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Li A, Fan L, Xie L, Ren Y, Li L. Associations between air pollution, climate factors and outpatient visits for eczema in West China Hospital, Chengdu, south-western China: a time series analysis. J Eur Acad Dermatol Venereol 2017; 32:486-494. [PMID: 29194790 DOI: 10.1111/jdv.14730] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 11/15/2017] [Indexed: 02/05/2023]
Affiliation(s)
- A. Li
- Department of Dermatology; West China School of Medicine; Sichuan University; Chengdu Sichuan China
| | - L. Fan
- Department of Dermatology; West China School of Medicine; Sichuan University; Chengdu Sichuan China
| | - L. Xie
- Department of Dermatology; West China School of Medicine; Sichuan University; Chengdu Sichuan China
| | - Y. Ren
- Department of Medical Statistics; West China School of Public Health; Sichuan University; Chengdu Sichuan China
| | - L. Li
- Department of Dermatology; West China Hospital; Sichuan University; Chengdu Sichuan China
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Maternal Exposure to Air Pollutants and Risk of Gestational Diabetes Mellitus in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121604. [PMID: 29261145 PMCID: PMC5751021 DOI: 10.3390/ijerph14121604] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/26/2017] [Accepted: 12/15/2017] [Indexed: 01/13/2023]
Abstract
Mounting evidence has shown an increased risk of gestational diabetes mellitus (GDM) in association with elevated exposure to air pollution. However, limited evidence is available concerning the effect of specific air pollutant(s) on GDM incidence. We conducted this case-control study on 6717 mothers with GDM diagnosed in 2006–2013 and 6717 age- and year of delivery-matched controls to further address the risk of GDM in relation to specific air pollutant. Both cases and controls were selected from a cohort of 1-million beneficiaries of Taiwan’s National Health Insurance program registered in 2005. Maternal exposures to mean daily air pollutant concentration, derived from 76 fixed air quality monitoring stations within the 12-week period prior to pregnancy and during the 1st and 2nd trimesters, were assessed by the spatial analyst method (i.e., ordinary kriging) with the ArcGIS software. After controlling for potential confounders and other air pollutants, an increase in pre-pregnancy exposure of 1 inter-quartile range (IQR) for PM2.5 and SO2 was found to associate with a significantly elevated odds ratio (OR) of GDM at 1.10 (95% confidence interval (CI) 1.03–1.18 and 1.37 (95% CI 1.30–1.45), respectively. Exposures to PM2.5 and SO2 during the 1st and 2nd trimesters were also associated with significantly increased ORs, which were 1.09 (95% CI 1.02–1.17) and 1.07 (95% CI 1.01–1.14) for PM2.5, and 1.37 (95% CI 1.30–1.45) and 1.38 (95% CI 1.31–1.46) for SO2. It was concluded that higher pre- and post-pregnancy exposures to PM2.5 and SO2 for mothers were associated with a significantly but modestly elevated risk of GDM.
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Yazd NKK, Patel RR, Dellavalle RP, Dunnick CA. Genetic Risk Factors for Development of Atopic Dermatitis: a Systematic Review. CURRENT DERMATOLOGY REPORTS 2017. [DOI: 10.1007/s13671-017-0199-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Pan SC, Huang CC, Lin SJ, Chen BY, Chan CC, Leon Guo YL. Gestational diabetes mellitus was related to ambient air pollutant nitric oxide during early gestation. ENVIRONMENTAL RESEARCH 2017; 158:318-323. [PMID: 28672129 DOI: 10.1016/j.envres.2017.06.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 06/07/2017] [Accepted: 06/09/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Ambient air pollution has been linked to the risk of gestational diabetes mellitus (GDM). However, evidence of this association is limited, and no study has examined the effects of nitric oxide (NO). OBJECTIVE This study investigated the association between air pollution exposure during gestation and GDM. METHODS The Taiwan Birth Cohort Study database was used to examine the association between the risk of GDM and all routinely monitored air pollutants among 21,248 women who were pregnant during 2004-2005. We further employed a two-pollutant model for confirming the effect of each pollutant on GDM. RESULTS After the exclusion criteria were applied, 19,606 women were included in the final analysis. Among them, 378 (1.9%) had been diagnosed as having GDM. These women were older and had higher BMIs than the women without GDM. The risks of GDM onset were significantly associated with NO exposure during the first [adjusted OR (aOR): 1.05, 95% confidence interval (CI): 1.02-1.08] and second (aOR: 1.05, 95%CI: 1.02-1.08) trimesters. Under the two-pollutant model, the effect of NO exposure was also significant during the first (aOR: 1.05, 95%CI: 1.02-1.08) and second (aOR: 1.05, 95%CI: 1.02-1.09) trimesters. CONCLUSION The results indicated that exposure to higher NO levels during pregnancy increases the risk of GDM.
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Affiliation(s)
- Shih-Chun Pan
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan.
| | - Ching-Chun Huang
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan; Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan.
| | - Shio-Jean Lin
- Genetic Counseling Center, Chi Mei Medical Center, Tainan, Taiwan.
| | - Bing-Yu Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
| | - Chang-Chuan Chan
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan.
| | - Yue-Liang Leon Guo
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan; Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
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Schleimer RP, Berdnikovs S. Etiology of epithelial barrier dysfunction in patients with type 2 inflammatory diseases. J Allergy Clin Immunol 2017; 139:1752-1761. [PMID: 28583447 DOI: 10.1016/j.jaci.2017.04.010] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 04/21/2017] [Accepted: 04/21/2017] [Indexed: 12/11/2022]
Abstract
Epithelial barriers of the skin, gastrointestinal tract, and airway serve common critical functions, such as maintaining a physical barrier against environmental insults and allergens and providing a tissue interface balancing the communication between the internal and external environments. We now understand that in patients with allergic disease, regardless of tissue location, the homeostatic balance of the epithelial barrier is skewed toward loss of differentiation, reduced junctional integrity, and impaired innate defense. Importantly, epithelial dysfunction characterized by these traits appears to pre-date atopy and development of allergic disease. Despite our growing appreciation of the centrality of barrier dysfunction in initiation of allergic disease, many important questions remain to be answered regarding mechanisms disrupting normal barrier function. Although our external environment (proteases, allergens, and injury) is classically thought of as a principal contributor to barrier disruption associated with allergic sensitization, there is a need to better understand contributions of the internal environment (hormones, diet, and circadian clock). Systemic drivers of disease, such as alterations of the endocrine system, metabolism, and aberrant control of developmental signaling, are emerging as new players in driving epithelial dysfunction and allergic predisposition at various barrier sites. Identifying such central mediators of epithelial dysfunction using both systems biology tools and causality-driven laboratory experimentation will be essential in building new strategic interventions to prevent or reverse the process of barrier loss in allergic patients.
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Affiliation(s)
- Robert P Schleimer
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Sergejs Berdnikovs
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Ill.
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Environmental Risk Factors for Development of Atopic Dermatitis: a Systematic Review. CURRENT DERMATOLOGY REPORTS 2017. [DOI: 10.1007/s13671-017-0189-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Werfel T, Allam JP, Biedermann T, Eyerich K, Gilles S, Guttman-Yassky E, Hoetzenecker W, Knol E, Simon HU, Wollenberg A, Bieber T, Lauener R, Schmid-Grendelmeier P, Traidl-Hoffmann C, Akdis CA. Cellular and molecular immunologic mechanisms in patients with atopic dermatitis. J Allergy Clin Immunol 2017; 138:336-49. [PMID: 27497276 DOI: 10.1016/j.jaci.2016.06.010] [Citation(s) in RCA: 416] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 12/18/2022]
Abstract
Atopic dermatitis (AD) is a complex skin disease frequently associated with other diseases of the atopic diathesis. Recent evidence supports the concept that AD can also recognize other comorbidities, such as chronic inflammatory bowel or cardiovascular diseases. These comorbidities might result from chronic cutaneous inflammation or from a common, yet-to-be-defined immunologic background leading to immune deviations. The activation of immune cells and their migration to the skin play an essential role in the pathogenesis of AD. In patients with AD, an underlying immune deviation might result in higher susceptibility of the skin to environmental factors. There is a high unmet medical need to define immunologic endotypes of AD because it has significant implications on upcoming stratification of the phenotype of AD and the resulting targeted therapies in the development of precision medicine. This review article emphasizes studies on environmental factors affecting AD development and novel biological agents used in the treatment of AD. Best evidence of the clinical efficacy of novel immunologic approaches using biological agents in patients with AD is available for the anti-IL-4 receptor α-chain antibody dupilumab, but a number of studies are currently ongoing with other specific antagonists to immune system players. These targeted molecules can be expressed on or drive the cellular players infiltrating the skin (eg, T lymphocytes, dendritic cells, or eosinophils). Such approaches can have immunomodulatory and thereby beneficial clinical effects on the overall skin condition, as well as on the underlying immune deviation that might play a role in comorbidities. An effect of these immunologic treatments on pruritus and the disturbed microbiome in patients with AD has other potential consequences for treatment.
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Affiliation(s)
- Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
| | - Jean-Pierre Allam
- Department of Dermatology and Allergy, Rheinische Friedrich Wilhelm University, Bonn, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Kilian Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Stefanie Gilles
- Institute of Environmental Medicine, UNIKA-T, Technical University Munich and Helmholtz Zentrum München, Augsburg, Germany
| | - Emma Guttman-Yassky
- Laboratory for Investigative Dermatology, Rockefeller University, and the Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Wolfram Hoetzenecker
- Department of Dermatology/Allergology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Edward Knol
- Departments of Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans-Uwe Simon
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Andreas Wollenberg
- Department of Dermatology and Allergy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Thomas Bieber
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland; Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - Roger Lauener
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland; Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
| | - Peter Schmid-Grendelmeier
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland; Allergy Unit, University of Zurich, Zurich, Switzerland
| | - Claudia Traidl-Hoffmann
- Institute of Environmental Medicine, UNIKA-T, Technical University Munich and Helmholtz Zentrum München, Augsburg, Germany; Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland
| | - Cezmi A Akdis
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland; Swiss Institute for Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
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Lu C, Deng L, Ou C, Yuan H, Chen X, Deng Q. Preconceptional and perinatal exposure to traffic-related air pollution and eczema in preschool children. J Dermatol Sci 2016; 85:85-95. [PMID: 27865567 DOI: 10.1016/j.jdermsci.2016.11.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 10/31/2016] [Accepted: 11/08/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Evidence linking prenatal exposure to outdoor air pollution with eczema in early childhood is scare, and the role of components of air pollution and exposure timing remains unclear. OBJECTIVES We investigated the association between exposure to air pollution during preconceptional and perinatal period and the risk of eczema in preschool children. METHODS We conducted a prospective cohort study of 2598 children aged 3-6 years in Changsha, China. The prevalence of eczema was assessed by a standardized health questionnaire administered by the parents. Individual exposures to nitrogen dioxide (NO2), sulfur dioxide (SO2) and particulate matter with an aerodynamic diameter≤10μm (PM10) during the 4th-6th and 1st-3rd month before pregnancy, entire pregnancy, and three trimesters were estimated by an inverse distance weighted (IDW) method based on concentrations measured at monitoring stations. Association between childhood eczema and exposure to air pollution was examined by logistic regression models in terms of odds ratio (OR) and 95% confidence interval (CI) for an interquartile range (IQR) increase in exposure. RESULTS Life-time prevalence of eczema in preschool children in Changsha was 28.6%. Childhood eczema was associated with traffic-related air pollutant NO2 during 3 months before pregnancy and entire pregnancy with adjusted ORs=1.19 (95% CI: 1.04-1.37) and 1.21 (95% CI: 1.03-1.42) respectively. The highest risk of eczema was observed for the 1st trimester exposure to NO2 [OR=1.26 (95% CI: 1.09-1.46)]. However, no association was detected for SO2 and PM10 exposure during any window. High-level exposure to NO2 during the whole time period significantly increased the effect of NO2 in all windows on eczema risk as compared with low-level exposure. Sensitivity analysis indicated that the association between both preconceptional and perinatal exposure to NO2 and childhood eczema was consistent and robust, and this association was modified by some personal, parental hereditary and indoor environmental factors. CONCLUSION Our findings support the hypothesis that early childhood eczema is associated with exposure to traffic-related air pollutant during both preconceptional and perinatal period, especially at a high level of exposure.
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Affiliation(s)
- Chan Lu
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Linjing Deng
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Cuiyun Ou
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Hong Yuan
- Institute of Environmental Health, Central South University, Changsha, Hunan, China; The Third XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Xiang Chen
- Department of Dermatology, XiangYa Hospital, Central South University, Changsha, Hunan, China; The State Key Laboratory of Medical Genetics, Central South University, Changsha, Hunan, China
| | - Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; Institute of Environmental Health, Central South University, Changsha, Hunan, China; XiangYa School of Public Health, Central South University, Changsha, Hunan, China.
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Deng Q, Lu C, Yu Y, Li Y, Sundell J, Norbäck D. Early life exposure to traffic-related air pollution and allergic rhinitis in preschool children. Respir Med 2016; 121:67-73. [PMID: 27888994 DOI: 10.1016/j.rmed.2016.10.016] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/18/2016] [Accepted: 10/24/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Evidence linking long-term exposure to outdoor air pollution with allergic rhinitis (AR) in children is scare, and the role of components of air pollution and timing of exposure remains unclear. OBJECTIVE To assess the association of pre- and post-natal exposure to air pollution with life-time prevalence of AR in preschool children. METHODS We conducted a cohort study of 2598 children aged 3-6 years in Changsha, China. The lifetime prevalence of AR was assessed by a questionnaire administered by parents. Children's exposures to dioxide nitrogen (NO2), sulfur dioxide (SO2) and particulate matter with an aerodynamic diameter ≤ 10 μm (PM10) during different pre- and post-natal timing windows were estimated using the measured concentrations at monitoring stations. The odds ratio (OR) and 95% confidence interval (CI) of childhood AR for exposure to different air pollutants during different timing windows were assessed by logistic regression model in terms of an interquartile range (IQR) increase in exposure level. RESULTS Life-time prevalence of AR in preschool children (7.3%) was associated with both pre- and post-natal exposure to traffic-related air pollution (TRAP), but only significant during the third trimester of pregnancy with adjusted OR = 1.40 (95% CI: 1.08-1.82) for a 15 μg/m3 increase in NO2 and during the first-year of life with adjusted OR = 1.36 (95% CI: 1.03-1.78) and 1.54 (95% CI: 1.07-2.21) respectively for 11 and 12 μg/m3 increase in NO2 and PM10. The association of early life exposure to TRAP with childhood AR was robust by adjusting for other air pollutants and timing windows. Sensitivity analysis indicated that the association was higher in the children who are male, young, with genetic predisposition by parental atopy, and living in damp houses. CONCLUSION Early life exposure to traffic-related air pollutant during pregnancy and first-year of life may contribute to childhood AR.
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Affiliation(s)
- Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; XiangYa School of Public Health, Central South University, Changsha, Hunan, China.
| | - Chan Lu
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yichen Yu
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Jan Sundell
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; School of Architecture, Tsinghua University, Beijing, China
| | - Dan Norbäck
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Deng Q, Lu C, Li Y, Sundell J. Exposure to outdoor air pollution during trimesters of pregnancy and childhood asthma, allergic rhinitis, and eczema. ENVIRONMENTAL RESEARCH 2016; 150:119-127. [PMID: 27281689 DOI: 10.1016/j.envres.2016.05.050] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/26/2016] [Accepted: 05/28/2016] [Indexed: 05/19/2023]
Abstract
BACKGROUND Mounting evidence suggests that exposure to ambient air pollution is associated with the development of childhood allergic diseases, but the effect of prenatal exposure to air pollution on the risk of childhood asthma and allergy is unclear. OBJECTIVES We evaluated the association between maternal exposure to outdoor air pollution during different trimesters of pregnancy and incidence of asthma, allergic rhinitis, and eczema in 2598 preschool children aged 3-6 years in China. METHODS Children's lifetime incidence of allergic diseases was obtained using questionnaire. Individual exposure to outdoor air pollutants during trimesters of pregnancy was estimated by an inverse distance weighted (IDW) method based on the measured concentrations at monitoring stations. We used multiple logistic regression method to estimate the odds ratio (OR) of asthma, allergic rhinitis, and eczema for per interquartile range (IQR) increase in the exposure to air pollutant in each trimester, which was adjusted for the effect of other air pollutants and its effect in other trimesters by a multi-pollutant/trimester model. RESULTS Incidence of asthma (6.8%), allergic rhinitis (7.3%), and eczema (28.6%) in children was associated with maternal exposure to traffic-related pollutant NO2 during entire pregnancy with OR (95% confidence interval [CI]) respectively 1.63 (0.99-2.70), 1.69 (1.03-2.77), and 1.37 (1.04-1.80). After adjustment for other pollutants and trimesters, we found the association was significant only in specific trimester: the first trimester for eczema (1.54, 1.14-2.09), the second trimester for asthma (1.72, 1.02-2.97), and the third trimester for allergic rhinitis (1.77, 1.09-2.89). Sensitivity analysis indicated that the trimester sensitive to the development of allergic diseases was stable. CONCLUSION Maternal exposure to traffic-related air pollutant NO2 during pregnancy, especially in specific trimesters, is associated with an increased risk of developing asthma, rhinitis, and eczema in children. Our results support the hypothesis that childhood allergic diseases originate in fetal life and are triggered by traffic-related air pollution in sensitive trimesters.
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Affiliation(s)
- Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; School of Public Health, Central South University, Changsha, Hunan, China; Institute of Environmental Health, Central South University, Changsha, Hunan, China.
| | - Chan Lu
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Jan Sundell
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; School of Architecture, Tsinghua University, Beijing, China
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