ORCID Profile
0000-0002-0702-6567
Current Organisations
Universidade Nova de Lisboa Faculdade de Ciências Médicas
,
University of Lisbon, Faculty of Medicine
,
Helmholtz Zentrum München - German Research Center for Environmental Health (HMGU)
,
Hospital Curry Cabral
,
Universidade Nova de Lisboa
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Publications
Short-Term Mortality Rates during a Decade of Improved Air Quality in Erfurt, Germany
Publisher: Environmental Health Perspectives
Date: 03-2009
DOI: 10.1289/EHP.11711
Effects of ultrafine and fine particulate and gaseous air pollution on cardiac autonomic control in subjects with coronary artery disease: The ULTRA study
Publisher: Springer Science and Business Media LLC
Date: 05-10-2005
Abstract: Previous studies have shown an association between elevated concentrations of particulate air pollution and cardiovascular morbidity and mortality. Therefore, the association between daily variation of ultrafine and fine particulate air pollution and cardiac autonomic control measured as heart rate variability (HRV) was studied in a large multicenter study in Amsterdam, the Netherlands, Erfurt, Germany, and Helsinki, Finland. Elderly subjects (n=37 in Amsterdam, n=47 in both Erfurt and Helsinki) with stable coronary artery disease were followed for 6 months with biweekly clinical visits. During the visits, ambulatory electrocardiogram was recorded during a standardized protocol including a 5-min period of paced breathing. Time and frequency domain analyses of HRV were performed. A statistical model was built for each center separately. The mean 24-h particle number concentration (NC) (1,000/cm(3)) of ultrafine particles (diameter 0.01-0.1 microm) was 17.3 in Amsterdam, 21.1 in Erfurt, and 17.0 in Helsinki. The corresponding values for PM2.5 were 20.0, 23.1, and 12.7 microg/m(3). During paced breathing, ultrafine particles, NO(2), and CO were at lags of 0-2 days consistently and significantly associated with decreased low-to-high frequency ratio (LF/HF), a measure of sympathovagal balance. In a pooled analysis across the centers, LF/HF decreased by 13.5% (95% confidence interval: -20.1%, -7.0%) for each 10,000/cm(3) increase in the NC of ultrafine particles (2-day lag). PM2.5 was associated with reduced HF and increased LF/HF in Helsinki, whereas the opposite was true in Erfurt, and in Amsterdam, there were no clear associations between PM2.5 and HRV. The results suggest that the cardiovascular effects of ambient ultrafine and PM2.5 can differ from each other and that their effect may be modified by the characteristics of the exposed subjects and the sources of PM2.5.
Particulate Air Pollution and Risk of ST-Segment Depression During Repeated Submaximal Exercise Tests Among Subjects With Coronary Heart Disease
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 20-08-2002
DOI: 10.1161/01.CIR.0000027561.41736.3C
Abstract: Background— Daily variations in ambient particulate air pollution have been associated with cardiovascular mortality and morbidity. We therefore assessed the associations between levels of the 3 main modes of urban aerosol distribution and the occurrence of ST-segment depressions during repeated exercise tests. Methods and Results— Repeated biweekly submaximal exercise tests were performed during 6 months among adult subjects with stable coronary heart disease in Helsinki, Finland. Seventy-two exercise-induced ST-segment depressions .1 mV occurred during 342 exercise tests among 45 subjects. Simultaneously, particle mass .5 μm (PM2.5) and the number concentrations of ultrafine particles (particle diameter 10 to 100 nm [NC 0.01–0.1 ]) and accumulation mode particles (100 to 1000 nm [NC 0.1–1 ]) were monitored at a central site. Levels of particulate air pollution 2 days before the clinic visit were significantly associated with increased risk of ST-segment depression during exercise test. The association was most consistent for measures of particles reflecting accumulation mode particles (odds ratio 3.29 95% CI, 1.57 to 6.92 for NC 0.1–1 and 2.84 95% CI, 1.42 to 5.66 for PM2.5), but ultrafine particles also had an effect (odds ratio 3.14 95% CI, 1.56 to 6.32), which was independent of PM2.5. Also, gaseous pollutants NO 2 and CO were associated with an increased risk for ST-segment depressions. No consistent association was observed for coarse particles. The associations tended to be stronger among subjects who did not use β-blockers. Conclusions— The present results suggest that the effect of particulate air pollution on cardiovascular morbidity is at least partly mediated through increased susceptibility to myocardial ischemia.
Effects of Fine and Ultrafine Particles on Cardiorespiratory Symptoms in Elderly Subjects with Coronary Heart Disease: The ULTRA Study
Publisher: Oxford University Press (OUP)
Date: 04-2003
DOI: 10.1093/AJE/KWG021
Abstract: The ULTRA Study, a study investigating the association between fine and ultrafine particulate air pollution and cardiorespiratory health, was conducted during the winter of 1998-1999 in Amsterdam, the Netherlands Erfurt, Germany and Helsinki, Finland. At each study center, a panel of elderly subjects with coronary heart disease recorded cardiac and respiratory symptoms in a diary. Exposure to ambient air pollution was characterized by measuring daily mass concentrations of particles smaller than 10 micro m (PM(10)) and 2.5 micro m (PM(2.5)), number concentrations of ultrafine particles (NC(0.01-0.1)), and gases. Odds ratios for the relation of symptoms to air pollution, adjusted for time trend, respiratory infections, and meteorologic variables, were mostly homogeneous across the centers. No association was found between air pollution and chest pain. A 10- micro g/m(3) increase in PM(2.5) was positively associated with the incidence of shortness of breath (odds ratio (OR) = 1.12, 95% confidence interval (CI): 1.02, 1.24) and with avoidance of activities (OR = 1.09, 95% CI: 0.97, 1.22). NC(0.01-0.1) was only associated with the prevalence of avoidance of activities (OR = 1.10, 95% CI: 1.01, 1.19). In conclusion, PM(2.5) was associated with some cardiac symptoms in three panels of elderly subjects. PM(2.5 )was more strongly related to cardiorespiratory symptoms than ultrafine particles were.
PM2.5 measurements in ambient aerosol: comparison between Harvard impactor (HI) and the tapered element oscillating microbalance (TEOM) system
Publisher: Elsevier BV
Date: 10-2001
DOI: 10.1016/S0048-9697(01)00648-9
Abstract: A comparison, based on the regression of 32 daily mean PM25 aerosol loadings determined by a tapered element oscillating microbalance (TEOM) and by a Harvard impactor (HI), is reported for the ambient aerosol of Erfurt (Germany). The PM2.5 concentrations measured by the TEOM were systematically lower then those obtained by the HI. The ratio of the means TEOM/HI was 0.74 and the regression equation is TEOM = 0.69 x HI + 0.071. This result is consistent with reports elsewhere suggesting that semi-volatile aerosol material is lost from the heated s le filter on the TEOM. To verify this assertion, a heating system was developed for the HI which was able to keep the HI s le filter at 50+/-1 degrees C. After the implementation of this heating system, no systematically differences were observed between the TEOM and the heated HI system. The ratio of means was 1.06 and the regression equation TEOM = 1.10 x HI - 0.668. Because the measured levels of ammonium nitrate were very low in Erfurt, we concluded that other compounds like semi-volatile organics were responsible for the loss of particulate material at 50 degrees C.
Sources and elemental composition of ambient PM2.5 in three European cities
Publisher: Elsevier BV
Date: 2005
DOI: 10.1016/J.SCITOTENV.2004.06.018
Abstract: Source apportionment of urban fine particle mass (PM(2.5)) was performed from data collected during 1998-1999 in Amsterdam (The Netherlands), Erfurt (Germany) and Helsinki (Finland), using principal component analysis (PCA) and multiple linear regression. Six source categories of PM(2.5) were identified in Amsterdam. They were traffic-related particles (30% of the average PM(2.5)), secondary particles (34%), crustal material (7%), oil combustion (11%), industrial and incineration processes (9%), and sea salt (2%). The unidentified PM(2.5) fraction was 7% on the average. In Erfurt, four source categories were extracted with some difficulties in interpretation of source profiles. They were combustion emissions related to traffic (32%), secondary PM (32%), crustal material (21%) and industrial processes (8%). In Erfurt, 3% of PM(2.5) remained unidentified. Air pollution data and source apportionment results from the two Central European cities were compared to previously published results from Helsinki, where about 80% of average PM(2.5) was attributed to transboundary air pollution and particles from traffic and other regional combustion sources. Our results indicate that secondary particles and local combustion processes (mainly traffic) were the most important source categories in all cities their impact on the average PM(2.5) was almost equal in Amsterdam and Erfurt whereas, in Helsinki, secondary particles made up for as much as half of the total average PM(2.5).
Effects of particulate air pollution on blood pressure and heart rate in subjects with cardiovascular disease: a multicenter approach.
Publisher: Environmental Health Perspectives
Date: 03-2004
DOI: 10.1289/EHP.6523
Abstract: Given the hypothesis that air pollution is associated with elevated blood pressure and heart rate, the effect of daily concentrations of air pollution on blood pressure and heart rate was assessed in 131 adults with coronary heart disease in Helsinki, Finland Erfurt, Germany and Amsterdam, the Netherlands. Blood pressure was measured by a digital monitor, and heart rate was calculated as beats per minute from an electrocardiogram recording with the patient in supine position. Particle concentrations were measured at central measuring sites. Linear regression was used to model the association between 24-hr mean concentrations of particles and blood pressure and heart rate. Estimates were adjusted for trend, day of week, temperature, barometric pressure, relative humidity, and medication use. Pooled effect estimates showed a small significant decrease in diastolic and systolic blood pressure in association with particulate air pollution a slight decrease in heart rate was found. Of the three centers, Erfurt revealed the most consistent particle effects. The results do not support findings from previous studies that had shown an increase in blood pressure and heart rate in healthy in iduals in association with particles. However, particle effects might differ in cardiac patients because of medication intake and disease status, both affecting the autonomic control of the heart.
Comparison of two particle-size spectrometers for ambient aerosol measurements
Publisher: Elsevier BV
Date: 2000
Elemental composition and sources of fine and ultrafine ambient particles in Erfurt, Germany
Publisher: Elsevier BV
Date: 04-2003
Air quality in postunification Erfurt, East Germany: associating changes in pollutant concentrations with changes in emissions.
Publisher: Environmental Health Perspectives
Date: 04-2001
DOI: 10.1289/EHP.01109325
Abstract: The unification of East and West Germany in 1990 resulted in sharp decreases in emissions of major air pollutants. This change in air quality has provided an opportunity for a natural experiment to evaluate the health impacts of air pollution. We evaluated airborne particle size distribution and gaseous co-pollutant data collected in Erfurt, Germany, throughout the 1990s and assessed the extent to which the observed changes are associated with changes in the two major emission sources: coal burning for power production and residential heating, and motor vehicles. Continuous data for sulfur dioxide, total suspended particulates (TSP), nitric oxide, carbon monoxide, and meteorologic parameters were available for 1990-1999, and size-selective particle number and mass concentration measurements were made during winters of 1991 and 1998. We used hourly profiles of pollutants and linear regression analyses, stratified by year, weekday/weekend, and hour, using NO and SO(2) as markers of traffic- and heating-related combustion sources, respectively, to study the patterns of various particle size fractions. Supplementary data on traffic and heating-related sources were gathered to support hypotheses linking these sources with observed changes in ambient air pollution levels. Substantially decreased (19-91%) concentrations were observed for all pollutants, with the exception of particles in the 0.01-0.03 microm size range (representing the smallest ultrafine particles that were measured). The number concentration for these particles increased by 115% between 1991 and 1998. The ratio of these ultrafine particles to TSP also increased by more than 500%, indicating a dramatic change in the size distribution of airborne particles. Analysis of hourly concentration patterns indicated that in 1991, concentrations of SO(2) and larger particle sizes were related to residential heating with coal. These peaks were no longer evident in 1998 due to decreases in coal consumption and consequent decreased emissions of SO(2) and larger particles. These decreases in coal combustion and the decreased concentrations of SO(2) and particles of larger size classes may have led to decreased particle scavenging and may be partially responsible for the observed increases in ultrafine particles. Traffic-related changes, such as increased numbers of trucks and increased use of diesel vehicles in Erfurt, were also associated with increased number concentrations of ultrafine particles. Morning particle peaks of all sizes were associated with NO and CO (markers for traffic) in both the 1991 and 1998 periods. There were significant differences in the ultrafine particle levels for morning hours between 1991 and 1998, suggesting that traffic was the cause of this increase.
Daily variation in fine and ultrafine particulate air pollution and urinary concentrations of lung Clara cell protein CC16
Publisher: BMJ
Date: 11-2004
Increased asthma medication use in association with ambient fine and ultrafine particles
Publisher: European Respiratory Society (ERS)
Date: 09-2002
DOI: 10.1183/09031936.02.01402001
Abstract: The association between particulate air pollution and asthma medication use and symptoms was assessed in a panel study of 53 adult asthmatics in Erfurt, Germany in winter 1996/1997. Number concentrations of ultrafine particles, 0.01-0.1 microm in diameter (NC(0.01-0.1), mean 17,300 x cm(-3), and mass concentrations of fine particles 0.01-2.5 microm in diameter (MC(0.01-2.5)), mean 30.3 microg x m(-3), were measured concurrently. They were not highly correlated (r=0.45). The associations between ambient particle concentrations and the prevalence of inhaled beta2-agonist, corticosteroid use and asthma symptoms, were analysed separately with logistic regression models, adjusting for trend, temperature, weekend, holidays, and first order autocorrelation of the error. Cumulative exposures over 14 days of ultrafine and fine particles were associated with corticosteroid use. Beta2-agonist use was associated with 5-day mean NC(0.01-0.1) and MC(0.01-2.5). The prevalence of asthma symptoms was associated with ambient particle concentrations. The results suggest that reported asthma medication use and symptoms increase in association with particulate air pollution and gaseous pollutants such as nitrogen dioxide.
Daily mortality and particulate matter in different size classes in Erfurt, Germany
Publisher: Springer Science and Business Media LLC
Date: 15-11-2006
Abstract: The link between elevated concentrations of ambient particulate matter (PM) and increased mortality has been investigated in numerous studies. Here we analyzed the role of different particle size fractions with respect to total and cardio-respiratory mortality in Erfurt, Germany, between 1995 and 2001. Number concentrations (NC) of PM were measured using an aerosol spectrometer consisting of a Differential Mobility Particle Sizer and a Laser Aerosol Spectrometer to characterize particles between 0.01 and 0.5 and between 0.1 and 2.5 microm, respectively. We derived daily means of particle NC for ultrafine (0.01-0.1 microm) and for fine particles (0.01-2.5 microm). Assuming spherical particles of a constant density, we estimated the mass concentrations (MC) of particles in these size ranges. Concurrently, data on daily total and cardio-respiratory death counts were obtained from local health authorities. The data were analyzed using Poisson Generalized Additive Models adjusting for trend, seasonality, influenza epidemics, day of the week, and meteorology using smooth functions or indicator variables. We found statistically significant associations between elevated ultrafine particle (UFP diameter: 0.01-0.1 microm) NC and total as well as cardio-respiratory mortality, each with a 4 days lag. The relative mortality risk (RR) for a 9748 cm(-3) increase in UFP NC was RR=1.029 and its 95% confidence interval (CI)=1.003-1.055 for total mortality. For cardio-respiratory mortality we found: RR=1.031, 95% CI: 1.003-1.060. No association between fine particle MC and mortality was found. This study shows that UFP, representing fresh combustion particles, may be an important component of urban air pollution associated with health effects.
Together We Stand, Divided We Fall: A Multidisciplinary Approach in Complicated Acute Pancreatitis
Publisher: MDPI AG
Date: 03-10-2019
DOI: 10.3390/JCM8101607
Abstract: Acute pancreatitis (AP) is an inflammatory condition with a mild course in most patients, but 20–30% evolve to single or multiple organ dysfunction and pancreatic eripancreatic necrosis, with potentially infected collections. In the first weeks of disease, a systemic inflammatory syndrome (SIRS) dominates the clinical setting, and early management decisions in this precocious phase can change the course of the disease. Imaging is crucial in the diagnosis, and since the adoption of the revised Atlanta classification, four different types of pancreatic eripancreatic collections have been defined. The management of the complicated forms of AP has been defined by several treatment guidelines, and the main indication for intervention is local infection, preferably in walled-off necrosis. Open surgery necrosectomy is associated with a very high rate of morbimortality, giving a place to different multidisciplinary methodologies, emphasizing drainage and necrosectomy techniques in a “step-up” approach starting from mini-invasive endoscopic drainage and moving, if needed, to progressively more invasive techniques, including interventional radiology and mini-invasive surgery. With the advent of several new technologies in the specialties involved, the complicated AP cases which need drainage and necrosectomy benefit from a new era of multidisciplinary cooperation, permitting higher efficacy with lower levels of morbimortality and reducing hospital stay and costs.
Change of the ambient particle size distribution in East Germany between 1993 and 1999
Publisher: Elsevier BV
Date: 09-2001
Long-term measurements of size-segregated ambient aerosol in two German cities located 100km apart
Publisher: Elsevier BV
Date: 10-2003
Source apportionment of ambient fine particle size distribution using positive matrix factorization in Erfurt, Germany
Publisher: Elsevier BV
Date: 07-2008
Diverging long-term trends in ambient urban particle mass and number concentrations associated with emission changes caused by the German unification
Publisher: Elsevier BV
Date: 09-2003
Relationship between different size classes of particulate matter and meteorology in three European cities
Publisher: Royal Society of Chemistry (RSC)
Date: 2005
DOI: 10.1039/B415153D
Abstract: Evidence on the correlation between particle mass and (ultrafine) particle number concentrations is limited. Winter- and spring-time measurements of urban background air pollution were performed in Amsterdam (The Netherlands), Erfurt (Germany) and Helsinki (Finland), within the framework of the EU funded ULTRA study. Daily average concentrations of ambient particulate matter with a 50% cut off of 2.5 microm (PM2.5), total particle number concentrations and particle number concentrations in different size classes were collected at fixed monitoring sites. The aim of this paper is to assess differences in particle concentrations in several size classes across cities, the correlation between different particle fractions and to assess the differential impact of meteorological factors on their concentrations. The medians of ultrafine particle number concentrations were similar across the three cities (range 15.1 x 10(3)-18.3 x 10(3) counts cm(-3)). Within the ultrafine particle fraction, the sub fraction (10-30 nm) made a higher contribution to particle number concentrations in Erfurt than in Helsinki and Amsterdam. Larger differences across the cities were found for PM2.5(range 11-17 microg m(-3)). PM2.5 and ultrafine particle concentrations were weakly (Amsterdam, Helsinki) to moderately (Erfurt) correlated. The inconsistent correlation for PM2.5 and ultrafine particle concentrations between the three cities was partly explained by the larger impact of more local sources from the city on ultrafine particle concentrations than on PM2.5, suggesting that the upwind or downwind location of the measuring site in regard to potential particle sources has to be considered. Also, relationship with wind direction and meteorological data differed, suggesting that particle number and particle mass are two separate indicators of airborne particulate matter. Both decreased with increasing wind speed, but ultrafine particle number counts consistently decreased with increasing relative humidity, whereas PM2.5 increased with increasing barometric pressure. Within the ultrafine particle mode, nucleation mode (10-30 nm) and Aitken mode (30-100 nm) had distinctly different relationships with accumulation mode particles and weather conditions. Since the composition of these particle fractions also differs, it is of interest to test in future epidemiological studies whether they have different health effects.
Related Organisations
Universidade Nova De Lisboa Faculdade De Ciências Médicas
Location: Portugal
GSF National Research Centre For Environment And Health
Location: Germany
Helmholtz Zentrum München - German Research Center For Environmental Health (HMGU)
Location: Germany
Related Funding Activities
No related grants have been discovered for Wolfgang Kreyling.