Health impact assessment of the surface water pollution in China.

China suffers from severe surface water pollution. Health impact assessment could provide a novel and quantifiable metric for the health burden attributed to surface water pollution. This study establishes a health impact assessment method for surface water pollution based on classic frameworks, integrating the multi-pollutant city water quality index (CWQI), informative epidemiological findings, and benchmark public health information. A relative risk level assignment approach is proposed based on the CWQI, innovatively addressing the challenge in surface water-human exposure risk assessment. A case study assesses the surface water pollution-related health impact in 336 Chinese cities. The results show (1) between 2015 and 2022, total health impact decreased from 3980.42 thousand disability-adjusted life years (DALYs) (95 % Confidence Interval: 3242.67-4339.29) to 3260.10 thousand DALYs (95 % CI: 2475.88-3641.35), measured by total cancer. (2) The annual average health impacts of oesophageal, stomach, colorectal, gallbladder, and pancreatic cancers added up to 2621.20 thousand DALYs (95 % CI: 2095.58-3091.10), revealing the significant health impact of surface water pollution on digestive cancer. (3) In 2022, health impacts in the Beijing-Tianjin-Hebei and surroundings, the Yangtze River Delta, and the middle reaches of the Yangtze River added up to 1893.06 thousand DALYs (95 % CI: 1471.82-2097.88), showing a regional aggregating trend. (4) Surface water pollution control has been the primary driving factor to health impact improvement, contributing -3.49 % to the health impact change from 2015 to 2022. It is the first city-level health impact map for China's surface water pollution. The methods and findings will support the water management policymaking in China and other countries suffering from water pollution.

Characterizing the water resource-environment-ecology system harmony in Chinese cities using integrated datasets: A Beautiful China perspective assessment.

Integrated management and synergistic improvement of the water system is a topic of widespread concern. This study innovatively integrates three functions of quality assessment, synergy evaluation, and driving influence determination to establish a systematic framework assessing water system harmony. A case study of 336 Chinese cities is further performed by combining multi-scale and multi-source datasets. The results show China's water system quality has improved from 2015 to 2022. Development in the water resource, environment, and ecology subsystems have been differentiated, with 0.05 %, 4.33 %, and -1.64 % changes, respectively. The degradation of water ecology and the weak synergy with the other two subsystems have limited China's water system harmony. Water environment improvement played a contributive role in improving the water system quality. The contribution structure of water resources, environment, and ecology has shifted towards equilibrium in recent years. We found and highlighted the north-south differentiation of water system harmony in Chinese cities. The Beijing-Tianjin-Hebei and its surroundings, the Yangtze River Delta, and the middle reaches of the Yangtze River are identified as priority regions for water system harmony improvement. The primary contribution of this study is to propose an assessing concept of water resource-environment-ecology system harmony, establish well-structured assessment methods, and integrate the multiple data sources. The novel methods and findings, including the indicator system, application of data mining and decomposing methods, and the city-level water system harmony map, deconstruct and quantify the complex and diverse water system, supporting clearer and more efficient water management policymaking.

Tracking short-term health impacts attributed to ambient PM2.5 and ozone pollution in Chinese cities: an assessment integrates daily population.

Joint and synergistic control of PM2.5 and ozone pollution is an urgent need in China and a global-widely concerned issue. Health impact assessment could provide a comprehensive perspective for PM2.5-ozone coordinated control strategies. For a detailed understanding of the seasonality and regionality of the health impacts attributed to PM2.5 and ozone in China, this study extended the classic health impact function by daily population and assessed the short-term (daily) health impacts in 335 Chinese cities in 2021. Population migration indexes from Baidu were introduced to estimate the cities' daily population. Using this method, we quantitatively investigated the influence of population on short-term health impact assessment and identified which was significant in the Pearl River Delta (PRD) region and other populous cities. Although the annual sums of PM2.5- and ozone-related daily health impacts were close for all Chinese cities, the PM2.5-related health impact was equivalent to 333.96% and 32.07% of that ozone-related, during the cold and warm periods. The correlation and local spatial association analysis found significant city-specific and city-cluster associations of daily health impacts during the warm period and in Beijing-Tianjin-Hebei and surrounding regions (BTHS) and the Yangtze River Delta (YRD). Policymakers could promote period- and pollutant-targeted control actions for the major city groups, especially the BTHS, YRD, and PRD. Our methods and findings investigated the various influences of the population on short-term health impact assessment and proposed the PM2.5-ozone collaborative control idea for key regions and city groups.

Population pharmacokinetic and optimization of polymyxin B dosing in adult patients with various renal functions.

AIMS: Current FDA-approved label recommends that the dosage of polymyxin B should be adjusted according to renal function. However, the correlation between polymyxin B pharmacokinetics (PK) and creatinine clearance (CrCL) is poor. This study aimed to develop a population PK model of polymyxin B in adult patients with various renal functions and to identify a dosing strategy. METHODS: A retrospective PK study was performed in 32 adult patients with various renal function. Nonlinear mixed effects modelling was applied to build a population PK model of polymyxin B followed by Monte Carlo simulations which designed polymyxin B dosing regimens across various renal function. RESULTS: Polymyxin B PK analyses included 112 polymyxin B concentrations at steady state from 32 adult patients, in which 71.9% of them were critically ill. In the final PK model, CrCL was the significant covariate on CL (typical value 1.59 L/h; between-subject variability 13%). The mean (SD) individual empirical Bayesian estimate of CL was 1.75 (0.43) L/h. In addition, a new dosing strategy combining the PK/pharmacodynamic (PD) targets and Monte Carlo simulation indicated that the reduction of polymyxin B dose in patients with renal insufficiency improved the probability of achieving optimal exposure. For severe infections caused by organisms with minimum inhibitory concentration (MIC) ≥ 2 mg/L, a high daily dose of polymyxin B might be possible for bacterial eradication, but the risk of nephrotoxicity is increased. CONCLUSIONS: Renal function plays a significant role in polymyxin B PK, and the dose of polymyxin B should be adjusted according to CrCL in patients with renal insufficiency.

Socioeconomic factors and regional differences of PM2.5 health risks in China.

China is a country with one of the highest concentrations of airborne particulate matter smaller than 2.5 µm (PM2.5) in the world, and it has obvious spatial-distribution characteristics. Areas of concentrated population tend to be regions with higher PM2.5 concentrations, which further aggravate the impact of PM2.5 pollution on population health. Using PM2.5-concentration and socioeconomic data for 225 cities in China in 2015, we adopted a PM2.5-health-risk-assessment method (with simplified calculation) and applied the Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model to analyze the effects of socioeconomic factors on PM2.5 health risks. The results showed that: (1) At the national level, the order of contribution degree of each socioeconomic factor in the PM2.5-health-risk and PM2.5-concentration model is consistent. (2) From a regional perspective, in all three regions, the industrial structure is the decisive factor affecting PM2.5 health risks, and reduction of energy intensity increases PM2.5 health risks, but the impact of the total amount of urban central heating on PM2.5 health risks is very low. In the eastern region, the increased urbanization rate and length of highways significantly increase PM2.5 health risks, but the increasing effect of the extent of built-up area is the lowest. In the central region, the increasing effects of the extent of built-up area on PM2.5 health risks are significantly greater than the decreasing effects of the urbanization rate. In the western region, economic development has the least effect on reducing PM2.5 health risks. Our research enriches PM2.5-health-risk theory and provides some theoretical support for PM2.5-health-risk diversity management in China.

Spatial assessment of air resources in China from 2013 to 2017.

The concept of air resource management originated in the United States and subsequently became the foundation of most air quality control programs in developed countries. However, little is known about its validity and quantitative assessment methods in regional atmospheric environment management. The aim of this study was to construct an air resource endowment (ARE) index and apply it in a case study for assessing the distribution of ARE across mainland China from 2013 to 2017. The quantification of the ARE index includes two terms: the atmospheric diffusion coefficient (A value) and self-purification ability (B value), which can be calculated via Weather Research and Forecasting modeling (WRF-CALMET). The results indicated that about 15% of China's land area enjoys high ARE, around 20-25% of China's land area was considered to have relatively high or relatively low ARE indices, and ARE in the rest of China's land area (40%) was considered to be low. Further, a complex network correlation model was created and used to demarcate highly inter-correlated regions based on the data mining of the ARE index. Six key Joint Prevention and Control of Atmospheric Pollution (JPCAP) regions with strong synchronicity in the ARE index were identified, which suggests that JPCAP could be implemented separately within each of these demarcated regions. The concepts and analysis methods proposed in this study for determining ARE and regional divisions can have broad significance for JPCAP implementation in China.

Analysis of soil risk characteristics by comprehensive assessment in an industrial area of China.

Soil pollution in industrial areas poses a major challenge for China's environmental protection. In this study, comprehensive assessment methodologies for soil risk in industrial areas were developed. The comprehensive assessment covered ecological and human health risks of soil pollution, as well as vulnerability of different types of risk receptors. Comprehensive ecological risk assessment integrated potential ecological risk assessment and landscape vulnerability assessment. Comprehensive social risk assessment specialized human health risk assessment by introducing spatial distribution of population. A typical industrial area in China was studied, and the quantitative and spatial assessments of the comprehensive soil risk were presented. The results showed that the spatial distribution of soil comprehensive ecological and social risks differed. High-risk areas of soil comprehensive ecological risk in the study area were mainly farmlands and nature reserves. Inhabited areas and industrial zones were less affected by comprehensive ecological risk of soil. By contrast, the spatial distribution of soil comprehensive social risk and human activities showed a clear trend of convergence. Vulnerability assessment of the risk receptors provided a suitable complement to the risk assessment of soil pollution.

Association between health service utilisation of internal migrant children and parents' acculturation in Guangdong, China: a cross-sectional study.

OBJECTIVES: To assess the health service utilisation of internal migrant children in Guangdong, China, and to explore the association between children's health service utilisation and their parents' acculturation. DESIGN: Cross-sectional survey between April and May 2016. SETTING: Six society-run schools of Tianhe and Baiyun districts in Guangzhou City of China. PARTICIPANTS: We recruited all students at grade 7 or 8 and one of their parents who resided in Guangzhou over 6 months without permanent registered residence (hukou) in Guangzhou (1161 pairs completed this survey). 258 children were ill within the past 2 weeks or during the last year. MAIN OUTCOME MEASURES: The main outcome was self-reported health service utilisation. Logistic regression analysis was conducted to explore the association between children's unmet needs for outpatient or inpatient service and their parents' acculturation (categorised into high, middle and low groups). RESULTS: In total, 216 children, or 18.6% of the total subjects, were ill within the past 2 weeks and were in need of outpatient service; 94 children, or 8.1% of the total subjects, were in need of inpatient service. Among them, 17.6% and 46.8% of the migrant children had unmet needs for outpatient and inpatient services, respectively. After controlling for enabling resources and predisposing characteristics, migrant children with parents in the middle-acculturation group (adjusted OR=3.17, 95% CIs 1.2 to 8.3, P<0.05) were more likely to have an unmet outpatient need than high-acculturation or low-acculturation groups, although only statistically significant when comparing with the high-acculturation group. Stratified analysis suggested that this association could be moderated by their family economic status. CONCLUSIONS: Our study suggested that the association between migrant children's health service utilisation and their parents' acculturation was complex and could be moderated by family economic status. Increasing the service utilisation among migrant children requires improving the acculturation and economic status of the parents of internal migrants.

[The Quality Assessment and Selection of Dynamic Spectrum Signal].

Near infrared spectroscopy analysis, as a kind of nondestructive real-time continuous detection method, has provided ideas for the noninvasive measurement of blood components. In this article, in order to ensure the accuracy and reliability of the collected spectral data, the 405 acquired samples are evaluated by combining valid single edge counts of dynamic spectrum pulse wave in the time domain with the quality factor Q value of dynamic spectrum pulse wave in the frequency domain. As a result, the abnormal samples are removed and 218 cases of valid samples are selected. We use the dynamic spectrum data of the selected 218 samples as the experimental group and another 218 samples as a control group modeling analysis with the hemoglobin concentration of the corresponding samples. Each group select 200 cases of samples as a calibration set and 18 cases of sample as a prediction set. The prediction accuracy of the experimental group reach 93.8%. The prediction accuracy of the two control group respectively evaluated by the valid single edge counts or Q value are 65.6% and 67.7% and the three unfiltered control groups are 53.7%, 33.3%, 42.6% respectively. The prediction mean relative error (MSEP) of the experimental group is 0.067 5, the other two control groups are 0.072 3 and 0.072 2, and the other three control groups are 0.082.3, 0.078 9, 0.082 8. So compared with another control groups, the MSEP of the experimental group is the minimal. The results show that the filtering method of the spectral data samples through combining time domain with frequency domain is reliable and effective.this will provide a method to the precision research of dynamic spectrum noninvasive detection.

Heavy metal contamination assessment and partition for industrial and mining gathering areas.

Industrial and mining activities have been recognized as the major sources of soil heavy metal contamination. This study introduced an improved Nemerow index method based on the Nemerow and geo-accumulation index. Taking a typical industrial and mining gathering area in Tianjin (China) as example, this study then analyzed the contamination sources as well as the ecological and integrated risks. The spatial distribution of the contamination level and ecological risk were determined using Geographic Information Systems. The results are as follows: (1) Zinc showed the highest contaminant level in the study area; the contamination levels of the other seven heavy metals assessed were relatively lower. (2) The combustion of fossil fuels and emissions from industrial and mining activities were the main sources of contamination in the study area. (3) The overall contamination level of heavy metals in the study area ranged from heavily contaminated to extremely contaminated and showed an uneven distribution. (4) The potential ecological risk showed an uneven distribution, and the overall ecological risk level ranged from low to moderate. This study also emphasized the importance of partition in industrial and mining areas, the extensive application of spatial analysis methods, and the consideration of human health risks in future studies.