2018 report on Air Pollution and Health Research

UTAH PHYSICIANS FOR A HEALTHY ENVIRONMENT
2018 REPORT ON
AIR POLLUTION AND HEALTH RESEARCH

When UPHE was formed in 2007, we committed ourselves first and foremost to delivering a message
on air pollution and public health based strictly on the science. As we searched through the research,
we were all struck by the parallels between the health consequences of air pollution and those of
cigarette smoking. The parallels between those two types of pollution exposure have only grown
closer in the last 12 years. What follows is a summary of key medical research from the past year
and a reiteration and expansion of concepts that have been strengthened by this research.

The Lungs

The lungs consist of airways that conduct air into the lung, air sacs called alveoli where oxygen enters
the blood stream and the waste gas, carbon dioxide is excreted and blood vessels that supply
nutrition and carry oxygen and carbon dioxide. The airways are like an upside down tree where the
trachea or windpipe is the widest part and as the branches form they keep getting narrower until they
reach the alveoli or air sacs. When particles larger than 10 microns (larger than a red blood cell and
about 5 to 10 times larger than most bacteria) they usually strike the wall of the airway, especially at a
branching point, and are trapped in the thin mucus layer and swept out of the lungs. Pollution
particles smaller than 10 microns can make their way down the airway and even settle in the air sacs.
They may be blown out in expiration. Particles smaller than 2.5 microns can reach the air sacs and
stay there. Thus, the smaller the particle, the greater the chances it can reach the air sac and stay
there. Very small particles can even cross the air sac wall and enter the blood that carries it all over
the body.
Air pollution consists of many particles of different sizes and in what occurs in the northern valleys of
Utah approximately 70% are 2.5 microns or smaller on an average day. Thus, most of our pollution
can get into the very small airways, the air sacs and even the blood. Some particles may be harmless
and some very harmful such as toxic metals. However, even the so-called harmless particles can
carry harmful chemicals, bacteria and viruses and do their damage through the attached rider. This
can explain many of the harmful effects of air pollution.
The entry into the blood explains the harmful effects on the brain, the fetus and other organs. The
settling of harmful particles in the air sacs explains how these air sacs can be destroyed leading to
emphysema and chronic obstructive pulmonary disease (COPD). (41,56,66,89) The irritation of the
small airway walls causes asthma and chronic bronchitis. The transport of viruses and bacteria in the
lung can lead to pneumonia. The inflammatory reactions to these particles leads to the release of
inflammatory chemical mediators that probably result in the formation and rupture of plaques in the
blood vessels causing strokes and heart attacks. Asthmatic attacks, COPD, bronchitis, pneumonia,
heart attacks and strokes all have been shown to be increased during our inversions and the
accumulation of pollutants in the air.
Cigarette smoking, which we all agree is a danger to our health, is a form of air pollution. When
smoking a cigarette you receive much higher levels of inhaled particles with each puff than you would
get from air pollution with a deep breath. However, a pack a day smoker is probably inhaling that
smoke maybe 400 times a day, or about 40 minutes worth of breathing, while we have to breathe
polluted air 12 times a minute, 24 hours/day. That comes to more than 17,000 breaths a day.
Smokers in our polluted valleys get the worst of both worlds.

The Heart and Blood Vessels

Numerous observational clinical studies have shown that exposure to acutely elevated levels of air
pollution is associated with increased risk of death due to myocardial infarction (“heart attack”) in
patients with preexisting cardiovascular diseases. Recent research from Europe shows that rapid
rises in air pollutants, over a 24 hour period, is associated with increased risk of myocardial infarction,
independently of absolute concentration. (83)
Multiple lines of recently accumulating evidence suggest that not only do acute spikes cause death,
chronic exposure to air pollution can actually contribute to the development of cardiovascular disease
in the first place. Just like cigarette smoking, diabetes mellitus and elevated cholesterol, exposure to
particulate matter (PM 2.5) is now considered a modifiable risk factor for cardiovascular disease.
Researchers in southwestern China found evidence of stiff blood vessels and increased blood
pressure, a well-known risk factor for cardiovascular disease, in middle-aged women exposed to
particulate matter air pollution from wood burning stoves. (80,81)
A national cross-sectional study in Lebanon showed that living conditions characterized by exposure
to indoor and outdoor air pollution are associated with high blood pressure.(82) In Philadelphia,
investigators recently aimed to study racial differences in air pollution exposure to ambient fine
particulate matter. With a median follow-up period of 8.3 years, they concluded that particulate matter
(PM 2.5) exposure was associated with elevated blood glucose, impaired blood vessel function,
increased incidence of adverse cardiovascular events and higher all-cause mortality. In this study,
blacks had higher exposure to PM 2.5 and a 45% higher risk of adverse cardiovascular events and
death from any cause. (76) Although less widely recognized, low-level environmental lead exposure
has recently been associated with increased risk of death from cardiovascular disease in large
population-based studies carried out in the United States. (74)
Finally, there is disturbing evidence accumulating from both clinical studies in people and basic
animal models, showing that exposure to PM 2.5 particulate matter is associated with decreased
cardiac function and increased heart size. In animal models, preconception exposure to PM 2.5, as
well as in utero prenatal and during the post-natal period, can cause cardiac dysfunction in adulthood.
(1)

Air Quality and Fertility, Pregnancy, and Newborn Health

The last year has continued the growth of research reports on the adverse outcomes associated with
poor air quality and women’s and men’s reproductive health. The significant majority of public health
outcomes research confirms that air pollution (particulate and ozone) adversely affects fertility,
pregnancy, and the health of newborns. This research also reveals that there is no “safe” level of air
pollution….adverse effects can be measured even at levels below EPA standards. Of course, these
reports also confirm that more pollution is worse and less pollution is better.
New reports add to earlier research that poor air quality adversely affects sperm quality (84) and this
confirms research done previously here in the Salt Lake Valley (98). Research from around the world
has shown the association of poor air quality with increased risk of spontaneous abortion and this
year a report from the University of Utah found similar risks here in Salt Lake City (5). More reports
from around the world confirm the increased risk of preterm birth and stillbirth with poor air quality (45).
Infants exposed to air pollution prior to birth have poorer cognitive function in school (7). Infants
exposed to poor air pollution have more heart defects (79) and more asthma (86). Although the
increases in all of these adverse effects are small, they are significant on a population level, and very
significant to the affected parents and children.
And there is good news! In California, researchers have looked at the reproductive health
consequences to people living close to oil and coal power plants. They found an increase in fertility in
people living near the recently closed coal and oil power plants, compared to when they were open
(47). They also found a significant decrease in premature births in women who lived nearby after the
power plants were closed (43). This mirrors research from Utah Valley that showed that premature
births dropped after a steel mill was closed (58). Also, data collected by citizen science efforts like
Purple Air allow men and women access to air quality information in their own neighborhood and
inside their own homes so that they can make decisions about driving, outdoor activities, and become
advocates for cleaner air.

Fetal Development, DNA Damage

We have known for several years that air pollution can harm the developing fetus in utero and
contribute to adverse pregnancy outcomes as mentioned above. One likely mechanism by which that
occurs is air pollution’s ability to interfere with DNA and genetic function. The study mentioned above
finding impaired cognition in children who were born in a home near heavily trafficked roads, showed
that the likely mechanism was damage to DNA. That is now a recurring and critical theme in air
pollution research, including a new study showing decreased ability to repair DNA damage with more
air pollution exposure. (30) Changes in the chemical environment of DNA in the placenta increase the
vulnerability of the unborn to chronic disease later in life. (46) Several new studies were published
demonstrating that air pollution changes the functioning of genes, a likely mechanism by which it
provokes chronic diseases of the heart, lungs, and endocrine systems. (67,68,69,70,71)
Telomeres are repeating sequences of DNA on the ends of chromosomes that shorten with cell
division as a person ages. More studies were published showing air pollution causes a specific type
of DNA damage—shorter telomere length, a marker of accelerated aging, and predictor of premature
death. (15,31)
An alarming new study in lab mice starkly shows what air pollution can do to future generations, even
if they are never exposed. In mice, merely “pre-conception” exposure to air pollution, and no
exposure after conception, at a level only slightly above the EPA’s 24 hour standard for PM2.5, was
enough to cause impaired heart function, decreased heart muscle mass, activated an oxidative stress
response and triggered systemic inflammation later on in adulthood. The mechanism was damage to
germ cells in the parents even before conception. The moral to this story is powerful. Even yet
unborn, future generations are harmed by the air pollution breathed today by future parents.1

Diseases of the Brain and Nervous System

Research studies published during the past year have demonstrated how alarmingly harmful air
pollution is to the human brain, including the presence of air pollution particles penetrating brain
tissue itself.
During early development, the brain is especially susceptible to damage from air pollution. A study
showed that air pollution chemically changes the DNA in children (22) while another study further
affirms the danger of diesel exposure showing that there is damage to the olfactory system of the
fetus in-utero. (92) As we have known, early life air pollution exposure affects the microscopic
anatomy of the brain, with a recent study demonstrating decreases in the number of neurons,
alteration of the blood brain barrier and increases in micro hemorrhages, all of which were associated
with impaired brain function in animals. (8) From this past year’s research, there is also new evidence
further connecting air pollution to autism. (72)
Research continues to show that air pollution is associated with a broad range of neurologic diseases.
This year’s research studies break new ground in finding a connection between air pollution and
Amyotrophic Lateral Sclerosis (ALS), i.e. Lou Gehrig’s disease, (97) increased relapses in multiple
sclerosis, (88) and increased risk of stroke and mortality from stroke. (12,13,14)
More air pollution exposure has been found to be associated with smaller volumes of brain grey
matter (78) and exposure to air pollution is associated with lower verbal scores. Less well-educated
men over age 60 are the most vulnerable to this effect. (9) Heavy metal exposure has been shown to
impair cognitive function, specifically, verbal memory, recognition, mental processing speed, and
executive function, which all focused in frontal and pre- frontal lobe areas. (6)
An autopsy study examining brains of 203 younger people age 1 to 40 found abnormal proteins linked
to Alzheimer’s disease in all but one of the specimens! And the amount of these abnormal proteins
was proportional to the amount of air pollution where the subjects lived. The principle author, probably
the world’s expert on this type of research said, “Alzheimer’s disease hallmarks start in childhood in
polluted environments, and we must implement effective preventative measures early. It is useless to
take reactive actions decades later.” (60)

Mental Health

There has long been acceptance that pollution increases the risks of heart disease, stroke dementia,
lung cancer and other lung diseases, and GI issues. In recent years, evidence has emerged that link
air pollution to mental health problems like early brain development, depression, anxiety, psychosis,
and suicide. Adding to the established literature on this topic, 2018 has brought us additional studies,
which confirm earlier concerns as well as introduce new ones.
Pollution may be particularly harmful to a young developing brain, as there appear to be associations
between pollution and autistic spectrum disorder (ASD). (72,99,100,101)
Studies also showed an association between behavioral difficulties of young children and air pollution
their mothers were exposed to while pregnant with them. 8,19 Self-harming in adolescents in China
was associated with pollution. (102) Youth exposed to pollution at age 12 had increased rates of
depression as adults. (103)
Adult brains are also sensitive to pollution’s effects. Behavioral problems, even criminal activity and
unethical behavior, are also observed in adults exposed to pollution. 85 There are higher rates of
depression, substance abuse and psychosis with pollution. (51, 53, 54) Even second-hand smoke
was associated with a roughly 50% increased in risk of major depression in non-smokers. (104)
Suicide rates were shown to be increased with exposure to pollution. (52,105,106)
When considering all-cause mortality, pollution haze was shown to be particularly dangerous for
people with mental illness. The combination of high ozone and haze was associated with a 79%
increase in the risk of death. (107)

Endocrine Diseases

Air pollution increases the risk of insulin resistance, obesity, type II diabetes, metabolic disorders like
fatty liver disease and an adverse blood lipid profile. (10,11,21,62,63,64,65)

Cancer

Just about every type of cancer is provoked by air pollution. Several new studies showed air
pollution’s association with increased risk of cancer—childhood cancers, lung cancer, and cancers of
the upper digestive tract and stomach. (32, 33, 34, 35, 59) Yet another study found a connection
between air pollution and brain cancer, with this one revealing a likely mechanism. (50) Even cancers
thought to be exclusively caused by smoking are associated with air pollution, including
nasopharyngeal cancer. (17)

Infections

Virtually every type of infection has been connected to air pollution. A study was done evaluating a
large patient population of over 100,000 right here on Utah’s Wasatch Front. It showed that serious
lower respiratory infections in every age group were increased with more air pollution, even shortterm
exposure lasting only several days. (61) Other studies showed air pollution triggers upper and
lower respiratory and ear infections in children. (23,55) Two new studies showing increased rates of
appendicitis with more air pollution. (36, 37)

Miscellaneous Diseases (Kidney, Bowel) and Other Studies

The connection between air pollution and kidney disease (16) and inflammatory bowel diseases was
strengthened, with a study showing how the bowel’s bacteria population is disrupted. (48)
We are often asked how bad does the air pollution have to get to make it more dangerous to your
health than the benefits of the exercise itself? We still don’t really know the answer, but this study
suggests that with dirty air, the benefits of the exercise are wiped out after 15 minutes, and that after
75 minutes, the air pollution is doing more damage than the benefits of the exercise. (57)
Another new study suggests that breathing through tightly fitting N-95 masks reduces the amount of
particles inhaled, but doesn’t proportionally decrease the body’s inflammation at the microscopic level,
and therefore the health consequences of pollution may not mitigated much. (58)
Infant mortality increases with air pollution. A study from Africa shows about the same relationship
between infant mortality and air pollution, as adult mortality–a 1% increase for every 1 ug/m3 in
PM2.5, or about 22% of infant deaths in this study. (39)
On a positive note, a new study showed that cardiorespiratory exercise may have a protective effect
on cognition in older women exposed to air pollution. (94)

Conclusions

The last year’s research solidifies these important concepts.
1. There is no safe level of air pollution and the relationship between air pollution and impaired public
health is not linear. Per unit of exposure low levels have even greater impact on health. Any industrial
project, or new source of pollution, must be analyzed in this context, and not judged or permitted in
the context of whether it may result in exceedances of national air quality standards. They must be
judged simply as to whether they add more pollution to a community that is already burdened with
poor air quality.
2. Virtually everyone is affected whether or not they have symptoms.
3. While everyone is affected, they are not affected equally. There are important genetic, gender and
even racial differences in how people respond to the biological stress of air pollution.
4. Pollution averages don’t tell the whole story. Even short term air pollution matters, and has
lingering and potentially long term health consequences, including some pollution particles remaining
inside the body’s organs for months or even permanently.
5. The timing of the exposure, and even the rate of an exposure may be more important than the
quantity of exposure. This is especially true for babies in utero.
6. Not all air pollution, and not even all particulate pollution is created equal. Some sources are
more chemically, mechanically and biologically toxic than others. For example, wood smoke and
diesel exhaust are two of the most toxic types of pollution.
7. Microenvironments matter. Pollution tends to concentrate near its sources, and the health
consequences that we allow as a community can be vastly different comparing the east side of the
valley to the west, and even from one neighborhood to another. No neighborhood or township should
be treated as a sacrifice zone for the economic development of another, or of the state as a whole.
North Salt Lake, Draper, the Point of the Mountain, and the Northwest Quadrant are examples of
communities that are, or will be, disproportionately impacted because of current or planned industrial
operations.
8. As we experienced last year, climate related factors will likely make our air pollution worse. More
regional wild fires and more ozone from hotter temperatures are likely to render current mitigation
strategies inadequate to provide consistently clean air on the Wasatch Front.
We feel it is imperative that the legislature considers all these factors during this and all future
sessions.
Healthy Summary compiled by:
Dr. Brian Moench – President and Founder UPHE
Dr. Park Willis IV – Vice President UPHE
Dr. Richard Kanner – Board Member UPHE
Dr. Kirtly Jones – Board Member UPHE
Dr. John Macfarlane – Board Member UPHE
Dr. Phil Wilson
Dr. Courtney Henley
##
UPHE is a 501(c)(3) tax-exempt, charitable organization. Tax ID# 80-0774496
423 W 800 S, Suite A108, Salt Lake City, UT 84101 Phone: 385.707.3677
www.uphe.org www.facbook.com/utahphysiciansforahealthyenvironment

References

1. Tanwar V, et al. Preconception Exposure to Fine Particulate Matter Leads to Cardiac Dysfunction
in Adult Male Offspring. Journal of the American Heart Association, 2018; 7 (24) DOI:
10.1161/JAHA.118.010797
2. Hamanaka RB, et al. Particulate Matter Air Pollution: Effects on the Cardiovascular System. Front
Endocrinol (Lausanne). 2018 Nov 16;9:680. doi: 10.3389/fendo.2018.00680. eCollection 2018.
3. Rajagopalan S, et al. Air Pollution and Cardiovascular Disease: JACC State-of-the-Art Review. J
Am Coll Cardiol. 2018 Oct 23;72(17):2054-2070. doi: 10.1016/j.jacc.2018.07.099.
4. Lee AG, et al. Prenatal Household Air Pollution is Associated with Impaired Infant Lung Function
with Sex-Specific Effects: Evidence from GRAPHS, a Cluster Randomized Cookstove Intervention
Trial. Am J Respir Crit Care Med. 2018 Sep 26. doi: 10.1164/rccm.201804-0694OC. [Epub ahead of
print]
5. Leiser CL, et al. Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover
study. Fertility and Sterility, 2018; DOI: 10.1016/j.fertnstert.2018.10.028
6. Wurth R, et al. Fine Particle Sources and Cognitive Function in An Older Puerto Rican Cohort in
Greater Boston. Environ Epidemiol. 2018 Sep;2(3). pii: e022. doi: 10.1097/EE9.0000000000000022.
7. Peng C, et al. Residential Proximity to Major Roadways at Birth, DNA Methylation at Birth and
Midchildhood, and Childhood Cognitive Test Scores: Project Viva(Massachusetts, USA) First
Published:18 September 2018097006https://doi.org/10.1289/EHP2034
8. Woodward NC, et al. Prenatal and early life exposure to air pollution induced hippocampal
vascular leakage and impaired neurogenesis in association with behavioral deficits. Transl Psychiatry.
2018 Nov 29;8(1):261. doi: 10.1038/s41398-018-0317-1.
9. Zhang X, et al. The impact of exposure to air pollution on cognitive performance. PNAS September
11, 2018 115 (37) 9193-9197; published ahead of print August 27, 2018
10. Dang J, et al. Associations of Exposure to Air Pollution with Insulin Resistance: A Systematic
Review and Meta-Analysis. Int J Environ Res Public Health. 2018 Nov 20;15(11). pii: E2593. doi:
10.3390/ijerph15112593.
11. Xu MX, et al. Prolonged PM2.5 exposure elevates risk of oxidative stress-driven nonalcoholic
fatty liver disease by triggering increase of dyslipidemia. Free Radic Biol Med. 2018 Nov 19. pii:
S0891-5849(18)31447-3. doi: 10.1016/j.freeradbiomed.2018.11.016. [Epub ahead of print]
12. Xue T, et al. A national case-crossover study on ambient ozone pollution and first-ever stroke
among Chinese adults: Interpreting a weak association via differential susceptibility. Sci Total Environ.
2018 Nov 6;654:135-143. doi: 10.1016/j.scitotenv.2018.11.067. [Epub ahead of print]
13. Zhang R, et al. Acute Effects of Particulate Air Pollution on Ischemic Stroke and Hemorrhagic
Stroke Mortality. Front Neurol. 2018 Oct 2;9:827. doi: 10.3389/fneur.2018.00827. eCollection 2018.
14. Tian Y, et al. Association between ambient air pollution and daily hospital admissions for
ischemic stroke: A nationwide time-series analysis. PLoS Med. 2018 Oct 4;15(10):e1002668. doi:
10.1371/journal.pmed.1002668. eCollection 2018 Oct.
15. Miri M, et al. Air pollution and telomere length in adults: A systematic review and meta-analysis of
observational studies. Environ Pollut. 2018 Oct 8;244:636-647. doi: 10.1016/j.envpol.2018.09.130.
[Epub ahead of print]
16. Chan TC, et al. Long-Term Exposure to Ambient Fine Particulate Matter and Chronic Kidney
Disease: A Cohort Study. Published:15 October 2018CID: 107002https://doi.org/10.1289/EHP3304
17. Fan HC, et al. Increased risk of incident nasopharyngeal carcinoma with exposure to air pollution.
PLoS One. 2018 Sep 28;13(9):e0204568. doi: 10.1371/journal.pone.0204568. eCollection 2018.
18. Aung N, et al. Association Between Ambient Air Pollution and Cardiac Morpho-Functional
Phenotypes, insights From the UK Biobank Population Imaging Study. Originally published3 Aug
2018Circulation. 2018;0:CIRCULATIONAHA.118.034856
19. Ren Y, et al. Outdoor air pollution pregnancy exposures are associated with behavioral problems
in China’s preschoolers. Environ Sci Pollut Res Int. 2018 Nov 22. doi: 10.1007/s11356-018-3715-2.
[Epub ahead of print]
20. Xie X, et al. Long-term exposure to fine particulate matter and tachycardia and heart rate: Results
from 10 million reproductive-age adults in China. Environ Pollut. 2018 Aug 11;242(Pt B):1371-1378.
doi: 10.1016/j.envpol.2018.08.022. [Epub ahead of print]
21. Yang BY, et al. Exposure to ambient air pollution and blood lipids in adults: The 33 Communities
Chinese Health Study. Environ Int. 2018 Jul 23;119:485-492. doi: 10.1016/j.envint.2018.07.016.
[Epub ahead of print]
23. Kennedy CM, et al. Associations of mobile source air pollution during the first year of life with
childhood pneumonia, bronchiolitis, and otitis media. Environ Epidemiol. 2018 Mar;2(1). pii: e007. doi:
10.1097/EE9.0000000000000007.
24. Gong X et al. Associations between maternal residential proximity to air emissions from industrial
facilities and low birth weight in Texas, USA. Environ Int. 2018 Aug 7;120:181-198. doi:
10.1016/j.envint.2018.07.045. [Epub ahead of print]
25. Wang L, et al. Association between early prenatal exposure to ambient air pollution and birth
defects: evidence from newborns in Xi’an, China. J Public Health (Oxf). 2018 Aug 18. doi:
10.1093/pubmed/fdy137. [Epub ahead of print]
26. He T, et al. Ambient air pollution, H19/DMR methylation in cord blood and newborn size: A pilot
study in Zhengzhou City, China. Chemosphere. 2018 Aug 30;212:863-871. doi:
10.1016/j.chemosphere.2018.08.140. [Epub ahead of print]
27. Barn P, et al. The effect of portable HEPA filter air cleaner use during pregnancy on fetal growth:
The UGAAR randomized controlled trial. Environ Int. 2018 Sep 10. pii: S0160-4120(18)31141-3. doi:
10.1016/j.envint.2018.08.036. [Epub ahead of print]
28. Wang Q, et al. Identifying windows of susceptibility for maternal exposure to ambient air pollution
and preterm birth. Environ Int. 2018 Sep 18;121(Pt 1):317-324. doi: 10.1016/j.envint.2018.09.021.
[Epub ahead of print]
29. Liu WY, et al. Association between ambient air pollutants and preterm birth in Ningbo, China: a
time-series study. BMC Pediatr. 2018 Sep 20;18(1):305. doi: 10.1186/s12887-018-1282-9.
30. Ledda C, et al. Mutagenic and DNA repair activity in traffic policemen: a case-crossover study.J
Occup Med Toxicol. 2018 Aug 8;13:24. doi: 10.1186/s12995-018-0206-9. eCollection 2018.
31. Zhao B, et al. Air pollution and telomere length: a systematic review of 12,058 subjects.
Cardiovasc Diagn Ther. 2018 Aug;8(4):480-492. doi: 10.21037/cdt.2018.06.05.
32. Consonni D, et al. Outdoor particulate matter (PM10) exposure and lung cancer risk in the
EAGLE study. PLoS One. 2018 Sep 14;13(9):e0203539. doi: 10.1371/journal.pone.0203539.
eCollection 2018.
33. Weinmayr G, et al. Particulate matter air pollution components and incidence of cancers of the
stomach and the upper aerodigestive tract in the European Study of Cohorts of Air Pollution Effects
(ESCAPE). Environ Int. 2018 Aug 7;120:163-171. doi: 10.1016/j.envint.2018.07.030. [Epub ahead of
print]
34. Ribeiro AG, et al. Incidence and mortality risk for respiratory tract cancer in the city of São Paulo,
Brazil: Bayesian analysis of the association with traffic density. Cancer Epidemiol. 2018 Jul 23;56:53-
59. doi: 10.1016/j.canep.2018.07.005. [Epub ahead of print]
35. Seifi M, et al. Exposure to ambient air pollution and risk of childhood cancers: A population-based
study in Tehran, Iran. Sci Total Environ. 2018 Jul 24;646:105-110. doi:
10.1016/j.scitotenv.2018.07.219. [Epub ahead of print]
36. Aroui H, et al. The effect of environmental factors on the incidence of perforated appendicitis.
Ann Ital Chir. 2018 Jul 23;7. pii: S0003469X18028014. [Epub ahead of print]
37. Chen CC, et al. Effects of ambient air pollution exposure on frequency of hospital admissions for
appendicitis in Taipei, Taiwan.J Toxicol Environ Health A. 2018 Jul 26:1-7.
doi:10.1080/15287394.2018.1498276. [Epub ahead of print]
38. Shale gas development and infant health: Evidence from Pennsylvania.J Health Econ. 2018 Aug
13;61:134-150. doi: 10.1016/j.jhealeco.2018.07.004. [Epub ahead of print]
39. Heft-Neal S. et al. Robust relationship between air quality and infant mortality in AfricaNature
volume 559, pages254–258 (2018)
40. Povedano M, et al. Spatial Assessment of the Association between Long-Term Exposure to
Environmental Factors and the Occurrence of Amyotrophic Lateral Sclerosis in Catalonia, Spain: A
Population-Based Nested Case-Control Study. Neuroepidemiology. 2018 May 31;51(1-2):33-49. doi:
10.1159/000489664. [Epub ahead of print]
41. Lopes dB, et al. Pre- and postnatal exposure of mice to concentrated urban PM2.5 decreases
the number of alveoli and leads to altered lung function at an early stage of life. Environ Pollut. 2018
Jun 4;241:511-520. doi: 10.1016/j.envpol.2018.05.055. [Epub ahead of print]
42. Li X, et al. Analysis of short-term and sub-chronic effects of ambient air pollution on preterm birth
in central China. Environ Sci Pollut Res Int. 2018 May 2. doi: 10.1007/s11356-018-2061-8. [Epub
ahead of print]
43. Casey JA, et al. Coal and oil power plant retirements in California associated with reduced
preterm birth among populations nearby. American Journal of Epidemiology, kwy110,
https://doi.org/10.1093/aje/kwy110 Published: 16 May 2018
44. Xue T, et al. Association Between Hypertensive Disorders in Pregnancy and Particulate Matter in
the Contiguous United States, 1999-2004. Hypertension. 2018 May 21. pii:
HYPERTENSIONAHA.118.11080. doi: 10.1161/HYPERTENSIONAHA.118.11080. [Epub ahead of
print].
45. Grippo A, et al. Air pollution exposure during pregnancy and spontaneous abortion and stillbirth.
Rev Environ Health. 2018 Jul 5. pii: /j/reveh.ahead-of-print/reveh-2017-0033/reveh-2017-0033.xml.
doi: 10.1515/reveh-2017-0033. [Epub ahead of print]
46. Maghbooli Z, et al. Air pollution during pregnancy and placental adaptation in the levels of global
DNA methylation. PLoS One. 2018 Jul 6;13(7):e0199772. doi: 10.1371/journal.pone.0199772.
eCollection 2018.
47. Casey JA, et al. Increase in fertility following coal and oil power plant retirements in California.
Environ Health. 2018 May 2;17(1):44. doi: 10.1186/s12940-018-0388-8.
48. Mutlu EA, et al. Inhalational exposure to particulate matter air pollution alters the compsition of
the gut microbiome. Environ Pollut. 2018 May 18;240:817-830. doi: 10.1016/j.envpol.2018.04.130.
[Epub ahead of print]
49. Béjot Y, et al. A review of epidemiological research on stroke and dementia and exposure to air
pollution. Int J Stroke. 2018 Jan 1:1747493018772800. doi: 10.1177/1747493018772800. [Epub
ahead of print]
50. Ljubimova, JY, et al. Coarse particulate matter (PM2.5–10) in Los Angeles Basin air induces
expression of inflammation and cancer biomarkers in rat brains. Scientific Reports, 2018; 8 (1) DOI:
10.1038/s41598-018-23885-3
51. Buoli M, et al. Is there a link between air pollution and mental disorders?
Environ Int. 2018 Jun 4;118:154-168. doi: 10.1016/j.envint.2018.05.044. [Epub ahead of print]
52. Lee H, et al. Ambient air pollution and completed suicide in 26 South Korean cities: Effect
modification by demographic and socioeconomic factors. Sci Total Environ. 2018 Oct 15;639:944-951.
doi: 10.1016/j.scitotenv.2018.05.210. Epub 2018 May 26.
53. Szyszkowicz M, et al. Ambient air pollution exposure and emergency department visits for
substance abuse. PLoS One. 2018 Jun 29;13(6):e0199826. doi: 10.1371/journal.pone.0199826.
eCollection 2018.
54. Duan J, et al. Is the serious ambient air pollution associated with increased admissions for
schizophrenia? Sci Total Environ. 2018 Jul 2;644:14-19. doi: 10.1016/j.scitotenv.2018.06.218. [Epub
ahead of print]
55. Park M, et al. Air pollution influences the incidence of otitis media in children: A national
population-based study. PLoS One. 2018 Jun 28;13(6):e0199296. doi:
10.1371/journal.pone.0199296. eCollection 2018.
56. Finke I, et al. Air pollution and airway resistance at age 8 years – the PIAMA birth cohort study.
Environ Health. 2018 Jul 17;17(1):61. doi: 10.1186/s12940-018-0407-9.
57. Pasqua LA, et al. Exercising in Air Pollution: The Cleanest versus Dirtiest Cities Challenge. Int J
Environ Res Public Health. 2018 Jul 17;15(7). pii: E1502. doi: 10.3390/ijerph15071502.
58. Parker JD1, Mendola P, Woodruff TJ. Preterm birth after the Utah Valley Steel Mill closure: a
natural experiment. Epidemiology. 2008 Nov;19(6):820-3. doi: 10.1097/EDE.0b013e3181883d5d.
59. Nagel G, et al. Air pollution and incidence of cancers of the stomach and the upper aerodigestive
tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Int J Cancer. 2018 Apr 26.
doi: 10.1002/ijc.31564. [Epub ahead of print]
60. Calderón-Garcidueñas L, et al. Hallmarks of Alzheimer disease are evolving relentlessly in
Metropolitan Mexico City infants, children and young adults. APOE4 carriers have higher suicide risk
and higher odds of reaching NFT stage V at ≤ 40 years of age. Environmental Research, 2018; 164:
475 DOI: 10.1016/j.envres.2018.03.023
61. Horne BD, et al. Short-term Elevation of Fine Particulate Matter Air Pollution and Acute Lower
Respiratory Infection. Am J Respir Crit Care Med. 2018 Apr 13. doi: 10.1164/rccm.201709-1883OC.
[Epub ahead of print]
62. Matthiessen C, et al. Long-term exposure to airborne particulate matter and NO2 and prevalent
and incident metabolic syndrome – Results from the Heinz Nixdorf Recall Study. Environ Int. 2018
Apr 10;116:74-82. doi: 10.1016/j.envint.2018.02.035. [Epub ahead of print]
63. Yang BY, et al. Ambient air pollution in relation to diabetes and glucose-homoeostasis markers in
China: a cross-sectional study with findings from the 33 Communities Chinese Health Study. Lancet
Planet Health. 2018 Feb;2(2):e64-e73. doi: 10.1016/S2542-5196(18)30001-9. Epub 2018 Feb 9.
64. Lucht SA, et al. Air Pollution and Glucose Metabolism: An Analysis in Non-Diabetic Participants of
the Heinz Nixdorf Recall Study. Environ Health Perspect. 2018 Apr 3;126(4):047001. doi:
10.1289/EHP2561.
65. Wang M, et al. Association between Short-Term Exposure to Air Pollution and Dyslipidemias
among Type 2 Diabetic Patients in Northwest China: A Population-Based Study. Int J Environ Res
Public Health. 2018 Mar 30;15(4). pii: E631. doi: 10.3390/ijerph15040631.
66. Xu F, et al. Necroptosis Contributes to Urban Particulate Matter-Induced Airway Epithelial Injury.
Cell Physiol Biochem. 2018 Mar 29;46(2):699-712. doi: 10.1159/000488726. [Epub ahead of print]
67. Favé M-J, et al. Gene-by-environment interactions in urban populations modulate risk phenotypes.
Nature Communications, 2018; 9 (1) DOI: 10.1038/s41467-018-03202-2
68. Plusquin M, et al. DNA methylome marks of exposure to particulate matter at three time points in
early life. Environ Sci Technol. 2018 Mar 30. doi: 10.1021/acs.est.7b06447. [Epub ahead of print]
69. Jie Y, et al. Changes in gene expression in lungs of mice exposed to traffic-related air pollution.
Mol Cell Probes. 2018 Apr 2. pii: S0890-8508(18)30034-3. doi: 10.1016/j.mcp.2018.03.005. [Epub
ahead of print].
70. Domingues ÉP, et al. Genotoxic effects following exposure to air pollution in street vendors from a
high-traffic urban area. Environ Monit Assess. 2018 Mar 14;190(4):215. doi: 10.1007/s10661-018-
6598-2.
71. Krauskopf J, Caiment F, van Veldhoven K, Chadeau-Hyam M, Sinharay R, Chung KF, Cullinan P,
Collins P, Barratt B, Kelly FJ, Vermeulen R, Vineis P, de Kok TM, Kleinjans JC. The human
circulating miRNome reflects multiple organ disease risks in association with short-term exposure to
traffic-related air pollution. Environ Int. 2018 Jan 27;113:26-34. doi: 10.1016/j.envint.2018.01.014.
[Epub ahead of print] PMID: 29421404 [PubMed – as supplied by publisher]
72. Kalkbrenner A, et al. Air Toxics in Relation to Autism Diagnosis, Phenotype, and Severity in a
U.S. Family-Based Study. Environ Health Perspect; DOI:10.1289/EHP1867
73. Whitworth KW, et al. Drilling and Production Activity Related to Unconventional Gas Development
and Severity of Preterm Birth. Environ Health Perspect; DOI:10.1289/EHP2622
74. Lanphear B, et al. Low-level lead exposure and mortality in US adults: a population-based cohort
study. The Lancet Public Health, 2018 DOI: 10.1016/S2468-2667(18)30025-2
75. Kulick ER, et al. Residential Proximity to Major Roadways and Risk of Incident Ischemic Stroke in
NOMAS (The Northern Manhattan Study). Stroke. 2018 Mar 14. pii: STROKEAHA.117.019580. doi:
10.1161/STROKEAHA.117.019580. [Epub ahead of print]
76. Erqou S, et al. Particulate Matter Air Pollution and Racial Differences in Cardiovascular Disease
Risk. Arterioscler Thromb Vasc Biol. 2018 Mar 15. pii: ATVBAHA.117.310305. doi:
10.1161/ATVBAHA.117.310305. [Epub ahead of print]
77. Wang Q, et al. Effects of prenatal exposure to air pollution on preeclampsia in Shenzhen, China.
Environ Pollut. 2018 Feb 18;237:18-27. doi: 10.1016/j.envpol.2018.02.010. [Epub ahead of print]
78. Power MC, et al. The Association of Long-Term Exposure to Particulate Matter Air Pollution with
Brain MRI Findings: The ARIC Study. Environ Health Perspect. 2018 Feb 16;126(2):027009. doi:
10.1289/EHP2152.
79. Ren Z, et al. Maternal exposure to ambient PM10 during pregnancy increases the risk of
congenital heart defects: Evidence from machine learning models. Sci Total Environ. 2018 Feb
19;630:1-10. doi: 10.1016/j.scitotenv.2018.02.181. [Epub ahead of print]
80. Baumgartner J, et al. Household air pollution and measures of blood pressure, arterial stiffness
and central haemodynamics. Heart. 2018 Feb 9. pii: heartjnl-2017-312595. doi: 10.1136/heartjnl-
2017-312595. [Epub ahead of print]
81. Nyhan MM, et al. Associations Between Ambient Particle Radioactivity and Blood Pressure: The
NAS (Normative Aging Study). J Am Heart Assoc. 2018 Mar 15;7(6). pii: e008245. doi:
10.1161/JAHA.117.008245.
82. Salameh P, et al. Hypertension prevalence and living conditions related to air pollution: results of
a national epidemiological study in Lebanon. Environ Sci Pollut Res Int. 2018 Feb 13. doi:
10.1007/s11356-018-1411-x. [Epub ahead of print]
83. Rasche M, et al. Rapid increases in nitrogen oxides are associated with acute myocardial
infarction: A case-crossover study. Eur J Prev Cardiol. 2018 Jan 1:2047487318755804. doi:
10.1177/2047487318755804. [Epub ahead of print]
84. Bosco L, et al. Sperm DNA fragmentation: An early and reliable marker of air pollution. Environ
Toxicol Pharmacol. 2018 Feb 7;58:243-249. doi: 10.1016/j.etap.2018.02.001. [Epub ahead of print]
85. Lu J, et al. Polluted Morality: Air Pollution Predicts Criminal Activity and Unethical Behavior.
Psychological Science, 2018; 095679761773580 DOI: 10.1177/0956797617735807
86. Lavigne É, Bélair MA, Rodriguez Duque D, Do MT, Stieb DM, Hystad P, van Donkelaar A, Martin
RV, Crouse DL, Crighton E, Chen H, Burnett RT, Weichenthal S, Villeneuve PJ, To T, Brook JR,
Johnson M, Cakmak S, Yasseen AS 3rd, Walker M. Effect modification of perinatal exposure to air
pollution and childhood asthma incidence. Eur Respir J. 2018 Feb 1. pii: 1701884. doi:
10.1183/13993003.01884-2017.
87. Yang S, Tan Y, Mei H, Wang F, Li N, Zhao J, Zhang Y, Qian Z, Chang JJ, Syberg KM, Peng A,
Mei H, Zhang D, Zhang Y, Xu S, Li Y, Zheng T, Zhang B. Ambient air pollution the risk of stillbirth: A
prospective birth cohort study in Wuhan, China. Int J Hyg Environ Health. 2018 Feb 5. pii: S1438-
4639(17)30531-X. doi: 10.1016/j.ijheh.2018.01.014. [Epub ahead of print] PMID: 29422441 [PubMed
– as supplied by publisher]
88. Jeanjean M, Bind MA, Roux J, Ongagna JC, de Sèze J, Bard D, Leray E. Ozone,
NO<sub>2</sub> and PM<sub>10</sub> are associated with the occurrence of multiple sclerosis
relapses. Evidence from seasonal multi-pollutant analyses. Environ Res. 2018 Feb 6;163:43-52. doi:
10.1016/j.envres.2018.01.040. [Epub ahead of print] PMID: 29426027 [PubMed – as supplied by
publisher]
89. Lin H, Qian ZM, Guo Y, Zheng Y, Ai S, Hang J, Wang X, Zhang L, Liu T, Guan W, Li X, Xiao J,
Zeng W, Xian H, Howard SW, Ma W, Wu F. The attributable risk of chronic obstructive pulmonary
disease due to ambient fine particulate pollution among older adults. Environ Int. 2018 Feb
5;113:143-148. doi: 10.1016/j.envint.2018.01.029. [Epub ahead of print] PMID: 29425898 [PubMed –
as supplied by publisher]
90. Guan L, et al. PM2.5 inhalation induces intracranial atherosclerosis which may be ameliorated by
omega 3 fatty acids. Oncotarget. 2017 Dec 16;9(3):3765-3778. doi: 10.18632/oncotarget.23347.
eCollection 2018 Jan 9.
91. Bernal-Meléndez E, et al. Repeated gestational exposure to diesel engine exhaust affects the
fetal olfactory system and alters olfactory-based behavior in rabbit offspring
Part Fibre Toxicol. 2019 Jan 17;16(1):5. doi: 10.1186/s12989-018-0288-7.
93. Molina-Sotomayor E, et al. Effects of Cardiorespiratory Exercise on Cognition in Older Women
Exposed to Air Pollution. Int J Environ Res Public Health. 2019 Jan 16;16(2). pii: E245. doi:
10.3390/ijerph16020245.
94. Zang H, et al. Ambient air pollution and the risk of stillbirth: a population-based prospective birth
cohort study in the coastal area of China. Environ Sci Pollut Res Int. 2019 Jan 10. doi:
10.1007/s11356-019-04157-7. [Epub ahead of print]
95. Stieb DM, et al. Air pollution in the week prior to delivery and preterm birth in 24 Canadian cities:
a time to event analysis. Environ Health. 2019 Jan 3;18(1):1. doi: 10.1186/s12940-018-0440-8.
96. Liu Y, et al. The association between air pollution and preterm birth and low birth weight in
Guangdong, China. BMC Public Health. 2019 Jan 3;19(1):3. doi: 10.1186/s12889-018-6307-7.
97. Seelen M, Toro Campos RA, Veldink JH, Visser AE, Hoek G, Brunekreef B., et al. 2017. Longterm
air pollution exposure and amyotrophic lateral sclerosis in the Netherlands: a population-based
case–control study. Environ Health Perspect 125(9):097023, 10.1289/EHP1115.
98. Hammoud A1, Carrell DT, Gibson M, Sanderson M, Parker-Jones K, Peterson CM Decreased
sperm motility is associated with air pollution in Salt Lake City. Fertil Steril. 2010 Apr;93(6):1875-9.
doi: 10.1016/j.fertnstert.2008.12.089. Epub 2009 Feb 12.
99. Kaufman JA, Wright JM, Rice G, Connolly N, Bowers K, Anixt J. Ambient ozone and fine
particulate matter exposures and autism spectrum disorder in metropolitan Cincinnati, Ohio. Environ
Res. 2019 Jan 10;171:218-227. doi: 10.1016/j.envres.2019.01.013. [Epub ahead of print]
100. Chen G et al. Early life exposure to particulate matter air pollution (PM1, PM2.5 and PM10 and
autism in Shanghai, China: A case-control study. Environ Int. 2018 Dec;121(Pt 2):1121-1127. doi:
10.1016/j.envint.2018.10.026. Epub 2018 Nov 5.)
101. Pagalan L et al. Association of Prenatal Exposure to Air Pollution With Autism Spectrum
Disorder. JAMA Pediatr. 2018 Nov 19. doi: 10.1001/jamapediatrics.2018.3101. [Epub ahead of print]
102. Liu W et al. Air pollution associated with non-suicidal self-injury in Chinese adolescent students:
A cross-sectional study. Chemosphere. 2018 Oct;209:944-949. doi:
10.1016/j.chemosphere.2018.06.168. Epub 2018 Jun 28.
103. Roberts S et al. Exploration of NO2 and PM2.5 air pollution and mental health problems using
high-resolution data in London-based children from a UK longitudinal cohort study. Psychiatry Res.
2018 Dec 10;272:8-17. doi: 10.1016/j.psychres.2018.12.050. [Epub ahead of print]
104. Patten SB et al. Major depression and secondhand smoke exposure. J Affect Disord. 2018 Jan
1;225:260-264. doi: 10.1016/j.jad.2017.08.006. Epub 2017 Aug 12.
105. Kim Y et al. Air Pollution and Suicide in 10 Cities in Northeast Asia: A Time-Stratified Case-
Crossover Analysis. Environ Health Perspect. 2018 Mar 6;126(3):037002. doi: 10.1289/EHP2223.
106. Min JY et al. Long-term exposure to air pollution and the risk of suicide death: A populationbased
cohort study. Sci Total Environ. 2018 Jul 1;628-629:573-579. doi:
10.1016/j.scitotenv.2018.02.011. Epub 2018 Feb 20.
107. Ho HC et al. Spatiotemporal influence of temperature, air quality, and urban environment on
cause-specific mortality during hazy days. Environ Int. 2018 Mar;112:10-22. doi:
10.1016/j.envint.2017.12.001. Epub 2017 Dec 12.

Comments are closed.