Sentinel animals for monitoring the environmental lead exposure: combination of traditional review and visualization analysis.

In nature, certain animals share a common living environment with humans, thus these animals have become biomonitors of health effects related to various environmental exposures. As one of the most toxic environmental chemicals, lead (Pb) can cause detriment health effects to animals, plants, and even humans through different exposure pathways such as atmosphere, soil, food, water, and dust, etc. Sentinel animals played an "indicative" role in the researches of environmental pollution monitoring and human health. In order to comprehend the usage of sentinel animals in the indication of environmental Pb pollution and human Pb exposure completely, a combination of traditional review and visualization analysis based on CiteSpace literature was used to review earlier researches in this study. In the first instance, present researches on exposure sources and exposure pathways of Pb were summarized briefly, and then the studies using sentinel animals to monitor environmental heavy metal pollution and human health were combed. Finally, visualization software CiteSpace 5.8.R3 was used to explore and analyze the hotspots and frontiers of lead exposure and sentinel animals researches at home and abroad. The results showed that certain mammals were good indicators for human lead exposure. Sentinel animals had been widely used to monitor the ecological environment and human lead exposure. Among them, the blood lead levels of small mammals, particularly for domestic dogs and cats, had a significant correlation with the blood lead levels of human living in the same environment. It indicated that certain biological indicators in animals can be used as surrogates to monitor human body exposure to heavy metals. This study also explored the challenges and perspectives that may be faced in sentinel animal research, in order to provide a certain theoretical basis and train of thought guidance for future research.

Association between exposure to air pollution and risk of allergic rhinitis: A systematic review and meta-analysis.

BACKGROUND: Allergic rhinitis (AR) is one of the most common allergic diseases in the world, and usually persists throughout the activity. Epidemiological studies have shown a positive association between air pollution and allergic rhinitis. However, we could not find any meta-analysis of the risk of air pollutants (PM2.5, PM10, NO2, SO2, O3 and CO) on the prevalence of AR in people of all ages. OBJECTIVES: Carry out a meta-analysis on the results of recent studies (up to 2020) to present valid information about exposure to air pollution and risk of prevalence of AR. METHODS: We systematically searched three databases for studies up to December 17, 2020, including air pollution and AR. Random effect models were conducted to estimate the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). Subgroup analysis, funnel plot, Egger's test, and the trim-and-fill method were also conducted. RESULTS: Thirty-five studies across 12 countries, including a total of 453,470 participants, were included. The OR per 10 µg/m3 increase of pollutants was 1.13 (1.04-1.22) for PM10 and 1.12 (1.05-1.20) for PM2.5. The OR per 10 µg/m3 increment of gaseous pollutants were 1.13 (1.07-1.20) for NO2, 1.13 (1.04-1.22) for SO2 and 1.07 (1.01-1.12) for O3. No significant association was observed between CO and AR. Children or adolescents are more sensitive to air pollution than adults. The effects of PM10 and SO2 were significantly stronger in Europe than Asia. The effects of air pollutants were more significant and higher in developing countries than in developed countries, except for PM10. A significant difference of subgroup test was found between developed and developing countries of NO2. CONCLUSION: This meta-analysis showed a positive association between air pollution and the prevalence of allergic rhinitis, and identified geographic area and economic level as the potential modifiers for the association.

Health risk assessment of As due to rice ingestion based on iAs distribution and actual consumption patterns for the residents in Beijing: a cross-sectional study.

As a well-known human carcinogen, arsenic (As) could pose various detrimental health effects to humans mainly through the exposure pathway of food ingestion. In comparison with other foods, rice can accumulate more arsenic due to its tissue specificity. Thus, it is of great significance to assess the health risk of As due to rice ingestion. However, the study on risk assessment from exposure to As in rice is still in an early stage and lack accuracy to date. In this study, after obtaining the rice exposure behavior patterns based on a questionnaire survey, a total of 160 rice samples, which consisted of 4 types (i.e., japonica, indica, glutinous and brown rice), rice from 4 areas and consumed by most of the population in Beijing, were collected. On the basis of the actual intake rate and the species weighted average concentration of consumed rice, average daily exposure dose and health risks of inorganic As (iAs) from rice ingestion were assessed for the population among different genders and ages in Beijing. The results show that japonica rice and rice from Northeast China had higher As content, with the same value of 0.064 mg kg-1. And, they were the most popular rice consumed by people, with the intake rates of 75.50 g d-1, and 67.91 g d-1, respectively. The proportion of iAs to total As (tAs) was 58.34%, with a range of 43.18-71.88%. The average daily dose of iAs for the population was 1.15 × 10-4, which mainly came from japonica rice and the rice from Northeast China ingestion. In comparison with the acceptable non-cancer risk, which had a HQ value of 0.38, the carcinogenic risk of the population in Beijing was 1.73 × 10-4 on average. Furthermore, males had higher carcinogenic risk (1.88 × 10-4) than females (1.62 × 10-4), and the people in the age of 45-55 suffered from the highest carcinogenic risk (2.22 × 10-4), which mainly was attributed to the japonica rice and the rice from Northeast China. This study strengthened that appropriate dietary patterns should be paid more attention in order to control the health risk due to As exposure.

Association between milk intake and childhood growth: results from a nationwide cross-sectional survey.

PURPOSE: The literature is inconsistent regarding milk intake and physical growth. This study aims to evaluate the association of milk intake with body height and weight in a nationally representative sample of Chinese children. METHODS: A total of 41,439 children ages 6-17 were recruited from 30 provinces in mainland China in 2013-2016 using a multistage stratified cluster sampling approach. Milk intake information was collected using a questionnaire aided with standard containers. Weight and height were measured using a standard physician beam scale with a height rod. Milk intake was categorized into no-, low-, and high-intake groups based on the intake rate, and weight status into normal, overweight, and obese groups based on the body-mass-index (BMI). Associations between height/weight status and milk intake were evaluated using multivariate weighted linear and logistic regression models. RESULTS: Chinese children had low milk intake: 1/5 of children did not drink milk, and those drinking milk had a median intake of 100 ml/month. The low- and high-intake groups were 0.83 cm (95% confidence interval: 0.00, 1.68 cm) and 1.26 cm (0.34, 2.19 cm) taller than the no-intake group for girls, respectively, after adjusting for confounding factors. Boys with high milk intake had lower BMI (-0.56, 95% CI: -1.00, -0.12 kg/m2) and risk of obesity (OR = 0.67, 95% CI: 0.46, 0.97) than those without milk intake. CONCLUSIONS: This study revealed the association of increased milk intake with increased body height and lowered obesity risk among Chinese children. Given the cross-sectional nature of the study and the possibility of residual confounding, further research is warranted to uncover the role of milk intake in promoting children's growth.

Patterns and sociodemographic determinants of water intake by children in China: results from the first national population-based survey.

PURPOSE: Accurate data on water and beverage intakes are essential for assessing hydration adequacy and setting proper guidelines. The objective of this study is to identify the patterns and sociodemographic determinants of water intake and to assess the intake adequacy for children in China. METHODS: The study team recruited 41,439 children aged 6-17 years using a multi-stage cluster random sampling method. Daily water and beverage intakes were investigated with the standard questionnaires and measuring containers in face-to-face interviews. Each participant was assigned an adjustment weight to obtain a nationally representative sample. Sociodemographic factors influencing water intake were identified using multi-variable regressions. Water intake adequacy was evaluated by comparing with the recommended water intake (RWI). RESULTS: The mean ± standard deviation of total water intake (TWI) was 1603 ± 731 mL/day for boys and 1487 ± 661 mL/day for girls. Plain water, food moisture, and other beverages contributed 51%, 20%, and 29% of the TWI. Multi-variable analyses showed that TWI of children increased with age, in urban areas and day schools, and with parents' economic and educational levels. The majority (82%) of children had TWI not meeting the corresponding RWI, and the percentage increased with age except for 14-17-year-old boys. CONCLUSIONS: Plain water is still the major source of daily water intake by children in China. Unfortunately, the majority of children do not have sufficient water intake, which warrants future actions and guidelines targeting adequate hydration.

Quantificational exposure, sources, and health risks posed by heavy metals in indoor and outdoor household dust in a typical smelting area in China.

Contamination of metals in household dust remains a concern for human health. However, few studies to date have been conducted on the contribution of both indoor and outdoor environments to the health risks posed by metals. This study was carried out to assess the potential health risks from both indoor and outdoor household dust and the respective contribution to the health risks for children. The results showed that household dusts were heavily polluted by metal(loid)s, which were up to 30 times higher than the relative background level, and were attributed to smelting activity. However, there are other pollution sources in indoor environments, since the I/O ratio values of Pb, Cd, and As were significantly higher than 1. HI values of Pb and As exceeded the threshold of (1) and accounted for approximately 60% and 24% to the HIt, respectively. The HIts of Zn, Cr, Mn, Hg, and Cu were mainly attributable to indoor dust exposure, particularly for Hg (73.44%), indicating non-carcinogenic health risks could be attributed more to the indoor dust exposure. This study highlights the potential risks of metal contamination in household environment, particularly indoor environment, on the health of children who live in the vicinity of smelting activity.

Association of solid fuel use with risk of stunting in children living in China.

Stunting adversely affects physical and mental outcomes of children. It has not been examined whether household air pollution from solid fuel combustion is a risk factor for stunting in children. In a total of 41,439 children aged 6-17 across China, height was measured using a unified protocol. Multivariable linear regression models and logistic regression models were used to assess the associations of solid fuel use for cooking/heating with stunting in children. Adjusted for covariates, cooking/heating with solid fuel was significantly associated with a lower z-score for height for age and sex (ß = -0.21 [-0.32 to -0.09] and -0.17 [-0.31 to -0.03], respectively) and an increased risk of stunting with an estimated ORs of 1.34 [1.07~1.68] and 1.37 [1.02~1.83], respectively. The risk of stunting associated with solid fuel use was statistically significant in high-age children. And the effect was greater on girls than on boys, though the difference was not statistically significant. Our study suggested that Chinese children living in households using solid fuel had a significantly higher risk of stunting than those living in households using cleaner fuel.

Health risks and source identification of dietary exposure to indicator polychlorinated biphenyls (PCBs) in Lanzhou, China.

Polychlorinated biphenyls (PCBs) are widely present in multiple environmental media even long after the phaseout, posing a health risk to the general population. Dietary intake is the major exposure route of PCBs; however, information is limited regarding PCBs in food that people directly consume. This study aims to measure personal exposure to indicator PCBs, evaluate the health risks, and identify their sources in a typical metropolitan city in China. Multi-day food samples were collected from 21 subjects in Lanzhou, Gansu Province, in two seasons using the duplicate plate method. Samples were extracted and analyzed for seven indicator PCBs using gas chromatography/mass spectrometry. Average daily doses (ADDs) of ∑7PCBs were estimated using Monte Carlo analysis with food intake information. Results show that PCB-118 and PCB-180 were the major congeners in food samples with average concentrations of 1.42 and 1.11 ng/g, respectively. The average (± SD) ADD of ∑7PCBs was 26.47 ± 22.10 ng/kg day among adults aged 18-69 years and displayed small variation across age groups. Comparing with the chronic RfD of 7 ng/kg day, 67% of people had their ADDs exceeding this threshold. The median cancer risk was 5.52 × 10-5, and 51% of residents had risks exceeding the action level of 10-4. The principal component analysis identified waste incineration, gasoline engine production, and leakage of #1 PCBs as the major PCBs sources. In conclusion, a large portion of Lanzhou residents has high non-cancer and cancer risks from dietary exposure to PCBs, which warrants control actions targeting these major sources.

Metals compositions of indoor PM2.5, health risk assessment, and birth outcomes in Lanzhou, China.

The study aimed to investigate the metal compositions in indoor PM2.5 and the potential health risks they pose to residents of an urban area in China. A total of 41 and 54 households were surveyed in February and September 2013, respectively. The results showed that the indoor concentrations of metals varied depending on the types of cooking fuels used. All measured concentrations of metals were highest among households using coal for cooking. In the majority of households, non-carcinogenic risks were posed by the use of coal. The carcinogenic risks posed by chromium (VI) and arsenic were generally higher among households using coal for cooking than among those using gas or electricity. The multivariate linear regression model suggested a potential adverse effect from arsenic and cadmium on birth weight and gestational weeks. This study also found that cooking fuel was the most significant factor that contributed to the differences in concentrations of metals in indoor PM2.5 and highlighted the importance of using clean energy for cooking and heating.

Emerging concern on air pollution and health: Trade-off between air pollution exposure and physical activity.

Air pollution is a major contributor to the global disease burden, especially affecting respiratory and cardiovascular health. However, physical activity is associated with improved lung function, a slower decline in lung function, and lower mortality. The public is more likely to be exposed to air pollution during outdoor physical activity. However, studies on how long-term and short-term exposure to air pollution interacts with physical activity yield inconsistent results, and the thresholds for air pollution and physical activity remain unclear. Thus, more studies are needed to provide sufficient evidence to guide the public to safely engage in outdoor physical activity when exposed to air pollution.

[Characteristics and Identification Priority Source of Heavy Metals Pollution in Farmland Soils in the Yellow River Basin].

Assessments of the soil environmental quality of farmland and pollution source apportionment are the foundation for ensuring national food security and agricultural sustainable development, as well as an important prerequisite for the pursuit to keep our lands clean. This study evaluated the characteristics of heavy metal pollution in farmland soils in the Yellow River Basin from 2000 to 2023, based on the data of heavy metal contents including As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn, using the geo-accumulation index method. Source apportionment was conducted by employing a positive matrix factorization (PMF) model. The probabilistic health risks were evaluated by coupling Monte Carlo simulation with a human health risk assessment model, and priority pollution sources and elements were identified. The results showed that:① the average content of all heavy metals in farmland soils within the study area was lower than the screening values specified in the soil environment quality risk control standard for soil contamination of agriculture land (GB 15618-2018) (pH>7.5). However, the contents of Cd, As, and Zn in the samples exceeded their screening values, with percentages of 21.69%, 5.56%, and 1.23%, respectively, with Cd having the highest rate of exceedance. ② Hg and Cd were moderately polluted, Cu and Pb were slightly polluted, and the other elements were not polluted. ③ The main sources of heavy metals in farmland soil were traffic-industrial sources, natural-agricultural sources, industrial-natural sources, and agricultural-industrial sources, with contribution rates of 37.04%, 26.69%, 21.72%, and 14.55%, respectively. ④ Heavy metals in farmland soil posed carcinogenic health risks to adults and children but did not have non-carcinogenic risks; As and Cd were priority control elements for human health risks, and industrial-natural sources and agricultural-industrial sources were priority control sources in the study area.

Domestic dogs as sentinels of children lead exposure: Multi-pathway identification and source apportionment based on isotope technique.

Environmental lead exposure poses risks to children' health, thus exposure sources and pathways identification remain important concern and research scope. Due to sharing the same environment, domestic animals, especially dogs, have been used as useful sentinels to identify human lead exposure. However, more evidence is needed on whether domestic dogs could be used to identify the lead exposure pathways and sources of children. Thus, this study investigated the dietary habits, behaviors, and household environment of children and dogs in a typical coal-fired area in China. The lead levels and lead isotope ratios (Acronym: LIRs, expressed as 208Pb/206Pb and 207Pb/206Pb) in dogs' and children's blood, as well as in environmental media (food, PM2.5, indoor/outdoor dust, drinking water and soil) were measured to explore the predominant lead pollution sources and exposure pathways of children. The results showed that the LIRs of children's blood (208Pb/206Pb = 2.0703 ± 0.0076, 207Pb/206Pb = 0.8501 ± 0.0052) were similar to those of dogs' blood (208Pb/206Pb = 2.0696 ± 0.0085, 207Pb/206Pb = 0.8499 ± 0.0052), as well as similar to the LIRs of environmental media, i.e. children's food (208Pb/206Pb = 2.0731 ± 0.0057, 207Pb/206Pb = 0.8491 ± 0.0036) and coal (208Pb/206Pb = 2.0683 ± 0.017, 207Pb/206Pb = 0.8515 ± 0.01). Children and dogs had similar lead exposure pathways, but the contributions of each exposure pathway were different, i.e., 83.1% vs. 76.9% for children and dogs via food ingestion, 1.4% vs. 5.6% via particulate matter exposure, and 15.5% vs. 17.5% via household dust exposure, respectively. The contribution of food via ingestion to lead exposure remains dominant, and coal combustion is a main lead exposure source for children and domestic dogs.

Traffic related activity pattern of Chinese adults: a nation-wide population based survey.

BACKGROUND: Traffic-related air pollutants lead to increased risks of many diseases. Understanding travel patterns and influencing factors are important for mitigating traffic exposures. However, there is a lack of national large-scale research. OBJECTIVE: This study aimed to evaluate the daily travel patterns of Chinese adults and provide basic data for traffic exposure and health risk research. METHODS: We conducted the first nation-wide survey of travel patterns of adults (aged 18 and above) in China during 2011-2012. We conducted a cross-sectional study based on a nationally representative sample of 91, 121 adults from 31 provinces in China. We characterized typical travel patterns by cluster analysis and identified the associated factors of each pattern using multiple logistic regression and generalized linear regression models. RESULTS: We found 115 typical daily travel patterns of Chinese adults and the top 11 accounted for 94% of the population. The interaction of age, urban and rural areas, income levels, gender, educational levels, city population and temperature affect people's choice of travel patterns. The average travel time of Chinese adults is 45 ± 40 min/day, with the longest travel time by the combination of walking and car (70 min/day). Gender has the largest effect on travel time (B = -8.94, 95% CI: -8.95, -8.93), followed by city GDP (B = -4.23, 95% CI: -4.23, -4.22), urban and rural areas (B = -3.62, 95% CI: -3.63, -3.61), age (B = -2.21, 95% CI: -2.21, -2.2), educational levels (B = -1.53, 95% CI: -1.53, -1.52), city area (B = -1.4, 95% CI: -1.4, -1.39) and temperature (B = 1.21, 95% CI: 1.2, 1.21). SIGNIFICANCE: This study was the first nation-wide study on traffic activity patterns in China, which provides basic data for traffic exposure and health risk research and provides the basis for the state to formulate transportation-related policies.

Environmental and Behavioral Factors in Association with Lung Function Impairment in Children Living in Wuhan, China.

Children's lung function is a significant predictor of health status throughout their lifetime. This study aims to identify the prevalence of impaired lung function in children and the potential influencing factors in elementary school children of Wuhan, China. Children of 6−12 years old were enrolled from elementary schools in Wuhan, China, in 2018, on the basis of a cross-sectional study design. Information on personal behavior patterns and household characteristics, as well as parental factors, was collected based on a questionnaire survey. Spirometry was used to measure fifteen lung function indicators. Logistic regression models were used to estimate odds ratios of prevalence of impaired lung function with regard to socioeconomic, personal behavior patterns, household, and parental factors, respectively. Four lung function indicators such as FET and EVC in urban children had higher values than in the suburban children after adjusting for confounders (p < 0.05). A higher prevalence of impaired lung function (FEV6, FEV3, EVC, and VC) was found in the children from the rural area than in those from the urban area. A sex difference in FET impairment was observed, however, no significant difference in impairment in other lung function indicators were found between girls and boys. The elevated height and weight of the children was significantly associated with an increased and decreased prevalence of impaired lung function, respectively, particularly both for FEV6, FEV3, FIVC, and FIV1. Opening windows for a longer time in summer was significantly associated with a lower prevalence of impaired FEF25 and MVV, and an extended time of opening windows in winter was significantly associated with a lower prevalence of impaired FEV6. While, opening windows for a longer time in autumn was significantly associated with higher prevalence of impaired FEV6 and FEV1/VC. Home renovations, doing physical exercise for more than 30 min per day, air pollution exposure during commuting, sleeping in own rooms, height stunting, and preterm birth were significantly associated with an increased risk of impaired lung function. Breastfeeding, having a father with a white-collar profession and with a higher education level were positively associated with the lower prevalence of impaired lung function. Impaired lung function is commonly found in school children in Wuhan, nowadays. Breastfeeding, opening windows long-term in summer and winter, higher socioeconomics, and an urban living environment were protective factors for impaired lung function. However, opening windows long-term and using air conditioning short-term in autumn, as well as home renovations, doing physical exercise for more than 30 min per day, preterm birth, height stunting, and air pollution exposure during commuting were regarded as significant risk factors for impaired lung function. Promoting breastfeeding, lengthening window opening times in winter and summer, and controlling household renovation and air pollution exposure during commuting are recommended to reduce the risk of impaired lung function in children in Wuhan.

A comprehensive analysis on source-distribution-bioaccumulation-exposure risk of metal(loid)s in various vegetables in peri-urban areas of Shenzhen, China.

The health risk induced by metal(loid)s in crops are becoming increasingly serious. In this study, eight major vegetables and rhizosphere soils were collected in a peri-urban area with intense electronic information manufacturing activities. The source, distribution and bioaccumulation of six typical metal(loid)s in different vegetable species were analyzed, and exposure risk through vegetable ingestion was estimated. Results showed that vegetables and agricultural soils in the study area suffered from serious metal(loid)s pollution, especially for Cd and Pb. The bioaccumulation capacity differed greatly among individual metal(loid)s and vegetable categories. In general, the highest transfer factors (TF) for Cd, Pb, and As were found in leafy vegetables, while leguminous vegetables had the highest TF of Cu and Zn and root vegetables had the highest TF for Cr. Significant correlations were found between concentrations in vegetables and rhizosphere soils for most metal(loid)s, the exceptions being Pb and Zn. The enrichment of Pb, Cd, Cr and As was mainly attributed to electronic information manufacturing activities, while the enrichment of Zn, Cu and Cd was associated with the application of commercial fertilizers and pesticides. The health risk associated with vegetable intake decreased in the order of leafy > fruit > leguminous > root vegetables. Leafy vegetables were identified as the category with the highest risk, with the mean risk value of 1.26. Cd was the major risk element for leafy vegetables. The non-carcinogenic risks estimated for leguminous and root vegetables were under the acceptable level. In conclusion, special attention should be paid to the health risks of toxic metal(loid)s in leafy vegetables in peri-urban areas with intense electronic information manufacturing activities. In order to minimize health risk, it is necessary to identify low-risk crops based on a comprehensive consideration of the metal(loid)s' pollution characteristics, transfer factors and local people's consumption behaviors.

Source identification of pollution and health risks to metals in household indoor and outdoor dust: A cross-sectional study in a typical mining town, China.

Dust is regarded as an important pathway of heavy metal(loid)s to the human body. Health risks posed by metal(loid)s from household dust are of particular concern. However, the contamination and sources of heavy metal(loid)s in household dust environments, as well as source identification of health risks related to heavy metal(loid)s from household dust for vulnerable populations such as children, have not been thoroughly studied in China, particularly for the areas involved with industrial activities such as ore mining. Thus, a cross-sectional study was conducted in a rural area famous for Pb/Zn ore mining, to assess the pollution sources and health risks of heavy metal(loid)s from household indoor and outdoor dust and to identify the contribution of household dust to the health risks for children. The results indicated that household environment was heavily contaminated by metal(loid)s, which were mainly attributed to mining activity. Meanwhile, the indoor/outdoor ratio and the redundancy analysis indicated that there were other pollution sources in indoor environments such as coal combustion, materials for interior building and decoration. Vapor inhalation was the main exposure pathway for Hg, while ingestion was the predominant pathway for other metal(loid)s. Although the cancer risks were relatively low, the HIt from household indoor and outdoor dust (2.19) was about twice the acceptable limit (1) and was primarily from Pb (64.52%) and As (23.42%). Outdoor dust was a larger contributor to the HI of Sb, As, Cr, Cd, Zn and Pb, which accounted for 51.37%, 58.63%, 52.14%, 59.66%, 52.87% and 64.47%, respectively, and the HIt was mainly from outdoor dust (60.76%). These results indicated that non-cancer health risks were largely from outdoor dust exposure, and strengthened the notion that concern should be given to the potential health risks from metal(loid)s in household dust both originating from mining activity and indoor environmental sources.

Distributions and determinants of time spent outdoors among school-age children in China.

BACKGROUND: The outdoor time is a key factor that determines children's exposure to environmental contaminants. Meanwhile, children reap numerous physical and mental health benefits from playing outdoors. OBJECTIVE: This study aimed to characterize the distributions and identify determinants of the time spent outdoors among school-age children in China. METHODS: The study recruited 41,439 children aged 6-17 years in Mainland China using a multi-stage cluster random sampling method. This sample was nationally representative with sample weights created to account for the complex survey design. Information on time-activity patterns were collected with a standard questionnaire through face-to-face interviews. Frequency distributions of time outdoors were created by age group, gender, region, and other sociodemographic factors with sample weights. The key factors influencing time outdoors were identified using multivariable linear regression models. RESULTS: The grand mean (±standard deviation) time outdoors was 101 ± 51 min/day for all the study participants, 22.3% having <60 min/day. Children spent longer time outdoors in warm seasons and on weekends. Children's outdoor time was significantly influenced by gender, age, urbanicity, region, annual total household expenditure, building environment, and meteorological conditions (annual mean temperature, sunshine time, and precipitation). Girls, 15-17 year old, and urban children had 6 min/day, 8 min/day, and 13 min/day less outdoor time than boys, 6-8 year old, and rural children, respectively. Most significantly, urban girls and high school students had the shortest outdoor time. The cement ground was the most important type of ground for children playing outside. SIGNIFICANCE: This was the first national-scale study that characterized the time outdoors and where is it spent among school-age children in China. It revealed that one-fifth of Chinese children spent less than one hour outdoors every day, and urban girls had particular "indoor tendencies". The findings provide bases for future interventions and guidelines aimed at promoting children's physical activities.

Has the Risk of Outpatient Visits for Allergic Rhinitis, Related to Short-Term Exposure to Air Pollution, Changed over the Past Years in Beijing, China?

A number of studies have found associations between the short-term exposure to ambient air pollution and hospital admissions. However, little is known about the temporal variations in ambient air pollution associated with health exposure, especially in China. We evaluated whether the risks of allergic rhinitis (AR) outpatient visits from short-term exposure to air pollution varied over time (2014-2020) in Beijing, China. A quasi-Poisson generalized additive model was used to evaluate the relative risks (RRs) and 95% confidence intervals (CIs) associated with the pollutant concentrations during the entire study period and three specific periods. We also analyzed the temporal variations of the period-specific associations and tested the trend of change using the Mann-Kendall test. The concentration-response relationships for the specific periods were further investigated. The RRs (95%CI) for an interquartile range (IQR) increased in PM10 (70 µg/m3) and CO (0.5 mg/m3) decreased from period 1 to period 3. However, The RRs (95%CI) of PM2.5 (55 µg/m3), SO2 (7 µg/m3) and NO2 (27 µg/m3) increased from 1.015 (0.978, 1.054), 1.027 (1.009, 1.044) and 1.086 (1.037, 1.137) in period 1 to 1.069 (1.005, 1.135), 1.074 (1.003, 1.149) and 1.214 (1.149, 1.282) in period 3, respectively. A statistically significant temporal change and the stable effects were observed between the NO2 exposure and AR visits over time. Despite a substantial reduction in ambient air pollution, the short-term effects on AR outpatient visits remained significant. Our findings provide a rationale for continued air pollution control efforts in the future to minimize air pollution and to protect the public.

Source apportionment based on lead isotope ratios: Could domestic dog's blood lead be used to identify the level and sources of lead pollution in children?

Domestic dogs have been proved to be used as "sentinel organisms" to monitor human lead exposure. However, whether dogs' blood can be used to identify the levels and pollution source of children's lead exposure still needs evidence. To evaluate the potential use of domestic dogs' blood lead as an indicator of lead exposure levels and pollution source of children, accompanying with potential environmental media samples, lead concentrations and isotope ratios (expressed as 207Pb/206Pb, 208Pb/206Pb) in blood were investigated and compared between children and dogs, who came from a Pb-Zn smelter area, a coal fired area and a control area without industrial activity. The results showed that there were significant correlations in blood lead levels (BLLs) between children and dogs in the study areas (p < 0.01). The lead isotope ratios (LIRs) in blood of children and dogs were disparate among the three areas, however, the LIRs of dogs were quite correlated with those of children in each area (p < 0.01). With the comparison of LIRs between potential pollution sources (slag, ore, coal, paint) and blood samples, the identified lead sources based on dogs' blood were found to be coincident with those based on children's blood. Ore smelting and coal combustion were the main sources of lead exposure for the dogs and children in the smelting area, and coal combustion was the predominant source for the children and dogs living in the coal burning area and control area. The results showed that dogs' BLLs might be used to estimate children's BLLs, and blood LIRs measurements of dogs' could be used as an alternative for identifying the sources of children's lead exposure. This study further provided relevant evidence for dogs to be sentinels exposed to human lead exposure and an alternative method for source apportionment of children's lead exposure.

Effects of physical activity intensity on adulthood obesity as a function of long-term exposure to ambient PM2.5: Observations from a Chinese nationwide representative sample.

Long-term exposure to PM2.5 has been associated with increased obesity risk, while physical activity (PA) is a suggested protective factor. This raises a dilemma whether the increased dose of PM2.5 due to PA-intensified ventilation would offset the benefits of PA. Using a national representative sample, we aim to (1) ascertain inclusive findings of the association between PA and obesity, and (2) examine whether PM2.5 exposure modifies the PA-obesity relationship. We recruited 91,121 Chinese adults from 31 provinces using a multi-stage stratified-clustering random sampling method. PM2.5 was estimated using a validated machine learning method with a spatial resolution of 0.1° × 0.1°. PA intensity was calculated as metabolic equivalent (MET)-hour/week by summing all activities. Body weight, height, and waist circumference (WC) were measured after overnight fasting. Obesity-related traits included continuous outcomes (Body mass index [BMI], WC, and waist-to-height ratio (WHtR)) and binomial outcomes (general obesity, abdominal obesity, and WHtR obesity). Generalized linear regression models were used to estimate the interaction effects between PM2.5 and PA on obesity, controlling for covariates. The results indicated that each IQR increase in PA was associated with 0.078 (95% CI: -0.096 to -0.061) kg/m2, 0.342 (-0.389 to -0.294) cm, and 0.0022 (-0.0025 to -0.0019) decrease in BMI, WC, and WHtR, respectively. The joint association showed that benefits of PA on obesity were attenuated as PM2.5 increased. Risk of abdominal obesity decreased 11.3% (OR = 0.887, 95% CI: 0.866, 0.908) per IQR increase in PA among the low-PM2.5 (≤55.9 µg/m3) exposure group, but only 5.5% (OR = 0.945, 95% CI: 0.930, 0.960) among the high-PM2.5 (>55.9 µg/m3) exposure group. We concluded the increase in PA intensity was significantly associated with lower risk of obesity in adults living across mainland China, where annual level of PM2.5 were mostly exceeding the standard. Reducing PM2.5 exposure would enhance the PA benefits as a risk reduction strategy.