Socioeconomic inequalities in urban and transport planning related exposures and mortality: A health impact assessment study for Bradford, UK Environ. Int. (IF 7.297) Pub Date : 2018-10-20 Natalie Mueller, David Rojas-Rueda, Haneen Khreis, Marta Cirach, Carles Milà, Ana Espinosa, Maria Foraster, Rosemary R.C. McEachan, Brian Kelly, John Wright, Mark Nieuwenhuijsen
BackgroundCities have unique geographic, environmental and sociocultural characteristics that influence the health status of their citizens. Identification and modification of these characteristics may help to promote healthier cities.ObjectiveWe estimated premature mortality impacts of breaching international exposure guidelines for physical activity (PA), air pollution, noise and access to green space for Bradford (UK) adult residents (n = 393,091).MethodsWe applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) methodology and estimated mortality, life expectancy (LE) and economic impacts of non-compliance with recommended exposure levels. We also investigated the distribution of the mortality burden among the population, focusing on socioeconomic position (SEP) as defined by deprivation status and ethnicity.ResultsWe estimated that annually almost 10% of premature mortality (i.e. 375 deaths, 95% CI: 276–474) in Bradford is attributable to non-compliance with recommended exposure levels. Non-compliance was also estimated to result in over 300 days of LE lost (95% CI: 238–432), which translated in economic losses of over £50,000 per person (95% CI: 38,518–69,991). 90% of the premature mortality impact resulted from insufficient PA performance. Air and noise pollution and the lack of green space had smaller impacts (i.e. 48 deaths). Residents of lower SEP neighborhoods had the highest risks for adverse exposure and premature death. A larger number of deaths (i.e. 253 and 145, respectively) could be prevented by reducing air and noise pollution levels well below the guidelines.DiscussionCurrent urban and transport planning related exposures result in a considerable health burden that is unequally distributed among the Bradford population. Improvements in urban and transport planning practices including the reduction of motor traffic and the promotion of active transport together with greening of the district, particularly in areas of lower SEP, are promising strategies to increase PA performance and reduce harmful environmental exposures.
Phthalates and organophosphates in settled dust and HVAC filter dust of U.S. low-income homes: Association with season, building characteristics, and childhood asthma Environ. Int. (IF 7.297) Pub Date : 2018-10-20 Chenyang Bi, Juan P. Maestre, Hongwan Li, Ge Zhang, Raheleh Givehchi, Alireza Mahdavi, Kerry A. Kinney, Jeffrey Siegel, Sharon D. Horner, Ying Xu
Phthalates and organophosphates are ubiquitous indoor semi-volatile organic contaminants (SVOCs) that have been widely used as plasticizers and flame retardants in consumer products. Although many studies have assessed their levels in house dust, only a few used dust samples captured by filters of building heating, ventilation, and air conditioning (HVAC) systems. HVAC filters collect particles from large volumes of air over a long period of time (potentially known) and thus provide a spatially and temporally integrated concentration. This study measured concentrations of phthalates and organophosphates in HVAC filter dust and settled floor dust collected from low-income homes in Texas, United States, in both the summer and winter seasons. The most frequently detected compounds were benzyl butyl phthalate (BBzP), di-(2-ethylhexyl) phthalate (DEHP), di-n-octyl phthalate (DnOP), tris (1-chloro-2-propyl) phosphate (TCIPP), triphenyl phosphate (TPHP), and tris (1,3-dichloroisopropyl) phosphate (TDCIPP). The median level of TCIPP in settled dust was 3- to 180-times higher than levels reported in other studies of residential homes. Significantly higher concentrations were observed in HVAC filter dust as compared to settled dust for most of the frequently detected compounds in both seasons, except for several phthalates in the winter. SVOC concentrations in settled dust in winter were generally higher than in summer, while different seasonality patterns were found for HVAC filter dust. Settled dust samples from homes with vinyl flooring contained significantly higher levels of BBzP and DEHP as compared to homes with other types of floor material. The concentration of DEHP and TDCIPP in settled dust also significantly associated with the presence of carpet in homes. Cleaning activities to remove dust from furniture actually increased the levels of certain compounds in HVAC filter dust, while frequent vacuuming of carpet helped to decrease the concentrations of some compounds in settled dust. Additionally, the size and age of a given house also correlated with the levels of some pollutants in dust. A statistically significant association between DEHP concentration in HVAC filter dust in summer and the severity of asthma in children was observed. These results suggest that HVAC filter dust represents a useful sampling medium to monitor indoor SVOC concentrations with high sensitivity; in contrast, when using settled dust, in addition to consideration of seasonal influences, it is critical to know the sampling location because the type and level of SVOCs may be related to local materials used there.
The added effects of heatwaves on cause-specific mortality: A nationwide analysis in 272 Chinese cities Environ. Int. (IF 7.297) Pub Date : 2018-10-20 Peng Yin, Renjie Chen, Lijun Wang, Cong Liu, Yue Niu, Weidong Wang, Yixuan Jiang, Yunning Liu, Jiangmei Liu, Jinlei Qi, Jinling You, Maigeng Zhou, Haidong Kan
BackgroundThe evidence was limited and inconclusive about the added effects of heatwaves, especially in developing countries.ObjectiveTo evaluate the added effects of heatwaves on cause-specific mortality in China.MethodsWe designed a nationwide time-series analysis based on daily data from 272 main Chinese cities to from 2013 to 2015. We adopted 12 definitions by combining 4 heat thresholds (90th, 92.5th, 95th, 97.5th percentile of city-specific daily mean temperature) and duration of ≥2, 3 and 4 days. We applied overdispersed generalized additive models with distributed lag models to estimate the city-specific cumulative effects of heatwaves over lags of 0–10 days after controlling for daily temperature. We then, used a meta-regression model to pool the effect estimates at national and regional levels.ResultsHeatwaves could significantly increase risk for mortality from total and cardiopulmonary diseases, including coronary heart disease, ischemic stroke (rather than hemorrhagic stroke) and chronic obstructive pulmonary disease. The effects increased with higher thresholds, but were not appreciably influenced by the duration of heat. The risks generally occurred immediately and lasted for 3 to 5 days. The risks were much larger in the temperate continental zone and the temperate monsoon zones than in the subtropical monsoon zone where there was an evident mortality displacement. The elderly, females and less-educated people were more vulnerable.ConclusionsThis analysis provided ample evidence for the added mortality risk associated with heatwaves, which had important implications for designing heatwave-warning systems and predicting the disease burden of future heatwaves.
Multiple pregnancies and air pollution in moderately polluted cities: Is there an association between air pollution and fetal growth? Environ. Int. (IF 7.297) Pub Date : 2018-10-20 Anne-Sophie Mariet, Frédéric Mauny, Sophie Pujol, Gérard Thiriez, Paul Sagot, Didier Riethmuller, Mathieu Boilleaut, Jérôme Defrance, Hélène Houot, Anne-Laure Parmentier, Marie Vasseur-Barba, Eric Benzenine, Catherine Quantin, Nadine Bernard
BackgroundMultiple pregnancies (where more than one fetus develops simultaneously in the womb) are systematically excluded from studies of the impact of air pollution on pregnancy outcomes. This study aims to analyze, in a population of multiple pregnancies, the relationship between fetal growth restriction (FGR), small for gestational age (SGA) and exposure to air pollution in moderately polluted cities.MethodsAll women with multiple pregnancies living in the city of Besançon or in the urban area of Dijon and who delivered at a university hospital between 2005 and 2009 were included. FGR and SGA were obtained from medical records. Outdoor residential nitrogen dioxide (NO2) exposure was assessed using the mother's address, considering a 50 m radius buffer over the following defined pregnancy periods: each trimester, entire pregnancy and two months before delivery. Logistic regression analyses were performed.ResultsThis study included 249 multiple pregnancies with 506 newborns. The median of NO2 concentration considering a 50 m radius buffer during entire pregnancy was 23.1 μg/m3 (minimum at 10.1 μg/m3 and maximum at 46.7 μg/m3). No association was observed between NO2 and SGA whatever the pregnancy period (the odds ratio (OR) range 0.78 to 0.88). Regarding FGR, the OR associated with an increase of 10 μg/m3 of NO2 exposure during entire pregnancy was 1.52 (95% Confidence Interval (CI): 1.02–2.26). Similar results were observed for NO2 exposure during the various pregnancy periods.ConclusionsThese results are in line with an association between NO2 and fetal growth in multiple pregnancies for an exposure mostly below the threshold set out in European legislation.
Long-term exposure to transportation noise and its association with adiposity markers and development of obesity Environ. Int. (IF 7.297) Pub Date : 2018-10-19 Maria Foraster, Ikenna C. Eze, Danielle Vienneau, Emmanuel Schaffner, Ayoung Jeong, Harris Héritier, Franziska Rudzik, Laurie Thiesse, Reto Pieren, Mark Brink, Christian Cajochen, Jean-Marc Wunderli, Martin Röösli, Nicole Probst-Hensch
The contribution of different transportation noise sources to metabolic disorders such as obesity remains understudied. We evaluated the associations of long-term exposure to road, railway and aircraft noise with measures of obesity and its subphenotypes using cross-sectional and longitudinal designs.We assessed 3796 participants from the population-based Swiss Cohort Study on Air Pollution and Lung and Heart Diseases (SAPALDIA), who attended the visits in 2001 (SAP2) and 2010/2011 (SAP3) and who were aged 29–72 at SAP2. At SAP2 we measured body mass index (BMI, kg/m2). At SAP3 we measured BMI, waist circumference (centimetres) and Kyle body Fat Index (%) and derived overweight, central and general obesity. Longitudinally for BMI, we derived change in BMI, incidence of overweight and obesity and a 3-category outcome combining the latter two. We assigned source-specific 5-year mean noise levels before visits and during follow-up at the most exposed dwelling façade (Lden, dB), using Swiss noise models for 2001 and 2011 and participants' residential history. Models were adjusted for relevant confounders, including traffic-related air pollution.Exposure to road traffic noise was significantly associated with all adiposity subphenotypes, cross-sectionally (at SAP3) [e.g. beta (95% CI) per 10 dB, BMI: 0.39 (0.18; 0.59); waist circumference: 0.93 (0.37; 1.50)], and with increased risk of obesity, longitudinally (e.g. RR = 1.25, 95% CI: 1.04; 1.51, per 10 dB in 5-year mean). Railway noise was significantly related to increased risk of overweight. In cross-sectional analyses, we further identified a stronger association between road traffic noise and BMI among participants with cardiovascular disease and an association between railway noise and BMI among participants reporting bad sleep. Associations were independent of the other noise sources, air pollution and robust to all adjustment sets. No associations were observed for aircraft noise.Long-term exposure to transportation noise, particularly road traffic noise, may increase the risk of obesity and could constitute a pathway towards cardiometabolic and other diseases.
Association between fertility rate reduction and pre-gestational exposure to ambient fine particles in the United States, 2003–2011 Environ. Int. (IF 7.297) Pub Date : 2018-10-21 Tao Xue, Tong Zhu
Dioxins as potential risk factors for autism spectrum disorder Environ. Int. (IF 7.297) Pub Date : 2018-10-20 Zhiling Guo, Heidi Qunhui Xie, Peng Zhang, Yali Luo, Tuan Xu, Yiyun Liu, Hualing Fu, Li Xu, Eugenia Valsami-Jones, Patricia Boksa, Bin Zhao
Autism spectrum disorder (ASD) has emerged as a major public health concern due to its fast-growing prevalence in recent decades. Environmental factors are thought to contribute substantially to the variance in ASD. Interest in environmental toxins as causes of ASD has arisen due to the high sensitivity of the developing human brain to toxic chemicals, particularly to dioxin and certain dioxin-like compounds (dioxins). As a group of typical persistent organic pollutants, dioxins have been found to exert adverse effects on human brain development. In this paper, we review the evidence for association of exposure to dioxins with neurodevelopmental abnormalities related to ASD based on both human epidemiological and animal studies. It has been documented that exposure to dioxins during critical developmental periods increased risk for ASD. This notion has been demonstrated in different populations exposed to high or background level of dioxins. Furthermore, the effects and mechanisms of action of dioxins relevant to the pathophysiology and pathogenesis of ASD are summarized, describing potential underlying mechanisms linking dioxin exposure with ASD onset. Further studies focusing on effects of prenatal/perinatal exposure to individual dioxin congeners or to mixtures of dioxins on ASD-associated behavioral and neurobiological consequences in animal models, and on the mechanisms of actions of dioxins, are needed in order to better understand how dioxin exposure might contribute to increased risk for ASD.
Potential risk to human skin cells from exposure to dicloran photodegradation products in water Environ. Int. (IF 7.297) Pub Date : 2018-10-18 Wei Xu, Emily N. Vebrosky, Kevin L. Armbrust
Urinary metals and metal mixtures in Bangladesh: Exploring environmental sources in the Health Effects of Arsenic Longitudinal Study (HEALS) Environ. Int. (IF 7.297) Pub Date : 2018-10-18 Tiffany R. Sanchez, Vesna Slavkovich, Nancy LoIacono, Alexander van Geen, Tyler Ellis, Steven N. Chillrud, Olgica Balac, Tarique Islam, Faruque Parvez, Habib Ahsan, Joseph H. Graziano, Ana Navas-Acien
IntroductionEnvironmental exposure to toxic metals and metalloids is pervasive and occurs from multiple sources. The Health Effects of Arsenic Longitudinal Study (HEALS) is an ongoing prospective study predominantly focused on understanding health effects associated with arsenic exposure from drinking water. The goal of this project was to measure a suite of elements in urine to better understand potential exposure patterns and to identify common environmental sources of exposure among this semi-rural Bangladeshi population.MethodsIn a random sample of 199 adult HEALS participants (50% female), the concentrations of 15 urinary elements (As, Ba, Cd, Co, Cs, Cu, Mn, Mo, Ni, Pb, Se, Sr, Tl, W, Zn) were assessed by Inductively-Coupled Plasma Mass Spectrometry (ICP-MS) to assess commonalities with sociodemographic characteristics and potential sources of exposure. We used principal component analysis (PCA) with varimax normalized rotations, and hierarchical cluster analysis (CA), using Ward's method with Euclidean distances, to evaluate these relationships.ResultsPCA and CA showed similar patterns, suggesting 6 principal components (PC) and 5 clusters: 1)PC: Sr-Ni-Cs/ CA: Sr-Ni-Co; 2) Pb-Tl/Pb-Tl-Se-Cs; 3) As-Mo-W/As-Mo-W; 4) Ba-Mn/Ba-Mn; 5) Cu-Zn/Cu-Zn-Cd; and 6) Cd. There was a strong significant association between the As-Mo-W PC/cluster and water arsenic levels (p < 0.001) and between the Cd PC and betel nut use (p = 0.003). The Sr-Ni-Cs PC was not related to any of the socio-demographic characteristics investigated, including smoking status and occupation. The first PC, Sr-Ni-Cs, explained 21% of the variability; the third PC, As-Mo-W, explained 12.5% of the variability; and the sixth PC, Cd, explained 10% of the variability. Day laborers appeared to have the highest exposure.ConclusionsGroundwater and betel nut use are likely important sources of metal and metalloid exposure in this population. These findings will guide future exposure assessment research in Bangladesh and future epidemiologic research investigating the degree to which metal mixtures play a role in disease development.
Predictors of selenium biomarker kinetics in 4–9-year-old Bangladeshi children Environ. Int. (IF 7.297) Pub Date : 2018-10-18 Helena Skröder, Maria Kippler, Jessica De Loma, Rubhana Raqib, Marie Vahter
BackgroundBiomarker selenium concentrations vary greatly between studies. Concentrations in erythrocytes, urine, and hair vary even at similar plasma concentrations, suggesting that unknown factors influence the distribution of selenium between body compartments.ObjectiveTo assess predictors of the different selenium biomarkers in children.DesignWe used a mother-child cohort, nested in a population-based supplementation trial in rural Bangladesh (MINIMat), established for evaluation of arsenic toxicity. Selenium was measured in plasma (n = 223), erythrocytes, urine, and hair at 9 years (n = 395) and in erythrocytes and urine at 4.5 years (n = 259) using inductively coupled plasma mass spectrometry. We also measured concentrations of arsenic (all biospecimen) and cadmium (erythrocytes and urine). Genotyping for INMT, a methyltransferase involved in selenium metabolism, was performed using TaqMan probes.ResultsAt 9 years, the selenium concentrations ranged 51–139 μg/L in plasma, 128–281 μg/L in erythrocytes, 2.2–55 μg/L in urine, and 258–723 μg/kg in hair. Correlations (rS) between biomarkers ranged 0.12–0.37, and were strongest between blood compartments and between erythrocytes and hair (long-term markers). In multivariable-adjusted linear regression analyses, plasma selenium differed by sampling season (highest in food-secure pre-monsoon season) and was inversely associated with plasma arsenic (range < 0.0080–20 μg/L; B = −1.1, 95% CI: -1.8, −0.41). In contrast, erythrocyte selenium was positively associated with erythrocyte arsenic (range 0.95–50 μg/L; B = 0.58, 95% CI: 0.26, 0.91) and inversely associated with erythrocyte cadmium (range 0.27–3.1 μg/L; B = −12, 95% CI: −17, −6.9). These associations were similar at 4.5 years. Only selenium in hair and urine were influenced by INMT polymorphisms. Finally, chronic malnutrition seemed to increase selenium retention, measured as the ratio plasma/urinary selenium.ConclusionsSelenium biomarkers seem to be influenced by malnutrition, genetics, and exposure to metal pro-oxidants. This might affect the evaluation of deficiency/sufficiency, normally assessed by selenium in plasma/serum.
Urban residential greenness and adiposity: A cohort study in Stockholm County Environ. Int. (IF 7.297) Pub Date : 2018-10-18 Å. Persson, A. Pyko, T. Lind, T. Bellander, C.-G. Östenson, G. Pershagen, C. Eriksson, M. Lõhmus
BackgroundIncreasing evidence suggests that exposure to residential greenness is associated with positive health outcomes among urban populations. However, few studies have considered effects on adiposity development in a longitudinal setting.ObjectivesThis study aimed to explore the association between long-term exposure to urban residential greenness and markers of adiposity.MethodsA cohort of 5126 adults from five municipalities in Stockholm County was examined clinically at baseline (1992–1998) and follow-up (2002–2006) after on average nine years. Time-weighted average exposure to urban greenness was estimated by Normalized Difference Vegetation Index (NDVI) within 100 m, 250 m, and 500 m buffers around the residential addresses of each participant. Multiple linear and Poisson regression models were used to estimate associations between greenness and change in weight and waist circumference as well as risk of overweight, obesity and central obesity. Co-exposures to air pollution, traffic noise and distance to water were also examined.ResultsIn women, higher levels of residential greenness were associated with a reduced increase in waist circumference during follow-up (β = −0.11 cm/year, 95% CI −0.14; −0.08 per one interquartile range increase in NDVI) and decreased risk for central obesity (IRR = 0.88: 95% CI 0.79; 0.99) in the 500 m buffer. No associations were observed for men or with regard to weight development or the risk of developing overweight or obesity. Exposure to low NDVI levels in combination with high NOx from road traffic and transportation noise as well as long distance to water rendered statistically significant increases in waist circumference in both sexes.ConclusionHigher long-term exposure to greenness was associated with a reduced increase in waist circumference and lower risk of central adiposity in women but not in men. In both sexes, low NDVI exposure in combination with other environmental risk factors appeared particularly harmful.
Association of heavy metals with measures of pulmonary function in children and youth: Results from the National Health and Nutrition Examination Survey (NHANES) Environ. Int. (IF 7.297) Pub Date : 2018-10-18 Jessica M. Madrigal, Victoria Persky, Andrea Pappalardo, Maria Argos
IntroductionExposure to cadmium, cobalt, lead, and manganese has been associated with decreased pulmonary function in adults. Little is known about the magnitude of these associations among children in the United States.ObjectivesWe evaluated cross-sectional associations of blood and urinary concentrations of cadmium, cobalt, lead, and manganese with pulmonary function measures [forced expiratory volume in one second (FEV1; milliliters), forced vital capacity (FVC; milliliters), ratio of FEV1 to FVC (FEV1:FVC), and mid-exhalation forced expiratory flow rate (FEF 25–75%; milliliters/second)] in a sample of 1234 6–17 year olds, who participated in the 2011–2012 survey cycle of the National Health and Nutrition Examination Survey (NHANES).MethodsSurvey-weighted linear regression was used to estimate beta coefficients and 95% confidence intervals (CIs) for the associations between metal exposure tertiles or quartiles and pulmonary function test parameters, with adjustment for relevant covariates.ResultsBlood manganese concentration was inversely associated with FVC (β for highest versus lowest quartile = −97.1, 95% CI = −230.6, 36.4; p for trend = 0.03). Urinary manganese was inversely associated with FEV1:FVC and FEF 25–75% (p for trend = 0.05 and 0.02, respectively). Urinary lead was inversely associated with FEF 25–75% (p for trend = 0.01). The associations between blood manganese and both FEV1 and FVC differed by age (p for interaction = 0.04 and 0.04, respectively), indicating an inverse trend that was strongest among older youth.ConclusionsEnvironmental exposure to manganese and lead may adversely impact the pulmonary function of young people in the United States. Our findings highlight a need to prioritize children's environmental health and evaluate these associations prospectively.
Underlying causes of PM2.5-induced premature mortality and potential health benefits of air pollution control in South and Southeast Asia from 1999 to 2014 Environ. Int. (IF 7.297) Pub Date : 2018-10-16 Yusheng Shi, Aimei Zhao, Tsuneo Matsunaga, Yasushi Yamaguchi, Shuying Zang, Zhengqiang Li, Tao Yu, Xingfa Gu
Quantification of spatial and temporal variations in premature mortality attributable to PM2.5 has important implications for air quality control in South and Southeast Asia (SSEA). The number of PM2.5-induced premature deaths during 1999–2014 in SSEA was estimated using an integrated exposure-response model based on 0.01° × 0.01° satellite-retrieved PM2.5 data, population density, and spatially and temporally variable baseline mortality data. The results showed extremely high premature death rates in North India and Bangladesh. PM2.5-induced premature deaths in SSEA increased with small interannual variations from 1999 to 2014 owing to the interannual variations in PM2.5 concentrations. Moreover, four scenarios on the effects of premature deaths by PM2.5 mitigation efforts based on World Health Organization (WHO) air quality guidelines (AQG) and interim targets (ITs) were investigated for each disease and each country during 1999–2014. Four scenarios based on WHO AQG (10 μg/m3), IT-3 (15 μg/m3), IT-2 (25 μg/m3), and IT-1 (35 μg/m3) resulted in 69.3%, 49.1%, 25.4%, and 12.8% reductions compared to the total reference premature deaths (1256,300), which was calculated using the original PM2.5 datasets. Overall, stroke was the most serious disease associated with air pollution, causing 40% of total premature deaths. Ischemic heart disease was the largest contributor (58%) to the deaths in relatively cleaner air (Scenario 1). The annual rate of change in premature deaths in South Asian countries (India, Bangladesh, and Pakistan) was higher than that in Southeast Asian countries under all scenarios. The results for different scenarios provide insight into the largest health benefits of PM2.5 reduction efforts.
In vitro assessment of endocrine disrupting potential of organic fractions extracted from hydraulic fracturing flowback and produced water (HF-FPW) Environ. Int. (IF 7.297) Pub Date : 2018-10-17 Yuhe He, Yifeng Zhang, Jonathan W. Martin, Daniel S. Alessi, John P. Giesy, Greg G. Goss
Long-term wind turbine noise exposure and incidence of myocardial infarction in the Danish nurse cohort Environ. Int. (IF 7.297) Pub Date : 2018-10-16 Elvira V. Bräuner, Jeanette T. Jørgensen, Anne Katrine Duun-Henriksen, Claus Backalarz, Jens E. Laursen, Torben H. Pedersen, Mette K. Simonsen, Zorana J. Andersen
BackgroundGrowing evidence supports the concept that traffic noise exposure leads to long-term health complications other than annoyance, including cardiovascular disease. Similar effects may be expected from wind turbine noise exposure, but evidence is sparse. Here, we examined the association between long-term exposure to wind turbine noise and incidence of myocardial infarction (MI).MethodsWe used the Danish Nurse Cohort with 28,731 female nurses and obtained data on incidence of MI in the Danish National Patient and Causes of Death Registries until ultimo 2013. Wind turbine noise levels at residential addresses between 1982 and 2013 were estimated using the Nord2000 noise propagation model, as the annual means of a weighted 24-hour average (Lden) at the most exposed façade. Time-varying Cox proportional hazard regression was used to examine the association between the 11-, 5- and 1-year rolling means prior to MI diagnosis of wind turbine noise levels and MI incidence.ResultsOf 23,994 nurses free of MI at cohort baseline, 686 developed MI by end of follow-up in 2013. At the cohort baseline (1993 or 1999), 10.4% nurses were exposed to wind turbine noise (≥1 turbine within a 6000-m radius of the residence) and 13.3% in 2013. Mean baseline residential noise levels among exposed nurses were 26.3 dB, higher in those who developed MI (26.6 dB) than among those who didn't develop MI (26.3 dB). We found no association between wind turbine noise and MI incidence: adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) comparing nurses with 11-years mean residential noise levels of <21.5 dB, 21.5–25.4 dB, 25.4–29.9 dB, and >29.9 dB, to non-exposed nurses were 0.89 (0.64–1.25), 1.20 (0.82–1.77), 1.38 (0.95–2.01), and 0.88 (0.53–1.28), respectively. Corresponding HR (95% CI) for the linear association between 11-year mean levels of wind turbine noise (per 10 dB increase) with MI incidence was 0.99 (0.77–1.28). Similar associations were observed when considering the 5- and 1-year running means, and with no evidence of dose-response.ConclusionsThe results of this comprehensive cohort study lend little support to a causal association between outdoor long-term wind-turbine noise exposure and MI. However, there were only few cases in the highest exposure groups and our findings need reproduction.
The influence of residential and workday population mobility on exposure to air pollution in the UK Environ. Int. (IF 7.297) Pub Date : 2018-10-16 Stefan Reis, Tomáš Liška, Massimo Vieno, Edward J. Carnell, Rachel Beck, Tom Clemens, Ulrike Dragosits, Samuel J. Tomlinson, David Leaver, Mathew R. Heal
Phthalate exposure and male reproductive outcomes: A systematic review of the human epidemiological evidence Environ. Int. (IF 7.297) Pub Date : 2018-10-16 Elizabeth G. Radke, Joseph M. Braun, John D. Meeker, Glinda S. Cooper
ObjectiveWe performed a systematic review of the epidemiology literature to identify the male reproductive effects associated with phthalate exposure.Data sources and study eligibility criteriaSix phthalates were included in the review: di(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DINP), dibutyl phthalate (DBP), diisobutyl phthalate (DIBP), butyl benzyl phthalate (BBP), and diethyl phthalate (DEP). The initial literature search (of PubMed, Web of Science, and Toxline) included all studies of male reproductive effects in humans, and outcomes were selected for full systematic review based on data availability.Study evaluation and synthesis methodsFor each outcome, studies were evaluated using criteria defined a priori for risk of bias and sensitivity by two reviewers using a domain-based approach. Evidence was synthesized by outcome and phthalate and strength of evidence was summarized using a structured framework.ResultsThe primary outcomes reviewed here are (number of included/excluded studies in parentheses): anogenital distance (6/1), semen parameters (15/9), time to pregnancy (3/5), testosterone (13/8), timing of pubertal development (5/15), and hypospadias/cryptorchidism (4/10). Looking at the overall hazard, there was robust evidence of an association between DEHP and DBP exposure and male reproductive outcomes; this was based primarily on studies of anogenital distance, semen parameters, and testosterone for DEHP and semen parameters and time to pregnancy for DBP. There was moderate evidence of an association between DINP and BBP exposure and male reproductive outcomes based on testosterone and semen parameters for DINP and semen parameters and time to pregnancy for BBP. DIBP and DEP were considered to have slight evidence of an association. For DIBP, the less conclusive evidence was attributed to a more limited literature base (i.e., fewer studies) and lower exposure levels in the population, decreasing the ability to observe an effect. For DEP, the findings were consistent with experimental animal data that suggest DEP does not haves as strong an anti-androgenic effect as other phthalates.Conclusions and implications of key findingsOverall, despite some inconsistencies across phthalates in the specific outcomes associated with exposure, these results support that phthalate exposure at levels seen in human populations may have male reproductive effects, particularly DEHP and DBP. The relative strength of the evidence reflects differing levels of toxicity as well as differences in the range of exposures studied and the number of available studies.The views expressed are those of the authors and do not necessarily represent the views or policies of the U.S. EPA.
In-utero and childhood chemical exposome in six European mother-child cohorts Environ. Int. (IF 7.297) Pub Date : 2018-10-14 Line Småstuen Haug, Amrit Kaur Sakhi, Enrique Cequier, Maribel Casas, Léa Maitre, Xavier Basagana, Sandra Andrusaityte, Georgia Chalkiadaki, Leda Chatzi, Muireann Coen, Jeroen de Bont, Audrius Dedele, Joane Ferrand, Regina Grazuleviciene, Juan Ramon Gonzalez, Kristine Bjerve Gutzkow, Hector Keun, Rosie McEachan, Cathrine Thomsen
BackgroundHarmonized data describing simultaneous exposure to a large number of environmental contaminants in-utero and during childhood is currently very limited.ObjectivesTo characterize concentrations of a large number of environmental contaminants in pregnant women from Europe and their children, based on chemical analysis of biological samples from mother-child pairs.MethodsWe relied on the Early-Life Exposome project, HELIX, a collaborative project across six established population-based birth cohort studies in Europe. In 1301 subjects, biomarkers of exposure to 45 contaminants (i.e. organochlorine compounds, polybrominated diphenyl ethers, per- and polyfluoroalkyl substances, toxic and essential elements, phthalate metabolites, environmental phenols, organophosphate pesticide metabolites and cotinine) were measured in biological samples from children (6–12 years) and their mothers during pregnancy, using highly sensitive biomonitoring methods.ResultsMost of the exposure biomarkers had high detection frequencies in mothers (35 out of 45 biomarkers with >90% detected) and children (33 out of 45 biomarkers with >90% detected). Concentrations were significantly different between cohorts for all compounds, and were generally higher in maternal compared to children samples. For most of the persistent compounds the correlations between maternal and child concentrations were moderate to high (Spearman Rho > 0.35), while for most non-persistent compounds correlations were considerably lower (Spearman Rho < 0.15). For mercury, PFOS and PFOA a considerable proportion of the samples of both mothers and their children exceeded the HBM I value established by The Human Biomonitoring Commission of the German Federal Environment Agency.DiscussionAlthough not based on a representative sample, our study suggests that children across Europe are exposed to a wide range of environmental contaminants in fetal life and childhood including many with potential adverse effects. For values exceeding the HBM I value identification of specific sources of exposure and reducing exposure in an adequate way is recommended. Considerable variability in this “chemical exposome” was seen between cohorts, showing that place of residence is a strong determinant of one's personal exposome. This extensive dataset comprising >100,000 concentrations of environmental contaminants in mother-child pairs forms a unique possibility for conducting epidemiological studies using an exposome approach.
Arsenic, one carbon metabolism and diabetes-related outcomes in the Strong Heart Family Study Environ. Int. (IF 7.297) Pub Date : 2018-10-12 Miranda J. Spratlen, Maria Grau-Perez, Jason G. Umans, Joseph Yracheta, Lyle G. Best, Kevin Francesconi, Walter Goessler, Poojitha Balakrishnan, Shelley A. Cole, Mary V. Gamble, Barbara V. Howard, Ana Navas-Acien
BackgroundInorganic arsenic exposure and inter-individual differences in its metabolism have been associated with cardiometabolic risk. A more efficient arsenic metabolism profile (lower MMA%, higher DMA%) has been associated with reduced risk for arsenic-related health outcomes; however, this profile has also been associated with increased risk for diabetes-related outcomes. The mechanism behind these contrasting associations is equivocal; we hypothesized one carbon metabolism (OCM) may play a role.MethodsWe evaluated the association between OCM-related variables (nutrient intake and genetic variants) and both arsenic metabolism biomarkers (iAs%, MMA% and DMA%) and diabetes-related outcomes (metabolic syndrome, diabetes, HOMA2-IR and waist circumference) in 935 participants free of prevalent diabetes and metabolic syndrome from the Strong Heart Family Study, a family-based prospective cohort comprised of American Indian tribal members aged 14+ years.ResultsOf the 935 participants free of both diabetes and metabolic syndrome at baseline, 279 (29.8%) developed metabolic syndrome over a median of 5.3 years of follow-up and of the 1458 participants free of diabetes at baseline, 167 (11.3%) developed diabetes over follow-up. OCM nutrients were not associated with arsenic metabolism, however, higher vitamin B6 was associated with diabetes-related outcomes (higher HOMA2-IR and increased risk for diabetes and metabolic syndrome). A polymorphism in an OCM-related gene, methionine synthase (MTR), was associated with both higher MMA% (β = 2.57, 95% CI: 0.22, 4.92) and lower HOMA2-IR (GMR = 0.79, 95% CI = 0.66, 0.93 per 5 years of follow-up). Adjustment for OCM variables did not affect previously reported associations between arsenic metabolism and diabetes-related outcomes; however, the association between the MTR variant and diabetes-related outcomes were attenuated after adjustment for arsenic metabolism.ConclusionsOur findings suggest MMA% may be a partial mediator in the association between OCM and diabetes-related outcomes. Additional mediation analyses with longer follow-up period are needed to confirm this finding. Further research is needed to determine whether excess B vitamin intake is associated with increased risk for diabetes-related outcomes.
Transportation noise exposure, noise annoyance and respiratory health in adults: A repeated-measures study Environ. Int. (IF 7.297) Pub Date : 2018-10-12 Ikenna C. Eze, Maria Foraster, Emmanuel Schaffner, Danielle Vienneau, Harris Héritier, Reto Pieren, Laurie Thiesse, Franziska Rudzik, Thomas Rothe, Marco Pons, Robert Bettschart, Christian Schindler, Christian Cajochen, Jean-Marc Wunderli, Mark Brink, Martin Röösli, Nicole Probst-Hensch
Association between maternal urinary speciated arsenic concentrations and gestational diabetes in a cohort of Canadian women Environ. Int. (IF 7.297) Pub Date : 2018-10-12 Jillian Ashley-Martin, Linda Dodds, Tye E. Arbuckle, Maryse F. Bouchard, Gabriel D. Shapiro, Mandy Fisher, Patricia Monnier, Anne-Sophie Morisset, Adrienne S. Ettinger
BackgroundEpidemiological and toxicological evidence suggests that maternal total arsenic (As) levels are associated with an elevated risk of gestational diabetes (GDM). Uncertainty remains regarding the metabolic toxicity of specific arsenic species, comprised of both organic and inorganic sources of arsenic exposure.ObjectivesWe assessed associations between speciated As and GDM using data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study.MethodsConcentrations of speciated As [(inorganic (trivalent, pentavalent)), methylated arsenic species metabolites (monomethylarsonic acid (MMA), dimethylarsinic acid (DMA)), and organic (arsenobetaine)] were measured in first trimester maternal urine samples. GDM cases were identified in accordance with Canadian guidelines. Multivariable regression models were used to estimate associations between speciated As and GDM, evaluate potential interaction between speciated As exposures, and assess fetal sex-specific findings.ResultsAmong 1243 women who had a live, singleton birth and no previous history of diabetes, 4% met the diagnostic criteria for GDM. Our analyses focused on DMA and arsenobetaine as these were the subtypes with detectable concentrations in at least 40% of samples. Compared to women in the lowest tertile of DMA (<1.49 μg As/L), women with concentrations exceeding 3.52 μg As/L (3rd tertile) experienced an increased risk of GDM (aOR = 3.86; 95% CI: 1.18, 12.57) (p-value for trend across tertiles = 0.04). When restricted to women carrying male infants, the magnitude of this association increased (aOR 3rd tertile = 4.71; 95% CI: 1.05, 21.10).ConclusionsThese results suggest a positive relation between DMA and GDM; potential differences in risk by fetal sex requires further investigation.
Association between Deepwater Horizon oil spill response and cleanup work experiences and lung function Environ. Int. (IF 7.297) Pub Date : 2018-10-11 Kaitlyn B. Gam, Lawrence S. Engel, Richard K. Kwok, Matthew D. Curry, Patricia A. Stewart, Mark R. Stenzel, John A. McGrath, W. Braxton Jackson, Maureen Y. Lichtveld, Dale P. Sandler
IntroductionOil spill response and cleanup (OSRC) workers had potentially stressful experiences during mitigation efforts following the 2010 Deepwater Horizon disaster. Smelling chemicals; skin or clothing contact with oil; heat stress; handling oily plants/wildlife or dead animal recovery; and/or being out of regular work may have posed a risk to worker respiratory health through psychological stress mechanisms.ObjectiveTo evaluate the association between six potentially stressful oil spill experiences and lung function among OSRC workers 1–3 years following the Deepwater Horizon disaster, while controlling for primary oil spill inhalation hazards and other potential confounders.MethodsOf 6811 GuLF STUDY participants who performed OSRC work and completed a quality spirometry test, 4806 provided information on all exposures and confounders. We carried out complete case analysis and used multiple imputation to assess risk among the larger sample. Potentially stressful work experiences were identified from an earlier study of these workers. The lung function parameters of interest include the forced expiratory volume in 1 s (FEV1, mL), the forced vital capacity (FVC, mL) and the ratio (FEV1/FVC, %).ResultsOn average, participants in the analytic sample completed spirometry tests 1.7 years after the spill. Among workers with at least 2 acceptable FEV1 and FVC curves, workers with jobs that involved oily plants/wildlife or dead animal recovery had lower values for FEV1 (Mean difference: −53 mL, 95% CI: −84, −22), FVC (Mean difference: −45 mL, 95% CI: −81, −9) and FEV1/FVC (Mean difference: −0.44%, 95% CI: −0.80, −0.07) compared to unexposed workers in analyses using multiple imputation.ConclusionsWorkers involved in handling oily plants/wildlife or dead animal recovery had lower lung function than unexposed workers after accounting for other OSRC inhalation hazards.
Associations of cumulative exposure to heavy metal mixtures with obesity and its comorbidities among U.S. adults in NHANES 2003–2014 Environ. Int. (IF 7.297) Pub Date : 2018-10-11 Xin Wang, Bhramar Mukherjee, Sung Kyun Park
Size-dependent distribution and inhalation exposure characteristics of particle-bound chlorinated paraffins in indoor air in Guangzhou, China Environ. Int. (IF 7.297) Pub Date : 2018-10-11 Wei Zhou, Mingjie Shen, James C.W. Lam, Mingshan Zhu, Liangying Liu, Hui Chen, Bibai Du, Lixi Zeng, Eddy Y. Zeng
Chlorinated paraffins (CPs) are now attracting special concerns worldwide as one type of new persistent toxic substances as classified by the Stockholm Convention. CPs are extensively applied in household goods and indoor decoration materials, but information on their occurrence and exposure risk in such environments is still very scarce. In this study, the current concentrations, particle size distributions, and inhalation exposure characteristics and risk of CPs were investigated in regard to indoor air particulate matter. Both short chain (SCCPs) and medium chain CPs (MCCPs) were determined in all size-fractioned particle samples with a range of 6.20–17.8 and 5.98–40.5 ng m−3, respectively. MCCPs were more abundant than SCCPs. Size distributions revealed that individual homologs, SCCPs, and MCCPs exhibited a similar unimodal distribution peaking in the fine particles with a diameter of 0.56–1.0 μm. The relative abundance of longer-chain or more heavily chlorinated homologs tend to gradually increase with particle size shift from coarse to fine mode. Vapor pressure may be a critical factor governing the size-dependent distribution of CPs. Deposition of particulate CPs in the human respiratory tract is also size-dependent. The contributions of fine particles to the regional depositions of CPs in the human respiratory tract increase with increasing carbon chain length or chlorine content. Based on the size-dependent distributions of CPs, inhalation exposure assessment from the ICRP model indicated no significant health risk due to CPs in current indoor environments.
Active commuting through natural environments is associated with better mental health: Results from the PHENOTYPE project Environ. Int. (IF 7.297) Pub Date : 2018-10-12 Wilma L. Zijlema, Ione Avila-Palencia, Margarita Triguero-Mas, Christopher Gidlow, Jolanda Maas, Hanneke Kruize, Sandra Andrusaityte, Regina Grazuleviciene, Mark J. Nieuwenhuijsen
BackgroundCommuting routes with natural features could promote walking or cycling for commuting. Commuting through natural environments (NE) could have mental health benefits as exposure to NE can reduce stress and improve mental health, but there is little evidence. This study evaluates the association between NE and commuting, whether active or not, and the association between commuting (through NE), whether active or not, and mental health. We also evaluate the moderating effect of NE quality on the association between NE commuting and mental health.MethodsThis cross-sectional study was based on adult respondents (n = 3599) of the Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions in Europe (PHENOTYPE) project. Data were collected in four European cities in Spain, the Netherlands, Lithuania and the United Kingdom. Data on commuting behavior (active commuting at least one day/week, daily NE commuting) and mental health were collected with questionnaires. Associations were estimated with multilevel analyses including random intercepts at city- and neighborhood level.ResultsAdjusted multilevel analyses showed that daily NE commuters were more often active commuters (OR 1.42; 95% CI 1.19, 1.70). There was no association between active commuting and mental health, but daily NE commuters had on average a 2.74 (95% CI 1.66, 3.82) point higher mental health score than those not commuting through NE. The association with mental health was stronger among active commuters (4.03, 95% CI 2.13, 5.94) compared to non-active commuters (2.21; 95% CI 0.90, 3.51) when daily commuting through NE, but NE quality did not have a moderating effect.ConclusionsDaily NE commuting was associated with better mental health, especially for active commuters. Daily NE commuters were likely to be active commuters. Active commuting itself was not associated with mental health. These findings suggest that cities should invest in commuting routes with nature for cycling and walking.
Human infectious diseases and the changing climate in the Arctic Environ. Int. (IF 7.297) Pub Date : 2018-10-11 Audrey Waits, Anastasia Emelyanova, Antti Oksanen, Khaled Abass, Arja Rautio
Prenatal fluoride exposure and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6–12 years of age in Mexico City Environ. Int. (IF 7.297) Pub Date : 2018-10-10 Morteza Bashash, Maelle Marchand, Howard Hu, Christine Till, E. Angeles Martinez-Mier, Brisa N. Sanchez, Niladri Basu, Karen E. Peterson, Rivka Green, Lourdes Schnaas, Adriana Mercado-García, Mauricio Hernández-Avila, Martha María Téllez-Rojo
BackgroundEpidemiologic and animal-based studies have raised concern over the potential impact of fluoride exposure on neurobehavioral development as manifested by lower IQ and deficits in attention. To date, no prospective epidemiologic studies have examined the effects of prenatal fluoride exposure on behavioral outcomes using fluoride biomarkers and sensitive measures of attention.ObjectiveWe aimed to examine the association between prenatal fluoride exposure and symptoms associated with attention-deficit/hyperactivity disorder (ADHD).Method213 Mexican mother-children pairs of the Early Life Exposures to Environmental Toxicants (ELEMENT) birth cohort study had available maternal urinary samples during pregnancy and child assessments of ADHD-like behaviors at age 6–12. We measured urinary fluoride levels adjusted for creatinine (MUFcr) in spot urine samples collected during pregnancy. The Conners' Rating Scales-Revised (CRS-R) was completed by mothers, and the Conners' Continuous Performance Test (CPT-II) was administered to the children.ResultsMean MUFcr was 0.85 mg/L (SD = 0.33) and the Interquartile Range (IQR) was 0.46 mg/L. In multivariable adjusted models using gamma regression, a 0.5 mg/L higher MUFcr (approximately one IQR higher) corresponded with significantly higher scores on the CRS-R for DSM-IV Inattention (2.84 points, 95% CI: 0.84, 4.84) and DSM-IV ADHD Total Index (2.38 points, 95% CI: 0.42, 4.34), as well as the following symptom scales: Cognitive Problems and Inattention (2.54 points, 95% CI: 0.44, 4.63) and ADHD Index (2.47 points; 95% CI: 0.43, 4.50). The shape of the associations suggested a possible celling effect of the exposure. No significant associations were found with outcomes on the CPT-II or on symptom scales assessing hyperactivity.ConclusionHigher levels of fluoride exposure during pregnancy were associated with global measures of ADHD and more symptoms of inattention as measured by the CRS-R in the offspring.
Weather and gastrointestinal disease in Spain: A retrospective time series regression study Environ. Int. (IF 7.297) Pub Date : 2018-10-10 Clara Morral-Puigmal, Èrica Martínez-Solanas, Cristina M. Villanueva, Xavier Basagaña
Kidney damage induced by sub-chronic fine particulate matter exposure Environ. Int. (IF 7.297) Pub Date : 2018-10-10 Iván Tavera Busso, Ana Carolina Mateos, Luis Isaías Juncos, Norma Canals, Hebe Alejandra Carreras
According to the WHO, about 3 million people die each year due to ambient air pollution. Most of the in vivo studies on the PM2.5 effects have been done on respiratory and cardiovascular tissues. However, little is known about the effects on the tissues involved on xenobiotic removal, such as kidneys. In the present study we assess the harmful effects of sub-chronic exposure to PM2.5 on the kidney, by investigating histologic and serum alterations in healthy and hypertensive rat models. Mean PM2.5 concentrations during exposures were slightly above the daily WHO standard. Exposed animals showed fibrosis, mesangial expansion, decrease glomerular and tubular lumen volumes in kidneys, with an elevated BUN. Hypertensive animals also exhibited much more severe alterations than healthy animals. We conclude that PM2.5 induces minimal or small-scale abnormalities that can be determinant for renal health preservation.
A Bayesian generalized log-normal model to dynamically evaluate the distribution of pesticide residues in soil associated with population health risks Environ. Int. (IF 7.297) Pub Date : 2018-10-09 Zijian Li
Exploring better models for evaluating the distribution of pesticide residues in soil and sediment is necessary to assess and avoid population health risk. Frequentist philosophy and probability are widely used in many studies to apply a log-normal distribution associated with the maximum likelihood estimation, which assumes fixed parameters and relies on a large sample size for long-run frequency. However, frequentist probability might not be suitable for analyzing pesticide residue distribution, whose parameters are affected by many complex factors and should be treated as unfixed. This study aimed to implement a Bayesian generalized log-normal (GLN) model to better understand the distribution of pesticide residues in soil and quantify population risks. The Bayesian GLN model, including location, scale, and shape parameters, was applied for the first time to dynamically evaluate pesticide residue distribution in soil and sediments. In addition, a comprehensive human health risk assessment of exposure to lindane via soil was conducted using the lifetime cancer risk for carcinogenic effect, margin of exposure for non-carcinogenic effect, and disability-adjusted life year for health damage. The Bayesian posterior analysis results indicated that the distribution of the concentration of some pesticide was better fitted to a log-Laplace (e.g., the mode value of shape parameter for lindane is 1.079) or showed mixtures of distributions within the family of log-normal distributions (e.g., the mode value of shape parameter for p,p′-DDE is 2.395), which can better explain the long-tail phenomenon of pesticide residue distribution and dynamically evaluate distribution models. For lindane, the 95% uncertainty bounds on the 95th percentile computed from 95% highest probability density regions (credible intervals) of three parameters by using the Bayesian p-box method were [2.063, 1558.609] ng/g, which is several orders of magnitude larger than the computed frequentist 95% confidence interval of [4.690, 8.095] ng/g and indicates that the population could have cancer risk concerns. These uncertainty analysis results from the Bayesian GLN approach indicated a larger variation of Lindane soil residues, which might reflect the complex and unpredictable mechanism of pesticide residue distribution including both unfixed models and distribution parameters. In summary, Bayesian GLN model is more flexible for the dynamic evaluation of pesticide soil residue distribution, retains posteriors for future data analysis, and could better quantify the uncertainties in population health risks. Therefore, this study can provide a novel and dynamical perspective of pesticide residue distribution and help better quantify health risks.
Fluoride exposure and thyroid function among adults living in Canada: Effect modification by iodine status Environ. Int. (IF 7.297) Pub Date : 2018-10-10 Ashley J. Malin, Julia Riddell, Hugh McCague, Christine Till
Socioeconomic inequalities in exposure to environmental tobacco smoke in children in Israel Environ. Int. (IF 7.297) Pub Date : 2018-10-10 Tamar Berman, Zohar Barnett-Itzhaki, Rachel Axelrod, Lital Keinan-Boker, Tal Shimony, Rebecca Goldsmith, Thomas Göen, Haim Geva, Laura Rosen
BackgroundEnvironmental tobacco smoke (ETS) exposure in infants and children causes more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome. The aim of this study was to measure ETS exposure in children in Israel (ages 4–11 years) using urinary cotinine measurements, in order to compare exposure levels to other international populations, and to assess predictors of ETS exposure in children in Israel.MethodsA subset of children who participated in the National Health and Nutrition Survey (RAV- MABAT) in 2015–2016 were invited to participate in the Second Israel Biomonitoring Survey. We analyzed urinary cotinine and creatinine concentrations in 103 children. Parents of study participants were interviewed in person on children's exposure to ETS at home and in other environments and on sociodemographic variables. We calculated creatinine-adjusted and unadjusted urinary cotinine geometric means in children and analyzed associations in univariable and multivariable analyses, between sociodemographic variables and parental – reported exposure, and urinary cotinine concentrations.ResultsBased on urinary creatinine measurement, over 60% of children are exposed to ETS (compared to <40% based on parental report). Linear regression showed a positive association between urinary cotinine concentration and reported ETS exposure (p = 0.001). Mean cotinine concentration among children whose parents reported that they are exposed to ETS at home (5.1 μg/l) was significantly higher than the concentration among children whose parents reported they are not exposed to ETS at home (1.6 μg/l, p < 0.001). There was an inverse relationship between total family income and urinary cotinine concentration (p < 0.05). In a multivariable model adjusted for ethnicity and other factors, family income was a significant predictor of urinary cotinine level (p = 0.04, slope = −0.49). Geometric mean creatinine adjusted concentrations in children in the current study were higher than in children in Canada and selected European countries.ConclusionsWe found evidence of widespread exposure to ETS in children in the study. There is an urgent need to protect children in Israel from exposure to ETS.
Air quality management policy and reduced mortality rates in Seoul Metropolitan Area: A quasi-experimental study Environ. Int. (IF 7.297) Pub Date : 2018-10-09 Changwoo Han, Youn-Hee Lim, Takashi Yorifuji, Yun-Chul Hong
BackgroundThe air quality management policy was introduced in Seoul and Incheon metropolitan cities in the Republic of Korea, from 2005 to 2014. Despite particulate matter concentrations decreasing after policy implementation, the consequent health benefits have not been evaluated. Therefore, we evaluated the effects of the air quality management policy on cause-specific mortality rates in Seoul and Incheon.MethodsUsing interrupted time series analysis with a generalized Poisson regression model, we compared daily average mortality rates before (baseline, 2004–2005) and after (2006–2007, 2008–2009, 2010–2011, 2012–2013) the policy implementation. To account for the long term mortality trends, we weighted daily mortality rate of Seoul and Incheon with daily mortality rate of Daejeon (another metropolitan city with no air quality management policy implemented during the same period).ResultsDecline in the particulate matter concentration was greater in Seoul and Incheon than in Daejeon. After adjusting for potential confounders, there were 8% decrease in cardiovascular disease mortality rates and 10% decrease in cerebrovascular disease mortality rates in Seoul in 2012–2013 compared to the baseline period. In Incheon, an 8% reduction in cerebrovascular disease mortality rates in 2012–2013 was calculated. There was no change in mortality rates due to external causes or respiratory disease after policy implementation.ConclusionsOur study suggests that the air quality management policy was effective in reducing cardiovascular and cerebrovascular mortality rates in Seoul and cerebrovascular mortality rates in Incheon.
Short-term exposure to air pollution: Associations with lung function and inflammatory markers in non-smoking, healthy adults Environ. Int. (IF 7.297) Pub Date : 2018-10-09 Luc Dauchet, Sébastien Hulo, Nathalie Cherot-Kornobis, Régis Matran, Philippe Amouyel, Jean-Louis Edmé, Jonathan Giovannelli
IntroductionAir pollution impacts health by increasing mortality and the incidence of acute events in unhealthy individuals. In contrast, the acute effects of pollution in healthy individuals are less obvious. The present study was designed to evaluate the associations between short-term exposure to air pollution on one hand and lung function, and inflammatory markers on the other in middle-aged, non-smoking adults with no respiratory disease, in two urban areas in northern France.MethodsA sample of 1506 non-smoking adults (aged from 40 to 65) with no respiratory disease was selected from the participants in the 2011–2013 cross-sectional Enquête Littoral Souffle Air Biologie Environnement (ELISABET) survey in two urban areas in the northern France. We evaluated the associations between (i) mean levels of particulate matter with aerodynamic diameter < 10 μm (PM10), nitrogen dioxide (NO2) and ozone (O3) exposure on the day and the day before the study examination for each participant, and (ii) spirometry data and levels of inflammatory markers. Coefficients of multiple linear regression models were expressed (except for the forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio) as the percentage change [95% confidence interval] per 10 μg increment in each pollutant.ResultsLevels of PM10, NO2 and O3 exposure were below or only close to the World Health Organization's recommended limits in our two study areas. An increment in NO2 levels was significantly associated with a lower FEV1/FVC ratio (−0.38 [−0.64; −0.12]), a lower forced expiratory flow between 25% and 75% of FVC (FEF25–75%) (−1.70 [−3.15; −0.23]), and a lower forced expiratory flow measured at 75% of FVC (FEF75%) (−3.07 [−4.92; −1.18]). An increment in PM10 levels was associated with lower FEF75% (−1.41 [−2.79; −0.01]) and a non-significant elevation in serum levels of high-sensitivity C-reactive protein (+3.48 [−0.25; 7.36], p = 0.07). Lastly, an increment in O3 levels was associated with a significantly higher blood eosinophil count (+2.41 [0.10; 4.77]) and a non-significant elevation in fractional exhaled nitric oxide (+2.93 [−0.16; 6.13], p = 0.06).ConclusionA short-term exposure to air pollution was associated with a subclinical decrement in distal lung function and increment in inflammatory markers in healthy inhabitants of two urban areas in France. If these exploratory results are confirmed, this could suggest that even moderate levels of air pollution could have an impact on respiratory health on the general population, and not solely on susceptible individuals.
Urinary trace metals individually and in mixtures in association with preterm birth Environ. Int. (IF 7.297) Pub Date : 2018-10-06 Stephani S. Kim, John D. Meeker, Rachel Carroll, Shanshan Zhao, Michael J. Mourgas, Michael J. Richards, Max Aung, David E. Cantonwine, Thomas F. McElrath, Kelly K. Ferguson
One in ten infants born in the United States is born preterm, or prior to 37 weeks gestation. Exposure to elevated levels of metals, such as lead and arsenic, has been linked to higher risk of preterm birth (PTB), but consequences of lower levels of exposure and less studied metals are unclear. We examined the associations between 17 urinary trace metals individually and in mixtures in relation to PTB. The LIFECODES birth cohort enrolled pregnant women at <15 weeks gestation at Brigham and Women's Hospital in Boston. We selected cases of PTB (n = 99) and unmatched controls (n = 291) and analyzed urine samples for a panel of trace metals (median: 26 weeks gestation). We used logistic regression models to calculate the odds ratio (OR) for PTB and subtypes of PTB based on presentation at delivery. Subtypes included spontaneous and placental PTB. We used elastic net (ENET) regularization to identify individual metals or pairwise interactions that had the strongest associations with PTB, and principal components analysis (PCA) to identify classes of exposures associated with the outcome. We observed increased odds of PTB (OR: 1.41, 95% Confidence Interval [CI]: 1.12, 1.78) in association with an interquartile range difference in urinary copper (Cu). We also observed an increased OR for selenium (OR: 1.33, 95% CI: 0.98, 1.81). ENET selected Cu as the most important trace metal associated with PTB. PCA identified 3 principal components (PCs) that roughly reflected exposure to toxic metals, essential metals, and metals with seafood as a common source of exposure. PCs reflecting essential metals were associated with increased odds of overall and spontaneous PTB. Maternal urinary copper in the third trimester was associated with increased risk of PTB, and statistical analyses for mixtures indicated that after accounting for correlation this metal was the most important statistical predictor of the outcome.
The association of traffic-related air and noise pollution with maternal blood pressure and hypertensive disorders of pregnancy in the HOME study cohort Environ. Int. (IF 7.297) Pub Date : 2018-10-06 Clara G. Sears, Joseph M. Braun, Patrick H. Ryan, Yingying Xu, Erika F. Werner, Bruce P. Lanphear, Gregory A. Wellenius
Traffic-related air and noise pollution may increase the risk for cardiovascular disorders, especially among susceptible populations like pregnant women. The objective of this study was to evaluate the association of exposure to traffic-related air pollution and traffic noise with blood pressure in pregnant women. We extracted systolic blood pressure (SBP) and diastolic blood pressure (DBP) at ≥20 weeks gestation, as well as hypertensive disorders of pregnancy from medical records in the HOME Study, a prospective pregnancy and birth cohort from Cincinnati, OH (n = 370). We estimated exposure to elemental carbon attributable to traffic (ECAT),1 a marker of traffic-related air pollution, at women's residences at ~20 weeks gestation using a validated land use regression model and traffic noise using a publicly available transportation noise model. We used linear mixed models and modified Poisson regression adjusted for covariates to examine associations of ECAT and traffic noise with blood pressure and hypertensive disorders of pregnancy risk, respectively. In adjusted models, we found a 1.6 (95% CI = 0.02, 3.3; p = 0.048) mm Hg increase in SBP associated with an interquartile range increase in ECAT concentration; the association was stronger after adjusting for traffic noise (1.9 mm Hg, 95% = 0.1, 3.7; p = 0.035). ECAT concentrations were not significantly associated with DBP or hypertensive disorders of pregnancy, and traffic noise was not associated with SBP, DBP, or hypertensive disorders of pregnancy. There was no evidence of a joint effect of traffic noise and ECAT on any outcome. In this cohort, higher residential traffic-related air pollution exposure at ~20 weeks gestation was associated with higher SBP in late pregnancy. It is important for future studies of traffic-related air or noise pollution to jointly consider both exposures and neighborhood characteristics given their correlation and potential cumulative impact on cardiovascular health.
Variability of urinary concentrations of non-persistent chemicals in pregnant women and school-aged children Environ. Int. (IF 7.297) Pub Date : 2018-10-06 Maribel Casas, Xavier Basagaña, Amrit K. Sakhi, Line S. Haug, Claire Philippat, Berit Granum, Cyntia B. Manzano-Salgado, Céline Brochot, Florence Zeman, Jeroen de Bont, Sandra Andrusaityte, Leda Chatzi, David Donaire-Gonzalez, Lise Giorgis-Allemand, Juan R. Gonzalez, Esther Gracia-Lavedan, Regina Grazuleviciene, Mariza Kampouri, Martine Vrijheid
BackgroundExposome studies are challenged by exposure misclassification for non-persistent chemicals, whose temporal variability contributes to bias in dose-response functions.ObjectivesWe evaluated the variability of urinary concentrations of 24 non-persistent chemicals: 10 phthalate metabolites, 7 phenols, 6 organophosphate (OP) pesticide metabolites, and cotinine, between weeks from different pregnancy trimesters in pregnant women, and between days and between seasons in children.Methods154 pregnant women and 152 children from six European countries were enrolled in 2014–2015. Pregnant women provided three urine samples over a day (morning, midday, and night), for one week in the 2nd and 3rd pregnancy trimesters. Children provided two urines a day (morning and night), over two one-week periods, six months apart. We pooled all samples for a given subject that were collected within a week. In children, we also made four daily pools (combining morning and night voids) during the last four days of the first follow-up week. Pools were analyzed for all 24 metabolites of interest. We calculated intraclass-correlation coefficients (ICC) and estimated the number of pools needed to obtain an ICC above 0.80.ResultsAll phthalate metabolites and phenols were detected in >90% of pools whereas certain OP pesticide metabolites and cotinine were detected in <43% of pools. We observed fair (ICC = 0.40–0.59) to good (0.60–0.74) between-day reliability of the pools of two samples in children for all chemicals. Reliability was poor (<0.40) to fair between trimesters in pregnant women and between seasons in children. For most chemicals, three daily pools of two urines each (for weekly exposure windows) and four weekly pools of 15–20 urines each would be necessary to obtain an ICC above 0.80.ConclusionsThis quantification of the variability of biomarker measurements of many non-persistent chemicals during several time windows shows that for many of these compounds a few dozen samples are required to accurately assess exposure over periods encompassing several trimesters or months.
Longitudinal trends of per- and polyfluoroalkyl substances in children's serum Environ. Int. (IF 7.297) Pub Date : 2018-10-08 Jani Koponen, Kerstin Winkens, Riikka Airaksinen, Urs Berger, Robin Vestergren, Ian T. Cousins, Anne M. Karvonen, Juha Pekkanen, Hannu Kiviranta
Studies suggest negative health impacts from early life exposure to per- and polyfluoroalkyl substances (PFASs). However, information on longitudinal exposure to PFASs during childhood is scarce for background-exposed individuals. This study sought to fill this gap by investigating children's longitudinal exposure trends through measurement of PFAS serum concentrations and calculation of body burdens (μg, total in body). Blood of 54 Finnish children was sampled 2005–2015 and analyzed for 20 PFASs at 1, 6 and 10.5 years of age. The body burden was calculated by multiplying the serum concentration by the volume of distribution and the bodyweight for each individual. Associations between serum concentrations or body burdens and parameters, such as sex, breastfeeding duration, body mass index as well as indoor dust and air PFAS concentrations, were evaluated. Serum concentrations of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorohexane sulfonic acid (PFHxS) decreased significantly (p < 0.001) with age. In contrast to serum concentrations, body burdens stayed unchanged or even increased significantly (p < 0.05), except for PFOA in female children. Breastfeeding duration was positively correlated (p < 0.001) with serum concentrations of PFHxS, PFOS, PFOA and PFNA at 1 year of age. Some associations were found at 10.5 years with sex and indoor PFAS concentrations. Observations of longitudinal decreasing trends of serum concentrations can be misleading for understanding exposure levels from external media during childhood, as the serum concentration is influenced by parallel temporal changes and growth dilution. Body burdens account for growth dilution and thus better reflect differences in early-life to adolescence exposure than serum concentrations.
The sensitivity of satellite-based PM2.5 estimates to its inputs: Implications to model development in data-poor regions Environ. Int. (IF 7.297) Pub Date : 2018-10-06 Guannan Geng, Nancy L. Murray, Howard H. Chang, Yang Liu
Exposure to fine particulate matter (PM2.5) has been associated with a wide range of negative health outcomes. The overwhelming majority of the epidemiological studies that helped establish such associations was conducted in regions with sufficient ground observations and other supporting data, i.e., the data-rich regions. However, air pollution health effects research in the data-poor regions, where pollution levels are often the highest, is still very limited due to the lack of high-quality exposure estimates. To improve our understanding of the desired input datasets for the application of satellite-based PM2.5 exposure models in data-poor areas, we applied a Bayesian ensemble model in the southeast U.S. that was selected as a representative data-rich region. We designed four groups of sensitivity tests to simulate various data-poor scenarios. The factors considered that would influence the model performance included the temporal sampling frequency of the monitors, the number of ground monitors, the accuracy of the chemical transport model simulation of PM2.5 concentrations, and different combinations of the additional predictors. While our full model achieved a 10-fold cross-validated (CV) R2 of 0.82, we found that when reducing the sampling frequency from the current 1-in-3 day to 1-in-9 day, the CV R2 decreased to 0.58, and the predictions could not capture the daily variations of PM2.5. Half of the current stations (i.e., 30 monitors) could still support a robust model with a CV R2 of 0.79. With 20 monitors, the CV R2 decreased from 0.71 to 0.55 when 100% additional random errors were added to the original CMAQ simulations. However, with a sufficient number of ground monitors (e.g., 30 monitors), our Bayesian ensemble model had the ability to tolerate CMAQ errors with only a slight decrease in CV R2 (from 0.79 to 0.75). With fewer than 15 monitors, our full model collapsed and failed to fit any covariates, while the models with only time-varying variables could still converge even with only five monitors left. A model without the land use parameters lacked fine spatial details in the prediction maps, but could still capture the daily variability of PM2.5 (CV R2 ≥ 0.67) and might support a study of the acute health effects of PM2.5 exposure.
Chiral pharmaceuticals: Environment sources, potential human health impacts, remediation technologies and future perspective Environ. Int. (IF 7.297) Pub Date : 2018-10-03 Yaoyu Zhou, Shikang Wu, Hao Zhou, Hongli Huang, Jia Zhao, Yaocheng Deng, Hua Wang, Yuan Yang, Jian Yang, Lin Luo
Chiral pharmaceuticals (CPs), including non-steroid anti-inflammatory drugs (NSAIDs), β-blockers and some herbicide and pesticides, are widely used in aquaculture, clinical treatment and many other fields. However, people are increasingly concerned about such ubiquitous pollutants, which can frequently be detected in contaminated soil and water. In large part, the significant sources of chiral pharmaceuticals stem from industrial processes, such as the direct discharge of untreated or incompletely treated wastewaters containing chiral pharmaceuticals, incorrect storage and use, animal wastes and biosolids. The main ways for human exposure to chiral pharmaceuticals are the disease treatment process and chiral pharmaceuticals contaminants. According to the results of a series of toxic studies, some diseases, even cancers, may be associated with exposure to certain chiral pharmaceuticals. Therefore, the treatment of chiral pharmaceuticals has become an important issue. The current advanced remediation techniques for chiral pharmaceuticals include the conventional method (sorption and sonolysis), biotransformation (an aerobic granular sludge-sequencing batch reactor and constructed wetland system) and advanced oxidation processes (ozonation and photocatalysis). Herein, in this review, we summarize the current status and sources of chiral pharmaceuticals, potential effects on human health, as well as the superiority, disadvantages and prospects of current advanced remediation technologies. Moreover, we also anticipate the prospect of the future research needed for chiral pharmaceuticals pollutant remediation.
Mortality burden attributable to PM1 in Zhejiang province, China Environ. Int. (IF 7.297) Pub Date : 2018-10-03 Kejia Hu, Yuming Guo, Deyun Hu, Rongguang Du, Xuchao Yang, Jieming Zhong, Fangrong Fei, Feng Chen, Gongbo Chen, Qi Zhao, Jun Yang, Yunquan Zhang, Qian Chen, Tingting Ye, Shanshan Li, Jiaguo Qi
BackgroundLimited evidence is available on the health effects of particulate matter with an aerodynamic diameter of <1 μm (PM1), mainly due to the lack of its ground measurement worldwide.ObjectivesTo identify and examine the mortality risks and mortality burdens associated with PM1, PM2.5, and PM10 in Zhejiang province, China.MethodsWe collected daily data regarding all-cause (stratified by age and gender), cardiovascular, stroke, respiratory, and chronic obstructive pulmonary disease (COPD) mortality, and PM1, PM2.5, and PM10, from 11 cities in Zhejiang province, China during 2013 and 2017. We used a quasi-Poisson regression model to estimate city-specific associations between mortality and PM concentrations. Then we used a random-effect meta-analysis to pool the provincial estimates. To show the mortality burdens of PM1, PM2.5, and PM10, we calculated the mortality fractions and deaths attributable to these PMs.ResultsDaily concentrations of PM1, PM2.5, and PM10 ranged between 0–199 μg/m3, 0–218 μg/m3, and 0–254 μg/m3, respectively; Mortality effects were significant in lag 0–2 days. The relative risks for all-cause mortality were 1.0064 (95% CI: 1.0034, 1.0094), 1.0061 (95% CI: 1.0034, 1.0089), and 1.0060 (95% CI: 1.0038, 1.0083) associated with a 10 μg/m3 increase in PM1, PM2.5, and PM10, respectively. Age- and gender-stratified analysis shows that elderly people (aged 65+) and females are more sensitive to PMs. The mortality fractions of all-cause mortality were estimated to be 2.39% (95% CI: 1.28, 3.48) attributable to PM1, 2.53% (95% CI: 1.42, 3.63) attributable to PM2.5, and 3.08% (95% CI: 1.95, 4.19) attributable to PM10. The ratios of attributable cause-specific deaths for PM1/PM2.5, PM1/PM10, and PM2.5/PM10 were higher than the ratios of their respective concentrations.ConclusionsPM1, PM2.5 and PM10 are risk factors of all-cause, cardiovascular, stroke, respiratory, and COPD mortality. PM1 accounts for the vast majority of short-term PM2.5- and PM10-induced mortality. Our analyses support the notion that smaller size fractions of PM have a more toxic mortality impacts, which suggests to develop strategies to prevent and control PM1 in China, such as to foster strict regulations for automobile and industrial emissions.
Predictors of urinary antibiotics in children of Shanghai and health risk assessment Environ. Int. (IF 7.297) Pub Date : 2018-10-03 Hexing Wang, Chuanxi Tang, Jiaqi Yang, Na Wang, Feng Jiang, Qinghua Xia, Gengsheng He, Yue Chen, Qingwu Jiang
BackgroundAn extensive exposure to antibiotics has been confirmed in children, but the predictors and potential health risk remain unclear.ObjectiveTo investigate the predictors of antibiotics in urine and potential health risk in children of Shanghai.MethodsWe selected 284 school children aged 8–11 years from a central area of Shanghai, China, in 2017. Ultra-performance liquid chromatography coupled with high-resolution mass spectrometry was used to measure 20 antibiotics, including four human antibiotics (HAs), six veterinary antibiotics (VAs), 10 human/veterinary antibiotics (H/VAs), and three metabolites in first morning urine. Logistic regression model was used to examine the associations of 17 variables related to demographic and socioeconomic factors, recent antibiotic use, drinking water intake, food consumption, and anthropometric measurements with the detection frequency of HAs, VAs, or H/VAs in urine. After daily intake was estimated, health risk was assessed for VAs and H/VAs by using hazard quotient (HQ) and hazard index (HI) based on microbiological or toxicological effects.ResultsThe detection frequencies of 20 antibiotics and three metabolites ranged from 0 to 27.8% with an overall detection frequency being 56.0%. The detection frequency of HAs increased with age and screen time at weekend. Sex, age, family income and screen time were positively associated with the detection frequencies of VAs and H/VAs. Children reporting antibiotic use in the past three months had a higher detection frequency of HAs. Children with a higher consumption frequency of dairy products had a higher detection frequency of VAs + H/VAs, but a lower detection frequency of HAs. An increased overall detection frequency of all antibiotics was seen in children with higher consumption frequencies of aquatic products, livestock and poultry meat, or milk and dairy products. HQ >1 was only found for ciprofloxacin (5.6%) and ofloxacin (0.4%) based on microbiological effect. HI >1 was found in 6.0% of children for microbiological effect and none was found for toxicological effect.ConclusionsPredictors for antibiotics in urine for children included sex, age, family income, screen time, clinical use, and animal-derived food consumption. There was potential health risk for children with exposure to antibiotics.
Associations between prenatal maternal urinary concentrations of personal care product chemical biomarkers and childhood respiratory and allergic outcomes in the CHAMACOS study Environ. Int. (IF 7.297) Pub Date : 2018-10-04 Kimberly Berger, Brenda Eskenazi, John Balmes, Nina Holland, Antonia M. Calafat, Kim G. Harley
BackgroundPersonal care product chemicals may be contributing to risk for asthma and other atopic illnesses. The existing literature is conflicting, and many studies do not control for multiple chemical exposures.MethodsWe quantified concentrations of three phthalate metabolites, three parabens, and four other phenols in urine collected twice during pregnancy from 392 women. We measured T helper 1 (Th1) and T helper 2 (Th2) cells in their children's blood at ages two, five, and seven, and assessed probable asthma, aeroallergies, eczema, and lung function at age seven. We conducted linear and logistic regressions, controlling for additional biomarkers measured in this population as selected by Bayesian Model Averaging.ResultsThe majority of comparisons showed null associations. Mono-n-butyl phthalate (MnBP) was associated with higher Th2% (RR: 10.40, 95% CI: 3.37, 17.92), and methyl paraben was associated with lower Th1% (RR: −3.35, 95% CI: −6.58, −0.02) and Th2% at borderline significance (RR: −4.45, 95% CI: −8.77, 0.08). Monoethyl phthalate was associated with lower forced expiratory flow from 25 to 75% of forced vital capacity (FEF25–75%) (RR: −3.22 L/s, 95% CI: −6.02, −0.34). Propyl paraben (OR: 0.86, 95% CI: 0.74, 0.99) was associated with decreased odds of probable asthma.ConclusionsWhile some biomarkers, particularly those from low molecular weight phthalates, were associated with an atopic cytokine profile and poorer lung function, no biomarkers were associated with a corresponding increase in atopic disease.
Indoor air pollution and exposure assessment of the gulf cooperation council countries: A critical review Environ. Int. (IF 7.297) Pub Date : 2018-10-01 Patrick Amoatey, Hamid Omidvarborna, Mahad Said Baawain, Abdullah Al-Mamun
Indoor air pollution is one of the human health threat problems in the Gulf Cooperation Council (GCC) countries. In these countries, due to unfavorable meteorological conditions, such as elevated ambient temperature, high relative humidity, and natural events such as dust storms, people spend a substantial amount of their time in indoor environments. In addition, production of physical and biological aerosols from air conditioners, cooking activities, burning of Arabian incense, and overcrowding due to pilgrimage programs are common causes of low quality indoor air in this region. Thus, due to infiltration of outdoor sources as well as various indoor sources, people living in the GCC countries are highly exposed to indoor air pollutants. Inhalation of indoor air pollutants causes mortalities and morbidities attributed to cardiorespiratory, pulmonary, and lung cancer diseases. Hence, the aim of this review study is to provide a summary of the major findings of indoor air pollution studies in different microenvironments in six GCC countries. These include characterization of detected indoor air pollutants, exposure concentration levels, source identifications, sustainable building designs and ventilation systems, and the mitigation strategies. To do so, >130 relevant indoor air pollution studies across the GCC countries were critically reviewed. Particulate matters (PM10 and PM2.5), total volatile organic compounds (TVOCs), carbon dioxide (CO2), sulfur dioxide (SO2), nitrogen dioxide (NO2), and heavy metals were identified as the reported indoor air pollutants. Apart from them, indoor Radon and bioaerosols were studied only in specific GCC countries. Thus, future studies should also focus on the investigation of emerging indoor air pollutants, such as ultrafine and nanoparticles and their associated health effects. Furthermore, studies on the mitigation of indoor air pollution through the development of advanced air purification and ventilation systems could improve the indoor air quality (IAQ) in the GCC region.
Environmental styrene exposure and neurologic symptoms in U.S. Gulf coast residents Environ. Int. (IF 7.297) Pub Date : 2018-10-01 Emily J. Werder, Lawrence S. Engel, David B. Richardson, Michael E. Emch, Fredric E. Gerr, Richard K. Kwok, Dale P. Sandler
BackgroundStyrene is an established neurotoxicant at occupational levels, but effects at levels relevant to the general population have not been studied. We examined the neurologic effects of environmental styrene exposure among U.S. Gulf coast residents.MethodsWe used National Air Toxics Assessment (NATA) 2011 estimates of ambient styrene concentrations to assign exposure levels for 21,962 non-diabetic Gulf state residents, and additionally measured blood styrene concentration in a subset of participants (n = 874). Neurologic symptoms, as well as detailed covariate information, were ascertained via telephone interview. We used log-binomial regression to estimate prevalence ratios (PR) and 95% confidence intervals (95% CI) for cross-sectional associations between both ambient and blood styrene levels and self-reported neurologic symptoms. We estimated associations independently for ten unique symptoms, as well as for the presence of any neurologic, central nervous system (CNS), or peripheral nervous system (PNS) symptoms. We also examined heterogeneity of associations with estimated ambient styrene levels by race and sex.ResultsOne-third of participants reported at least one neurologic symptom. The highest quartile of estimated ambient styrene was associated with one or more neurologic (PR, 1.12; 95% CI: 1.07,1.18), CNS (PR, 1.17; 95% CI: 1.11,1.25), and PNS (PR, 1.16; 95% CI: 1.09,1.25) symptom. Results were less consistent for biomarker analyses, but blood styrene level was suggestively associated with nausea (PR, 1.78; 95% CI: 1.04, 3.03). In stratified analyses, we observed the strongest effects among non-White participants.ConclusionsIncreasing estimated ambient styrene concentration was consistently associated with increased prevalence of neurologic symptoms. Associations between blood styrene levels and some neurologic symptoms were suggestive. Environmental styrene exposure levels may be sufficient to elicit symptomatic neurotoxic effects.
A meta-analysis of blood lead levels in India and the attributable burden of disease Environ. Int. (IF 7.297) Pub Date : 2018-09-29 Bret Ericson, Russell Dowling, Subhojit Dey, Jack Caravanos, Navya Mishra, Samantha Fisher, Myla Ramirez, Promila Sharma, Andrew McCartor, Pradeep Guin, Mark Patrick Taylor, Richard Fuller
Multiple studies in India have found elevated blood lead levels (BLLs) in target populations. However the data have not yet been evaluated to understand population-wide exposure levels. We used arithmetic mean blood lead data published from 2010 to 2018 on Indian populations to calculate the average BLLs for multiple subgroups. We then calculated the attributable disease burden in IQ decrement and Disability Adjusted Life Years (DALYs). Our Pubmed search yielded 1066 articles. Of these, 31 studies representing the BLLs of 5472 people in 9 states met our study criteria. Evaluating these, we found a mean BLL of 6.86 μg/dL (95% CI: 4.38–9.35) in children and 7.52 μg/dL (95% CI: 5.28–9.76) in non-occupationally exposed adults. We calculated that these exposures resulted in 4.9 million DALYs (95% CI: 3.9–5.6) in the states we evaluated. Population-wide BLLs in India remain elevated despite regulatory action to eliminate leaded petrol, the most significant historical source. The estimated attributable disease burden is larger than previously calculated, particularly with regard to associated intellectual disability outcomes in children. Larger population-wide BLL studies are required to inform future calculations. Policy responses need to be developed to mitigate the worst exposures.
Associations between repeated measures of maternal urinary phthalate metabolites during pregnancy and cord blood glucocorticoids Environ. Int. (IF 7.297) Pub Date : 2018-09-29 Xiaojie Sun, Jiufeng Li, Shuna Jin, Yuanyuan Li, Wenyu Liu, Hongzhi Zhao, Yanqiu Zhou, Yangqian Jiang, Hongxiu Liu, Wei Xia, Zongwei Cai, Shunqing Xu, Xiantao Shen
BackgroundPrevious studies have suggested that phthalates might disrupt fetal steroidogenesis. However, the evidence of the effects of prenatal phthalate exposure across pregnancy on fetal glucocorticoids was insufficient.ObjectiveWe investigated the associations between urinary phthalate metabolites across pregnancy and cord blood glucocorticoids in a prospective birth cohort.MethodsOur study included 553 mother-infant pairs from a prospective birth cohort conducted in Wuhan, China. Maternal urine samples were collected at 14, 24 and 36 weeks of gestation (mean). Urinary phthalate metabolites and cord blood glucocorticoids (cortisol and cortisone) were measured. Generalized estimating equation models were conducted to explore the relationships of phthalate metabolite concentrations at each trimester and glucocorticoid levels.ResultsAmong the participants, mono‑benzyl phthalate (MBzP) in the first trimester was associated with higher cortisol/cortisone ratio concentrations, and mono‑(2‑ethyl‑5‑carboxypentyl) phthalate (MECPP) and mono‑(2‑ethyl‑5‑oxohexyl) phthalate (MEOHP) measured in the third trimester were associated with decreased cortisone. Moreover, the associations between phthalates and glucocorticoids varied by sex. Among the female infants, each 10-fold increase in several maternal urinary phthalate metabolite concentrations in 1st and 3rd trimester was associated with the increased glucocorticoid levels with percent changes ranged from 16.2%–55.9%. However, among male infants, each 10-fold increase in maternal urinary MECPP, mono‑(2‑ethyl‑5‑hydroxyhexyl) phthalate (MEHHP) and MEOHP in 3rd trimester was associated with 20.8%–36.3% decreased cortisol and cortisone levels, respectively.ConclusionWe have shown that prenatal phthalate exposure during early and late trimester disrupted the infant steroidogenesis and these associations might be modified by infant sex. To the best of our knowledge, this is the first study to evaluate phthalate exposure at three trimesters during pregnancy in relation to infant glucocorticoids.
Greenspace seems protective of both high and low blood pressure among residents of an Alpine valley Environ. Int. (IF 7.297) Pub Date : 2018-09-28 Angel M. Dzhambov, Iana Markevych, Peter Lercher
BackgroundThere is some data suggesting that residential greenspace may protect against high blood pressure in urbanized areas, but there is no evidence of effects on hypotension, in less urbanized areas, and in idiosyncratic geographic contexts such as mountain valleys.ObjectivesThe current study aimed to investigate the associations between residential greenspace and blood pressure in an alpine valley in Austria.MethodsWe conducted a cross-sectional survey of a representative sample of 555 adults living in the Lower Inn Valley, Austria. Several definitions of blood pressure were employed: continuously-measured systolic (SBP) and diastolic blood pressure (DBP), doctor-diagnosed hyper- and hypotension, and high- and low blood pressure medication use. Greenspace metrics considered were: Normalized Difference Vegetation Index (NDVI), Soil Adjusted Vegetation Index (SAVI), and tree cover as measures of surrounding greenness in circular buffers of 100 m, 300 m, 500 m, and 1000 m around the home; distance to different types of structured green space; and having a domestic garden and a balcony. Relationships were examined across different definitions of blood pressure and greenspace and evaluated for potential effect modification by demographic factors, presence of a domestic garden/balcony, adiposity, and traffic sensitivity.ResultsHigher overall greenness was associated with 30–40% lower odds of hyper/hypotension and 2–3 mm Hg lower SBP. Similar pattern was revealed for tree cover, however, associations with hypertension were less consistent across buffers, and SBP and DBP were lower only in association with greenness in the 100-m buffer. Having a domestic garden also seemed protective of high DBP. Residing near to forests, agricultural land, or urban green spaces was not related to blood pressure. Higher NDVI500-m was stronger associated with lower SBP in those having a domestic garden, while the effect on DBP was stronger in overweight/obese participants.ConclusionThese findings support the idea that greenspace should be considered as protective of both high and low blood pressure, however, underlying mechanisms remain insufficiently understood.
The impact of social capital, land use, air pollution and noise on individual morbidity in Dutch neighbourhoods Environ. Int. (IF 7.297) Pub Date : 2018-09-28 Jan-Paul Zock, Robert Verheij, Marco Helbich, Beate Volker, Peter Spreeuwenberg, Maciek Strak, Nicole A.H. Janssen, Martin Dijst, Peter Groenewegen
BackgroundBoth social and physical neighbourhood factors may affect residents' health, but few studies have considered the combination of several exposures in relation to individual health status.AimTo assess a range of different potentially relevant physical and social environmental characteristics in a sample of small neighbourhoods in the Netherlands, to study their mutual correlations and to explore associations with morbidity of residents using routinely collected general practitioners' (GPs') data.MethodsFor 135 neighbourhoods in 43 Dutch municipalities, we could assess area-level social cohesion and collective efficacy using external questionnaire data, urbanisation, amount of greenspace and water areas, land use diversity, air pollution (particulate matter (PM) with a diameter <10 μm (PM10), PM <2.5 μm (PM2.5) and nitrogen dioxide (NO2), and noise (from road traffic and from railways). Health data of the year 2013 from GPs were available for 4450 residents living in these 135 neighbourhoods, that were representative for the entire country. Morbidity of 10 relevant physical or mental health groupings was considered. Individual-level socio-economic information was obtained from Statistics Netherlands. Associations between neighbourhood exposures and individual morbidity were quantified using multilevel mixed effects logistic regression analyses, adjusted for sex, age (continuous), household income and socio-economic status (individual level) and municipality and neighbourhood (group level).ResultsMost physical exposures were strongly correlated with degree of urbanisation. Social cohesion and collective efficacy tended to be higher in less urbanised municipalities. Degree of urbanisation was associated with higher morbidity of all disease groupings. A higher social cohesion at the municipal level coincided with a lower prevalence of depression, migraine/severe headache and Medically Unexplained Physical Symptoms (MUPS). An increase in both natural and agricultural greenspace in the neighbourhood was weakly associated with less morbidity for all conditions. A high land use diversity was consistently associated with lower morbidities, in particular among non-occupationally active individuals.ConclusionA high diversity in land use of neighbourhoods may be beneficial for physical and mental health of the inhabitants. If confirmed, this may be incorporated into urban planning, in particular regarding the diversity of greenspace.
Colorectal cancer, sun exposure and dietary vitamin D and calcium intake in the MCC-Spain study Environ. Int. (IF 7.297) Pub Date : 2018-09-25 Xavier Vallès, M. Henar Alonso, Juan Francisco López-Caleya, Virginia Díez-Obrero, Trinidad Dierssen-Sotos, Virginia Lope, Ana Molina-Barceló, María Dolores Chirlaque, José Juan Jiménez-Moleón, Guillermo Fernández Tardón, Jesús Castilla, Pilar Amiano, Rocío Capelo, Gemma Castaño-Vinyals, Elisabet Guinó, Antonio José Molina de la Torre, Conchi Moreno-Iribas, Beatriz Pérez Gómez, Victor Moreno
ObjectivesTo explore the association of colorectal cancer with environmental solar radiation and sun exposure behavior, considering phenotypic variables (eye color, hair color and skin phenotype), dietary intake of vitamin D and calcium, and socio-demographic factors.Study designMulticenter population-based frequency matched case-control study in Spain (MCC-Spain), with 2140 CRC cases and 3950 controls.MethodsData were obtained through personal interviews using a structured epidemiological questionnaire that included socio-demographic data, residential history, environmental exposures, behavior, phenotypic and dietary information. An environmental-lifetime sun exposure score was constructed combining residential history and average daily solar radiation, direct and diffuse. Logistic regression was used to explore the association between different variables. A structural equation model was used to verify the associations of the conceptual model.ResultsWe found a lower risk of CRC in subjects frequently exposed to sunlight during the previous summer and skin burning due to sun exposure. No association was observed in relation to the residential solar radiation scores. Subjects with light eye or light hair colors had a lower risk of CRC that those with darker colors. Dietary calcium and vitamin D were also protective factors, but not in the multivariate model. The structural equation model analysis suggested that higher sun exposure was associated with a decreased risk of CRC, as well as dietary intake of calcium and vitamin D, and these factors are correlated among themselves and with environmental solar radiation and skin phenotypes.ConclusionThe results agree with previous observations that sun exposure, dietary vitamin D and calcium intake, and serum 25(OH)D concentration reduce the risk of CRC and indicate that these factors may be relevant for cancer prevention.
Associations of residential exposure to agricultural pesticides with asthma prevalence in adolescence: The PIAMA birth cohort Environ. Int. (IF 7.297) Pub Date : 2018-09-25 Joseph S. Bukalasa, Bert Brunekreef, Maartje Brouwer, Gerard H. Koppelman, Alet H. Wijga, Anke Huss, Ulrike Gehring
Risks and burden of lung cancer incidence for residential petrochemical industrial complexes: A meta-analysis and application Environ. Int. (IF 7.297) Pub Date : 2018-09-24 Cheng-Kuan Lin, Yu-Tien Hsu, David C. Christiani, Huei-Yang Hung, Ro-Ting Lin
Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases: A prospective cohort study in Australia Environ. Int. (IF 7.297) Pub Date : 2018-09-25 Farhad Salimi, Geoffrey Morgan, Margaret Rolfe, Evangelia Samoli, Christine T. Cowie, Ivan Hanigan, Luke Knibbs, Martin Cope, Fay H. Johnston, Yuming Guo, Guy B. Marks, Jane Heyworth, Bin Jalaludin
BackgroundShort- and long-term spatiotemporal variation in exposure to air pollution is associated with respiratory morbidity in areas with moderate-to-high level of air pollution, but very few studies have examined whether these associations also exist in areas with low level exposure.ObjectivesWe assessed the association between spatial variation in long-term exposure to PM2.5 and NO2 and hospitalisation for all respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), and pneumonia, in older adults residing in Sydney, Australia, a city with low-level concentrations.MethodsWe recorded data on hospitalisations for 100,084 participants, who were aged >45 years at entry in 2006–2009 until June 2014. Annual NO2 and PM2.5 concentrations were estimated for the participants' residential addresses and Cox proportional hazards regression was used to model the association between exposure to air pollutants and first episode of hospitalisation, controlling for personal and area level covariates. We further investigated the shape of the exposure-response association and potential effect modification by age, sex, education level, smoking status, and BMI.ResultsNO2 and PM2.5 annual mean exposure estimates were 17.5 μg·m−3 and 4.5 μg·m−3 respectively. NO2 and PM2.5 was positively, although not significantly, associated with asthma. The adjusted hazard ratio for a 1 μg·m−3 increase in PM2.5 was 1.08, 95% confidence interval 0.89–1.30. The adjusted hazard ratio for a 5 μg·m−3 increase in NO2 was 1.03, 95% confidence interval 0.88–1.19. We found no positive statistically significant associations with hospitalisation for all respiratory diseases, and pneumonia while negative associations were observed with COPD.ConclusionsWe found weak positive associations of exposure to air pollution with hospitalisation for asthma while there was no evidence of an association for all respiratory diseases.
Prenatal exposure to arsenic and neurobehavioral development of newborns in China Environ. Int. (IF 7.297) Pub Date : 2018-09-25 Bin Wang, Jing Liu, Bin Liu, Xiaoyan Liu, Xiaodan Yu
The link between arsenic exposure and deficits in children's neurodevelopment has been suggested, but it remains unclear regarding the arsenic-related effects on the developing brain in early life. To investigate the associations of in utero arsenic exposure with neonatal neurobehavioral development, we conducted a cross-sectional study of 892 mother-infant pairs from 10 hospitals of different levels in Shanghai, China. The concentrations of arsenic were determined in cord blood samples. Neurobehavioral measures were administered at 3 days postpartum in full-term newborns using the neonatal behavioral neurological assessment (NBNA). Logistic regression models were used to estimate odds ratios for dichotomous NBNA outcomes. After adjusting for potential confounders, a natural log unit (ln-unit) increase in cord blood arsenic was associated with 90% increased odds of low NBNA score (95% confidence interval [CI]: 1.62, 2.23). As for clusters, each ln-unit arsenic increase was associated with 47% increased odds of low score for behavior (95% CI: 1.31, 1.66) and 36% increased odds of low score for passive muscle tone (95% CI: 1.23, 1.51). Odds ratios comparing extreme tertiles were 8.62 (95% CI: 4.19, 17.8) for total scale, 3.69 (95% CI: 2.35, 5.82) for behavior, and 3.32 (95% CI: 2.21, 4.97) for passive tone (all p-trend < 0.001). Stratified analyses showed that these associations were strengthened in newborns of mothers over 29 years of age. Our results provide evidence for an inverse association between low-level prenatal arsenic exposure and neurobehavioral performance of newborns, particularly among those born to older mothers. Further studies are warranted to confirm these findings and to determine whether such decrements in early neurodevelopment persist in later childhood.
Exposure to chromium during pregnancy and longitudinally assessed fetal growth: Findings from a prospective cohort Environ. Int. (IF 7.297) Pub Date : 2018-09-20 Yang Peng, Jie Hu, Yuanyuan Li, Bin Zhang, Wenyu Liu, Han Li, Hongling Zhang, Chen Hu, Xiaomei Chen, Wei Xia, Shi Lu, Shunqing Xu
BackgroundPrenatal exposure to chromium may be associated with reduced birth weight; however, critical windows of such exposure for fetal growth are unclear.ObjectiveOur study was aimed to assess trimester-specific associations of chromium exposure with fetal growth parameters measured repeatedly by ultrasound and birth size, and to see whether these associations were modified by fetal sex.MethodsWe conducted a prospective cohort of 3041 women in Wuhan, China, from 2013 to 2016. Chromium concentrations were measured in maternal urine samples collected in the 1st, 2nd, and 3rd trimesters using an inductively coupled plasma mass spectrometry. We calculated standard deviation scores for ultrasound measured head circumference, abdominal circumference (AC), femur length, and estimated fetal weight (EFW) at 16, 24, and 31 weeks of gestation. Linear regressions with generalized estimating equations were used to estimate the associations of specific gravity-adjusted urinary chromium concentrations in each trimester with fetal growth parameters and birth weight, birth length, and ponderal index.ResultsInverse associations of chromium exposure in the 1st trimester with fetal growth parameters at 31 weeks of gestation were observed, resulting in significant reductions in AC of −5.4% (95% confidence interval [CI]: −9.6%, −1.2%) and EFW of −5.6% (95% CI: −9.8%, −1.4%) per unit increase in natural logarithm transformed urinary chromium concentration. Urinary chromium concentration in the 2nd trimester was also associated with reductions in AC of −7.0% (95% CI: −12.5%, −1.4%) and in EFW of −5.0% (95% CI: −10.6%, 0.6%) at 31 weeks, and these inverse associations were evident in boys (reduction in AC of −13.9% [95% CI: −21.1%, −6.7%]; EFW of −9.5% [95% CI: −16.9%, −2.0%]) but not in girls (increase in AC of 2.9% [95% CI: −5.7%, 11.5%]; EFW of 1.5% [95% CI: −6.8%, 9.8%]) (both pineraction < 0.05). Moreover, one-unit increase in urinary chromium concentrations in the 1st and 2nd trimesters were both associated with significant reductions in ponderal index of −0.11 kg/m3 (95% CI: −0.19, −0.03 kg/m3) and −0.15 kg/m3 (95% CI: −0.27, −0.03 kg/m3), respectively.ConclusionOur findings suggest that chromium may be a toxic metal for fetal growth. Early and mid-pregnancy seem to be the most vulnerable period for fetal exposure to chromium, but these results need further confirmation.
Urinary excretion of phenols, parabens and benzophenones in young men: Associations to reproductive hormones and semen quality are modified by mutations in the Filaggrin gene Environ. Int. (IF 7.297) Pub Date : 2018-09-20 Ulla Nordström Joensen, Niels Jørgensen, Jacob P. Thyssen, Pal Bela Szecsi, Steen Stender, Jørgen Holm Petersen, Anna-Maria Andersson, Hanne Frederiksen
BackgroundThe filaggrin gene (FLG) encodes an epidermal protein, filaggrin, which is important for normal skin barrier functions. We previously showed that FLG loss-of-function mutation carriers have a higher internal exposure to some non-persistent chemicals such as certain phthalates and parabens, suggesting increased trans-epidermal penetration. Several groups of non-persistent chemicals are suspected endocrine disrupters with potential to affect testicular function.ObjectivesTo investigate associations between exposure to non-persistent chemicals and testicular function in young Danish men with and without FLG mutations.MethodsWe measured urinary concentrations of bisphenol A (BPA) and other simple phenols, parabens, and UV filters including benzophenones (BP-1, BP-3 and 4-HBP) in men genotyped for FLG R501X, 2282del4, and R2447X loss-of-function mutations; in total 65 mutation carriers and 130 non-carriers (controls) were included. Outcomes were markers of testicular function, assessed by serum reproductive hormones and semen quality.ResultsWe found that associations between urinary chemical concentrations and outcomes were different in cases and controls. Within the group of FLG mutation carriers, higher urinary concentrations of BPA, BP-1 and BP-3 were associated with higher testosterone and estradiol serum levels and lower FSH. Similar trends in hormone levels were observed for FLG mutation carriers with measurable levels of 4-HBP compared to those who had no detectable levels of urinary 4-HBP. Furthermore, those in the highest urinary BPA quartile had lower sperm motility than those in the lower quartiles. None of these associations were evident in the control group. In the control group, however, lower sperm motility and sperm concentration were observed in the men with detectable urinary 4-HBP compared to the men non-detectable urinary 4-HBP. We found no association between any parabens and outcomes, nor for the other measured phenols or UV filters.ConclusionsAssociations between male reproductive health parameters and urinary levels of BPA and benzophenones such as BP-3, BP-1 and 4-HBP were observed in FLG mutation carriers but not in controls from the same study population. This difference between FLG mutation carriers and non-carriers is not explained solely by differences in exposure levels of the examined compounds as e.g. BPA and 4-HBP urinary levels did not differ between the two groups. We hypothesise that effects of exposure to these compounds may be modulated in FLG mutation carriers by either different levels of co-exposures or by route of uptake, with a higher fraction of the uptake by dermal uptake.
Ambient air pollution exposure and risk of migraine: Synergistic effect with high temperature Environ. Int. (IF 7.297) Pub Date : 2018-09-20 Hyewon Lee, Woojae Myung, Hae-Kwan Cheong, Seung-Muk Yi, Yun-Chul Hong, Sung-Il Cho, Ho Kim
BackgroundMigraine is a chronic and agonizing neurological disorder prevalent worldwide. Although its pathogenesis remains unclear, limited evidence exists on the role of air pollution.ObjectiveWe aimed to assess the association of short-term air pollution exposure with migraine in conjunction with the synergistic effect of temperature.MethodsWe identified 18,921 patients who visited emergency departments (EDs) for migraine as a primary disease in Seoul from the national emergency database between 2008 and 2014. We conducted a time-stratified, case-crossover analysis to compare levels of particles <2.5 μm (PM2.5), particles <10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) on ED visit days and those on the control days matched to day of the week, month, and year. We evaluated the synergistic effects of air pollution and temperature using an interaction term.ResultsHigher air pollution levels were significantly associated with risk of migraine over various lag structures. In the best fitting lags, the odds ratio (OR) associated with an interquartile range increase of PM2.5, PM10, NO2, O3, and CO was 1.031 (95% CI: 1.010–1.053), 1.032 (95% CI: 1.007–1.057), 1.053 (95% CI: 1.022–1.085), 1.034 (95% CI: 1.001–1.067), and 1.029 (95% CI: 1.005–1.053), respectively. The SO2 effect was positive but not significant (OR 1.019 [95% CI: 0.991–1.047]). The PM effect was significantly stronger on high-temperature days (above the 75th percentile) than on low-temperature days (PM2.5, high: OR 1.068, low: OR 1.021, Pinteract = 0.03; PM10, high: OR 1.066, low: OR 1.014, Pinteract = 0.02).ConclusionOur study provides new evidence that air pollution exposure may trigger migraine especially on high-temperature days, and this finding may contribute in establishing preventive measures against migraine.
PM2.5-related health and economic loss assessment for 338 Chinese cities Environ. Int. (IF 7.297) Pub Date : 2018-09-21 Kamal Jyoti Maji, Wei-Feng Ye, Mohit Arora, S.M. Shiva Nagendra
The role of oxidative stress in cardiometabolic risk related to phthalate exposure in elderly diabetic patients from Shanghai Environ. Int. (IF 7.297) Pub Date : 2018-09-20 RuiHua Dong, JingSi Chen, JianHeng Zheng, MeiRu Zhang, Han Zhang, Min Wu, ShuGuang Li, Bo Chen
The effect of human exposure to phthalates and consequent contribution to the development of cardiometabolic health problems is unknown. However, oxidative stress has been established as playing an important role in the pathogenesis of cardiometabolic outcomes. In this study, we aimed to explore whether exposure to phthalate metabolites could induce cardiometabolic risk by increasing oxidative stress in a diabetic population from Shanghai. We collected paired blood and urine samples from a total of 300 volunteers, and measured 10 phthalate metabolites in urine and biomarkers of oxidative stress from serum including glucose and lipid levels, and liver and kidney damage. The insulin resistance (IR) risk was assessed by the surrogate indices including homeostasis model assessment-insulin resistance (HOMA-IR) and triglyceride glucose (TyG). We used multivariable linear regression to assess the association between phthalates and these physiological parameters. Mediation and modification analyses were performed to identify the role that oxidative stress played in the underlying mechanisms. The results showed that most of the determined phthalate metabolites were positively associated with HOMA-IR, 8‑hydroxy‑2′‑deoxyguanosine (8-OHDG), and malondialdehyde (MDA). In the mediation analysis, only γ‑glutamiltransferase (GGT) was found to be a significant mediator of the association between phthalates and TyG. In the modification analysis, exposure to phthalates strengthened the association between oxidative stress (MDA and 8-OHDG) and HOMA-IR. Our findings demonstrate that exposure to phthalates might be positively associated with elevated IR and oxidative stress. The direct participation (mediation effect) of GGT might play an important mechanism in promoting IR.
Urinary cadmium concentrations and metabolic syndrome in U.S. adults: The National Health and Nutrition Examination Survey 2001–2014 Environ. Int. (IF 7.297) Pub Date : 2018-09-20 Nudrat Noor, Geng Zong, Ellen W. Seely, Marc Weisskopf, Tamarra James-Todd
BackgroundLow to moderate acute cadmium exposure has been associated with increased risk of chronic diseases, such as cardiovascular and kidney disease. Little is known about the association between urinary cadmium levels—an indicator of longer-term exposure—and metabolic syndrome (MetS).MethodsWe analysed data from 3982 participants aged 20–<80 years of the National Health and Nutrition Examination Survey 2001–2014. Urinary cadmium levels were measured and adjusted for creatinine using spot urine samples. Cadmium levels were evaluated in quintiles (Q). MetS was defined by National Cholesterol Education Program's Adult Treatment Panel III report criteria. Prevalence odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression accounting for complex survey design, while adjusting for potential confounders and stratifying by sex and smoking status.ResultsIn the overall study population, there was a marginal inverse association between urinary cadmium and MetS (adj. OR for Q5 versus Q1: 0.7; 95% CI: 0.5–1.0). Sex stratified models were similar. When examining individual components of MetS, participants with higher levels of urinary cadmium had decreased odds of abdominal obesity (adj. OR for Q5 versus Q1 0.4; 95% CI: 0.3–0.6), but increased odds for low HDL (adj. OR for Q5 versus Q1 2.1; 95% CI: 1.4–3.1). Among current smokers, higher urinary cadmium was associated with increased odds of MetS, hypertension, and low HDL even after accounting for serum cotinine—a marker of smoking intensity.ConclusionsHigher levels of urinary cadmium, a marker of long term exposure, were not associated with an increased risk of MetS in the overall study population. However, higher urine cadmium was associated with altered MetS components. Current smokers were the most vulnerable group, with higher long-term cadmium exposure being associated with increased risk of MetS, low HDL, and hypertension.
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