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1.
Environ Pollut ; 260: 114077, 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-32041030

RESUMO

Association between long-term exposure to ambient air pollution and obesity remains inconclusive, and the evidence from rural areas was limited. Thus, this study aimed to assess the association between ambient air pollution and obesity based on different anthropometric indices in Chinese rural adults, and further to compare the effect sizes of different air pollution types. A total of 38,824 participants (aged 18-79 years) were recruited from the Henan Rural Cohort Study. Logistic and multivariable linear regression model were used to examine the association between ambient air pollution exposure (including particulate matter with aerodynamic diameters ≤ 1.0 µm (PM1), ≤2.5 µm (PM2.5), and ≤10 µm (PM10), and nitrogen dioxide (NO2)) and obesity as well as obese anthropometric indices (including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), and visceral fat index (VFI)). The potential effect modifications were also examined. Positive associations were found between long-term exposure to PM1, PM2.5, PM10 and NO2 and obesity regardless of how obesity was defined (false discovery rate (FDR) < 0.05). Moreover, BMI, WC, WHR, WHtR, BFP, and VFI displayed increased trends with PM1, PM2.5, PM10 and NO2 concentrations increasing (all FDR<0.05). PM10 had the largest effects on obesity among the four types of air pollution. The elderly, women, individuals with low level of education and income, and those who had high fat diet were more vulnerable to the adverse effects of air pollution. In addition, the results of the sensitivity analysis showed that those associations between ambient air pollution and obesity remained robust. These findings suggest that long-term exposure to ambient air pollutant (particularly PM10) may be positively associated with obesity in Chinese rural adults, especially among the elderly, women, individuals with low education and income, as well as unhealthy lifestyles.

2.
Chemosphere ; 248: 126103, 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32041074

RESUMO

BACKGROUND: Excessive daytime sleepiness is associated with many adverse consequences, including cardiovascular diseases and mortality. Although exposure to air pollution has been suggested in connection with excessive daytime sleepiness, evidence in China is scarce. The study aimed to explore the association between long-term exposure to air pollution and excessive daytime sleepiness in rural China. METHODS: A lot of 27935 participants (60% females) from the Henan Rural Cohort Study were included in this analysis. A satellite-based spatiotemporal model estimated a 3-year average air pollution exposure to NO2 (nitrogen dioxide), PM1 (particulate matter with aerodynamic diameters not more than 1 µm) and PM2.5 (particulate matter with aerodynamic diameters not more than 2.5 µm) at the home address of participants before the baseline survey. Logistic regression was used to evaluate the odds ratio and 95% confidence interval between long-term air pollution and excessive daytime sleepiness. RESULTS: The average concentrations of NO2, PM1 and PM2.5 during three years preceding baseline survey were 38.22 µg/m³, 56.29 µg/m³ and 72.30 µg/m³. Exposure to NO2, PM1 and PM2.5 were all associated with excessive daytime sleepiness. Each 1 µg/m³ increment of NO2, PM1 and PM2.5 were related to a 20% (OR: 1.20, 95% CI: 1.13-1.27), 10% (OR: 1.10, 95% CI: 1.05-1.16) and 17% (OR: 1.17, 95% CI: 1.10-1.23) increase of the prevalence of excessive daytime sleepiness. CONCLUSION: The study demonstrated that long-term exposure to NO2, PM1 and PM2.5 were all associated with excessive daytime sleepiness. The impact of air pollution should be considered when treating individuals with excessive daytime sleepiness.

3.
Environ Int ; 136: 105459, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31931348

RESUMO

BACKGROUND: Long-term exposure to ambient air pollution and physical activity are linked to metabolic syndrome (MetS). However, the joint effect of physical activity and ambient air pollution on MetS remains largely unknown in rural Chinese adult population. METHODS: In this study, 39 089 individuals were included from the Henan Rural Cohort study that recruited 39 259 individuals at the baseline. Participants' exposure to air pollutants (including particulate matter with an aerodynamic diameter ≤ 1.0 µm (PM1), ≤2.5 µm (PM2.5), or ≤ 10 µm (PM10) and nitrogen dioxide (NO2)) were evaluated by using a spatiotemporal model based on satellites data. Individuals were defined as MetS according to the recommendation of the Joint Interim Societies. Physical activity-metabolic equivalent (MET) was calculated based on the formula of MET coefficient of activity × duration (hour per time) × frequency (times per week). Generalized linear models were used to analyze the individual air pollutant or physical activity and their interaction on MetS. Interaction effects of individual air pollutant and physical activity on MetS were assessed by using Interaction plots which exhibited the estimated effect of physical activity on MetS as a function of individual air pollutant. RESULTS: The prevalence of MetS was 30.8%. The adjusted odd ratio of MetS with a per 5 µg/m3 increase in PM1, PM2.5, PM10, NO2 or a 10 MET (hour/day) of physical activity increment was 1.251(1.199, 1.306), 1.424(1.360, 1.491), 1.228(1.203, 1.254), 1.408(1.363, 1.455) or 0.814(0.796, 0.833). The protective effect of physical activity on MetS was decreased with accompanying air pollutant concentrations increased. CONCLUSIONS: The results indicated that long-term exposure to ambient air pollutants related to increased risk of MetS and physical activity attenuated the effects of ambient air pollutants on increased risk for MetS.

4.
Sci Total Environ ; 703: 134909, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-31757557

RESUMO

BACKGROUND: Evidence for associations between fine particulate matter (PM2.5) and cardiovascular diseases (CVDs) in Iran is scarce. Given large within-day variations of PM2.5 concentration, using the daily mean of PM2.5 (PM2.5mean) as exposure metric might bias the health-related assessment. This study applied a novel indicator, daily excessive concentration hours (DECH), to evaluate the effect of ambient PM2.5 on CVD mortality and years of life lost (YLL) in Tehran, the capital city of Iran. METHODS: Hourly concentration data for PM2.5, daily information for meteorology and records of registered cardiovascular deaths from 2012 to 2016 were obtained from Tehran, Iran. Daily excessive concentration hours of PM2.5 (PM2.5DECH) was defined as daily total concentration-hours exceeding 35 µg/m3. Using a time-series design, we applied generalized linear models to assess the attributable effects of PM2.5DECH and PM2.5mean on CVD mortality and YLL. RESULTS: For an interquartile range (IQR) rise in PM2.5DECH, total CVD mortality at lag 0-10 days and YLL at lag 0-8 days increased 2.26% (95% confidence interval (CI): 0.85-3.69%) and 23.24 (6.07-40.42) person years, respectively. Corresponding increases were 3.45% (1.44-5.49%) and 35.21 (10.85-59.58) person years for an IQR rise in PM2.5mean. Significant associations between PM2.5 pollution (i.e., PM2.5mean and PM2.5DECH) and cause-specific cardiovascular health (i.e., mortality and YLL) were only identified in stroke. Subgroup analyses showed that male and people aged 0-64 years suffered more from PM2.5 pollution. Furthermore, we attributed a greater CVD burden to PM2.5DECH (1.67% for mortality and 2.67% for YLL) than PM2.5mean (0.63% for mortality and 0.70% for YLL) during the study period. CONCLUSIONS: This study strengthened the evidence for the aggravated CVD mortality burden associated with short-term exposure to PM2.5. Our findings also suggested that PM2.5DECH might be a potential alternative indicator of exposure assessment in PM2.5-related health investigations.

5.
Environ Pollut ; 256: 113434, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31672350

RESUMO

BACKGROUND: Little information exists on interaction effects between air pollution and influenza vaccination on allergic respiratory diseases. We conducted a large population-based study to evaluate the interaction effects between influenza vaccination and long-term exposure to ambient air pollution on allergic respiratory diseases in children and adolescents. METHODS: A cross-sectional study was investigated during 2012-2013 in 94 schools from Seven Northeastern Cities (SNEC) in China. Questionnaires surveys were obtained from 56 137 children and adolescents aged 2-17 years. Influenza vaccination was defined as receipt of the influenza vaccine. We estimated air pollutants exposure [nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters ≤1 µm (PM1), ≤2.5 µm (PM2.5) and ≤10 µm (PM10)] using machine learning methods. We employed two-level generalized linear mix effects model to examine interactive effects between influenza vaccination and air pollution exposure on allergic respiratory diseases (asthma, asthma-related symptoms and allergic rhinitis), after controlling for important covariates. RESULTS: We found statistically significant interactions between influenza vaccination and air pollutants on allergic respiratory diseases and related symptoms (doctor-diagnosed asthma, current wheeze, wheeze, persistent phlegm and allergic rhinitis). The adjusted ORs for doctor-diagnosed asthma, current wheeze and allergic rhinitis among the unvaccinated group per interquartile range (IQR) increase in PM1 and PM2.5 were significantly higher than the corresponding ORs among the vaccinated group [For PM1, doctor-diagnosed asthma: OR: 1.89 (95%CI: 1.57-2.27) vs 1.65 (95%CI: 1.36-2.00); current wheeze: OR: 1.50 (95%CI: 1.22-1.85) vs 1.10 (95%CI: 0.89-1.37); allergic rhinitis: OR: 1.38 (95%CI: 1.15-1.66) vs 1.21 (95%CI: 1.00-1.46). For PM2.5, doctor-diagnosed asthma: OR: 1.81 (95%CI: 1.52-2.14) vs 1.57 (95%CI: 1.32-1.88); current wheeze: OR: 1.46 (95%CI: 1.21-1.76) vs 1.11 (95%CI: 0.91-1.35); allergic rhinitis: OR: 1.35 (95%CI: 1.14-1.60) vs 1.19 (95%CI: 1.00-1.42)]. The similar patterns were observed for wheeze and persistent phlegm. The corresponding p values for interactions were less than 0.05, respectively. We assessed the risks of PM1-related and PM2.5-related current wheeze were decreased by 26.67% (95%CI: 1.04%-45.66%) and 23.97% (95%CI: 0.21%-42.08%) respectively, which was attributable to influenza vaccination (both p for efficiency <0.05). CONCLUSIONS: Influenza vaccination may play an important role in mitigating the detrimental effects of long-term exposure to ambient air pollution on childhood allergic respiratory diseases. Policy targeted at increasing influenza vaccination may yield co-benefits in terms of reduced allergic respiratory diseases.

6.
Environ Pollut ; 256: 113403, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31711721

RESUMO

Both air pollution and dyslipidemias contributed to large number of deaths and disability-adjusted life lost years. Long-term air pollution exposure was related to changed blood lipids and risk of dyslipidemias. This study was designed to evaluate relationships between air pollutants, blood lipids and prevalence of dyslipidemias in a Chinese rural population exposed to high-level air pollution based on baseline data of The Henan Rural Cohort study. An amount of 39,057 participants from rural areas in China were included. The 3-year average exposure of air pollutants (PM2.5, PM10, NO2) was estimated by a spatiotemporal model. Logistic and linear regression models were employed to explore relationships between air pollutants, blood lipids (TC, TG, HDL-C and LDL-C) and prevalence of dyslipidemias. The three-year concentration of PM2.5, PM10 and NO2 was 72.8 ±â€¯2.3 µg/m3, 131.5 ±â€¯5.7 µg/m3and 39.1 ±â€¯3.1 µg/m3, respectively. Overall, increased air pollution exposure was related to increased TC and LDL-C, while decreased TG and HDL-C. Each 1-µg/m3 increment of PM2.5 was related to 0.10% (0.07%-0.19%) increase in TC, 0.63% (0.50%-0.77%) increase in LDL-C, 2.93% (2.70%-3.16%) decrease in TG, 0.49% (0.38%-0.60%) decrease in HDL-C; and 5.7% (95%CI: 3.7%-7.6%), 4.0% (95%CI: 2.1%-6.0%) and 3.8% (95%CI: 2.5%-5.1%) increase in odds for hypercholesterolemia, hyperbetalipoproteinemia and hypoalphalipoproteinemia, respectively. Stronger associations were found in male and older participants. Findings suggest that air pollutants were associated with changed blood lipid levels and higher risk of dyslipidemias among rural population. Male and elder people should pay more attention to personal safety protection.

7.
Hypertension ; 75(2): 347-355, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31838909

RESUMO

Evidence on the associations between airborne particulates of diameter ≤1 µm (PM1) and airborne particulates of diameter ≤2.5 µm (PM2.5) and childhood blood pressure (BP) is scarce. To help to address this literature gap, we conducted a study to explore the associations in Chinese children. Between 2012 and 2013, we recruited 9354 children, aged 5 to 17 years, from 62 schools in 7 northeastern Chinese cities. We measured their BP with a mercury sphygmomanometer. We used a spatiotemporal model to estimate daily ambient PM1 and PM2.5 exposures, which we assigned to participants' home addresses. Associations between particulate matter exposure and BP were evaluated with generalized linear mixed regression models. The findings indicated that exposure to each 10 mg/m3 greater PM1 was significantly associated with 2.56 mm Hg (95% CI, 1.47-3.65) higher systolic BP and 61% greater odds for hypertension (odds ratio=1.61 [95% CI, 1.18-2.18]). PM1 appears to play an important role in associations reported between PM2.5 exposure and BP, and we found that the ambient PM1/PM2.5 ratio (range, 0.80-0.96) was associated with BP and with hypertension. Age and body weight modified associations between air pollutants and BP (P<0.01), with stronger associations among younger (aged ≤11 years) and overweight/obese children. This study provides the first evidence that long-term exposure to PM1 is associated with hypertension in children, and that PM1 might be a leading contributor to the hypertensive effect of PM2.5. Researchers and policy makers should pay closer attention to the potential health impacts of PM1.

8.
Sci Total Environ ; 699: 134397, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31677469

RESUMO

Children are vulnerable to air pollution-induced lung function deficits, and the prevalence of obesity has been increasing in children. To evaluate the joint effects of long-term PM1 (particulate matter with an aerodynamic diameter ≤ 1.0 µm) exposure and obesity on children's lung function, a cross-sectional sample of 6740 children (aged 7-14 years) was enrolled across seven northeastern Chinese cities from 2012 to 2013. Weight and lung function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF), were measured according to standardized protocols. Average PM1, PM2.5, PM10 and nitrogen dioxide (NO2) exposure levels were estimated using a spatiotemporal model, and sulphur dioxide (SO2) and ozone (O3) exposure were estimated using data from municipal air monitoring stations. Two-level logistic regression and general linear models were used to analyze the joint effects of body mass index (BMI) and air pollutants. The results showed that long-term air pollution exposure was associated with lung function impairment and there were significant interactions with BMI. Associations were stronger among obese and overweight than normal weight participants (the adjusted odds ratios (95% confidence intervals) for PM1 and lung function impairments in three increasing BMI categories were 1.50 (1.07-2.11) to 2.55 (1.59-4.07) for FVC < 85% predicted, 1.44 (1.03-2.01) to 2.51 (1.53-4.11) for FEV1 < 85% predicted, 1.34 (0.97-1.84) to 2.04 (1.24-3.35) for PEF < 75% predicted, and 1.34 (1.01-1.78) to 1.93 (1.26-2.95) for MMEF < 75% predicted). Consistent results were detected in linear regression models for PM1, PM2.5 and SO2 on FVC and FEV1 impairments (PInteraction < 0.05). These modification effects were stronger among females and older participants. These results can provide policy makers with more comprehensive information for to develop strategies for preventing air pollution induced children's lung function deficits among children.


Assuntos
Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Obesidade/epidemiologia , Adolescente , Poluentes Atmosféricos/análise , Criança , China/epidemiologia , Cidades , Feminino , Volume Expiratório Forçado , Humanos , Pulmão/efeitos dos fármacos , Masculino , Dióxido de Nitrogênio/análise , Sobrepeso , Ozônio/análise , Material Particulado/análise , Testes de Função Respiratória , Dióxido de Enxofre , Capacidade Vital
9.
Environ Int ; 133(Pt B): 105213, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31654916

RESUMO

OBJECTIVES: To evaluate the associations between long-term exposure to particulate matter with an aerodynamic diameter ≤1.0 µm and ≤2.5 µm (PM1 and PM2.5), nitrogen dioxide (NO2) and type 2 diabetes prevalence and fasting blood glucose levels in Chinese rural populations. MATERIAL AND METHODS: A total of 39, 259 participants were enrolled in The Henan Rural Cohort study. Questionnaires and medical examination were conducted from July 2015 to September 2017 in rural areas of Henan province, China. Three-year average residential exposure levels of PM1, PM2.5, NO2 for each subject were estimated by a spatiotemporal model. Logistic regression and linear regression models were applied to estimate the associations between PM1, PM2.5, NO2 exposure and type 2 diabetes prevalence and fasting blood glucose levels. RESULTS: The mean 3-year residential exposure concentrations of PM1, PM2.5 and NO2 was 57.4 µg/m3, 73.4 µg/m3 and 39.9 µg/m3, respectively. Higher exposure concentrations of PM1, PM2.5, NO2 by 1 µg/m3 was positively related to a 4.0% (95%CIs: 1.026, 1.054), 6.8% (1.052, 1.084) and 5.0% (1.039, 1.061) increase in odds of type 2 diabetes in the final adjusted models. Besides, a 1 µg/m3 increase of PM1, PM2.5 and NO2 was related to a 0.020 mmol/L (95%CIs: 0.014, 0.026), 0.036 mmol/L (95%CIs: 0.030, 0.042) and 0.030 mmol/L (95%CIs: 0.026, 0.034) mmol/L higher fasting blood glucose levels. CONCLUSIONS: Higher exposure concentrations of air pollutants were positively related to the increased odds of type 2 diabetes, as well as higher fasting blood glucose levels in Chinese rural populations.

10.
Environ Int ; 133(Pt B): 105205, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31639600

RESUMO

BACKGROUND: Poor sleep quality is associated with poor quality of life and may even lead to mental illnesses. Several studies have indicated the association between exposure to air pollution and sleep quality. However, the evidence is very limited in China, especially in rural areas. METHODS: Participants in this study were obtained from the Henan Rural Cohort established during 2015-2017. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) in the baseline survey. Poor sleep quality was defined by the global score of PSQI > 5. Participants' exposures to PM2.5, PM10 (particulate matter with aerodynamic diameters ≤2.5 µm and 10 µm, respectively) and NO2 (nitrogen dioxide) during the three years before the baseline survey were estimated using a satellite-based prediction. The associations between long-term exposure to air pollutants and sleep quality were examined using both the linear regression and logistic regression models. RESULTS: The IQRs (interquartile range) of mean levels of participants' exposures to PM2.5, PM10 and NO2 were 3.3 µg/m3, 8.8 µg/m3, and 4.8 µg/m3, respectively. After adjusted for potential confounders, the global score of PSQI (and 95%CI, 95% confidence intervals) increased by 0.16 (0.04, 0.27), 0.09 (-0.01, 0.19) and 0.14 (0.03, 0.24), associated with per IQR increase in PM2.5, PM10 and NO2, respectively. The odds ratios (and 95%CI) of poor sleep quality associated with per IQR increase in PM2.5, PM10 and NO2 were 1.15 (1.03, 1.29), 1.11 (1.02, 1.21) and 1.14 (1.03, 1.25), respectively. CONCLUSIONS: Long-term exposures to PM2.5, PM10 and NO2 were associated with poor sleep quality in rural China. Improvement of air quality may help to improve sleep quality among rural population of China.

11.
Artigo em Inglês | MEDLINE | ID: mdl-31527480

RESUMO

Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne infectious disease caused by hantaviruses. About 90% of global cases were reported in China. We collected monthly data on counts of HFRS cases, climatic factors (mean temperature, rainfall, and relative humidity), and vegetation (normalized difference vegetation index (NDVI)) in 109 Chinese counties from January 2002 to December 2013. First, we used a quasi-Poisson regression with a distributed lag non-linear model to assess the impacts of these four factors on HFRS in 109 counties, separately. Then we conducted a multivariate meta-analysis to pool the results at the national level. The results of our study showed that there were non-linear associations between the four factors and HFRS. Specifically, the highest risks of HFRS occurred at the 45th, 30th, 20th, and 80th percentiles (with mean and standard deviations of 10.58 ± 4.52 °C, 18.81 ± 17.82 mm, 58.61 ± 6.33%, 198.20 ± 22.23 at the 109 counties, respectively) of mean temperature, rainfall, relative humidity, and NDVI, respectively. HFRS case estimates were most sensitive to mean temperature amongst the four factors, and the lag patterns of the impacts of these factors on HFRS were heterogeneous. Our findings provide rigorous scientific support to current HFRS monitoring and the development of early warning systems.


Assuntos
Febre Hemorrágica com Síndrome Renal/epidemiologia , China/epidemiologia , Humanos , Incidência , Análise Multivariada , Plantas , Tempo (Meteorologia)
12.
Sci Total Environ ; 691: 868-873, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31326810

RESUMO

BACKGROUND: The health effects of particulate matter (PM) air pollution on glucose metabolism have been rarely examined in children and adolescents. OBJECTIVE: We aimed to investigate the associations between long-term PM exposure and blood glucose and prevalence of impaired fasting glucose in a large population of Chinese children and adolescents. METHODS: In 2013, a total of 11,814 children and adolescents aged 7 to 18 years were recruited from seven provinces/municipalities in China. Fasting blood sample was taken for the measurement of blood glucose. Satellite-based spatial-temporal models were used to estimate exposure to ambient submicrometer particles (PM1), fine particles (PM2.5) and thoracic particles (PM10). Cross-sectional analyses were performed using mixed-effects multivariable linear and logistic regression models. RESULTS: After adjustment for a range of covariates, every 10 µg/m3 increment in PM1, PM2.5 and PM10 concentrations was associated with 0.160 [95% confidence interval (CI): 0.039, 0.280], 0.150 (95% CI: 0.044, 0.256) and 0.079 (95% CI: -0.009, 0.167) mmol/L higher blood glucose levels, respectively. PM exposure was also associated with higher prevalence of impaired fasting glucose, but the associations did not reach statistical significance [odds ratio per 10 µg/m3 increment in PM1, PM2.5 and PM10: 1.30 (95% CI: 0.86,1.96), 1.20 (95% CI: 0.85,1.69) and 1.08 (95% CI: 0.83,1.41)]. CONCLUSIONS: We found that long-term exposure to PM air pollution was associated with increased levels of blood glucose in children and adolescents. The associations were more evident for PM1 and PM2.5.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Glicemia/metabolismo , Exposição Ambiental/estatística & dados numéricos , Material Particulado/análise , Adolescente , Criança , China , Feminino , Humanos , Masculino
13.
Environ Pollut ; 252(Pt B): 1235-1245, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31252121

RESUMO

Previous meta-analyses on associations between air pollution (AP) and type 2 diabetes mellitus (T2DM) were mainly focused on studies conducted in high-income countries. Evidence should be updated by including more recent studies, especially those conducted in low- and middle-income countries. We therefore conducted a systematic review and meta-analysis of epidemiological studies to conclude an updated pooled effect estimates between long-term AP exposure and the prevalence and incidence of T2DM. We searched PubMed, Embase, and Web of Science to identify studies regarding associations of AP with T2DM prevalence and incidence prior to January 2019. A random-effects model was employed to analyze the overall effects. A total of 30 articles were finally included in this meta-analysis. The pooled results showed that higher levels of AP exposure were significantly associated with higher prevalence of T2DM (per 10 µg/m3 increase in concentrations of particles with aerodynamic diameter < 2.5 µm (PM2.5): odds ratio (OR) = 1.09, 95% confidence interval (95%CI): 1.05, 1.13; particles with aerodynamic diameter < 10 µm (PM10): OR = 1.12, 95%CI: 1.06, 1.19; nitrogen dioxide (NO2): OR = 1.05, 95%CI:1.03, 1.08). Besides, higher level of PM2.5 exposure was associated with higher T2DM incidence (per 10 µg/m3 increase in concentration of PM2.5: hazard ratio (HR) = 1.10, 95%CI:1.04, 1.16), while the associations between PM10, NO2 and T2DM incidence were not statistically significant. The associations between AP exposure and T2DM prevalence showed no significant difference between high-income countries and low- and middle-incomes countries. However, different associations were identified between PM2.5 exposure and T2DM prevalence in different geographic areas. No significant differences were found in associations of AP and T2DM prevalence/incidence between females and males, except for the effect of NO2 on T2DM incidence. Overall, AP exposure was positively associated with T2DM. There still remains a need for evidence from low- and middle-income countries on the relationships between AP and T2DM.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/análise , Diabetes Mellitus Tipo 2/epidemiologia , Exposição Ambiental/análise , Material Particulado/análise , Poluentes Atmosféricos/toxicidade , Diabetes Mellitus Tipo 2/induzido quimicamente , Feminino , Humanos , Incidência , Masculino , Dióxido de Nitrogênio/análise , Razão de Chances , Material Particulado/toxicidade , Prevalência
14.
JAMA Netw Open ; 2(5): e194186, 2019 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-31125097

RESUMO

Importance: Breastfeeding and exposure to ambient air pollutants have been found to be independently associated with respiratory health in children; however, previous studies have not examined the association of breastfeeding as a potential moderator of the association. Objective: To assess associations of breastfeeding and air pollution with lung function in children. Design, Setting, and Participants: Using a cross-sectional study design, children were recruited from 62 elementary and middle schools located in 7 Chinese cities from April 1, 2012, to October 31, 2013. Data analyses were conducted from November 1, 2018, to March 31, 2019. Exposures: Long-term concentrations of airborne particulate matter with a diameter of 1 µm or less (PM1), airborne particulate matter with a diameter of 2.5 µm or less (PM2.5), airborne particulate matter with a diameter of 10 µm or less (PM10), and nitrogen dioxide were estimated using a spatial statistical model matched to children's geocoded home addresses, and concentrations of PM10, sulfur dioxide, nitrogen dioxide, and ozone were measured by local air monitoring stations. Main Outcomes and Measures: Breastfeeding was defined as maternal report of having mainly breastfed for longer than 3 months. Lung function was measured using portable electronic spirometers. Using previously published predicted spirometric values for children in Northeast China as the reference, lung impairment was defined as forced vital capacity (FVC) less than 85%, forced expiratory volume in the first second of expiration less than 85%, peak expiratory flow less than 75%, or maximum midexpiratory flow less than 75%. Results: Participants included 6740 children (mean [SD] age, 11.6 [2.1] years; 3382 boys [50.2%]). There were 4751 children (70.5%) who were breastfed. Mean (SD) particulate matter concentrations ranged from 46.8 (6.5) µg/m3 for PM1 to 95.6 (9.8) µg/m3 for PM10. The prevalence of lung function impairment ranged from 6.8% for peak expiratory flow to 11.3% for FVC. After controlling for age, sex, and other covariates, 1-interquartile range greater concentration of pollutants was associated with higher adjusted odds ratios (AORs) for lung function impairment by FVC among children who were not breastfed compared with those who were (PM1: AOR, 2.71 [95% CI, 2.02-3.63] vs 1.20 [95% CI, 0.97-1.48]; PM2.5: AOR, 2.27 [95% CI, 1.79-2.88] vs 1.26 [95% CI, 1.04-1.51]; and PM10: AOR, 1.93 [95% CI, 1.58-2.37] vs 1.46 [95% CI, 1.23-1.73]). Younger age (<12 years) was associated with lower lung function impairment among the children who had been breastfed. In children from elementary schools, 1-interquartile range greater concentration of pollutants was associated with higher AORs for lung function impairment by FVC among children who had not been breastfed compared with those who had (PM1: AOR, 6.43 [95% CI, 3.97-10.44] vs 1.89 [95% CI, 1.28-2.80]; PM2.5: AOR, 3.83 [95% CI, 2.63-5.58] vs 1.50 [95% CI, 1.12-2.01]; and PM10: AOR, 2.61 [95% CI, 1.90-3.57] vs 1.52 [95% CI, 1.19-1.95]). Results from linear regression models also showed associations of air pollution with worse lung function among children who were not breastfed compared with their counterparts who were breastfed, especially for FVC (PM1: ß, -240.46 [95% CI, -288.71 to -192.21] vs -38.21 [95% CI, -69.27 to -7.16] mL) and forced expiratory volume in the first second of expiration (PM1: ß, -201.37 [95% CI, -242.08 to -160.65] vs -30.30 [95% CI, -57.66 to -2.94] mL). Conclusions and Relevance: In this study, breastfeeding was associated with lower risk of lung function impairment among children in China exposed to air pollution, particularly among younger children.

15.
Environ Int ; 128: 103-108, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31035113

RESUMO

BACKGROUND: Air pollution has been associated with elevated blood pressure in adults. However, epidemiological evidence from children and adolescents is limited. We investigated the associations between long-term exposure to particulate matter (PM) air pollution and blood pressure in a large population of children and adolescents. METHODS: A cross-sectional analysis was performed in a nationally representative sample consisting of 43,745 children and adolescents aged 7 to 18 years in seven provinces in China. Exposure to ambient fine particles (PM2.5) and thoracic particles (PM10) was estimated using spatiotemporal models based on satellite remote sensing, meteorological data and land use information. Mixed-effects (two-level) linear and logistic regression models were used to investigate the associations between PM exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension. RESULTS: After adjustment for a wide range of covariates, every 10 µg/m3 increment in PM2.5 and PM10 concentration was associated with 1.46 [95% confidence interval (CI): 0.05, 2.88] and 1.36 (95% CI: 0.34, 2.39) mmHg increases in SBP, respectively. PM10 was also associated with higher prevalence of hypertension [odds ratio per 10 µg/m3 increment: 1.45 (95% CI: 1.07, 1.95)]. CONCLUSIONS: Long-term exposure to ambient PM air pollution was associated with increased blood pressure and higher prevalence of hypertension in children and adolescents. Our findings support air pollution reduction strategies as a prevention measure of childhood hypertension, a well-recognized risk factor of future cardiovascular health.


Assuntos
Exposição Ambiental , Hipertensão/epidemiologia , Material Particulado/toxicidade , Adolescente , Pressão Sanguínea , Criança , China/epidemiologia , Estudos Transversais , Humanos , Hipertensão/induzido quimicamente , Razão de Chances , Fatores de Risco
16.
Environ Int ; 128: 95-102, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31035115

RESUMO

BACKGROUND: The epidemiological evidence on relationships between long-term exposure to particulate matter and hypertension and blood pressure has been inconclusive. Limited evidence was available for particulate matter with an aerodynamic diameter ≤ 1 µm (PM1) in rural areas of developing countries. OBJECTIVE: This study aimed to investigate the associations between long-term exposure to PM1 and hypertension and blood pressure among rural Chinese population. METHODS: This study included 39,259 participants who had completed the baseline survey from Henan Rural Cohort. Participants' exposure to PM1 was assessed by a satellite-based spatiotemporal model. The binary logistic regression model was used to examine the association between long-term PM1 exposure and hypertension, and multivariable linear regression model was used to investigate the associations between long-term PM1 exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Moreover, we examined potential effect modifications by demographic, lifestyle and diet factors. RESULTS: The mean concentration of PM1 for all participants during the 3-year before baseline survey was 59.98 µg/m3. Each 1 µg/m3 increase in PM1 concentration was significantly associated with an increase of 4.3% [Odds ratio(OR) = 1.043, 95% confidence interval(CI): 1.033, 1.053] in odds for hypertension, an increase of 0.401 mm Hg (95% CI, 0.335, 0.467), 0.328 mm Hg (95% CI, 0.288, 0.369), 0.353 mm Hg (95% CI, 0.307, 0.399) and 0.073 mm Hg (95% CI, 0.030, 0.116) in SBP, DBP, MAP and PP, respectively. Further stratified analyses showed that the effect of PM1 on hypertension and blood pressure could be modified by sex, lifestyle and diet. CONCLUSIONS: This study suggests that long-term exposure to ambient PM1 increases the risk of hypertension and is associated with elevations in blood pressure in rural Chinese adults, especially in male and those with unhealthy habits.


Assuntos
Hipertensão/epidemiologia , Material Particulado/toxicidade , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Pressão Sanguínea/efeitos dos fármacos , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Hipertensão/induzido quimicamente , Modelos Lineares , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , População Rural
17.
Environ Health Perspect ; 127(3): 37001, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30822387

RESUMO

BACKGROUND: Temperature-related mortality risks have mostly been studied in urban areas, with limited evidence for urban-rural differences in the temperature impacts on health outcomes. OBJECTIVES: We investigated whether temperature-mortality relationships vary between urban and rural counties in China. METHODS: We collected daily data on 1 km gridded temperature and mortality in 89 counties of Zhejiang Province, China, for 2009 and 2015. We first performed a two-stage analysis to estimate the temperature effects on mortality in urban and rural counties. Second, we performed meta-regression to investigate the modifying effect of the urbanization level. Stratified analyses were performed by all-cause, nonaccidental (stratified by age and sex), cardiopulmonary, cardiovascular, and respiratory mortality. We also calculated the fraction of mortality and number of deaths attributable to nonoptimum temperatures associated with both cold and heat components. The potential sources of the urban-rural differences were explored using meta-regression with county-level characteristics. RESULTS: Increased mortality risks were associated with low and high temperatures in both rural and urban areas, but rural counties had higher relative risks (RRs), attributable fractions of mortality, and attributable death counts than urban counties. The urban-rural disparity was apparent for cold (first percentile relative to minimum mortality temperature), with an RR of 1.47 [95% confidence interval (CI): 1.32, 1.62] associated with all-cause mortality for urban counties, and 1.98 (95% CI: 1.87, 2.10) for rural counties. Among the potential sources of the urban-rural disparity are age structure, education, GDP, health care services, air conditioners, and occupation types. CONCLUSIONS: Rural residents are more sensitive to both cold and hot temperatures than urban residents in Zhejiang Province, China, particularly the elderly. The findings suggest past studies using exposure-response functions derived from urban areas may underestimate the mortality burden for the population as a whole. The public health agencies aimed at controlling temperature-related mortality should develop area-specific strategies, such as to reduce the urban-rural gaps in access to health care and awareness of risk prevention. Future projections on climate health impacts should consider the urban-rural disparity in mortality risks. https://doi.org/10.1289/EHP3556.


Assuntos
Temperatura Baixa/efeitos adversos , Exposição Ambiental , Temperatura Alta/efeitos adversos , Mortalidade , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Risco , Adulto Jovem
18.
JAMA Netw Open ; 2(3): e190318, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30848806

RESUMO

Importance: Which cardiometabolic risk factors (eg, hypertension, type 2 diabetes, overweight or obesity, and dyslipidemia) are more sensitive to long-term exposure to ambient air pollution and whether participants with these conditions are more susceptible to the cardiovascular effects of air pollution remain unclear. Objectives: To evaluate the associations among long-term exposure to air pollutants, cardiometabolic risk factors, and cardiovascular disease (CVD) prevalence. Design, Setting, and Participants: This population-based cross-sectional study was conducted from April 1 through December 31, 2009, in 3 cities in Northeastern China. Participants were adults aged 18 to 74 years who had lived in study area for 5 years or longer. Data analysis was performed from May 1 through December 31, 2018. Exposures: Long-term (2006-2008) exposure to air pollutants was measured using a spatiotemporal statistical model (particulate matter with an aerodynamic diameter of ≤2.5 µm [PM2.5] and ≤1.0 µm [PM1.0]) and data from air monitoring stations (particulate matter with an aerodynamic diameter of ≤10.0 µm [PM10.0], sulfur dioxide [SO2], nitrogen dioxide [NO2], and ozone [O3]). Main Outcomes and Measures: Cardiovascular disease was determined by self-report of physician-diagnosed CVD. Blood pressure, body mass index, and levels of triglycerides and low-density lipoprotein cholesterol were measured using standard methods. Results: Participants included 15 477 adults (47.3% women) with a mean (SD) age of 45.0 (13.5) years. The prevalence of CVD was 4.8%, and the prevalence of cardiometabolic risk factors ranged from 8.6% (hyperbetalipoproteinemia) to 40.5% (overweight or obesity). Mean (SD) air pollutant concentrations ranged from 35.3 (5.5) µg/m3 (for NO2) to 123.1 (14.6) µg/m3 (for PM10.0). Associations with air pollutants were identified for individuals with hyperbetalipoproteinemia (eg, odds ratio [OR], 1.36 [95% CI, 1.03-1.78] for a 10-µg/m3 increase in PM1.0) and the weakest association for those with for overweight or obesity (eg, OR, 1.06 [95% CI, 1.02-1.09] for a 10-µg/m3 increase in PM1.0). Cardiometabolic risk factors only partially mediated associations between air pollution and CVD. However, they modified the associations such that greater associations were found in participants with these cardiometabolic conditions (eg, ORs for CVD and per 10-µg/m3 increase in PM1.0, 1.22 [95% CI, 1.12-1.33] in participants with hyperbetalipoproteinemia and 1.07 [95% CI, 0.98-1.16] in participants without hyperbetalipoproteinemia). Conclusions and Relevance: In this population-based study of Chinese adults with CVD, long-term exposure to air pollution was associated with a higher prevalence of cardiometabolic risk factors, and the strongest associations were observed for hyperbetalipoproteinemia. In addition, participants with cardiometabolic risk factors may have been more vulnerable to the effects of air pollution on CVD.


Assuntos
Doenças Cardiovasculares , Hiperlipoproteinemia Tipo II , Exposição por Inalação , Material Particulado , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Doenças Cardiovasculares/classificação , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , China/epidemiologia , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/epidemiologia , Exposição por Inalação/efeitos adversos , Exposição por Inalação/análise , Exposição por Inalação/prevenção & controle , Masculino , Pessoa de Meia-Idade , Material Particulado/efeitos adversos , Material Particulado/análise , Prevalência , Fatores de Risco , Tempo
19.
Stroke ; 50(3): 563-570, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30741622

RESUMO

Background and Purpose- China bears a heavy burden of stroke because of its large population of elderly people and the propensity for stroke. Previous studies have examined the association between air pollution and stroke mortality or hospital admission. However, the global evidence for adverse effects of air pollution on survival after stroke is scarce. Methods- We used the first national hospital-based prospective registry cohort of stroke in China, which included 12 291 ischemic stroke patients who visited hospitals during 2007 to 2008. All patients were followed for 1-year poststroke. Deaths during the follow-up period were recorded. Participants' 3-year prestroke exposures to ambient PM1, PM2.5, PM10 (particulate matter with aerodynamic diameters ≤1, ≤2.5, and ≤10 µm, respectively) and NO2 (nitrogen dioxide) were estimated by machine learning algorithms with satellite remote sensing, land use information, and meteorological data. Cox proportional hazards models were used to examine the association between air pollution and survival after ischemic stroke. Results- In total, 1649 deaths were identified during the 1-year follow-up period. After controlling for potential confounders, significant associations were observed between exposure to PM1 and PM2.5 and incident fatal ischemic stroke. The corresponding hazard ratios and 95% CIs associated with 10 µg/m3 increase in PM1 and PM2.5 were 1.05 (1.02-1.09) and 1.03 (1.00-1.06), respectively. No significant association was observed for PM10 or NO2 (hazard ratios and 95% CIs, 1.01 [1.00-1.03] and 1.03 [0.99-1.06], respectively). Higher hazard ratios (and 95% CIs) were observed for male, elderly and obese individuals. Conclusions- Prestroke exposure to PM1 and PM2.5 was associated with increased incident fatal ischemic stroke in the year following an ischemic stroke in China. Improved air quality may be beneficial for people to recover from stroke.


Assuntos
Poluição do Ar/efeitos adversos , Isquemia Encefálica/mortalidade , Exposição Ambiental/efeitos adversos , Acidente Vascular Cerebral/mortalidade , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Óxidos de Nitrogênio/efeitos adversos , Obesidade/complicações , Obesidade/mortalidade , Material Particulado , Sistema de Registros , Imagens de Satélites , Fatores Sexuais , Análise de Sobrevida , Tempo (Meteorologia)
20.
Environ Res ; 170: 344-350, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30623880

RESUMO

Epidemiological studies increasingly provide evidence about the adverse health effects of temperature variability (TV), which reflects short-term intra- and inter-day temperature change. However, calculation of TV only considers the temporal variability and lacks spatial variability. This study intends to investigate whether the lack of spatial variability in TV calculations has biased the health effect estimates. We collected daily data from the fine-gridded hourly temperatures and more than 2 million all-cause mortality counts in Zhejiang province in China from 2009 to 2015. A spatiotemporal TV index was developed by calculating the standard deviation of the hourly temperatures based on records from multiple sites. This new index could be compared to the two typical temporal TV indices that are calculated based on the hourly temperatures from one-site and area-average records. The three types of TV are compared using a three-stage analytical approach: district-specific time series Poisson regression, meta-analysis, and calculation of attributable mortality fraction. We observe that both spatiotemporal and temporal TVs produce very similar TV-mortality associations, attributable mortality fractions, and model fits at the district level. For example, the mortality increase associated for every increase of 1 °C during 0-7 exposure days is 1.53% (95% CI: 1.31, 1.73) in spatiotemporal TV, whereas it is 1.48% (95% CI: 1.27, 1.68) and 1.45% (95% CI: 1.24, 1.67) in the one-site and area-average temporal TV, respectively. Thus, time series models using temporal TV index are equally good at estimating the associations between TV and mortality as spatiotemporal TV at the district level in population-based epidemiological studies in China. Epidemiological studies using temperature from one site or the averages of multiple sites in TV calculation will not bias the effect estimates of TV. Our study could provide an important guidance method for future TV-related research in China and even in other countries.


Assuntos
Exposição Ambiental , Mortalidade , Temperatura Ambiente , China , Coleta de Dados , Estações do Ano
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