Health-risk perception and its mediating effect on protective behavioral adaptation to heat waves.

Ensuring spontaneously adjusting behaviors of the public in their daily life in response to heat waves is an important aspect of successful public health intervention under climate change. However, the current response behavior guidance released by the government is insufficient because of the limited understanding of public perceptions of heat-related risk and the motivating factors for the public's diverse adaptive behaviors. Here, we conducted a survey on the behavioral adaptations of 3065 urban residents in response to heat waves in Jinan, which is a typical city suffering from a hot climate. We provided evidence on the current state of residents' perception of heat waves and the mechanism of how risk perception mediates individual behavioral intentions upon exposure to high ambient temperatures. We found that the mediating effects of risk perception varied significantly with respect to different types of adaptive behaviors. Concern behaviors appeared be motivated completely by the mediating effects of perceived concern (b = 0.45, p < 0.01 for concerns about health guidelines; b = 0.36, p < 0.01 for concerns about the weather forecast) and severity (b = 0.11, p < 0.01 for concerns about health guidelines), while outdoor activity could be consciously adjusted according to temperature changes without those mediating effects (p > 0.05). Indoor cooling behaviors and transportation behaviors are partially mediated by risk perception (b = -0.04, p < 0.01; b = 0.08, p < 0.01; b = 0.08, p < 0.01 for indoor fan usage, use of air-conditioned buses, and use of private cars, respectively). The conclusions could help determine more targeted and detailed interventions to enhance public behavioral adjustments, including participation in adaption to and emergency preparedness for extreme temperature under the ongoing climate changes.

Air pollution exposure and immunological and systemic inflammatory alterations among schoolchildren in China.

Exposure to air pollution is associated with an increased risk of respiratory infection, to which children are more susceptible than adults. However, epidemiological evidence regarding the association of chronic exposure to air pollution with the immune and systemic inflammatory function of children is scarce, especially in the context of higher exposure levels. In this study, we included 163 chronically exposed schoolchildren from a polluted area and 110 schoolchildren from a control area in Licheng district, Jinan, China. Immune biomarkers, including the absolute counts of lymphocyte subsets and the levels of immunoglobulins G, A, and M, C3, and C4 were determined. To explore the related biological process of altered immune biomarkers, 2 systemic inflammatory biomarkers, including C-reactive protein and the neutrophil-to-lymphocyte ratio, were also determined. After adjusting for confounders, the decreased B lymphocyte count (p = 0.021) and C3 and C4 levels (both p < 0.001) and the increased monocyte count (p = 0.009) and CD8+ T lymphocyte proportion (p = 0.054) were associated with living in the polluted area. Significant differences in the C4 and C3 levels between the areas were only seen in male schoolchildren and in schoolchildren without passive smoking exposure (Pinteraction = 0.036 and 0.042, respectively). The alterations in immune biomarkers suggested that air pollution-induced immunotoxic effects and relevant adaptive responses were simultaneously present in schoolchildren exposed to a higher level of air pollution. Future studies investigating the temporal patterns of these biomarkers among children are warranted.

The association of ambient PM2.5 with school absence and symptoms in schoolchildren: a panel study.

BACKGROUND: Children are a susceptible population to exposure of ambient fine particulate air pollution (PM2.5), and the associated symptoms are sensitive prevalent indicators of morbidity. However, few studies to date investigate the association between PM2.5 exposure and school absence and symptoms. METHODS: In a panel study including 20,291 observations in 615 schoolchildren 8-13 years of age, we asked the participants to record their school absence and symptoms on every school day from 17 November to 31 December 2014 in Jinan, China. We used the generalized linear mixed effects models to examine the adverse effects of ambient PM2.5 on school absence and symptoms, adjusting for covariates including meteorological and individual factors. RESULTS: The 3-day moving average of PM2.5 was significantly associated with school absence (1.37; 95% CI: 1.07-1.74) and increases in symptoms of the throat (1.03; 95% CI: 1.00-1.05), nose (1.03; 95% CI: 1.01-1.06), and skin (1.09; 95% CI: 1.06-1.12). High PM2.5 exposure also increased the risks of individual symptoms, especially for cough (1.02; 95% CI: 1.00-1.04), sneezing (1.03; 95% CI: 1.00-1.07), and stuffy nose (1.09; 95% CI: 1.02-1.17). CONCLUSION: High PM2.5 exposure is a risk factor for the health of schoolchildren. Allocation of medical resources for children should take into account the ambient PM2.5 concentrations and be proportioned accordingly.