Ambient particulate matter and surrounding greenness in relation to sleep quality among pregnant women: A nationwide cohort study.

Background: Particulate air pollution and residential greenness are associated with sleep quality in the general population; however, their influence on maternal sleep quality during pregnancy has not been assessed. Objective: This cross-sectional study investigated the individual and interactive effects of exposure to particulate matter (PM) air pollution and residential greenness on sleep quality in pregnant women. Methods: Pregnant women (n = 4933) enrolled in the Korean Children's Environmental Health Study with sleep quality information and residential address were included. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The average concentrations of PM (PM2.5 and PM10) during pregnancy were estimated through land use regression, and residential greenness in a 1000 m buffer area around participants' residences was estimated using the Normalized Difference Vegetation Index (NDVI1000-m). Modified Poisson regression models were used to estimate the associations between PM and NDVI and poor sleep quality (PSQI >5) after controlling for a range of covariates. A four-way mediation analysis was conducted to examine the mediating effects of PM. Results: After adjusting for confounders, each 10 µg/m3 increase in PM2.5 and PM10 exposure was associated with a higher risk of poor sleep quality (relative risk [RR]: 1.06; 95% confidence interval [CI]: 1.01, 1.11; and RR: 1.09; 95% CI: 1.06, 1.13, respectively), and each 0.1-unit increase in NDVI1000-m was associated with a lower risk of poor sleep quality (RR: 0.97; 95% CI: 0.95, 0.99). Mediation analysis showed that PM mediated approximately 37%-56% of the association between residential greenness and poor sleep quality. Conclusions: This study identified a positive association between residential greenness and sleep quality. Furthermore, these associations are mediated by a reduction in exposure to particulate air pollution and highlight the link between green areas, air pollution control, and human health.

Low-Level Environmental Mercury Exposure and Thyroid Cancer Risk Among Residents Living Near National Industrial Complexes in South Korea: A Population-Based Cohort Study.

Background: Previous studies suggested that mercury may be linked to thyroid cancer due to its bioaccumulation in the thyroid gland, but no studies have evaluated the association between mercury exposure and thyroid cancer risk. We examined the relationship between mercury exposure and thyroid cancer risk, with the potential modification of hematological parameters. Methods: We performed a secondary analysis of a prospective cohort study among residents living near industrial complexes in South Korea (recruited from 2003 to 2011). Incident thyroid cancer cases (C73, ICD-10 code) were identified from the National Cancer Registry and Statistics Korea. Urinary mercury concentrations were measured using thermal decomposition amalgamation atomic absorption spectrometry (TDA-AAS). Cox proportional hazards regression models (adjusted for age, sex, educational level, smoking status, and employment) were used to estimate the hazard ratio (HR) and confidence interval [CI] between mercury exposure and the incidence of thyroid cancer. Results: We documented 69 cases of thyroid cancer in a total of 5213 participants during follow-up (median 8.7 years). The geometric mean of urinary mercury concentration was 1.8 µg/L for thyroid cancer cases and 1.2 µg/L for noncases (p for difference = 0.001). After adjusting for potential confounders, those in the highest tertile of urinary mercury levels had a twofold higher risk of thyroid cancer (HR = 1.97 [CI 1.03 - 3.80] in the highest tertile vs. the lowest tertile, p for trend = 0.043). This association was stronger for those with lower mean corpuscular volume and mean corpuscular hemoglobin status. Conclusions: Urinary mercury concentration was positively associated with the risk of thyroid cancer among residents living near national industrial complexes, and this association was influenced by red blood cell indices status. These results provide some evidence suggesting the adverse effects of environmental metal pollution in the development of thyroid cancer.

Toluene concentrations in the blood and risk of thyroid cancer among residents living near national industrial complexes in South Korea: A population-based cohort study.

BACKGROUND: Toluene is classified as a possible carcinogen, but its role on thyroid cancer is not well established. Vehicle emissions are one of the largest contributed sources of toluene, but no studies evaluating the influence of living near a road on the association between toluene and the incidence of thyroid cancer have been reported. Therefore, we examined potential associations between blood toluene concentrations and incidence risk of thyroid cancer, and an effect modification of living near a road. METHODS: We conducted a prospective cohort study using data from South Korean "Monitoring Project for Exposure to Environmental Pollutants and Health Effects among Residents Living near Industrial Complexes" survey. Study participants living near national industrial complexes were recruited from January 2003 to 2011. Incidence and mortality cases of thyroid cancer (C73, ICD-10 code) were identified using the National Cancer Registry and Statistics Korea, respectively. Blood toluene concentrations were measured using gas chromatography mass spectrometry. We used Cox proportional hazards regression models to estimate the hazard ratios (HR) and the 95% confidence interval (CI) between blood toluene concentrations and thyroid cancer risk. RESULTS: During the follow-up (median 8.6 years), 33 cases of thyroid cancer were diagnosed. The geometric mean of the toluene concentration in the blood was 0.56 µg/L for cases and 0.29 µg/L for non-cases. After adjusting for potential confounders, a positive association between blood toluene concentrations and thyroid cancer was found (HR = 2.77, 95% CI = 1.00-7.65 in the highest tertile vs. the lowest tertile, p for trend = 0.044). This positive association was stronger in people living near a road (≤50 m). CONCLUSIONS: Blood toluene concentrations may be positively associated with the incidence risk of thyroid cancer. Moreover, this association may be stronger among people living near a road.

Environmental exposure to cadmium and risk of thyroid cancer from national industrial complex areas: A population-based cohort study.

BACKGROUND: Cadmium is known to act as a thyroid disruptor and carcinogen in humans. Recent evidence suggests that cadmium may play a role as a thyroid carcinogen due to its endocrine-disrupting activity, but this characterization remains unclear. OBJECTIVE: We investigated the association between urinary cadmium and primary thyroid cancer, and the modifying effect of diabetes on this association. METHODS: We included 5406 participants over 19 years old with measured urinary cadmium from samples collected at eight National Industrial Complex areas from 2003 to 2011. Among 5406 participants, 68 cases were diagnosed with thyroid cancer between enrollment and the end of follow-up (December 31, 2016). Incidence rate ratios for thyroid cancer were estimated using random-effects Cox proportional hazards models with follow-up time as the time scale. In addition, we conducted a stratified analysis by diabetes status. RESULTS: Compared with the lowest tertile, the middle and highest tertiles had higher risks of thyroid cancer, respectively (HRmiddle vs. lowest = 1.90, 95% CI = 0.93 to 3.91; HRhighest vs. lowest = 2.28, 95% CI = 1.09 to 4.78), with a significant dose-response relationship (P for trend = 0.03). There was no linear association between cadmium level and risk of thyroid cancer. Higher cadmium levels increased thyroid cancer risk in participants without diabetes (HRmiddle vs. lowest = 2.35, 95% CI = 1.05 to 5.24; HRhighest vs. lowest = 2.70, 95% CI = 1.18 to 6.19); although, an association between cadmium levels and thyroid cancer risk in participants with diabetes was not found. CONCLUSION: Low-level exposure to cadmium is associated with thyroid cancer risk. Our results provide the evidence to limit exposure to cadmium for cancer prevention in the general population. Further studies are needed to investigate the consequence of diabetes and antidiabetic drugs between cadmium and thyroid cancer.

Evaluation of the Exposure to Environmental Pollutants Emanating from National Industrial Complexes.

The industrial complexes built during the course of economic development in South Korea played a pivotal role in the country's rapid economic growth. However, this growth was accompanied by health problems due to the pollutants released from the industrial complexes inevitably located near residential areas, given the limited land area available in South Korea. This study was conducted to evaluate the exposure to each pollutant emanating from industrial complexes for residents living in nearby areas, and to determine the substances requiring priority attention in future surveys. Pollutants were comprehensively categorized according to their emission and exposure levels based on data previously collected from the study areas. The emission, ambient concentration, and biomarker concentration levels of major pollutants emitted from eight national industrial complexes (Ulsan, Pohang, Gwangyang, Yeosu, Chungju, Daesan, Sihwa, and Banwol) were determined and tabulated. Each of the values was compared with the national/local average values, reference values, or control area concentrations depending on availability. Substances with completed exposure pathways and with high values for emissions, ambient concentrations, and biomarker concentrations were considered the substances posing exposure risks to the residents living near the corresponding industrial complex. The substances requiring continuous monitoring or supplementary exposure investigation were also categorized and presented. Lead and benzene had higher values for emissions, ambient concentrations, and biomarker concentrations in the Ulsan Industrial Complex area; thus, they were most likely to pose exposure risks to residents living in the area's neighborhoods. In other areas, styrene, xylene, cadmium, nitrogen oxide, trichloroethylene, nickel, manganese, and chromium required continuous monitoring, and arsenic, nickel, manganese, and chromium required biomarker measurements. In conclusion, the substances identified and categorized in this study need to be given appropriate attention in future surveys on exposure risks and health effects related to industrial complexes.

Effects of ambient fine particles on pulmonary function in children with mild atopic dermatitis.

The effects of particulate pollutants on lung function in children with atopic dermatitis (AD) remain to be determined. The authors investigated the short-term effects of ambient particles on peak expiratory flow rate (PEFR) in 84 children with and without AD. Daily particulates less than 10, 2.5, and 1 µm (PM(10), PM(2.5), and PM(1)) and number concentrations of submicron particles were measured. The authors observed elevated levels of PM(10), PM(2.5), and PM(1), and accumulation-mode particles were associated with decreased PEFR in children with AD. The PEFR decrements were -2.89 L/min (95% confidence interval [CI], -4.93 to -0.89) for an interquartile-range increase of previous-day PM(10), -2.79 L/min (95% CI, -4.89 to -0.69) for PM(2.5), and -2.71 L/min (95% CI, -4.81 to -0.61) for PM(1). These results suggest that ambient fine particles may affect the pulmonary function in children with AD. The respiratory health of children with atopic skin disorders renders them more vulnerable to ambient particles than healthy subjects.

Exposure to ambient ultrafine particles and urinary 8-hydroxyl-2-deoxyguanosine in children with and without eczema.

Ambient fine and ultrafine particles (UFPs) in urban air are known to contribute to inflammatory and allergic disease. It has been suggested that oxidative stress is an underlying mechanism for the detrimental health effects. The objective of this study was to investigate the short-term effect of ambient UFPs and particulate polycyclic aromatic hydrocarbons (PAHs) on urinary 8-hydroxyl-2-deoxyguanosine (8-OHdG) concentrations in children with and without eczema. Spot urine samples were collected from 84 children twice weekly for 61 days and 8-OHdG content was measured. Significant associations were found between the ambient UFPs and particle bound PAHs and increase in urinary 8-OHdG levels. An inter-quartile range (IQR) increase in the UFP concentration in the 24-h (IQR, 32,300/m(3)) period preceding urine collection was significantly associated with a 5.7% (95% confidence interval [CI], 0.16-1.27%) increase in the urinary 8-OHdG level children with AD. In children without eczema, such short-term effect of previous day UFPs on urinary 8-OHdG was not observed. There were no significant positive associations between the mass fraction of PMs and urinary 8-OHdG. The results suggest that short-term exposure to ambient UFPs plays a critical role in PM induced oxidative stress in children with eczema.

Acute health effects of urban fine and ultrafine particles on children with atopic dermatitis.

Although ambient particulate pollutants have been shown to exacerbate existing allergic symptoms of mucous membranes including rhinitis and asthma, the effects on skin such as atopic dermatitis in childhood deserve further study. We investigated the effects of urban particulate pollutants including ultrafine particles on atopic severity in children with atopic dermatitis. We included 41 schoolchildren, 8-12 years old, who had been diagnosed with atopic dermatitis. For 67 consecutive days, all of them measured their symptoms in a diary. To assess exposure, the daily ambient mass concentrations of particulate matter less than 10, 2.5 and 1 µm (PM(10), PM(2.5) and PM(1), respectively) and concentrations of submicron particles (0.01- 1 µm) were measured at a local school. The mean mass concentrations of PM(10), PM(2.5) and PM(1) were 74.0, 57.8 and 50.8 µg/m(3), respectively. The mean concentrations were 41,335/cm(3) ultrafine particles (UFPs) and 8577/cm(3) accumulation mode (0.1-1 µm) particles. Significant associations were found between the concentrations of ultrafine particles and the itchiness symptom in children with atopic dermatitis. An interquartile range (IQR) increase in previous day ultrafine particles concentration (IQR: 28-140/m(3)) was significantly associated with a 3.1% (95% confidence interval, 0.2-6.1) increase in the itch symptom score for children with atopic dermatitis. The results suggested that the concentration of ambient ultrafine particles may exacerbate skin symptoms in children with atopic dermatitis.

Asian Dust Storm and pulmonary function of school children in Seoul.

Health effects of the Asian Dust Storm (ADS) have not been evaluated adequately, even though it may affect health of people in East Asia. This study was conducted to evaluate whether the ADS affects particulate air pollution and pulmonary function of children. We studied 110 school children in Seoul, Korea with daily measurement of peak expiratory flow rate (PEFR) from May 13 to June 15, 2007. PM(2.5), PM(10) and metals bound to the particles were also determined daily during the study period in Ala Shan and Beijing (China) as well as in Seoul (Korea). Three-day back trajectories showed that air parcels arrived at Seoul mostly from the desert areas in China and Mongolia through eastern China during ADS event affecting levels of particulate pollutants in the areas. Analysis of metals bound to the particulates showed that natural metal levels were much higher than the anthropogenic metal levels. We found that ambient concentrations of PM(2.5) and PM(10) were not significantly associated with PEFR in school children except asthmatics during the study period (P>0.05). However, most of the metal concentrations bound to the particulates were significantly associated with decrease of the children's PEFR (P<0.05). The effect of anthropogenic metals was not different from natural components of metals for reduction of PEFR. This result indicates that exposure to the metals bound to particles during the ADS period reduces children's pulmonary function, but there was no difference of potency for reduction of the pulmonary function between natural and anthropogenic metal components.