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Modeling long-term effects attributed to nitrogen dioxide (NO2) and sulfur dioxide (SO2) exposure on asthma morbidity in a nationwide cohort in Israel.

Abstract Studies have provided extensive documentation that acutely elevated environmental exposures contribute to chronic health problems. However, only attention has been paid to the effects of modificate of exposure assessment methods in environmental health investigations, leading to uncertainty and gaps in our understanding of exposure- and dose-response relationships. The goal of the present study was to evaluate whether average or peak concentration exerts a greater influence on asthma outcome, and which of the exposure models may better explain various physiological responses generated by nitrogen dioxide (NO2) or sulfur dioxide (SO2) air pollutants. The effects of annual NO2 and SO2 exposures on asthma prevalence were determined in 137,040 17-year-old males in Israel, who underwent standard health examinations before induction to military service during 1999-2008. Three alternative models of cumulative exposure were used: arithmetic mean level (AM), average peak concentration (APC), and total number of air pollution exposure episodes (NEP). Air pollution data for NO2 and SO2 levels were linked to the residence of each subject and asthma prevalence was predicted using bivariate logistic regression. There was significant increased risk for asthma occurrence attributed to NO2 exposure in all models with the highest correlations demonstrated using the APC model. Data suggested that exposure-response is better correlated with NO2 peak concentration than with average exposure concentration in subjects with asthma. For SO2, there was a weaker but still significant exposure response association in all models. These differences may be related to differences in physiological responses including effects on different regions of the airways following exposure to these pollutants. NO2, which is poorly soluble in water, penetrates deep into the bronchial tree, producing asthmatic manifestations such as inflammation and increased mucus production as a result of high gaseous concentrations in the lung parenchyma. In contrast, SO2, which is highly water soluble, exerts its effects rapidly in the upper airways, leading to similar limited correlations at all levels of exposure with fewer asthmatic manifestations observed. These data indicate that differing exposure assessment methods may be needed to capture specific disease consequences associated with these air pollutants.
PMID
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Authors

Mayor MeshTerms

Environmental Exposure

Models, Theoretical

Keywords
Journal Title journal of toxicology and environmental health. part a
Publication Year Start




PMID- 28644724
OWN - NLM
STAT- MEDLINE
DA  - 20170623
DCOM- 20170714
LR  - 20170714
IS  - 1528-7394 (Print)
IS  - 0098-4108 (Linking)
VI  - 80
IP  - 6
DP  - 2017
TI  - Modeling long-term effects attributed to nitrogen dioxide (NO2) and sulfur
      dioxide (SO2) exposure on asthma morbidity in a nationwide cohort in Israel.
PG  - 326-337
LID - 10.1080/15287394.2017.1313800 [doi]
AB  - Studies have provided extensive documentation that acutely elevated environmental
      exposures contribute to chronic health problems. However, only attention has been
      paid to the effects of modificate of exposure assessment methods in environmental
      health investigations, leading to uncertainty and gaps in our understanding of
      exposure- and dose-response relationships. The goal of the present study was to
      evaluate whether average or peak concentration exerts a greater influence on
      asthma outcome, and which of the exposure models may better explain various
      physiological responses generated by nitrogen dioxide (NO2) or sulfur dioxide
      (SO2) air pollutants. The effects of annual NO2 and SO2 exposures on asthma
      prevalence were determined in 137,040 17-year-old males in Israel, who underwent 
      standard health examinations before induction to military service during
      1999-2008. Three alternative models of cumulative exposure were used: arithmetic 
      mean level (AM), average peak concentration (APC), and total number of air
      pollution exposure episodes (NEP). Air pollution data for NO2 and SO2 levels were
      linked to the residence of each subject and asthma prevalence was predicted using
      bivariate logistic regression. There was significant increased risk for asthma
      occurrence attributed to NO2 exposure in all models with the highest correlations
      demonstrated using the APC model. Data suggested that exposure-response is better
      correlated with NO2 peak concentration than with average exposure concentration
      in subjects with asthma. For SO2, there was a weaker but still significant
      exposure response association in all models. These differences may be related to 
      differences in physiological responses including effects on different regions of 
      the airways following exposure to these pollutants. NO2, which is poorly soluble 
      in water, penetrates deep into the bronchial tree, producing asthmatic
      manifestations such as inflammation and increased mucus production as a result of
      high gaseous concentrations in the lung parenchyma. In contrast, SO2, which is
      highly water soluble, exerts its effects rapidly in the upper airways, leading to
      similar limited correlations at all levels of exposure with fewer asthmatic
      manifestations observed. These data indicate that differing exposure assessment
      methods may be needed to capture specific disease consequences associated with
      these air pollutants.
FAU - Greenberg, N
AU  - Greenberg N
AD  - a School of Public Health , University of Haifa , Haifa , Israel.
AD  - b Israeli Defense Forces (IDF), Medical Corps , Ramat Gan Israel.
FAU - Carel, R S
AU  - Carel RS
AD  - a School of Public Health , University of Haifa , Haifa , Israel.
FAU - Derazne, E
AU  - Derazne E
AD  - b Israeli Defense Forces (IDF), Medical Corps , Ramat Gan Israel.
FAU - Tiktinsky, A
AU  - Tiktinsky A
AD  - b Israeli Defense Forces (IDF), Medical Corps , Ramat Gan Israel.
FAU - Tzur, D
AU  - Tzur D
AD  - b Israeli Defense Forces (IDF), Medical Corps , Ramat Gan Israel.
FAU - Portnov, B A
AU  - Portnov BA
AUID- ORCID: http://orcid.org/0000-0003-1537-0832
AD  - c Department of Natural Resources & Environment Management, Faculty of Management
      , University of Haifa , Haifa , Israel.
LA  - eng
PT  - Journal Article
DEP - 20170623
PL  - England
TA  - J Toxicol Environ Health A
JT  - Journal of toxicology and environmental health. Part A
JID - 100960995
RN  - 0UZA3422Q4 (Sulfur Dioxide)
RN  - S7G510RUBH (Nitrogen Dioxide)
SB  - IM
MH  - Adolescent
MH  - Asthma/*chemically induced/*epidemiology
MH  - Cohort Studies
MH  - *Environmental Exposure
MH  - Environmental Monitoring
MH  - Humans
MH  - Israel/epidemiology
MH  - Male
MH  - *Models, Theoretical
MH  - Nitrogen Dioxide/*toxicity
MH  - Prevalence
MH  - Sulfur Dioxide/*toxicity
EDAT- 2017/06/24 06:00
MHDA- 2017/07/15 06:00
CRDT- 2017/06/24 06:00
AID - 10.1080/15287394.2017.1313800 [doi]
PST - ppublish
SO  - J Toxicol Environ Health A. 2017;80(6):326-337. doi:
      10.1080/15287394.2017.1313800. Epub 2017 Jun 23.