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Lu J, Liang J, Yang J, Mischoulon D, Nyer M. Does the association between Herpes Simplex 2 infection and depressive symptoms vary among different sexual minority statuses and sex groups? Findings from a nationally representative sample. J Affect Disord 2023; 327:226-229. [PMID: 36623565 DOI: 10.1016/j.jad.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/18/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Herpes Simplex Virus Type 2 (HSV-2) has been associated with depression, but the relationship has yet to be explored with respect to gender and sexual orientation in a nationally representative sample to help identify individuals at higher risk for depression. METHODS A dataset from National Health and Nutrition Examination Survey 2009-2014 was used in this study. Multivariable logistic regression models were constructed to test effect modification on both the multiplicative and additive scale using a sample of 57,684 subjects. RESULTS Effect modification by sexual minority status was not significant on either the multiplicative scale (Ratio of ORs: 0.74, 95 % CI: 0.37-1.50, p = 0.395) or the additive scale (RERI: -0.22, 95%CI: -2.27-1.84, p = 0.833). Meanwhile, biological sex assigned at birth was a significant modifier only on the additive scale (RERI: 0.82, 95 % CI: 0.004-1.64, P = 0.049). Specifically, females (OR: 1.43, 95 % CI: 1.03-1.97, P = 0.032) had greater odds of having depressive symptoms compared with males (OR: 1.20, 95 % CI: 0.69-2.08, p = 0.509) after the HSV-2 infection. LIMITATIONS The analysis was based on a cross-sectional study; further investigation using longitudinal datasets might be beneficial. CONCLUSIONS Sexual minority status did not modify the association between HSV-2 infection and having depressive symptoms. However, biological sex assigned at birth was a modifier only on the additive but not the multiplicative scale. Health workers should be alert for depression symptoms in females with HSV-2 infection.
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Affiliation(s)
- Junjie Lu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, United States of America
| | - Jingyang Liang
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, United States of America
| | - Jiarui Yang
- Department of Radiology, Massachusetts General Hospital, United States of America
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, United States of America; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, United States of America
| | - Maren Nyer
- Depression Clinical and Research Program, Massachusetts General Hospital, United States of America; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, United States of America.
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Zhang Y, Wang Y, Du Z, Chen S, Qu Y, Hao C, Ju X, Lin Z, Wu W, Xiao J, Chen X, Lin X, Chen S, Chen L, Jiang J, Zhang W, Hao Y. Potential causal links between long-term ambient particulate matter exposure and cardiovascular mortality: New evidence from a large community-based cohort in South China. Ecotoxicol Environ Saf 2023; 254:114730. [PMID: 36905844 DOI: 10.1016/j.ecoenv.2023.114730] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) mortality is associated with long-term particulate matter (PM) exposure. However, evidence from large, highly-exposed population cohort and observational-data-based causal inference approaches remains limited. AIMS We examined the potential causal links between PM exposure and the CVD mortality in South China. METHODS 580,757 participants were recruited during 2009-2015 and followed up through 2020. Satellite-based annual concentrations of PM2.5, PM10, and PMcoarse (i.e., PM10 - PM2.5) at 1 km2 spatial resolution were estimated and assigned to each participant. Marginal structural Cox models with time-varying covariates, adjusted using inverse probability weighting, were developed to evaluate the association between prolonged PM exposure and CVD mortality. RESULTS For overall CVD mortality, the hazard ratios and 95% confidence interval for each 1 μg/m3 increase in the annual average concentration of PM2.5, PM10, and PMcoarse were 1.033 (1.028-1.037), 1.028 (1.024-1.032), and 1.022 (1.012-1.033), respectively. All three PMs were linked to a higher mortality risk for myocardial infarction and ischemic heart disease (IHD). The mortality risk of chronic IHD and hypertension was linked to PM2.5 and PM10. Significant association between PMcoarse and other heart disease mortality was also observed. The older, women, less-educated participants, or inactive participants exhibited particularly higher susceptibility. Participants who were generally exposed to PM10 concentrations below 70 μg/m3 were more vulnerable to PM2.5-, PM10- and PMcoarse-CVD mortality risks. CONCLUSION This large cohort study provides evidence for the potential causal links between increased CVD mortality and ambient PM exposure, as well as socio-demographics linked to the highest vulnerability.
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Affiliation(s)
- Yuqin Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Ying Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Shirui Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yanji Qu
- Global Health Research Center, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, China
| | - Chun Hao
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xu Ju
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Ziqiang Lin
- Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xiuyuan Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xiao Lin
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Shimin Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Lichang Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Jie Jiang
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China.
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China.
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Rai M, Stafoggia M, de'Donato F, Scortichini M, Zafeiratou S, Vazquez Fernandez L, Zhang S, Katsouyanni K, Samoli E, Rao S, Lavigne E, Guo Y, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Maasikmets M, Jaakkola JJK, Ryti N, Pascal M, Hashizume M, Fook Sheng Ng C, Alahmad B, Hurtado Diaz M, De la Cruz Valencia C, Nunes B, Madureira J, Scovronick N, Garland RM, Kim H, Lee W, Tobias A, Íñiguez C, Forsberg B, Åström C, Maria Vicedo-Cabrera A, Ragettli MS, Leon Guo YL, Pan SC, Li S, Gasparrini A, Sera F, Masselot P, Schwartz J, Zanobetti A, Bell ML, Schneider A, Breitner S. Heat-related cardiorespiratory mortality: Effect modification by air pollution across 482 cities from 24 countries. Environ Int 2023; 174:107825. [PMID: 36934570 DOI: 10.1016/j.envint.2023.107825] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence on the potential interactive effects of heat and ambient air pollution on cause-specific mortality is inconclusive and limited to selected locations. OBJECTIVES We investigated the effects of heat on cardiovascular and respiratory mortality and its modification by air pollution during summer months (six consecutive hottest months) in 482 locations across 24 countries. METHODS Location-specific daily death counts and exposure data (e.g., particulate matter with diameters ≤ 2.5 µm [PM2.5]) were obtained from 2000 to 2018. We used location-specific confounder-adjusted Quasi-Poisson regression with a tensor product between air temperature and the air pollutant. We extracted heat effects at low, medium, and high levels of pollutants, defined as the 5th, 50th, and 95th percentile of the location-specific pollutant concentrations. Country-specific and overall estimates were derived using a random-effects multilevel meta-analytical model. RESULTS Heat was associated with increased cardiorespiratory mortality. Moreover, the heat effects were modified by elevated levels of all air pollutants in most locations, with stronger effects for respiratory than cardiovascular mortality. For example, the percent increase in respiratory mortality per increase in the 2-day average summer temperature from the 75th to the 99th percentile was 7.7% (95% Confidence Interval [CI] 7.6-7.7), 11.3% (95%CI 11.2-11.3), and 14.3% (95% CI 14.1-14.5) at low, medium, and high levels of PM2.5, respectively. Similarly, cardiovascular mortality increased by 1.6 (95%CI 1.5-1.6), 5.1 (95%CI 5.1-5.2), and 8.7 (95%CI 8.7-8.8) at low, medium, and high levels of O3, respectively. DISCUSSION We observed considerable modification of the heat effects on cardiovascular and respiratory mortality by elevated levels of air pollutants. Therefore, mitigation measures following the new WHO Air Quality Guidelines are crucial to enhance better health and promote sustainable development.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesca de'Donato
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | | | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | - Shilpa Rao
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada and Environmental Health Science & Research Bureau, Health Canada, Ottawa, Canada
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | | | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - César De la Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Baltazar Nunes
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
| | - Noah Scovronick
- Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, USA
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Carmen Íñiguez
- Department of Statistics and Computational Research. Universitat de València, València, Spain
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | | | | | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, and Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Pierre Masselot
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven CT, USA
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
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Yang T, Gu T, Xu Z, He T, Li G, Huang J. Associations of residential green space with incident type 2 diabetes and the role of air pollution: A prospective analysis in UK Biobank. Sci Total Environ 2023; 866:161396. [PMID: 36608823 DOI: 10.1016/j.scitotenv.2023.161396] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/20/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Green space is a newly modifiable environmental factor which would bring health benefits, and identifying potential pathways is important to better promote public health. Nowadays, limited evidence is available on residential green space and risk of incident type 2 diabetes (T2D). To evaluate the longitudinal association between residential green space and incident T2D, and further illustrate the role of air pollution, we conducted a prospective analysis in UK Biobank. METHODS Incident cases of T2D were ascertained through medical linkage of hospital admissions. Residential green space indicated by percentage of green space at 300 m buffer was estimated using land use data. Annual average air pollution was modelled using Land Use Regression model. Cox proportional hazard regression models were used to determine the association between the exposure and incident T2D. Effect modification of air pollution was assessed using log-likelihood tests. Casual mediation analysis including interaction of green space and air pollution was used to quantity pure natural indirect effect of air pollution. RESULTS Of 379,238 participants at baseline, 15564 incident T2D cases were identified with 12.4 years of follow-up. In main models, individuals who exposed to residential green space at 300 m buffer in high level (≥75 %) had 14.4 % (95 % CI: 8.0 %, 20.3 %) lower risk of incident T2D compared with those in low level (<25 %). This association was modified by NO2, with green space indicating higher protective effect in low NO2 level (Pinteraction = 0.098). PM2.5 had a high mediation effect of 37.0 % in the association. CONCLUSION Elevated residential green space level was associated with lower risk of incident T2D, and air pollution played an important role in this association. These findings would contribute to policy making and healthy city construction to take air pollution into consideration while planning green space, which would maximize public health benefits.
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Affiliation(s)
- Teng Yang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - Tiantian Gu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - Tianfeng He
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China; Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China; Environmental Research Group, School of Public Health, Imperial College London, Sir Michael Uren Building, White City Campus, 80-92 Wood Lane, London W12 0BZ, United Kingdom.
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China; Institute for Global Health and Development, Peking University, Beijing 100871, China.
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Phosri A, Ueda K, Seposo X, Honda A, Takano H. Effect modification by temperature on the association between O 3 and emergency ambulance dispatches in Japan: A multi-city study. Sci Total Environ 2023; 861:160725. [PMID: 36493818 DOI: 10.1016/j.scitotenv.2022.160725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/18/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Numerous epidemiological studies have reported that ozone (O3) and temperature are independently associated with health outcomes, but modification of the effects of O3 on health outcomes by temperature, and vice versa, has not been fully described. This study aimed to investigate effect modification by temperature on the association between O3 and emergency ambulance dispatches (EADs) in Japan. Data on daily air pollutants, ambient temperature, and EADs were obtained from eight Japanese cities from 2007 to 2015. A distributed lag non-linear model combined with Poisson regression was performed with temperature as a confounding factor and effect modifier to estimate the effects of O3 on EADs at low (<25th percentile), moderate (25th-75th percentile), and high (>75th percentile) temperature for each city. The estimates obtained from each city were pooled by random-effects meta-analysis. When temperature was entered as a confounder, the estimated effects of O3 on EADs for all acute, cardiovascular, and respiratory illnesses were largest at lag 0 (current-day lag). Therefore, this lag was used to further estimate the effects of O3 on EADs in each temperature category. The estimated effects of O3 on EADs for all acute, cardiovascular, and respiratory illnesses in all eight Japanese cities increased with increasing temperature. Specifically, a 10 ppb increase in O3 was associated with 0.80 % (95 % CI: 0.25 to 1.35), 0.19 % (95 % CI: -0.85 to 1.25), and 1.14 % (95 % CI: -0.01 to 2.31) increases in the risk of EADs for all acute, cardiovascular, and respiratory illnesses, respectively, when city-specific daily temperature exceeded the 75th percentile. Our findings suggest that the association between O3 and EADs for all acute, cardiovascular, and respiratory illnesses is the highest during high temperature. Finding of this study can be used to develop potential mitigation measures against O3 exposure in high temperature environment to reduce its associated adverse health effects.
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Affiliation(s)
- Arthit Phosri
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), OPS, Ministry of Higher Education, Science, Research and Innovation, Bangkok, Thailand.
| | - Kayo Ueda
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Department of Hygiene, Social Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan
| | - Xerxes Seposo
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Department of Hygiene, Social Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Akiko Honda
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan
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Lavigne E, Maltby A, Côté JN, Weinberger KR, Hebbern C, Vicedo-Cabrera AM, Wilk P. The effect modification of extreme temperatures on mental and behavior disorders by environmental factors and individual-level characteristics in Canada. Environ Res 2023; 219:114999. [PMID: 36565843 DOI: 10.1016/j.envres.2022.114999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/17/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Ambient extreme temperatures have been associated with mental and behavior disorders (MBDs). However, few studies have assesed whether vulnerability factors such as ambient air pollution, pre-existing mental health conditions and residential environmental factors increase susceptibility. This study aims to evaluate the associations between short-term variations in outdoor ambient extreme temperatures and MBD-related emergency department (ED) visits and how these associations are modified by vulnerability factors. METHODS We conducted a case-crossover study of 9,958,759 MBD ED visits in Alberta and Ontario, Canada made between March 1st, 2004 and December 31st, 2020. Daily average temperature was assigned to individual cases with ED visits for MBD using gridded data at a 1 km × 1 km spatial resolution. Conditional logistic regression was used to estimate associations between extreme temperatures (i.e., risk of ED visit at the 2.5th percentile temperature for cold and 97.5th percentile temperature for heat for each health region compared to the minimal temperature risk) and MBD ED visits. Age, sex, pre-existing mental health conditions, ambient air pollution (i.e. PM2.5, NO2 and O3) and residential environmental factors (neighborhood deprivation, residential green space exposure and urbanization) were evaluated as potential effect modifiers. RESULTS Cumulative exposure to extreme heat over 0-5 days (odds ratio [OR] = 1.145; 95% CI: 1.121-1.171) was associated with ED visits for any MBD. However, cumulative exposure to extreme cold was associated with lower risk of ED visits for any MBD (OR = 0.981; 95% CI: 0.976-0.987). We also found heat to be associated with ED visits for specific MBDs such as substance use disorders, dementia, neurotic disorders, schizophrenia and personality behavior disorder. Individuals with pre-existing mental health conditions, those exposed to higher daily concentrations of NO2 and O3 and those residing in neighborhoods with greater material and social deprivation were at higher risk of heat-related MBD ED visits. Increasing tree canopy coverage appeared to mitigate risks of the effect of heat on MBD ED visits. CONCLUSIONS Findings provide evidence that the impacts of heat on MBD ED visits may vary across different vulnerability factors.
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Affiliation(s)
- Eric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada.
| | - Alana Maltby
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jean-Nicolas Côté
- Department of Applied Geomatics, Sherbrooke University, Sherbrooke, Quebec, Canada
| | - Kate R Weinberger
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Yu Z, Feng Y, Chen Y, Zhang X, Zhao X, Chang H, Zhang J, Gao Z, Zhang H, Huang C. Green space, air pollution and gestational diabetes mellitus: A retrospective cohort study in central China. Ecotoxicol Environ Saf 2023; 249:114457. [PMID: 38321676 DOI: 10.1016/j.ecoenv.2022.114457] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 02/08/2024]
Abstract
Emerging evidence suggests residential surrounding green space is beneficial for human health. The association between green space and GDM showed inconsistent results, and potential effect modification of green space with air pollution is still unclear. This study aims to evaluate the association between green space and GDM, and further explore potential interaction and medication effects. Participants were recruited from a retrospective cohort study between 2015 and 2020 in Henan, China. Residential green space based on normalized difference vegetation index (NDVI) and air pollution exposure were estimated using spatial-statistical models. Multivariate logistic regression was applied to evaluate the association between per 0.1 unit increase in NDVI with 4 buffer sizes (250 m, 500 m, 1000 m, 2000 m) and GDM. We examined potential interaction of green space and air pollutants on GDM. Mediating effects of air pollution associated with green space exposure on GDM were also investigated by causal mediation analyses. A total of 46,665 eligible pregnant women were identified. There were 4092 (8.8 %) women diagnosed with GDM according to the IADPSG criteria. We found that per 0.1-unit increment in NDVI250 m, NDVI500 m, NDVI1000 m and NDVI2000 m in second trimester were associated with the decreased risk of GDM, with adjusted OR of 0.921(95 %CI: 0.890-0.953), 0.922 (95 %CI: 0.891-0.953), 0.921 (95 %CI: 0.892-0.952) and 0.921 (95 %CI: 0.892-0.951), respectively. We identified significant interactions between second trimester PM2.5 and O3 exposure and NDVI for GDM (Pinteraction < 0.001). The causal mediation analysis showed that PM2.5 mediated approximately 2.5-5.5 % of the association between green space and GDM, while the estimated mediating effect of O3 was approximately 30.1-38.5 %. In conclusion, our study indicates that residential green space was associated with a reduced risk of GDM, particularly second trimester. Green space may benefit to GDM partly mediated by a reduction in PM2.5 and O3.
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Affiliation(s)
- Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China; NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Yang Feng
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yao Chen
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoan Zhang
- The Third Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- The Third Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Chang
- The Third Hospital of Zhengzhou University, Zhengzhou, China
| | - Junxi Zhang
- NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Zhan Gao
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China.
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Kang N, Song X, Zhang C, Li R, Yuchi Y, Liao W, Hou X, Liu X, Mao Z, Huo W, Hou J, Wang C. Association of household air pollution with glucose homeostasis markers in Chinese rural women: Effect modification of socioeconomic status. Ecotoxicol Environ Saf 2022; 248:114283. [PMID: 36371884 DOI: 10.1016/j.ecoenv.2022.114283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Socioeconomic status (SES) was a crucial influencing factor of household air pollution (HAP). However, few studies have explored the potential effect modification of SES on the associations of HAP with type 2 diabetes mellitus (T2DM) and glucose homeostasis. METHODS A total of 20900 participants were obtained from the Henan Rural Cohort. HAP reflected by cooking fuel type and cooking duration was assessed via questionnaire. SES was evaluated by two dimensions: educational level and average monthly income. Associations of cooking fuel type, cooking duration with T2DM and glucose homeostasis indices (insulin, fasting plasma glucose (FPG), and HOMA-β) were assessed by the generalized linear model. Analyses were also conducted in different SES groups to explore the potential effect modification. RESULTS Significant negative association of cooking fuel type and cooking duration with T2DM, FPG, and HOMA-β was not observed. However, cooking with solid fuel and long-duration cooking were associated with decreased insulin level in women, and the adjusted coefficients were - 0.35 (95% confidence interval (95% CI): - 0.53, - 0.17) and - 0.36 (95% CI: -0.50, -0.21), respectively. Results from stratified analyses showed that these associations were more prominent in women with low average monthly income, with corresponding coefficient of - 0.57 (95% CI: -0.77, -0.37) for cooking with solid fuel and - 0.34 (95% CI: -0.52, -0.16) for long-duration cooking. Among women with low average monthly income, the largest decreased insulin level was observed in those who cooked with solid fuel, long-duration and poor kitchen ventilation, while the negative association of cooking fuel type and cooking duration with insulin level was slightly alleviated in the good kitchen ventilation group. CONCLUSIONS Low average monthly income aggravated the negative association of HAP and insulin level among rural women, while improving kitchen ventilation may be a practical intervention. TRAIL REGISTRATION The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375.
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Affiliation(s)
- Ning Kang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoqin Song
- Physical Examination Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Caiyun Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yinghao Yuchi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoyu Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Demoury C, De Troeyer K, Berete F, Aerts R, Van Schaeybroeck B, Van der Heyden J, De Clercq EM. Association between temperature and natural mortality in Belgium: Effect modification by individual characteristics and residential environment. Sci Total Environ 2022; 851:158336. [PMID: 36037893 DOI: 10.1016/j.scitotenv.2022.158336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/12/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is strong evidence of mortality being associated to extreme temperatures but the extent to which individual or residential factors modulate this temperature vulnerability is less clear. METHODS We conducted a multi-city study with a time-stratified case-crossover design and used conditional logistic regression to examine the association between extreme temperatures and overall natural and cause-specific mortality. City-specific estimates were pooled using a random-effect meta-analysis to describe the global association. Cold and heat effects were assessed by comparing the mortality risks corresponding to the 2.5th and 97.5th percentiles of the daily temperature, respectively, with the minimum mortality temperature. For cold, we cumulated the risk over lags of 0 to 28 days before death and 0 to 7 days for heat. We carried out stratified analyses and assessed effect modification by individual characteristics, preexisting chronic health conditions and residential environment (population density, built-up area and air pollutants: PM2.5, NO2, O3 and black carbon) to identify more vulnerable population subgroups. RESULTS Based on 307,859 deaths from natural causes, we found significant cold effect (OR = 1.42, 95%CI: 1.30-1.57) and heat effect (OR = 1.17, 95%CI: 1.12-1.21) for overall natural mortality and for respiratory causes in particular. There were significant effects modifications for some health conditions: people with asthma were at higher risk for cold, and people with psychoses for heat. In addition, people with long or frequent hospital admissions in the year preceding death were at lower risk. Despite large uncertainties, there was suggestion of effect modification by air pollutants: the effect of heat was higher on more polluted days of O3 and black carbon, and a higher cold effect was observed on more polluted days of PM2.5 and NO2 while for O3, the effect was lower. CONCLUSIONS These findings allow for targeted planning of public-health measures aiming to prevent the effects of extreme temperatures.
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Affiliation(s)
- Claire Demoury
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium.
| | | | - Finaba Berete
- Lifestyle and Chronic Diseases, Sciensano, Brussels, Belgium
| | - Raf Aerts
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium; Division Ecology, Evolution and Biodiversity Conservation, KU Leuven, Leuven, Belgium; Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - Bert Van Schaeybroeck
- Department of Meteorological Research and Development, Royal Meteorological Institute of Belgium, Brussels, Belgium
| | | | - Eva M De Clercq
- Risk and Health Impact Assessment, Sciensano, Brussels, Belgium
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Chandia-Poblete D, Cole-Hunter T, Haswell M, Heesch KC. The influence of air pollution exposure on the short- and long-term health benefits associated with active mobility: A systematic review. Sci Total Environ 2022; 850:157978. [PMID: 35964755 DOI: 10.1016/j.scitotenv.2022.157978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Active mobility (AM), defined as walking and cycling for transportation, can improve health through increasing regular physical activity. However, these health improvements could be outweighed by harm from inhaling traffic-related air pollutants during AM participation. The interaction of AM and air pollutants on health is complex physiologically, manifesting as acute changes in health indicators that may lead to poor long-term health consequences. The aim of this study was to systematically review the current evidence of effect modification by air pollution (AP) on associations between AM and health indicators. Studies were included if they examined associations between AM and health indicators being modified by AP or, conversely, associations between AP and health indicators being modified by AM. Thirty-three studies met eligibility criteria. The main AP indicators studied were particulate matter, ultrafine particles, and nitrogen oxides. Most health indicators studied were grouped into cardiovascular and respiratory indicators. There is evidence of a reduction by AP, mainly ultrafine particles and PM2.5, in the short-term health benefits of AM. Multiple studies suggest that long-term health benefits of AM are not negatively associated with levels of the single traffic-related pollutant NO2. However, other studies reveal reduced long-term health benefits of AM in areas affected by high levels of pollutant mixtures. We recommend that future studies adopt consistent and rigorous study designs and include reporting of interaction testing, to advance understanding of the complex relationships between AM, AP, and health indicators.
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Affiliation(s)
- Damian Chandia-Poblete
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia.
| | - Thomas Cole-Hunter
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Melissa Haswell
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia; Office of the Deputy Vice Chancellor (Indigenous Strategy and Services) and School of Geosciences, Faculty of Science, University of Sydney, Australia.
| | - Kristiann C Heesch
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia.
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Rundle AG, Bader MDM, Branas CC, Lovasi GS, Mooney SJ, Morrison CN, Neckerman KM. Causal Inference with Case-Only Studies in Injury Epidemiology Research. CURR EPIDEMIOL REP 2022; 9:223-232. [PMID: 37152190 PMCID: PMC10161782 DOI: 10.1007/s40471-022-00306-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/03/2022]
Abstract
Purpose of Review We review the application and limitations of two implementations of the "case-only design" in injury epidemiology with example analyses of Fatality Analysis Reporting System data. Recent Findings The term "case-only design" covers a variety of epidemiologic designs; here, two implementations of the design are reviewed: (1) studies to uncover etiological heterogeneity and (2) studies to measure exposure effect modification. These two designs produce results that require different interpretations and rely upon different assumptions. The key assumption of case-only designs for exposure effect modification, the more commonly used of the two designs, does not commonly hold for injuries and so results from studies using this design cannot be interpreted. Case-only designs to identify etiological heterogeneity in injury risk are interpretable but only when the case-series is conceptualized as arising from an underlying cohort. Summary The results of studies using case-only designs are commonly misinterpreted in the injury literature.
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Affiliation(s)
- Andrew G. Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 727, New York, NY 10032, USA
| | | | - Charles C. Branas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 727, New York, NY 10032, USA
| | - Gina S. Lovasi
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, USA
| | - Stephen J. Mooney
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Christopher N. Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 727, New York, NY 10032, USA
| | - Kathryn M. Neckerman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 727, New York, NY 10032, USA
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Xiao Y, Ran H, Fang D, Che Y, Peng J, Sun H, Liang X, Chen L, Wang S, Lu J. Childhood maltreatment and depressive disorders in Chinese children and adolescents: A population-based case-control study. Asian J Psychiatr 2022; 78:103312. [PMID: 36335843 DOI: 10.1016/j.ajp.2022.103312] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/14/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The association between childhood maltreatment (CM) and clinically diagnosed depressive disorders (DD) in children and adolescents remains inconclusive, in large part due to a lack of high-quality epidemiological evidence. This study aimed to investigate the association between CM and DD in a large sample of Chinese children and adolescents. METHODS The study subjects were chosen from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), and a population-based and individually-matched case-control study design was adopted. RESULTS CM was in general associated with an odds ratio (OR) of 5.38 (95% CI: 3.33, 8.71) for DD in children and adolescents, and a prominent dose-response association was detected. For the five specific types of CM, emotional abuse was independently related to the highest odds of DD (OR=3.90, 95% CI: 2.75, 5.54), followed by physical neglect (OR=2.04, 95% CI: 1.45, 2.87) and physical abuse (OR=1.51, 95% CI: 1.06, 2.13), while insignificant associations were found between DDs and sexual abuse and emotional neglect. Subsequently performed stratified analyses identified noticeable effect modification by important demographic factors. CONCLUSION CM was significantly associated with increased risk of DD in Chinese children and adolescents. The major findings of the current study suggest that victims of CM, especially those who had been emotionally abused, were susceptible to early-onset DD. Targeted interventions should be considered.
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Affiliation(s)
- Yuanyuan Xiao
- Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Hailiang Ran
- Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Die Fang
- Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yusan Che
- Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Junwei Peng
- Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Hao Sun
- Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Xuemeng Liang
- Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Lin Chen
- Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Sifan Wang
- Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Jin Lu
- Psychiatry Department, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China; Mental Health Institute of Yunnan, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China; Yunnan Clinical Research Center for Mental Health, Kunming, Yunnan, China.
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Shiba K, Kubzansky LD, Williams DR, VanderWeele TJ, Kim ES. Purpose in life and 8-year mortality by gender and race/ethnicity among older adults in the U.S. Prev Med 2022; 164:107310. [PMID: 36283485 DOI: 10.1016/j.ypmed.2022.107310] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 10/31/2022]
Abstract
We examined the associations between a sense of purpose and all-cause mortality by gender and race/ethnicity groups. Data were from the Health and Retirement Study, a nationally representative cohort study of U.S. adults aged >50 (n = 13,159). Sense of purpose was self-reported at baseline (2006/2008), and risk of all-cause mortality was assessed over an 8-year follow-up period. We also formally tested for potential effect modification by gender and race/ethnicity. We observed the associations between higher purpose and lower all-cause mortality risk across all gender and race/ethnicity groups. There was modest evidence that the highest level of purpose (versus lowest quartile) was associated with even lower risk of all-cause mortality among women (risk ratio = 0.66, 95% confidence interval: 0.56, 0.77) compared to men (risk ratio = 0.80, 95% confidence interval: 0.69, 0.93; p-value for multiplicative effect modification =0.07). However, we observed no evidence of effect modification by race/ethnicity. Having a higher sense of purpose appears protective against all-cause mortality regardless of gender and race/ethnicity. Purpose, a potentially modifiable factor, might be a health asset across diverse populations.
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Affiliation(s)
- Koichiro Shiba
- Department of Epidemiology, Boston University School of Public Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Human Flourishing Program, University of British Columbia, Vancouver, Canada.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Lee Kum Sheung Center for Health and Happiness, University of British Columbia, Vancouver, Canada
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Sociology, University of British Columbia, Vancouver, Canada
| | - Tyler J VanderWeele
- Harvard University, Cambridge, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Biostatistics, Human Flourishing Program, University of British Columbia, Vancouver, Canada
| | - Eric S Kim
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Lee Kum Sheung Center for Health and Happiness, Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA; Department of Psychology, University of British Columbia, Vancouver, Canada
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马 麟, 吴 静, 李 双, 李 鹏, 张 路. [Effect of modification of antihypertensive medications on the association of nitrogen dioxide long-term exposure and chronic kidney disease]. Beijing Da Xue Xue Bao Yi Xue Ban 2022; 54:1047-1055. [PMID: 36241250 PMCID: PMC9568383 DOI: 10.19723/j.issn.1671-167x.2022.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To investigate the potential effect of modification of antihypertensive medications on the association of nitrogen dioxide (NO2) long-term exposure and chronic kidney disease (CKD). METHODS Data of the national representative sample of adult population from the China National Survey of Chronic Kidney Disease (2007-2010) were included in the analyses, and exposure data of NO2 were collected and matched. Generalized mixed-effects models were used to analyze the associations between NO2 and CKD, stratified by the presence of hypertension and taking antihypertensive medications. The stratified exposure-response curves of NO2 and CKD were fitted using the natural spine smoothing function. The modifying effects of antihypertensive medications on the association and the exposure-response curve of NO2 and CKD were analyzed. RESULTS Data of 45 136 participants were included, with an average age of (49.5±15.3) years. The annual average exposure concentration of NO2 was (7.2±6.4) μg/m3. Altogether 6 517 (14.4%) participants were taking antihypertensive medications, and 4 833 (10.7%) participants were identified as having CKD. After adjustment for potential confounders, in the hypertension population not using antihypertensive medications, long-term exposure to NO2 was associated with a significant increase risk of CKD (OR: 1.38, 95%CI: 1.24-1.54, P < 0.001); while in the hypertension population using antihypertensive medications, no significant association between long-term exposure to NO2 and CKD (OR: 0.96, 95%CI: 0.86-1.07, P=0.431) was observed. The exposure-response curve of NO2 and CKD suggested that there was a non-linear trend in the association between NO2 and CKD. The antihypertension medications showed significant modifying effects both on the association and the exposure-response curve of NO2 and CKD (interaction P < 0.001). CONCLUSION The association between long-term exposure to NO2 and CKD was modified by antihypertensive medications. Taking antihypertensive medications may mitigate the effect of long-term exposure to NO2 on CKD.
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Affiliation(s)
- 麟 马
- 北京大学医学部学科建设办公室, 北京 100191Office of Development Planning and Academic Development, Peking University, Beijing 100191, China
| | - 静依 吴
- 浙江省北大信息技术高等研究院, 杭州 311215Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - 双成 李
- 北京大学地表过程分析与模拟教育部重点实验室, 北京大学城市与环境学院, 北京 100871Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - 鹏飞 李
- 浙江省北大信息技术高等研究院, 杭州 311215Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
- 北京大学健康医疗大数据国家研究院, 北京 100191National Institute of Health Data Science, Peking University, Beijing 100191, China
| | - 路霞 张
- 浙江省北大信息技术高等研究院, 杭州 311215Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
- 北京大学健康医疗大数据国家研究院, 北京 100191National Institute of Health Data Science, Peking University, Beijing 100191, China
- 北京大学第一医院肾内科, 北京大学肾脏病研究所, 北京 100034Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China
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Choi HM, Lee W, Roye D, Heo S, Urban A, Entezari A, Vicedo-Cabrera AM, Zanobetti A, Gasparrini A, Analitis A, Tobias A, Armstrong B, Forsberg B, Íñiguez C, Åström C, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, Sera F, Orru H, Kim H, Kyselý J, Madueira J, Schwartz J, Jaakkola JJK, Katsouyanni K, Diaz MH, Ragettli MS, Pascal M, Ryti N, Scovronick N, Osorio S, Tong S, Seposo X, Guo YL, Guo Y, Bell ML. Effect modification of greenness on the association between heat and mortality: A multi-city multi-country study. EBioMedicine 2022; 84:104251. [PMID: 36088684 PMCID: PMC9471476 DOI: 10.1016/j.ebiom.2022.104251] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/29/2022] [Accepted: 08/17/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortality relationship among different greenspace levels in a global setting. METHODS We collected daily ambient temperature and mortality data for 452 locations in 24 countries and used Enhanced Vegetation Index (EVI) as the greenspace measurement. We used distributed lag non-linear model to estimate the heat-mortality relationship in each city and the estimates were pooled adjusting for city-specific average temperature, city-specific temperature range, city-specific population density, and gross domestic product (GDP). The effect modification of greenspace was evaluated by comparing the heat-related mortality risk for different greenspace groups (low, medium, and high), which were divided into terciles among 452 locations. FINDINGS Cities with high greenspace value had the lowest heat-mortality relative risk of 1·19 (95% CI: 1·13, 1·25), while the heat-related relative risk was 1·46 (95% CI: 1·31, 1·62) for cities with low greenspace when comparing the 99th temperature and the minimum mortality temperature. A 20% increase of greenspace is associated with a 9·02% (95% CI: 8·88, 9·16) decrease in the heat-related attributable fraction, and if this association is causal (which is not within the scope of this study to assess), such a reduction could save approximately 933 excess deaths per year in 24 countries. INTERPRETATION Our findings can inform communities on the potential health benefits of greenspaces in the urban environment and mitigation measures regarding the impacts of climate change. FUNDING This publication was developed under Assistance Agreement No. RD83587101 awarded by the U.S. Environmental Protection Agency to Yale University. It has not been formally reviewed by EPA. The views expressed in this document are solely those of the authors and do not necessarily reflect those of the Agency. EPA does not endorse any products or commercial services mentioned in this publication. Research reported in this publication was also supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD012769. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Also, this work has been supported by the National Research Foundation of Korea (2021R1A6A3A03038675), Medical Research Council-UK (MR/V034162/1 and MR/R013349/1), Natural Environment Research Council UK (Grant ID: NE/R009384/1), Academy of Finland (Grant ID: 310372), European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655 and 874990), Czech Science Foundation (22-24920S), Emory University's NIEHS-funded HERCULES Center (Grant ID: P30ES019776), and Grant CEX2018-000794-S funded by MCIN/AEI/ 10.13039/501100011033 The funders had no role in the design, data collection, analysis, interpretation of results, manuscript writing, or decision to publication.
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Affiliation(s)
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, USA
| | - Dominic Roye
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Seulkee Heo
- School of the Environment, Yale University, New Haven, CT, USA
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar Khorasan Razavi, Iran
| | | | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Ene Indermitte
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar Khorasan Razavi, Iran
| | | | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic; Global Change Research Institute, Czech Academy of Sciences, Brno, Czech Republic
| | - Joana Madueira
- Department of Environmental Health, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal; EPI Unit, Institute of Public Health, University of Porto, Lisbon, Portugal
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Mathilde Pascal
- Department of Environmental Health, French National Public Health Agency, Public Health France, Saint Maurice, France
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Samuel Osorio
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yue Leon Guo
- National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan; National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
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Dai J, Li A, Liu Y, Chen Y, Tjakkes GHE, Visser A, Xu S. Denture wearing status, cardiovascular health profiles, and mortality in edentulous patients: A prospective study with a 27-year follow-up. J Dent 2022; 126:104287. [PMID: 36126778 DOI: 10.1016/j.jdent.2022.104287] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/14/2022] [Accepted: 09/13/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Life's Simple 7 (LS7) metrics provide insight into improving cardiovascular health (CVH) and help reduce mortality risks. Edentulous older adults have a higher mortality risk than dentulous ones, probably due to worse oral function. It is reported that wearing dentures will decrease the mortality risk factor by improving oral function. This prospective study aimed to investigate if denture wearing could modify the association between CVH profile and mortality risk among edentulous elderly. METHODS From the Third National Health and Nutrition Examination Survey (NHANES III), 1,735 edentulous older adults (mean age 69.4 years old) with CVH profiles and data on denture wearing status were selected for this study. CVH profiles according to LS7 metrics were classified into poor, intermediate, or ideal. Denture wearers were defined as those wearing complete dentures in both arches all the time or only when awake. Multivariable Cox proportional-hazards regression was conducted to estimate the association of CVH profiles with all-cause and cardiovascular mortality. Stratified analyses and the testing of interaction terms were used to evaluate the difference between the association in edentulous patients with and without dentures. RESULTS A total of 1,420 (81.8%) older adults died during the 27-year follow-up, with 475 (27.6%) cases attributable to heart disease. After controlling for potential confounders, edentulous patients with an ideal CVH (LS7 = 10-14) had a lower mortality risk than those with poor CVH (LS7 = 0-4). Furthermore, we observed an effect modification by denture use (Pinteraction = 0.046), with the role of ideal CVH in mitigating mortality among the denture wearers (Hazard Ratio = 0.440 [0.329-0.588]), while no significant association among those without dentures. Similar results were achieved for cardiovascular mortality, but there was no effect modification of denture use (Pinteraction = 0.352). CONCLUSION In this study, a favorable cardiovascular health profile presents a protective effect on all-cause mortality only among edentulous patients wearing dentures instead of non-wearer. CLINICAL SIGNIFICANCE Denture usage could improve oral function (e.g., chewing, smiling, speaking, etc.) and promote general health. Effect modification found in this study indicates having ideal CVH alone cannot substantially reduce mortality risk among edentulous patients. Therefore, health care professionals should keep an eye on the elderly not wearing dentures as they are probably more at risk for adverse health outcomes. It remains unclear if denture wearing has a causal relation with lower mortality risks, and further research is needed.
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Affiliation(s)
- Jingtao Dai
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - An Li
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China; Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
| | - Yang Liu
- Department of Oral Medicine, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Yuntao Chen
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Geerten-Has E Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Anita Visser
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands; Department for Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China.
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Li Y, Zhou Y, Cai Z, Li R, Leng P, Liu H, Liu J, Mahai G, Li Y, Xu S, Xia W. Associations of benzotriazoles and benzothiazoles with estrogens and androgens among pregnant women: A cohort study with repeated measurements. Sci Total Environ 2022; 838:155998. [PMID: 35588816 DOI: 10.1016/j.scitotenv.2022.155998] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/22/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
People are extensively exposed to benzotriazoles (BTRs) and benzothiazoles (BTHs) derivatives, which are environmental pollutants that may possess endocrine-disrupting potential; however, no epidemiological evidence is available on the associations of BTRs and BTHs with estrogens and androgens. This study aimed at investigating the associations of BTRs and BTHs with estrogens and androgens among pregnant women. Based on a prospective cohort study, we included 459 pregnant women who donated a complete serial of urine samples at each trimester and had repeated measurements of four BTRs, four BTHs, three estrogens (estrone, 17β-estradiol, and estrio), and two androgens (dehydroepiandrosterone and testosterone) in the urine samples. Associations of repeatedly measured BTRs and BTHs with maternal urinary estrogens and androgens were analyzed, and the cross-sectional associations were also analyzed. Tolyltriazole (TTR) (≥59.3%) and benzothiazole (BTH) (≥93.5%) had the highest detection rate among the BTRs and BTHs, respectively. Repeated measurement analysis and cross-sectional analysis consistently found the target BTRs and BTHs were positively associated with 17β-estradiol, estriol, and testosterone, while the trend of the associations with estrone and dehydroepiandrosterone was inconsistent. Among the positive associations with 17β-estradiol, estriol, and testosterone, the percent of change in estriol associated with TTR was the most prominent [28.5% (95% confidential interval: 24.2%, 32.9%) for each doubling in TTR]. The significant associations with estrone, estriol, testosterone, and dehydroepiandrosterone were stronger among pregnant women who gave birth to a boy than those who gave birth to a girl. These findings add epidemiological evidence on the endocrine-disrupting potential of BTRs and BTHs and highlight the importance of focusing on the health outcomes of BTRs and BTHs related to disturbed estrogens and androgens. Future studies are needed to validate these findings and explore the underlying mechanisms.
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Affiliation(s)
- Ying Li
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Yanqiu Zhou
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Zongwei Cai
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong, China
| | - Ruizhen Li
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, 100 Hong Kong Road, Wuhan 430015, Hubei, China
| | - Pei Leng
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, 100 Hong Kong Road, Wuhan 430015, Hubei, China
| | - Hongxiu Liu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Juan Liu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Gaga Mahai
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Yuanyuan Li
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Shunqing Xu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Wei Xia
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China.
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Gong Y, Sun P, Fu X, Jiang L, Yang M, Zhang J, Li Q, Chai J, He Y, Shi C, Wu J, Li Z, Yu F, Ba Y, Zhou G. The type of previous abortion modifies the association between air pollution and the risk of preterm birth. Environ Res 2022; 212:113166. [PMID: 35346659 DOI: 10.1016/j.envres.2022.113166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/05/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Air pollution and previous abortion have been reported to be related to preterm birth (PTB). But rare study examined the effect of air pollution on PTB risk among mothers with previous abortion. OBJECTIVE To estimate the effect of air pollution on PTB and the potential effect modification of previous abortion on such an association in rural part of Henan province (China). METHOD Based on National Free Preconception Health Examination Project (NFPHEP), information from the medical records of 57,337 mothers with previous abortion were obtained. An inverse distance-weighted model was used to estimate exposure levels of air pollutants. The effect of air pollution on the risk of PTB was estimated with a multiple logistic regression model. Stratified and interaction analyses were undertaken to explore the potential effect modification of previous abortion on this association. RESULTS The risk of PTB was positively associated with exposure to levels of nitrogen dioxide (NO2; OR: 1.03; 95%CI: 1.02-1.04)], and sulfur dioxide (SO2; 1.04; 1.02-1.07), and negatively associated with ozone (O3) exposure (0.97; 0.97-0.98) during the entire pregnancy. Besides, we observed a positive effect of carbon monoxide (CO) exposure during the third trimester of pregnancy on PTB (1.14; 1.01-1.29). The type of previous abortion could modify the effect of air pollution on the PTB risk (P-interaction < 0.05). Compared with mothers with previous induced abortion, mothers with previous spontaneous abortion carried a higher risk of PTB induced by NO2, CO, and O3. CONCLUSIONS The risk of PTB was positively associated with levels of NO2, SO2 and CO, and negatively associated with the O3 level. The types of previous abortion could modify the effect of air pollution on PTB. Mothers who had an abortion previously, especially spontaneous abortion, should avoid exposure to air pollution to improve their pregnancy outcome.
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Affiliation(s)
- Yongxiang Gong
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Panpan Sun
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China
| | - Xiaoli Fu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Lifang Jiang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China
| | - Meng Yang
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Junxi Zhang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China
| | - Qinyang Li
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Jian Chai
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China
| | - Yanan He
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Chaofan Shi
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Jingjing Wu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Zhiyuan Li
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Fangfang Yu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Yue Ba
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
| | - Guoyu Zhou
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; Yellow River Institute for Ecological Protection & Regional Coordinated Development, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
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Quraishi SM, Hazlehurst MF, Loftus CT, Nguyen RHN, Barrett ES, Kaufman JD, Bush NR, Karr CJ, LeWinn KZ, Sathyanarayana S, Tylavsky FA, Szpiro AA, Enquobahrie DA. Association of prenatal exposure to ambient air pollution with adverse birth outcomes and effect modification by socioeconomic factors. Environ Res 2022; 212:113571. [PMID: 35640705 PMCID: PMC9674115 DOI: 10.1016/j.envres.2022.113571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/22/2022] [Accepted: 05/24/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Maternal exposure to air pollution has been associated with birth outcomes; however, few studies examined biologically critical exposure windows shorter than trimesters or potential effect modifiers. OBJECTIVES To examine associations of prenatal fine particulate matter (PM2.5), by trimester and in biologically critical windows, with birth outcomes and assess potential effect modifiers. METHODS This study used two pregnancy cohorts (CANDLE and TIDES; N = 2099) in the ECHO PATHWAYS Consortium. PM2.5 was estimated at the maternal residence using a fine-scale spatiotemporal model, averaged over pregnancy, trimesters, and critical windows (0-2 weeks, 10-12 weeks, and last month of pregnancy). Outcomes were preterm birth (PTB, <37 completed weeks of gestation), small-for-gestational-age (SGA), and continuous birthweight. We fit multivariable adjusted linear regression models for birthweight and Poisson regression models (relative risk, RR) for PTB and SGA. Effect modification by socioeconomic factors (maternal education, household income, neighborhood deprivation) and infant sex were examined using interaction terms. RESULTS Overall, 9% of births were PTB, 10.4% were SGA, and mean term birthweight was 3268 g (SD = 558.6). There was no association of PM2.5 concentration with PTB or SGA. Lower birthweight was associated with higher PM2.5 averaged over pregnancy (β -114.2, 95%CI -183.2, -45.3), during second (β -52.9, 95%CI -94.7, -11.2) and third (β -45.5, 95%CI -85.9, -5.0) trimesters, and the month prior to delivery (β -30.5, 95%CI -57.6, -3.3). Associations of PM2.5 with likelihood of SGA and lower birthweight were stronger among male infants (p-interaction ≤0.05) and in those with lower household income (p-interaction = 0.09). CONCLUSIONS Findings from this multi city U.S. birth cohort study support previous reports of inverse associations of birthweight with higher PM2.5 exposure during pregnancy. Findings also suggest possible modification of this association by infant sex and household income.
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Affiliation(s)
- Sabah M Quraishi
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Marnie F Hazlehurst
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Piscataway, NJ, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Division of General Internal Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Daniel A Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Guo YT, Bernard Goggins W, Chan EYY, Ho KF. Individual socioeconomic status as a modifier of the association between high ambient temperature and hospital admissions: a time series study in Hong Kong, 2010-2019. Environ Sci Pollut Res Int 2022; 29:67353-67361. [PMID: 35524101 PMCID: PMC9492594 DOI: 10.1007/s11356-022-20512-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
Few studies have examined individual socioeconomic status (SES) as a potential modifier of ambient temperature-health associations, especially for temperature-related hospitalizations. We fit penalized distributed lag non-linear models within generalized additive models to study the short-term associations (0-3 days) between temperature and hospital admissions stratified by common causes, age, and individual SES, as determined by whether patients received public assistance (PA) to cover their medical fee at the time of hospitalizations, during the hot season (May 15 to October 15) in Hong Kong for the years 2010-2019. We calculated the ratio of relative risk (RRR) and corresponding 95% confidence interval (CI) to statistically test the difference of the associations between PA groups. For 75 + patients, the PA group had significantly increased risks of hospitalizations at higher temperature for most causes, with relative risks (RR, 99th %ile vs. 25%ile) and 95% CIs of 1.138 (1.099, 1.179), 1.057 (1.008, 1.109), and 1.163 (1.094, 1.236) estimated for all non-cancer non-external, circulatory, and respiratory admissions, respectively. There were slight decreases of RRs with higher temperature for 75 + patients without PA. The strengths of temperature-hospitalization associations were strongly and significantly different between PA groups for all examined causes for 75 + patients, with the most considerable discrepancy found for ischemic heart disease (RRR = 1.266; 95% CI, 1.137, 1.410). Hospitalizations for patients aged 15-74 were less affected by heat, and the difference of the associations between groups was small. Individual SES is a significant modifier of high temperature-hospitalization associations in Hong Kong among the elderly. Public health interventions are needed to better protect this subpopulation from adverse health impacts of high temperature.
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Affiliation(s)
- Yi Tong Guo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - William Bernard Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Emily Ying Yang Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kin Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Wang M, Ma H, Song Q, Zhou T, Hu Y, Heianza Y, Manson JE, Qi L. Red meat consumption and all-cause and cardiovascular mortality: results from the UK Biobank study. Eur J Nutr 2022; 61:2543-2553. [PMID: 35220441 DOI: 10.1007/s00394-022-02807-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/11/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE To investigate the prospective associations between red meat consumption and all-cause and cardiovascular diseases (CVD) mortality, and to assess the modification effects of lifestyle and genetic risk factors. METHODS 180,642 individuals free of CVD or cancer were enrolled from 2006 to 2010 and followed up to 2018 in the UK Biobank. Information on demographics, lifestyles, and medical history was collected through a baseline touchscreen questionnaire. The information on diet was collected through a single touchscreen food-frequency questionnaire. A total of ten single-nucleotide polymorphisms were used to calculate the genetic risk score (GRS) of trimethylamine N-oxide (TMAO), a gut microbiota metabolite from red meat. Adjusted Cox proportional hazard regression models were used to assess the association of red meat consumption with mortality. RESULTS We documented 3596 deaths [655 CVD deaths, 285 coronary heart disease (CHD) deaths, and 149 stroke deaths] during median 8.6 years of follow-up. Compared with the lowest red meat intake (< 1.5 times/week), the highest red meat intake (≥ 3.0 times/week) was associated with a 20%, 53%, and 101% elevated risk for CVD, CHD, and stroke mortality (P for trend = 0.04, 0.007, and 0.02, respectively), but not all-cause mortality. We found that the associations between red meat intake and mortality were not modified by dietary and lifestyle factors, as well as TMAO GRS. In addition, substitution analyses showed that a decrease in red meat consumption and an increase in the consumption of poultry or cereal was significantly associated with 9%-16% lower CVD or CHD mortality risk. CONCLUSION Our results indicated that red meat consumption was associated with higher risks of CVD, CHD, and stroke mortality, and the associations were not modified by lifestyle and genetic risk factors. Replacing red meat by poultry or cereal was related to lower risks of CVD and CHD mortality.
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Affiliation(s)
- Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Qiying Song
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - JoAnn E Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA.
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Insaf TZ, Adeyeye T, Adler C, Wagner V, Proj A, McCauley S, Matson J. Road traffic density and recurrent asthma emergency department visits among Medicaid enrollees in New York State 2005-2015. Environ Health 2022; 21:73. [PMID: 35896993 PMCID: PMC9331590 DOI: 10.1186/s12940-022-00885-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Environmental exposures such as traffic may contribute to asthma morbidity including recurrent emergency department (ED) visits. However, these associations are often confounded by socioeconomic status and health care access. OBJECTIVE This study aims to assess the association between traffic density and recurrence of asthma ED visits in the primarily low income Medicaid population in New York State (NYS) between 2005 and 2015. METHODS The primary outcome of interest was a recurrent asthma ED visit within 1-year of index visit. Traffic densities (weighted for truck traffic) were spatially linked based on home addresses. Bivariate and multivariate logistic regression analyses were conducted to identify factors predicting recurrent asthma ED visits. RESULTS In a multivariate model, Medicaid recipients living within 300-m of a high traffic density area were at a statistically significant risk of a recurrent asthma ED visit compared to those in a low traffic density area (OR = 1.31; 95% CI:1.24,1.38). Additionally, we evaluated effect measure modification for risk of recurrent asthma visits associated with traffic exposure by socio-demographic factors. The highest risk was found for those exposed to high traffic and being male (OR = 1.87; 95% CI:1.46,2.39), receiving cash assistance (OR = 2.11; 95% CI:1.65,2.72), receiving supplemental security income (OR = 2.21; 95% CI:1.66,2.96) and being in the 18.44 age group (OR = 1.59;95% CI 1.48,1.70) was associated with the highest risk of recurrent asthma ED visit. Black non-Hispanics (OR = 2.35; 95% CI:1.70,3.24), Hispanics (OR = 2.13; 95% CI:1.49,3.04) and those with race listed as "Other" (OR = 1.89 95% CI:1.13,3.16) in high traffic areas had higher risk of recurrent asthma ED visits as compared to White non-Hispanics in low traffic areas. CONCLUSION We observed significant persistent disparities in asthma morbidity related to traffic exposure and race/ethnicity in a low-income population. Our findings suggest that even within a primarily low-income study population, socioeconomic differences persist. These differences in susceptibility in the extremely low-income group may not be apparent in health studies that use Medicaid enrollment as a proxy for low SES.
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Affiliation(s)
- Tabassum Zarina Insaf
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, 1203 Corning Tower, Empire State Plaza, Albany, NY, USA.
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, NY, Rensselaer, USA.
| | - Temilayo Adeyeye
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, 1203 Corning Tower, Empire State Plaza, Albany, NY, USA
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, NY, Rensselaer, USA
- Department of Environmental Health Sciences, University at Albany School of Public Health, Rensselaer, NY, USA
| | - Catherine Adler
- Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, 1203 Corning Tower, Empire State Plaza, Albany, NY, USA
| | - Victoria Wagner
- Office of Quality and Patient Safety, New York State Department of Health, Albany, NY, USA
| | - Anisa Proj
- Office of Quality and Patient Safety, New York State Department of Health, Albany, NY, USA
| | - Susan McCauley
- Office of Quality and Patient Safety, New York State Department of Health, Albany, NY, USA
| | - Jacqueline Matson
- Office of Quality and Patient Safety, New York State Department of Health, Albany, NY, USA
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Clark J, Bommarito P, Stýblo M, Rubio-Andrade M, García-Vargas GG, Gamble MV, Fry RC. Maternal serum concentrations of one-carbon metabolism factors modify the association between biomarkers of arsenic methylation efficiency and birth weight. Environ Health 2022; 21:68. [PMID: 35836250 PMCID: PMC9281096 DOI: 10.1186/s12940-022-00875-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/27/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Inorganic arsenic (iAs) is a ubiquitous metalloid and drinking water contaminant. Prenatal exposure is associated with birth outcomes across multiple studies. During metabolism, iAs is sequentially methylated to mono- and di-methylated arsenical species (MMAs and DMAs) to facilitate whole body clearance. Inefficient methylation (e.g., higher urinary % MMAs) is associated with increased risk of certain iAs-associated diseases. One-carbon metabolism factors influence iAs methylation, modifying toxicity in adults, and warrant further study during the prenatal period. The objective of this study was to evaluate folate, vitamin B12, and homocysteine as modifiers of the relationship between biomarkers of iAs methylation efficiency and birth outcomes. METHODS Data from the Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort (2011-2012) with maternal urine and cord serum arsenic biomarkers and maternal serum folate, vitamin B12, and homocysteine concentrations were utilized. One-carbon metabolism factors were dichotomized using clinical cutoffs and median splits. Multivariable linear regression models were fit to evaluate associations between each biomarker and birth outcome overall and within levels of one-carbon metabolism factors. Likelihood ratio tests of full and reduced models were used to test the significance of statistical interactions on the additive scale (α = 0.10). RESULTS Among urinary biomarkers, % U-MMAs was most strongly associated with birth weight (β = - 23.09, 95% CI: - 44.54, - 1.64). Larger, more negative mean differences in birth weight were observed among infants born to women who were B12 deficient (β = - 28.69, 95% CI: - 53.97, - 3.42) or experiencing hyperhomocysteinemia (β = - 63.29, 95% CI: - 154.77, 28.19). Generally, mean differences in birth weight were attenuated among infants born to mothers with higher serum concentrations of folate and vitamin B12 (or lower serum concentrations of homocysteine). Effect modification by vitamin B12 and homocysteine was significant on the additive scale for some associations. Results for gestational age were less compelling, with an approximate one-week mean difference associated with C-tAs (β = 0.87, 95% CI: 0, 1.74), but not meaningful otherwise. CONCLUSIONS Tissue distributions of iAs and its metabolites (e.g., % MMAs) may vary according to serum concentrations of folate, vitamin B12 and homocysteine during pregnancy. This represents a potential mechanism through which maternal diet may modify the harms of prenatal exposure to iAs.
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Affiliation(s)
- Jeliyah Clark
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Paige Bommarito
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Miroslav Stýblo
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marisela Rubio-Andrade
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Gonzalo G García-Vargas
- Facultad de Medicina, Universidad Juarez del Estado de Durango, Gómez Palacio, Durango, Mexico
| | - Mary V Gamble
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
- Curriculum in Toxicology and Environmental Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
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Steenland K, Vu B, Scovronick N. Effect modification by maximum temperature of the association between PM 2.5 and short-term cardiorespiratory mortality and emergency room visits in Lima, Peru, 2010-2016. J Expo Sci Environ Epidemiol 2022; 32:590-595. [PMID: 34657126 PMCID: PMC9012782 DOI: 10.1038/s41370-021-00393-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The health effects of fine particulate matter (PM2.5) may be worse at higher temperatures. OBJECTIVE To investigate temperature's effect on PM2.5-mortality/morbidity associations in Lima, Peru. METHODS Time-series regressions relating PM2.5 and temperature to mortality and emergency room (ER) visits during 2010-2016. Daily PM2.5 levels (assigned to 40 Lima districts) and daily maximum temperature (Lima-wide) were estimated based on ground monitors, remote sensing, and modeling. We analyzed all-cause, cardiovascular (ICD codes I00-I99), and respiratory (ICD codes J00-J99) mortality, and cardiovascular and respiratory causes for ER visits. RESULTS The average PM2.5 concentration was 20.9 µg/m3 (IQR 17.5-23.5). The mean daily maximum temperature was 23.8 °C (IQR 20.8-26.9). PM2.5's effect on all-cause, respiratory, and circulatory disease mortality was significantly (p < 0.05) stronger at temperatures above the maximum temperature median. The rate ratios per increase of 10 µg/m3 of PM2.5 for all cause, respiratory, and circulatory mortality respectively were 1.03 (1.00-1.06), 1.04 (0.98-1.10), and 1.04 (0.98-1.10) at temperatures below the median, vs. 1.08 (1.04-1.12), 1.11 (1.03-1.19), and 1.14 (1.05-1.25) when temperatures were above the median. Results were analogous for ER visits for respiratory but not circulatory disease. SIGNIFICANCE Results strengthen the evidence that air pollution may be more dangerous when temperatures are higher. IMPACT Our data contribute to a growing body of literature which indicates that the damaging effects of PM2.5 may be worse at higher temperature, adding new evidence from Lima, Peru.
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Affiliation(s)
| | - Bryan Vu
- Corresponding author: Kyle Steenland,
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Wang W, Guo T, Guo H, Chen X, Ma Y, Deng H, Yu H, Chen Q, Li H, Liu Q, Shan A, Li Y, Pang B, Shi J, Wang X, Chen J, Deng F, Sun Z, Guo X, Wang Y, Tang N, Wu S. Ambient particulate air pollution, blood cell parameters, and effect modification by psychosocial stress: Findings from two studies in three major Chinese cities. Environ Res 2022; 210:112932. [PMID: 35176316 DOI: 10.1016/j.envres.2022.112932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/04/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
The associations between particulate matter (PM) exposure, psychosocial stress and blood cell parameters are bringing novel insights to characterize the early damage of multiple diseases. Based on two studies conducted in three Chinses cities using cross-sectional (Beijing, 425 participants) and panel study (Tianjin and Shanghai, 92 participants with 361 repeated measurements) designs, this study explored the associations between short-term exposure to ambient PM and blood cell parameters, and the effect modification by psychosocial stress. Increasing PM2.5 exposure was significantly associated with decreases in red blood cell (RBC) count and mean corpuscular hemoglobin concentration (MCHC), and increases in mean corpuscular volume (MCV), platelets count (PLT) and platelet hematocrit (PCT) in both studies. For instance, a 10 μg/m3 increment in PM2.5 concentration was associated with a 1.04% (95%CI: 0.16%, 1.92%) increase in PLT (4-d) and a 1.09% (95%CI: 0.31%, 1.87%) increase in PCT (4-d) in the cross-sectional study, and a 0.64% (95%CI: 0.06%, 1.22%) increase in PLT (1-d) and a 0.72% (95%CI: 0.33%, 1.11%) increase in PCT (1-d) in the panel study, respectively. In addition, stronger increases in MCV, PLT, and PCT associated with PM2.5 exposure were found in higher psychosocial stress group compared to lower psychosocial stress group (p for interaction <0.10), indicating that blood cell parameters of individuals with higher psychosocial stress might be more susceptible to the early damages of PM2.5 exposure.
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Affiliation(s)
- Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Tongjun Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Huaqi Guo
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Chen
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yating Ma
- Institute of Social Psychology, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hongyan Deng
- Qinglongqiao Community Health Service Center, Haidian District, Beijing, China
| | - Hengyi Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiao Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Qisijing Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Anqi Shan
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yaoyan Li
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Bo Pang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Jiazhang Shi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xinmei Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Juan Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Yan Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; The Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Naijun Tang
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China.
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Moodie EEM, Coulombe J, Danieli C, Renoux C, Shortreed SM. Privacy-preserving estimation of an optimal individualized treatment rule: a case study in maximizing time to severe depression-related outcomes. Lifetime Data Anal 2022; 28:512-542. [PMID: 35499604 PMCID: PMC10805063 DOI: 10.1007/s10985-022-09554-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
Estimating individualized treatment rules-particularly in the context of right-censored outcomes-is challenging because the treatment effect heterogeneity of interest is often small, thus difficult to detect. While this motivates the use of very large datasets such as those from multiple health systems or centres, data privacy may be of concern with participating data centres reluctant to share individual-level data. In this case study on the treatment of depression, we demonstrate an application of distributed regression for privacy protection used in combination with dynamic weighted survival modelling (DWSurv) to estimate an optimal individualized treatment rule whilst obscuring individual-level data. In simulations, we demonstrate the flexibility of this approach to address local treatment practices that may affect confounding, and show that DWSurv retains its double robustness even when performed through a (weighted) distributed regression approach. The work is motivated by, and illustrated with, an analysis of treatment for unipolar depression using the United Kingdom's Clinical Practice Research Datalink.
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Affiliation(s)
- Erica E M Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.
| | - Janie Coulombe
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Coraline Danieli
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Christel Renoux
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Susan M Shortreed
- Biostatistics Unit, Kaiser Permanente Washington Health Research Institute, Seattle, USA
- Biostatistics Department, University of Washington, Seattle, USA
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Zeng JY, Miao Y, Liu C, Deng YL, Chen PP, Zhang M, Cui FP, Shi T, Lu TT, Liu CJ, Zeng Q. Serum multiple organochlorine pesticides in relation to testosterone concentrations among Chinese men from an infertility clinic. Chemosphere 2022; 299:134469. [PMID: 35367495 DOI: 10.1016/j.chemosphere.2022.134469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/24/2022] [Accepted: 03/27/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Organochlorine pesticides (OCPs) are endocrine-disrupting chemicals and may alter male reproductive hormone concentrations. OBJECTIVE To explore the associations between multiple OCP exposures and serum testosterone concentrations among Chinese men. METHODS We investigated 421 men who provided serum samples from an infertility clinic in Wuhan, China. Each man completed a questionnaire concerning demographic characteristics and lifestyle habits. Serum concentrations of 18 OCPs and total testosterone were measured. Linear regression models were used to explore whether serum OCP levels were associated with altered testosterone concentrations, and potential effect modifications by age and body mass index (BMI) were also examined. RESULTS After adjusting for potential confounders, elevated dieldrin and p,p'-DDD levels had monotonically negative and positive exposure-response associations with testosterone concentrations, respectively (-30.98 ng/dL, 95% CI: -72.34, 10.37; P for trend = 0.12 and 41.31 ng/dL, 95% CI: -0.32, 82.93; P for trend = 0.06 for the highest vs. non-detectable exposure category, respectively). After stratification by age and BMI, dieldrin in relation to decreased testosterone concentrations was more pronounced among men aged <30 years old, and p,p'-DDD in relation to increased testosterone concentrations was stronger among men aged ≥30 years old and among men with a BMI <24 kg/m2, though the differences were not statistically significant. CONCLUSION The study found evidence that serum dieldrin and p,p'-DDD concentrations might be associated with altered serum testosterone concentrations.
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Affiliation(s)
- Jia-Yue Zeng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yu Miao
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chong Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yan-Ling Deng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Pan-Pan Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Min Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Fei-Peng Cui
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Tian Shi
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Ting-Ting Lu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chang-Jiang Liu
- NHC Key Laboratory of Birth Defects and Reproductive Health, Chongqing Population and Family Planning Science and Technology Research Institute, Chongqing, PR China.
| | - Qiang Zeng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
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Apanga PA, Christiansen EJ, Weber AM, Darrow LA, Riddle MS, Tung WC, Liu Y, Kohnen T, Garn JV. The role of state breastfeeding laws and programs on exclusive breastfeeding practice among mothers in the special supplemental nutrition program for Women, Infants, and Children (WIC). Int Breastfeed J 2022; 17:46. [PMID: 35752853 PMCID: PMC9233787 DOI: 10.1186/s13006-022-00490-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background It is unclear if state laws supporting breastfeeding are associated with exclusive breastfeeding (EBF) practice among low-income mothers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The main objectives of our study were to assess the relationship between such laws and EBF among WIC-participating mothers and to assess whether this association varied by employment status. We also assessed how mother’s exposure to WIC breastfeeding consultation was associated with EBF. Methods A cross-sectional study was conducted across seven WIC program locations (i.e., Georgia, Massachusetts, Nevada, Pennsylvania, Wisconsin, Wyoming, Chickasaw Nation) between July–August 2020. Data were collected using convenient sampling from each program location and surveys were administered electronically or on paper to WIC-participating mothers. We restricted our analysis to data from 1161 WIC-participating mothers with infants aged zero to five months old. Multivariable mixed models were used to estimate the relationship between our exposures of interest (i.e., number of laws supporting breastfeeding, employment-related breastfeeding laws, WIC breastfeeding consultation) and EBF, while controlling for potential confounders and accounting for clustering by program location. Effect modification by employment status was assessed on the additive and multiplicative scales. Results Among WIC-participating mothers living in program locations with no employment-related breastfeeding laws, EBF was 26% less prevalent for employed mothers compared to unemployed mothers (adjusted prevalence ratios [aPR]: 0.74, 95% CI: 0.67,0.83). Among all mothers, a one-unit increase in laws supporting breastfeeding was not associated with EBF (aPR: 0.88, 95% CI: 0.71,1.10). However, among employed mothers, living in areas with more employment-related laws was associated with a higher prevalence of EBF (aPR: 1.43, 95% CI: 0.83, 2.44). Infants whose mothers received a WIC breastfeeding consultation had 33% higher prevalence of being exclusively breastfed compared to infants whose mothers did not receive a WIC breastfeeding consultation (aPR: 1.33, 95% CI: 1.05,1.70). Conclusions Infants whose WIC-participating mothers were employed, were less likely to be exclusively breastfed, but our effect modification analyses showed that laws supporting breastfeeding at the workplace may promote EBF among employed women. EBF was more prevalent among mothers who received a WIC breastfeeding consultation compared to those who did not receive such a consultation. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00490-9.
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Affiliation(s)
- Paschal A Apanga
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Elizabeth J Christiansen
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Ann M Weber
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Lyndsey A Darrow
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Mark S Riddle
- School of Medicine, University of Nevada, Reno, 1664 N Virginia St, NV, 89557, Reno, USA
| | - Wei-Chen Tung
- The Valley Foundation of School of Nursing, San Jose State University, 1 Washington Sq, San Jose, CA, 95192, USA
| | - Yan Liu
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Taya Kohnen
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Joshua V Garn
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA.
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Kampe RT, Nielsen SM, Hotea I, van Durme C, Christensen R, Boonen A. Effect modification by contextual factors of urate-lowering therapy on serum urate in people with gout: A systematic review with meta-regression analysis. Semin Arthritis Rheum 2022; 56:152049. [PMID: 35728446 DOI: 10.1016/j.semarthrit.2022.152049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To synthesize evidence of the effect of contextual factors (CFs) on efficacy of urate-lowering therapy (ULT) on serum urate (SU) as outcome in gout patients. METHODS Randomised controlled trials (RCTs) from (updated) Cochrane reviews were the starting point. RCTs were included if they explored the role of any CF on efficacy of ULT on SU in gout patients. For CFs with sufficient data (i.e. ≥3 trials), a mixed-effects meta-regression analysis was performed with trial and comparison as random effects, whereas specific CFs were modelled as fixed factors. RESULTS Eight RCTs were included. Effect modification by CFs was explored for age, sex, race, renal function, cardiovascular comorbidity, tophi, thiazide-diuretic use, and previous ULT use. Crude data stratified by renal function were available for four trials (36 randomised comparisons), and suitable for meta-analysis. Pooled estimates revealed that gout patients with a normal, mildly-, or moderately impaired renal function were consistently more likely to achieve SU target with ULT compared to control. Among RCTs comparing ULT to placebo (30 comparisons), effects of ULT on achieving SU target were not statistically different for those with normal (OR:66.87;[11.39-392.75]) compared to mildly (OR:28.54;[5.11-159.46]) and moderately (OR:21.45;[3.20-143.64]) impaired renal function, but seemed lower in those with severely impaired (OR:9.13;[0.96-86.97]) renal function. Data were insufficient to draw conclusions on effect modification by other CFs. CONCLUSION Few RCTs report stratified analyses exploring the role of CFs. ULT seemed effective in reaching the SU target in all levels of renal function, though severely impaired renal function appeared to render a slight disadvantage.
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Affiliation(s)
- Ritch Te Kampe
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, P.O. Box 5800, Maastricht, AZ 6202, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands.
| | - Sabrina Mai Nielsen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark
| | - Ioana Hotea
- Department of Rheumatology, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Caroline van Durme
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, P.O. Box 5800, Maastricht, AZ 6202, the Netherlands; Centre Hospitalier Chrétien, Liège, Belgium
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, P.O. Box 5800, Maastricht, AZ 6202, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Zhan ZY, Zhong X, Yang J, Ding Z, Xie XX, Zheng ZQ, Hu ZJ. Effect of apparent temperature on hospitalization from a spectrum of cardiovascular diseases in rural residents in Fujian, China. Environ Pollut 2022; 303:119101. [PMID: 35248617 DOI: 10.1016/j.envpol.2022.119101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
Cardiovascular disease (CVD) is a leading threat to global public health. Although associations between temperature and CVD hospitalization have been suggested for developed countries, limited evidence is available for developing countries or rural residents. Moreover, the effect of apparent temperature (AT) on the spectrum of cause-specific CVDs remains unknown. Based on 2,024,147 CVD hospitalizations for rural residents from eight regions in Fujian Province, China, during 2010-2016, a quasi-Poisson regression with distributed lag non-linear model was fitted to estimate the AT effect on daily CVD hospitalization for each region, and then pooled in a meta-regression that included regional indicators related to rural residents. Stratified analyses were performed according to the cause of hospitalization, sex and age groups. Finally, we calculated the fraction of CVD hospitalizations attributable to AT, as a reflection of the burden associated with AT. The heat effect appeared at lag 0-1 days, with 19% (95% CI, 11-26%) increased risk of CVD hospitalization, which was worse for ischemic heart disease, heart failure, arrhythmias and ischemic stroke. The decreased AT was associated with increase of hemorrhagic stroke at lag 0-28 days. People aged 65 and above suffered more from the heat effect on cardiovascular and cerebrovascular diseases. Regions with a lower gross value of agricultural production, rural residents' per capita net income, number of air conditioners and water heaters were more susceptible. A large number of hospitalizations were attributable to heat for most subcategories. High AT level increased CVD hospitalization, and the subcategories had different susceptibilities. The effects were modified by individual and regional characteristics. These findings have important implications for the development of targeted interventions and for hospital service planning.
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Affiliation(s)
- Zhi-Ying Zhan
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China
| | - Xue Zhong
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Zan Ding
- Institute of Low Carb Medicine, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, 518102, Guangdong Province, China
| | - Xiao-Xu Xie
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China
| | - Zhen-Quan Zheng
- Institute of Health Research, Fujian Medical University, Fuzhou, 350122, Fujian Province, China
| | - Zhi-Jian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China.
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Wu J, Ye Q, Fang L, Deng L, Liao T, Liu B, Lv X, Zhang J, Tao J, Ye D. Short-term association of NO 2 with hospital visits for chronic kidney disease and effect modification by temperature in Hefei, China: A time series study. Ecotoxicol Environ Saf 2022; 237:113505. [PMID: 35462193 DOI: 10.1016/j.ecoenv.2022.113505] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND A large body of evidence has linked air pollution and temperature with chronic kidney disease (CKD) prevalence and hospitalizations. However, most studies have focused on the influence of heat stress on CKD prevalence, and the potential effect modification of temperature on the association between air pollution and CKD has not been well-investigated. In this study, we examined the associations of the whole temperature spectrum and air pollution with CKD-related hospital visits and explored whether temperature modifies the short-term association of air pollution with CKD-related hospital visits. METHODS AND FINDINGS We collected 40 276 CKD-related hospital visits from the first Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital in Hefei, China, during 2015-2019. A two-stage time-series design was conducted to investigate the associations of air pollution and daily mean temperature with CKD-related hospital visits. First, we estimated the associations between air pollution and CKD-related hospital visits as well as temperature and CKD-related hospital visits. Second, we analyzed the associations of air pollution with CKD hospital visits at different temperatures. We found that NO2 exposure and low temperature were associated with an increased risk of CKD-related hospital visits. Low temperature enhanced the association between NO2 exposure and CKD-related hospital visits, with an increase of 4.30% (95% CI: 2.47-5.92%) per 10 μg/m3 increment in NO2 at low temperature. Effect modification of the association between NO2 and the risk of CKD-related hospital visits was stronger at low temperature across the whole population. CONCLUSIONS Our findings indicate that low temperature-related chronic kidney damage should be of immediate public health concern. Impact of NO2 exposure on the risk of CKD-related hospital visits may increase under the low temperature, which suggests the need for NO2 exposure mitigation strategies in the context of climate change and an enhanced understanding of the mechanisms underlying the temperature variance of air pollution effect to help reduce the magnitude of the CKD burden on the healthcare systems.
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Affiliation(s)
- Jun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - QianLing Ye
- Department of Oncology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - LanLan Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - LiJun Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Tao Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Bo Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - XiaoJie Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - JinHui Tao
- Department of Rheumatology & Immunology, Anhui Provincial Hospital, Hefei, Anhui, China.
| | - DongQing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
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Li C, Zhu Y, She K, Jia Y, Liu T, Han C, Fang Q, Cheng C, Han L, Liu Y, Zhang Y, Li X. Modified effects of air pollutants on the relationship between temperature variability and hand, foot, and mouth disease in Zibo City, China. Environ Sci Pollut Res Int 2022; 29:44573-44581. [PMID: 35133585 DOI: 10.1007/s11356-022-18817-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
Hand, foot, and mouth disease (HFMD) poses a great disease burden in China. However, there are few studies on the relationship between temperature variability (TV) and HFMD. Moreover, whether air pollutions have modified effects on this relationship is still unknown. Therefore, this study aims to explore the modified effects of air pollutants on TV-HFMD association in Zibo City, China. Daily data of HFMD cases, meteorological factors, and air pollutants from 2015 to 2019 were collected for Zibo City. TV was estimated by calculating standard deviation of minimum and maximum temperatures over the exposure days. We used generalized additive model to estimate the association between TV and HFMD. The modified effects of air pollutants were assessed by comparing the estimated TV-HFMD associations between different air stratums. We found that TV increased the risk of HFMD. The effect was strongest at TV03 (4 days of exposure), when the incidence of HFMD increased by 3.6% [95% CI: 1.3-5.9%] for every 1℃ increases in TV. Males, children aged 0-4 years, were more sensitive to TV. We found that sulfur dioxide (SO2) enhanced TV's effects on all considered exposure days, while ozone (O3) reduced TV's effects on some exposure days in whole concerned population. However, we did not detect significant effect modification by particulate matter less than 10 microns in aerodynamic diameter (PM10). These findings are of significance in developing policies and public health practices to reduce the risks of HFMD by integrating changes in temperatures and air pollutants.
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Affiliation(s)
- Chunyu Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Yuchen Zhu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Kaili She
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Yan Jia
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Tingxuan Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Chuang Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Qidi Fang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Chuanlong Cheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Luyi Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China
| | - Ying Zhang
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong, China.
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Yu X, Rahman MM, Wang Z, Carter SA, Schwartz J, Chen Z, Eckel SP, Hackman D, Chen JC, Xiang AH, McConnell R. Evidence of susceptibility to autism risks associated with early life ambient air pollution: A systematic review. Environ Res 2022; 208:112590. [PMID: 34929192 DOI: 10.1016/j.envres.2021.112590] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Many studies have found associations between early life air pollution exposure and subsequent onset of autism spectrum disorder (ASD). However, characteristics that affect susceptibility remain unclear. OBJECTIVE This systematic review examined epidemiologic studies on the modifying roles of social, child, genetic and maternal characteristics in associations between prenatal and early postnatal air pollution exposure and ASD. METHODS A systematic literature search in PubMed and Embase was conducted. Studies that examined modifiers of the association between air pollution and ASD were included. RESULTS A total of 19 publications examined modifiers of the associations between early life air pollution exposures and ASD. In general, estimates of effects on risk of ASD in boys were larger than in girls (based on 11 studies). Results from studies of effects of family education (2 studies) and neighborhood deprivation (2 studies) on air pollution-ASD associations were inconsistent. Limited data (1 study) suggest pregnant women with insufficient folic acid intake might be more susceptible to ambient particulate matter less than 2.5 μm (PM2.5) and 10 μm (PM10) in aerodynamic diameter, and to nitrogen dioxide (NO2). Children of mothers with gestational diabetes had increased risk of ozone-associated ASD (1 study). Two genetic studies reported that copy number variations may amplify the effect of ozone, and MET rs1858830 CC genotype may augment effects of PM and near-roadway pollutants on ASD. CONCLUSIONS Child's sex, maternal nutrition or diabetes, socioeconomic factors, and child risk genotypes were reported to modify the effect of early-life air pollutants on ASD risk in the epidemiologic literature. However, the sparsity of studies on comparable modifying hypotheses precludes conclusive findings. Further research is needed to identify susceptible populations and potential targets for preventive intervention.
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Affiliation(s)
- Xin Yu
- Spatial Science Institute, University of Southern California, Los Angeles, CA, USA
| | - Md Mostafijur Rahman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zhongying Wang
- Spatial Science Institute, University of Southern California, Los Angeles, CA, USA
| | - Sarah A Carter
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel Hackman
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Rob McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Hatakeyama K, Seposo X. Heatstroke-related ambulance dispatch risk before and during COVID-19 pandemic: Subgroup analysis by age, severity, and incident place. Sci Total Environ 2022; 821:153310. [PMID: 35085629 PMCID: PMC8784651 DOI: 10.1016/j.scitotenv.2022.153310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND In summer 2020 under the COVID-19 pandemic, the Ministry of Health, Labour and Welfare has made public warnings that specific preventive measures such as maskwearing and stay-at-home orders, may increase heatstroke risk. In our previous work, we found a lower risk of heatstroke-related ambulance dispatches (HSAD) during the COVID-19 period, however, it is uncertain whether similar risk reductions can be observed in different vulnerable subgroups. This study aimed to determine the HSAD risk during the COVID-19 pandemic by age, severity, and incident place subgroups. METHOD A summer-specific (June-September), time-series analysis was performed, using daily HSAD and meteorological data from 47 Japanese prefectures from 2017 to 2020. A two-stage analysis was applied to determine the association between HSAD and COVID-19 pandemic, adjusting for maximum temperature, humidity, seasonality, and relevant temporal adjustments. A generalized linear model was utilized in the first stage to estimate the prefecture-specific effect estimates. Thereafter, a fixed effect meta-analysis in the second stage was implemented to pool the first stage estimates. Subsequently, subgroup analysis via an interaction by age, severity, and incident place was used to analyze the HSAD risk among subgroups. RESULTS A total of 274,031 HSAD cases was recorded across 47 Japanese prefectures. The average total number of HSAD in the pre-COVID-19 period was 69,721, meanwhile, the COVID-19 period was 64,869. Highest reductions in the risks was particularly observed in the young category (ratio of relative risk (RRR) = 0.54, 95% Confidential Interval (CI): 0.51, 0.57) compared to the elderly category. Whereas highest increment in the risks were observed in severe/death (RRR = 1.25, 95% CI: 1.13, 1.37) compared to the mild category. CONCLUSION COVID-19 situation exhibited a non-uniform change in the HSAD risk for all subgroups, with the magnitude of the risks varying by age, severity, and incident place.
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Affiliation(s)
- Koya Hatakeyama
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
| | - Xerxes Seposo
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan.
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Wu R, Guo Q, Fan J, Guo C, Wang G, Wu W, Xu J. Association between air pollution and outpatient visits for allergic rhinitis: Effect modification by ambient temperature and relative humidity. Sci Total Environ 2022; 821:152960. [PMID: 35016948 DOI: 10.1016/j.scitotenv.2022.152960] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
Mounting evidence indicated the associations between air pollution and outpatient visits for allergic rhinitis (AR), while few studies assessed the effect modification of these associations by ambient temperature and relative humidity (RH). In this study, dataset of AR outpatients was obtained from Chinese People's Liberation Army Strategic Support Force Characteristic Medical Center in Beijing during 2014 to 2019, and the average concentrations of air pollutants including particulate matter ≤2.5 μm in diameter (PM2.5) and ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and meteorological factors (temperature and RH) at the same period were collected from one nearby air monitoring station. We performed a time-series study with Poisson regression model to examine the effects of air pollutants on AR outpatients after adjustment for potential confounders. And the effects modification analysis was further conducted by stratifying temperature and RH by tertiles into three groups of low, middle and high. In total of 33,599 outpatient visits for AR were recorded during the study period. Results found that a 10 μg/m3 increase in PM2.5, PM10, NO2 and SO2 was associated with significant increases in AR outpatients of 1.24% (95% confidence interval (CI): 0.69%, 1.78%), 0.79% (95% CI: 0.43%, 1.15%), 3.05% (95% CI: 1.72%, 4.40%) and 5.01% (95% CI: 1.18%, 8.96%), respectively. Stronger associations were observed in males than those in females, as well as in young adults (18-44 years) than those in other age groups. Air pollution effects on AR outpatients increased markedly at low temperature (<33.3th percentile) and high RH (>66.7th percentile). Findings in this study indicate that air pollution is associated with increased risk of AR outpatients, and the effects of air pollution on AR could be enhanced at low temperature and high RH.
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Affiliation(s)
- Rongshan Wu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Qun Guo
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Jingpu Fan
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Changsheng Guo
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Gang Wang
- Department of Otolaryngology, Strategic Support Force Medical Center, Beijing 100005, China; State Environmental Protection Key Laboratory of Environmental Sense Organ Stress and Health, Beijing 100005, China
| | - Wei Wu
- Department of Otolaryngology, Strategic Support Force Medical Center, Beijing 100005, China; State Environmental Protection Key Laboratory of Environmental Sense Organ Stress and Health, Beijing 100005, China.
| | - Jian Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing 100012, China; Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012, China.
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Yan S, Wang X, Yao Z, Cheng J, Ni H, Xu Z, Wei Q, Pan R, Yi W, Jin X, Tang C, Liu X, He Y, Wu Y, Li Y, Sun X, Liang Y, Mei L, Su H. Seasonal characteristics of temperature variability impacts on childhood asthma hospitalization in Hefei, China: Does PM 2.5 modify the association? Environ Res 2022; 207:112078. [PMID: 34599899 DOI: 10.1016/j.envres.2021.112078] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/06/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Evidence of childhood asthma hospitalizations associated with temperature variability (TV) and the attributable risk are limited in China. We aim to use a comprehensive index that reflected both intra- and inter-day TV to assess the TV-childhood asthma relationship and disease burden, further to identify seasonality vulnerable populations, and to explore the effect modification of PM2.5. METHODS A quasi-distributed lagged nonlinear model (DLNM) combined with a linear threshold function was applied to estimate the association between TV and childhood asthma hospitalizations during 2013-2016 in Hefei, China. Subgroup analysis was conducted by age and sex. Disease burden is reflected by the attributable fraction and attributable number. Besides, modifications of PM2.5 were tested by introducing the cross-basis of TV and binary PM2.5 as an interaction term. RESULTS The risk estimates peaked at TV0-3 and TV0-4 in the cool and the warm season separately, with RR of 1.051 (95%CI: 1.021-1.081) and 1.072 (95%CI: 1.008-1.125), and the effects lasted longer in the cool season. The school-age children in the warm season and all subgroups except pre-school children in the cool season were vulnerable to TV. It is estimated that the disease burden related to TV account for 6.2% (95% CI: 2.7%-9.4%) and 4% (95% CI: 0.6%-7.1%) during the cool and warm seasons in TV0-3. In addition, the risks of TV were higher under the high PM2.5 level compared with the low PM2.5 level in the cool season, although no significant differences between them. CONCLUSIONS TV exposure significantly increases the risk and disease burden of childhood asthma hospitalizations, especially in the cool season. More medical resources should be allocated to school-age children. Giving priority to pay attention to TV in the cool season in practice could obtain the greatest public health benefits and those days with high TV and high PM2.5 need more attention.
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Affiliation(s)
- Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Xu Wang
- Anhui Provincial Children's Hospital, China
| | - Zhenhai Yao
- Anhui Public Meteorological Service Center, Hefei, Anhui, 230011, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Hong Ni
- Anhui Provincial Children's Hospital, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China.
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87
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Wicke FS, Ernst M, Otten D, Werner A, Dreier M, Brähler E, Tibubos AN, Reiner I, Michal M, Wiltink J, Münzel T, Lackner KJ, Pfeiffer N, König J, Wild PS, Beutel ME. The association of depression and all-cause mortality: Explanatory factors and the influence of gender. J Affect Disord 2022; 303:315-322. [PMID: 35176339 DOI: 10.1016/j.jad.2022.02.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/29/2021] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The association of depression with mortality and the significance of explanatory factors, in particularly gender, have remained an issue of debate. We therefore aimed to estimate the effect of depression on all-cause mortality, to examine potential explanatory factors and to assess effect modification by gender. METHODS We used Cox regression models to estimate the effect of depression on mortality based on data from the Gutenberg Health Study, which is a prospective cohort study of the adult population in the districts of Mainz and Mainz-Bingen, Germany. Baseline assessment was between 2007 and 2012. Effect modification by gender was measured on both additive and multiplicative scales. RESULTS Out of 14,653 participants, 7.7% were depressed according to Patient Health Questionnaire 9 (PHQ-9), and 1,059 (7.2%) died during a median follow-up of 10.7 years. Depression elevated the risk of mortality in men and women in age-adjusted models (HR: 1.41, 95%-CI: 1.03-1.92; resp. HR: 1.96, 95%-CI: 1.43-2.69). Adjustment for social status, physical health and lifestyle covariates attenuated the effect and in the fully-adjusted model the hazard ratio was 0.96 (95%-CI: 0.69-1.33) in men and 1.53 (95%-CI: 1.10-2.12) in women. For effect modification by gender, the measure on multiplicative interaction was 0.68 (95%-CI 0.44-1.07) and on additive interaction was RERI=-0.47 (95%-CI -1.24-0.30). LIMITATIONS The PHQ-9 is a single self-report measure of depression reflecting symptoms of the past two weeks, limiting a more detailed assessment of depression and course of symptoms, which likely affects the association with mortality. CONCLUSIONS Depression elevates mortality by multifactorial pathways, which should be taken into account in the biopsychosocially informed treatment of depression. Effect modification by gender was not statistically significant.
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Affiliation(s)
- F S Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany.
| | - M Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - D Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Dreier
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - I Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - J Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - T Münzel
- Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - K J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - J König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P S Wild
- Preventive Cardiology and Preventive Medicine - Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
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88
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Remigio RV, He H, Raimann JG, Kotanko P, Maddux FW, Sapkota AR, Liang XZ, Puett R, He X, Sapkota A. Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States. Sci Total Environ 2022; 812:152481. [PMID: 34921874 PMCID: PMC8962569 DOI: 10.1016/j.scitotenv.2021.152481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Increasing number of studies have linked air pollution exposure with renal function decline and disease. However, there is a lack of data on its impact among end-stage kidney disease (ESKD) patients and its potential modifying effect from extreme heat events (EHE). METHODS Fresenius Kidney Care records from 28 selected northeastern US counties were used to pool daily all-cause mortality (ACM) and all-cause hospital admissions (ACHA) counts. County-level daily ambient PM2.5 and ozone (O3) were estimated using a high-resolution spatiotemporal coupled climate-air quality model and matched to ESKD patients based on ZIP codes of treatment sites. We used time-stratified case-crossover analyses to characterize acute exposures using individual and cumulative lag exposures for up to 3 days (Lag 0-3) by using a distributed lag nonlinear model framework. We used a nested model comparison hypothesis test to evaluate for interaction effects between air pollutants and EHE and stratification analyses to estimate effect measures modified by EHE days. RESULTS From 2001 to 2016, the sample population consisted of 43,338 ESKD patients. We recorded 5217 deaths and 78,433 hospital admissions. A 10-unit increase in PM2.5 concentration was associated with a 5% increase in ACM (rate ratio [RRLag0-3]: 1.05, 95% CI: 1.00-1.10) and same-day O3 (RRLag0: 1.02, 95% CI: 1.01-1.03) after adjusting for extreme heat exposures. Mortality models suggest evidence of interaction and effect measure modification, though not always simultaneously. ACM risk increased up to 8% when daily ozone concentrations exceeded National Ambient Air Quality Standards established by the United States, but the increases in risk were considerably higher during EHE days across lag periods. CONCLUSION Our findings suggest interdependent effects of EHE and air pollution among ESKD patients for all-cause mortality risks. National level assessments are needed to consider the ESKD population as a sensitive population and inform treatment protocols during extreme heat and degraded pollution episodes.
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Affiliation(s)
- Richard V Remigio
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Hao He
- Department of Atmospheric and Oceanic Sciences, University of Maryland, College Park, MD, USA
| | | | - Peter Kotanko
- Research Division, Renal Research Institute, New York, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Amy Rebecca Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Xin-Zhong Liang
- Department of Atmospheric and Oceanic Sciences, University of Maryland, College Park, MD, USA; Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Robin Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
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89
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Collatuzzo G, Etienne M, Factor SH, Maso LD, Polesel J, Crispo A, Levi F, Parazzini F, Negri E, La Vecchia C, Boffetta P. Effect modification of body mass index on the association between ovarian cysts and endometrial cancer. Cancer Epidemiol 2022; 78:102129. [PMID: 35272258 DOI: 10.1016/j.canep.2022.102129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Ovarian cysts represent a common condition among women. Epidemiologic studies are inconsistent in determining if women with cysts are more likely to develop endometrial cancer (EC) regardless of overweight/obesity. We investigated the combined role of cysts and body mass index (BMI) on EC risk. METHODS We pooled data from three case-control studies conducted in Italy and Switzerland on 920 women with EC and 1700 controls. The prevalence of cysts was 5% among both cases and controls, with 63% of cases being overweight/obese. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression models, adjusting for potential confounders. We conducted stratified analyses according to BMI, and estimated the interaction between cysts and BMI; we carried out additional analyses according to age at diagnosis of cysts. RESULTS Overall, history of cysts was not associated to EC (OR=1.27, 95% CI=0.82-1.97, P = 0.29). Normal weight women reporting cysts had an increased risk of EC (OR=2.49, 95% CI=1.31-4.74), while no such effect was found among overweight/obese women (OR=0.65, 95% CI=0.36-1.18; P for interaction=0.004). The association was limited to women below 65 years of age and was stronger in those who reported cysts at age 48 or older. CONCLUSIONS Cysts appeared to be a risk factor for EC in lean women but not in overweight/obese ones; these results are consistent with an effect of cysts and obesity on EC along common pathways.
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90
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Marrocos MSM, Teixeira AA, Quinto BM, Canzian MEF, Manfredi S, Batista MC. Diabetes acts on mortality in hemodialysis patients predicted by asymmetric dimethylarginine and inflammation. Nefrologia 2022; 42:177-185. [PMID: 36153914 DOI: 10.1016/j.nefroe.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/10/2021] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The mortality rate of diabetic patients on dialysis is higher than that of non-diabetic patients. Asymmetric dimethylarginine and inflammation are strong predictors of death in hemodialysis. This study aimed to evaluate asymmetric dimethylarginine and C-reactive protein interaction in predicting mortality in hemodialysis according to the presence or absence of diabetes. METHODS Asymmetric dimethylarginine and C-reactive protein were measured in 202 patients in maintenance hemodialysis assembled from 2011 to 2012 and followed for four years. Effect modification of C-reactive protein on the relationship between asymmetric dimethylarginine and all-cause mortality was investigated dividing the population into four categories according to the median of asymmetric dimethylarginine and C-reactive protein. RESULTS Asymmetric dimethylarginine and C-reactive protein levels were similar between diabetics and non-diabetics. Asymmetric dimethylarginine - median IQR μM - (1.95 1.75-2.54 versus 1.03 0.81-1.55 P=0.000) differed in non-diabetics with or without evolution to death (HR 2379 CI 1.36-3.68 P=0.000) and was similar in diabetics without or with evolution to death. Among non-diabetics, the category with higher asymmetric dimethylarginine and C-reactive protein levels exhibited the highest mortality (69.0% P=0.000). No differences in mortality were seen in diabetics. A joint effect was found between asymmetric dimethylarginine and C-reactive protein, explaining all-cause mortality (HR 15.21 CI 3.50-66.12 P=0.000). CONCLUSIONS Asymmetric dimethylarginine is an independent predictor of all-cause mortality in non-diabetic patients in hemodialysis. Other risk factors may overlap asymmetric dimethylarginine in people with diabetes. Inflammation dramatically increases the risk of death associated with high plasma asymmetric dimethylarginine in hemodialysis.
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Affiliation(s)
- Mauro Sergio Martins Marrocos
- Universidade Federal de São Paulo, Rua Pedro de Toledo, 781 14 andar, Vila Clementino, CEP: 04039-032 São Paulo, SP, Brazil; Hospital do Servidor Público do Estado de São Paulo, Rua Pedro de Toledo, 1800, CEP: 04039-901 São Paulo, SP, Brazil.
| | - Andrei Alkmim Teixeira
- Universidade Federal de São Paulo, Rua Pedro de Toledo, 781 14 andar, Vila Clementino, CEP: 04039-032 São Paulo, SP, Brazil
| | - Beata Marie Quinto
- Universidade Federal de São Paulo, Rua Pedro de Toledo, 781 14 andar, Vila Clementino, CEP: 04039-032 São Paulo, SP, Brazil
| | | | - Silvia Manfredi
- Universidade Federal de São Paulo, Rua Pedro de Toledo, 781 14 andar, Vila Clementino, CEP: 04039-032 São Paulo, SP, Brazil
| | - Marcelo Costa Batista
- Universidade Federal de São Paulo, Rua Pedro de Toledo, 781 14 andar, Vila Clementino, CEP: 04039-032 São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701, Morumbi, CEP 05652-900 São Paulo, SP, Brazil
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91
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Rudolph AE, Dembo RS, Tobin K, Latkin C. Perceived HIV Treatment Norms Modify the Association Between HIV-Related Stigma and Adherence to Antiretroviral Therapy Among Persons Living with HIV in Baltimore, Maryland. AIDS Behav 2022; 26:537-548. [PMID: 34338899 PMCID: PMC8807774 DOI: 10.1007/s10461-021-03409-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 02/03/2023]
Abstract
Adherence to antiretroviral therapy (ART) is associated with reduced HIV-related morbidity/mortality and ongoing transmission; however, the extent to which this association is modified by perceived HIV treatment norms is unknown. 270 PLWH completed a survey to assess demographics, risk behaviors, stigma, ART adherence, and perceived HIV treatment norms (Baltimore, 2014-2017). We used modified Poisson regression to examine effect modification by perceived HIV treatment norms. The association between HIV-related stigma and ART adherence was modified by perceived HIV treatment norms. Among individuals who perceived that friends/family were sub-optimally adherent, HIV-related stigma was negatively associated with ART adherence (Adjusted Risk Ratio [ARR] = 0.36; 95%CI 0.15-0.87). Among those who perceived optimal adherence among friends/family, the relationship between HIV-related stigma and ART adherence was not statistically significant (ARR = 1.07; 95%CI 0.65-1.76). Interventions to improve ART adherence among those who are sub-optimally adherent could focus on increasing perceptions of ART adherence among their friends/family.
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Affiliation(s)
- Abby E Rudolph
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, 1301 Cecil B Moore Avenue, Ritter Annex 905, Philadelphia, PA, 19122, USA.
| | - Robert S Dembo
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI, 53705, USA
| | - Karin Tobin
- Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Carl Latkin
- Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Bixel K, Barrington DA, Vetter MH, Suarez AA, Felix AS. Determinants of Surgical Approach and Survival Among Women with Endometrial Carcinoma. J Minim Invasive Gynecol 2022; 29:219-230. [PMID: 34348183 PMCID: PMC8803987 DOI: 10.1016/j.jmig.2021.07.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVE To investigate determinants of surgical approach among women with endometrial carcinoma (EC) and associations between surgical approach and overall survival (OS). DESIGN Retrospective cohort. SETTING The National Cancer Database, 2010 to 2015. PATIENTS A total of 140 470 patients with histologically confirmed EC who underwent hysterectomy. INTERVENTIONS Patients were grouped according to surgical approach. MEASUREMENTS AND MAIN RESULTS A total of 140 470 patients with EC were included. Robotic-assisted laparoscopy (RAL) was the most common surgical approach (48.8%), followed by laparotomy (33.6%) and traditional laparoscopy (17.6%). Use of RAL increased over the study period, and the percentages of cases managed by laparotomy decreased. Older women, those with insurance, residing in ZIP codes with lower proportions of individuals who did not graduate from high school, and those treated at noncommunity cancer programs were less likely to undergo laparotomy than RAL, and non-white women, those diagnosed with high-grade histology, and those with advanced-stage EC were more likely to undergo laparotomy than RAL. Compared with RAL, all other surgical approaches were associated with worse OS (laparotomy: hazard ratio 1.21; 95% confidence interval, 1.18-1.25; traditional laparoscopy: hazard ratio 1.06; 95% confidence interval, 1.02-1.09). Significant effect modification of the surgical approach and OS relationship according to age, race, histology, stage, and adjuvant treatment was observed. CONCLUSION RAL increased in frequency over the study period and was associated with improved OS, supporting the continued use of RAL for EC management.
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Affiliation(s)
- Kristin Bixel
- Division of Gynecologic Oncology (Drs. Bixel and Barrington).
| | | | - Monica H Vetter
- Division of Gynecologic Oncology, Baptist Health Medicine Group, Lexington, Kentucky (Dr. Vetter)
| | - Adrian A Suarez
- Division of Surgical Pathology (Dr. Suarez), College of Medicine
| | - Ashley S Felix
- Division of Epidemiology, College of Public Health (Dr. Felix), The Ohio State University, Columbus, Ohio
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93
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Pitrou I, Vasiliadis HM, Hudon C. Body mass index and cognitive decline among community-living older adults: the modifying effect of physical activity. Eur Rev Aging Phys Act 2022; 19:3. [PMID: 35033022 PMCID: PMC8903608 DOI: 10.1186/s11556-022-00284-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To examine the associations between BMI categories and subsequent 3-year cognitive decline among older adults, and to test whether physical activity modifies the associations. Methods Study sample included n = 1028 cognitively unimpaired older adults participating in the Étude sur la Santé des Aînés (ESA)-Services longitudinal study and followed 3 years later. Cognitive decline was defined as a decrease of > 3 points in MMSE scores between baseline and follow-up. BMI categories (normal weight (reference), underweight, overweight, obese) were derived from self-reported weight and height. Moderate to vigorous physical activity of ≥20 min (# of times per week) was self-reported. The presence of chronic disorders was ascertained from administrative and self-reported data. Logistic regression analyses were used to study the risk of cognitive decline associated with BMI categories stratified by weekly physical activity (≥140 min), the presence of metabolic, cardiovascular and anxio-depressive disorders. Results In the overall sample, there was no evidence that underweight, overweight, or obesity, as compared to normal weight, was associated with cognitive decline, after adjusting for sociodemographic, lifestyle factors, and comorbidities. Individuals with overweight reporting high physical activity had lower odds of cognitive decline (OR = 0.25, 95% CI = 0.07–0.89), whereas no association was observed in individuals with overweight reporting low physical activity (OR = 0.85, 95% CI = 0.41–1.75). Among participants with metabolic and cardiovascular disorders, individuals with overweight reporting high physical activity had lower odds of cognitive decline (OR = 0.09, 95% CI = 0.01–0.59 and OR = 0.03, 95% CI = 0.01–0.92 respectively), whereas no association was observed in those with low physical activity. Conclusion Physical activity modifies the association between overweight and cognitive decline in older adults overall, as in those with metabolic and cardiovascular disorders. Results highlight the importance of promoting and encouraging regular physical activity in older adults with overweight as prevention against cognitive decline. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-022-00284-2.
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Affiliation(s)
- Isabelle Pitrou
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center (CRCLM), 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada.
| | - Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center (CRCLM), 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Carol Hudon
- School of Psychology, Université Laval, CERVO Brain Research Center, 2601 chemin de la Canardière (F-2400), Québec, QC, G1J 2G3, Canada
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94
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Yu T, Zhou L, Xu J, Kan H, Chen R, Chen S, Hua H, Liu Z, Yan C. Effects of prenatal exposures to air sulfur dioxide/nitrogen dioxide on toddler neurodevelopment and effect modification by ambient temperature. Ecotoxicol Environ Saf 2022; 230:113118. [PMID: 34979314 DOI: 10.1016/j.ecoenv.2021.113118] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Emerging evidence suggests that prenatal exposure to ambient SO2 or NO2 induces fetal brain-damage. However, effects of prenatal exposure to SO2 or NO2 on toddler neurodevelopment and the effect-modification by ambient temperature remain unclear. Therefore, a prospective birth-cohort study was conducted from 2010 to 2012 in Shanghai, and 225 mother-child pairs were followed-up from mid-to-late pregnancy until 24-36 months postpartum. During the whole pregnancy, daily SO2/NO2 and temperature levels were obtained for each woman. Gesell-Development-Schedule was used to assess toddler neurodevelopment in the domains of gross-motor, fine-motor, adaptive-behavior, language and social-behavior. Distributed-lag-nonlinear-models simultaneously accounting for exposure-response and lag-response associations were applied to assess the impacts of prenatal SO2/NO2 exposure on neurodevelopment. Each 10-μg/m3 increase in weekly average SO2 concentrations had adverse associations with gross-motor in gestational-weeks 1-6, with adaptive-behavior in weeks 26-30, and with language in weeks 30-36 (developmental-quotient changes: - 1.17% to - 0.12%, P-values < 0.05). Each 10-μg/m3 increase in weekly average NO2 concentrations had adverse associations with gross-motor in gestational-weeks 33-36, with fine-motor in weeks 26-36 and with social-behavior in weeks 31-36 (developmental-quotient changes: - 0.91% to - 0.20%, P-values < 0.05). The cumulative effects for the whole pregnancy showed that each 10-μg/m3 increase in SO2 induced significant deficits in gross-motor and adaptive-behavior (developmental-quotient changes: - 4.71% and - 4.06%, respectively, P < 0.05). We found prenatal cumulative SO2 exposure induced more deficits in low temperature in language and adaptive-behavior than in high/moderate temperature. Thus, prenatal ambient SO2/NO2 exposure in specific time-windows (1st and 3rd trimesters for SO2; 3rd trimester for NO2) could impair toddler neurodevelopment and low temperature may aggravate the SO2-induced neurotoxicity.
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Affiliation(s)
- Ting Yu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Leilei Zhou
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092 China
| | - Jian Xu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Haidong Kan
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032 China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai 200032 China
| | - Renjie Chen
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032 China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai 200032 China
| | - Shuwen Chen
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Hui Hua
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Zhiwei Liu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Chonghuai Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092 China
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95
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Xu L, Li L, Xu D, Qiu J, Feng Q, Wen T, Lu S, Meng F, Shu X. Hormone replacement therapy in relation to the risk of colorectal cancer in women by BMI: a multicentre study with propensity score matching. Int J Clin Oncol 2022; 27:765-773. [PMID: 35025014 DOI: 10.1007/s10147-021-02110-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/15/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Epidemiological evidence about hormone replacement therapy and colorectal carcinogenesis by demographic and clinical traits remains unclear. We aimed to assess this postulated association in a large multicentre study and further explore the modification effect by BMI and others. METHODS We retrospectively collected records of women diagnosed with colorectal cancer (CRC) at the age of 50 years and older during 2014-2017 and their HRT dispensing prior to CRC diagnosis in three tertiary hospitals in China. CRC cases were matched with controls at a ratio of 1:3 using nearest neighbour propensity scores matching to better control for the remaining imbalance between groups, which generated a total of 824 cases with 2472 controls. RESULTS Our study confirmed the inversed association between colorectal cancer risk and hormone replacement therapy (OR, 0.62; 95% CI, 0.54-0.75), which was more prominent among women having multiple HRT dispenses (OR, 0.60; 95% CI, 0.52-0.76). Furthermore, significant associations were consistently observed for the short-term (OR, 0.69; 95% CI, 0.57-0.88), middle-term (OR, 0.51; 95% CI, 0.41-0.66), and long-term HRT users (OR, 0.70; 95% CI, 0.43-0.90). Estrogen-related regimen reduced CRC risk more than progestogen-only. We, for the first time, found that the modifying effect of BMI on HRT use and CRC risk was in different ways when BMI was categorized by a medium level of 27. CONCLUSION Our findings mainly suggest that there might be a different mechanism for the reversed association between HRT and colorectal tumorigenesis by BMI level, providing thoughts on clinical treatment of CRC.
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Affiliation(s)
- Lingkai Xu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China
| | - Lin Li
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China
| | - Dongkui Xu
- VIP Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Junlan Qiu
- Department of Oncology and Hematology, the Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou, 215153, China
| | - Qingting Feng
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China
| | - Tao Wen
- Medical Research Centre, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Shun Lu
- Department of Radiation Oncology, Sichuan Cancer Hospital/Institute, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Fang Meng
- Centre of Systems Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China.,Suzhou Institute of Systems Medicine, Suzhou, 215123, China
| | - Xiaochen Shu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China.
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96
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Du Z, Yang B, Jalaludin B, Knibbs L, Yu S, Dong G, Hao Y. Association of neighborhood greenness with severity of hand, foot, and mouth disease. BMC Public Health 2022; 22:38. [PMID: 34991526 PMCID: PMC8739664 DOI: 10.1186/s12889-021-12444-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/20/2021] [Indexed: 11/24/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is an epidemic infectious disease in China. Relationship of neighborhood greenness with human health has been widely studied, yet its association with severe HFMD has not yet been established. Methods Individual HFMD cases that occurred in Guangdong province in 2010 were recruited and were categorised into mild and severe cases. Residential greenness was assessed using global land cover data. We used a case-control design (i.e., severe versus mild cases) with logistic regression models to assess the association between neighborhood greenness and HFMD severity. Effect modification was also examined. Results A total of 131,606 cases were included, of whom 130,840 were mild cases and 766 were severe cases. In an unadjusted model, HFMD severity increased with higher proportion of neighborhood greenness (odds ratio, OR = 1.029, 95%CI: 1.009–1.050). The greenness-HFMD severity association remained (OR = 1.031, 95%CI: 1.006–1.057) after adjusting for population density, demographic variables and climate variables. Both population density (Z = 4.148, P < 0.001) and relative humidity (Z = -4.297, P < 0.001) modified the association between neighborhood greenness and HFMD severity. In the stratified analyses, a protective effect (OR = 0.769, 95%CI: 0.687–0.860) of greenness on HFMD severity were found in the subgroup of population density being lower than and equal to 5 ln(no.)/km2. While in both the subgroups of population density being higher than 5, the greenness had hazard effects (subgroup of > 5 & ≤7: OR = 1.071, 95%CI: 1.024–1.120; subgroup of > 7: OR = 1.065, 95%CI: 1.034–1.097) on HFMD severity. As to relative humidity, statistically significant association between greenness and HFMD severity was only observed in the subgroup of being lower than and equal to 76% (OR = 1.059, 95%CI: 1.023–1.096). Conclusions Our study found that HFMD severity is associated with the neighborhood greenness in Guangdong, China. This study provides evidence on developing a prevention strategy of discouraging the high-risk groups from going to the crowded green spaces during the epidemic period. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12444-7.
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Affiliation(s)
- Zhicheng Du
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Boyi Yang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bin Jalaludin
- School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW, 1871, Australia
| | - Luke Knibbs
- School of Public Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Guanghui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Yuantao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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97
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Perez LG, Siconolfi D, Troxel WM, Tucker JS, Seelam R, Rodriguez A, Shih RA, D'Amico EJ. Loneliness and multiple health domains: associations among emerging adults. J Behav Med 2022; 45:260-271. [PMID: 34981307 PMCID: PMC8723800 DOI: 10.1007/s10865-021-00267-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/19/2021] [Indexed: 12/30/2022]
Abstract
Emerging adults (18–25 years), particularly racially/ethnically diverse and sexual and gender minority populations, may experience loneliness following major life transitions. How loneliness relates to health and health disparities during this developmental period is not well understood. We examine associations of loneliness with physical (self-rated health), behavioral (alcohol/marijuana consequences; nicotine dependence), and health behavior outcomes (weekday and weekend sleep; trouble sleeping), and investigate moderating effects by sex, race/ethnicity, and sexual/gender minority (SGM) status. Adjusted models using cross-sectional data from 2,534 emerging adults, predominantly in California, examined associations between loneliness and each outcome and tested interactions of loneliness with sex, race/ethnicity, and SGM status. Higher loneliness was significantly associated with worse self-rated health, higher marijuana consequences, less weekday sleep, and greater odds of feeling bothered by trouble sleeping. None of the interactions were significant. Findings suggest that interventions to reduce loneliness may help promote healthy development among emerging adults across subgroups.
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Affiliation(s)
- Lilian G Perez
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - Daniel Siconolfi
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Wendy M Troxel
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | | | - Regina A Shih
- RAND Corporation, 1200 South Hayes Street, Arlington, VA, 22202, USA
| | - Elizabeth J D'Amico
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
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98
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Ji JS, Liu L, Shu C, Yan LL, Zeng Y. Sex Difference and Interaction of SIRT1 and FOXO3 Candidate Longevity Genes on Life Expectancy: A 10-year Prospective Longitudinal Cohort Study. J Gerontol A Biol Sci Med Sci 2021; 77:1557-1563. [PMID: 34928346 DOI: 10.1093/gerona/glab378] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Indexed: 11/14/2022] Open
Abstract
SIRT1 and FOXO3 are both associated with longevity. Molecular biology research in many organisms (yeast, nematode worm Caenorhabditis elegans, and mice mammalian models) shows SIRT1 acts on the FOXO family of forkhead transcription factors to respond to oxidative stress better, shifting processes away from cell death towards stress resistance. Human population studies need epidemiologic evidence. We used an open cohort of 3,166 community-dwelling participants in China with follow-up from 2008 to 2018. The mean age at baseline was 84.6 years. In 16,375 person-years of follow-up, there were 1,968 mortality events. SIRT1 and FOXO3 exhibited mendelian randomization as there was no correlation with each other and with baseline study population characteristics. Some SIRT1 and FOXO3 SNPs showed protective effects for mortality risk. The FOXO3 protective effect was stronger in females, and the SIRT1 protective effect was stronger in male study participants. We did not see evidence of a synergistic effect of being carriers of both SIRT1 and FOXO3.
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Affiliation(s)
- John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Linxin Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Chang Shu
- Department of Pediatrics & Department of System Biology, Columbia University, New York, USA
| | - Lijing L Yan
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.,Center for the Study of Aging and Human Development, Duke Medical School, Durham, NC, USA
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99
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Seposo X, Madaniyazi L, Ng CFS, Hashizume M, Honda Y. COVID-19 pandemic modifies temperature and heat-related illness ambulance transport association in Japan: a nationwide observational study. Environ Health 2021; 20:122. [PMID: 34857008 PMCID: PMC8637525 DOI: 10.1186/s12940-021-00808-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/15/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, several illnesses were reduced. In Japan, heat-related illnesses were reduced by 22% compared to pre-pandemic period. However, it is uncertain as to what has led to this reduction. Here, we model the association of maximum temperature and heat-related illnesses in the 47 Japanese prefectures. We specifically examined how the exposure and lag associations varied before and during the pandemic. METHODS We obtained the summer-specific, daily heat-related illness ambulance transport (HIAT), exposure variable (maximum temperature) and covariate data from relevant data sources. We utilized a stratified (pre-pandemic and pandemic), two-stage approach. In each stratified group, we estimated the 1) prefecture-level association using a quasi-Poisson regression coupled with a distributed lag non-linear model, which was 2) pooled using a random-effects meta-analysis. The difference between pooled pre-pandemic and pandemic associations was examined across the exposure and the lag dimensions. RESULTS A total of 321,655 HIAT cases was recorded in Japan from 2016 to 2020. We found an overall reduction of heat-related risks for HIAT during the pandemic, with a wide range of reduction (10.85 to 57.47%) in the HIAT risk, across exposure levels ranging from 21.69 °C to 36.31 °C. On the contrary, we found an increment in the delayed heat-related risks during the pandemic at Lag 2 (16.33%; 95% CI: 1.00, 33.98%). CONCLUSION This study provides evidence of the impact of COVID-19, particularly on the possible roles of physical interventions and behavioral changes, in modifying the temperature-health association. These findings would have implications on subsequent policies or heat-related warning strategies in light of ongoing or future pandemics.
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Affiliation(s)
- Xerxes Seposo
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
| | - Lina Madaniyazi
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
- Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Chris Fook Sheng Ng
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Hashizume
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
- Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
- National Institute for Environmental Studies, Tsukuba, Japan
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100
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Klompmaker JO, Hart JE, James P, Sabath MB, Wu X, Zanobetti A, Dominici F, Laden F. Air pollution and cardiovascular disease hospitalization - Are associations modified by greenness, temperature and humidity? Environ Int 2021; 156:106715. [PMID: 34218186 PMCID: PMC8380672 DOI: 10.1016/j.envint.2021.106715] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/03/2021] [Accepted: 06/10/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND Studies have observed associations between long-term air pollution and cardiovascular disease hospitalization. Little is known, however, about effect modification of these associations by greenness, temperature and humidity. METHODS We constructed an open cohort consisting of all fee-for-service Medicare beneficiaries, aged ≥ 65, living in the contiguous US from 2000 through 2016 (~63 million individuals). We assigned annual average PM2.5, NO2 and ozone zip code concentrations. Cox-equivalent Poisson models were used to estimate associations with first cardiovascular disease (CVD), coronary heart disease (CHD) and cerebrovascular disease (CBV) hospitalization. RESULTS PM2.5 and NO2 were both positively associated with CVD, CHD and CBV hospitalization, after adjustment for potential confounders. Associations were substantially stronger at the lower end of the exposure distributions. For CVD hospitalization, the hazard ratio (HR) of PM2.5 was 1.041 (1.038, 1.045) per IQR increase (4.0 µg/m3) in the full study population and 1.327 (1.305, 1.350) per IQR increase for a subgroup with annual exposures always below 10 µg/m3 PM2.5. Ozone was only positively associated with CVD, CHD and CBV hospitalization for the low-exposure subgroup (<40 ppb). Associations of PM2.5 were stronger in areas with higher greenness, lower ozone and Ox, lower summer and winter temperature and lower summer and winter specific humidity. CONCLUSION PM2.5 and NO2 were positively associated with CVD, CHD and CBV hospitalization. Associations were more pronounced at low exposure levels. Associations of PM2.5 were stronger with higher greenness, lower ozone and Ox, lower temperature and lower specific humidity.
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Affiliation(s)
- Jochem O Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States.
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, United States
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Boston, MA 02215, United States
| | - M Benjamin Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
| | - Xiao Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
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