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Affiliation(s)
- Lise Van Susteren
- Advisory Board for Center for Health and the Global Environment; Harvard T. H. Chan School of Public Health; The Climate Psychiatry Alliance, email
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Sheffield PE, Speranza R, Chiu YHM, Hsu HHL, Curtin PC, Renzetti S, Pajak A, Coull B, Schwartz J, Kloog I, Wright RJ. Association between particulate air pollution exposure during pregnancy and postpartum maternal psychological functioning. PLoS One 2018; 13:e0195267. [PMID: 29668689 PMCID: PMC5905884 DOI: 10.1371/journal.pone.0195267] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 03/19/2018] [Indexed: 11/18/2022] Open
Abstract
Postpartum psychological functioning impacts both women’s health and outcomes in children. Lower income, ethnic minority women may be at particular risk for adverse postpartum mental health outcomes. Studies link ambient air pollution exposure with psychological dysfunction in adults although this association has not been examined among postpartum women.
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Affiliation(s)
- Perry E. Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- * E-mail:
| | - Rosa Speranza
- Oregon Health & Science University School of Medicine, Portland, OR, United States of America
| | - Yueh-Hsiu Mathilda Chiu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Hsiao-Hsien Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Paul C. Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Ashley Pajak
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Rosalind J. Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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53
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Association between Ambient Temperatures and Mental Disorder Hospitalizations in a Subtropical City: A Time-Series Study of Hong Kong Special Administrative Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040754. [PMID: 29662001 PMCID: PMC5923796 DOI: 10.3390/ijerph15040754] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/06/2018] [Accepted: 04/12/2018] [Indexed: 11/16/2022]
Abstract
Background: Mental disorders have been found to be positively associated with temperature in cool to cold climatic regions but the association in warmer regions is unclear. This study presented the short-term association between temperatures and mental disorder hospitalizations in a subtropical city with a mean annual temperature over 21 °C. Methods: Using Poisson-generalized additive models and distributed-lagged nonlinear models, daily mental disorder hospitalizations between 2002 and 2011 in Hong Kong were regressed on daily mean temperature, relative humidity, and air pollutants, adjusted for seasonal trend, long-term trend, day-of-week, and holiday. Analyses were stratified by disease class, gender and age-group. Results: 44,600 admissions were included in the analysis. Temperature was positively associated with overall mental-disorder hospitalizations (cumulative relative risk at 28 °C vs. 19.4 °C (interquartile range, lag 0-2 days) = 1.09 (95% confidence interval 1.03, 1.15)), with the strongest effect among the elderly (≥75 years old). Transient mental disorders due to conditions classified elsewhere and episodic mood disorders also showed strong positive associations with temperature. Conclusion: This study found a positive temperature-mental-disorder admissions association in a warm subtropical region and the association was most prominent among older people. With the dual effect of global warming and an aging population, targeted strategies should be designed to lower the disease burden.
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D'Angiulli A. Severe Urban Outdoor Air Pollution and Children's Structural and Functional Brain Development, From Evidence to Precautionary Strategic Action. Front Public Health 2018; 6:95. [PMID: 29670873 PMCID: PMC5893638 DOI: 10.3389/fpubh.2018.00095] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/12/2018] [Indexed: 12/18/2022] Open
Abstract
According to the latest estimates, about 2 billion children around the world are exposed to severe urban outdoor air pollution. Transdisciplinary, multi-method findings from epidemiology, developmental neuroscience, psychology, and pediatrics, show detrimental outcomes associated with pre- and postnatal exposure are found at all ages. Affected brain-related functions include perceptual and sensory information processing, intellectual and cognitive development, memory and executive functions, emotion and self-regulation, and academic achievement. Correspondingly, with the breakdown of natural barriers against entry and translocation of toxic particles in the brain, the most common structural changes are responses promoting neuroinflammation and indicating early neurodegenerative processes. In spite of the gaps in current scientific knowledge and the challenges posed by non-scientific issues that influence policy, the evidence invites the conclusion that urban outdoor air pollution is a serious threat to healthy brain development which may set the conditions for neurodegenerative diseases. Such evidence supports the perspective that urgent strategic precautionary actions, minimizing exposure and attenuating its effects, are needed to protect children and their brain development.
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Affiliation(s)
- Amedeo D'Angiulli
- Neuroscience, Carleton University, Ottawa, ON, Canada.,Institute of Interdisciplinary Studies (Child Studies Program), Carleton University, Ottawa, ON, Canada
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Fordyce TA, Leonhard MJ, Chang ET. A critical review of developmental exposure to particulate matter, autism spectrum disorder, and attention deficit hyperactivity disorder. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2018; 53:174-204. [PMID: 29157090 DOI: 10.1080/10934529.2017.1383121] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Autism spectrum disorder (ASD) and attention deficit (hyperactivity) disorder (ADD/ADHD) are key focuses of current health research due to their increasing prevalence. The objective of this systematic literature search and critical review was to evaluate whether the human epidemiologic data indicate a pattern of association between ASD or ADD/ADHD and developmental exposure to particulate matter (PM), with a focus on exposures encountered before the age of three. A MEDLINE and EMBASE search was conducted; following preliminary and full-text screening, 14 relevant articles were identified for review. Three of the 14 studies were prospective cohort studies evaluating exposure to PM10; 11 studies had a case-control design. There was no consistent association between developmental PM exposure and ASD across the three of the cohort studies. Seven of the case-control studies examined the relationship between PM2.5 and/or PM10 and ASD; four examined the relationship between developmental diesel PM exposure and ASD. Overall, there was low external consistency in results among studies of PM2.5/PM10 and ASD, with some reporting high internal consistency without significant associations, others showing associations with high internal consistency for specific exposure windows only (e.g., third trimester), and still others showing high consistency for moderate to strong associations between PM and ASD. The majority of studies reporting significant results had low effect sizes in conjunction with small sample sizes. The four studies of diesel PM and ASD also had low external consistency of results. Only one study evaluated associations with ADD/ADHD, and it found no significant associations with PM10. The inconsistent findings across studies of developmental exposure to PM and ASD may be attributed to differences in the study populations, exposure assessments, outcome assessments, or chance. Further research is needed to understand the underlying biological mechanisms that lead to ASD and ADD/ADHD and how PM might be involved in those mechanisms, if at all. High-quality epidemiologic studies are also needed to conclusively determine whether developmental PM exposure is a causal factor for ASD or ADD/ADHD, with focus on a well-developed exposure assessment.
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Affiliation(s)
- Tiffani A Fordyce
- a Exponent, Inc., Center for Health Sciences , Menlo Park , California , USA
| | - Megan J Leonhard
- b Exponent, Inc., Center for Health Sciences , Bellevue , Washington , USA
| | - Ellen T Chang
- a Exponent, Inc., Center for Health Sciences , Menlo Park , California , USA
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56
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Oudin A, Åström DO, Asplund P, Steingrimsson S, Szabo Z, Carlsen HK. The association between daily concentrations of air pollution and visits to a psychiatric emergency unit: a case-crossover study. Environ Health 2018; 17:4. [PMID: 29321054 PMCID: PMC5763570 DOI: 10.1186/s12940-017-0348-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 12/12/2017] [Indexed: 05/23/2023]
Abstract
BACKGROUND Air pollution is one of the leading causes of mortality and morbidity worldwide. Experimental studies, and a few epidemiological studies, suggest that air pollution may cause acute exacerbation of psychiatric disorders, and even increase the rate of suicide attempts, but epidemiological studies on air pollution in association with psychiatric disorders are still few. Our aim was to investigate associations between daily fluctuations in air pollution concentrations and the daily number of visits to a psychiatric emergency unit. METHODS Data from Sahlgrenska University Hospital, Gothenburg, Sweden, on the daily number of visits to the Psychiatric emergency unit were combined with daily data on monitored concentrations of respirable particulate matter(PM10), ozone(O3), nitrogen dioxides(NO2) and temperature between 1st July 2012 and 31st December 2016. We used a case-crossover design to analyze data with conditional Poisson regression models allowing for over-dispersion. We stratified data on season. RESULTS Visits increased with increasing PM10 levels during the warmer season (April to September) in both single-pollutant and two-pollutant models. For example, an increase of 3.6% (95% Confidence Interval, CI, 0.4-7.0%) was observed with a 10 μg/m3 increase in PM10 adjusted for NO2. In the three-pollutant models (adjusting for NO2 and O3 simultaneously) the increase was 3.3% (95% CI, -0.2-6.9). There were no clear associations between the outcome and NO2, O3, or PM10 during the colder season (October to March). CONCLUSIONS Ambient air particle concentrations were associated with the number of visits to the Psychiatric emergency unit in the warm season. The results were only borderline statistically significant in the fully adjusted (three-pollutant) models in this small study. The observation could be interpreted as indicative of air pollution as either exacerbating an underlying psychiatric disorder, or increasing mental distress, even in areas with comparatively low levels of air pollution. In combination with the severe impact of psychiatric disorders and mental distress on society and individuals, our results are a strong warrant for future research in this area.
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Affiliation(s)
- Anna Oudin
- Occupational and Environmental Medicine, Lund University, Medicon Village, Byggnad 402A, Scheelevägen 2, 223 63 Lund, Sweden
- Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Daniel Oudin Åström
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Peter Asplund
- Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Steinn Steingrimsson
- Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden
- CELAM - Centre for Ethics, Law and Mental Health, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Zoltan Szabo
- Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanne Krage Carlsen
- Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
- Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden
- Environment and Natural Resources, University of Iceland, Reykjavík, Iceland
- Occupational and Environmental Medicine, Gothenburg University, Gothenburg, Sweden
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57
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Sheffield PE, Speranza R, Chiu YHM, Hsu HHL, Curtin PC, Renzetti S, Pajak A, Coull B, Schwartz J, Kloog I, Wright RJ. Association between particulate air pollution exposure during pregnancy and postpartum maternal psychological functioning. PLoS One 2018. [PMID: 29668689 DOI: 10.1371/journal.10.1371/journal.pone.0195267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
METHODS We studied associations between prenatal exposure to particulate matter with diameter ≤ 2.5 μm (PM2.5) and postpartum psychological functioning in a lower income, ethnically mixed sample of urban US women enrolled in a pregnancy cohort study. Analyses included 557 mothers who delivered at ≥37 weeks gestation. Daily estimates of residential PM2.5 over gestation were derived using a satellite-based spatio-temporally resolved model. Outcomes included the Edinburgh Postnatal Depression Scale (EPDS) score from 6 or 12 months postpartum and subscale scores for anhedonia, depressive and anxiety symptoms. Associations were also examined within racial/ethnic groups. Distributed lag models (DLMs) were implemented to identify windows of vulnerability during pregnancy. RESULTS Most mothers had less than a high school education (64%) and were primarily Hispanic (55%) and Black (29%). In the overall sample, a DLM adjusted for age, race, education, prenatal smoking, and season of delivery, we found significant associations between higher PM2.5 exposure in the second trimester and increased anhedonia subscale scores postpartum. In race stratified analyses, mid-pregnancy PM2.5 exposure was significantly associated with increased total EPDS scores as well as higher anhedonia and depressive symptom subscale scores among Black women. CONCLUSIONS Increased PM2.5 exposure in mid-pregnancy was associated with increased depressive and anhedonia symptoms, particularly in Black women.
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Affiliation(s)
- Perry E Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Rosa Speranza
- Oregon Health & Science University School of Medicine, Portland, OR, United States of America
| | - Yueh-Hsiu Mathilda Chiu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Hsiao-Hsien Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Paul C Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Ashley Pajak
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Rosalind J Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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58
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Oudin A, Bråbäck L, Oudin Åström D, Forsberg B. Air Pollution and Dispensed Medications for Asthma, and Possible Effect Modifiers Related to Mental Health and Socio-Economy: A Longitudinal Cohort Study of Swedish Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111392. [PMID: 29144419 PMCID: PMC5708031 DOI: 10.3390/ijerph14111392] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/09/2017] [Accepted: 11/11/2017] [Indexed: 12/30/2022]
Abstract
It has been suggested that children that are exposed to a stressful environment at home have an increased susceptibility for air pollution-related asthma. The aim here was to investigate the association between air pollution exposure and asthma, and effect modification by mental health and by socio-economic status (as markers of a stressful environment). All individuals under 18 years of age in four Swedish counties during 2007 to 2010 (1.2 million people) were included. The outcome was defined as dispensing at least two asthma medications during follow up. We linked data on NO2 from an empirical land use regression to data from national registers on outcome and potential confounders. Data was analyzed with logistic regression. There was an odds ratio (OR) of 1.02 (95% Confidence Interval (CI: 1.01–1.03) for asthma associated with a 10 µg·m−3 increase in NO2. The association only seemed to be present in areas where NO2 was higher than 15 µg·m−3 with an OR of 1.09 (95% CI: 1.07–1.12), and the association seemed stronger in children with parents with a high education, OR = 1.05 (95% CI: 1.02–1.09) and OR = 1.04 (95% CI: 1.01–1.07) in children to mothers and father with a high education, respectively. The association did not seem to depend on medication history of psychiatric disorders. There was weak evidence for the association between air pollution and asthma to be stronger in neighborhoods with higher education levels. In conclusion, air pollution was associated with dispensed asthma medications, especially in areas with comparatively higher levels of air pollution, and in children to parents with high education. We did not observe support for our hypothesis that stressors linked to socio-economy or mental health problems would increase susceptibility to the effects of air pollution on the development of asthma.
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Affiliation(s)
- Anna Oudin
- Occupational and Environmental Medicine, Umeå University, 90187 Umeå, Sweden.
| | - Lennart Bråbäck
- Occupational and Environmental Medicine, Umeå University, 90187 Umeå, Sweden.
| | - Daniel Oudin Åström
- Occupational and Environmental Medicine, Umeå University, 90187 Umeå, Sweden.
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Umeå University, 90187 Umeå, Sweden.
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Abstract
Although too small to be seen with the human eye, atmospheric particulate matter has major impacts on the world around us, from our health to global climate. Understanding the sources, properties, and transformations of these particles in the atmosphere is among the major challenges in air quality and climate research today. Significant progress has been made over the past two decades in understanding atmospheric aerosol chemistry and its connections to climate. Advances in technology for characterizing aerosol chemical composition and physical properties have enabled rapid discovery in this area. This article reviews fundamental concepts and recent developments surrounding ambient aerosols, their chemical composition and sources, light-absorbing aerosols, aerosols and cloud formation, and aerosol-based solar radiation management (also known as solar geoengineering).
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Affiliation(s)
- V. Faye McNeill
- Department of Chemical Engineering, Columbia University, New York, New York 10027
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60
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Laundy Frisenstam K, van den Bosch M, Chen Y, Friberg P, Osika W. Self-Reported Psychosomatic Complaints In Swedish Children, Adolescents, and Young Adults Living in Rural and Urban Areas: An Internet-Based Survey. JMIR Public Health Surveill 2017; 3:e9. [PMID: 28270381 PMCID: PMC5360894 DOI: 10.2196/publichealth.5902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 12/09/2016] [Accepted: 01/03/2017] [Indexed: 12/02/2022] Open
Abstract
Background Frequencies in reported psychosomatic illnesses have increased in Sweden among children, adolescents, and young adults. Little is known about demographic differences in self-reported psychosomatic complaints, such as between urban and rural areas, and whether surveys launched on the Internet could be a useful method in sampling such data. Objectives This study examines the connection between psychosomatic illnesses and demographics in Swedish children and youth. The feasibility of using the Internet to gather large amounts of data regarding psychosomatic complaints in this group is another major objective of this study. Methods A cross-sectional study using 7 validated questions about psychosomatic health, were launched in a controlled way onto a recognized Swedish Internet community site, which targeted users 10 to 24 years of age. The subjects were able to answer the items while they were logged in to their personal domain. The results were analyzed cross-geographically within Sweden. Results In total, we received 100,000 to 130,000 individual answers per question. Subjects of both sexes generally reported significantly higher levels of self-reported psychosomatic complaints in major city areas as compared with minor city/rural areas, even though the differences between the areas were small. For example, 12.00% (4472/37,265) of females in minor regions reported always feeling tense, compared with 13.80% (3156/22,873) of females in major regions (P<.001). In males, the answer pattern was similar, 16.40% (4887/29,801) in major regions versus 15.60% (2712/17,386) in minor regions, (P=.006). Females reported significantly higher frequencies of psychosomatic complaints than males (P<.001). Conclusions In subjects aged 10 to 24 years, higher levels of psychosomatic complaints appear to correlate with living in major city areas in comparison with minor city/rural areas. Surveys launched on the Internet could be a useful method in sampling data regarding psychosomatic health for this age group.
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Affiliation(s)
- Katarina Laundy Frisenstam
- The Sahlgrenska Academy and University Hospital, Department of Molecular and Clinical Medicine/Clinical Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Matilda van den Bosch
- School of Population and Public health, The University of British Columbia, Vancouver, BC, Canada.,Department of Forest and Conservation Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Yun Chen
- The Sahlgrenska Academy and University Hospital, Department of Molecular and Clinical Medicine/Clinical Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Peter Friberg
- The Sahlgrenska Academy and University Hospital, Department of Molecular and Clinical Medicine/Clinical Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Walter Osika
- Center för Social Sustainability, Department for Neurobiology, Care Sciences and Society, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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61
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Min JY, Min KB. Exposure to ambient PM 10 and NO 2 and the incidence of attention-deficit hyperactivity disorder in childhood. ENVIRONMENT INTERNATIONAL 2017; 99:221-227. [PMID: 27939018 DOI: 10.1016/j.envint.2016.11.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 11/24/2016] [Accepted: 11/24/2016] [Indexed: 05/06/2023]
Abstract
BACKGROUND Epidemiological studies have implicated air pollution in the causation of neurodevelopmental disorders, including attention-deficit hyperactivity disorder (ADHD), but definitive evidence of this linkage is lacking. OBJECTIVES We examined the association between cumulative exposure to air pollutants from birth to diagnosis, particularly particulate matter of <10μm (PM10) and nitric dioxide (NO2), and childhood ADHD. METHODS We used the National Health Insurance Service-National Sample Cohort (2002-2012), a population-wide health insurance claims dataset. A total of 8936 infants (age 0) born between January 2002 and December 2002 were followed-up for a 10-year period (2003-2012). ADHD was defined as per ICD-10 code F90.0. Exposure levels of PM10 and NO2 were extrapolated using geographic information systems and collated with the subjects' administrative district code, and individual exposure levels assigned. Hazard ratios (HRs) were calculated for the development of ADHD, after adjusting for gender, metropolitan area, income, and history of diseases. RESULTS During the study period, ADHD occurred in 314 subjects (3.5%). With the increase in 1μg/m3 of air pollutants, the HRs of childhood ADHD were 1.18 (95% CI: 1.15-1.21) in case of PM10 and 1.03 (95% CI: 1.02-1.04) in case of NO2. Compared with infants with the lowest tertile of PM10 or NO2 exposure, those with the highest tertile of PM10 (HR=3.88; 95% CI: 2.87-5.23) or NO2 (HR=2.10; 95% CI, 1.54-2.85) exposure had a 2 to 3 fold increased risk for ADHD. CONCLUSION Exposure to PM10 and NO2 was associated with the incidence of ADHD in childhood.
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Affiliation(s)
- Jin-Young Min
- Institute of Health and Environment, School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
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