Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 559
Filtrar
1.
Environ Res ; : 112397, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34798120

RESUMO

BACKGROUND: The widely used Air Quality Index (AQI) has been criticized due to its inaccuracy, leading to the development of the air quality health index (AQHI), an improvement on the AQI. However, there is currently no consensus on the most appropriate construction strategy for the AQHI. OBJECTIVES: In this study, we aimed to evaluate the utility of AQHIs constructed by different models and health outcomes, and determine a better strategy. METHODS: Based on the daily time-series outpatient visits and hospital admissions from 299 hospitals (January 2016-December 2018), and mortality (January 2017-December 2019) in Guangzhou, China, we utilized cumulative risk index (CRI) method, Bayesian multi-pollutant weighted (BMW) model and standard method to construct AQHIs for different health outcomes. The effectiveness of AQHIs constructed by different strategies was evaluated by a two-stage validation analysis and examined their exposure-response relationships with the cause-specific morbidity and mortality. RESULTS: Validation by different models showed that AQHI constructed with the BMW model (BMW-AQHI) had the strongest association with the health outcome either in the total population or subpopulation among air quality indexes, followed by AQHI constructed with the CRI method (CRI-AQHI), then common AQHI and AQI. Further validation by different health outcomes showed that AQHI constructed with the risk of outpatient visits generally exhibited the highest utility in presenting mortality and morbidity, followed by AQHI constructed with the risk of hospitalizations, then mortality-based AQHI and AQI. The contributions of NO2 and O3 to the final AQHI were prominent, while the contribution of SO2 and PM2.5 were relatively small. CONCLUSIONS: The BMW model is likely to be more effective for AQHI construction than CRI and standard methods. Based on the BMW model, the AQHI constructed with the outpatient data may be more effective in presenting short-term health risks associated with the co-exposure to air pollutants than the mortality-based AQHI and existing AQIs.

2.
Environ Int ; 158: 106975, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34781209

RESUMO

BACKGROUND: The premenstrual syndrome (PMS) causes clinically relevant psychological and physical symptoms in up to 20% of women of reproductive age. To date, no studies have investigated the relationship between PMS and residential surrounding greenspace, although a green living environment has been reported to have beneficial associations with overall and reproductive health. OBJECTIVE: To investigate whether lifelong exposure to residential surrounding greenspace is associated with PMS and whether such an association is mediated by BMI, air pollution or physical activity. METHODS: This study used data collected in 2013-2015 from 1069 Scandinavian women aged 18-49 years, participating in RHINESSA, a European multi-centre and population-based cohort. Satellite-derived Normalised Difference Vegetation Index was used as a proxy of greenspace. Presence of eight common PMS symptoms and their sum (PMS symptom count) were used as outcomes. The associations were assessed by adjusted multilevel logistic and negative binomial regressions. Subsequently we carried out mediation analyses for physical activity, BMI and air pollution exposure. RESULTS: Higher exposure to residential surrounding greenspace was associated with "Anxiety or tension" (Odds Ratio 0.82, 95% Confidence Interval (CI): 0.70 - 0.95), "Depression or hopelessness" (0.84, 0.73 - 0.98), "Difficulty with sleeping" (0.82, 0.68 - 1.00) and "Breast tenderness and abdominal bloating" (0.84, 0.71 - 0.99) before or around the start of the menstrual period. There was also an association with a lower PMS symptom count (Risk Ratio: 0.94, 95% CI: 0.91 - 0.99). These associations were robust to sensitivity analyses and were not mediated by BMI, physical activity or air pollution. CONCLUSIONS: Living in greener areas may be beneficial against PMS symptoms. Further studies are needed to confirm these novel findings and to explore the underlying biological mechanisms.

3.
Artigo em Inglês | MEDLINE | ID: mdl-34769928

RESUMO

Molar-incisor hypomineralization (MIH) is a condition with specific clinical presentation whose etiology to date still remains unknown. This study prospectively investigated the association between nutrition during the 1st year of life and the presence of MIH in the permanent dentition. Data from 1070 10-year-old children from two prospective birth cohort studies were included. Information on exclusive breastfeeding (EBF) and introduction of 48 food items into the child's diet was assessed at 4-, 6-, and 12-month time-points. Food diversity was defined according to the number of food items or food groups introduced into the child's diet and then subsequent categorization into low-, middle- and high-diversity groups was performed. MIH was scored in the permanent dentition at age of 10 years. The statistical analysis included logistic and Poisson hurdle regression models adjusted for potential confounders. EBF, food item and food group diversity at 4-, 6-, 12-month time-points were found to be non-significant in most of the categories for the development of MIH. However, significantly higher odds for the presence of MIH were found for certain categories. Despite the limitation of this study, such as arbitrary cut-offs for categorization of food items, the results of this study suggest the lack of an association between early nutrition in the first year of life and MIH in the permanent dentition.


Assuntos
Hipoplasia do Esmalte Dentário , Incisivo , Criança , Estudos de Coortes , Hipoplasia do Esmalte Dentário/epidemiologia , Hipoplasia do Esmalte Dentário/etiologia , Dentição Permanente , Humanos , Prevalência , Estudos Prospectivos
4.
Artigo em Inglês | MEDLINE | ID: mdl-34779040

RESUMO

BACKGROUND: Hand eczema is a common inflammatory skin disorder in both adolescence and adulthood. OBJECTIVES: We sought to assess the lifetime prevalence of hand eczema and associated exogenous and endogenous risk factors among adolescents in Germany. METHODS: This was a cross-sectional study embedded into a prospective population-based birth cohort in four regions of Germany, which recruited healthy neonates born between November 1997 and January 1999. We included 1,736 participants who had completed the 15-year follow-up from birth cohort and 84.6% (1,468/1,736) had clearly reported whether they have ever had hand eczema. All the data was based on questionnaires and blood tests (immunoglobulin E). Multivariable logistic regression analysis was used to examine endogenous and exogenous factors in relation to the lifetime prevalence of hand eczema among adolescents. RESULTS: 1,468 adolescents (715 girls, 48.7%) were included in the final analysis. The lifetime prevalence of hand eczema among adolescents at the age of 15 was 10.4% (95% confidence interval [CI]: 8.9%-12.1%), with a significantly higher lifetime prevalence among girls than boys (12.7% vs. 8.2%, P = 0.005). Multivariable logistic regression analysis indicated statistically significant associations between the lifetime prevalence of hand eczema and having ever been diagnosed with atopic dermatitis (aOR = 1.8, 95% CI: 1.1-2.8) or having ever had dry skin (aOR=1.9, 95% CI: 1.1-3.1), respectively. No statistically significant independent associations were found between asthma, hay fever, allergy-related clinical symptoms, immunoglobulin E positivity and other exogenous factors in relation to hand eczema. CONCLUSION: Our study fills a research gap on the epidemiological burden of hand eczema among adolescents. One out of ten ever suffered from hand eczema until age 15 years indicating that hand eczema constitutes a significant burden in pediatric populations. The role of atopic dermatitis in hand eczema reinforces previous findings. Exogenous risk factors warrant further investigation.

5.
Innovation (N Y) ; 2(4): 100164, 2021 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-34622241

RESUMO

Multiple systematic reviews on greenspace and health outcomes exist, but the overall evidence base remains unclear. Therefore, we performed an umbrella review to collect and appraise all relevant systematic reviews of epidemiological studies on greenness exposure and health. We searched PubMed, Embase, and Web of Science from inception to June 28, 2021, and screened references of relevant articles. Systematic reviews with or without meta-analyses of epidemiological studies that examined the associations of greenness with any health outcome were included. Two independent investigators performed study selection and data extraction. We also evaluated the methodological quality of the included systematic reviews using the "Assessing the Methodological Quality of Systematic Reviews 2" checklist. A total of 40 systematic reviews and meta-analyses were included, of which most were cross-sectional studies conducted in high-income countries. Greenspace exposure was estimated with various objective and subjective parameters. Beneficial associations of greenspace with all-cause and stroke-specific mortality, CVD morbidity, cardiometabolic factors, mental health, low birth weight, physical activity, sleep quality, and urban crime were observed. No consistent associations between greenspace and other health outcomes (e.g., cancers) were observed. Most of the included systematic reviews and meta-analyses had one or more limitations in methodology. Our findings provide supportive evidence regarding the beneficial effects of greenspace exposure on some aspects of human health. However, the credibility of such evidence was compromised by methodological limitations. Better performed systematic reviews and meta-analyses as well as longitudinal designed primary studies are needed to validate this conclusion.

6.
Artigo em Inglês | MEDLINE | ID: mdl-34717016

RESUMO

BACKGROUND: Allergic diseases pose a health problem worldwide. Pollen are widespread aeroallergens which can cause symptoms like shortness of breath, cough, itchy eyes, or rhinitis. Apart from preventive measures and pharmacological treatment, also non-pharmacological interventions have been suggested to reduce symptoms. The objective of this work was to review studies investigating the effectiveness of non-pharmacologic interventions to reduce allergic symptoms. METHODS: PubMed, EMBASE, and CENTRAL were systematically reviewed in July 2018 and April 2020. Several authors worked on the screening of titles, abstracts, and full texts. One author for each literature search performed the data extraction and the risk of bias assessment. Studies were included if they met the inclusion criteria defined by the PECOs. Studies which investigating the effect of non-pharmacologic interventions on patients with allergic rhinitis were included. RESULTS: Twenty-nine studies investigating eleven types of non-pharmacologic interventions to avoid and reduce allergic symptoms due to pollen exposure were included in this review. Out of all studies, seven studies addressed nasal rinsing and 22 included acupuncture, air filtering, artisanal tears, individual allergen avoidance advice, various nasal applications, self-hypnosis, rhinophototherapy, and wraparound sunglasses. CONCLUSION: Most studies had a high risk of bias and small sample sizes. There were only a few high-quality studies that give hints about the effectiveness of non-pharmacological interventions. For future research, more high-quality studies are required to confirm the effectiveness of simple, safe, and cost-effective interventions.

7.
Environ Health Perspect ; 129(10): 107006, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34704791

RESUMO

BACKGROUND: Evidence concerning the effects of greenness on childhood visual impairment is scarce. OBJECTIVES: We aimed to assess whether greenness surrounding schools was associated with visual impairment prevalence and visual acuity levels in Chinese schoolchildren and whether the associations might be explained by reduced air pollution. METHODS: In September 2013, we recruited 61,995 children and adolescents 6-18 years of age from 94 schools in seven provinces/municipalities in China. Greenness exposure was assessed using the normalized difference vegetation index (NDVI) and the soil-adjusted vegetation index (SAVI) from July to August 2013. Visual impairment was defined as at least one visual acuity level (dimensionless) lower than 4.9 (Snellen 5/6 equivalent). Three-year annual averages of particulate matter (PM) with an aerodynamic diameter of ≤1µm (PM1) and nitrogen dioxide (NO2) at each school were assessed using machine learning methods. We used generalized linear mixed models to estimate the associations between greenness and prevalent visual impairment and visual acuity levels and used mediation analyses to explore the potential mediating role of air pollution. RESULTS: In the adjusted model, an interquartile range increase in NDVI500m was associated with lower odds of prevalent visual impairment [odds ratio (OR)=0.95; 95% confidence interval (CI): 0.93, 0.97]. The same increase in NDVI500m was also associated with 0.012 (95% CI: 0.008, 0.015) and 0.011 (95% CI: 0.007, 0.015) increases in visual acuity levels for left- and right-eye, respectively. Our results also suggested that PM1 and NO2 significantly mediated the association between NDVI500m and visual impairment. Similar effect estimates were observed for SAVI500m, and our estimates were generally robust in several sensitivity analyses. DISCUSSION: These findings suggest higher greenness surrounding schools might reduce the risk of visual impairment, possibly owing in part to lower PM1 and NO2 in vegetated areas. Further longitudinal studies with more precise greenness assessment are warranted to confirm these findings. https://doi.org/10.1289/EHP8429.

8.
Gesundheitswesen ; 83(8-09): 581-592, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34496446

RESUMO

AIM: The aim of this review is to identify epidemiological studies on the risk of infection with SARS-CoV-2 during travel by train and bus and to critically evaluate them also with regard to extrapolating the findings to the German situation. METHODS: Systematic review based on searching two electronic databases (PubMed, Web of Science) according to the principle of Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) for epidemiological studies on SARS-CoV-2 or COVID-19 and travel by train or bus. RESULTS: Searches of the two electronic databases yielded 746 publications. Of these, 55 met the selection criteria and were included in the full-text search. Finally, 5 original publications were used to answer the question about SARS-CoV-2 infections related to long-distance travel by train and 4 related to bus travel. The studies were very heterogeneous and referred almost exclusively to long-distance travel in China. They consistently showed a risk of infection when infected persons travelled in the same train, car or bus without mouth-to-nose (MNB) coverage. The risk was not limited to those sitting in close proximity to an infected fellow traveler. Despite all the differences between travel by train and bus in China and Germany, there is no fundamental doubt that the reported results from China can also be extrapolated to Germany in qualitative terms. However, it must be taken into account that the results of the three key publications predominantly included the period before the lockdown in China without the strict use of MNB. Thus, the question remains whether the results would be similar under current conditions with MNB and more virulent viral mutations. No single study was found related to infection when using public transportation. CONCLUSIONS: There are several lines of evidence that travel by train is associated with a significantly lower risk of infection compared with the risk of infection in the home environment. Due to a lack of observational data, one will need to model the risk of infection for long-distance travel by bus and use of local public transport based on air exchange in the passenger compartment, travel duration, distance from other passengers, and ultimately passenger density.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis , Estudos Epidemiológicos , Alemanha/epidemiologia , Humanos , SARS-CoV-2 , Viagem
9.
Environ Res ; 204(Pt A): 112004, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34499893

RESUMO

BACKGROUND: Greenness exposure may lower blood pressure. However, few studies of this relationship have been conducted with children and adolescents, especially in low and middle-income countries. OBJECTIVES: To evaluate associations between greenness around schools and blood pressure among children and adolescents across China. METHODS: We recruited 61,229 Chinese citizens aged 6-18 years from 94 schools in a nationwide cross-sectional study in seven Chinese provinces/province-level municipalities. Participants' blood pressures and hypertension were assessed with standardized protocols. Greenness levels within 500 m and 1,000 m of each school were estimated with three satellite-based indices: vegetation continuous fields (VCF), normalized difference vegetation index (NDVI), and soil adjusted vegetation index (SAVI). Generalized linear mixed models were used to evaluate associations between greenness and blood pressure, greenness and prevalent hypertension, using coefficient and odds ratio respectively. Stratified analyses and mediation analyses were also performed. RESULTS: One interquartile range increase in greenness was associated with a 17%-20% reduced prevalence of hypertension for all measures of greenness (odds ratios for VCF500m = 20% (95% CI:18%, 23%); for NDVI500m = 17% (95% CI:13%, 21%); and for SAVI500m = 17% (95% CI: 13%, 20%). Increases in greenness were also associated with reductions in systolic blood pressure (0.48-0.58 mmHg) and diastolic blood pressure (0.26-0.52 mmHg). Older participants, boys, and urban dwellers showed stronger associations than their counterparts. No evidence of mediation was observed for air pollution (i.e., NO2 and PM2.5) and body mass index. CONCLUSION: Higher greenness around schools may lower blood pressure levels and prevalent hypertension among Chinese children and adolescents, particularly in older subjects, boys, and those living in urban districts. Further studies, preferably longitudinal, are needed to examine causality.

10.
Clin Exp Allergy ; 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34536262

RESUMO

BACKGROUND: Fractional exhaled nitric oxide (FeNO) is a well-known marker of type-2 inflammation. FeNO is elevated in asthma and allergic rhinitis, with IgE sensitization as a major determinant. OBJECTIVE: We aimed to see whether there was an independent association between upper airway inflammatory disorders (UAID) and FeNO, after adjustment for asthma and sensitization, in a multi-centre population-based study. METHODS: A total of 741 subjects with current asthma and 4155 non-asthmatic subjects participating in the second follow-up of the European Community Respiratory Health Survey (ECRHS III) underwent FeNO measurements. Sensitization status was based on measurement of IgE against airborne allergens; information on asthma, UAID and medication was collected through interview-led questionnaires. Independent associations between UAID and FeNO were assessed in adjusted multivariate regression models and test for interaction with perennial sensitization and asthma on the relation between UAID and FeNO were made. RESULTS: UAID were associated with higher FeNO after adjusting for perennial sensitization, asthma and other confounders: with 4.4 (0.9-7.9) % higher FeNO in relation to current rhinitis and 4.8 (0.7-9.2) % higher FeNO in relation to rhinoconjunctivitis. A significant interaction with perennial sensitization was found in the relationship between current rhinitis and FeNO (p = .03) and between rhinoconjunctivitis and FeNO (p = .03). After stratification by asthma and perennial sensitization, the association between current rhinitis and FeNO remained in non-asthmatic subjects with perennial sensitization, with 12.1 (0.2-25.5) % higher FeNO in subjects with current rhinitis than in those without. CONCLUSIONS & CLINICAL RELEVANCE: Current rhinitis and rhinoconjunctivitis was associated with higher FeNO, with an interaction with perennial sensitization. This further highlights the concept of united airway disease, with correlations between symptoms and inflammation in the upper and lower airways and that sensitization needs to be accounted for in the relation between FeNO and rhinitis.

11.
Int J Epidemiol ; 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34406380

RESUMO

BACKGROUND: Beneficial effects of greenness on birth outcomes have been reported, but few studies have investigated the associations in both urban and non-urban settings. We aimed to evaluate and compare linear and nonlinear associations between greenness and birth outcomes in urban and non-urban settings. METHODS: From October 2015 to December 2018, participants were recruited into the Maoming Birth Cohort Study. A total of 11 258 live birth records were obtained. Greenness exposure was assessed using the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). Linear regression and nonlinear restricted cubic spline models were implemented to investigate the associations between greenness and birthweight, birth length, gestational age, preterm birth, low birthweight, small for gestational age and the potential for effect variation under urban or non-urban settings, after adjusting for covariates. RESULTS: A 0.1-unit increase in NDVI-500m was significantly associated with an increase of 35.4 g in birthweight [95% confidence interval (CI): 13.2, 57.7], 0.15 cm in birth length (95% CI: 0.03, 0.26), 0.88 days in gestational age (95% CI: 0.05, 1.71) and lower odds of low birthweight [odds ratio (OR) = 0.69, 95% CI: 0.56, 0.85] and preterm birth (OR = 0.70, 95% CI: 0.58, 0.85). No association with head circumference was observed. For all outcomes, no significant linear associations were observed among non-urban dwellers. Inversed 'U-shaped' associations between greenness exposure and birth outcomes were observed in the total study population. CONCLUSIONS: Greenness exposure was associated with increased gestational age, birthweight and birth length in urban dwellers. Nonlinear associations assessed by restricted cubic splines suggested that health benefits could be larger when increasing greenness levels from low to medium compared with increasing greenness from medium to high levels. Further studies adopting nonlinear methods are warranted to verify our findings.

12.
Artigo em Alemão | MEDLINE | ID: mdl-34213569

RESUMO

After caries, molar incisor hypomineralisation (MIH)-also known as chalky teeth-is one the most common dental diseases in children and adolescents. In addition to aesthetic limitations, especially on the anterior teeth, hypersensitivities and enamel breakdowns on permanent molars are of functional importance. While the MIH prevalence rates range from ~ 10% to ~ 30% and is well described, the situation regarding aetiology is unsatisfactory. Although efforts have been made in the past to clarify the aetiology, no plausible reason is available so far. Aetiology research has to be judged as methodologically challenging, since it should ideally be embedded in prospectively planned birth cohort studies. The aim of this article is to summarize typical clinical characteristics of MIH, epidemiological findings and potential causes with special reference to the earlier published results from the two Munich birth cohort studies GINIplus and LISA.


Assuntos
Hipoplasia do Esmalte Dentário , Incisivo , Adolescente , Criança , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/epidemiologia , Hipoplasia do Esmalte Dentário/etiologia , Alemanha/epidemiologia , Humanos , Dente Molar , Prevalência
13.
Artigo em Inglês | MEDLINE | ID: mdl-34063674

RESUMO

The aim of this study was to determine the proportion of adolescents with severe caries to analyze the prevalence of caries and to visualize the unequal distribution. Data from three epidemiological studies (10- and 15-year-olds: GINIplus and LISA cohorts in Munich, Bavaria; 12-year-olds: LAGZ survey in Bavaria, Germany) with 2875 adolescents were available for analysis. All individuals were examined according to the WHO standard. Statistics included the calculation of mean dmft/DMFT values (standard deviation), Significant Caries Index (SiC) values, Specific Affected Caries Index (SaC) values, and Lorenz curves. Overall caries-free status was 58.6% in primary and 83.9% in secondary teeth (10-year-olds), 61.5% (12-year-olds), and 64.6% (15-year-olds). The proportion of 12- and 15-year-olds with at least four DMFTs was 9.4% and 8.3%, respectively. In addition, eight 15-year-olds with DMFT values ≥8 (0.6%) were registered. The SaC/SiC values amounted to 1.8/0.9 DMFT (10-year-olds), 2.6/2.8 DMFT (12-year-olds), and 2.5/2.5 DMFT (15-year-olds). The mean DMFT values in the upper 1% of subjects were 4.2 DMFT (10-year-olds), 8.5 DMFT (12-year-olds), and 8.5 DMFT (15-year-olds). Thus, caries is not equally distributed throughout adolescence, but individuals with severe caries are rare. Nevertheless, further interdisciplinary research seems to be needed to clarify potential risk factors.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária , Adolescente , Criança , Estudos Transversais , Índice CPO , Cárie Dentária/epidemiologia , Alemanha/epidemiologia , Humanos , Prevalência , Fatores de Risco
14.
Environ Res ; 200: 111434, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34087194

RESUMO

BACKGROUND: Urban greenness may protect against obesity, but very few studies have assessed 'street view' (SV) greenness metrics, which may better capture people's actual exposure to greenness compared to commonly-used satellite-derived metrics. We aimed to investigate these associations further in a Chinese adult study. METHODS: Our analysis included 24,845 adults in the 33 Chinese Community Health Study in 2009. SV images from Tencent Map, segmented by machine learning algorithms, were used to determine the average proportion of green vegetation in SV images at community level in 800m road network buffer. Sensitivity analyses were performed with an alternative buffer size. Overall greenness was assessed as normalized difference vegetation index (NDVI) in 800 m buffer. We used predicted PM2.5 and monitored NO2 as proxies of air pollution. Body mass index (BMI), waist circumference (WC) and hip circumference (HC) were regressed on SV greenness by generalized linear mixed models, with adjustment for covariates. Mediation analyses were performed to assess the mediation effects of air pollution. RESULTS: Each interquartile range (IQR = 3.6%) increase in street view greenness was associated with a 0.15 kg/m2 (95% CI: -0.22, -0.09) decrease in BMI and 0.23 cm (95% CI: -0.35, -0.11) reduction in HC, and was associated with 7% lower odds of overweight (OR = 0.93, 95% CI:0.90, 0.96) and 18% lower odds of obesity (OR = 0.82, 95% CI:0.76, 0.89). Similar effect estimation was observed compared with commonly-used NDVI measures. PM2.5 and NO2 mediated 15.5% and 6.1% of the effects of SV greenness with BMI, respectively. CONCLUSIONS: Our findings suggest beneficial associations between community-level SV greenness and lower body weight in Chinese adults. The effects were observed in women but not in men. Air pollution may partially mediate the association. These findings may have implications to support efforts to promote greening in urban areas.


Assuntos
Poluição do Ar , Saúde Pública , Adulto , Poluição do Ar/análise , Índice de Massa Corporal , China/epidemiologia , Feminino , Humanos , Masculino , Obesidade/epidemiologia
15.
World Allergy Organ J ; 14(5): 100544, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34093956

RESUMO

Background: Fractional exhaled nitric oxide (FeNO) is a marker of type-2 inflammation used both to support diagnosis of asthma and follow up asthma patients. The associations of FeNO with lung function decline and bronchodilator (BD) response have been studied only scarcely in large populations. Objectives: To study the association between FeNO and a) retrospective lung function decline over 20 years, and b) lung function response to BD among asthmatic subjects compared with non-asthmatic subjects and with regards to current smoking and sex. Methods: Longitudinal analyses of previous lung function decline and FeNO level at follow-up and cross-sectional analyses of BD response and FeNO levels in 4257 participants (651 asthmatics) from the European Community Respiratory Health Survey. Results: Among asthmatic subjects, higher percentage declines of FEV1 and FEV1/FVC were associated with higher FeNO levels (p = 0.001 for both) at follow-up. These correlations were found mainly among non-smoking individuals (p = 0.001) and females (p = 0.001) in stratified analyses.Percentage increase in FEV1 after BD was positively associated with FeNO levels in non-asthmatic subjects. Further, after stratified for sex and smoking separately, a positive association was seen between FEV1 and FeNO levels in non-smokers and women, regardless of asthma status. Conclusions: We found a relationship between elevated FeNO and larger FEV1 decline over 20 years among subjects with asthma who were non-smokers or women. The association between elevated FeNO levels and larger BD response was found in both non-asthmatic and asthmatic subjects, mainly in women and non-smoking subjects.

16.
Dtsch Arztebl Int ; 118(29-30): 491-496, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34158151

RESUMO

BACKGROUND: The chronic effects of ozone have only rarely been investigated in disease burden studies to date. Our goal was to determine this disease burden in Germany over the period 2007-2016, with particular attention to estimation based on effect estimates adjusted for particulate matter (PM2.5) and nitrogen dioxide (NO2). METHODS: The nationwide, high-spatial-resolution (2 km × 2 km), population-based exposure to ozone in the summer months ("summer ozone") was calculated on the basis of modeled ozone data and population counts in Germany. Next, risk estimates derived from cohort studies were used to quantify the burden of chronic obstructive pulmonary disease (COPD). Data on population counts, life expectancy, and mortality in Germany were used to reflect the situation across the country as accurately as possible. RESULTS: The estimates of years of life lost (YLL) due to summer ozone ranged from 18.33 per 100 000 people (95% confidence interval [14.02; 22.08]) in 2007 to 35.77 per 100 000 people [27.45; 42.98] in 2015. These findings indicate that ozone affects the COPD burden independently of other harmful components of the air. No clear secular trend in the COPD burden can be seen over the period 2007 to 2016. CONCLUSION: Long-term exposure to ozone contributes to the COPD burden among the general population in Germany. As climate change may lead to a rise in the ozone concentration, more intensive research is required on the effects of ozone on health.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Ozônio , Doença Pulmonar Obstrutiva Crônica , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Exposição Ambiental/análise , Alemanha/epidemiologia , Humanos , Doença Pulmonar Obstrutiva Crônica/epidemiologia
17.
ERJ Open Res ; 7(1)2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33937388

RESUMO

Although there are many health benefits from being active, there was no benefit observed in this study from vigorous physical activity in reducing the risk of asthma onset in middle-aged adults https://bit.ly/3bEtHDn.

18.
Environ Int ; 153: 106548, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33838617

RESUMO

BACKGROUND: Evidence of maternal exposure to ambient air pollution on congenital heart defects (CHD) has been mixed and are still relatively limited in developing countries. We aimed to investigate the association between maternal exposure to air pollution and CHD in China. METHOD: This longitudinal, population-based, case-control study consecutively recruited fetuses with CHD and healthy volunteers from 21 cities, Southern China, between January 2006 and December 2016. Residential address at delivery was linked to random forests models to estimate maternal exposure to particulate matter with an aerodynamic diameter of ≤ 1 µm (PM1), ≤2.5 µm, and ≤10 µm as well as nitrogen dioxides, in three trimesters. The CHD cases were evaluated by obstetrician, pediatrician, or cardiologist, and confirmed by cardia ultrasound. The CHD subtypes were coded using the International Classification Diseases. Adjusted logistic regression models were used to assess the associations between air pollutants and CHD and its subtypes. RESULTS: A total of 7055 isolated CHD and 6423 controls were included in the current analysis. Maternal air pollution exposures were consistently higher among cases than those among controls. Logistic regression analyses showed that maternal exposure to all air pollutants during the first trimester was associated with an increased odds of CHD (e.g., an interquartile range [13.3 µg/m3] increase in PM1 was associated with 1.09-fold ([95% confidence interval, 1.01-1.18]) greater odds of CHD). No significant associations were observed for maternal air pollution exposures during the second trimester and the third trimester. The pattern of the associations between air pollutants and different CHD subtypes was mixed. CONCLUSIONS: Maternal exposure to greater levels of air pollutants during the pregnancy, especially the first trimester, is associated with higher odds of CHD in offspring. Further longitudinal well-designed studies are warranted to confirm our findings.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Cardiopatias Congênitas , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Estudos de Casos e Controles , China/epidemiologia , Feminino , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/etiologia , Humanos , Exposição Materna/efeitos adversos , Dióxido de Nitrogênio , Material Particulado/efeitos adversos , Material Particulado/análise , Gravidez
19.
Eur Respir J ; 58(5)2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33863744

RESUMO

Patients with concomitant features of asthma and chronic obstructive pulmonary disease (COPD) have a heavy disease burden.Using data collected prospectively in the European Community Respiratory Health Survey, we compared the risk factors, clinical history and lung function trajectories from early adulthood to late sixties of middle-aged subjects with asthma+COPD (n=179), past (n=263) or current (n=808) asthma alone, COPD alone (n=111) or none of these (n=3477).Interview data and pre-bronchodilator forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were obtained during three clinical examinations in 1991-1993, 1999-2002 and 2010-2013. Disease status was classified in 2010-2013, when the subjects were aged 40-68 years, according to the presence of fixed airflow obstruction (post-bronchodilator FEV1/FVC below the lower limit of normal), a lifetime history of asthma and cumulative exposure to tobacco or occupational inhalants. Previous lung function trajectories, clinical characteristics and risk factors of these phenotypes were estimated.Subjects with asthma+COPD reported maternal smoking (28.2%) and respiratory infections in childhood (19.1%) more frequently than subjects with COPD alone (20.9% and 14.0%, respectively). Subjects with asthma+COPD had an impairment of lung function at age 20 years that tracked over adulthood, and more than half of them had asthma onset in childhood. Subjects with COPD alone had the highest lifelong exposure to tobacco smoking and occupational inhalants, and they showed accelerated lung function decline during adult life.The coexistence between asthma and COPD seems to have its origins earlier in life compared to COPD alone. These findings suggest that prevention of this severe condition, which is typical at older ages, should start in childhood.

20.
Environ Int ; 152: 106476, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33714142

RESUMO

BACKGROUND: Air pollution is hypothesized to affect pubertal development. However, the few studies on this topic yielded overall mixed results. These studies did not consider important pollutants like ozone, and none of them involved pubertal development assessed by estradiol and testosterone measurements. We aimed to analyze associations between long-term exposure to four pollutants and pubertal development based on sex hormone concentrations among 10-year-old children. METHODS: These cross-sectional analyses were based on the 10-year follow-up medical examinations of 1945 children from the Munich and Wesel centers of the GINIplus and LISA German birth cohorts. Female and male pubertal development was assessed by dichotomizing the concentration of hormones in serum at 18.4 pmol/L and 0.087 nmol/L using the lower limits of quantification for estradiol and testosterone, respectively. Land-use regression models derived annual average concentrations of particulate matter with an aerodynamic diameter < 2.5 and 10 µm (PM2.5 and PM10), as well as spatial models assessed yearly average concentrations of nitrogen dioxide (NO2) and ozone, were calculated at the 10-year residential addresses. To evaluate associations, we utilized logistic regressions adjusted for potential covariates. The analyses were stratified by area and sex. RESULTS: Around 73% of the 943 females and 25% of the 1002 males had a high level of hormones and had already started puberty at the age of 10. Overall, we found no statistically significant associations between exposure to particles (PM2.5 or PM10) and pubertal development. Results on NO2 and ozone were not significant as well; for instance, per 10 µg/m3 increase in ozone concentration, odds ratios and 95% confidence intervals were 0.900 (0.605, 1.339) and 0.830 (0.573, 1.203) for females and males, respectively. Stratified by area, the aforementioned results did not reveal any associations either. CONCLUSIONS: Our study did not observe the associations between ambient air pollutants and pubertal development determined by estradiol and testosterone levels in children. However, due to the current limited number of studies on this topic, our results should be cautiously interpreted. Future longitudinal studies are needed to assess the association.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Criança , Estudos Transversais , Exposição Ambiental/análise , Feminino , Hormônios , Humanos , Masculino , Dióxido de Nitrogênio/análise , Dióxido de Nitrogênio/toxicidade , Material Particulado/análise , Material Particulado/toxicidade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...