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1.
Sci Total Environ ; 711: 134843, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32000326

RESUMO

China's rapid urbanization has led to an increasing level of exposure to air pollution and a decreasing level of exposure to vegetation among urban populations. Both trends may pose threats to psychological well-being. Previous studies on the interrelationships among greenness, air pollution and psychological well-being rely on exposure measures from remote sensing data, which may fail to accurately capture how people perceive vegetation on the ground. To address this research gap, this study aimed to explore relationships among neighbourhood greenness, air pollution exposure and psychological well-being, using survey data on 1029 adults residing in 35 neighbourhoods in Guangzhou, China. We used the Normalized Difference Vegetation Index (NDVI) and streetscape greenery (SVG) to assess greenery exposure at the neighbourhood level, and we distinguished between trees (SVG-tree) and grasses (SVG-grass) when generating streetscape greenery exposure metrics. We used two objective (PM2.5 and NO2 concentrations) measures and one subjective (perceived air pollution) measure to quantify air pollution exposure. We quantified psychological well-being using the World Health Organization Well-Being Index (WHO-5). Results from multilevel structural equation models (SEM) showed that, for parallel mediation models, while the association between SVG-grass and psychological well-being was completely mediated by perceived air pollution and NO2, the relationship between SVG-tree and psychological well-being was completely mediated by ambient PM2.5, NO2 and perceived air pollution. None of three air pollution indicators mediated the association between psychological well-being and NDVI. For serial mediation models, measures of air pollution did not mediate the relationship between NDVI and psychological well-being. While the linkage between SVG-grass and psychological well-being scores was partially mediated by NO2-perceived air pollution, SVG-tree was partially mediated by both ambient PM2.5-perceived air pollution and NO2-perceived air pollution. Our results suggest that street trees may be more related to lower air pollution levels and better mental health than grasses are.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32011752

RESUMO

BACKGROUND: Air pollution, especially PM2.5 (particulate matter with a diameter of below 2.5 µm), has been recognized as a key environmental factor that affects mental health, but few studies have focused on its influence on older adults, who are a vulnerable group. OBJECTIVE: This study focused on the influence of PM2.5 on health-related behaviors, such as physical activities and social contact, to assess their role as mediators of depression among older adults in China. METHODS: We used data (N = 24 623) from the CHARLS (China Health and Retirement Longitudinal Study) of 2011-2015. CES-D 10 (Center for Epidemiology Studies of Depression scale) was used to measure depression. Using multilevel linear models, we examined the relationships between the variables, with different times nested within the same individual and individuals nested within the cities. RESULTS: Before mediators were added, depression symptoms among older adults increased with annual concentration of PM2.5 (Coeff = 0.57, SE = 0.11). However, after the mediators were added, the coefficient of the annual concentration of PM2.5 decreased (Coeff = 0.37, SE = 0.10). While both physical activities (Sobel test Z score = 2.37, P value = .02) and social contact (Z score = 7.33, P value = .00) mediated the relationship between PM2.5 and depression, the mediating effects decreased with increasing PM2.5 . CONCLUSIONS: Exposure to PM2.5 , therefore, increases depressive symptoms in older Chinese adults by decreasing their physical activities and social contact. Also, the positive effects of physical activities and social contact on depression decreased with increasing PM2.5 concentrations.

3.
Sci Total Environ ; 715: 136859, 2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-32014767

RESUMO

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.

4.
Environ Res ; 183: 109197, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32058142

RESUMO

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.

5.
Environ Int ; 137: 105555, 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32059142

RESUMO

The detrimental effects of perfluoroalkyl substances (PFASs) on several physiological systems have been reported, but the association of PFASs with eye, one of the most sensitive and exposed organ, has never been explored. To investigate the association between eye diseases including visual impairment (VI) and PFASs isomers, a cross-sectional stratified study was conducted in 1202 Chinese population, aged 22-96 years, from Shenyang, China. A standard protocol including Snellen vision chart, slit-lamp microscopy and direct ophthalmoscopy was used to examine eye diseases/conditions relating to anterior and posterior segment of eyes. In addition, we measured the blood concentrations of 19 linear and branched PFASs at one-time point. Results indicated that blood levels of PFASs were significantly higher in eye disease group than normal group. PFASs exposure were positively associated with both combined eye diseases and individual eye diseases. Among other PFASs, linear perfluorooctane sulfonate (n-PFOS; odds ratio [OR] = 3.37, 95% confidence interval [CI]: 2.50, 4.56), branched perfluorooctane sulfonate (Br-PFOS; OR = 2.25, 95% CI: 1.72, 2.93) and linear perfluorooctanoic acid (n-PFOA; OR = 1.79, 95% CI: 1.36, 2.37) significantly increases the odds of VI. Vitreous disorder was adversely associated with long-chain PFASs exposure. For example, perfluorotridecanoic acid (PFTrDA; OR = 1.86, 95% CI: 1.51, 2.29) and perfluorodecanoic acid (PFDA; OR = 1.79, 95% CI: 1.36, 2.36) showed the most significant association. In conclusion, this study suggests higher serum PFASs levels were associated with increase odds of VI and vitreous disorder in Chinese adults.

6.
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.

7.
Environ Pollut ; 256: 113422, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31672364

RESUMO

Evidence suggests that residential greenness may be protective of high blood pressure, but there is scarcity of evidence on the associations between greenness around schools and blood pressure among children. We aimed to investigate this association in China. Our study included 9354 children from 62 schools in the Seven Northeastern Cities Study. Greenness around each child's school was measured by NDVI (Normalized Difference Vegetation Index) and SAVI (Soil-Adjusted Vegetation Index). Particulate matter ≤ 1 µm (PM1) concentrations were estimated by spatiotemporal models and nitrogen dioxide (NO2) concentrations were collected from air monitoring stations. Associations between greenness and blood pressure were determined by generalized linear and logistic mixed-effect models. Mediation by air pollution was assessed using mediation analysis. Higher greenness was consistently associated with lower blood pressure. An increase of 0.1 in NDVI corresponded to a reduction in SBP of 1.39 mmHg (95% CI: 1.86, -0.93) and lower odds of hypertension (OR = 0.76, 95% CI: 0.69, 0.82). Stronger associations were observed in children with higher BMI. Ambient PM1 and NO2 mediated 33.0% and 10.9% of the association between greenness and SBP, respectively. In summary, greater greenness near schools had a beneficial effect on blood pressure, particularly in overweight or obese children in China. The associations might be partially mediated by air pollution. These results might have implications for policy makers to incorporate more green space for both aesthetic and health benefits.

8.
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.

9.
Environ Int ; 135: 105365, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31830731

RESUMO

BACKGROUND: Experimental studies show that chlorinated polyfluorinated ether sulfonic acids (Cl-PFESA 6:2 and 8:2), one of perfluoroalkyl substances (PFAS) used as perfluorooctane sulfonate (PFOS) alternatives, are reproductive toxicants in vivo and in vitro. However, the associations between gestational exposure to Cl-PFESAs and birth outcomes are unknown. OBJECTIVES: We investigated associations between 6:2 Cl-PFESA and 8:2 Cl-PFESA in maternal serum and birth outcomes. METHODS: We measured four PFAS, including 6:2 Cl-PFESA, 8:2 Cl-PFESA, PFOS, and perfluorooctanoic acid (PFOA) in third-trimester maternal serum collected from 372 mother-child dyads participating in the Guangzhou Birth Cohort Study. Characteristics of mothers and infants were gathered from medical records and by interviewer-administered questionnaires. RESULTS: PFOS was the most abundant PFAS in maternal serum (median: 7.15 ng/mL), followed by 6:2 Cl-PFESA (median: 2.41 ng/mL). Greater maternal serum levels of all PFAS alternatives were significantly associated with lower birth weight, adjusted for confounding variables. For example, each ln-ng/mL greater concentration of 6:2 Cl-PFESA and 8:2 Cl-PFESA was associated with a 54.44 g [95% confidence interval (CI): -95.66, -13.22] and 21.15 g (95% CI: -41.44, -0.86) lower birth weight, respectively. Greater continuous maternal serum 6:2 Cl-PFESA (OR: 2.67, 95% CI: 1.73, 4.15) and PFOS (OR: 2.03, 95% CI: 1.24, 3.32) were also associated with higher risks for preterm birth, adjusted for confounders, with a possible threshold effect at the highest quartile of 6:2 Cl-PFESA. CONCLUSIONS: For the first time, we report associations between maternal serum 6:2 Cl-PFESA and 8:2 Cl-PFESA concentrations and adverse birth outcomes. Our findings suggest that PFOS alternatives may be reproductive toxicants in human populations and should be considered with caution before widespread use. Given the preliminary nature of our results, additional epidemiological and toxicological investigations are needed to more definitively assess the risks.

10.
Environ Int ; 135: 105388, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31837524

RESUMO

BACKGROUND: Residing in greener areas has several health benefits, but no study to date has examined the effects of greenness on metabolic syndrome (MetS). We aimed to assess associations between residential greenness and MetS prevalence in China, and to explore whether air pollution and physical activity mediated any observed associations. METHODS: We analyzed data from 15,477 adults who participated in the 33 Communities Chinese Health Study during 2009. We defined MetS according to standard guidelines for Chinese populations. Residential greenness was estimated using the Normalized Difference Vegetation Index (NDVI), the Soil Adjusted Vegetation Index (SAVI), and the Vegetation Continuous Field (VCF). We used generalized linear mixed models to assess the associations between greenness and MetS, and mediation analyses to explore potential mechanisms underlying the associations. RESULTS: Higher greenness levels were associated with lower odds of MetS [e.g., for every interquartile range increase of NDVI500-m, SAVI500-m, and VCF500-m, the adjusted odds ratio of MetS was 0.81 (95% confidence interval: 0.70-0.93), 0.80 (95% confidence interval: 0.69-0.93), and 0.91 (95% confidence interval: 0.83-1.00), respectively]. The direction and the magnitude of the associations persisted in several sensitivity analyses. Stratified analyses showed that age and household income modified the associations, with greater effect estimates observed in participants younger than 65 years old or those with higher household income. Particulate matter with an aerodynamic diameter ≤10 µm, nitrogen dioxide, and ozone mediated 2.1-20.3% of the associations between greenness and MetS; no evidence of mediation was observed for physical activity. CONCLUSIONS: Our findings suggest a beneficial association for residential greenness and MetS in Chinese urban dwellers, especially for participants younger than 65 years old and those with higher household income. Particulate matter with an aerodynamic diameter ≤10 µm, nitrogen dioxide and ozone, but not physical activity, may only partially mediate the association.

11.
Sci Total Environ ; 705: 135885, 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-31841927

RESUMO

BACKGROUND: Recent studies suggest that perfluoroalkyl substances (PFAS) and PFAS alternatives can cross the placental barrier. However, little is known on the differential patterns of trans-placental transfer (TPT) among conventional PFAS and PFAS alternatives in epidemiological study. OBJECTIVES: We aimed to characterize comprehensive TPT patterns in conventional PFAS and PFAS alternatives using matched maternal-cord blood serum from a birth cohort. METHODS: A total of 424 mother-fetus pairs were recruited from the Maoming Birth Cohort during 2015-2018. We detected 20 PFAS in cord and maternal serum using an ultraperformance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). TPT of PFAS was calculated via cord to maternal serum concentration ratios. RESULTS: Both of PFOS alternatives (chlorinated polyfluorinated ether sulfonates, Cl-PFESAs) and PFOA short-chain alternative (perfluorobutanoic acid, PFBA) were widely detected in the cord and maternal serum. In cord serum, the predominant PFAS was PFOS (1.93 ng/mL), followed by PFBA (1.45 ng/mL), PFOA (0.75 ng/mL) and 6:2 Cl-PFESA (0.32 ng/mL). We found that the PFAS alternatives had higher TPT than PFOS and PFOA, such as PFBA vs. PFOA (median: 1.41 vs. 0.73, P < 0.001) and 8:2 Cl-PFESA vs. PFOS (median: 0.98 vs. 0.42, P < 0.001). Moreover, the TPT of 8:2 Cl-PFESA was higher than the precursor, linear and isomeric PFOS, respectively (P < 0.01). Furthermore, we found a U-shaped pattern for TPT in perfluorocarboxylic acid compounds (PFCAs) across different length of carbon chain. CONCLUSION: Our findings suggest that PFAS alternatives may be more easily across the placenta than conventional PFAS. Given the widespread usage of PFAS alternatives, our results indicate that more research is needed to assess the potential health risks of prenatal exposure to PFAS alternatives in children.

12.
Sci Total Environ ; 701: 134721, 2020 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-31715478

RESUMO

Although epidemiological studies have evaluated the associations of ambient air pollution with depression, the results remained mixed. To clarify the nature of the association, we performed a comprehensive systematic review and meta-analysis with the Inverse Variance Heterogeneity (IVhet) model to estimate the effect of ambient air pollution on depression. Three English and four Chinese databases were searched for epidemiologic studies investigating associations of ambient particulate (diameter ≤ 2.5 µm (PM2.5), ≤10 µm (PM10)) and gaseous (nitric oxide (NO), nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2) and ozone (O3)) air pollutants with depression. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated to evaluate the strength of the associations. We identified 22 eligible studies from 10 countries of the world. Under the IVhet model, per 10 µg/m3 increase in long-term exposure to PM2.5 (OR: 1.12, 95% CI: 0.97-1.29, I2: 51.6), PM10 (OR: 1.04, 95% CI: 0.88-1.25, I2: 85.7), and NO2 (OR: 1.05, 95% CI: 0.83-1.34, I2: 83.6), as well as short-term exposure to PM2.5 (OR: 1.01, 95% CI: 0.99-1.04, I2: 51.6), PM10 (OR: 1.01, 95% CI: 0.98-1.04, I2: 86.7), SO2 (OR: 1.03, 95% CI: 0.99-1.07, I2: 71.2), and O3 (OR: 1.01, 95% CI: 0.99-1.03, I2: 82.2) was not significantly associated with depression. However, we observed significant association between short-term NO2 exposure (per 10 µg/m3 increase) and depression (OR: 1.02, 95% CI: 1.00-1.04, I2: 65.4). However, the heterogeneity was high for all of the pooled estimates, which reduced credibility of the cumulative evidence. Additionally, publication bias was detected for six of eight meta-estimates. In conclusion, short-term exposure to NO2, but not other air pollutants, was significantly associated with depression. Given the limitations, a larger meta-analysis incorporating future well-designed longitudinal studies, and investigations into potential biologic mechanisms, will be necessary for a more definitive result.


Assuntos
Poluição do Ar/estatística & dados numéricos , Depressão/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino
13.
Sci Total Environ ; 702: 135040, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31726339

RESUMO

Living in greener places may protect against obesity, but epidemiological evidence is inconsistent and mainly comes from developed nations. We aimed to investigate the association between greenness and obesity in Chinese adults and to assess air pollution and physical activity as mediators of the association. We recruited 24,845 adults from the 33 Communities Chinese Health Study in 2009. Central and peripheral obesity were defined by waist circumference (WC) and body mass index (BMI), respectively, based on international obesity standards. The Normalized Difference Vegetation Index (NDVI) was used to quantify community greenness. Two-level logistic and generalized linear mixed regression models were used to evaluate the association between NDVI and obesity, and a conditional mediation analysis was used also performed. In the adjusted models, an interquartile range increase in NDVI500-m was significantly associated with lower odds of peripheral 0.80 (95% confidence interval [CI]: 0.74-0.87) and central obesity 0.88 (95% CI: 0.83-0.93). Higher NDVI values were also significantly associated with lower BMI. Age, gender, and household income significantly modified associations between greenness and obesity, with stronger associations among women, older participants, and participants with lower household incomes. Air pollution mediated 2.1-20.8% of the greenness-obesity associations, but no mediating effects were observed for physical activity. In summary, higher community greenness level was associated with lower odds of central and peripheral obesity, especially among women, older participants, and those with lower household incomes. These associations were partially mediated by air pollutants. Future well-designed longitudinal studies are needed to confirm our findings.


Assuntos
Obesidade/epidemiologia , Desenvolvimento Sustentável , Poluição do Ar , Índice de Massa Corporal , China/epidemiologia , Cidades/epidemiologia , Exercício , Humanos , Características de Residência , Fatores Socioeconômicos , População Urbana/tendências
14.
Environ Res ; 180: 108817, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31627156

RESUMO

BACKGROUND: Air pollutants are suggested to be related to type 2 diabetes (T2D). Since several high quality papers on air pollutants and T2D have been published beyond the last reviews, an extended systematic review is highly warranted. We review epidemiological studies to quantify the association between air pollutants and T2D, and to answer if diabetes patients are more vulnerable to air pollutants. METHODS: We systematically reviewed the databases of PubMed and Web of Science based on the guidelines of the Preferred Reporting Items for Systematic review and Meta-analysis (PRISMA). We calculated odds ratios (OR) or hazard ratios (HR) and their 95% confidence intervals (CI) to assess the strength of the associations between air pollutants [e.g., particulate matter with diameter ≤ 2.5 µm (PM2.5), particulate matter with diameter ≤ 10 µm (PM10), and nitrogen dioxide (NO2)] and T2D. We evaluated the quality and risk of bias of the included studies and graded the credibility of the pooled evidence using several recommended tools. We also performed sensitivity analysis, meta-regression analysis, and publication bias test. RESULTS: Out of 716 articles identified, 86 were used for this review and meta-analysis. Meta-analyses showed significant associations of PM2.5 with T2D incidence (11 studies; HR = 1.10, 95% CI = 1.04-1.17 per 10 µg/m3 increment; I2 = 74.4%) and prevalence (11 studies; OR = 1.08; 95% CI = 1.04-1.12 per 10 µg/m3 increment; I2 = 84.3%), of PM10 with T2D prevalence (6 studies; OR = 1.10; 95% CI = 1.03-1.17 per 10 µg/m3 increment; I2 = 89.5%) and incidence (6 studies; HR = 1.11; 95% CI = 1.00-1.22 per µg/m3 increment; I2 = 70.6%), and of NO2 with T2D prevalence (11 studies; OR = 1.07; 95% CI = 1.04-1.11 per 10 µg/m3 increment; I2 = 91.1%). The majority of studies on glucose-homoeostasis markers also showed increased risks with higher air pollutants levels, but the studies were too heterogeneous for meta-analysis. Overall, patients with diabetes might be more vulnerable to PM. CONCLUSIONS: Recent publications strengthened the evidence for adverse effects of ambient air pollutants exposure (especially for PM) on T2D and that diabetic patients might be more vulnerable to air pollutants exposure.

15.
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
16.
JAMA Netw Open ; 2(12): e1917862, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31851349

RESUMO

Importance: Few studies have investigated the association between greenness and childhood attention-deficit/hyperactivity disorder (ADHD). Objective: To evaluate the association between greenness surrounding schools or kindergartens and symptoms of ADHD in children. Design, Setting, and Participants: This population-based cross-sectional study was performed between April 2012 and January 2013 in 7 cities in northeastern China. This analysis included 59 754 children (aged 2-17 years) from 94 schools and kindergartens, who had resided in the study area for 2 years or longer. Data were analyzed from April 15, 2019, to October 10, 2019. Exposures: Greenness surrounding each child's school or kindergarten was estimated using 2 satellite image-derived vegetation indexes: the normalized difference vegetation index and the soil-adjusted vegetation index. Main Outcomes and Measures: Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) scales were used to measure ADHD symptoms (9 inattention symptoms and 9 hyperactivity-impulsivity symptoms). Parents or guardians rated the frequency of each of 18 ADHD symptoms during the preceding 6 months. Children with 6 or more symptoms of either inattention or hyperactivity-impulsivity were defined as having ADHD symptoms. Generalized linear mixed models were applied to estimate the association between greenness and ADHD symptoms. Results: The mean (SD) age of the 59 754 study participants was 10.3 (3.6) years, and 29 494 (49.4%) were girls. A total of 2566 participants (4.3%) had ADHD symptoms. Greenness levels differed substantially across schools and kindergartens. The normalized difference vegetation index within 500 m of a school or kindergarten ranged from -0.09 to 0.77. Greater greenness levels were associated with lower odds of ADHD symptoms. In covariate-adjusted models, a 0.1-unit increase in normalized difference vegetation index or soil-adjusted vegetation index within 500 m of a school or kindergarten was significantly associated with lower odds of ADHD symptoms (odds ratios, 0.87 [95% CI, 0.83-0.91] and 0.80 [95% CI, 0.74-0.86], respectively; P < .001 for both). The associations were robust in a series of sensitivity analyses. Conclusions and Relevance: These findings suggest that there may be a beneficial association between school-based greenness and ADHD symptoms in Chinese children. Future longitudinal and mechanistic studies are needed to confirm the findings of this cross-sectional analysis and further explore potential mechanisms of this association.

17.
Wei Sheng Yan Jiu ; 48(5): 751-756, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31601315

RESUMO

OBJECTIVE: To investigate the association between environmental tobacco smoke( ETS) and blood pressure in children. METHODS: A cross-sectional study was conducted to study the effects of ETS and children's blood pressure among 1623 children aged 5 to 17 years, who were selected randomly from 10 primary and secondary schools in Shenyang from 2012-2013, Liaoning Province. The basic information of children was collected through questionnaires, including demographic characteristics, living environment, history of disease and passive smoking status. We also measured the height, weight and blood pressure of these children. Multiple Logistic regression analyses were used to determine whether ETS was associated with the risk of hypertension after adjustment for potential confounders. RESULTS: Nearly half of the participants( 37%, n = 600) had current ETS exposures, and in for 34% of the children( n = 514), their current ETS exposure was from tobacco use by their father. The adjusted odds ratios( a OR) for hypertension and ETS exposure in utero were 1. 59( 95% CI 1. 02-2. 48) in males and 2. 88( 95% CI 1. 82-4. 56) in females. Current ETS exposure( a OR = 2. 22, 95% CI 1. 47-3. 34) and current ETS exposure from the child's father( a OR = 2. 20, 95% CI 1. 46-3. 31), in addition different intensity of ETS exposure during workdays and during days off were associated with a higher rate of hypertension only in females. CONCLUSION: Prenatal and postnatal ETS exposure was significantly associated with increased odds of hypertension in children, especially in females.


Assuntos
Hipertensão/epidemiologia , Exposição Materna/estatística & dados numéricos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Razão de Chances , Gravidez , Fumar/epidemiologia , Inquéritos e Questionários
18.
Environ Int ; 133(Pt A): 105160, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31518937

RESUMO

BACKGROUND: Greater levels of serum per- and polyfluoroalkyl substances (PFAS) are known to be associated with higher uric acid which itself leads to a number of chronic diseases. However, whether this association varies across PFAS isomers which recently have been found to be associated with human health remains unknown. OBJECTIVES: To address this research gap, we explored isomer-specific associations between serum PFAS and uric acid in Chinese adults. METHODS: We conducted a cross-sectional study of associations between serum PFAS isomer and serum uric acid in 1612 participants from the Isomer of C8 Health Project. We used multivariable linear and logistic regression models to analyze serum isomers of perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), and other PFASs as continuous and categorical predictors of uric acid, adjusted for confounders. The association was also stratified by kidney function stage based on estimated glomerular filtration rate (GF-1, GF-2, GF-3a, and GF-3b/4). RESULTS: We found positive associations between serum PFAS isomer concentrations and uric acid. Uric acid levels were greater for each log-unit increase in branched PFOA (ß = 0.30, 95% CI: 0.21, 0.40), linear PFOA (ß = 0.18, 95% CI: 0.09, 0.26), branched PFOS (ß = 0.09, 95% CI: 0.02, 0.17) and linear PFOS (ß = 0.06, 95% CI: -0.01, 0.14) concentration. The associations between PFAS and uric acid showed an inverted 'U' shaped pattern across kidney function stages. For example, uric acid level was greater with each log-unit increase in total-PFOA among GF-1 (ß = 0.21, 95% CI: 0.06, 0.37), this relationship was greater in GF-3a (ß = 0.49, 95% CI: 0.09, 0.89) and decreased in GF-3b/4 (ß = -0.22, 95% CI: -0.83, 0.39). We also found the odds of hyperuricemia increased linearly with increasing branched PFOA in quartiles (odds ratio = 2.67, 95% CI: 1.86, 3.85 at the highest quartile). CONCLUSION: We report novel results in which PFAS associations with uric acid varied according to isomer and adult kidney function. Besides, our findings are consistent with previous epidemiologic studies in finding a positive association between serum PFAS concentrations and serum uric acid, especially for PFOA. Our results indicate that more research is needed to more clearly assess the impact of PFAS isomers on human health, which will help to refine regulation policies for PFAS.

19.
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.

20.
Environ Pollut ; 250: 14-22, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30981931

RESUMO

While exposure to places with higher greenness shows health benefits, evidence is scarce on its lipidemic effects. We assessed the associations between residential greenness and blood lipids and effect mediations by air pollution, physical activity, and adiposity in China. Our study included 15,477 adults from the population-based 33 Communities Chinese Health Study, conducted between April and December 2009, in Northeastern China. We measured total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Residential greenness was estimated using two satellite-derived vegetation indices - the Normalized Difference Vegetation Index (NDVI) and the Soil Adjusted Vegetation Index (SAVI). We used both nitrogen dioxide (NO2) and particles ≤2.5 µm in aerodynamic diameter (PM2.5) as proxies of outdoor air pollution. Associations were assessed using linear mixed effects regression models and logistic mixed effects regression models, and mediation analyses were also performed. Living in higher greenness areas was consistently associated with lower TC, TG, and LDL-C levels and higher HDL-C levels (e.g., change in TC, TG, LDL-C, and HDL-C per 0.1-unit increase in NDVI500-m was -1.52%, -3.05%, -1.91%, and 0.52%, respectively). Similar results were obtained for the corresponding dyslipidemias. These associations were generally stronger in women and older adults. While educational levels showed effect modifications, the effect pattern was inconsistent. Both outdoor air pollution and body mass index mediated 9.1-62.3% and 5.6-40.1% of the associations for greenness and blood lipids, respectively, however, physical activity did not. Our results suggest beneficial associations between residing in places with higher greenness and blood lipid levels, especially in women and the elder individuals. The associations were partly mediated by lower air pollution and adiposity.


Assuntos
Poluição do Ar/análise , Ambiente Construído , Exposição Ambiental/análise , Lipídeos/sangue , População Urbana , Adiposidade , Idoso , Poluição do Ar/efeitos adversos , Índice de Massa Corporal , China , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Dióxido de Nitrogênio/efeitos adversos , Dióxido de Nitrogênio/análise , Obesidade/epidemiologia , Material Particulado/efeitos adversos , Material Particulado/análise
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