Joint effects of air pollution and genetic susceptibility on incident primary open-angle glaucoma.

BACKGROUND: Air pollutants are important exogenous stimulants to eye diseases, but knowledge of associations between long-term exposure to air pollutants and the risk of primary open-angle glaucoma (POAG) is limited. This study aimed to determine whether long-term exposure to air pollutants, genetic susceptibility, and their joint effects lead to an elevated risk of incident POAG. METHODS: This is a population-based prospective cohort study from UK Biobank participants with complete measures of air pollution exposure and polygenetic risk scores. Cox proportional hazard models were fitted to assess the individual and joint effects of long-term exposure to air pollutants and genetics on the risk of POAG. In addition, the effect modification of genetic susceptibility was examined on an additive or multiplicative scale. RESULTS: Among 434,290 participants with a mean (SD) age of 56.5 (8.1) years, 6651 (1.53 %) were diagnosed with POAG during a median follow-up of 13.7 years. Long-term exposure to air pollutants was associated with an increased risk of POAG. The hazard ratios associated with per interquartile range increase in PM2.5, PM2.5 absorbance, PM10, NO2, and NOX individually ranged from 1.027 (95 % CI: 1.001-1.054) to 1.067 (95 % CI: 1.035-1.099). Compared with individuals residing in low-pollution areas and having low polygenic risk scores, the risk of incident POAG increased by 105.5 % (95 % CI: 78.3 %-136.9 %), 79.7 % (95 % CI: 56.5 %-106.5 %), 103.2 % (95 % CI: 76.9 %-133.4 %), 89.4 % (95 % CI: 63.9 %-118.9 %), and 90.2 % (95 % CI: 64.8 %-119.5 %) among those simultaneously exposed to high air pollutants levels and high genetic risk, respectively. Genetic susceptibility interacted with PM2.5 absorbance and NO2 in an additive manner, while no evidence of multiplicative interaction was found in this study. Stratification analyses revealed stronger effects in Black people and the elderly. CONCLUSION: Long-term air pollutant exposure was associated with an increased risk of POAG incidence, particularly in the population with high genetic predisposition.

Association between ambient temperature and mammalian-related injuries in Guangzhou, China, 2014-2019.

BACKGROUND: Meteorological factors are associated with various health outcomes. However, it remains uncertain whether ambient temperature affects animal aggressive behaviors and causes mammalian-related injuries (MRI) in humans. The study aimed to examine the effect of daily mean temperature on MRI in Guangzhou, China. METHODS: Individual cases of MRI were obtained from Guangzhou Injury Surveillance System during 2014-2019. A combination of a distributed lag nonlinear model and conditional quasi-Poisson regression, implemented within a time-stratified case-crossover design, was employed to evaluate the association between temperature and MRI. Subgroup analyses were conducted by sex, age group, education level, and types of mammals. RESULT: This study included 24,206 MRI cases among which 89.7 % were caused by cats or dogs. We observed a nonlinear relationship between daily mean temperature and MRI. The impact of high temperatures was most pronounced on the current day and remained statistically significant on the next day. Compared with the reference temperature with a minimum risk of injuries (9.3 °C, approximately 2nd percentile of temperature), 75th percentile of temperature (27.4 °C) exerted the greatest relative risk (RR) of injuries (RR = 1.45, 95 % CI: 1.25-1.68) over lag 0-1 days. In subgroup analyses, the effects of high temperatures among males and females were similar. Individuals aged 15-34 years and 35-59 years were more susceptible to MRI at high temperatures compared to other age groups. The risk of injuries caused by cats or dogs consistently increased with high temperatures. We did not find significant impacts of low temperatures. CONCLUSION: Short-term heat exposure plays an important role in the occurrence of MRI. The findings highlight the importance of enhancing public awareness regarding the high temperature-associated hazards posed by mammals. There is a need for enhanced regulations and measures on the management for cats and dogs to mitigate the harm caused in hot seasons.

The Effectiveness of National Expanded Program on Immunization With Hepatitis A Vaccines in the Chinese Mainland: Interrupted Time-Series Analysis.

BACKGROUND: The high prevalence of hepatitis A delivered a blow to public health decades ago. The World Health Organization (WHO) set a goal to eliminate viral hepatitis including hepatitis A by 2030. In 2008, hepatitis A vaccines were integrated into the Expanded Program on Immunization (EPI) in China to alleviate the burden of hepatitis A, although the effectiveness of the EPI has not been well investigated. OBJECTIVE: We aimed to evaluate the intervention effect at both provincial and national levels on the incidence of hepatitis A in the Chinese mainland from 2005 to 2019. METHODS: Based on the monthly reported number of hepatitis A cases from 2005 to 2019 in each provincial-level administrative division, we adopted generalized additive models with an interrupted time-series design to estimate province-specific effects of the EPI on the incidence of hepatitis A among the target population (children aged 2-9 years) from 2005 to 2019. We then pooled province-specific effect estimates using random-effects meta-analyses. We also assessed the effect among the nontarget population and the whole population. RESULTS: A total of 98,275 hepatitis A cases among children aged 2-9 years were reported in the Chinese mainland from 2005 to 2019, with an average annual incidence of 5.33 cases per 100,000 persons. Nationally, the EPI decreased the hepatitis A incidence by 80.77% (excess risk [ER] -80.77%, 95% CI -85.86% to -72.92%) during the study period, guarding an annual average of 28.52 (95% empirical CI [eCI] 27.37-29.00) cases per 100,000 persons among the target children against hepatitis A. Western China saw a more significant effect of the EPI on the decrease in the incidence of hepatitis A among the target children. A greater number of target children were protected from onset in Northwest and Southwest China, with an excess incidence rate of -129.72 (95% eCI -135.67 to -117.86) and -66.61 (95% eCI -67.63 to -64.22) cases per 100,000 persons on average, respectively. Intervention effects among nontarget (ER -32.88%, 95% CI -39.76% to -25.21%) and whole populations (ER -31.97%, 95% CI -39.61% to -23.37%) were relatively small. CONCLUSIONS: The EPI has presented a lasting positive effect on the containment of hepatitis A in the target population in China. The EPI's effect on the target children also provided a degree of indirect protection for unvaccinated individuals. The continuous surveillance of hepatitis A and the maintenance of mass vaccination should shore up the accomplishment in the decline of hepatitis A incidence to ultimately achieve the goal set by the WHO.

The use of generalized synthetic control method to evaluate air pollution control measures of G20 Hangzhou Summit.

The traditional campaign-style enforcement in environmental governance has been debated whether its rebound effect is likely to eat away the short-term environmental benefits and subsequently bring about severer pollution. There are methodological challenges in assessing the effect of temporary environmental intervention. By applying the generalized synthetic control method (GSCM), we quantified and characterized the effectiveness of environmental regulations implemented for the G20 Hangzhou Summit held on 4-5 September, 2016. The summit was successful in reducing Air Quality Composite Index by 17.40% (95% CI: 9.53%, 24.60%), 13.30% (95% CI: 4.23%, 21.50%), and 10.09% (95% CI: 2.01%, 17.51%) in the core, strictly-regulated and regulated areas respectively, comparing with the index expected under a "No-G20" scenario during the preparatory period and the summit period (July-September 2016), and the reduction of the levels in specific pollutants (PM10, PM2.5, NO2, and CO) was also observed. Besides, the environmental benefits lasted for at least 3 months after the summit. This study demonstrates that the pollution control measures during the G20 Hangzhou Summit improved air quality immediately and continuously, and the GSCM provides a useful tool for evaluating the intervention effects of environmental regulations.