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Background Tracheal, bronchial, and lung (TBL) cancer presents significant health challenges for individuals aged 70 and older. However, comprehensive insights into the epidemiological patterns of and risk factors for TBL cancer in this population remain limited. This study aimed to analyze the global, regional, and national burdens and trends of TBL cancer patients aged ≥ 70 years from 1990–2021. Methods The incidence, mortality, and disability-adjusted life years (DALYs) for TBL cancer patients aged ≥ 70 years from 1990–2021 were obtained from the 2021 Global Burden of Disease study. Global trends were stratified age, sex, and sociodemographic index (SDI). Decomposition analysis identified the primary drivers of burden changes, and a global risk attribution analysis was conducted. The Bayesian Age‒Period‒Cohort (BAPC) model forecasted trends over the next 14 years. The analyses were performed with Joinpoint software and the R software. Results From 1990–2021, the ASIRs, ASMRs, and ASDRs of TBL cancer among patients ≥ 70 years increase significantly, mainly due to aging and population growth. In the precision medicine era (2015–2021), these indicators for both sexes and males have declined, but the burden among females has increased. The burden varies across regions, with the incidence of TBL cancer increasing more severely in middle-SDI regions, East Asia, and western sub-Saharan Africa, whereas high-SDI regions have shown a decline after peaking. Although the DALY proportion of smoking decreased, it was still the main cause of TBL cancer. However, the burden of environmental particulate pollution has increased. The BAPC model predicted that in the future, the ASIR, ASMR, and ASDR for males and both sexes would decrease, whereas these indicators would either remain stable or increase among females. Conclusions The burden of TBL cancer is increasing significantly among patients aged ≥ 70 years. Despite new hopes and approaches from precision medicine, environmental and behavioral factors still critically influence the TBL cancer burden. Future strategies could enhance subgroup-specific management and promote effective control of known risk factors.

This study aimed to reveal harm of exposure to indoor air pollution to cognitive function through “gut-brain-axis” among rural elderly residents. There were 120 participants recruited in rural villages of northwest China from December 2021 to February 2022. The cognitive level was assessed by eight-item ascertain dementia (AD) questionnaire, and indoor air pollution exposure was measured by air quality sensor. Inflammatory cytokines and oxidative stress-related index were detected in blood serum. Fecal samples were collected for gut microbiota analysis. The 120 participants were divided into impaired cognition (AD8) (81/67.5%) and cognition normal (NG) (39/32.5%). And there had more female in AD8 (FAD) (55/67.9%) than NG (FNG) (18/46.2%) ( P = 0.003). Exposure of air pollution in FAD was higher than FNG (PM 1 , PM 2.5 , PM 10 , P < 0.001; NO 2 , P < 0.001; CO, P = 0.014; O 3 , P = 0.002). The risk of cognitive impairment increases 6.8%, 3.6%, 2.6%, 11%, and 2.4% in female for every 1 μg/m 3 increased in exposure of PM 1 , PM 2.5 , PM 10 , NO 2 , and O 3 , separately. And GSH-Px and T-SOD in FAD were significantly lower than the FNG group ( P = 0.011, P = 0.019). Gut microbiota in FAD is disordered with lower richness and diversity. Relative abundance of core bacteria Faecalibacterium (top 1 genus) in FAD was reduced (13.65% vs 19.81%, P = 0.0235), while Escherichia_Shigella and Akkermansia was increased. Correlation analysis showed Faecalibacterium was negatively correlated with age, and exposure of O 3 , PM 1 , PM 2.5 , and PM 10 ; Akkermansia and Monoglobus were positively correlated with exposure of PM 1 , PM 2.5 and PM 10 ; Escherichia_Shigella was significantly positively correlated with NO 2 . Indoor air pollution exposure impaired cognitive function in elderly people, especially female, which may cause systemic inflammation, dysbiosis of the gut microbiota, and ultimately leading to early cognitive impairment through the gut-brain axis. Graphical Abstract

Jing-Jin-Ji is the largest and most dynamic economic region in northern China, and its air pollution has attracted much public attention. Scientific evaluation of health losses caused by air pollution can provide decision-making basis for formulation and improvement of pollution reduction policies in the Jing-Jin-Ji region. This paper estimated the adverse effects of particulate matter pollution on health in the Jing-Jin-Ji region in 2016 by using logarithmic linear exposure-response function, and monetized the health effects by adjusting human capital method and disease cost method. The results show non-ignorable health hazards and economic impacts caused by atmospheric particulate pollution. The economic losses relevant to health hazards by PM2.5 in the Jing-Jin-Ji region are 122.40 billion yuan, and those relevant to PM10 are 118.34 billion yuan, accounting for 1.62% and 1.56% of the region’s GDP, respectively. Similar evaluations previously conducted in other countries yielded figures within the same order of magnitude. Considering the difference in economic losses per unit among disease types, the economic losses caused by air pollution in the Jing-Jin-Ji region mainly come from premature deaths. Infants and elderly people are the main victims of particulate matter. Affected by population, pollutant concentration, industrial structure, and other factors, the economic losses of particulate matter pollution in Beijing, Tianjin, Shijiazhuang, Tangshan, and Baoding are large. In order to reduce health hazards and economic impacts caused by particulate matter pollution, this paper put forward to guide the urban population diversion, reduce the outgoing frequency of susceptible groups such as infants and the elderly in haze weather, adopt high-efficiency particulate matter air purifier indoors, and develop public transportation to reduce motor vehicle exhaust emissions. In Tianjin and Hebei, promoting cleaner production in industries such as steel and cement and reducing coal use in the power industry are also suggested.

Background Mental illness is the leading cause of years lived with disability, and the global disease burden of mental ill-health has increased substantially in the last number of decades. There is now increasing evidence that environmental conditions, and in particular poor air quality, may be associated with mental health and wellbeing. Methods This cross-sectional analysis uses data on mental health and wellbeing from The Irish Longitudinal Study on Ageing (TILDA), a nationally representative survey of the population aged 50+ in Ireland. Annual average PM 2.5 concentrations at respondents’ residential addresses over the period 1998–2014 are used to measure long-term exposure to ambient PM 2.5 . Results We find evidence of associations between long-term exposure to ambient PM 2.5 and depression and anxiety. The measured associations are strong, and are comparable with effect sizes for variables such as sex. Effects are also evident at relatively low concentrations by international standards. However, we find no evidence of associations between long-term ambient particulate pollution and other indicators of mental health and well-being such as stress, worry and quality of life. Conclusions The measured associations are strong, particularly considering the relatively low PM 2.5 concentrations prevailing in Ireland compared to many other countries. While it is estimated that over 90 per cent of the world’s population lives in areas with annual mean PM 2.5 concentrations greater than 10 μg/m 3 , these results contribute to the increasing evidence that suggests that harmful effects can be detected at even low levels of air pollution.

Significance We illustrate the similarity and difference in particulate matter (PM) formation between Beijing and other world regions. The periodic cycle of PM events in Beijing is regulated by meteorological conditions. While the particle chemical compositions in Beijing are similar to those commonly measured worldwide, efficient nucleation and growth over an extended period in Beijing are distinctive from the aerosol formation typically observed in other global areas. Gaseous emissions of volatile organic compounds and nitrogen oxides from urban transportation and sulfur dioxide from regional industry are responsible for large secondary PM formation, while primary emissions and regional transport of PM are insignificant. Reductions in emissions of the aerosol precursor gases from transportation and industry are essential to mediate severe haze pollution in China. As the world’s second largest economy, China has experienced severe haze pollution, with fine particulate matter (PM) recently reaching unprecedentedly high levels across many cities, and an understanding of the PM formation mechanism is critical in the development of efficient mediation policies to minimize its regional to global impacts. We demonstrate a periodic cycle of PM episodes in Beijing that is governed by meteorological conditions and characterized by two distinct aerosol formation processes of nucleation and growth, but with a small contribution from primary emissions and regional transport of particles. Nucleation consistently precedes a polluted period, producing a high number concentration of nano-sized particles under clean conditions. Accumulation of the particle mass concentration exceeding several hundred micrograms per cubic meter is accompanied by a continuous size growth from the nucleation-mode particles over multiple days to yield numerous larger particles, distinctive from the aerosol formation typically observed in other regions worldwide. The particle compositions in Beijing, on the other hand, exhibit a similarity to those commonly measured in many global areas, consistent with the chemical constituents dominated by secondary aerosol formation. Our results highlight that regulatory controls of gaseous emissions for volatile organic compounds and nitrogen oxides from local transportation and sulfur dioxide from regional industrial sources represent the key steps to reduce the urban PM level in China.

Due to biomass burning and coal combustion, heavy fine particulate matter (PM 2.5 ) pollution frequently occurs in Northeast China, threatening the health of more than 117 million inhabitants. Although meteorological conditions have always been considered key factors in the accumulation and dilution of PM 2.5 pollution, their exact contribution to particulate pollution in Northeast China is still highly uncertain. Applying multiple regression analysis to observational data, we identify the wind speed, temperature inversion, and height of the planetary boundary layer as the dominant meteorological factors affecting PM 2.5 pollution (PM 2.5 > 75 µg m −3 ) in the major cities of Northeast China, with the wind speed and the planetary boundary layer playing the primary roles in Harbin and Shenyang, and Changchun, respectively. Heavy pollution (PM 2.5 > 150 µg m −3 ) in this region typically occurs when the wind speed is less than 20 knots, the planetary boundary layer is below 500 m, and the temperature inversion is greater than 6°C. These results suggest that reducing the PM 2.5 pollution requires us to focus not only on anthropogenic emissions but also on special meteorological conditions that can affect the air pollution mechanisms in Northeast China.

Study Objective: Many studies have shown that ambient particulate air pollution (PM) is associated with increased risk of hospital admissions and deaths for cardiovascular or respiratory causes around the world. In general these have been analysed in association with PM10 and ozone, whereas PM2.5 is now the particle measure of greatest health and regulatory concern. And little has been published on associations of hospital admissions and PM components. Design: This study analysed hospital admissions for myocardial infarction (15 578 patients), and pneumonia (24 857 patients) in associations with fine particulate air pollution, black carbon (BC), ozone, nitrogen dioxide (NO2), PM not from traffic, and carbon monoxide (CO) in the greater Boston area for the years 1995–1999 using a case-crossover analysis, with control days matched on temperature. Main results: A significant association was found between NO2 (12.7% change (95% CI: 5.8, 18)), PM2.5 (8.6% increase (95% CI: 1.2, 15.4)), and BC (8.3% increase (95% CI: 0.2, 15.8)) and the risk of emergency myocardial infarction hospitalisation; and between BC (11.7% increase (95% CI: 4.8, 17.4)), PM2.5 (6.5% increase (95% CI: 1.1, 11.4)), and CO (5.5% increase (95% CI: 1.1, 9.5)) and the risk of pneumonia hospitalisation. Conclusions: The pattern of associations seen for myocardial infarction and pneumonia (strongest associations with NO2, CO, and BC) suggests that traffic exposure is primarily responsible for the association with heart attacks.

Nitrogen oxides (NOx = NO + NO2) emitted from combustion and natural sources are reactive gases that regulate the composition of Earth’s atmosphere. Nocturnal oxidation driven by nitrate radicals is an important but poorly understood process in atmospheric chemistry, affecting the lifetimes of NOx and ozone and particulate pollution levels. Understanding the trends of nitrate radicals is important to formulating effective pollution mitigation strategies and understanding the influence of NOx on climate. Here we analyse publicly available monitoring data on NOx and ozone to assess production rates and trends of surface nitrate radicals from 2014 to 2021 across the globe. We show that nitrate radicals have undergone strong increases in China during 2014–2019 but exhibited modest decreases in the United States and the European Union. Accelerated night-time oxidation has shortened the lifetime of summer NOx in China by 30% during 2014–2019. This change will strongly affect ozone formation and has policy implications for the joint control of ozone and fine particulate pollution.Measurements show that night-time production of atmospheric nitrate radicals increased in China but decreased in the European Union and the United States from 2014 to 2019. This suggests the increasing contribution of night-time atmospheric oxidation in China to air pollution.

AbstractObjectiveTo estimate the risks of daily hospital admissions for cause specific major cardiovascular diseases associated with short term exposure to ambient fine particulate matter (aerodynamic diameter ≤2.5 μm; PM2.5) pollution in China.DesignNational time series study.Setting184 major cities in China.Population8 834 533 hospital admissions for cardiovascular causes in 184 Chinese cities recorded by the national database of Urban Employee Basic Medical Insurance from 1 January 2014 to 31 December 2017.Main outcome measuresDaily counts of city specific hospital admissions for primary diagnoses of ischaemic heart disease, heart failure, heart rhythm disturbances, ischaemic stroke, and haemorrhagic stroke among different demographic groups were used to estimate the associations between PM2.5 and morbidity. An overdispersed generalised additive model was used to estimate city specific associations between PM2.5 and cardiovascular admissions, and random effects meta-analysis used to combine the city specific estimates.ResultsOver the study period, a mean of 47 hospital admissions per day (standard deviation 74) occurred for cardiovascular disease, 26 (53) for ischaemic heart disease, one (five) for heart failure, two (four) for heart rhythm disturbances, 14 (28) for ischaemic stroke, and two (four) for haemorrhagic stroke. At the national average level, an increase of 10 μg/m3 in PM2.5 was associated with a 0.26% (95% confidence interval 0.17% to 0.35%) increase in hospital admissions on the same day for cardiovascular disease, 0.31% (0.22% to 0.40%) for ischaemic heart disease, 0.27% (0.04% to 0.51%) for heart failure, 0.29% (0.12% to 0.46%) for heart rhythm disturbances, and 0.29% (0.18% to 0.40%) for ischaemic stroke, but not with haemorrhagic stroke (−0.02% (−0.23% to 0.19%)). The national average association of PM2.5 with cardiovascular disease was slightly non-linear, with a sharp slope at PM2.5 levels below 50 μg/m3, a moderate slope at 50-250 μg/m3, and a plateau at concentrations higher than 250 μg/m3. Compared with days with PM2.5 up to 15 μg/m3, days with PM2.5 of 15-25, 25-35, 35-75, and 75 μg/m3 or more were significantly associated with increases in cardiovascular admissions of 1.1% (0 to 2.2%), 1.9% (0.6% to 3.2%), 2.6% (1.3% to 3.9%), and 3.8% (2.1% to 5.5%), respectively.According to projections, achieving the Chinese grade 2 (35 μg/m3), Chinese grade 1 (15 μg/m3), and World Health Organization (10 μg/m3) regulatory limits for annual mean PM2.5 concentrations would reduce the annual number of admissions for cardiovascular disease in China. Assuming causality, which should be done with caution, this reduction would translate into an estimated 36 448 (95% confidence interval 24 441 to 48 471), 85 270 (57 129 to 113 494), and 97 516 (65 320 to 129 820), respectively.ConclusionsThese data suggest that in China, short term exposure to PM2.5 is associated with increased hospital admissions for all major cardiovascular diseases except for haemorrhagic stroke, even for exposure levels not exceeding the current regulatory limits.

Background: Particulate matter pollution (PMP), both ambient (APMP) and household (HPMP), significantly contributes to global health issues, affecting mortality and disability‑adjusted life years (DALYs) across different populations. This study aims to analyze the temporal and spatial trends of deaths and DALYs attributable to APMP and HPMP from 1990 to 2021, stratified by age, sex, and SDI, to understand the evolving global health burden. Method: In this study, data on deaths, DALYs, and population attributable fractions due to overall PMP, APMP, and HPMP from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021. The counts, rates per 100,000 population, and their estimated annual percentage changes, with 95% uncertainty intervals, were reported for each estimate. Results: This study reveals that the global PMP‑attributable deaths increased, driven by the doubling of APMP‑attributable deaths. Rates attributable to overall PMP and HPMP decreased with rising SDI, while APMP‑attributable rates followed an inverted U‑shaped pattern, from 1990 to 2021. In 2021, the highest age‑specific death and DALY rates occurred in infants and the elderly, with males consistently exhibiting higher rates than females. Regionally, North Africa and the Middle East, and Oceania had the highest rates attributable to APMP and HPMP, respectively, while South Asia showed the largest increase in APMP‑attributable rates. The leading PMP‑attributable diseases were cardiovascular diseases, maternal and neonatal disorders, and respiratory infections. APMP primarily contributed to chronic obstructive pulmonary disease (COPD), ischemic heart disease, and stroke, while HPMP had the greatest impact on lower respiratory infections, COPD, and neonatal disorders. Conclusions: This study revealed that the burden of different PMP‑attributable diseases varied by region, gender, and age. In addition, APMP‑attributable deaths and DALYs doubled, with significant regional, gender, and age disparities, underscoring the need for targeted prevention and control strategies.