scholarly journals A route to school informational intervention for air pollution exposure reduction

2020 ◽  
Vol 53 ◽  
pp. 101965 ◽  
Author(s):  
Shiraz Ahmed ◽  
Muhammad Adnan ◽  
Davy Janssens ◽  
Geert Wets
Keyword(s):  
Air Pollution ◽  
Exposure Reduction ◽  
Air Pollution Exposure ◽  
Informational Intervention ◽  
Pollution Exposure

scholarly journals Air pollution interventions and respiratory health: a systematic review

2020 ◽  
Vol 24 (2) ◽  
pp. 150-164 ◽  
Author(s):  
S. Saleh ◽  
W. Shepherd ◽  
C. Jewell ◽  
N. L. Lam ◽  
J. Balmes ◽  
...  
Keyword(s):  
Air Pollution ◽  
Particulate Matter ◽  
Respiratory Health ◽  
Grey Literature ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Potential Health ◽  
Exposure Reduction ◽  
Air Pollution Exposure ◽  
Pollution Exposure

BACKGROUND: Indoor and ambient air pollution exposure is a major risk to respiratory health worldwide, particularly in low- and middle-income countries (LMICs). Interventional trials have mainly focused on alternatives to cooking stoves, with mixed results. Beyond cooking, additional sources of particulate matter also contribute to the burden of air pollution exposure. This review explores evidence from current randomised controlled trials (RCTs) on the clinical effectiveness of interventions to reduce particulate matter in LMICs.METHODS: Twelve databases and the grey literature (e.g., Government reports and policy papers) were searched. Eligible studies were RCTs conducted in LMICs aiming to reduce particulate exposure from any source and reporting on at least one clinical respiratory outcome (respiratory symptoms, lung function or clinical diagnoses). Data from relevant studies were systematically extracted, the risk of bias assessed and narrative synthesis provided.RESULTS: Of the 14 included studies, 12 tested ‘improved' cookstoves, most using biomass, but solar and bioethanol cookers were also included. One trial used solar lamps and another was an integrated intervention incorporating behavioural and environmental components for the treatment and prevention of chronic obstructive pulmonary disease. Of the six studies reporting child pneumonia outcomes, none demonstrated significant benefit in intention-to-treat analysis. Ten studies reported respiratory symptom outcomes with some improvements seen, but self-reporting made these outcomes highly vulnerable to bias. Substantial inter-study clinical and methodological heterogeneity precluded calculation of pooled effect estimates.CONCLUSION: Evidence from the RCTs performed to date suggests that individual household-level interventions for air pollution exposure reduction have limited benefits for respiratory health. More comprehensive approaches to air pollution exposure reduction must be developed so their potential health benefits can be assessed.

scholarly journals The MEDEA childhood asthma study design for mitigation of desert dust health effects: implementation of novel methods for assessment of air pollution exposure and lessons learned

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Panayiotis Kouis ◽  
Stefania I. Papatheodorou ◽  
Maria G. Kakkoura ◽  
Nicos Middleton ◽  
Emmanuel Galanakis ◽  
...  
Keyword(s):  
Air Pollution ◽  
Clinical Outcomes ◽  
Health Effects ◽  
Childhood Asthma ◽  
Primary Schools ◽  
Desert Dust ◽  
Exposure Reduction ◽  
Air Pollution Exposure ◽  
Dust Events ◽  
Pollution Exposure

Abstract Background Desert dust events in Mediterranean countries, originating mostly from the Sahara and Arabian deserts, have been linked to climate change and are associated with significant increase in mortality and hospital admissions from respiratory causes. The MEDEA clinical intervention study in children with asthma is funded by EU LIFE+ program to evaluate the efficacy of recommendations aiming to reduce exposure to desert dust and related health effects. Methods This paper describes the design, methods, and challenges of the MEDEA childhood asthma study, which is performed in two highly exposed regions of the Eastern Mediterranean: Cyprus and Greece-Crete. Eligible children are recruited using screening surveys performed at primary schools and are randomized to three parallel intervention groups: a) no intervention for desert dust events, b) interventions for outdoor exposure reduction, and c) interventions for both outdoor and indoor exposure reduction. At baseline visits, participants are enrolled on MEDena® Health-Hub, which communicates, alerts and provides exposure reduction recommendations in anticipation of desert dust events. MEDEA employs novel environmental epidemiology and telemedicine methods including wearable GPS, actigraphy, health parameters sensors as well as indoor and outdoor air pollution samplers to assess study participants’ compliance to recommendations, air pollutant exposures in homes and schools, and disease related clinical outcomes. Discussion The MEDEA study evaluates, for the first time, interventions aiming to reduce desert dust exposure and implement novel telemedicine methods in assessing clinical outcomes and personal compliance to recommendations. In Cyprus and Crete, during the first study period (February–May 2019), a total of 91 children participated in the trial while for the second study period (February–May 2020), another 120 children completed data collection. Recruitment for the third study period (February–May 2021) is underway. In this paper, we also present the unique challenges faced during the implementation of novel methodologies to reduce air pollution exposure in children. Engagement of families of asthmatic children, schools and local communities, is critical. Successful study completion will provide the knowledge for informed decision-making both at national and international level for mitigating the health effects of desert dust events in South-Eastern Europe. Trial registration ClinicalTrials.gov: NCT03503812, April 20, 2018.

scholarly journals Differential Effect of Ambient Air Pollution Exposure on Risk of Gestational Hypertension and Preeclampsia

Hypertension ◽  
2019 ◽  
Vol 74 (2) ◽  
pp. 384-390 ◽  
Author(s):  
Carrie J. Nobles ◽  
Andrew Williams ◽  
Marion Ouidir ◽  
Seth Sherman ◽  
Pauline Mendola
Keyword(s):  
Air Pollution ◽  
Differential Effect ◽  
Gestational Hypertension ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Air Pollution Exposure ◽  
Pollution Exposure

scholarly journals Maternal immune response and air pollution exposure during pregnancy: insights from the Early Markers for Autism (EMA) study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Heather E. Volk ◽  
Bo Park ◽  
Calliope Hollingue ◽  
Karen L. Jones ◽  
Paul Ashwood ◽  
...  
Keyword(s):  
Air Pollution ◽  
Intellectual Disability ◽  
Prenatal Screening ◽  
Maternal Serum ◽  
Serum Samples ◽  
Maternal Immune Activation ◽  
Early Markers ◽  
Air Pollution Exposure ◽  
Pollution Exposure ◽  
The Relationship

Abstract Background Perinatal exposure to air pollution and immune system dysregulation are two factors consistently associated with autism spectrum disorders (ASD) and other neurodevelopmental outcomes. However, little is known about how air pollution may influence maternal immune function during pregnancy. Objectives To assess the relationship between mid-gestational circulating levels of maternal cytokines/chemokines and previous month air pollution exposure across neurodevelopmental groups, and to assess whether cytokines/chemokines mediate the relationship between air pollution exposures and risk of ASD and/or intellectual disability (ID) in the Early Markers for Autism (EMA) study. Methods EMA is a population-based, nested case–control study which linked archived maternal serum samples collected during weeks 15–19 of gestation for routine prenatal screening, birth records, and Department of Developmental Services (DDS) records. Children receiving DDS services for ASD without intellectual disability (ASD without ID; n = 199), ASD with ID (ASD with ID; n = 180), ID without ASD (ID; n = 164), and children from the general population (GP; n = 414) with no DDS services were included in this analysis. Serum samples were quantified for 22 cytokines/chemokines using Luminex multiplex analysis technology. Air pollution exposure for the month prior to maternal serum collection was assigned based on the Environmental Protection Agency’s Air Quality System data using the maternal residential address reported during the prenatal screening visit. Results Previous month air pollution exposure and mid-gestational maternal cytokine and chemokine levels were significantly correlated, though weak in magnitude (ranging from − 0.16 to 0.13). Ten pairs of mid-pregnancy immune markers and previous month air pollutants were significantly associated within one of the child neurodevelopmental groups, adjusted for covariates (p < 0.001). Mid-pregnancy air pollution was not associated with any neurodevelopmental outcome. IL-6 remained associated with ASD with ID even after adjusting for air pollution exposure. Conclusion This study suggests that maternal immune activation is associated with risk for neurodevelopmental disorders. Furthermore, that prenatal air pollution exposure is associated with small, but perhaps biologically relevant, effects on maternal immune system function during pregnancy. Additional studies are needed to better evaluate how prenatal exposure to air pollution affects the trajectory of maternal immune activation during pregnancy, if windows of heightened susceptibility can be identified, and how these factors influence neurodevelopment of the offspring.

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