Association between active commuting and low-grade inflammation: a population-based cross-sectional study.

BACKGROUND: Prior studies suggest that physical activity lowers circulating C-reactive protein (CRP) levels. However, little is known about the association between regular active commuting, i.e. walking or cycling to work, and CRP concentrations. This study examines whether active commuting is associated with lower CRP. METHODS: We conducted a cross-sectional study using population-based FINRISK data from 1997, 2002, 2007 and 2012. Participants were working adults living in Finland (n = 6208; mean age = 44 years; 53.6% women). We used linear and additive models adjusted for potential confounders to analyze whether daily active commuting, defined as the time spent walking or cycling to work, was associated with lower high-sensitivity (hs-) CRP serum concentrations compared with passive commuting. RESULTS: We observed that daily active commuting for 45 min or more (vs. none) was associated with lower hs-CRP [% mean difference in the main model: -16.8%; 95% confidence interval (CI) -25.6% to -7.0%), and results were robust to adjustment for leisure-time and occupational physical activity, as well as diet. Similarly, active commuting for 15-29 min daily was associated with lower hs-CRP in the main model (-7.4; 95% CI -14.1 to -0.2), but the association attenuated to null after further adjustments. In subgroup analyses, associations were only observed for women. CONCLUSIONS: Active commuting for at least 45 min a day was associated with lower levels of low-grade inflammation. Promoting active modes of transport may lead not only to reduced emissions from motorized traffic but also to population-level health benefits.

Cross-sectional associations of different types of nature exposure with psychotropic, antihypertensive and asthma medication.

BACKGROUND: Exposure to natural environments is thought to be beneficial for human health, but the evidence is inconsistent. OBJECTIVE: To examine whether exposure to green and blue spaces in urban environments is associated with mental and physical health in Finland. METHODS: The Helsinki Capital Region Environmental Health Survey was conducted in 2015-2016 in Helsinki, Espoo and Vantaa in Finland (n=7321). Cross-sectional associations of the amounts of residential green and blue spaces within 1 km radius around the respondent's home (based on the Urban Atlas 2012), green and blue views from home and green space visits with self-reported use of psychotropic (anxiolytics, hypnotics and antidepressants), antihypertensive and asthma medication were examined using logistic regression models. Indicators of health behaviour, traffic-related outdoor air pollution and noise and socioeconomic status (SES) were used as covariates, the last of these also as a potential effect modifier. RESULTS: Amounts of residential green and blue spaces or green and blue views from home were not associated with medications. However, the frequency of green space visits was associated with lower odds of using psychotropic medication (OR=0.67, 95% CI 0.55 to 0.82 for 3-4 times/week; 0.78, 0.63 to 0.96 for ≥5 times/week) and antihypertensive (0.64, 0.52 to 0.78; 0.59, 0.48 to 0.74, respectively) and asthma (0.74, 0.58 to 0.94; 0.76, 0.59 to 0.99, respectively) medication use. The observed associations were attenuated by body mass index, but no consistent interactions with SES indicators were observed. CONCLUSIONS: Frequent green space visits, but not the amounts of residential green or blue spaces, or green and blue views from home, were associated with less frequent use of psychotropic, antihypertensive and asthma medication in urban environments.

Long-term exposure to traffic noise and risk of incident colon cancer: A pooled study of eleven Nordic cohorts.

Background Colon cancer incidence is rising globally, and factors pertaining to urbanization have been proposed involved in this development. Traffic noise may increase colon cancer risk by causing sleep disturbance and stress, thereby inducing known colon cancer risk-factors, e.g. obesity, diabetes, physical inactivity, and alcohol consumption, but few studies have examined this. Objectives The objective of this study was to investigate the association between traffic noise and colon cancer (all, proximal, distal) in a pooled population of 11 Nordic cohorts, totaling 155,203 persons. Methods We identified residential address history and estimated road, railway, and aircraft noise, as well as air pollution, for all addresses, using similar exposure models across cohorts. Colon cancer cases were identified through national registries. We analyzed data using Cox Proportional Hazards Models, adjusting main models for harmonized sociodemographic and lifestyle data. Results During follow-up (median 18.8 years), 2757 colon cancer cases developed. We found a hazard ratio (HR) of 1.05 (95% confidence interval (CI): 0.99-1.10) per 10-dB higher 5-year mean time-weighted road traffic noise. In sub-type analyses, the association seemed confined to distal colon cancer: HR 1.06 (95% CI: 0.98-1.14). Railway and aircraft noise was not associated with colon cancer, albeit there was some indication in sub-type analyses that railway noise may also be associated with distal colon cancer. In interaction-analyses, the association between road traffic noise and colon cancer was strongest among obese persons and those with high NO2-exposure. Discussion A prominent study strength is the large population with harmonized data across eleven cohorts, and the complete address-history during follow-up. However, each cohort estimated noise independently, and only at the most exposed façade, which may introduce exposure misclassification. Despite this, the results of this pooled study suggest that traffic noise may be a risk factor for colon cancer, especially of distal origin.

Occupational noise exposure and risk of incident stroke: a pooled study of five Scandinavian cohorts.

OBJECTIVES: To investigate the association between occupational noise exposure and stroke incidence in a pooled study of five Scandinavian cohorts (NordSOUND). METHODS: We pooled and harmonised data from five Scandinavian cohorts resulting in 78 389 participants. We obtained job data from national registries or questionnaires and recoded these to match a job-exposure matrix developed in Sweden, which specified the annual average daily noise exposure in five exposure classes (LAeq8h): <70, 70-74, 75-79, 80-84, ≥85 dB(A). We identified residential address history and estimated 1-year average road traffic noise at baseline. Using national patient and mortality registers, we identified 7777 stroke cases with a median follow-up of 20.2 years. Analyses were conducted using Cox proportional hazards models adjusting for individual and area-level potential confounders. RESULTS: Exposure to occupational noise at baseline was not associated with overall stroke in the fully adjusted models. For ischaemic stroke, occupational noise was associated with HRs (95% CI) of 1.08 (0.98 to 1.20), 1.09 (0.97 to 1.24) and 1.06 (0.92 to 1.21) in the 75-79, 80-84 and ≥85 dB(A) exposure groups, compared with <70 dB(A), respectively. In subanalyses using time-varying occupational noise exposure, we observed an indication of higher stroke risk among the most exposed (≥85 dB(A)), particularly when restricting analyses to people exposed to occupational noise within the last year (HR: 1.27; 95% CI: 0.99 to 1.63). CONCLUSIONS: We found no association between occupational noise and risk of overall stroke after adjustment for confounders. However, the non-significantly increased risk of ischaemic stroke warrants further investigation.

Mortality risk related to heatwaves in Finland - Factors affecting vulnerability.

BACKGROUND: Heatwaves are known to increase mortality. However, there is a need for more quantitative information on factors affecting sensitivity to the adverse health effects, particularly in countries with cool summer temperatures. OBJECTIVES: We evaluated mortality risk related to heatwave days in Finland. Risk was examined by age, sex, cause of death, and place of death, including health and social care facilities and homes. Mortality was also analysed for different patient subgroups in healthcare facilities. METHODS: Heatwaves were defined as periods when the daily average temperature exceeded the 90th percentile of that from May to August in 2000-2014 for ≥4 days. In addition to all heatwave days, risk was analysed for short (4-5 days) and long (≥10 days) heatwaves. Mortality analyses were based on linking registry data on i) daily non-accidental and cause-specific mortality and ii) admissions to a health or social care facility. Statistical analyses were conducted using generalised estimating equations for longitudinal data analysis, assuming a Poisson distribution for the daily mortality count. RESULTS: During all heatwave days, mortality increased among those aged 65-74 years (6.7%, 95% confidence interval 2.9-10.8%) and ≥75 years (12.8%, 95% CI 9.8-15.9%). Mortality increased in both sexes, but the risk was higher in women. Positive associations were observed for deaths due to respiratory diseases, renal diseases, mental and behavioural disorders, diseases of the nervous system, and cardiovascular diseases. Overall, effects were stronger for long than short heatwaves. During all heatwave days, mortality increased in healthcare facilities in outpatients (26.9%, 95% CI 17.3-37.2%) and inpatients. Among inpatients, the risk was higher in long-term inpatients (stay in ward > 30 days, 13.1%, 95% CI 8.6-17.7%) than others (5.8%, 95% CI 2.7-9.0%). At homes, mortality increased by 8.1% (95% CI 1.9-14.6%). Elevated risk estimates were also detected for social care facilities. CONCLUSIONS: In Finland, a cold-climate Northern country, heatwaves increase mortality risk significantly among the elderly. Women are more susceptible than men, and many chronic diseases are important risk factors. To reduce heatwave-related deaths, preparedness should be improved particularly in hospital and healthcare centre wards, where the most vulnerable are long-term inpatients. However, measures are also needed to protect the elderly at home and in social care facilities, especially during prolonged hot periods.

Symptoms intuitively associated with wind turbine infrasound.

In many countries, a certain proportion of individuals living in the vicinity of wind power areas have reported symptoms that they have intuitively associated with infrasound from wind turbines. While the reason for these symptoms remains under debate, this is the first study to describe the phenomenon by assessing the prevalence and severity of these wind turbine infrasound related symptoms as well as factors associated with being symptomatic. Four wind power areas in Finland assessed to have the most problems intuitively associated with wind turbine infrasound were selected for the study. The questionnaire was mailed to 4847 adults in four distance zones (≤ 2.5 km, > 2.5-5 km, > 5-10 km, > 10-20 km from the closest wind turbine), and 28% responded. In the closest distance zone, 15% of respondents reported having symptoms that they have intuitively associated with wind turbine infrasound. In the whole study area, the symptom prevalence was 5%. Many of the symptomatic respondents were annoyed by audible wind turbine sound and associated their symptoms also with vibration or electromagnetic field from wind turbines. One third of the symptomatic respondents rated their symptoms severe, and the symptom spectrum was very broad covering several organ systems. In multivariate models, many factors such as proximity to wind turbines, impaired health status, being annoyed by different aspects of wind turbines and considering wind turbines as a health risk were associated with having wind turbine infrasound related symptoms. Although causal relationships cannot be assessed based on a cross-sectional questionnaire study, it can be speculated that interpretations of symptoms are affected by many other factors in addition to actual exposure.

Wood stove use and other determinants of personal and indoor exposures to particulate air pollution and ozone among elderly persons in a Northern Suburb.

A six-month winter-spring study was conducted in a suburb of the northern European city of Kuopio, Finland, to identify and quantify factors determining daily personal exposure and home indoor levels of fine particulate matter (PM2.5 , diameter <2.5 µm) and its light absorption coefficient (PM2.5abs ), a proxy for combustion-derived black carbon. Moreover, determinants of home indoor ozone (O3 ) concentration were examined. Local central site outdoor, home indoor, and personal daily levels of pollutants were monitored in this suburb among 37 elderly residents. Outdoor concentrations of the pollutants were significant determinants of their levels in home indoor air and personal exposures. Natural ventilation in the detached and row houses increased personal exposure to PM2.5 , but not to PM2.5abs , when compared with mechanical ventilation. Only cooking out of the recorded household activities increased indoor PM2.5 . The use of a wood stove room heater or wood-fired sauna stove was associated with elevated concentrations of personal PM2.5 and PM2.5abs , and indoor PM2.5abs . Candle burning increased daily indoor and personal PM2.5abs , and it was also a determinant of indoor ozone level. In conclusion, relatively short-lasting wood and candle burning of a few hours increased residents' daily exposure to potentially hazardous, combustion-derived carbonaceous particulate matter.

Acute effects of visits to urban green environments on cardiovascular physiology in women: A field experiment.

BACKGROUND: Epidemiological studies have reported positive associations between the amount of green space in the living environment and mental and cardiovascular human health. In a search for effect mechanisms, field studies have found short-term visits to green environments to be associated with psychological stress relief. Less evidence is available on the effect of visits on cardiovascular physiology. OBJECTIVES: To evaluate whether visits to urban green environments, in comparison to visits to a built-up environment, lead to beneficial short-term changes in indicators of cardiovascular health. METHODS: Thirty-six adult female volunteers visited three different types of urban environments: an urban forest, an urban park, and a built-up city centre, in Helsinki, Finland. The visits consisted of 15min of sedentary viewing, and 30min of walking. During the visits, blood pressure and heart rate were measured, and electrocardiogram recorded for the determination of indicators of heart rate variability. In addition, levels of respirable ambient particles and environmental noise were monitored. RESULTS: Visits to the green environments were associated with lower blood pressure (viewing period only), lower heart rate, and higher indices of heart rate variability [standard deviation of normal-to-normal intervals (SDNN), high frequency power] than visits to the city centre. In the green environments, heart rate decreased and SDNN increased during the visit. Associations between environment and indicators of cardiovascular health weakened slightly after inclusion of particulate air pollution and noise in the models. CONCLUSIONS: Visits to urban green environments are associated with beneficial short-term changes in cardiovascular risk factors. This can be explained by psychological stress relief with contribution from reduced air pollution and noise exposure during the visits. Future research should evaluate the amount of exposure to green environments needed for longer-term benefits for cardiovascular health.

Effects of long-range transported air pollution from vegetation fires on daily mortality and hospital admissions in the Helsinki metropolitan area, Finland.

INTRODUCTION: Fine particulate matter (PM2.5) emissions from vegetation fires can be transported over long distances and may cause significant air pollution episodes far from the fires. However, epidemiological evidence on health effects of vegetation-fire originated air pollution is limited, particularly for mortality and cardiovascular outcomes. OBJECTIVE: We examined association between short-term exposure to long-range transported PM2.5 from vegetation fires and daily mortality due to non-accidental, cardiovascular, and respiratory causes and daily hospital admissions due to cardiovascular and respiratory causes in the Helsinki metropolitan area, Finland. METHODS: Days significantly affected by smoke from vegetation fires between 2001 and 2010 were identified using air quality measurements at an urban background and a regional background monitoring station, and modelled data on surface concentrations of vegetation-fire smoke. Associations between daily PM2.5 concentration and health outcomes on i) smoke-affected days and ii) all other days (i.e. non-smoke days) were analysed using Poisson time series regression. All statistical models were adjusted for daily temperature and relative humidity, influenza, pollen, and public holidays. RESULTS: On smoke-affected days, 10µg/m3 increase in PM2.5 was associated with a borderline statistically significant increase in cardiovascular mortality among total population at a lag of three days (12.4%, 95% CI -0.2% to 26.5%), and among the elderly (≥65 years) following same-day exposure (13.8%, 95% CI -0.6% to 30.4%) and at a lag of three days (11.8%, 95% CI -2.2% to 27.7%). Smoke day PM2.5 was not associated with non-accidental mortality or hospital admissions due to cardiovascular causes. However, there was an indication of a positive association with hospital admissions due to respiratory causes among the elderly, and admissions due to chronic obstructive pulmonary disease or asthma among the total population. In contrast, on non-smoke days PM2.5 was generally not associated with the health outcomes, apart from suggestive small positive effects on non-accidental mortality at a lag of one day among the elderly and hospital admissions due to all respiratory causes following same-day exposure among the total population. CONCLUSIONS: Our research provides suggestive evidence for an association of exposure to long-range transported PM2.5 from vegetation fires with increased cardiovascular mortality, and to a lesser extent with increased hospital admissions due to respiratory causes. Hence, vegetation-fire originated air pollution may have adverse effects on public health over a distance of hundreds to thousands of kilometres from the fires.

Impact of Statin Adherence on Cardiovascular Morbidity and All-Cause Mortality in the Primary Prevention of Cardiovascular Disease: A Population-Based Cohort Study in Finland.

OBJECTIVES: To assess the extent to which adherence to statins is associated with the incidence of cardiovascular (CV) events and all-cause mortality in the primary prevention of CV diseases and whether different analytical approaches influence the observed associations. METHODS: This population-based cohort study used data from Finnish registers. The cohort included 97,575 new statin users aged 45 to 75 years in 2001 to 2004 with no CV diseases at baseline. Exposure was defined as adherence to statins (proportion of days covered [PDC]). The primary outcome was any CV event or death during a 3-year follow-up. Different analytical approaches, including multivariable-adjusted Cox regression, inverse probability weighting with time-varying adherence, and propensity score calibration, were used. RESULTS: During the first year of follow-up, 53% displayed good (PDC ≥80%), 26% had intermediate (PDC 40%-79%), and 21% exhibited poor (PDC <40%) adherence. After adjustment for sociodemographic and clinical covariates, a 25% relative risk reduction (hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.71-0.79) was observed in the rate of any CV event or death among good versus poor adherers. Good adherers also had a lower incidence than poor adherers of acute coronary syndrome (HR 0.56; 95% CI 0.49-0.65) and acute cerebrovascular disease events (HR 0.67; 95% CI 0.60-0.76). The different analytical approaches achieved comparable results for all the outcomes. CONCLUSIONS: The incidence of CV events and mortality was higher in poor versus good adherers. Different analytical methods that took into account changes in adherence and confounding at baseline did not appreciably affect the results.

Source-specific fine particulate air pollution and systemic inflammation in ischaemic heart disease patients.

OBJECTIVE: To compare short-term effects of fine particles (PM2.5; aerodynamic diameter <2.5 µm) from different sources on the blood levels of markers of systemic inflammation. METHODS: We followed a panel of 52 ischaemic heart disease patients from 15 November 2005 to 21 April 2006 with clinic visits in every second week in the city of Kotka, Finland, and determined nine inflammatory markers from blood samples. In addition, we monitored outdoor air pollution at a fixed site during the study period and conducted a source apportionment of PM2.5 using the Environmental Protection Agency's model EPA PMF 3.0. We then analysed associations between levels of source-specific PM2.5 and markers of systemic inflammation using linear mixed models. RESULTS: We identified five source categories: regional and long-range transport (LRT), traffic, biomass combustion, sea salt, and pulp industry. We found most evidence for the relation of air pollution and inflammation in LRT, traffic and biomass combustion; the most relevant inflammation markers were C-reactive protein, interleukin-12 and myeloperoxidase. Sea salt was not positively associated with any of the inflammatory markers. CONCLUSIONS: Results suggest that PM2.5 from several sources, such as biomass combustion and traffic, are promoters of systemic inflammation, a risk factor for cardiovascular diseases.

Long-term exposure to transportation noise and obesity: A pooled analysis of eleven Nordic cohorts.

Background: Available evidence suggests a link between exposure to transportation noise and an increased risk of obesity. We aimed to assess exposure-response functions for long-term residential exposure to road traffic, railway and aircraft noise, and markers of obesity. Methods: Our cross-sectional study is based on pooled data from 11 Nordic cohorts, including up to 162,639 individuals with either measured (69.2%) or self-reported obesity data. Residential exposure to transportation noise was estimated as a time-weighted average Lden 5 years before recruitment. Adjusted linear and logistic regression models were fitted to assess beta coefficients and odds ratios (OR) with 95% confidence intervals (CI) for body mass index, overweight, and obesity, as well as for waist circumference and central obesity. Furthermore, natural splines were fitted to assess the shape of the exposure-response functions. Results: For road traffic noise, the OR for obesity was 1.06 (95% CI = 1.03, 1.08) and for central obesity 1.03 (95% CI = 1.01, 1.05) per 10 dB Lden. Thresholds were observed at around 50-55 and 55-60 dB Lden, respectively, above which there was an approximate 10% risk increase per 10 dB Lden increment for both outcomes. However, linear associations only occurred in participants with measured obesity markers and were strongly influenced by the largest cohort. Similar risk estimates as for road traffic noise were found for railway noise, with no clear thresholds. For aircraft noise, results were uncertain due to the low number of exposed participants. Conclusion: Our results support an association between road traffic and railway noise and obesity.

Exposure to long-term source-specific transportation noise and incident breast cancer: A pooled study of eight Nordic cohorts.

BACKGROUND: Environmental noise is an important environmental exposure that can affect health. An association between transportation noise and breast cancer incidence has been suggested, although current evidence is limited. We investigated the pooled association between long-term exposure to transportation noise and breast cancer incidence. METHODS: Pooled data from eight Nordic cohorts provided a study population of 111,492 women. Road, railway, and aircraft noise were modelled at residential addresses. Breast cancer incidence (all, estrogen receptor (ER) positive, and ER negative) was derived from cancer registries. Hazard ratios (HR) were estimated using Cox Proportional Hazards Models, adjusting main models for sociodemographic and lifestyle variables together with long-term exposure to air pollution. RESULTS: A total of 93,859 women were included in the analyses, of whom 5,875 developed breast cancer. The median (5th-95th percentile) 5-year residential road traffic noise was 54.8 (40.0-67.8) dB Lden, and among those exposed, the median railway noise was 51.0 (41.2-65.8) dB Lden. We observed a pooled HR for breast cancer (95 % confidence interval (CI)) of 1.03 (0.99-1.06) per 10 dB increase in 5-year mean exposure to road traffic noise, and 1.03 (95 % CI: 0.96-1.11) for railway noise, after adjustment for lifestyle and sociodemographic covariates. HRs remained unchanged in analyses with further adjustment for PM2.5 and attenuated when adjusted for NO2 (HRs from 1.02 to 1.01), in analyses using the same sample. For aircraft noise, no association was observed. The associations did not vary by ER status for any noise source. In analyses using <60 dB as a cutoff, we found HRs of 1.08 (0.99-1.18) for road traffic and 1.19 (0.95-1.49) for railway noise. CONCLUSIONS: We found weak associations between road and railway noise and breast cancer risk. More high-quality prospective studies are needed, particularly among those exposed to railway and aircraft noise before conclusions regarding noise as a risk factor for breast cancer can be made.

Long-Term Exposure to Transportation Noise and Ischemic Heart Disease: A Pooled Analysis of Nine Scandinavian Cohorts.

BACKGROUND: Transportation noise may induce cardiovascular disease, but the public health implications are unclear. OBJECTIVES: The study aimed to assess exposure-response relationships for different transportation noise sources and ischemic heart disease (IHD), including subtypes. METHODS: Pooled analyses were performed of nine cohorts from Denmark and Sweden, together including 132,801 subjects. Time-weighted long-term exposure to road, railway, and aircraft noise, as well as air pollution, was estimated based on residential histories. Hazard ratios (HRs) were calculated using Cox proportional hazards models following adjustment for lifestyle and socioeconomic risk factors. RESULTS: A total of 22,459 incident cases of IHD were identified during follow-up from national patient and mortality registers, including 7,682 cases of myocardial infarction. The adjusted HR for IHD was 1.03 [95% confidence interval (CI) 1.00, 1.05] per 10 dB Lden for both road and railway noise exposure during 5 y prior to the event. Higher risks were indicated for IHD excluding angina pectoris cases, with HRs of 1.06 (95% CI: 1.03, 1.08) and 1.05 (95% CI: 1.01, 1.08) per 10 dB Lden for road and railway noise, respectively. Corresponding HRs for myocardial infarction were 1.02 (95% CI: 0.99, 1.05) and 1.04 (95% CI: 0.99, 1.08). Increased risks were observed for aircraft noise but without clear exposure-response relations. A threshold at around 55 dB Lden was suggested in the exposure-response relation for road traffic noise and IHD. DISCUSSION: Exposure to road, railway, and aircraft noise in the prior 5 y was associated with an increased risk of IHD, particularly after exclusion of angina pectoris cases, which are less well identified in the registries. https://doi.org/10.1289/EHP10745.

Low-level exposure to ambient particulate matter is associated with systemic inflammation in ischemic heart disease patients.

Short-term exposure to ambient air pollution is associated with increased cardiovascular mortality and morbidity. This adverse health effect is suggested to be mediated by inflammatory processes. The purpose of this study was to determine if low levels of particulate matter, typical for smaller cities, are associated with acute systemic inflammation. Fifty-two elderly individuals with ischemic heart disease were followed for six months with biweekly clinical visits in the city of Kotka, Finland. Blood samples were collected for the determination of inflammatory markers interleukin (IL)-1ß, IL-6, IL-8, IL-12, interferon (IFN)γ, C-reactive protein (CRP), fibrinogen, myeloperoxidase and white blood cell count. Particle number concentration and fine particle (particles with aerodynamic diameters <2.5 µm (PM(2.5))) as well as thoracic particle (particles with aerodynamic diameters <10 µm (PM(10))) mass concentration were measured daily at a fixed outdoor measurement site. Light-absorbance of PM(2.5) filter samples, an indicator of combustion derived particles, was measured with a smoke-stain reflectometer. In addition, personal exposure to PM(2.5) was measured with portable photometers. During the study period, wildfires in Eastern Europe led to a 12-day air pollution episode, which was excluded from the main analyses. Average ambient PM(2.5) concentration was 8.7 µg/m(3). Of the studied pollutants, PM(2.5) and absorbance were most strongly associated with increased levels of inflammatory markers; most notably with C-reactive protein and IL-12 within a few days of exposure. There was also some evidence of an effect of particulate air pollution on fibrinogen and myeloperoxidase. The concentration of IL-12 was considerably (227%) higher during than before the forest fire episode. These findings show that even low levels of particulate air pollution from urban sources are associated with acute systemic inflammation. Also particles from wildfires may exhibit pro-inflammatory effects.

Exposure-Response Functions for the Effects of Traffic Noise on Self-Reported Annoyance and Sleep Disturbance in Finland: Effect of Exposure Estimation Method.

Large variations in transportation noise tolerance have been reported between communities. In addition to population sensitivity, exposure-response functions (ERFs) for the effects of transportation noise depend on the exposure estimation method used. In the EU, the new CNOSSOS-EU method will change the estimations of exposure by changing the assignment of noise levels and populations to buildings. This method was officially used for the first time in the strategic noise mapping performed by Finnish authorities in 2017. Compared to the old method, the number of people exposed to traffic noise above 55 dB decreased by 50%. The main aim of this study, conducted in the Helsinki Capital Region, Finland, was to evaluate how the exposure estimation method affects ERFs for road traffic noise. As an example, with a façade road traffic noise level of 65 dB, the ERF based on the highest façade noise level of the residential building resulted in 5.1% being highly annoyed (HAV), while the ERF based on the exposure estimation method that is similar to the CNOSSOS-EU method resulted in 13.6%. Thus, the substantial increase in the health effect estimate compensates for the reduction in the number of highly exposed people. This demonstrates the need for purpose-fitted ERFs when the CNOSSOS-EU method is used to estimate exposure in the health impact assessment of transportation noise.

Fish consumption in relation to other foods in the diet.

Our aim was to investigate whether fish consumption is associated with the consumption of other healthy foods. The study population consisted of 2605 men and 3199 women from the nationally representative Health 2000 survey and 114 professional fishermen and 114 fishermen's wives (the Fishermen substudy) in Finland. Dietary data were collected using a calibrated (i.e. determined to have relative validity) FFQ. Model-adjusted means for food consumption and P values for linear trend were calculated across fish consumption tertiles. Those with the highest fish consumption had the highest consumption of vegetables, fruit and berries, potatoes, oil and wine even after adjusting for other food groups. The consumption of red meat and sausages had a tendency to decrease across fish consumption tertiles but the associations were inconsistent in the study populations. In conclusion, fish consumption had a positive linear association with the consumption of some other healthy foods such as vegetables, fruit, berries, and oil both in the general population of Finland and in a population with high fish consumption. Additional adjustment for other food groups had a clear effect on some of the studied associations. Therefore, when evaluating the health effects of fish consumption, confounding by other foods characterising a healthy diet needs to be considered.

Self-reported health in the vicinity of five wind power production areas in Finland.

In many countries, some people living in the vicinity of wind power production areas report having symptoms that they intuitively associate with wind turbines. Recently public discussions have focused especially on wind turbine infrasound. However, scientific evidence supporting an association is lacking. The aim of this study was to assess the association between exposure to wind turbines and the prevalence of self-reported symptoms, diseases and medications. A cross-sectional questionnaire study (n = 2,828) was conducted in the vicinity of five wind power production areas in Finland in 2015-2016. Each area had 3-16 turbines with a nominal power of 2.4-3.3 MW. The response rate was 50% (n = 1,411). Continuous and categorised (≤ 2.5, > 2.5-5, > 5-10 km) distance between the respondents' home and the closest wind turbine was used to represent exposure to wind turbines. Wind turbine sound pressure level outdoors could be reliably modelled only for the closest distance zone where the yearly average was 34 dB and maximum 43 dB. The data on symptoms (headache, nausea, dizziness, tinnitus, ear fullness, arrhythmia, fatigue, difficulties in falling asleep, waking up too early, anxiety, stress), diseases (hypertension, heart insufficiency, diabetes), and medications (analgesics for headache, joint/muscle pain and other pain, and medication for sleep disturbance, anxiety and depression, and hypertension) was obtained from the questionnaire. Logistic regression analyses were adjusted for age, sex, marital status, education, work situation, smoking, alcohol consumption, physical activity, body mass index, and hearing problems. Annoyance and sleep disturbance due to wind turbine noise were inversely associated with the distance to the closest wind turbine. The prevalence of symptoms, diseases and medications was essentially the same in all distance categories. In multivariate regression modelling, the odds ratio estimates were generally close to unity and statistically non-significant. Beyond annoyance and sleep disturbance, there were no consistent associations between exposure to wind turbines and self-reported health problems. The results do not support the hypothesis that broadband sound or infrasound from wind turbines could cause the proposed health problems.

Heterogeneous Urban Exposures and Prevalent Hypertension in the Helsinki Capital Region, Finland.

Urban dwellers are simultaneously exposed to several environmental health risk factors. This study aimed to examine the relationship between long-term exposure to fine particulate matter (PM2.5, diameter < 2.5 µm) of residential-wood-burning and road-traffic origin, road-traffic noise, green space around participants' homes, and hypertension. In 2015 and 2016, we conducted a survey of residents of the Helsinki Capital Region to determine their perceptions of environmental quality and safety, lifestyles, and health statuses. Recent antihypertensive medication was used as an indicator of current hypertensive illness. Individual-level exposure was estimated by linking residential coordinates with modelled outdoor levels of wood-smoke- and traffic-related PM2.5, road-traffic noise, and coverage of natural spaces. Relationships between exposure and hypertension were modelled using multi-exposure and single-exposure binary logistic regression while taking smooth functions into account. Twenty-eight percent of the participants were current users of antihypertensive medication. The odds ratios (95% confidence interval) for antihypertensive use were 1.12 (0.78-1.57); 0.97 (0.76-1.26); 0.98 (0.93-1.04) and 0.99 (0.94-1.04) for wood-smoke PM2.5, road-traffic PM2.5, road-traffic noise, and coverage of green space, respectively. We found no evidence of an effect of the investigated urban exposures on prevalent hypertension in the Helsinki Capital Region.

Long-term exposure to ambient fine particulate matter originating from traffic and residential wood combustion and the prevalence of depression.

INTRODUCTION: Air pollution has been suggested to be associated with depression. However, current evidence is conflicting, and no study has considered different sources of ambient particulate matter with an aerodynamic diameter below 2.5 µm (PM2.5). We evaluated the associations of long-term exposure to PM2.5 from road traffic and residential wood combustion with the prevalence of depression in the Helsinki region, Finland. METHODS: We conducted a cross-sectional analysis based on the Helsinki Capital Region Environmental Health Survey 2015-2016 (N=5895). Modelled long-term outdoor concentrations of PM2.5 were evaluated using high-resolution emission and dispersion modelling on an urban scale and linked to the home addresses of study participants. The outcome was self-reported doctor-diagnosed or treated depression. We applied logistic regression and calculated the OR for 1 µg/m3 increase in PM2.5, with 95% CI. Models were adjusted for potential confounders, including traffic noise and urban green space. RESULTS: Of the participants, 377 reported to have been diagnosed or treated for depression by a doctor. Long-term exposure to PM2.5 from road traffic (OR=1.23, 95% CI 0.86 to 1.73; n=5895) or residential wood combustion (OR=0.78, 95% CI 0.43 to 1.41; n=5895) was not associated with the prevalence of depression. The estimates for PM2.5 from road traffic were elevated, but statistically non-significant, for non-smokers (OR=1.38, 95% CI 0.94 to 2.01; n=4716). CONCLUSIONS: We found no convincing evidence of an effect of long-term exposure to PM2.5 from road traffic or residential wood combustion on depression.