Exposure to air pollution and cognitive function based on the minimum mental state examination: a systematic review and meta-analysis.

Evidence regarding the cognitive effects of air pollution is inconsistent. This study aimed to quantitatively analyze the relationship between air pollutants and cognitive abilities using the Mini-Mental State Examination (MMSE). We systematically searched for studies published until July 1, 2023, and assessed heterogeneity with Cochran's Q test and I² statistics, while publication bias was evaluated using Funnel plots and Egger's test. Out of 380 studies, 17 were included in the meta-analysis. Results demonstrated significant relationship among long-term exposure to PM2.5, O3, and cognitive decline. The pooled RR of cognitive impairment per 10µg/m3 increase were 1.17 for PM2.5 and 1.07 for PM10. Furthermore, there was a significant association between cognitive decline and long-term exposure to PM2.5 (ß = -0.30; I2 = 95.30%) and PM10 (ß = -0.15; I2 = 87.50%). Our research suggests that long-term exposure to air pollution, especially PM2.5, is a risk factor for cognitive impairment.

Meta-analysis of the SARS-CoV-2 positivity rate in municipal wastewater.

The aim of this study is to conduct a systematic analysis of the SARS-CoV-2 levels in urban sewage and evaluate the associated positivity rates, thereby developing comprehensive insights into the epidemic situation and providing valuable inputs for the development of effective disease prevention and control strategies. The PubMed, Scopus, Embase, China National Knowledge Infrastructure, Wanfang Database, and VIP databases were systematically searched based on the predefined retrieval strategy. The literature published up to February 2023 was meticulously screened according to the predetermined inclusion and exclusion criteria, and the relevant data were extracted for subsequent integration. The quality assessment of the included studies adhered to the rigorous Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement guidelines. The meta-analysis was conducted using Stata 17.0 software. The meta-analysis included a total of 34 studies, encompassing 8429 municipal wastewater samples. A random effects model was employed for the analysis, revealing an overall SARS-CoV-2 positivity rate of 53.7% in the municipal wastewater samples. The subgroup analyses demonstrated significant regional variations in the SARS-CoV-2 positivity rate in municipal wastewater, with Africa exhibiting the highest rate at 62.5% (95% confidence interval [CI] 47.4 ~ 76.0%) and Oceania displaying the lowest at 33.3% (95% CI 22.0 ~ 46.3%). However, the subgroup analyses based on the sampling site, strain prevalence period, and laboratory testing method did not yield any statistically significant differences. The SARS-CoV-2 positivity rate in wastewater is relatively high globally, although it exhibits regional disparities. Regions with larger populations and lower economic levels demonstrate higher viral detection rates in sewage. Different types of wastewater sampling sites can be employed to monitor distinct aspects of the COVID-19 pandemic. Continuous surveillance of SARS-CoV-2 in wastewater plays a pivotal role in complementing clinical data, helping to track outbreak progression across diverse regions.

Associations between the incidence and mortality rates of type 2 diabetes mellitus and long-term exposure to ambient air pollution: A 12-year cohort study in northern China.

BACKGROUND: Ambient air pollution has recently been related to type 2 diabetes mellitus (T2DM), a disease that has caused an economic and health burden worldwide. Evidence of an association between air pollution and T2DM was reported in the United States and Europe. However, few studies have focused on the association with high levels of air pollutants in a developing country. OBJECTIVES: We conducted a 12-year cohort study to assess the incidence and mortality of T2DM associated with long-term exposure to PM10, SO2, and NO2. METHODS: A retrospective cohort with participants from four cities in northern China was conducted to assess mortality and incidence of T2DM from 1998 to 2009. Incidence of T2DM was self-reported, and incident intake of an antidiabetic drug or injection of insulin simultaneously and mortality of T2DM was obtained from a family member and double checked against death certificates provided from the local center for disease control and prevention. Individual pollution exposures were the mean concentrations of pollutants estimated from the local environmental monitoring centers over the survival years. Hazard ratios (HRs) were estimated using Cox regression models after adjusting for potential confounding factors. RESULTS: A total of 39 054 participants were recruited into the mortality cohort, among which 59 subjects died from T2DM; 38 529 participants were analyzed in the incidence cohort, and 1213 developed new cases of T2DM. For each 10 µg/m3 increase in PM10, SO2, and NO2, the adjusted HRs and 95% confidence interval (CI) for diabetic incidence were 1.831 (1.778, 1.886), 1.287 (1.256, 1.318), and 1.472 (1.419, 1.528), respectively. Similar results can be observed in the analysis of diabetic mortality with HRs (95% CI) up to 2.260 (1.732, 2.950), 1.130 (1.042, 1.225), and 1.525 (1.280, 1.816), respectively. CONCLUSIONS: Our results suggested that long-term exposure to high levels of PM10, SO2, and NO2 increase risk of incident and mortality of T2DM in China.

Combined health effects of air pollutant mixtures on respiratory mortality using BKMR in Hangzhou, China.

Previous research on respiratory system mortality primarily focused on understanding their combined effects and have neglected the fact that air pollution mixtures are interrelated. This study used Bayesian kernel machine regression (BKMR) to analyze the relationship between air pollutant mixtures and respiratory mortality in Hangzhou, China from 2014 to 2018. The results showed a significant association between pollutant mixtures and respiratory system mortality primarily driven by PM2.5 and SO2. The joint exposure of air pollutants was positively correlated with respiratory system mortality at lag 01 and lag 02 days. The estimated joint effects of log-transformed mixture air pollution exposure on log-transformed respiratory system mortality increased from -0.02 (95% CI: -0.08-0.02) and -0.01 (95% CI: -0.05-0.04) at the 25th percentile to 0.06 (95% CI: 0.01-0.12) and 0.04 (95% CI: -0.001, 0.09) at the 75th percentile. Additionally, there was evidence of an interaction between O3 and PM10. This study confirms that exposure to multiple pollutants is a significant public health problem facing the Hangzhou population given the compounded effect proven with regression analysis, while furthermore, the control of PM2.5 and SO2 also represents a serious concern.Implications: Evidence indicates interactions between O3 and PM10. This study demonstrates that exposure to multiple pollutants exerts combined effects on the public health of the Hangzhou population, highlighting the importance of controlling PM2.5 and SO2.

Associations between ambient air pollutants and blood pressure among children and adolescents: A systemic review and meta-analysis.

OBJECTIVE: Numerous epidemiological studies have investigated the effects of short-term and long-term exposure to ambient air pollution on hypertension and blood pressure among children and adolescents. However, the results were controversial. To provide researchers reliable evidence, this meta-analysis was performed. METHODS: We searched all published studies in four databases examining the effects of particulate matter (PM10, PM2.5 and PM1.0), nitrogen oxide (NO2), sulfur dioxide (SO2), ozone (O3) and carbon monoxide (CO) on hypertension and blood pressure in children and adolescents. Overall risk estimates associated with per 10 µg/m3 increase of air pollution were analyzed by a random-effect model for articles with significant heterogeneity, otherwise, a fixed-effect model was applied. Subgroup analysis was conducted for studies with significant heterogeneity. RESULTS: Of 3918 identified literatures, 154 were evaluated in-depth with 15 satisfying inclusion criteria. Increased risk of hypertension was associated with long-term PM10 exposure (OR = 1.17, 95% confidence interval [CI]:1.13, 1.21). For systolic blood pressure (SBP), significant results were found for short-term PM10 (ß = 0.26, 95% CI: -0.00, 0.53) exposure, long-term PM2.5 (ß = 1.80, 95% CI: 0.94, 2.65) and PM10 (ß = 0.50, 95% CI: 0.19, 0.81) exposure. The corresponding estimates of diastolic blood pressure (DBP) were 0.32 mmHg (95% CI: 0.19, 0.45) for short-term PM10 exposure, 1.06 mmHg (95% CI: 0.32, 1.80), 0.34 mmHg (95% CI: 0.11, 0.57) and 0.44 mmHg (95% CI: 0.25, 0.63) for long-term PM2.5, PM10 and NO2 exposure, respectively. Stratified analyses showed stronger effects of PM10 on blood pressure among studies with ≥50% boys' percentage (0.57 mmHg [95% CI: 0.44, 0.70] for SBP, 0.44 mmHg, [95% CI: 0.34, 0.54] for DBP, respectively) and articles using models to estimate exposure (0.90 mmHg [95% CI: 0.20 1.59] for SBP). CONCLUSION: Ambient air pollution was associated with higher hypertension prevalence and elevated blood pressure in children and adolescents.

Long-term exposure to high particulate matter pollution and incident hypertension: a 12-year cohort study in northern China.

Numerous cohort studies have reported the association of long-term exposure to particulate matter <10 µm in diameter (PM10) and hypertension in American and European countries. However, these results have been inconsistent and subject to various confounding factors. The study aimed to explore the effect of long-term exposure to high-level concentrations of PM10 on incident hypertension in a large-scale cohort from northern China. A retrospective cohort study of 39,054 participants aged between 23 and 98 years old from four cities in northern China was followed from 1998 to 2009. Excluding those with hypertension, 37,386 non-hypertensive participants (overall population) were followed for self-reported hypertension. The individuals' exposure to PM10 was the mean concentration during the follow-up period, according to the data of local environmental monitoring centers. Hazard ratios (HRs) were calculated by Cox proportional hazards models. The adjusted potential confounding factors included sociodemographic information, lifestyle, and diet. There were 2619 (7.0%) incident cases of hypertension among the overall population. In multivariable models, the HR (95% CI) of incident hypertension was 1.537 (1.515, 1.560) for each 10 µg/m3 increase in PM10. Stratified analyses showed individuals (age <65) were prone to developing hypertension. Moreover, the effects of PM10 increased and produced an HR (95% CI) of 1.555 (1.527, 1.584) for the healthy population in the sensitivity analysis. We found that the association between long-term exposure to PM10 air pollution and incident hypertension was significantly positive.

Association between long-term exposure to Sulfur dioxide pollution and hypertension incidence in northern China: a 12-year cohort study.

Several studies have researched the short-term effect of sulfur dioxide (SO2) exposure on hypertension. However, no evidence has provided the relationship between long-term high pollution exposure of SO2 and morbidity of hypertension in cohort studies in China. This retrospective cohort study aimed to evaluate this association. We used Cox proportional hazards regression models to examine the hazard ratios (HR) for hypertension risks from 1998 to 2009 associated with accumulative exposure of air SO2 among adults in northern China. Annual average concentrations of sulfur dioxide (SO2) were obtained from 15 local environmental monitoring centers. Hypertension was identified according to self-reported diagnostic time and treatment for hypertension with anti-hypertensive medication. Among 37,386 participants, 2619 new cases of hypertension were identified during 426,334 person-years. In the fully adjusted model, HR and 95% confidence interval (CI) of hypertension incidence for each 10 µg/m3 increase in SO2 were 1.176 (1.163 and 1.189). Results from stratified analyses suggested that effects of SO2 on hypertension morbidity were more pronounced in participants < 60 years old, tea drinkers, and those with high education, high poultry consumption, and active (occasional and frequent) exercise. We found that long-term exposure to high levels of SO2 increased the risk of incidence of hypertension in China.