The relationship between traffic-related air pollution exposures and allostatic load score among youth with type 1 diabetes in the SEARCH cohort.

OBJECTIVE: We investigated the effects of chronic exposures to particulate and traffic-related air pollution on allostatic load (AL) score, a marker of cumulative biological risk, among youth with type 1 diabetes. RESEARCH DESIGN AND METHODS: Participants were drawn from five clinical sites of the SEARCH for Diabetes in Youth (SEARCH) study (n = 2338). Baseline questionnaires, anthropometric measures, and a fasting blood test were taken at a clinic visit between 2001 and 2005. AL was operationalized using 10 biomarkers reflecting cardiovascular, metabolic, and inflammatory risk. Annual residential exposures to PM2.5 and proximity to heavily-trafficked major roadways were estimated for each participant. Poisson regression models adjusted for sociodemographic and lifestyle factors were conducted for each exposure. RESULTS: No significant associations were observed between exposures to PM2.5 or proximity to traffic and AL score, however analyses were suggestive of effect modification by race for residential distance to heavily-trafficked major roadways (p = 0.02). In stratified analyses, residing <100, 100-<200 and 200-<400 m compared to 400 m or more from heavily-trafficked major roadways was associated with 11%, 26% and 14% increases in AL score, respectively (95% CIs: -4, 29; 9, 45; -1, 30) for non-white participants compared to 6%, -2%, and -2% changes (95% CIs: -2, 15; -10, 7; -8, 6) for white participants. CONCLUSIONS: Among this population of youth with type 1 diabetes, we did not observe consistent relationships between chronic exposures to particulate and traffic-related air pollution and changes in AL score, however associations for traffic-related pollution exposures may differ by race/ethnicity and warrant further examination.

Trends and disparities in urinary BPA concentrations among U.S. emerging adults.

BACKGROUND: Emerging adulthood (ages 18-25 years) is a key turning point in the life course characterized by particularly poor eating behaviors (e.g., low in fruits and vegetables, and high in fast food) and weight gain. Emerging adults are also prime consumers of personal care and other consumer products that may result in differential exposures to environmental contaminants, such as Bisphenol A (BPA), compared to adults aged 26+ years. This is of concern given BPA has been associated with adverse health outcomes such as obesity, metabolic disorders, miscarriage, infertility and breast cancer. However, no research has examined exposure to BPA among emerging adults. OBJECTIVE: To assess trends of exposure to urinary BPA among a representative sample of emerging adults compared to adults aged 26+ years. Secondarily, we aimed to identify differential associations between BPA concentrations and sociodemographic characteristics and BMI by age group. METHODS: This study uses National Health and Examination Surveys (NHANES) over 2003-2014 to test differences in BPA concentrations comparing emerging adults to adults aged 26+ years. Generalized linear models predicting log BPA by age group and sex, race/ethnicity, education, income, and food security status, and generalized linear models predicting BMI by log BPA, both age group and age as a continuous variable, sex, race/ethnicity, education, income, and food security status were conducted. Interactions with age group (i.e., age group x sex) were examined for the mutually adjusted models. All models controlled for survey year, month, and time of day, and were run with, and without, an adjustment for urinary creatinine. RESULTS: In models adjusted, and not adjusted, for urinary creatinine, emerging adults had a higher log BPA concentration than adults aged 26+ years (ß=0.153, p=0.004; ß=0.544, p<0.001), and a significantly steeper decline in BPA concentration between 2003-2004 and 2013-2014 than adults aged 26+ years (ß=-0.051, p=0.002; ß=-0.071, p=0.001). Males' log BPA concentration were lower than that for females when urinary creatinine was included in the model, and higher when urinary creatinine was excluded from the model (ß=-0.188, p<0.001; ß=0.203, p<0.001). Higher income was significantly associated with lower log BPA concentration (ß=-0.220, p<0.001; ß=-0.166, p<0.001). A significant interaction between emerging adult age group and food security status was observed, which was associated with higher BPA exposures. Log BPA concentration was associated with BMI only when urinary creatinine was excluded from the models (urinary creatinine included: ß=0.031, p=0.747; ß=0.022, p=0.815, urinary creatinine excluded: ß=0.528, p<0.001; ß=0.552, p<0.001). CONCLUSION: Findings indicate that emerging adults had higher BPA exposures than adults aged 26+ years in 2003-2004, and that emerging adults' exposure level has decreased faster than that of adults aged 26+ years. There were suggestions that the BPA concentration of emerging adults in 2013-2014 was lower than that for adults aged 26+ years, and that BPA exposure is associated with higher BMI. Our results highlight the need for additional research to identify the sources and routes of exposure to BPA and BPA replacements among emerging adults and to better characterize the variability in exposure. Intervention studies are needed to assist emerging adults in limiting their exposure to BPA, and potentially also the BPA alternatives.

Ambient air pollution: an emerging risk factor for diabetes mellitus.

Growing evidence supports that air pollution has become an important risk factor for developing diabetes mellitus. Understanding the contributing effect of air pollution in population studies, elucidating the potential mechanisms involved, and identifying the most responsible pollutants are all required in order to promulgate successful changes in policy and to help formulate preventive measures in an effort to reduce the risk for diabetes. This review summarizes recent findings from epidemiologic studies and mechanistic insights that provide links between exposure to air pollution and a heightened risk for diabetes.

Sociodemographic and Environmental Determinants of Indoor Versus Outdoor Active Play Among Children Living in the Washington, DC Area.

BACKGROUND: Sociodemographic and environmental factors play important roles in determining both indoor and outdoor play activities in children. METHODS: The Built Environment and Active Play Study assessed neighborhood playability for children (7-12 y), based on parental report of their children's active play behaviors, neighborhood characteristics, and geographic locations. Simple logistic regression modeling tested the associations between sociodemographic characteristics and the frequency of and access to venues for indoor and outdoor play. RESULTS: Children of higher socioeconomic status were almost 3 times more likely to live more than a 30-minute walk from indoor recreational facilities compared with their less affluent peers (odds ratio [OR] = 2.9; 95% confidence interval [CI], 1.2-6.8). Non-Hispanic black children were less likely to live more than 30 minutes from indoor facilities (OR = 0.21; 95% CI, 0.08-0.57) and more were likely to engage in indoor activity (OR = 3.40; 95% CI, 1.17-9.88) than were white children. Boys were substantially more likely to play outdoors at a playing fields compared with girls (OR = 5.37; 95% CI, 2.10-13.69). CONCLUSIONS: Findings from this study could be used to enhance indoor and outdoor activity spaces for children and to reduce disparities in access to such spaces.

Inflammation and acute traffic-related air pollution exposures among a cohort of youth with type 1 diabetes.

BACKGROUND: Evidence remains equivocal regarding the association of inflammation, a precursor to cardiovascular disease, and acute exposures to ambient air pollution from traffic-related particulate matter. Though youth with type 1 diabetes are at higher risk for cardiovascular disease, the relationship of inflammation and ambient air pollution exposures in this population has received little attention. OBJECTIVES: Using five geographically diverse US sites from the racially- and ethnically-diverse SEARCH for Diabetes in Youth Cohort, we examined the relationship of acute exposures to PM2.5 mass, Atmospheric Dispersion Modeling System (ADMS)-Roads traffic-related PM concentrations near roadways, and elemental carbon (EC) with biomarkers of inflammation including interleukin-6 (IL-6), c-reactive protein (hs-CRP) and fibrinogen. METHODS: Baseline questionnaires and blood were obtained at a study visit. Using a spatio-temporal modeling approach, pollutant exposures for 7 days prior to blood draw were assigned to residential addresses. Linear mixed models for each outcome and exposure were adjusted for demographic and lifestyle factors identified a priori. RESULTS: Among the 2566 participants with complete data, fully-adjusted models showed positive associations of EC average week exposures with IL-6 and hs-CRP, and PM2.5 mass exposures on lag day 3 with IL-6 levels. Comparing the 25th and 75th percentiles of average week EC exposures resulted in 8.3% higher IL-6 (95%CI: 2.7%,14.3%) and 9.8% higher hs-CRP (95%CI: 2.4%,17.7%). We observed some evidence of effect modification for the relationships of PM2.5 mass exposures with hs-CRP by gender and with IL-6 by race/ethnicity. CONCLUSIONS: Indicators of inflammation were associated with estimated traffic-related air pollutant exposures in this study population of youth with type 1 diabetes. Thus youth with type 1 diabetes may be at increased risk of air pollution-related inflammation. These findings and the racial/ethnic and gender differences observed deserve further exploration.

Short-term exposure to ambient ozone and stroke hospital admission: A case-crossover analysis.

We evaluated the association between short-term exposure to ambient ozone air pollution and stroke hospital admissions among adult residents of South Carolina (SC). Data on all incident stroke hospitalizations from 2002 to 2006 were obtained from the SC Office of Research and Statistics. Ozone exposure data were obtained from the US Environmental Protection Agency's Hierarchical Bayesian Model. A semi-symmetric bidirectional case-crossover design was used to examine the association between ozone exposure on lag days 0-2 (0 to 2 days before admission) and stroke hospitalization. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). No significant associations were observed between short-term ozone exposure and hospitalization for all stroke (e.g., lag day 0: OR=0.98; 95% CI=0.96, 1.00) or ischemic stroke (lag day 0: OR=0.98; 95% CI=0.96, 1.01). Risk of hospitalization for hemorrhagic stroke appeared to be higher among African Americans than European Americans; however, the majority of these associations did not reach statistical significance. Among adults in SC from 2002 to 2006, there was no evidence of an association between ozone exposure and risk of hospitalization for all stroke or ischemic stroke; however, African Americans may have an increased risk of hemorrhagic stroke.

Differences in Stroke Mortality Among Adults Aged 45 and Over: United States, 2010-2013.

KEY FINDINGS: •During 2010-2013, the age-adjusted stroke death rate for non-Hispanic black men aged 45 and over (154.8 deaths per 100,000 population) was 54% to 68% higher than the rates for men of the same age in other race-ethnicity groups. The rate for non-Hispanic black women aged 45 and over was 30% to 61% higher than the rates for women of the same age in other race-ethnicity groups. •The age distribution of stroke deaths differed by race and ethnicity. •Stroke death rates were 32% higher in counties in the lowest median household income quartile than in counties in the highest income quartile. •Nonmetropolitan counties had higher stroke death rates than counties at other urbanization levels. •Stroke mortality inside and outside the Stroke Belt differed by race and ethnicity.

Physical activity: does environment make a difference for tension, stress, emotional outlook, and perceptions of health status?

BACKGROUND: The importance of physical activity for health is well-established. Questions remain whether outdoor exercise additionally benefits overall mental and physical well-being. METHODS: Using cross-sectional data from the Aerobics Center Longitudinal Study, we examined relationships of physical activity environment (PAE) with reported tension, stress, emotional outlook, and health. RESULTS: 11,649 participants were included. 18% exercised indoors, 54% outdoors, and 28% in both. Participants who exercised partially or entirely outdoors exercised more. In fully adjusted models, for women combined PAE was protective for worse emotional outlook (OR: 0.72; 95% CI: 0.52-0.98). Combined PAE was also protective for reported poor health (OR for women: 0.63; 95% CI: 0.44-0.91; OR for men: 0.75; 95% CI: 0.61-0.92). Amount of physical activity modified PAE relationships with outcomes. Combined and outdoor PAE were more consistently protective for worse outcomes among high activity participants. Regardless of PAE, better outcomes were observed in active versus inactive participants. CONCLUSION: The current study suggests addition of outdoor PAE may be linked with better stress management, outlook and health perceptions for more active populations, whereas indoor PAE may be more important for low active populations. Further research should examine the order of causation and whether type of outdoor PAE (eg, urban, natural) is important.