and Wilkins, 2008: 87–209
40	M Elwood. Study designs which can demonstrate and test causation. In: M Elwood. Critical Appraisal of Epidemiological Studies and Clinical Trials. 3rd ed. New York, NY: Oxford University Press, 2007: 19–52
41	RA Michaels. Airborne particle excursions contributing to daily average particle levels may be managed via a 1- hour standard, with possible public health benefits. Aerosol Sci Technol 1996; 25(4): 437–444 https://doi.org/10.1080/02786829608965408
42	RA Michaels. Permissible daily airborne particle mass levels encompass brief excursions to the “London Fog” range, which may contribute to daily mortality and morbidity in communities. Appl Occup Environ Hyg 1998; 13(6): 385–394 https://doi.org/10.1080/1047322X.1998.10389562
43	WQ Chen, SW Zhang, XN Zou, P Zhao. Cancer incidence and mortality in China, 2006. Chin J Cancer Res 2011; 23(1): 3–9 https://doi.org/10.1007/s11670-011-0003-9 pmid: 23467577
44	WQ Chen, HM Zeng, RS Zheng, SW Zhang, J He. Cancer incidence and mortality in China, 2007. Chin J Cancer Res 2012; 24(1): 1–8 https://doi.org/10.1007/s11670-012-0001-6 pmid: 23359628
45	WQ Chen, RS Zheng, SW Zhang, N Li, P Zhao, GL Li, LY Wu, J He. Report of incidence and mortality in China cancer registries, 2008. Chin J Cancer Res 2012; 24(3): 171–180 https://doi.org/10.1007/s11670-012-0171-2 pmid: 23359321
46	W Chen, R Zheng, S Zhang, P Zhao, G Li, L Wu, J He. Report of incidence and mortality in China cancer registries, 2009. Chin J Cancer Res 2013; 25(1): 10–21 pmid: 23372337
47	W Chen, R Zheng, S Zhang, P Zhao, H Zeng, X Zou, J He. Annual report on status of cancer in China, 2010. Chin J Cancer Res 2014; 26(1): 48–58 pmid: 24653626
48	W Chen, R Zheng, H Zeng, S Zhang. The epidemiology of lung cancer in China. J Cancer Biol Res 2014; 2(1): 1043
49	DW Dockery, CA Pope, X Xu, JD Spengler, JH Ware, ME Fay, BG Ferris Jr, FEN Speizer. An association between air pollution and mortality in six U.S. cities. N Engl J Med 1993; 329(24): 1753–1759 pmid: 8179653
50	M Jerrett, K Shankardass, K Berhane, WJ Gauderman, N Künzli, E Avol, F Gilliland, F Lurmann, JN Molitor, JT Molitor, DC Thomas, J Peters, R McConnell. Traffic-related air pollution and asthma onset in children: a prospective cohort study with individual exposure measurement. Environ Health Perspect 2008; 116(10): 1433–1438 https://doi.org/10.1289/ehp.10968 pmid: 18941591

[1]	Jun Wang, Wenshuai Xu, Xinlun Tian, Yanli Yang, Shao-Ting Wang, Kai-Feng Xu. Lung function and air pollution exposure in adults with asthma in Beijing: a 2-year longitudinal panel study[J]. Front. Med., 2022, 16(4): 574-583.
[2]	Chun Cai, Yuexing Liu, Yanyun Li, Yan Shi, Haidong Zou, Yuqian Bao, Yun Shen, Xin Cui, Chen Fu, Weiping Jia, the SIM Study Group. Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai Integration Model (SIM)[J]. Front. Med., 2022, 16(1): 126-138.
[3]	William J. Liu, Haixia Xiao, Lianpan Dai, Di Liu, Jianjun Chen, Xiaopeng Qi, Yuhai Bi, Yi Shi, George F. Gao, Yingxia Liu. Avian influenza A (H7N9) virus: from low pathogenic to highly pathogenic[J]. Front. Med., 2021, 15(4): 507-527.
[4]	Solmaz Ohadian Moghadam, Seyed Ali Momeni. Human microbiome and prostate cancer development: current insights into the prevention and treatment[J]. Front. Med., 2021, 15(1): 11-32.
[5]	Honglu Zhou, Songmei Wang, Lorenz von Seidlein, Xuanyi Wang. The epidemiology of norovirus gastroenteritis in China: disease burden and distribution of genotypes[J]. Front. Med., 2020, 14(1): 1-7.
[6]	Xiaoxin Wu, Lanlan Xiao, Lanjuan Li. Research progress on human infection with avian influenza H7N9[J]. Front. Med., 2020, 14(1): 8-20.
[7]	Eun Young Lee, Kun-Ho Yoon. Epidemic obesity in children and adolescents: risk factors and prevention[J]. Front. Med., 2018, 12(6): 658-666.
[8]	Min Chen, Yuan Xu, Nan Hong, Yali Yang, Wenzhi Lei, Lin Du, Jingjun Zhao, Xia Lei, Lin Xiong, Langqi Cai, Hui Xu, Weihua Pan, Wanqing Liao. Epidemiology of fungal infections in China[J]. Front. Med., 2018, 12(1): 58-75.
[9]	Biao Kan, Haijian Zhou, Pengcheng Du, Wen Zhang, Xin Lu, Tian Qin, Jianguo Xu. Transforming bacterial disease surveillance and investigation using whole-genome sequence to probe the trace[J]. Front. Med., 2018, 12(1): 23-33.
[10]	Chongguang Yang, Qian Gao. *Recent transmission of Mycobacterium tuberculosis* in China: the implication of molecular epidemiology for tuberculosis control**[J]. Front. Med., 2018, 12(1): 76-83.
[11]	Fatemeh Mehravar,Soheil Rafiee,Behnaz Bazrafshan,Mahmoud Khodadost. Prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran[J]. Front. Med., 2016, 10(3): 345-350.
[12]	Rui Yu, Rong Fan, Jinlin Hou. Chronic hepatitis B virus infection: epidemiology, prevention, and treatment in China[J]. Front. Med., 2014, 8(2): 135-144.
[13]	Jay H. Ryu, Xinlun Tian, Misbah Baqir, Kaifeng Xu. Diffuse cystic lung diseases[J]. Front Med, 2013, 7(3): 316-327.
[14]	Jingyao Zhang, Dapeng Wu, Hong Ai, Jigang Bai, Shunbin Dong, Qinling Yang, Kai Qu, Lei Zhou, Xinsen Xu, Chang Liu. Epidemiological study of a von Hippel-Lindau family in northwest China[J]. Front Med, 2013, 7(3): 378-385.
[15]	Riffat Meraj, Kathryn A. Wikenheiser-Brokamp, Lisa R. Young, Sue Byrnes, Francis X. McCormack. Utility of transbronchial biopsy in the diagnosis of lymphangioleiomyomatosis[J]. Front Med, 2012, 6(4): 395-405.

Viewed

Full text

Abstract

Cited

Shared

Discussed