Effect of COVID-19-restrictive measures on ambient particulate matter pollution in Yangon, Myanmar.

BACKGROUND: Particulate matter (PM) is recognized as the most harmful air pollutant to the human health. The Yangon city indeed suffers much from PM-related air pollution. Recent research has interestingly been focused on the novel subject of changes in the air quality associated with the restrictive measures in place during the current coronavirus disease-2019 (COVID-19) pandemic. The first case of COVID-19 in Myanmar was diagnosed on March 23, 2020. In this article, we report on our attempt to evaluate any effects of the COVID-19-restrictive measures on the ambient PM pollution in Yangon. METHODS: We measured the PM concentrations every second for 1 week on four occasions at three study sites with different characteristics; the first occasion was before the start of the COVID-19 pandemic and the remaining three occasions were while the COVID-19-restrictive measures were in place, including Stay-At-Home and Work-From-Home orders. The Pocket PM2.5 Sensor [PRO] designed by the National Institute for Environmental Studies (NIES), Japan, in cooperation with Yaguchi Electric Co., Ltd., (Miyagi, Japan) was used for the measurement of the ambient PM2.5 and PM10 concentrations. RESULTS: The results showed that there was a significant reduction (P < 0.001) in both the PM2.5 and PM10 concentrations while the COVID-19-restrictive measures were in place as compared to the measured values prior to the pandemic. The city experienced a profound improvement in the PM-related air quality from the "unhealthy" category prior to the onset of the COVID-19 pandemic to the "good" category during the pandemic, when the restrictive measures were in place. The percent changes in the PM concentrations varied among the three study sites, with the highest percent reduction noted in a semi-commercial crowded area (84.8% for PM2.5; 88.6% for PM10) and the lowest percent reduction noted in a residential quiet area (15.6% for PM2.5; 12.0% for PM10); the percent reductions also varied among the different occasions during the COVID-19 pandemic that the measurements were made. CONCLUSIONS: We concluded that the restrictive measures which were in effect to combat the COVID-19 pandemic had a positive impact on the ambient PM concentrations. The changes in the PM concentrations are considered to be largely attributable to reduction in anthropogenic emissions as a result of the restrictive measures, although seasonal influences could also have contributed in part. Thus, frequent, once- or twice-weekly Stay-At-Home or Telework campaigns, may be feasible measures to reduce PM-related air pollution. When devising such an action plan, it would be essential to raise the awareness of public about the health risks associated with air pollution and create a social environment in which Telework can be carried out, in order to ensure active compliance by the citizens.

Environmental cadmium exposure induces kidney tubular and glomerular dysfunction in the Myanmar adults.

Cadmium is an environmental toxic metal and its exposure has become a worldwide public health threat. We aimed to evaluate the exposure assessment of cadmium in people living in Ta Zin Yae Kyaw village of Nyaung Don Township in Ayeyarwady Division, Myanmar and adverse effects of cadmium on the kidneys. Subjects (18-40 years) residing in this village were selected as the exposed group (n = 65) and those living in Kamayut Township in Yangon Division, Myanmar as the control group (n = 65). Spot urine samples were taken for determination of urinary cadmium concentration using graphite-furnace atomic absorption spectrometry (GFAAS) method and adjusted to the concentration of creatinine in urine. To assess the kidney function, urinary ß2-microglobulin level was determined by ELISA, serum creatinine was measured by colorimetric Jaffe method and estimated glomerular filtration rate (eGFR) was calculated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Urine cadmium concentrations were significantly higher in the exposed group (median (Interquartile range): 0.96 (0.19-1.77) µg/g Creatinine) compared to the control (p = 0.036). Urinary ß2-microglobulin levels were significantly higher (p = 0.000) and eGFR was significantly lower in the exposed group (p = 0.013) compared to the control. In addition, urine cadmium level showed significant positive correlation with urinary ß2-microglobulin in all study population (p < 0.01). Positive correlation becomes stronger (p < 0.01) in the exposed group only. For eGFR, significant negative correlation was found in all study population (p < 0.01) and exposed group (p < 0.01). Our findings suggested that environmental cadmium exposure can induce renal dysfunction in both tubular and glomerular functions in apparently healthy human adults.

Indoor Formaldehyde Concentration, Personal Formaldehyde Exposure and Clinical Symptoms during Anatomy Dissection Sessions, University of Medicine 1, Yangon.

The formaldehyde (FA) embalming method, the world's most common protocol for the fixation of cadavers, has been consistently used in medical universities in Myanmar. This study was designed to examine the indoor FA concentrations in anatomy dissection rooms, an exposed site, and lecture theater, an unexposed control site, and to access personal exposure levels of FA and clinical symptoms of medical students and instructors. In total, 208 second year medical students (1/2019 batch) and 18 instructors from Department of Anatomy, University of Medicine 1, participated. Thirteen dissection sessions were investigated from February 2019 to January 2020. Diffusive sampling devices were used as air samplers and high-performance liquid chromatography was used for measurement of FA. Average indoor FA concentration of four dissection rooms was 0.43 (0.09-1.22) ppm and all dissection rooms showed indoor concentrations above the occupational exposure limits and short-term exposure limit for general population. Personal FA exposure values were higher than indoor FA concentrations and the instructors (0.68, 0.04-2.11 ppm) had higher exposure than the students (0.44, 0.06-1.72 ppm). Unpleasant odor, eye and nose irritations and inability to concentrate were frequently reported FA-related symptoms, and the students were found to have significantly higher risks (p < 0.05) of having these symptoms during the dissection sessions than during lecture.

Improvement of GPS-attached Pocket PM2.5 Measuring Device for Personal Exposure Assessment.

Assessment of personal exposure to particulate matter with an aerodynamic diameter less than or 2.5 µm (PM2.5) is necessary to study the association between PM exposure and health risk. Development of a personal PM2.5 sensor or device is required for the evaluation of individual exposure level. In this study, we aimed to develop a small-sized, lightweight sensor with a global positioning system (GPS) attached that can measure PM2.5 and PM10 every second to assess continuous personal exposure levels. The participants in this study were apparently healthy housewives (n = 15) and university female teaching staff (n = 15) who live in a high PM2.5 area, Yangon, Myanmar. The average PM2.5 exposure levels during 24 h were 16.1 ± 10.0 µg/m3 in the housewives and 15.8 ± 4.0 µg/m3 in the university female teaching staff. The university female teaching staff showed high exposure concentrations during commuting hours, and had stable, relatively low concentrations at work, whereas the housewives showed short-term high exposure peaks due to differences in their lifestyles. This is the first study to show that a GPS-attached standalone PM2.5 and PM10 Sensor [PRO] can be successfully used for mobile sensing, easy use, continuous measurement, and rapid data analysis.

Protective role of selenium in the shortening of telomere length in newborns induced by in utero heavy metal exposure.

The effects of toxic heavy metals, such as arsenic (As), cadmium (Cd), and lead (Pb), on telomere length (TL) have been reported previously. Although selenium (Se) is considered as an anti-oxidant which may detoxify the effects, there are no data on whether Se could protect against the TL-shortening effects of heavy metals. Thus, the aim of this study was to evaluate the protective role of Se against heavy metal-induced TL shortening. A birth cohort study was conducted in Myanmar in 2016, including 408 mother-infant pairs. First, pregnant women in the third trimester were interviewed concerning their socioeconomic, and pregnancy and birth characteristics using a pre-validated questionnaire. Maternal spot urine samples were collected after the interview. During the follow-up period (1-3 months), blood samples were collected from the umbilical cord at birth by local health workers. Metal concentrations were measured using inductively coupled plasma mass spectrometry (ICP-MS). TL was measured by quantitative real-time polymerase chain reaction (PCR). Relative TL was calculated as the ratio of telomere genes to single-copy genes. To evaluate the effect of Se on TL shortening, molar ratios were calculated. Linear regression analyses were performed to examine the associations between heavy metals and TL, individually and after adjustment for Se level. The effects of As, Cd, and Pb exposure on TL were smaller after adjustment for the Se level, especially for Pb (unadjusted ß = -0.10; 95% CI: 0.18, -0.01; adjusted ß = -0.03; 95% CI: 0.13, 0.05). On stratifying the data by Se concentration, there was no significant association between Cd or Pb exposure and TL in the high-Se group. Our study indicated a protective effect of Se against the TL shortening induced by heavy metal exposure, where the effect sizes were smaller after adjusting for the Se level, compared to individual metal exposure.

Arsenic exposure through drinking Water and oxidative stress Status: A cross-sectional study in the Ayeyarwady region, Myanmar.

Arsenic is a well-known toxic heavy metal that is naturally dispersed in groundwater. Whereas arsenic is widely accepted to be involved in oxidative stress damage, little is known about arsenic-induced oxidative damage in relationship to contaminated drinking water as a source. The aim of this study was to determine the association between arsenic exposure through drinking water and oxidative stress status by measuring levels of urinary 8-hydroxydeoxyguanosine (8-OHdG) as a biomarker of oxidative stress damage in a Myanmar population. A questionnaire-based survey and drinking water and urine sampling (n = 198) were performed to assess the association between arsenic exposure and urinary 8-OHdG concentration in the Ayeyarwady Region, Myanmar. Urinary arsenic concentrations were significantly correlated with drinking water arsenic concentrations (Spearman's rho = 0.32, p < 0.001). Multivariate linear regression analysis showed that higher urinary arsenic concentrations were significantly associated with higher 8-OHdG concentrations (coefficient = 0.09, 95% confidence interval, 0.03 - 0.15; p = 0.002). The present study identified that exposure to arsenic through drinking water could induce an increase in the urinary 8-OHdG concentration, reflecting increased oxidative DNA damage. These findings provide evidence that may explain the role of arsenic-induced oxidative stress in the pathophysiology of arsenic-induced diseases including cancers.

Social behavior, neuroimmune markers and glutamic acid decarboxylase levels in a rat model of valproic acid-induced autism.

Autism is a complex neurodevelopmental disorder characterized by impaired social communication and social interactions, and repetitive behaviors. The etiology of autism remains unknown and its molecular basis is not yet well understood. Pregnant Sprague-Dawley (SD) rats were administered 600 mg/kg of valproic acid (VPA) by intraperitoneal injection on day 12.5 of gestation. Both 11- to 13-week-old male and female rat models of VPA-induced autism showed impaired sociability and impaired preference for social novelty as compared to the corresponding control SD rats. Significantly reduced mRNA expressions of social behavior-related genes, such as those encoding the serotonin receptor, brain-derived neurotrophic factor and neuroligin3, and significantly increased expression levels of proinflammatory cytokines, such as interleukin-1 ß and tumor necrosis factor-α, were noted in the hippocampi of both male and female rats exposed to VPA in utero. The hippocampal expression level of gamma amino butyric acid (GABA) enzyme glutamic acid decarboxylase (GAD) 67 protein was reduced in both male and female VPA-exposed rats as compared to the corresponding control animals. Our results indicate that developmental exposure to VPA affects the social behavior in rats by modulating the expression levels of social behavior-related genes and inflammatory mediators accompanied with changes in GABA enzyme in the hippocampus.

Preliminary monitoring of concentration of particulate matter (PM2.5) in seven townships of Yangon City, Myanmar.

BACKGROUND: Airborne particulate pollution is more critical in the developing world than in the developed countries in which industrialization and urbanization are rapidly increased. Yangon, a second capital of Myanmar, is a highly congested and densely populated city. Yet, there is limited study which assesses particulate matter (PM2.5) in Yangon currently. Few previous local studies were performed to assess particulate air pollution but most results were concerned PM10 alone using fixed monitoring. Therefore, the present study aimed to assess distribution of PM2.5 in different townships of Yangon, Myanmar. This is the first study to quantify the regional distribution of PM2.5 in Yangon City. METHODS: The concentration of PM2.5 was measured using Pocket PM2.5 Sensor (Yaguchi Electric Co., Ltd., Miyagi, Japan) three times (7:00 h, 13:00 h, 19:00 h) for 15 min per day for 5 days from January 25th to 29th in seven townships. Detailed information of eight tracks for PM2.5 pollution status in different areas with different conditions within Kamayut Township were also collected. RESULTS: The results showed that in all townships, the highest PM2.5 concentrations in the morning followed by the evening and the lowest concentrations in the afternoon were observed. Among the seven townships, Hlaingtharyar Township had the highest concentrations (164 ± 52 µg/m3) in the morning and (100 ± 35 µg/m3) in the evening. Data from eight tracks in Kamayut Township also indicated that PM2.5 concentrations varied between different areas and conditions of the same township at the same time. CONCLUSION: Myanmar is one of the few countries that still have to establish national air quality standards. The results obtained from this study are useful for the better understanding of the nature of air pollution linked to PM2.5. Moreover, the sensor which was used in this study can provide real-time exposure, and this could give more accurate exposure data of the population especially those subpopulations that are highly exposed than fixed station monitoring.

Impact of prenatal heavy metal exposure on newborn leucocyte telomere length: A birth-cohort study.

Arsenic, cadmium and lead are toxic environmental contaminants. They were shown to be associated with telomere length (TL) in adults. Although they can cross the placental barrier, the effect of prenatal exposure of these metals on newborn TL is unknown. The aim of this study was to examine whether prenatal exposure to heavy metals has an impact on newborn leucocyte TL. A birth-cohort study was conducted with 409 pregnant women and their newborns in Myanmar. During the first visit, face-to-face interviews were conducted, and maternal spot urine sampling was performed. Cord blood samples were collected during follow-up. Urinary heavy metal concentration was measured by ICP-MS and adjusted for creatinine. Relative TL was measured by quantitative real-time polymerase chain reaction. The extent of prenatal arsenic, cadmium and lead exposure and their associations with newborn leucocyte TL were assessed using multivariate linear regression. The median values of maternal urinary arsenic, cadmium, and lead concentrations were 73.9, 0.9, and 1.8 µg/g creatinine, respectively. Prenatal arsenic and cadmium exposure was significantly associated with newborn TL shortening (lowest vs highest quartile, coefficient = - 0.13, 95% CI: - 0.22, - 0.03, p = 0.002, and coefficient = - 0.17, 95% CI: - 0.27, - 0.07, p = 0.001, respectively), and the associations remained robust after adjusting for confounders. There was no significant association between prenatal lead exposure and newborn TL. The present study identified the effect of arsenic and cadmium exposure on TL shortening, even in utero exposure at a lower concentration.

Prenatal Heavy Metal Exposure and Adverse Birth Outcomes in Myanmar: A Birth-Cohort Study.

Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. This study is part of a birth-cohort study conducted with 419 pregnant women in the Ayeyarwady Division, Myanmar. Face-to-face interviews were performed using a questionnaire, and maternal spot urine samples were collected at the third trimester. Birth outcomes were evaluated at delivery during the follow up. The median values of adjusted urinary arsenic, cadmium, selenium and lead concentration were 74.2, 0.9, 22.6 and 1.8 µg/g creatinine, respectively. Multivariable logistic regression revealed that prenatal cadmium exposure (adjusted odds ratio (OR) = 1.10; 95% confidence interval (CI): 1.01-1.21; p = 0.043), gestational age (adjusted OR = 0.83; 95% CI: 0.72-0.95; p = 0.009) and primigravida mothers (adjusted OR = 4.23; 95% CI: 1.31-13.65; p = 0.016) were the predictors of low birth weight. The present study identified that Myanmar mothers were highly exposed to cadmium. Prenatal maternal cadmium exposure was associated with an occurrence of low birth weight.

Role of TLR4 in olfactory-based spatial learning activity of neonatal mice after developmental exposure to diesel exhaust origin secondary organic aerosol.

Exposure to ambient air pollutants has been reported to have various adverse health impacts. Ambient particulate matter comprises primary particles released directly via engine exhaust and secondary organic aerosols (SOAs) formed from oxidative reactions of the ultrafine particle fraction of diesel exhaust (DE). Toll-like receptor 4 (TLR4) is well known to initiate the inflammatory cascade in the central nervous system. However, whether and how DE and DE-SOA exposure influences TLR4 signaling in the immature brain remains unclear. We attempted to evaluate the roles of TLR-4, inflammatory mediators and microglial markers in the impaired spatial learning ability of neonatal mice exposed to DE and DE-SOAs. Pregnant C3H/HeN (TLR4-intact) and C3H/HeJ (TLR4- mutated) mice were exposed to clean air, DE or DE-SOA from gestational day 14 to postnatal day (PND) 10 (5h/day for 5days) in exposure chambers. PND11 neonatal mice were examined for their performance in the olfactory-based spatial learning test. After the spatial learning test, the hippocampi of the mice were removed and real-time RT-PCR analysis was performed to examine the neurological and immunological markers. Both male and female C3H/HeN and C3H/HeJ neonatal mice exposed to DE and DE-SOAs showed poor performance in the test phase of spatial learning as compared to the mice exposed to clean air. However, this spatial learning deficit was prominent in C3H/HeJ neonatal mice. In the neonatal C3H/HeN male mice exposed to DE and DE-SOAs, the mRNA expression levels of the NMDA receptor subunits (NR1, NR2B), proinflammatory cytokines, tumor necrosis factor-α and cyclooxygenase-2, oxidative stress marker, heme oxygenase-1, and microglial marker, Iba1, in the hippocampus were significantly increased, but these changes were not observed in female mice. Our findings indicate that activation of the neuroimmune system and TLR4 signaling may possibly be involved in environmental pollutant-induced spatial learning impairment in neonatal mice.