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Short-term effect of multi-pollutant air quality indexes and PM2.5 on cardiovascular hospitalization in Hamadan, Iran: a time-series analysis

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Abstract

Air pollutants are the most important environmental factors that contributed to cardiovascular disease (CVD). The present study aimed to investigate the number of hospitalization due to heart failure (HF) and myocardial infarction (MI) following the air pollutant exposure using a time-series regression analysis with a distributed lag model in Hamadan, Iran (2015-2019). A total of 2091 cases of CVD were registered. Based on the findings, the highest health effects on HF hospitalization were observed with air quality health index (AQHI) at lag 9 (RR = 1.043, 95% CI 0.991-1.098), and air quality index (AQI) at lags 2, 7, and 9 (RR = 1.001, 95% CI 0.998-1.002), for an increase in 1 unit of the indexes, and with PM2.5 at lag 0 (RR = 1.001, 95% CI 0.996-1.004) for 10 μg/m3 increase in PM2.5 levels. The highest health effects on MI hospitalization were calculated with AQHI at lag 10 (RR = 1.059, 95% CI 1.001-1.121) and AQI at lags 1 and 2 (RR = 1.001, 95% CI 0.998-1.002), for an increase in 1 unit of the indexes, and with PM2.5 at lag 8 (RR = 1.002, 95% CI 0.997-1.005) for 10 μg/m3 increase in PM2.5 levels. According to a seasonal classification, results showed that hospitalization in the warm season was higher than that of the cold season. Based on our knowledge, the current study is the first study that investigated the effect of air quality indexes on hospitalization due to HF and MI in Iran. Findings can provide basic information to plan preventive measures for reducing exposure chance and hospitalization rate in high-risk people.

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References

  • Akioka H, Yufu K, Teshima Y, Kawano K, Ishii Y, Abe I, Kondo H, Saito S, Fukui A, Okada N (2019) Seasonal variations of weather conditions on acute myocardial infarction onset: Oita AMI Registry. Heart Vessel 34:9–18

    Article  Google Scholar 

  • Alizadeh M, Hashtroodi LG, Chavoshzadeh Z, Rezaei N (2016) Effect of air pollution in frequency of hospitalizations in asthmatic children. Acta Med Iranica:542–546

  • Al-Kindi SG, Brook RD, Biswal S, Rajagopalan S (2020) Environmental determinants of cardiovascular disease: lessons learned from air pollution. Nat Rev Cardiol 17:656–672

    Article  Google Scholar 

  • Amarloei A, Fazlzadeh M, Jafari AJ, Zarei A, Mazloomi S (2020) Particulate matters and bioaerosols during Middle East dust storms events in Ilam, Iran. Microchem J 152:104280

    Article  CAS  Google Scholar 

  • An Z, Jin Y, Li J, Li W, Wu W (2018) Impact of particulate air pollution on cardiovascular health. Curr Allergy Asthma Rep 18:15

    Article  CAS  Google Scholar 

  • Ansari M, Ehrampoush MH (2019) Meteorological correlates and AirQ+ health risk assessment of ambient fine particulate matter in Tehran, Iran. Environ Res 170:141–150

    Article  CAS  Google Scholar 

  • Åström DO, Schifano P, Asta F, Lallo A, Michelozzi P, Rocklöv J, Forsberg B (2015) The effect of heat waves on mortality in susceptible groups: a cohort study of a mediterranean and a northern European City. Environ Health 14:30

    Article  Google Scholar 

  • Bai L, Shin S, Burnett RT, Kwong JC, Hystad P, van Donkelaar A, Goldberg MS, Lavigne E, Copes R, Martin RV (2019) Exposure to ambient air pollution and the incidence of congestive heart failure and acute myocardial infarction: a population-based study of 5.1 million Canadian adults living in Ontario. Environ Int 132:105004

    Article  CAS  Google Scholar 

  • Bonyadi Z, Arfaeinia H, Ramavandi B, Omidvar M, Asadi R (2020) Quantification of mortality and morbidity attributed to the ambient air criteria pollutants in Shiraz city, Iran. Chemosphere 257: 27233

  • Bourdrel T, Bind M-A, Béjot Y, Morel O, Argacha J-F (2017) Cardiovascular effects of air pollution. Arch Cardiovasc Dis 110:634–642

    Article  Google Scholar 

  • Burnett R, Chen H, Szyszkowicz M, Fann N, Hubbell B, Pope CA, Apte JS, Brauer M, Cohen A, Weichenthal S (2018) Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter. Proc Natl Acad Sci 115:9592–9597

    Article  CAS  Google Scholar 

  • Cakmak S, Kauri L, Shutt R, Liu L, Green MS, Mulholland M, Stieb D, Dales R (2014) The association between ambient air quality and cardiac rate and rhythm in ambulatory subjects. Environ Int 73:365–371

    Article  CAS  Google Scholar 

  • Chen S-Y, Chan C-C, Su T-C (2017) Particulate and gaseous pollutants on inflammation, thrombosis, and autonomic imbalance in subjects at risk for cardiovascular disease. Environ Pollut 223:403–408

    Article  CAS  Google Scholar 

  • Climate-Data (2019): Climate-Data.Org. Available from: https://en.climate-data.org/asia/iran/hamadan-2131/

  • Combes A, Franchineau G (2019) Fine particle environmental pollution and cardiovascular diseases. Metabolism 100:153944

    Article  CAS  Google Scholar 

  • D’Ippoliti D, Forastiere F, Ancona C, Agabiti N, Fusco D, Michelozzi P, Perucci CA (2003) Air pollution and myocardial infarction in Rome: a case-crossover analysis. Epidemiology 14:528–535

    Article  Google Scholar 

  • Dastoorpoor M, Sekhavatpour Z, Masoumi K, Mohammadi MJ, Aghababaeian H, Khanjani N, Hashemzadeh B, Vahedian M (2019) Air pollution and hospital admissions for cardiovascular diseases in Ahvaz, Iran. Sci Total Environ 652:1318–1330

    Article  CAS  Google Scholar 

  • Du X, Chen R, Meng X, Liu C, Niu Y, Wang W, Li S, Kan H, Zhou M (2020) The establishment of National Air Quality Health Index in China. Environ Int 138:105594

    Article  CAS  Google Scholar 

  • Ebi KL, Exuzides KA, Lau E, Kelsh M, Barnston A (2004) Weather changes associated with hospitalizations for cardiovascular diseases and stroke in California, 1983–1998. Int J Biometeorol 49:48–58

    Article  CAS  Google Scholar 

  • European Parliament, Council of the European Union (2008) Directive 2008/50/EC of the European Parliament and of the council of 21May 2008 on ambient air quality and cleaner air for Europe. Official Journal of the European Union 15:169–212. http://data.europa.eu/eli/dir/2008/50/oj

  • Evangelista LS, Doering LV, Dracup K, Westlake C, Hamilton M, Fonarow GC (2003) Compliance behaviors of elderly patients with advanced heart failure. Eur J Cardiovasc Nurs 18:197–206

    Article  Google Scholar 

  • Fanaei F, Ghorbanian A, Shahsavani A, Jafari AJ, Abdolahnejad A, Kermani M (2020) Quantification of mortality and morbidity in general population of heavily-industrialized city of Abadan: effect of long-term exposure. J Air Pollut Health 5:171–180

    Google Scholar 

  • Farhadi Z, Gorgi HA, Shabaninejad H, Delavar MA, Torani S (2020) Association between PM 2.5 and risk of hospitalization for myocardial infarction: a systematic review and a meta-analysis. BMC Public Health 20:1–12

    Article  Google Scholar 

  • Feng S, Gao D, Liao F, Zhou F, Wang X (2016) The health effects of ambient PM2. 5 and potential mechanisms. Ecotoxicol Environ Saf 128:67–74

    Article  CAS  Google Scholar 

  • Fisher JA, Jiang C, Soneja SI, Mitchell C, Puett RC, Sapkota A (2017) Summertime extreme heat events and increased risk of acute myocardial infarction hospitalizations. J Expos Sci Environ Epidemiol 27:276–280

    Article  Google Scholar 

  • Hajizadeh Y, Jafari N, Mohammadi A, Momtaz SM, Fanaei F, Abdolahnejad A (2020) Concentrations and mortality due to short-and long-term exposure to PM 2.5 in a megacity of Iran (2014–2019). Environ Sci Pollut Res 27:38004–38014

    Article  CAS  Google Scholar 

  • Huschmann A, Rasche M, Schlattmann P, Witte OW, Schwab M, Schulze PC, Rakers F (2020) A case-crossover study on the effect of short-term exposure to moderate levels of air pollution on the risk of heart failure. ESC Heart Fail 7:3851–3858

  • Jankowska-Polańska B, Świątoniowska-Lonc N, Sławuta A, Krówczyńska D, Dudek K, Mazur G (2020) Patient-Reported Compliance in older age patients with chronic heart failure. PLoS One 15:e0231076

    Article  CAS  Google Scholar 

  • Javanmardi P, Morovati P, Farhadi M, Geravandi S, Khaniabadi YO, Angali KA, Taiwo AM, Sicard P, Goudarzi G, Valipour A (2018) Monitoring the impact of ambient ozone on human health using time series analysis and air quality model approaches. Fresenius Environ Bull 27:533–544

    CAS  Google Scholar 

  • Kermani M, Jafari AJ, Gholami M, Fanaei F, Arfaeinia H (2020) Association between meteorological parameter and PM2. 5 concentration in Karaj, Iran. Int J Environ Health Eng 9:4

    CAS  Google Scholar 

  • Kermani M, Jafari AJ, Gholami M, Arfaeinia H, Shahsavani A, Fanaei F (2021) Characterization, possible sources and health risk assessment of PM2. 5-bound Heavy Metals in the most industrial city of Iran. J Environ Health Sci Eng 1-13. https://doi.org/10.1007/s40201-020-00589-3

  • Khaniabadi YO, Sicard P, Takdastan A, Hopke PK, Taiwo AM, Khaniabadi FO, De Marco A, Daryanoosh M (2019) Mortality and morbidity due to ambient air pollution in Iran. Clin Epidemiol Global Health 7:222–227

    Article  Google Scholar 

  • Kim RB, Kim B-G, Kim Y-M, Seo JW, Lim YS, Kim HS, Lee HJ, Moon JY, Kim KY, Shin J-Y (2013) Trends in the incidence of hospitalized acute myocardial infarction and stroke in Korea, 2006-2010. J Korean Med Sci 28:16–24

    Article  Google Scholar 

  • Kim A, Jung J, Hong J, Yoon S-J (2020) Time series analysis of meteorological factors and air pollutants and their association with hospital admissions for acute myocardial infarction in Korea. Int J Cardiol 322:220–226. https://doi.org/10.1016/j.ijcard.2020.08.060

  • Kojima S, Matsui K, Ogawa H (2013) Temporal trends in hospitalization for acute myocardial infarction between 2004 and 2011 in Kumamoto, Japan. Circulation 77:2841–2843

    Article  Google Scholar 

  • Lelieveld J, Klingmüller K, Pozzer A, Pöschl U, Fnais M, Daiber A, Münzel T (2019) Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions. Eur Heart J 40:1590–1596

    Article  CAS  Google Scholar 

  • Li L, Lin G-Z, Liu H-Z, Guo Y, Ou C-Q, Chen P-Y (2015) Can the Air Pollution Index be used to communicate the health risks of air pollution? Environ Pollut 205:153–160

    Article  CAS  Google Scholar 

  • Li X, Xiao J, Lin H, Liu T, Qian Z, Zeng W, Guo L, Ma W (2017) The construction and validity analysis of AQHI based on mortality risk: a case study in Guangzhou, China. Environ Pollut 220:487–494

    Article  CAS  Google Scholar 

  • Li M, Wu Y, Tian Y-H, Cao Y-Y, Song J, Huang Z, Wang X-W, Hu Y-H (2018) Association between PM2. 5 and daily hospital admissions for heart failure: a time-series analysis in Beijing. Int J Environ Res Public Health 15:2217

    Article  CAS  Google Scholar 

  • Liang H, Qiu H, Tian L (2018) Short-term effects of fine particulate matter on acute myocardial infraction mortality and years of life lost:a time series study in Hong Kong. Sci Total Environ 615:558–563

    Article  CAS  Google Scholar 

  • Liu H, Tian Y, Xiang X, Sun K, Juan J, Song J, Cao Y, Xu B, Hu Y (2017) Air pollution and hospitalization for acute myocardial infarction in China. Am J Cardiol 120:753–758

    Article  Google Scholar 

  • Liu H, Tian Y, Song J, Cao Y, Xiang X, Huang C, Li M, Hu Y (2018) Effect of ambient air pollution on hospitalization for heart failure in 26 of China’s largest cities. Am J Cardiol 121:628–633

    Article  Google Scholar 

  • Luo C, Zhu X, Yao C, Hou L, Zhang J, Cao J, Wang A (2015) Short-term exposure to particulate air pollution and risk of myocardial infarction: a systematic review and meta-analysis. Environ Sci Pollut Res 22:14651–14662

    Article  CAS  Google Scholar 

  • Ma Y, Zhang H, Zhao Y, Zhou J, Yang S, Zheng X, Wang S (2017) Short-term effects of air pollution on daily hospital admissions for cardiovascular diseases in western China. Environ Sci Pollut Res 24:14071–14079

    Article  CAS  Google Scholar 

  • Machado M, Reisen VA, Santos JM, Júnior NCR, Frère S, Bondon P, Ispany M, Cotta HHA (2020) Use of multivariate time series techniques to estimate the impact of particulate matter on the perceived annoyance. Atmos Environ 222:117080

    Article  CAS  Google Scholar 

  • Martins LC, Pereira LA, Lin CA, Santos UP, Prioli G, Luiz OC, Saldiva PH, Braga ALF (2006) The effects of air pollution on cardiovascular diseases: lag structures. Rev Saude Publica 40:677–683

    Article  Google Scholar 

  • Mason TG, Schooling CM, Ran J, Chan K-P, Tian L (2020) Does the AQHI reduce cardiovascular hospitalization in Hong Kong’s elderly population? Environ Int 135:105344

    Article  CAS  Google Scholar 

  • Miller MR, Newby DE (2020) Air pollution and cardiovascular disease: car sick. Cardiovasc Res 116:279–294

    CAS  Google Scholar 

  • Mills NL, Donaldson K, Hadoke PW, Boon NA, MacNee W, Cassee FR, Sandström T, Blomberg A, Newby DE (2009) Adverse cardiovascular effects of air pollution. Nat Clin Pract Cardiovasc Med 6:36–44

    Article  CAS  Google Scholar 

  • Mohseni J, Kazemi T, Maleki MH, Beydokhti H (2017) A systematic review on the prevalence of acute myocardial infarction in Iran. Heart Views 18:125

    Article  Google Scholar 

  • Movahedi S, Afzali SM (2013) Analysis of the number of dusty days in the west and south west of Iran. Res J Recent Sci 2:18–21

    Google Scholar 

  • Mustafić H, Jabre P, Caussin C, Murad MH, Escolano S, Tafflet M, Périer M-C, Marijon E, Vernerey D, Empana J-P (2012) Main air pollutants and myocardial infarction: a systematic review and meta-analysis. Jama 307:713–721

    Article  Google Scholar 

  • Nourmoradi H, Goudarzi G, Daryanoosh SM, Omidi-Khaniabadi F, Jourvand M, Omidi-Khaniabadi Y (2015) Health impacts of particulate matter in air using AirQ model in Khorramabad city, Iran. J Basic Res Med Sci 2:44–52

    Google Scholar 

  • Olstrup H, Johansson C, Forsberg B, Tornevi A, Ekebom A, Meister K (2019) A multi-pollutant air quality health index (aqhi) based on short-term respiratory effects in stockholm, sweden. Int J Environ Res Public Health 16:105

    Article  CAS  Google Scholar 

  • Phosri A, Ueda K, Phung VLH, Tawatsupa B, Honda A, Takano H (2019) Effects of ambient air pollution on daily hospital admissions for respiratory and cardiovascular diseases in Bangkok, Thailand. Sci Total Environ 651:1144–1153

    Article  CAS  Google Scholar 

  • Phung D, Hien TT, Linh HN, Luong LM, Morawska L, Chu C, Binh ND, Thai PK (2016a) Air pollution and risk of respiratory and cardiovascular hospitalizations in the most populous city in Vietnam. Sci Total Environ 557:322–330

    Article  CAS  Google Scholar 

  • Phung D, Thai PK, Guo Y, Morawska L, Rutherford S, Chu C (2016b) Ambient temperature and risk of cardiovascular hospitalization: an updated systematic review and meta-analysis. Sci Total Environ 550:1084–1102

    Article  CAS  Google Scholar 

  • Portet S (2020) A primer on model selection using the Akaike Information Criterion. Infect Dis Model 5:111–128

    Google Scholar 

  • Ravindra K, Rattan P, Mor S, Aggarwal AN (2019) Generalized additive models: Building evidence of air pollution, climate change and human health. Environ Int 132:104987

    Article  CAS  Google Scholar 

  • Shah AS, Langrish JP, Nair H, McAllister DA, Hunter AL, Donaldson K, Newby DE, Mills NL (2013) Global association of air pollution and heart failure: a systematic review and meta-analysis. Lancet 382:1039–1048

    Article  CAS  Google Scholar 

  • Shahsavani A, Naddafi K, Haghighifard NJ, Mesdaghinia A, Yunesian M, Nabizadeh R, Arahami M, Sowlat M, Yarahmadi M, Saki H (2012) The evaluation of PM10, PM2. 5, and PM1 concentrations during the Middle Eastern Dust (MED) events in Ahvaz, Iran, from april through september 2010. J Arid Environ 77:72–83

    Article  Google Scholar 

  • Soleimani Z, Boloorani AD, Khalifeh R, Griffin DW, Mesdaghinia A (2019) Short-term effects of ambient air pollution and cardiovascular events in Shiraz, Iran, 2009 to 2015. Environ Sci Pollut Res 26:6359–6367

    Article  CAS  Google Scholar 

  • Stewart S, Keates AK, Redfern A, McMurray JJ (2017) Seasonal variations in cardiovascular disease. Nat Rev Cardiol 14:654–664

    Article  Google Scholar 

  • Stieb DM, Szyszkowicz M, Rowe BH, Leech JA (2009) Air pollution and emergency department visits for cardiac and respiratory conditions: a multi-city time-series analysis. Environ Health 8:1–13

    Article  CAS  Google Scholar 

  • Sun Z, Chen C, Xu D, Li T (2018) Effects of ambient temperature on myocardial infarction: a systematic review and meta-analysis. Environ Pollut 241:1106–1114

    Article  CAS  Google Scholar 

  • Tian Y, Liu H, Si Y, Cao Y, Song J, Li M, Wu Y, Wang X, Xiang X, Juan J (2019) Association between temperature variability and daily hospital admissions for cause-specific cardiovascular disease in urban China: a national time-series study. PLoS Med 16:e1002738

    Article  Google Scholar 

  • To T, Feldman L, Simatovic J, Gershon AS, Dell S, Su J, Foty R, Licskai C (2015) Health risk of air pollution on people living with major chronic diseases: a Canadian population-based study. BMJ Open 5:e009075

    Article  Google Scholar 

  • Vahedian M, Khanjani N, Mirzaee M, Koolivand A (2017) Ambient air pollution and daily hospital admissions for cardiovascular diseases in Arak, Iran. ARYA Atheroscler 13:117

    Google Scholar 

  • van der Wal MHL, Jaarsma T, Moser DK, Veeger NJGM, van Gilst WH, van Veldhuisen DJ (2005) Compliance in heart failure patients: the importance of knowledge and beliefs. Eur Heart J 27:434–440

    Google Scholar 

  • Vanasse A, Talbot D, Chebana F, Bélanger D, Blais C, Gamache P, Giroux J-X, Dault R, Gosselin P (2017) Effects of climate and fine particulate matter on hospitalizations and deaths for heart failure in elderly: a population-based cohort study. Environ Int 106:257–266

    Article  Google Scholar 

  • von Klot S, Peters A, Aalto P, Bellander T, Berglind N, D’Ippoliti D, Elosua R, Hörmann A, Kulmala M, Lanki T (2005) Ambient air pollution is associated with increased risk of hospital cardiac readmissions of myocardial infarction survivors in five European cities. Circulation 112:3073–3079

    Article  CAS  Google Scholar 

  • WHO (2018) World Health Organization. Burden of disease from the joint effects of household and ambient air pollution https://www.who.int/airpollution/data/AP_joint_effect_BoD_results_May2018.pdf

  • Wu Y, Li M, Tian Y, Cao Y, Song J, Huang Z, Wang X, Hu Y (2019) Short-term effects of ambient fine particulate air pollution on inpatient visits for myocardial infarction in Beijing, China. Environ Sci Pollut Res 26:14178–14183

    Article  CAS  Google Scholar 

  • Yu Y, Yao S, Dong H, Ji M, Chen Z, Li G, Yao X, Wang S-L, Zhang Z (2018) Short-term effects of ambient air pollutants and myocardial infarction in Changzhou, China. Environ Sci Pollut Res 25:22285–22293

    Article  CAS  Google Scholar 

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Acknowledgements

This manuscript is a part of a funded Ph.D. thesis (no. 9705022515). The authors are grateful to the Department of the Environment for providing data on hourly air pollutant concentrations, the Hamadan University of Medical Sciences for providing the data on hospital admission, and Hamadan’s Meteorological Organization for providing the climate data.

Availability of data and materials

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

Funding

The research was funded by the Vice Chancellery for Research at Hamadan University of Medical Sciences (Ph.D. thesis no. 9705022515).

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Authors and Affiliations

  1. Department of Environmental Health Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran

    Mostafa Leili & Azam Nadali

  2. Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

    Manoochehr Karami

  3. Department of Occupational Health, Faculty of Health, Hamadan University of Medical Sciences, Hamadan, Iran

    Abdolrahman Bahrami

  4. Faculty of Chemistry, Bu-Ali Sina University, Fahmideh Av, Hamadan, 65174, Iran

    Abbas Afkhami

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  1. Mostafa Leili
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Contributions

ML: conceptualization, methodology, validation, formal analysis, investigation, resources, writing—original draft, writing—review and editing, supervision, funding acquisition, project administration. AN: conceptualization, methodology, validation, formal analysis, resources, writing—original draft, writing—review and editing. MK: conceptualization, methodology, validation, formal analysis, writing AB: conceptualization, methodology, formal analysis. AA: conceptualization, methodology, formal analysis. All authors read and approved the final manuscript.

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Correspondence to Azam Nadali.

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This study was approved by the ethics committee of Hamadan University of Medical Sciences (with the code of ethics: IR.UMSHA.REC.1397.313) and was conducted according to the mentioned guidelines.

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Not applicable.

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The authors declare no competing interests.

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Highlights

• Air pollution effects on MI and HF hospitalization were investigated with the GLM model.

• A higher relative risk was observed for AQHI level than AQI and PM2.5 levels.

• Hospitalization due to HF and MI was more in the warm season than the cold season.

• The health effects in the cold season were observed with more delay than the warm season.

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Leili, M., Nadali, A., Karami, M. et al. Short-term effect of multi-pollutant air quality indexes and PM2.5 on cardiovascular hospitalization in Hamadan, Iran: a time-series analysis. Environ Sci Pollut Res 28, 53653–53667 (2021). https://doi.org/10.1007/s11356-021-14386-4

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