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Artigo em Inglês | MEDLINE | ID: mdl-32144804


BACKGROUND: Patients receiving long-term parenteral nutrition (PN) treatment are at risk of developing metabolic bone diseases (MBDs). The bone compartment serves as a repository for a range of metal(loid)s that are administered intravenously to patients via PN solutions. Thus, the mineral composition of patient bones may be linked to the development of MBDs in this group. METHODS: We measured 12 elements in bone samples obtained post mortem from 7 long-term (2-21 years) PN patients and 18 control bones obtained from hip/knee replacement surgery. The samples were cleaned, digested, and subsequently analyzed using a method based on inductively coupled plasma tandem mass spectrometry. RESULTS: Compared with the control group, bones obtained from PN patients were significantly (P < 0.05) depleted in calcium (Ca), phosphorus (P), magnesium (Mg), chromium, and strontium and enriched in manganese (Mn), zinc, barium, cadmium (Cd), and uranium (U). No differences were observed for cobalt or lead. CONCLUSIONS: Depletion of major components of bone mineral (Ca, P, and Mg) and enrichment in known toxicants (Cd, Mn, U) are concerns for PN patients.

Artigo em Inglês | MEDLINE | ID: mdl-32133611


Children's health, attendance, and academic performance may be affected by school environmental hazards. While prior studies evaluated home environment and health, few have evaluated indicators of school in-/outdoor environment and health. This study addresses this knowledge gap by systematically reviewing and evaluating outdoor and indoor indicators of school environment and student's health and performance in New York State (NYS). We also evaluate statistical methodologies to address highly correlated indicators and integrate multiple exposures. Multiple school environmental indicators were identified from various existing NYS datasets. We summarized data sources, completeness, geographic and temporal coverage, and data quality for each indicator. Each indicator was evaluated by scientific basis/relevance, analytic soundness/feasibility, and interpretation/utility, and validated using objective NYS data. Finally, advanced variable selection methods were described and discussed. We have identified and evaluated multiple school environmental health indicators. It was found that mold and moisture problems, ventilation problems, ambient ozone, and PM2.5 levels are among the top priorities of school environmental issues/indicators in NYS, which were also consistent while using NYS data. Choice of best variable selection method should be made based on the research questions and data characteristics. The school environmental health indicators identified, and variable selection methods evaluated, in this study could be used by other researchers to help school officials and policy makers initiate prevention programs.

Sci Total Environ ; 715: 136859, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32014767


BACKGROUND: Little is known about whether exposure to pets influences the association between hypertension and environmental tobacco smoke (ETS). The current study aims to examine the interaction of pet ownership on ETS exposure and the development of hypertension in children. METHODS: From 2012 to 2013, a total of 9354 children, 5 to 17 years of age, were recruited from 62 schools in seven northeastern cities. BP in children was measured and hypertension was defined as an average diastolic blood pressure (DBP) or systolic blood pressure (SBP) at or above the 95th percentile for that child's age, sex, and height. Pet ownership in three different time periods (in utero, past 2 years, and currently) and ETS exposure data were collected from parents via a questionnaire. Two-level regressions were used for the data analyses. RESULTS: The data show consistent, significant interactions between exposure to pets and effects from ETS. Children who were not exposed to pets experienced stronger effects from ETS on hypertension when compared to those exposed to pets, and the protective effect of pet ownership became stronger with a greater number of pets in the home. Exposure to in utero ETS was associated with hypertension [adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI): 1.13-1.54] only for those children without pet exposure in utero but not for those with pets (aOR = 0.75; 95% CI: 0.49-1.15) (pinteraction < 0.05). Moreover, household dog ownership was related to significantly lower effects of current ETS on hypertension (aOR = 0.80, 95% CI: 0.61-1.05) compared with children without dogs (aOR = 1.26, 95% CI: 1.11-1.44) (pinteraction = 0.001). Interaction associations between ETS and pet ownership were more robust for girls than for boys and for younger than older children. CONCLUSION: This study indicates an inverse relationship between pet ownership and ETS, potentially pointing to pet ownership as protecting against the development of hypertension in children.

Hipertensão , Poluição por Fumaça de Tabaco , Animais , Criança , Cidades , Estudos de Coortes , Cães , Exposição Ambiental , Feminino , Humanos , Masculino , Propriedade , Animais de Estimação
Environ Res ; 183: 109197, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32058142


There is a large body of evidence linking Environmental Tobacco Smoke (ETS) exposure with impaired lung function. However, it is not known whether exposure to pets modifies this relationship. To investigate if pet ownership changes the association between ETS exposure and lung function, a population-based sample of 7326 children, 7-14 years old, were randomly recruited from 24 districts in northeast China. Lung function including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF) was measured by spirometry, while pet ownership time periods and ETS exposure were collected by questionnaire. Two-level regression analysis was done, with covariates controlled for. The results showed pet exposure in certain early lifetime windows modified the associations of ETS exposure on decreased lung function in children. Among children exposed to current ETS, those exposed to pets in utero had greater reductions in lung function (for instance: OR for reduced FVC (<85% predicted) = 10.86; 95% CI: 3.80-30.97) than those not exposed to pets in utero (OR = 2.32; 95% CI: 1.76-3.05) (pinteraction = 0.005). While, children exposed to current pet ownership reduced the lung function impairment induced by ETS exposure during the first 2 years of life and/or ETS exposure during pregnancy, especially for FVC impairment. For instance, OR (95%CI) for reduced FVC (<85% predicted) was 0.81 (0.56, 1.18) and 1.42 (1.15, 1.74), respectively, for children with or without current pet ownership exposed to ETS during the first 2 years of life (pinteraction = 0.010). Furthermore, pet type or number of pets did not significantly modify associations between ETS exposure and lung function. In conclusion, the timing of pet ownership modified associations between ETS exposure and lung function, pet ownership in utero and during the first 2 years of life significantly worsened the adverse impacts of passive smoking on lung function.

BMC Infect Dis ; 19(1): 1029, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31796004


BACKGROUND: Hand, foot, and mouth disease (HFMD) raises an urgent public health issue in the Asia-Pacific region, especially in China. The associations between weather factors and HFMD have been widely studied but with inconsistent results. Moreover, previous studies utilizing ecological design could not rule out the bias of exposure misclassification and unobserved confounders. METHODS: We used case-crossover analysis to assess the associations of weather factors on HFMD. Individual HFMD cases from 2009 to 2012 in Guangdong were collected and cases located within 10 km of the meteorological monitoring sites were included. Lag effects were examined through the previous 7 days. In addition, we explored the variability by changing the distance within 20 km and 30 km. RESULTS: We observed associations between HFMD and weather factors, including temperature and relative humidity. An approximately U-shaped relationship was observed for the associations of temperature on HFMD across the same day and the previous 7 days, while an approximately exponential-shaped was seen for relative humidity. Statistically significant increases in rates of HFMD were associated with each 10-unit increases in temperature [Excess rate (ER): 7.7%; 95% Confidence Interval (CI): 3.9, 11.7%] and relative humidity (ER: 1.9%; 95% CI: 0.7, 3.0%) on lag days 0-6, when assessing within 10 km of the monitoring sites. Potential thresholds for temperature (30.0 °C) and relative humidity (70.3%) detected showed associations with HFMD. The associations remained robust for 20 km and 30 km. CONCLUSIONS: Our study found that temperature and relative humidity are significantly associated with the increased rates of HFMD. Thresholds and lag effects were observed between weather factors and HFMD. Our findings are useful for planning on targeted prevention and control of HFMD.

Medicina Ambiental/métodos , Doença de Mão, Pé e Boca/epidemiologia , Tempo (Meteorologia) , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Estudos Cross-Over , Ecologia/métodos , Feminino , Humanos , Umidade/efeitos adversos , Incidência , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Temperatura Ambiente
Rev Environ Health ; 34(3): 275-281, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31216266


Background Environmental research involving children often relies on the self-report or parental report of symptoms and environmental issues. While previous studies explored the agreements between child and parental reports, few of them were conducted in younger children and in developing countries. In this study, we addressed the research gaps by assessing the agreement between child and parental report on respiratory symptoms and school environment in Romanian primary schools. Methods Two hundred and eighty students from five schools and their parents participated in this study. Information on child's respiratory symptoms and perceptions of school environment was collected via both student and parent questionnaires. Agreement between the two questionnaires was assessed by absolute agreement rates and kappa statistics. Prevalence index (PI), bias index (BI) and maximum attainable kappas were calculated to identify potential sources of disagreements. Results The agreement between student and parent questionnaires was low. Compared to the student's report, parents often reported more symptoms than their children, particularly flu-like symptoms, and school environment problems. Parent and child tend to agree when there was no symptom reported, but disagreements often occurred when symptoms were reported. After adjusting for the PI, the agreements for asthma and allergic symptoms improved substantially. Disagreement on reporting of flu-like symptoms was strongly affected by pre-existing causes, such as different understandings of the questions between students and parents. Conclusion Parental report may have a higher sensitivity in capturing a child's respiratory symptoms and school environment problems compared to self-report among young children in developing countries.

Asma/epidemiologia , Meio Ambiente , Hipersensibilidade/epidemiologia , Instituições Acadêmicas , Asma/etiologia , Criança , Feminino , Humanos , Hipersensibilidade/etiologia , Masculino , Pais , Prevalência , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/etiologia , Romênia/epidemiologia , Inquéritos e Questionários