Trends in elemental Pb concentrations within atmospheric PM2.5 and associated risk to human health in major cities of China.

High concentrations of elemental lead (Pb) in the atmosphere pose a serious threat to human health. This study presents and summarizes data obtained from relevant literature on Pb concentrations within fine particulate matter (PM2.5) recorded in major cities in China from 2008 to 2019. An environmental health risk assessment model was then used to evaluate the health hazards of inhaling Pb among adults and children in China. Owing to the promulgation and implementation of a series of air pollution control measures, the Pb concentrations within PM2.5 measured in major cities in China showed a downward trend after peaking in 2013. The concentrations were higher in winter than in summer, and higher in northern cities than in southern cities. Although the Pb concentrations in most cities did not exceed the limit (500 ng/m3) set by China, they remained much higher than concentrations recorded in developed countries. The results of the environmental health risk analysis showed that the non-carcinogenic risk from atmospheric Pb exposure was higher in children than in adults (adult females > adult males), while the carcinogenic risk was higher in adults than in children. This study shows that even if the health risk of Pb in PM2.5 does not exceed the acceptable limit, stricter Pb pollution control measures are required to safeguard population health due to the dangers of Pb.

The exposome in practice: an exploratory panel study of biomarkers of air pollutant exposure in Chinese people aged 60-69 years (China BAPE Study).

The exposome overhauls conventional environmental health impact research paradigms and provides a novel methodological framework that comprehensively addresses the complex, highly dynamic interplays of exogenous exposures, endogenous exposures, and modifiable factors in humans. Holistic assessments of the adverse health effects and systematic elucidation of the mechanisms underlying environmental exposures are major scientific challenges with widespread societal implications. However, to date, few studies have comprehensively and simultaneously measured airborne pollutant exposures and explored the associated biomarkers in susceptible healthy elderly subjects, potentially resulting in the suboptimal assessment and management of health risks. To demonstrate the exposome paradigm, we describe the rationale and design of a comprehensive biomarker and biomonitoring panel study to systematically explore the association between individual airborne exposure and adverse health outcomes. We used a combination of personal monitoring for airborne pollutants, extensive human biomonitoring, advanced omics analysis, confounding information, and statistical methods. We established an exploratory panel study of Biomarkers of Air Pollutant Exposure in Chinese people aged 60-69 years (China BAPE), which included 76 healthy residents from a representative community in Jinan City, Shandong Province. During the period between September 2018 and January 2019, we conducted prospective longitudinal monitoring with a 3-day assessment every month. This project: (1) leveraged advanced tools for personal airborne exposure monitoring (external exposures); (2) comprehensively characterized biological samples for exogenous and endogenous compounds (e.g., targeted and untargeted monitoring) and multi-omics scale measurements to explore potential biomarkers and putative toxicity pathways; and (3) systematically evaluated the relationships between personal exposure to air pollutants, and novel biomarkers of exposures and effects using exposome-wide association study approaches. These findings will contribute to our understanding of the mechanisms underlying the adverse health impacts of air pollution exposures and identify potential adverse clinical outcomes that can facilitate the development of effective prevention and targeted intervention techniques.

Knowledge, Practice of Personal Hygiene, School Sanitation, and Risk Factors of Contracting Diarrhea among Rural Students from Five Western Provinces in China.

BACKGROUND: Diarrhea is a global public health issue and a leading cause of childhood malnutrition, growth disturbances, and mortality. The spread of diarrhea is closely linked to the knowledge and maintenance of personal hygiene and quality of drinking water and sanitation facilities. However, there are few such investigations and analysis in rural areas of China. This study aims to determine the association between the risk of contracting diarrhea and knowledge and practices of personal hygiene and school sanitation among rural students as well as provide a scientific basis for preventing the spread of diarrhea and other infectious diseases. A stratified cluster sampling method was used to randomly select 12 rural primary schools in each of 5 counties where the Water, Sanitation and Hygiene (WASH) Plus Program has been implemented. The counties are located in the Guangxi Zhuang autonomous region, Chongqing municipality, Guizhou province, Yunnan province, and Xinjiang Uygur autonomous region. A single fourth-grade class was randomly chosen from each of the 60 schools for observation and a questionnaire survey. The study involved a total of 2330 students. The logistic regression method was adopted to determine the factors contributing to diarrhea in rural students. The results show that male students accounted for 49.40% (n = 1151) of the 2330 research subjects; the average age of the students was 9.9 ± 0.3 years. Approximately 33.09% of the students suffered from diarrhea in the three months leading up to the survey. The odds ratios (ORs) of students who did not know that "diarrhea can be prevented by washing fruits before eating them raw and not drinking untreated water" (OR: 1.303, 95% confidence interval [CI]: 1.063, 1.597) and that "the disease can be prevented by washing hands before meals and after going to the toilet" (OR: 1.522, 95% CI: 1.207, 1.920) were higher than those who knew the above stated facts. Students who "have drunk untreated water at school" (OR: 1.584, 95% CI: 1.268, 1.978), "have drunk untreated water at home" (OR: 1.643, 95% CI: 1.319, 2.048), and "did not wash hands before every meal" (OR: 1.490, 95% CI: 1.120, 1.983) were at a higher risk of contracting diarrhea than those who drank treated water at school and at home and washed their hands before every meal. Diarrhea was more likely to affect students who attended schools with unclean and poorly maintained toilets (OR: 1.586, 95% CI: 1.261, 1.995) or toilets with flies (OR: 1.383, 95% CI: 1.114, 1.717) and without adequate drinking water facilities (OR: 1.407, 95% CI: 1.009, 1.962). The knowledge of methods to maintain personal hygiene, general hygiene practices, and school sanitation are the three major risk factors that account for the spread of diarrhea among rural students from five western provinces (municipalities and autonomous regions) of China. Therefore, to prevent such diseases and maintain health, it is important to provide students with health education, help them develop good hygiene habits, ensure the provision of clean water at schools, and improve the overall school environments.

Exploring personal chemical exposures in China with wearable air pollutant monitors: A repeated-measure study in healthy older adults in Jinan, China.

The health impact of airborne contaminants has been challenging to assess due to current limitations in measurement technologies. The emergence of wearable passive samplers coupled with high resolution mass spectrometry (HR-MS) chemical analysis has enabled comprehensive characterization of personal exposures. We conducted a repeated-measure study among 84 older adults in Jinan, China, as part of the Biomarkers for Air Pollutants Exposure (China BAPE) study. Study objectives were: 1) to characterize the occurrence, magnitude, and distribution of personal exposure to airborne contaminants; 2) to evaluate the temporal variation of chemical exposures across the study population; and 3) to identify behavioral and environmental factors that influence the observed variance in chemical exposures. The FreshAir wristband was worn by participants for three consecutive days each month from September 2018 to January 2019 and collected with paired time-activity logs. Passive air samplers were also deployed in parallel at a local outdoor air monitoring station. Spearman's Rho trend test and trajectory cluster analysis were used to identify exposure trends and variation patterns, respectively. Out of the 70 airborne compounds of potential concern screened, 26 compounds from 10 chemical classes were found to be above detection thresholds across >70% of the study population. Personal exposures were predominantly characterized by nine polycyclic aromatic hydrocarbons (PAHs), four phthalates, three nitroaromatics, and two volatile organic compounds (VOCs). Phthalate personal exposures were positively correlated with outdoor temperatures while the inverse relationship was observed for certain PAHs (p < 0.05). Specifically, dimethyl phthalate (rs = 0.31) decreased as temperatures declined, while nitrobenzene (rs = -0.35) and naphthalene (rs = -0.40) increased as temperatures decreased. Compared to levels measured at the outdoor air monitoring site, personal exposure of phthalates was elevated (p < 0.05) and hexachlorobutadiene was lower across participants (p < 0.01). Personal exposure of these chemicals was further found to be weakly associated with daily duration participants spent outdoors. Individuals formed distinct clusters based on trajectories of chemical exposures across the sampling period (September to January), potentially suggestive of distinct emission sources. In conclusion, we demonstrate the feasibility of characterizing the occurrence and magnitude of personal exposure to airborne chemical contaminants using passive wristband samplers. The temporal variability of these personal exposure profiles was highlighted and with distinct trends identified across different groups of individuals. Future studies will integrate this data with other omics datasets collected from this population of Chinese older adults to investigate associations between exposure profiles and health relevant biomarkers, to provide evidence in feasibility of disease prevention through environmental improvements.

Risk factors and on-site simulation of environmental transmission of SARS-CoV-2 in the largest wholesale market of Beijing, China.

From June 11, 2020, a surge in new cases of coronavirus disease 2019 (COVID-19) in the largest wholesale market of Beijing, the Xinfadi Market, leading to a second wave of COVID-19 in Beijing, China. Understanding the transmission modes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the personal behaviors and environmental factors contributing to viral transmission is of utmost important to curb COVID-19 rise. However, currently these are largely unknown in food markets. To this end, we completed field investigations and on-site simulations in areas with relatively high infection rates of COVID-19 at Xinfadi Market. We found that if goods were tainted or personnel in market was infected, normal transaction behaviors between sellers and customers, daily physiological activities, and marketing activities could lead to viral contamination and spread to the surroundings via fomite, droplet or aerosol routes. Environmental factors such as low temperature and high humidity, poor ventilation, and insufficient hygiene facilities and disinfection practices may contribute to viral transmission in Xinfadi Market. In addition, precautionary control strategies were also proposed to effectively reduce the clustering cases of COVID-19 in large-scale wholesale markets.

Exploring the external exposome using wearable passive samplers - The China BAPE study.

Environmental exposures are one of the greatest threats to human health, yet we lack tools to answer simple questions about our exposures: what are our personal exposure profiles and how do they change overtime (external exposome), how toxic are these chemicals, and what are the sources of these exposures? To capture variation in personal exposures to airborne chemicals in the gas and particulate phases and identify exposures which pose the greatest health risk, wearable exposure monitors can be deployed. In this study, we deployed passive air sampler wristbands with 84 healthy participants (aged 60-69 years) as part of the Biomarkers for Air Pollutants Exposure (China BAPE) study. Participants wore the wristband samplers for 3 days each month for five consecutive months. Passive samplers were analyzed using a novel gas chromatography high resolution mass spectrometry data-processing workflow to overcome the bottleneck of processing large datasets and improve confidence in the resulting identified features. The toxicity of chemicals observed frequently in personal exposures were predicted to identify exposures of potential concern via inhalation route or other routes of airborne contaminant exposure. Three exposures were highlighted based on elevated toxicity: dichlorvos from insecticides (mosquito/malaria control), naphthalene partly from mothballs, and 183 polyaromatic hydrocarbons from multiple sources. Other exposures explored in this study are linked to diet and personal care products, cigarette smoke, sunscreen, and antimicrobial soaps. We highlight the potential for this workflow employing wearable passive samplers for prioritizing chemicals of concern at both the community and individual level, and characterizing sources of exposures for follow up interventions.

Changes of environmental and personal hygiene in rural schools of Henan and Sichuan from 2016 to 2018 / 中国学校卫生

Objective@#To investigate the changes of environmental sanitation, health knowledge and behavior of students and diarrhea in rural schools in Henan and Sichuan Provinces from 2016 to 2018, and to provide data for improving environmental sanitation, health literacy, as well as reducing diarrhea and other infectious diseases among rural students.@*Methods@#Based on the "Community Approach to Total Sanitation (CATS)", a total of 13 rural primary schools were selected in 2016 and 2018 respectively, including 8 in Henan and 5 in Sichuan. One class of fourth grade students was selected from each school. Totally 450 students were surveyed in 2016 and 2018, respectively. The drinking water, environmental hygiene, students personal hygiene and behavior, and the incidence of diarrhea in recent 3 months were investigated by interview, observation, inquiry and questionnaire.@*Results@#Between 2016 and 2018, the number of schools providing safe drinking water for students increased from 6 to 8, the number of schools with proper hand washing facilities increased from 9 to 12, the number of schools with hand washing facilities equipped with soap or hand sanitizer increased from 2 to 9, and the number of schools with sanitary toilet type increased from 9 to 12. The awareness rate of students total health knowledge increased from 58.74% (793/1 350) to 64.96% (877/1 350), the formation rate of students total health behavior increased from 67.78% (1 220/1 800) to 75.28 % (1 355/1 800), the proportion of diarrhea in recent 3 months decreased from 36.89% (166/450) to 21.11% (95/450), the differences were statistically significant( χ 2=11.08, 24.86, 27.20, P <0.05).@*Conclusion@#The basic environmental sanitation facilities of rural schools in Henan and Sichuan has improved substantially, together with increased students health knowledge and hygiene behavior, and decreased incidence of students diarrhea.

Rural school environment and sanitation in five provinces of western China / 中国学校卫生

Objective@#To understand environmen and sanitation of rural schools in western China, and to provide data support and reference for improving school environmental conditions and facilities and promoting the healthy development of students.@*Methods@#Based on the "School Comprehensive Environmental Improvement Project", a total of 38 087 students from 60 primary school from were randomly selected from 5 provinces in western China from September to December 2018. Environment and sanitation of schools was investigated through interviews, on site observation and inquiry, so as to obtain the survey data.@*Results@#All schools had water supply, 80.0% (48) could meet the needs of teachers and students, 91.7% (55) provided drinking water facilities, 93.3 % (56) provided hand washing facilities, and 66.7% (40) provided soap and other cleaning supplies for students. 71.7% (43) of the schools had sanitary toilets, 40.0% (24) toilets were qualified for femail, 86.7% (52) were clean and 58.3% (35) were odorless. The garbage disposal methods of schools are mainly collected by professional institutions, supplemented by fixed point stacking, accounting for 45.0% (27) and 35.0% (21) respectively. About 30% (22, 17, 20) of school sewage is discharged by open ditch, underground ditch and pipeline. 93.3% (56) of schools offered health education courses, 91.7% (55) had sanitation system, 70.0% (42) had drinking water sanitation management system, and 41.7% (25) had toilet management system.@*Conclusion@#The basic environmental sanitation facilities in the school are well equipped, and there are some problems to be improved in the establishment of environmental sanitation management system and the provision of hand washing and cleaning supplies.