Effects of PM10 Airborne Particles from Different Regions of a Megacity on In Vitro Secretion of Cytokines by a Monocyte Line during Different Seasons.

Several epidemiological studies have demonstrated that particulate matter (PM) in air pollution can be involved in the genesis or aggravation of different cardiovascular, respiratory, perinatal, and cancer diseases. This study assessed the in vitro effects of PM10 on the secretion of cytokines by a human monocytic cell line (THP-1). We compared the chemotactic, pro-inflammatory, and anti-inflammatory cytokines induced by PM10 collected for two years during three different seasons in five different Mexico City locations. MIP-1α, IP-10, MCP-1, TNF-α, and VEGF were the main secretion products after stimulation with 80 µg/mL of PM10 for 24 h. The THP-1 cells showed a differential response to PM10 obtained in the different sites of Mexico City. The PM10 from the north and the central city areas induced a higher pro-inflammatory cytokine response than those from the south. Seasonal pro-inflammatory cytokine secretion always exceeded anti-inflammatory secretion. The rainy-season-derived particles caused the lowest pro-inflammatory effects. We concluded that toxicological assessment of airborne particles provides evidence supporting their potential role in the chronic exacerbation of local or systemic inflammatory responses that may worsen the evolution of some chronic diseases.

Autistic Regression and Exposure to Industrial Chemicals: Preliminary Observations.

Exposure to industrial pollutants is a potential risk factor not fully explored in ASD with regression (ASD+R). We studied geographical collocation patterns of industrial air chemical emissions and the location of homes of children with ASD+R at different exposure times, compared with ASD cases without regression (ASD-R). Fifteen of 111 emitted chemicals collocated with ASD+R, and 65 with ASD-R. ASD+R collocated more strongly with different neurotoxicants/immunotoxicants a year before diagnosis, whereas ASD-R were moderately collocated with chemicals across all exposure periods. This preliminary exploratory analysis of differences in exposure patterns raises a question regarding potential pathophysiological differences between the conditions.

Chaotic finite difference operators.

In this article, we analyze the chaotic behavior of finite difference operators associated with certain differential equations. Our examples range from numerical schemes for a birth-and-death model with proliferation to a class of second-order partial differential equations that includes the hyperbolic heat transfer equation, the telegraph equation, and the wave equation. We provide sufficient conditions on the spatial and time steps of the scheme that guarantee chaos for the corresponding operators, and we compare them with the conditions needed to ensure chaotic analytical solutions.

The pregnancy research on inflammation, nutrition, & city environment: systematic analyses study (PRINCESA) cohort, 2009-2015.

The Pregnancy Research on Inflammation, Nutrition, & City Environment: Systematic Analyses Study (PRINCESA) cohort was set up to evaluate associations between air pollution and birth outcomes among pregnant persons in Mexico City. Specifically, the study was designed to improve air pollution exposure assessment and elucidate biological mechanisms underlying associations between maternal exposures and adverse pregnancy outcomes. Pregnant persons (all women) (N = 935) between ages 18-45 who lived and/or worked in metropolitan Mexico City, Mexico, from 2009 to 2015 and liveborn singleton infants (N = 815) of participants who completed follow-up were enrolled in the cohort. We followed participants monthly from enrollment to delivery and the following categories of data were obtained: demographic, medical and obstetric history, geo-referenced data, repeated measures on daily activity patterns, reported food intake, anthropometric, clinical and obstetric data, 20 serum and 20 cervicovaginal cytokines, and lower reproductive tract infection. Repeated ultrasound measures of fetal parameters and infant birth data are also included in the study's database. In addition, PRINCESA investigators calculated air pollution exposure measures for six pollutants measured by the Mexico City Atmospheric Monitoring System (SIMAT). These estimates utilize participants' addresses to account for spatial variation in exposure (nearest monitor, inverse distance weighting, and kriging) and are available daily during pregnancy for participants. To date, associations between environmental and nutritional impacts on maternal and child health outcomes have been evaluated. PRINCESA has a comprehensive database of maternal and infant data and biological samples and offers collaboration opportunities to study associations between environmental and other factors, including nutrition and pregnancy outcomes.

Climate change impacts on the health of South Asian children and women subpopulations - A scoping review.

Background and objectives: Climate change impacts are felt unequally worldwide; populations that experience geographical vulnerability, those living in small island states and densely populated coastal areas, and children and women are affected disproportionately. This scoping review aims to synthesize evidence from relevant studies centred on South Asia, identify research gaps specifically focused on children and women's health, and contribute to knowledge about South Asia's existing mitigation and adaptation strategies. Methods: A research librarian executed the search on six databases using controlled vocabulary (e.g., MeSH, Emtree, etc.) and keywords representing the concepts "vulnerable populations" and "climate change" and "health impacts" and "South Asia." Databases were searched from January 2010 to May 2020. Papers were screened independently by two researchers. Results: Forty-two studies were included, of which 23 were based in India, 14 in Bangladesh, and five in other South Asian countries. Nineteen studies focused on meteorological factors as the primary exposure. In contrast, thirteen focused on extreme weather events, nine on air pollution, and one on salinity in coastal areas. Thirty-four studies focused on the health impacts on children related to extreme weather events, meteorological factors, and air pollution, while only eight studies looked at health impacts on women. Undernutrition, ARI (acute respiratory infection), diarrheal diseases, low birth weight, and premature mortality were the major health impacts attributed to extreme weather events, meteorological factors, and air pollution exposure in children and women in the region. Conclusion: Extreme weather events, meteorological factors and air pollution have affected the health of children and women in South Asia. However, the gap in the literature across the South Asian countries concerning relationships between exposure to extreme weather events, meteorological factors, air pollution and health effects, including mental health problems in children and women, are opportunities for future work.

Geographic inequalities in paediatric emergency department visits in Ontario and Alberta: a multilevel analysis of 2.5 million visits.

BACKGROUND: Research on intra- and inter-regional variations in emergency department (ED) visits among children can provide a better understanding of the patterns of ED utilization and further insight into how contextual features of the urban environment may be associated with these health events. Our objectives were to assess intra-urban and inter-urban variation in paediatric emergency department (PED) visits in census metropolitan areas (CMAs) in Ontario and Alberta, Canada and explore if contextual factors related to material and social deprivation, proximity to healthcare facilities, and supply of family physicians explain this variation. METHODS: A retrospective, population-based analysis of data on PED visits recorded between April 1, 2015 and March 31, 2017 was conducted. Random intercept multilevel regression models were constructed to quantify the intra- (between forward sortation areas [FSAs]) and inter- (between CMAs) variations in the rates of PED visits. RESULTS: In total, 2,537,442 PED visits were included in the study. The overall crude FSA-level rate of PED visits was 415.4 per 1,000 children population. Across CMAs, the crude rate of PED visits was highest in Thunder Bay, Ontario (771.6) and lowest in Windsor, Ontario (237.2). There was evidence of substantial intra- and inter-urban variation in the rates of PED visits. More socially deprived FSAs, FSAs with decreased proximity to healthcare facilities, and CMAs with a higher rate of family physicians per 1,000 children population had higher rates of PED visits. CONCLUSIONS: The variation in rates of PED visits across CMAs and FSAs cannot be fully accounted for by age and sex distributions, material and social deprivation, proximity to healthcare facilities, or supply of family physicians. There is a need to explore additional contextual factors to better understand why some metropolitan areas have higher rates of PED visits.

Ambient Air Pollution and Pediatric Inflammatory Bowel Diseases: An Updated Scoping Review.

To review and discuss recent findings on the associations between pediatric/early-life exposures to ambient air pollution and the risk of pediatric-onset inflammatory bowel diseases (IBD). A scoping review was conducted using the Peters Micah et al. framework. We searched, selected, extracted, and reviewed information from published peer-reviewed papers from three bibliographic databases, chosen to cover a broad range of disciplines. Limits on date (last decade), language, and subject were placed on the database search. The search identified 109 papers from 2010 to June 2021. After screening, we identified nine articles with data on air pollution as a risk factor for IBD, but only four epidemiologic studies directly investigated the association between air pollution and IBD development in children and young adults. These four papers show that air pollution components have different associations with pediatric IBD (pIBD) incidence. Consequently, sulfur dioxide (SO2), nitrogen dioxide (NO2), and the oxidant capacity of air pollution (Ox) were positively associated with pIBD incidence, whereas the association effects of particulate matter (PM) and ozone (O3) exposures were not clear. Despite good scientific rationale and some studies, the evidence on the role that air pollution has in IBD development is limited, highlighting the need for further investigation. Future studies should include the epidemiology of air pollutants and its sources, identifying and understanding mechanisms linking air pollution and pIBD, and identifying signatures of biological responses to air pollutants.

Comparison of the clinical and ultrasound evaluation of haemophilic arthropathy in children.

BACKGROUND: Joint ultrasound examination using the HEAD-US method in the detection of early arthropathy is poorly studied in our country. OBJECTIVE: To compare the clinical and ultrasound evaluation of the joints in haemophilia. METHOD: Longitudinal, prospective and descriptive study with paediatric patients with haemophilia A and B evaluated with the HJHS 2.1 scale and ultrasound with a linear transducer of 8 to 12 MHz. Elbows, knees and ankles joints were evaluated bilaterally, with HEAD-US protocol. RESULTS: 69 paediatric patients were included of which 48 with severe haemophilia A (weight: 40.1 kg). On the HJHS scale, a greater involvement was observed in the left knee (0.49), and less in the right ankle (0.05). With the HEAD-US scale, the most affected was the right knee (0.78). There is a significant relationship in the involvement of the right knee evaluated with the HEAD-US scale in the presence of inhibitor. CONCLUSIONS: Weight above the 50th percentile is an independent risk factor for joint bleeding complications, while age and type of haemophilia do not appear to be related. The HEAD-US method is a useful and accessible tool for early detection of arthropathy and hemarthrosis.

ANTECEDENTES: La exploración articular por ultrasonido mediante el método HEAD-US en la detección de la artropatía temprana ha sido poco estudiada en nuestro país. OBJETIVO: Comparar la evaluación clínica y por ultrasonido de las articulaciones en niños con hemofilia. MÉTODOS: Estudio longitudinal, prospectivo y descriptivo con pacientes pediátricos con hemofilia A y B valorados con la escala HJHS 2.1 y ultrasonido con transductor lineal de 8 a 12 MHz. Se evaluaron las articulaciones de codos, rodillas y tobillos de forma bilateral, con el método HEAD-US. RESULTADOS: Se incluyeron 69 pacientes; de ellos, 48 con hemofilia A grave (peso: 40.1 kg). En la escala HJHS se observó mayor afectación en la rodilla izquierda (0.49) y menor en el tobillo derecho (0.05). Con la escala HEAD-US, la más afectada fue la rodilla derecha (0.78). Existe una relación significativa en la afectación de la rodilla derecha evaluada con la escala HEAD-US en presencia de inhibidor. CONCLUSIONES: El peso superior al percentil 50 es un factor de riesgo independiente de complicaciones por sangrado articular, mientras que la edad y el tipo de hemofilia no parecen relacionados. El método HEAD-US es una herramienta útil y accesible para la detección temprana de artropatía y hemartrosis.

Cold Climate Impact on Air-Pollution-Related Health Outcomes: A Scoping Review.

In cold temperatures, vehicles idle more, have high cold-start emissions including greenhouse gases, and have less effective exhaust filtration systems, which can cause up to ten-fold more harmful vehicular emissions. Only a few vehicle technologies have been tested for emissions below -7 °C (20 °F). Four-hundred-million people living in cities with sub-zero temperatures may be impacted. We conducted a scoping review to identify the existing knowledge about air-pollution-related health outcomes in a cold climate, and pinpoint any research gaps. Of 1019 papers identified, 76 were selected for review. The papers described short-term health impacts associated with air pollutants. However, most papers removed the possible direct effect of temperature on pollution and health by adjusting for temperature. Only eight papers formally explored the modifying effect of temperatures. Five studies identified how extreme cold and warm temperatures aggravated mortality/morbidity associated with ozone, particles, and carbon-monoxide. The other three found no health associations with tested pollutants and temperature. Additionally, in most papers, emissions could not be attributed solely to traffic. In conclusion, evidence on the relationship between cold temperatures, traffic-related pollution, and related health outcomes is lacking. Therefore, targeted research is required to guide vehicle regulations, assess extreme weather-related risks in the context of climate change, and inform public health interventions.

Comparación de la evaluación clínica y por ultrasonido de la artropatía hemofílica en pacientes pediátricos / Comparison of the clinical and ultrasound evaluation of haemophilic arthropathy in children

Resumen Antecedentes: La exploración articular por ultrasonido mediante el método HEAD-US en la detección de la artropatía temprana ha sido poco estudiada en nuestro país. Objetivo: Comparar la evaluación clínica y por ultrasonido de las articulaciones en niños con hemofilia. Métodos: Estudio longitudinal, prospectivo y descriptivo con pacientes pediátricos con hemofilia A y B valorados con la escala HJHS 2.1 y ultrasonido con transductor lineal de 8 a 12 MHz. Se evaluaron las articulaciones de codos, rodillas y tobillos de forma bilateral, con el método HEAD-US. Resultados: Se incluyeron 69 pacientes; de ellos, 48 con hemofilia A grave (peso: 40.1 kg). En la escala HJHS se observó mayor afectación en la rodilla izquierda (0.49) y menor en el tobillo derecho (0.05). Con la escala HEAD-US, la más afectada fue la rodilla derecha (0.78). Existe una relación significativa en la afectación de la rodilla derecha evaluada con la escala HEAD-US en presencia de inhibidor. Conclusiones: El peso superior al percentil 50 es un factor de riesgo independiente de complicaciones por sangrado articular, mientras que la edad y el tipo de hemofilia no parecen relacionados. El método HEAD-US es una herramienta útil y accesible para la detección temprana de artropatía y hemartrosis.

Abstract Background: Joint ultrasound examination using the HEAD-US method in the detection of early arthropathy is poorly studied in our country. Objective: To compare the clinical and ultrasound evaluation of the joints in haemophilia. Methods: Longitudinal, prospective and descriptive study with paediatric patients with haemophilia A and B evaluated with the HJHS 2.1 scale and ultrasound with a linear transducer of 8 to 12 MHz. Elbows, knees and ankles joints were evaluated bilaterally, with HEAD-US protocol. Results: 69 paediatric patients were included of which 48 with severe haemophilia A (weight: 40.1 kg). On the HJHS scale, a greater involvement was observed in the left knee (0.49), and less in the right ankle (0.05). With the HEAD-US scale, the most affected was the right knee (0.78). There is a significant relationship in the involvement of the right knee evaluated with the HEAD-US scale in the presence of inhibitor. Conclusions: Weight above the 50th percentile is an independent risk factor for joint bleeding complications, while age and type of haemophilia do not appear to be related. The HEAD-US method is a useful and accessible tool for early detection of arthropathy and hemarthrosis.

PM2.5 induces airway hyperresponsiveness and inflammation via the AhR pathway in a sensitized Guinea pig asthma-like model.

Exposure to fine particulate matter (PM2.5) induces airway inflammation and hyperreactivity that lead to asthma. The mechanisms involved are still under investigation. We investigated the effect of resveratrol (3,4',5-trihydroxystilbene) (RES) on airway hyperresponsiveness, inflammation and CYP1A1 protein expression (an aryl hydrocarbon receptor (AhR) target) induced by PM2.5 exposure in an allergic asthma experimental guinea pig model. The polyphenolic compound RES was used due to its antioxidant and anti-inflammatory properties and as an antagonist of the AhR; thus, providing mechanistic insights. Animals were sensitized with aluminum hydroxide and ovalbumin and exposed to filtered air or PM2.5. Exposure to PM2.5 was conducted using a whole-body chamber particle concentrator (5 h/day) for 15 days. Animals received saline solution or RES (10 mg/kg per day) orally for 21 days simultaneously to the OVA challenge or PM2.5 exposure. PM2.5 exposure (mean 433 ± 111 µg/m3 in the exposure chamber) in OVA challenged animals induced an asthma-like phenotype characterized by increased baseline lung resistance (Rrs) and central airway resistance (Rn) in response to acetylcholine (ACh) evaluated using a flexiVent system®. A parallel increase of pro-inflammatory cytokines (IL-6, IL-17, TNF-α and IFN-γ), inflammatory cells (eosinophils and neutrophils) in bronchoalveolar lavage fluid (BALF) and lung CYP1A1 increase also occurred. RES significantly inhibited airway hyperresponsiveness, inflammation, and CYP1A1 protein expression in the OVA-challenged PM2.5 exposed animals. In summary, with the use of RES we demonstrate that PM-induced airway hyperreactivity is modulated by the inflammatory response via the AhR pathway in an allergic asthma guinea pig model.

Residential proximity to greenness and adverse birth outcomes in urban areas: Findings from a national Canadian population-based study.

BACKGROUND: Over the last decade, several studies have reported that residential proximity to vegetation, or 'greenness', is associated with improved birth outcomes, including for term birth weight (TBW), preterm birth (PTB), and small for gestational age (SGA). However, there remain several uncertainties about these possible benefits including the role of air pollution, and the extent to they are influenced socioeconomic status. METHODS: We addressed these gaps using a national population-based study of 2.2 million singleton live births in Canadian metropolitan areas between 1999 and 2008. Exposures to greenness, fine particulate matter (PM2.5), and nitrogen dioxide (NO2) were assigned to infants using the postal code of their mother's residence at the time of birth. The Normalized Difference Vegetation Index (NDVI) was used to characterize greenness, while estimates of ambient PM2.5 and NO2 were estimated using remote sensing, and a national land-use regression surface, respectively. Multivariable regression analysis was performed to describe associations between residential greenness and the birth outcomes. Stratified analyses explored whether these associations were modified by neighbourhood measures of socioeconomic status. RESULTS: Mothers who lived in greener areas had a lower risk of low TBW, PTB, and SGA babies. These associations persisted after adjustment for ambient NO2 and PM2.5. Specifically, in fully adjusted models, an interquartile range (IQR = 0.16) increase in the NDVI within a residential buffer of 250 m yielded odds ratios of 0.93 (95% confidence interval (CI): 0.92, 0.94), 0.94 (95% CI: 0.92, 0.95), and 0.94 (95% CI: 0.93, 0.95) for the outcomes of PTB, low TBW, and SGA, respectively. Similarly, an IQR increase in greenness was associated with a 16.3 g (95% CI: 15.3, 17.4) increase in TBW. We found inverse associations between greenness and the occurrence of adverse birth outcomes regardless of the socioeconomic status of the neighbourhood. INTERPRETATION: Our findings support the hypothesis that residential greenness contributes to healthier pregnancies, that these associations are independent from exposure to air pollution. , and that proximity to greenness benefits all mothers regardless of socioeconomic status.

Effect of titanium dioxide nanoparticles on DNA methylation of human peripheral blood mononuclear cells.

The aim of the current study was to investigate the effect of well-characterized TiO2 nanoparticles on DNA methylation of peripheral blood mononuclear cells (PBMCs) in vitro. Maximum non-toxic concentration of nanoparticles for PBMCs was determined by MTT assay. The effect of TiO2 nanoparticles at concentrations of 25-100 µg/ml on DNA methylation of PBMCs was investigated by measuring the %5-mC alterations through an ELISA assay. The physicochemical analysis showed that the TiO2 nanoparticles were crystalline, pure and in the anatase phase. Peaks related to Ti-O tensile vibrations were observed in the range of 1510 cm-1. The size of nanoparticles was in the range of 39-74 nm with an average hydrodynamic diameter of 43.82 nm. According to the results of the MTT test, 100 µg/ml was found to be maximum non-toxic concentration. The %5-mC in treated PBMCs revealed that TiO2 nanoparticles could lead to DNA hypomethylation in PBMCs. The %5-mC difference compared with the negative control was found to be 2.07 ± 1.02% (P = 0.03). The difference of %5-mC between the 25 and 100 µg/ml concentration of nanoparticles was statistically significant (P = 0.02). The results of the current study show that the TiO2 nanoparticles cause DNA hypomethylation in PBMCs in a dose-response manner. Therefore, it is recommended to evaluate the effects of cytotoxicity and epigenotoxicity of commonly used nanoparticles before their use.

Risk and Resilience: How Is the Health of Older Adults and Immigrant People Living in Canada Impacted by Climate- and Air Pollution-Related Exposures?

BACKGROUND: In the rapidly shifting Canadian climate, an ageing population, and increased migration, a greater understanding of how local climate and air pollution hazards impact older adults and immigrant populations will be necessary for mitigating and adapting to adverse health impacts. OBJECTIVES: To explore the reported health impacts of climate change and air pollution exposures in older adults and immigrant people living in Canada, identify known factors influencing risk and resilience in these populations and gaps in the literature. METHODS: We searched for research focused on older adults and immigrants living in Canada, published from 2010 onward, where the primary exposures were related to climate or air pollution. We extracted data on setting, exposures, health outcomes, and other relevant contextual factors. RESULTS AND DISCUSSION: We identified 52 eligible studies, most focused in Ontario and Quebec. Older people in Canada experience health risks due to climate and air pollution exposures. The extent of the risk depends on multiple factors. We found little information about the climate- and air pollution-related health impacts experienced by immigrant communities. CONCLUSIONS: Further research about climate- and air pollution-related exposures, health, and which factors promote or reduce resiliency in Canada's older adults and immigrant communities is necessary.

Long-term exposure to particulate matter from air pollution alters airway ß-defensin-3 and -4 and cathelicidin host defense peptides production in a murine model.

Epidemiological studies have associated long-term exposure to environmental air pollution particulate matter (PM) with the development of diverse health problems. They include infectious respiratory diseases related to the deregulation of some innate immune response mechanisms, such as the host defense peptides' expression. Herein, we evaluated in BALB/c mice the effect of long-standing exposure (60 days) to urban-PM from the south of Mexico City, with aerodynamic diameters below 2.5 µm (PM2.5) and 10 µm (PM10) on the lung's gene expression and production of three host defense peptides (HDPs); murine beta-defensin-3, -4 (mBD-3, mBD-4) and cathelin-related antimicrobial peptide (CRAMP). We also evaluated mRNA levels of Il1b and Il10, two cytokines related to the expression of host defense peptides. Exposure to PM2.5 and PM10 differentially induced lung inflammation, being PM2.5, which caused higher inflammation levels, probably associated with a differential deposition on the airways, that facilitate the interaction with alveolar macrophages. Inflammation levels were associated with an early upregulation of the three HDPs assessed and an increment in Il1b mRNA levels. Interestingly, after 28 days of exposure, Il10 mRNA upregulation was observed and was associated with the downregulation of HDPs and Il1b mRNA levels. The upregulation of Il10 mRNA and suppression of HDPs might facilitate microbial colonization and the development of diseases associated with long-term exposure to PM.

Wildfire exposure during pregnancy and the risk of adverse birth outcomes: A systematic review.

BACKGROUND: Maternal wildfire exposure (e.g., smoke, stress) has been associated with poor birth outcomes with effects potentially mediated through air pollution and psychosocial stress. Despite the recent hike in the intensity and frequency of wildfires in some regions of the world, a critical appraisal of the evidence on the association between maternal wildfire exposure and adverse birth outcomes has not yet been undertaken. We conducted a systematic review that evaluated the scientific evidence on the association between wildfire exposure during pregnancy and the risk of adverse birth outcomes. METHODS: Comprehensive searches in nine bibliographic databases were conducted from database inception up to June 2020. Observational epidemiological studies that evaluated associations between exposure to wildfire during pregnancy and adverse birth outcomes were eligible for inclusion. Studies were assessed using the National Toxicology Program's Office of Health Assessment and Translation (NTP OHAT) risk of bias tool and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Screening of retrieved articles, data extraction, and risk of bias assessment were performed by two independent reviewers. Study results were synthesized descriptively. RESULTS: Eight epidemiological studies conducted in four countries and involving 1,702,252 births were included in the review. The exposure to wildfire during pregnancy was assessed in individual studies by measurement of PM2.5 (n = 2), PM10 (n = 1), Total Ozone Mapping Spectrometer (TOMS)aerosol index (n = 1), heat spots (n = 1), and by proximity of maternal residence to wildfire-affected areas (n = 3). There is some evidence indicating that maternal wildfire exposure associates with birth weight reduction (n = 7) and preterm birth (n = 4), particularly when exposure to wildfire smoke occurred in late pregnancy. The association between wildfire exposure and small for gestational age (n = 2) and infant mortality (n = 1) was inconclusive. CONCLUSION: Current evidence suggests that maternal exposure to wildfire during late pregnancy is linked to reduced birth weight and preterm birth. Well-designed comprehensive studies are needed to better understand the perinatal effects of wildfires.

Patterns of respiratory health services utilization from birth to 5 years of children who experienced adverse birth outcomes.

INTRODUCTION: Adverse birth outcomes have important consequences for future lung health. We evaluated patterns of respiratory health services utilization in early childhood among children born preterm (PTB), small and large for gestational age at term (SGA and LGA, respectively), and appropriate-for-gestational age at term. MATERIALS AND METHODS: We conducted a population-based retrospective cohort study using administrative health data of all singleton live births in Alberta, Canada between 2005-2010. Data on hospitalizations and emergency department (ED) visits from birth to 5 years were collected for asthma, bronchitis, bronchiolitis, croup, influenza, pneumonia, and other acute upper and lower respiratory tract infections (other URTI and other LRTI, respectively). Adjusted rate ratios were estimated for respiratory ED visits and hospitalizations for adverse birth outcomes using the appropriate-for-gestational age at term group as reference. Age-specific trajectories of total respiratory health services utilization rates for each group were estimated in Poisson models. RESULTS: A total of 293,764 episodes of respiratory care from 206,994 children were analyzed. Very PTB children had the highest rates of health services use for all respiratory conditions, particularly for asthma, pneumonia, and bronchiolitis hospitalizations. Moderate/late PTB children also had elevated ED visits and hospitalizations for all respiratory conditions. Children born SGA showed high rates of ED visits for other LRTI, and of hospitalizations for bronchitis, bronchiolitis, and other URTI. Children born LGA had high rates of croup and other URTI ED visits, and of bronchiolitis and bronchiolitis hospitalizations. Age-specific trajectories showed a decreasing trend in the rates of total respiratory health service utilization from birth to five years of age for all groups studied. Children born PTB and LGA at term significantly required more respiratory health services over time compared to the reference group. CONCLUSION: Patterns of paediatric respiratory health services utilization vary according to gestational age and fetal growth.

Childhood Leukemia in Small Geographical Areas and Proximity to Industrial Sources of Air Pollutants in Three Colombian Cities.

Acute leukemia is the most common childhood cancer and has been associated with exposure to environmental carcinogens. This study aimed to identify clusters of acute childhood leukemia (ACL) cases and analyze their relationship with proximity to industrial sources of air pollution in three capital cities in Colombia during 2000-2015. Incident ACL cases were obtained from the population cancer registries for the cities of Bucaramanga, Cali, and Medellín. The inventory of industrial sources of emissions to the air was obtained from the regional environmental authorities and industrial conglomerates were identified. The Kulldorf's circular scan test was used to detect city clusters and to identify clusters around industrial conglomerates. Multivariable spatial modeling assessed the effect of distance and direction from the industrial conglomerates controlling for socioeconomic status. We identified industrials sectors within a buffer of 1 km around industrial conglomerates related to the ACL clusters. Incidence rates showed geographical heterogeneity with low spatial autocorrelation within cities. The spatio-temporal tests identified one cluster in each city. The industries located within 1 km around the ACL clusters identified in the three cities represent different sectors. Exposure to air pollution from industrial sources might be contributing to the incidence of ACL cases in urban settings in Colombia.

Assessing the Influence of Socioeconomic Status and Air Pollution Levels on the Public Perception of Local Air Quality in a Mexico-US Border City.

Air pollution in developing countries is a growing concern. It is associated with urbanization and social and economic structures. The understanding of how social factors can influence the perception and the potential impact of air pollution have not been addressed sufficiently. This paper addresses the social vulnerability and exposure to PM10 association and its influence on the air quality perception of residents in Mexicali, a Mexico-US border city. This study used individual variables and population census data, as well as statistical and spatial analyses. A cluster of socially vulnerable populations with high exposure to coarse particulate matter (PM10) was found in the city's peripheral areas. The spatial distribution of the local perception of air quality varied by the exposure zones of the estimated PM10 concentrations. Respondents living in very high exposure areas perceive air quality as "poor," contrarily to a worse perception in areas of intermediate and lower exposure to PM10. Proximity to stationary sources of pollution was associated with a poor perception of air quality. Results also indicate that low household income and poor air quality perceived at the place of residence negatively influences the perceived changes in the air quality over time. The knowledge of chronic health effects related to air pollution was scarce in the sampled population, especially in the areas with very high exposure and high social vulnerability. These findings can serve as a support in local air quality management.