Publications (36) View all
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Article: Particulate matter air pollution and respiratory symptoms in individuals having either asthma or chronic obstructive pulmonary disease: a European multicentre panel study.
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ABSTRACT: BACKGROUND: Particulate matter air pollution has been associated with adverse health effects. The fraction of ambient particles that are mainly responsible for the observed health effects is still a matter of controversy. Better characterization of the health relevant particle fraction will have major implications for air quality policy since it will determine which sources should be controlled.The RUPIOH study, an EU-funded multicentre study, was designed to examine the distribution of various ambient particle metrics in four European cities (Amsterdam, Athens, Birmingham, Helsinki,) and assess their health effects in participants with asthma or COPD, based on a detailed exposure assessment. In this paper the association of central site measurements with respiratory symptoms and restriction of activities is examined. METHODS: At each centre a panel of participants with either asthma or COPD recorded respiratory symptoms and restriction of activities in a diary for six months. Exposure assessment included simultaneous measurements of coarse, fine and ultrafine particles at a central site. Data on gaseous pollutants were also collected. The associations of the 24-hour average concentrations of air pollution indices with the health outcomes were assessed in a hierarchical modelling approach. A city specific analysis controlling for potential confounders was followed by a meta-analysis to provide overall effect estimates. RESULTS: A 10 mug/m3 increase in previous day coarse particles concentrations was positively associated with most symptoms (an increase of 0.6 to 0.7% in average) and limitation in walking (OR= 1.076, 95% CI: 1.026-1.128). Same day, previous day and previous two days ozone concentrations were positively associated with cough (OR= 1.061, 95% CI: 1.013-1.111; OR= 1.049, 95% CI: 1.016-1.083 and OR= 1.059, 95% CI: 1.027-1.091, respectively). No consistent associations were observed between fine particle concentrations, nitrogen dioxide and respiratory health effects. As for particle number concentrations negative association (mostly non-significant at the nominal level) was observed with most symptoms whilst the positive association with limitation of activities did not reach the nominal level of significance. CONCLUSIONS: The observed associations with coarse particles are in agreement with the findings of toxicological studies. Together they suggest it is prudent to regulate also coarse particles in addition to fine particles.Environmental Health 10/2012; 11(1):75. · 2.65 Impact Factor -
Article: Temporal variations of atmospheric aerosol in four European urban areas.
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ABSTRACT: The concentrations of PM(10) mass, PM(2.5) mass and particle number were continuously measured for 18 months in urban background locations across Europe to determine the spatial and temporal variability of particulate matter. Daily PM(10) and PM(2.5) samples were continuously collected from October 2002 to April 2004 in background areas in Helsinki, Athens, Amsterdam and Birmingham. Particle mass was determined using analytical microbalances with precision of 1 μg. Pre- and post-reflectance measurements were taken using smoke-stain reflectometers. One-minute measurements of particle number were obtained using condensation particle counters. The 18-month mean PM(10) and PM(2.5) mass concentrations ranged from 15.4 μg/m(3) in Helsinki to 56.7 μg/m(3) in Athens and from 9.0 μg/m(3) in Helsinki to 25.0 μg/m(3) in Athens, respectively. Particle number concentrations ranged from 10,091 part/cm(3) in Helsinki to 24,180 part/cm(3) in Athens with highest levels being measured in winter. Fine particles accounted for more than 60% of PM(10) with the exception of Athens where PM(2.5) comprised 43% of PM(10). Higher PM mass and number concentrations were measured in winter as compared to summer in all urban areas at a significance level p < 0.05. Significant quantitative and qualitative differences for particle mass across the four urban areas in Europe were observed. These were due to strong local and regional characteristics of particulate pollution sources which contribute to the heterogeneity of health responses. In addition, these findings also bear on the ability of different countries to comply with existing directives and the effectiveness of mitigation policies.Environmental Science and Pollution Research 03/2011; 18(7):1202-12. · 2.65 Impact Factor -
Article: Body mass index is associated with leukotriene inflammation in asthmatics.
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ABSTRACT: Obesity and asthma are characterized by the presence of inflammation. Leptin and adiponectin are circulating hormones produced by adipose tissue that regulate several metabolic and inflammatory functions. We aimed to determine whether obesity influences asthmatic inflammation as well as the contribution of leptin or/and adiponectin to a possible linkage between asthmatic and obesity-related inflammation. One hundred patients with asthma and 60 healthy controls were studied. Subjects who had a comorbid illness that could interfere with the proposed tests were excluded. All subjects were divided into three groups (normal range, pre-obese, obese) according to the criteria of the current WHO international classification for body mass index (BMI). Possible associations between variables expressing airway inflammation, bronchial hyper-responsiveness, systemic inflammation and obesity, as assessed by BMI, were evaluated. Leptin and adiponectin were also measured and were associated with asthma airway and systemic inflammatory variables to elucidate possible associations. Obese patients had significant higher values of LTE(4) /creatinine in urine compared with pre-obese and normal range ones. In a linear regression model, the only significant associations were those between BMI and LTE(4) /creatinine in urine. Using the same model, log leptin and log adiponectin presented positive and negative associations, respectively with LTE(4) /creatinine in urine. No other significant associations were observed in both patients and healthy subjects. In a selected cohort of asthmatic patients, obesity is significantly associated with increased urinary leukotriene levels. Alterations of leptin/adiponectin balance may be related to the presence of leukotriene inflammation in obese asthmatic patients.European Journal of Clinical Investigation 01/2011; 41(1):30-8. · 3.02 Impact Factor -
Article: P. C. A. Louis (1787-1872): introducing medical statistics in pneumonology.
American Journal of Respiratory and Critical Care Medicine 12/2010; 182(12):1569. · 11.08 Impact Factor -
Article: Lung function and indicators of exposure to indoor and outdoor particulate matter among asthma and COPD patients.
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ABSTRACT: Misclassification of exposure related to the use of central sites may be larger for ultrafine particles than for particulate matter < or =2.5 microm and < or =10 microm (PM(2.5) and PM(10)) and may result in underestimation of health effects. This paper describes the relative strength of the association between outdoor and indoor exposure to ultrafine particles, PM(2.5) and PM(10) and lung function. In four European cities (Helsinki, Athens, Amsterdam and Birmingham), lung function (forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)) and peak expiratory flow (PEF)) was measured three times a day for 1 week in 135 patients with asthma or chronic obstructive pulmonary disease (COPD), covering study periods of >1 year. Daily concentrations of particle number, PM(2.5) and PM(10) were measured at a central site in each city and both inside and outside the subjects' homes. Daily average particle number concentrations ranged between 2100 and 66 100 particles/cm(3). We found no association between 24 h average particle number or particle mass concentrations and FVC, FEV(1) and PEF. Substituting home outdoor or home indoor concentrations of particulate air pollution instead of the central site measurements did not change the observed associations. Analyses restricted to asthmatics also showed no associations. No consistent associations between lung function and 24 h average particle number or particle mass concentrations were found in panels of patients with mild to moderate COPD or asthma. More detailed exposure assessment did not change the observed associations. The lack of association could be due to the high prevalence of medication use, limited ability to assess lagged effects over several days or absence of an effect.Occupational and environmental medicine 10/2009; 67(1):2-10. · 3.64 Impact Factor
