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There is limited information regarding spatial and seasonal variations of atmospheric microplastics (MPs) and factors influencing MPs at the intersection of tropical and subtropical regions. A one-year study was conducted at sites in a high-population-density village (HPDV) and a low-population-density village (LPDV) in Taiwan to investigate the characteristics and influencing factors of airborne MPs. The predominant shapes, sizes, and polymer compositions of MPs were fragments, 3 to 25 and 26-50 µm, and polyamide at both sites. Seasonal variation in MP morphologies was not significant. Average MP concentrations were 2.20 ± 2.97 particles/m3 and 1.92 ± 2.35 particles/m3 at the HPDV and LPDV sites, respectively, and did not differ significantly. Higher concentrations and smaller sizes of MPs were found during the summer at both sites, while the predominant wind direction was southerly or southwesterly. In samples with temperatures exceeding 25 °C, the temperature was positively associated with MP concentrations at both the HPDV and LPDV sites. These results reflect that temperature influences the variations in the concentrations and sizes of MPs at our study site. Future research should consider the adverse risks of MP inhalation during the hot season. Moreover, when sites with different population densities and levels of human activity are closed, MP concentrations will not differ significantly between these areas since airflow can transport these particles from high-population-density areas into low-population-density areas in a short time.
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The clarification of possible exposure sources of multiple metals to identify associations between metal doses and urothelial carcinoma (UC) risk is currently limited in the literature. We sought to identify the exposure sources of 10 metals (Vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, cadmium, and lead) using principal component analysis (PCA) and then linked various principal component (PC) scores with environmental characteristics, including smoking-related indices, PM2.5, and distance to the nearest bus station. In addition, urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and DNA hypomethylation markers (5-methyl-2'-deoxycytidine levels; %5-MedC) were investigated in combination with UC risks. We conducted this hospital-based case control study in 359 UC patients with histologically confirmed disease and 718 controls. All data were collected from face-to-face interviews and medical records. Approximately 6 mL blood was collected from participants for analysis of multiple heavy metal and DNA methylation in leukocyte DNA. Further, a 20 mL urine sample was collected to measure urinary cotinine and 8-OHdG levels. In addition, average values for PM2.5 for individual resident were calculated using the hybrid kriging/land-use regression model. In UC patients, significantly higher cobalt, nickel, copper, arsenic, and cadmium (µg/L) levels were observed in blood when compared with controls. Three PCs with eigenvalues > 1 accounted for 24.3, 15.8, and 10.7% of UC patients, and 26.9, 16.7, and 11.1% of controls, respectively. Environmental metal sources in major clusters were potentially associated with industrial activities and traffic emissions (PC1), smoking (PC2), and food consumption, including vitamin supplements (PC3). Multiple metal doses were linked with incremental urinary 8-OHdG and DNA hypomethylation biomarkers. For individuals with high PC1 and PC2 scores, both displayed an approximate 1.2-fold risk for UC with DNA hypomethylation.In conclusion, we provide a foundation for health education and risk communication strategies to limit metal exposure in environment, so that UC risks can be improved potentially.
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Arsénico , Carcinoma de Células Transicionales , Metales Pesados , Neoplasias de la Vejiga Urinaria , Humanos , Estudios de Casos y Controles , Cobre , Cadmio , Arsénico/orina , Níquel , Monitoreo Biológico , Taiwán/epidemiología , Metales Pesados/orina , Cobalto , 8-Hidroxi-2'-Desoxicoguanosina , Material Particulado , Monitoreo del AmbienteRESUMEN
BACKGROUND: Chronic kidney disease (CKD) is increasing, with heavy metal exposure an important risk factor. Additionally, the antioxidant folic acid has been studied for reducing blood arsenic levels and related tissue damage. Therefore, we explored the association and mediation effects among various heavy metal levels in blood, plasma folate, other CKD risk factors, and impaired estimated glomerular filtration rate (eGFR). METHODS: We constructed a community-based cross-sectional study from the Human Biomonitoring and Environmental Health Program in central Taiwan. A total of 1643 participants had lived locally for > 5 years, > 40 years old, and completely received health examinations and biospecimen collections. Impaired eGFR was defined as one single eGFR < 60 mL/min/1.73 m2. Plasma folate and metal levels in blood were determined, as well as urinary 8-hydroxy-2'-deoxyguanosine as an oxidative stress marker. Generalized weighted quantile sum (WQS) regression analysis was used to calculate a WQS score, reflecting overall body-burden of multiple metals (arsenic, cadmium, chromium, nickel, and lead) in blood. RESULTS: Impaired eGFR was identified in 225 participants. Participants with high WQS scores had increased risk of impaired eGFR (odds ratio = 1.67; 95% confidence interval [CI]: 1.34, 2.07). Of five metals, arsenic, lead, and cadmium were weighted highly in impaired eGFR. Participants with high WQS and folate insufficiency (< 6 ng/mL) had 2.38-fold risk of impaired eGFR compared to those with low WQS and high folate (≥6 ng/mL) (95% CI: 1.55, 5.17). Similar increased 4.16-fold risk of impaired eGFR was shown in participants with high WQS and uric acid levels (95% CI: 2.63, 6.58). However, there were no significant WQS-folate (p = 0.87) or WQS-uric acid (p = 0.38) interactions on impaired eGFR risk. As a mediator, uric acid contributed 24% of the association between WQS score and impaired eGFR risk (p < 0.0001). However, no mediation effect of plasma folate was observed. CONCLUSION: WQS analysis could be applied to evaluate the joint effects of multiple metals exposure. High WQS scores may influence impaired eGFR risk through increased uric acid levels. A large-scale and prospective cohort study is necessary to validate these results and demonstrate any causal relationship.
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Arsénico , Metales Pesados , Insuficiencia Renal Crónica , Adulto , Cadmio , Estudios Transversales , Femenino , Ácido Fólico , Tasa de Filtración Glomerular , Humanos , Masculino , Análisis de Mediación , Estudios Prospectivos , Insuficiencia Renal Crónica/inducido químicamente , Insuficiencia Renal Crónica/epidemiología , Taiwán/epidemiología , Ácido ÚricoRESUMEN
The relationship between heavy metal exposure and human health has been investigated mostly for individual metals, failing to consider their potential interactions. In this study, we assessed the joint effects of multiple metals using generalized weighted quantile sum (WQS) regression on the risk of urothelial carcinoma (UC). Also, we performed mediation analysis to evaluate the mediator %5-MedC in DNA involved in the mechanism of urothelial carcinogenesis. We conducted a hospital-based case-control study of 355 UC patients and 710 controls, where diagnosis of UC was histologically confirmed. All data were collected from face-to-face interviews and medical records. Also, we measured six metals and 8-OHdG in urine samples along with %5-MedC in peripheral blood. Ni and Pb levels increased with UC risk in single-pollutant analysis using traditional logistic regression, and similar results were obtained in multi-pollutant analysis, where all metals analyzed were considered. In WQS analysis, the weights of Ni (27%), Pb (20%), Cr (18%), and Co (16%) predominated in the metal mixture index. WQS score and UC risk showed odds ratios of 1.65 (95%CI: 1.26, 2.15) and 1.43 (95%CI: 1.00, 2.05) for a linear and non-linear relationship, respectively. Finally, we did not observe a natural indirect effect of %5-MedC in DNA; however, a marginal effect of WQS score and natural direct effect were still found after considering a natural indirect effect. In conclusion, positive associations between WQS scores and increased risk of UC were observed. Interactions of multiple metals should be considered in assessing human health risk.
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Carcinoma de Células Transicionales , Contaminantes Ambientales , Metales Pesados , Neoplasias de la Vejiga Urinaria , Estudios de Casos y Controles , Metilación de ADN , Femenino , Humanos , Plomo , Masculino , Metales Pesados/toxicidad , Taiwán/epidemiologíaRESUMEN
BACKGROUND: Previous studies have shown inconsistent results regarding the impact of traffic pollution on the prevalence of chronic obstructive pulmonary disease (COPD). Therefore, using frequency matching and propensity scores, we explored the association between traffic pollution and COPD in a cohort of 8284 residents in a major agricultural county in Taiwan. METHODS: All subjects completed a structured questionnaire interview and health checkups. Subjects with COPD were identified using Taiwan National Health Insurance Research Databases. A hybrid kriging/LUR model was used to identify levels of traffic-related air pollutants (PM2.5 and O3). Multiple logistic regression models were used to calculate the prevalence ratios (PRs) of COPD and evaluate the role played by traffic-related indices between air pollutants and COPD. The distributed lag nonlinear model was applied in the analysis; we excluded current or ever smokers to perform the sensitivity analysis. RESULTS: Increased PRs of COPD per SD increment of PM2.5 were 1.10 (95% CI 1.05-1.15) and 1.25 (95% CI 1.13-1.40) in the population with age and sex matching as well as propensity-score matching, respectively. The results of the sensitivity analysis were similar between the single and two pollutant models. PM2.5 concentrations were significantly associated with traffic flow including sedans, buses, and trucks (p < 0.01). The higher road area and the higher PM2.5 concentrations near the subject's residence correlated with a greater risk of developing COPD (p for interaction < 0.01). CONCLUSIONS: Our results suggest that long-term exposure to traffic-related air pollution may be positively associated with the prevalence of COPD.
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Exposición a Riesgos Ambientales/efectos adversos , Vida Independiente , Material Particulado/efectos adversos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Emisiones de Vehículos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Exposición a Riesgos Ambientales/análisis , Femenino , Humanos , Vida Independiente/tendencias , Masculino , Persona de Mediana Edad , Material Particulado/análisis , Enfermedad Pulmonar Obstructiva Crónica/etiología , Taiwán/epidemiología , Emisiones de Vehículos/análisisRESUMEN
Highway vehicle emissions can result in adverse health problems to nearby residents and workers, especially during traffic congestion. In response, the policy to implement electronic toll collection (ETC) has helped alleviate traffic congestion, as compared to manual toll collection (MTC) and has led to reduced air pollution and improved public health. However, the effect of ETC in reducing particulate matter polluting the air is not well understood, especially in the ultrafine particle (UFP) range (particle diameter <100 nm). To the best of our knowledge, this is the first study to investigate how ETC affects the traffic pattern and air quality, especially UFP and PM2.5. We selected a site in Tainan, Taiwan, and measured UFP and PM2.5 concentrations before and after the construction of the ETC system. The computed traffic volumes during peak travel periods (7:00 AM to 9:00 AM and 4:00 PM to 6:00 PM) respectively, accounted for approximately 23-25% and 14-18% before and after the implementation of ETC, indicating that peak traffic volumes were more homogeneous after ETC. Moreover, the results indicate that the full implementation of ETC can help reduce UFP number concentrations and PM2.5 mass concentrations in the highway downwind area by 4 × 103 #/cm3 and 20.5 µg/m3, respectively. After the full implementation of the ETC, significant reductions in both the UFP number concentration and PM2.5 mass concentration were seen. Furthermore, excessive lifetime cancer risks (ELCR) from exposure to PM2.5 and UFP together were reduced 49.3% after the implementation of the ETC. Accordingly, ETC not only helps alleviate traffic congestion but also reduces traffic emissions and lifetime cancer risk for people living or working near highways.
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Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Monitoreo del Ambiente , Humanos , Tamaño de la Partícula , Material Particulado/análisis , Taiwán , Emisiones de Vehículos/análisisRESUMEN
Chronic exposure to inorganic arsenic (iAs) is associated with chronic kidney disease (CKD) and urinary cancer, but the risks are poorly understood. Human biomonitoring can serve as a tool to better quantify human exposure and to conduct risk assessment. We aimed to assess the population risks of CKD and urinary cancer due to iAs intake based on the blood arsenic concentrations of 601 participants in Taiwan. A physiologically based pharmacokinetic modeling-based reverse dosimetry was conducted to estimate the daily intakes of iAs (DIiAs). We performed the benchmark dose (BMD) modeling for CKD using participants' estimated glomerular filtration rate (eGFR) and the estimated DIiAs to derive a point of departure (POD). Margin of exposure (MOE) was used to characterize the risks. The population with eGFR values of <60â¯mL/min/1.73â¯m2 had significantly higher DIiAs (median: 3.20⯵g/kg/day, 2.5th-97.5th percentiles: 2.35-4.67⯵g/kg/day) than those with normal renal function (1.99, 1.22-3.42⯵g/kg/day). The POD for CKD was 1.557⯵g/kg/day, which could serve as a possible reference value for CKD risk assessment. The MOEs indicated that the CKD risk due to iAs intake may potentially be a cause for high concern for the population with reduced renal function. The iAs-induced urinary cancer risk may be a cause for moderate-to-high concern.
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Arsenicales/sangre , Monitoreo Biológico/métodos , Contaminantes Ambientales/sangre , Insuficiencia Renal Crónica/epidemiología , Neoplasias Urológicas/epidemiología , Arsenicales/efectos adversos , Contaminantes Ambientales/toxicidad , Femenino , Tasa de Filtración Glomerular , Humanos , Masculino , Radiometría , Insuficiencia Renal Crónica/fisiopatología , Medición de Riesgo , Taiwán/epidemiología , Neoplasias Urológicas/fisiopatologíaRESUMEN
The present study combined air sampling with pulmonary function tests (PFTs) to determine both the extent of air pollution proximal to an electric arc furnace (EAF) and its impact on human health. The mass concentrations of particulate matter with aerodynamic diameters less than 2.5 µm (PM2.5) in exposure areas were not significantly higher than the samples taken at a control area. However, the concentrations of five metal elements, Cd, Cr, Cu, Ni, and Zn in PM2.5 were significantly higher in the exposure area than that of the control area. PFTs showed that the average forced vital capacity (FVC) of boys was decreased with decreasing distance from the EAF factory. With normalization of pulmonary function by age, height, and weight, we found that the FVC became more negative with a decrease in distance from the EAF. Lastly, regression analysis was performed to analyze the impact of the concentrations of the five metals in PM2.5 on the performance of pulmonary function. The results showed that the metals can be ranked from the highest to the lowest in terms of impact on the FVC of boys as follows: Cr, Cd, Ni, Cu, and Zn. This finding is consistent with the ranking of metal toxicity reported in the literature for a rat lung epithelial cell line. The results of this study showed that only measuring PM2.5 mass concentrations may not provide a full explanation of its toxicity and health effects. The chemical composition of the PM2.5 can be an important factor that determined the health impact of PM2.5.
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Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/efectos adversos , Calefacción/efectos adversos , Metales/toxicidad , Material Particulado/toxicidad , Adolescente , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Cadmio/análisis , Cadmio/toxicidad , Niño , Cromo/análisis , Cromo/toxicidad , Cobre/análisis , Cobre/toxicidad , Monitoreo del Ambiente , Calefacción/métodos , Humanos , Metales/análisis , Níquel/análisis , Níquel/toxicidad , Material Particulado/análisis , Regresión Psicológica , Pruebas de Función Respiratoria , Instituciones Académicas , Taiwán , Zinc/análisis , Zinc/toxicidadRESUMEN
OBJECTIVES: To evaluate possible sources of exposure to heavy metals in the general population, and to determine the association between urinary heavy metals and urothelial carcinoma risk. METHODS: We recruited 205 patients with urothelial carcinoma and 406 control participants for a case-control study between June 2011 and December 2013. The control participants were frequency-matched with cases according to sex and age. We measured the urinary levels of arsenic, cadmium, chromium, nickel and lead by using inductively coupled plasma mass spectrometry. We collected environmental exposure-related information through questionnaires. Multivariate logistic regression and 95% confidence intervals were applied to estimate the urothelial carcinoma risk and potential effects of urothelial carcinoma-related risk factors on the levels of urinary heavy metals. RESULTS: Patients with urothelial carcinoma showed higher urinary levels of arsenic, cadmium, chromium, nickel and lead than the controls. After considering other potential risk factors, a significantly increased risk for urothelial carcinoma was observed in patients with increased urinary levels of cadmium, chromium, nickel and lead. Smokers showed a high urinary cadmium level. In addition to cadmium, a high urinary lead level was associated with cumulative cigarette smoking and herbal medicine use. CONCLUSION: Environmental factors might contribute to higher urinary levels of heavy metals and ultimately result in urothelial carcinoma carcinogenesis. These findings can promote proper environmental surveillance of exposure to heavy metals in the general population.
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Carcinoma de Células Transicionales/epidemiología , Exposición a Riesgos Ambientales , Contaminantes Ambientales/orina , Metales Pesados/orina , Neoplasias Urológicas/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Carcinogénesis/inducido químicamente , Estudios de Casos y Controles , Monitoreo del Ambiente , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Exposición Profesional , Preparaciones de Plantas/efectos adversos , Preparaciones de Plantas/química , Factores de Riesgo , Fumar/orina , Encuestas y Cuestionarios , Taiwán/epidemiologíaRESUMEN
There were many studies that reported the concentrations of trace elements in fish and assessed the human health risk through consumption of contaminated fish. However, fish species with different feeding habits may accumulate toxic elements differentially in their muscle. In this study, we conducted a field survey to analyze concentrations of ten trace elements in water, sediment, artificial feed, and different part of muscles either with or without skin of two species of fish, tilapia and milkfish. The results of this study showed that the ventral and dorsal muscles with skin contained higher concentrations of metals than those without skin for both species of fish. Tilapia lives in the bottom layer, the ventral part therefore contacts closely with sediment. A higher metal concentration in ventral muscle was obtained in this study when compared to dorsal muscle for tilapia. The estimated Metal Pollution Index (MPI) of tilapia is higher than that of milkfish. Our results indicated that metal concentrations in muscle of tilapia are mainly originated from sediment. However, sources of metal concentrations in muscle of milkfish can be from sediment and artificial feed.
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Conducta Alimentaria/fisiología , Peces/metabolismo , Metales/metabolismo , Músculos/química , Estanques/química , Tilapia/metabolismo , Oligoelementos/metabolismo , Contaminantes Químicos del Agua/metabolismo , Alimentación Animal/análisis , Animales , Monitoreo del Ambiente , Explotaciones Pesqueras , Sedimentos Geológicos/química , Metales/análisis , Músculos/metabolismo , Oligoelementos/análisis , Contaminantes Químicos del Agua/análisisRESUMEN
The release of chloroform from water to air in an indoor swimming pool (ISP) exhibits complex physicochemical interactions among many variables, including environmental conditions, occupant activities, and geometry of the ISP. By combining the relevant variables, a structured mathematical model, the double-layer air compartment (DLAC) model, was developed to predict the level of chloroform in ISP air. A physical parameter, the indoor airflow recycle ratio (R), was incorporated into the DLAC model due to internal airflow circulation resulting in the ISP structural configuration. The theoretical R-value for a specific indoor airflow rate (vy) can be found by fitting the predicted residence time distribution (RTD) to the simulated RTD from computational fluid dynamics (CFD), showing a positive linear relationship with vy. The mechanical energies induced by occupant activities were converted into a lumped overall mass-transfer coefficient to account for the enhanced mass transfer of chloroform from the water into the air and mixing in ISP air. The DLAC model predicted that chloroform air concentrations were statistically less accurate without considering the influence of R compared with the online open-path Fourier transform infrared measurements. A novel index, the magnitude of emission (MOE) from swimmers, was linked to the level of chloroform in ISP water. The capability of the DLAC model associated with the MOE concept may facilitate upgrading the hygiene management of ISPs, including the ability to administer necessary chlorine additives in pool water and monitor the chloroform in ISP air.
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Contaminación del Aire Interior , Piscinas , Cloroformo/análisis , Natación , Pulmón/química , Modelos TeóricosRESUMEN
Background: Fuzzy inference systems (FISs) based on fuzzy theory in mathematics were previously applied to infer supplementary points for the limited number of monitoring sites and improve the uncertainty of spatial data. Therefore we adopted the FIS method to simulate spatiotemporal levels of air pollutants [particulate matter <2.5 µm (PM2.5), sulfur dioxide (SO2) and (NO2)] and investigated the association of levels of air pollutants with the community-based prevalence of chronic kidney disease (CKD). Methods: A Complex Health Screening program was launched during 2012-2013 and a total of 8284 community residents in Chiayi County, which is located in southwestern Taiwan, received a series of standard physical examinations, including measurement of estimated glomerular filtration rate (eGFR). CKD cases were defined as eGFR <60 mL/min/1.73 m2 and were matched for age and gender in a 1:4 ratio of cases:controls. Data on air pollutants were collected from air quality monitoring stations during 2006-2016. The longitude, latitude and recruitment month of the individual case were entered into the trained FIS. The defuzzification process was performed based on the proper membership functions and fuzzy logic rules to infer the concentrations of air pollutants. In addition, we used conditional logistic regression and the distributed lag nonlinear model to calculate the prevalence ratios of CKD and the 95% confidence interval. Confounders including Framingham Risk Score (FRS), diabetes, gout, arthritis, heart disease, metabolic syndrome and vegetables consumption were adjusted in the models. Results: Participants with a high FRS (>10%), diabetes, heart disease, gout, arthritis or metabolic syndrome had significantly increased CKD prevalence. After adjustment for confounders, PM2.5 levels were significantly increased in CKD cases in both single- and two-pollutant models (prevalence ratio 1.31-1.34). There was a positive association with CKD in the two-pollutant models for NO2. However, similar results were not observed for SO2. Conclusions: FIS may be helpful to reduce uncertainty with better interpolation for limited monitoring stations. Meanwhile, long-term exposure to ambient PM2.5 appears to be associated with an increased prevalence of CKD, based on a FIS model.
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Limited literature has explored the effect of air pollutants on chronic kidney disease (CKD) progression, especially for patients with pre-end-stage renal disease (pre-ESRD). In this study, we reported the linear and nonlinear relationships of air pollutants of particles with diameter <2.5 µm (PM2.5) and nitrogen dioxide (NO2) with estimated glomerular filtration rate (eGFR) deterioration after adjusting for smoking status and other traditional clinical factors. This study adopted a retrospective cohort of patients with stage 3b to stage 5 CKD (N = 11,479) from Taichung Veterans General Hospital during January 2006 to December 2020. The eGFR deterioration was defined as a decline in eGFR > 5 ml/min/1.73 m2/year. Hybrid kriging/land-use regression models were used to estimate the individual exposure levels of PM2.5 and NO2. The relationships of air pollutants with eGFR deterioration were evaluated using Cox proportional hazard models. After adjusting for smoking status, baseline eGFR stages, and other traditional clinical factors, the risk of eGFR deterioration was found to increase with increasing PM2.5 and NO2 level (p < 0.0001 and p = 0.041, respectively), especially for those exposed to PM2.5 ≥ 31.44 µg/m3 or NO2 ≥ 15.00 ppb. Similar results were also found in the two-pollutant models. Nonlinear dose-response relationships of eGFR deterioration were observed for concentrations of 26.11 µg/m3 for PM2.5 and 15.06 ppb for NO2. In conclusion, linear and nonlinear associations between PM2.5 and NO2 levels and the incidence risk of eGFR deterioration were observed in patients with pre-ESRD.
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Contaminantes Atmosféricos , Contaminación del Aire , Fallo Renal Crónico , Insuficiencia Renal Crónica , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Estudios de Cohortes , Exposición a Riesgos Ambientales/efectos adversos , Femenino , Tasa de Filtración Glomerular , Humanos , Fallo Renal Crónico/epidemiología , Masculino , Dióxido de Nitrógeno/análisis , Material Particulado/efectos adversos , Material Particulado/análisis , Insuficiencia Renal Crónica/epidemiología , Insuficiencia Renal Crónica/etiología , Estudios RetrospectivosRESUMEN
Sodium-glucose cotransporter 2 inhibitor (SGLT2i) potentially decrease all-cause and cardiovascular death, however, associations with non-cardiovascular death remain unclear. Therefore, we investigated SGLT2i associations with death and the cause of death. We used the Taiwanese National Health Institutes Research database linked to the National Register of Deaths (NRD). Incident type 2 diabetes mellitus (T2DM) patients and propensity score matched T2DM SGLT2i and Dipeptidyl peptidase 4 inhibitor (DPP4i) users were investigated. The index year was the SGLT2i or DPP4i prescription date from May 2016. Patients were followed-up until death or December 2018. Deaths verified by the NRD and grouped accordingly. Multiple Cox proportional hazards models were used. In total, 261,211 patients were included in the population; 47% of the patients were female and the average age was 62 years. The overall incidence of all-cause death was 8.67/1000 patient-years for SGLT2i and 12.41 for DPP4i users during follow-up. After adjusting for potential risk factors in the propensity score matched population, SGLT2i users were associated with lower risks of all-cause death, cardiovascular death, cancer death, and non-cancer, non-vascular death compared with DPP4i-users. For specific death causes, significantly lower death risks from heart disease, cerebrovascular disease, and accidents were associated with SGLT2i-use. SGLT2i benefits for T2DM patients were not different across subgroups. Compared with DPP4i-use, SGLT2i-use for T2DM was associated with lower disease and death risk.
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Diabetes Mellitus Tipo 2 , Inhibidores de la Dipeptidil-Peptidasa IV , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Causas de Muerte , Diabetes Mellitus Tipo 2/complicaciones , Inhibidores de la Dipeptidil-Peptidasa IV/farmacología , Femenino , Humanos , Hipoglucemiantes/efectos adversos , Incidencia , Masculino , Persona de Mediana Edad , Inhibidores del Cotransportador de Sodio-Glucosa 2/farmacologíaRESUMEN
BACKGROUND: The effects of emissions from coal-fired power plants on children's exposure to polycyclic aromatic hydrocarbons (PAHs) are not well understood. OBJECTIVES: This study aimed to evaluate the sources and the urinary levels of 1-hydroxypyrene, a biomarker of exposure to PAHs, among children living in proximity to a coal-fired power plant. METHODS: Study areas consisted of two high exposure and two low exposure communities, at different distances and directions from a large coal-fired power plant in central Taiwan. Study subjects included 369 children aged 1-13 years and randomly selected from each community. Each child's urinary 1-hydroxypyrene concentration was measured by a high-performance liquid chromatography-fluorescence detector method. Samples of ambient air were analyzed for PAHs using a gas chromatography-mass spectrometry method. Information on important factors was collected by an interview using a structured questionnaire. Multiple regression analysis was used to assess factors significantly associated with urinary 1-hydroxypyrene levels. RESULTS: Levels of PAHs in ambient air in the high exposure communities were higher than those in the low exposure communities. Children living in high exposure communities had higher mean urinary 1-hydroxypyrene concentrations than those in low exposure communities (0.186 and 0.194 vs. 0.113 and 0.122 µmol/mol-creatinine, respectively). The difference in urinary 1-hydroxypyrene levels between the high exposure communities and one low exposure community remained significant after adjusting for age, gender, environmental tobacco smoke, dietary exposure, and traffic. CONCLUSIONS: Children living in communities downwind of and in proximity to the coal-fired power plant had significantly increased urinary 1-hydroxypyrene levels.
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Carbón Mineral , Centrales Eléctricas , Pirenos/análisis , Orina/química , Adolescente , Niño , Preescolar , Cromatografía Líquida de Alta Presión , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Espectrometría de Fluorescencia , TaiwánRESUMEN
BACKGROUND: Limited studies have prospectively examined the role of body mass index (BMI) as a major risk factor for asthma during adolescence. This study investigates whether BMI is associated with increased risk of developing physician-diagnosed asthma during 12-month follow-up among adolescents with undiagnosed asthma-like symptoms at baseline. METHODS: A total of 4,052 adolescents with undiagnosed asthma-like symptoms at baseline were re-examined after a 12-month follow-up. Asthma cases were considered confirmed only after diagnosis by a physician based on the New England core and International Study of Asthma and Allergies in Childhood (ISAAC) criteria video questionnaires, and accompanying pulmonary function tests. Logistic regression analyses were used to evaluate the relationship of BMI and the risk of acquiring asthma. RESULTS: The results indicated that girls with higher BMI were at an increased risk of developing asthma during the 12-month follow-up. The odds ratios for girls developing physician-diagnosed asthma were 1.75 (95% CI = 1.18-2.61) and 1.12 (95% CI = 0.76-1.67), respectively, for overweight and obesity as compared to the normal weight reference group after adjustment for other covariates. A similar relationship was not observed for overweight and obese boys who were also significantly more active than their female counterparts. CONCLUSIONS: Increased BMI exaggerates the risk of acquiring asthma in symptomatic adolescent females but not in adolescent males. Thus, gender is an important modifier of BMI-related asthma risk. Additional research will be required to determine whether the increased asthma risk results from genetic, physiological or behavioural differences.
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Asma/etiología , Asma/fisiopatología , Índice de Masa Corporal , Adolescente , Asma/diagnóstico , Estudios de Cohortes , Intervalos de Confianza , Femenino , Humanos , Modelos Logísticos , Masculino , Oportunidad Relativa , Estudios Prospectivos , Medición de Riesgo , Encuestas y Cuestionarios , TaiwánRESUMEN
Previous studies have indicated that women suffer from dry eye syndrome (DES) more significantly than men. Therefore, we specifically explore the associations between air pollutant levels and the risks of DES for women. The study obtained 27,605 participants from the 29 recruitment centers of the Taiwan Biobank, which was established in October 2012. A large scale cross-sectional study involving DES sufferers and age- and education-matched control groups without DES was designed. Based on the municipality of residence, the predicted concentration levels of various air pollutants, including PM2.5, sulfur dioxide (SO2), ozone (O3), and nitrogen dioxide (NO2) were estimated by using hybrid kriging/LUR model. Multiple logistic regressions were applied to estimate the prevalence ratios (PR) of DES and 95% confidence interval. Hormone supplementations, DBP, allergies, and arthritis were considered as important comorbidities for increased PR risk of DES. In addition, with each standard deviation (SD) increment of PM2.5 and temperature, women had significant increases in PRs of DES of 1.09- and 1.07-fold, respectively; conversely, each SD increment of relative humidity (RH) had a protective effect against the risk of DES. After considering hormone supplementation, arthritis, and allergy, the SD increment of NO2 and temperature were associated with the PRs of DES. In conclusion, significant associations of ambient NO2 concentration, RH and temperature with DES indicated the importance of increased environmental protection in the female population. Female exposure to high levels of NO2 when receiving hormone supplementation, or suffering with allergies or arthritis, had significantly increased risk of DES.
Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Síndromes de Ojo Seco , Ozono , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Estudios Transversales , Síndromes de Ojo Seco/inducido químicamente , Síndromes de Ojo Seco/epidemiología , Exposición a Riesgos Ambientales/análisis , Femenino , Humanos , Masculino , Dióxido de Nitrógeno/análisis , Dióxido de Nitrógeno/toxicidad , Ozono/análisis , Material Particulado/análisis , Material Particulado/toxicidad , Taiwán/epidemiologíaRESUMEN
This study aimed to determine the concentration of volatile organic compounds (VOCs) and investigate the impacts of traffic and industrial activities on the concentration of VOCs near the Central Taiwan Science Park (CTSP) in Taiwan during 2005. Twelve-hour canister sampling was performed at 10 sites near CTSP every season. Samples were analyzed by gas chromatography with a mass-selective detector. The traffic flow rate, industrial production rates, and meteorological information were also collected to assess their impacts on VOC concentrations using multiple linear regression models. The major components determined in the atmosphere were toluene (29.4-218.8 microg m(-3)), acetone (30-71.3 microg m(-3)), m/p-xylene (7.8-51.7 microg m(-3)), and ethanol (16.4-47.8 microg m(-3)); only ethanol revealed a pattern of increasing concentration from spring to winter. The log-transformed mean concentrations of toluene, acetone, and ethanol were significantly associated with the production rates of the optoelectronic companies after adjustment for traffic flow and meteorological factors (P < 0.05). There was no significant association between the total traffic flow rate and any log-transformed mean concentrations of VOCs. Each $1 million (U.S.) increase in optoelectronic sales was significantly associated with increasing mean concentrations of 1.29 +/- 1.08 microg m(-3) for toluene, 1.13 +/- 1.05 microg m(-3) for acetone, and 1.25 +/- 1.09 microg m(-3) for ethanol. The authors' findings suggest that optoelectronic industrial activities are still the predominant source for VOC emissions surrounding this industrial park.
Asunto(s)
Contaminantes Atmosféricos/análisis , Residuos Industriales/análisis , Emisiones de Vehículos/análisis , Compuestos Orgánicos Volátiles/análisis , Monitoreo del Ambiente , Estaciones del Año , Taiwán , Tiempo (Meteorología)RESUMEN
Fine particulate matter (PM2.5) emitted from electric arc furnaces (EAFs) poses health concerns. However, little research has been done on the impact of EAF on the health of community residents. This cross-sectional study conducted a PM2.5 exposure assessment and health examination of community residents living near an EAF. A total of 965 residents aged 40-90 years were recruited. The residents' exposure to PM2.5 was categorized according to the distance of their residence from the EAFs (<500, 500-1000, 1000-1500, 1500-2000, and > 2000 m). Average ambient PM2.5 concentrations were estimated using a hybrid kriging/land-use regression (LUR) model. In addition, we selected two air-sampling sites to monitor the 2-year levels of PM2.5 and particle-bound metals. A spot urine sample and blood samples were collected and ten heavy metal concentrations in the blood were analyzed. Inflammation- and oxidative stress-related biomarkers were measured. The associations between environmental factors and a biochemical examination were estimated using a generalized linear model. Active air sampling and hybrid kriging/LUR model simulation indicated increased levels of PM2.5 near the EAF. The metal concentrations in PM2.5 included Fe, Pb, Mn, Ni, As, Cu, Ni, Zn, and Al, which also significantly increased near the EAF. PM2.5 levels were significantly associated with an increased total cholesterol-high-density lipoprotein (TC/HDL) ratio. High levels of PM2.5 and malondialdehyde were associated with a 1.72-fold increased risk of TC/HDL ratio ≥ 4 (95% CI: 1.12-2.65) after adjusting for potential confounding factors. Blood Pb levels were significantly associated with increased systolic and diastolic blood pressure and decreased estimated glomerular filtration rate but negatively associated with distance from the EAF. The results show that people living near EAFs should pay more attention to adverse health problems, including atherogenic dyslipidemia, hypertension, and chronic kidney disease associated with exposure to PM2.5 and particle-bound metals.
Asunto(s)
Contaminantes Atmosféricos/análisis , Metales Pesados/análisis , Estudios Transversales , Monitoreo del Ambiente , Material Particulado/análisisRESUMEN
Cigarette smoke is a known risk factor for urothelial carcinoma (UC). However, there is limited information about the distributions and effects of volatile organic compounds (VOCs) on smoking-related UC risk. With this hospital-based case-control study, we explored the associations between urinary levels of cotinine and VOC metabolites (acrylamide, 1,3-butadiene, and benzene) and the risk of UC. Urological examinations and pathological verifications were used to confirm the diagnoses of UC. All study participants provided smoking-related information via questionnaires and face-to-face interviews; they also provided urine samples for the measurement of VOC metabolites, cotinine, and 8-hydroxydeoxyguanosine (8-OHdG), which was used as an indicator of oxidative stress. We applied multiple logistic regression analysis to estimate the risk of UC, and we found that levels of urinary cotinine and 8-OHdG were higher in the UC group than in the control group. Furthermore, urinary levels of VOC metabolites, including N-acetyl-S-(2-carbamoylethyl)-L-cysteine (AAMA), N-acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine, N-acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine-3, trans,trans-muconic acid (t,t-MA), and S-phenylmercapturic acid (SPMA), increased with increasing levels of urinary cotinine. After adjusting for potential risk factors, dose-response relationships were observed between UC risk and urinary levels of AAMA, t,t-MA, SPMA, and 8-OHdG. Participants with high urinary levels of cotinine, AAMA, t,t-MA, SPMA, and 8-OHdG had risks of UC that were 3.5- to 6-fold higher than those of participants with lower levels. Future, large-scale investigations of the risks of UC should be explored, and repeated measurement of VOC metabolites should be assessed.