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Abstract
In this article, the authors discuss primarily what is known about the epidemiology of all-cause dementia. Dementia is caused by a complex interplay of genetics, comorbidities, and lifestyle factors, and drug development has been challenging. However, evidence from large, prospective, observational studies has identified a variety of factors that may prevent or delay the onset of dementia. Several of these factors are modifiable and lend themselves to well to treatments currently available. The authors discuss the state of current evidence on dementia risk factors, the most promising avenues, and future directions for dementia prevention and management.
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Affiliation(s)
- Christina S Dintica
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Kristine Yaffe
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA; San Francisco VA Health Care System, San Francisco, CA, USA.
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52
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Luo Z, Shen G, Men Y, Zhang W, Meng W, Zhu W, Meng J, Liu X, Cheng Q, Jiang K, Yun X, Cheng H, Xue T, Shen H, Tao S. Reduced inequality in ambient and household PM 2.5 exposure in China. ENVIRONMENT INTERNATIONAL 2022; 170:107599. [PMID: 36323065 DOI: 10.1016/j.envint.2022.107599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
The society has high concerns on the inequality that people are disproportionately exposed to ambient air pollution, but with more time spent indoors, the disparity in the total exposure considering both indoor and outdoor exposure has not been explored; and with the socioeconomical development and efforts in fighting against air pollution, it is unknown how the exposure inequality changed over time. Based on the city-level panel data, this study revealed the Concentration Index (C) in ambient PM2.5 exposure inequality was positive, indicating the low-income group exposed to lower ambient PM2.5; however, the total PM2.5 exposure was negatively correlated with the income, showing a negative C value. The low-income population exposed to high PM2.5 associated with larger contributions of indoor exposure from the residential emissions. The total PM2.5 exposure caused 1.13 (0.63-1.73) million premature deaths in 2019, with only 14 % were high-income population. The toughest-ever air pollution countermeasures have reduced ambient PM2.5 exposures effectively that, however, benefited the rich population more than the others. The transition to clean household energy sources significantly affected on indoor air quality improvements, as well as alleviation of ambient air pollution, resulting in notable reductions of the total PM2.5 exposure and especially benefiting the low-income groups. The negative C values decreased from 2000 to 2019, indicating a significantly reducing trend in the total PM2.5 exposure inequality over time.
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Affiliation(s)
- Zhihan Luo
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Guofeng Shen
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China.
| | - Yatai Men
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Wenxiao Zhang
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Wenjun Meng
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Wenyuan Zhu
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Jing Meng
- The Bartlett School of Sustainable Construction, University College London, London WC1E 7HB, United Kingdom
| | - Xinlei Liu
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Qin Cheng
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Ke Jiang
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Xiao Yun
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Hefa Cheng
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Tao Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Huizhong Shen
- College of Environmental Science and Technology, Southern University of Science and Technology, Shenzhen 518055, China
| | - Shu Tao
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China; College of Environmental Science and Technology, Southern University of Science and Technology, Shenzhen 518055, China
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53
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Esie P, Daepp MIG, Roseway A, Counts S. Neighborhood Composition and Air Pollution in Chicago: Monitoring Inequities With a Dense, Low-Cost Sensing Network, 2021. Am J Public Health 2022. [PMID: 36383946 DOI: 10.2105/ajph.022.307068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objectives. To evaluate the efficacy of a novel, real-time sensor network for routine monitoring of racial and economic disparities in fine particulate matter (PM2.5; particulate matter ≤ 2.5 µm in diameter) exposures at the neighborhood level. Methods. We deployed a dense network of low-cost PM2.5 sensors in Chicago, Illinois, to evaluate associations between neighborhood-level composition variables (percentage of Black residents, percentage of Hispanic/Latinx residents, and percentage of households below poverty) and interpolated PM2.5. Relationships were assessed in spatial lag models after adjustment for all composition variables. Models were fit with data both from the overall period and during high-pollution episodes associated with social events (July 4, 2021) and wildfires (July 23, 2021). Results. The spatial lag models showed that racial/ethnic composition variables were associated with higher PM2.5 levels. Levels were notably higher in neighborhoods with larger compositions of Hispanic/Latinx residents across the entire study period and notably higher in neighborhoods with larger Black populations during the July 4 episode. Conclusions. As a complement to sparse regulatory networks, dense, low-cost sensor networks can capture spatial variations during short-term air pollution episodes and enable monitoring of neighborhood-level inequities in air pollution exposures in real time. (Am J Public Health. 2022;112(12):1765-1773. https://doi.org/10.2105/AJPH.2022.307068).
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Affiliation(s)
- Precious Esie
- At the time of the study, the authors were with Microsoft Research, Redmond, WA
| | - Madeleine I G Daepp
- At the time of the study, the authors were with Microsoft Research, Redmond, WA
| | - Asta Roseway
- At the time of the study, the authors were with Microsoft Research, Redmond, WA
| | - Scott Counts
- At the time of the study, the authors were with Microsoft Research, Redmond, WA
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54
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Esie P, Daepp MIG, Roseway A, Counts S. Neighborhood Composition and Air Pollution in Chicago: Monitoring Inequities With a Dense, Low-Cost Sensing Network, 2021. Am J Public Health 2022; 112:1765-1773. [PMID: 36383946 PMCID: PMC9670210 DOI: 10.2105/ajph.2022.307068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Objectives. To evaluate the efficacy of a novel, real-time sensor network for routine monitoring of racial and economic disparities in fine particulate matter (PM2.5; particulate matter ≤ 2.5 µm in diameter) exposures at the neighborhood level. Methods. We deployed a dense network of low-cost PM2.5 sensors in Chicago, Illinois, to evaluate associations between neighborhood-level composition variables (percentage of Black residents, percentage of Hispanic/Latinx residents, and percentage of households below poverty) and interpolated PM2.5. Relationships were assessed in spatial lag models after adjustment for all composition variables. Models were fit with data both from the overall period and during high-pollution episodes associated with social events (July 4, 2021) and wildfires (July 23, 2021). Results. The spatial lag models showed that racial/ethnic composition variables were associated with higher PM2.5 levels. Levels were notably higher in neighborhoods with larger compositions of Hispanic/Latinx residents across the entire study period and notably higher in neighborhoods with larger Black populations during the July 4 episode. Conclusions. As a complement to sparse regulatory networks, dense, low-cost sensor networks can capture spatial variations during short-term air pollution episodes and enable monitoring of neighborhood-level inequities in air pollution exposures in real time. (Am J Public Health. 2022;112(12):1765-1773. https://doi.org/10.2105/AJPH.2022.307068).
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Affiliation(s)
- Precious Esie
- At the time of the study, the authors were with Microsoft Research, Redmond, WA
| | - Madeleine I G Daepp
- At the time of the study, the authors were with Microsoft Research, Redmond, WA
| | - Asta Roseway
- At the time of the study, the authors were with Microsoft Research, Redmond, WA
| | - Scott Counts
- At the time of the study, the authors were with Microsoft Research, Redmond, WA
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55
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Gaffney AW. Disparities in Disease Burden and Treatment of Patients Asthma and Chronic Obstructive Pulmonary Disease. Med Clin North Am 2022; 106:1027-1039. [PMID: 36280330 DOI: 10.1016/j.mcna.2022.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lung health reflects the inequities of our society. Asthma and chronic obstructive pulmonary disease are 2 lung conditions commonly treated in general clinical practice; each imposes a disproportionate burden on disadvantaged patients. Numerous factors mediate disparities in lung health, including air pollution, allergen exposures, tobacco, and respiratory infections. Members of racial/ethnic minorities and those of low socioeconomic status also have inferior access to high-quality medical care, compounding disparities in disease burden. Physicians can work against disparities in their practice, but wide-ranging policy reforms to achieve better air quality, housing, workplace safety, and healthcare for all are needed to achieve equity in lung health.
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Affiliation(s)
- Adam W Gaffney
- Harvard Medical School, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02138, USA.
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56
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Collins TW, Grineski SE, Shaker Y, Mullen CJ. Communities of color are disproportionately exposed to long-term and short-term PM 2.5 in metropolitan America. ENVIRONMENTAL RESEARCH 2022; 214:114038. [PMID: 35961542 DOI: 10.1016/j.envres.2022.114038] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
We conducted a novel investigation of neighborhood-level racial/ethnic exposure disparities employing measures aligned with long-term and short-term PM2.5 air pollution benchmarks across metropolitan contexts of the contiguous United States, 2012-2016. We used multivariable generalized estimating equations (GEE) to quantify PM2.5 exposure disparities based on the census tract composition of people of color (POC) and POC groups (Hispanic/Latina/x/o, Black, Asian). We examined eight census tract-level measures of longer-to-shorter term exposures derived from data on modeled daily ambient PM2.5 concentrations. We found associations between increased POC composition and greater exposure to all PM2.5 measures, with associations strengthening across measures of longer-to-shorter term exposures. In a GEE with a negative binomial distribution, a standard deviation increase in POC composition predicted a 0.6% increase (incidence rate ratio (IRR): 1.006, 95% confidence interval (CI): 1.005-1.008) in the number of days PM2.5 concentrations were ≥5 μg/m3 (longest-term benchmark). In a GEE with an inverse Gaussian distribution, a standard deviation increase in POC composition predicted a 0.110 μg/m3 (1.0%) increase (B: 0.110, 95% CI: 0.076-0.143) in mean PM2.5 concentration. In GEEs with a negative binomial distribution, the effect of a standard deviation increase in POC composition on exposure strengthened to 2.6% (IRR:1.026, 95% CI:1.017-1.035), 3.4% (IRR:1.034, 95% CI:1.022-1.047), 4.2% (IRR:1.042, 95% CI:1.025-1.058), 16.2% (IRR:1.162, 95% CI:1.117-1.210), 22.7% (IRR:1.227, 95% CI:1.137-1.325) and 28.3% (IRR:1.283, 95% CI:1.144-1.439) with respect to the number of days PM2.5 concentrations were ≥10, 12, 15, 25, 35 and 55.5 μg/m3. POC group models indicated exposure disparities based on greater Hispanic/Latina/x/o, Asian, and Black composition. Evidence for stronger POC associations with shorter-term (higher concentration) PM2.5 exceedances suggests that reducing PM2.5 would attenuate racial/ethnic exposure disparities.
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Affiliation(s)
- Timothy W Collins
- Department of Geography, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA; Center for Natural & Technological Hazards, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA.
| | - Sara E Grineski
- Center for Natural & Technological Hazards, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA; Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, USA
| | - Yasamin Shaker
- Center for Natural & Technological Hazards, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA; Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, USA
| | - Casey J Mullen
- Center for Natural & Technological Hazards, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA; Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, USA
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57
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Feng S, Meng Q, Guo B, Guo Y, Chen G, Pan Y, Zhou J, Xu J, Zeng Q, Wei J, Xu H, Chen L, Zeng C, Zhao X. Joint exposure to air pollution, ambient temperature and residential greenness and their association with metabolic syndrome (MetS): A large population-based study among Chinese adults. ENVIRONMENTAL RESEARCH 2022; 214:113699. [PMID: 35714687 DOI: 10.1016/j.envres.2022.113699] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 06/15/2023]
Abstract
Previous studies assessing adverse health have traditionally focused on a single environmental exposure, failing to reflect the reality of various exposures present simultaneously. Air pollution, ambient temperature and greenness have been proposed as critical environmental factors associated with metabolic syndrome (MetS). However, evidence exploring their joint relationships with MetS is needed for identifying interactive factors and developing more targeted public health interventions. The baseline data was obtained from China Multi-Ethnic Cohort (CMEC). Environmental data of air pollutants (PM2.5, O3) and NDVI for greenness was calculated from satellites data. Ambient temperature data were obtained from European Center for Medium-Range Weather Forecasts (ECMWF). MetS was classified based on National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) using anthropometric measures and biomarkers. Logistic regression models were utilized to examine the combined relationship of MetS with three-year exposure to air pollutants, temperature and NDVI. Relative excess risk due to interaction (RERI) was calculated to evaluate interaction on an additive scale. We found associations between prevalent MetS and interquartile range (IQR) increases in PM2.5 (OR: 1.38; 95% confidence interval [95% CI]: 1.23, 1.55) and O3 (OR: 1.15; 95% CI: 1.09, 1.22). Additive and multiplicative interactions were observed between air pollutants and temperature exposure. Compared to low-temperature level, the relationship between PM2.5 and MetS attenuated (RERI: 0.22, 95% CI: 0.44, -0.04) at high-temperature level, while the relationship between O3 and MetS enhanced (RERI: 0.05, 95% CI: 0.02, 0.11). At low NDVI 250 m, the association between PM2.5 and MetS was stronger (RERI: 0.13, 95% CI: 0.05, 0.19) with high NDVI 250 m as the reference group. Our findings showed that ambient temperature and residential greenness could affect the relationship between air pollutants and MetS.
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Affiliation(s)
- Shiyu Feng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiong Meng
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | | | - Jing Zhou
- Chenghua District Center for Disease Control and Prevention, China
| | - Jingru Xu
- Chongqing Municipal Center for Disease Control and Prevention, China
| | - Qibing Zeng
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Huan Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chunmei Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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58
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Kodros JK, Bell ML, Dominici F, L'Orange C, Godri Pollitt KJ, Weichenthal S, Wu X, Volckens J. Unequal airborne exposure to toxic metals associated with race, ethnicity, and segregation in the USA. Nat Commun 2022; 13:6329. [PMID: 36319637 PMCID: PMC9626599 DOI: 10.1038/s41467-022-33372-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 09/15/2022] [Indexed: 11/05/2022] Open
Abstract
Persons of color have been exposed to a disproportionate burden of air pollution across the United States for decades. Yet, the inequality in exposure to known toxic elements of air pollution is unclear. Here, we find that populations living in racially segregated communities are exposed to a form of fine particulate matter with over three times higher mass proportions of known toxic and carcinogenic metals. While concentrations of total fine particulate matter are two times higher in racially segregated communities, concentrations of metals from anthropogenic sources are nearly ten times higher. Populations living in racially segregated communities have been disproportionately exposed to these environmental stressors throughout the past decade. We find evidence, however, that these disproportionate exposures may be abated though targeted regulatory action. For example, recent regulations on marine fuel oil not only reduced vanadium concentrations in coastal cities, but also sharply lessened differences in vanadium exposure by segregation.
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Affiliation(s)
- John K Kodros
- Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado, USA.
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christian L'Orange
- Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado, USA
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Scott Weichenthal
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Xiao Wu
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - John Volckens
- Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado, USA
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59
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Medrano J, Crnosija N, Prather RW, Payne-Sturges D. Bridging the environment and neurodevelopment for children's health: Associations between real-time air pollutant exposures and cognitive outcomes. Front Psychol 2022; 13:933327. [PMID: 36329746 PMCID: PMC9623017 DOI: 10.3389/fpsyg.2022.933327] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 09/28/2022] [Indexed: 11/29/2023] Open
Abstract
Research suggests that children's exposure to pollutants may impact their neurocognitive development. While researchers have found associations between air pollutants and cognitive development, these associations remain underspecified. Further, these exposures occur in the context of the built environment and may be exacerbated by local social vulnerability; in this context, individuals may experience a suite of socioenvironmental stressors that lead to increased cumulative risk exposure. In this pilot study, we tested whether real-time-measured personal exposure to PM2.5 relates to children's executive function and mathematical skills, outcomes that may predict later mathematical performance, general academic performance and even employment outcomes. We recruited 30 families to participate in two rounds in Winter 2020 and Summer 2021. We collected children's demographic data, as well as data about their living environment. In each round, children carried a small device that collected real-time ambient air pollution data for 3 days; parents logged their children's activities each day. On the last day, children completed cognitive assessments indexing their working memory (n-back), inhibitory control (Go/No-Go), nonsymbolic math skills (dot comparison), and arithmetic skills (equation verification). Overall, 29 participants had pollutant readings from both rounds, and 21 had a full dataset. Nonparametric statistical analysis revealed no significant differences in ambient air pollution and cognitive performance over time, Spearman's rho correlation assessment found that PM2.5 was not significantly correlated with cognitive outcomes in R1 and R2. However, the correlations suggested that an increase in PM2.5 was associated with worse working memory, inhibitory control, nonsymbolic skills, and arithmetic skills, at least in R1. We used each participant's zip code-aggregated Social Vulnerability Index, which range from 0 to 1, with higher numbers indicating more social vulnerability. Wilcoxon Rank-Sum tests indicated that participants living in higher SVI zip codes (≥0.70; n = 15) were not significantly different from those living in lower SVI zip codes (<0.70; n = 14), in terms of their PM2.5 exposures and cognitive performance in each round. We also found that socioeconomic characteristics mattered, such that children whose parent (s) had at least a Master's degree or earned more than $100,000 a year had lower PM2.5 exposures than children in the other end.
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Affiliation(s)
- Josh Medrano
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, United States
| | - Natalie Crnosija
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, United States
| | - Richard W Prather
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, United States
| | - Devon Payne-Sturges
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, United States
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60
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Yu YT, Xiang S, Zhang T, You Y, Si S, Zhang S, Wu Y. Evaluation of City-Scale Disparities in PM 2.5 Exposure Using Hyper-Localized Taxi-Based Mobile Monitoring. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:13584-13594. [PMID: 36124860 DOI: 10.1021/acs.est.2c02354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Efforts have been directed to pollution control of fine particles (PM2.5) because exposure to PM2.5 could result in adverse health effects. However, PM2.5 exposure disparities persisted even with largely declined concentrations. Here, we applied taxi-based measurements to characterize hyper-localized PM2.5 exposures (30 m resolution) in Xi'an in December 2019 and July 2020. A big data set was derived from the taxi-based measurements (∼6 × 106 hourly PM2.5) and was used to evaluate the performance of existing regulatory measurements in urban and rural regions. Results from regulatory measurements tend to alleviate PM2.5 exposure disparities compared with taxi-based measurements. The taxi-based measurements reported higher population-weighted average (PWA) exposure in December 2019 (90 μg/m3) and July 2020 (27 μg/m3) compared to regulatory measurements (76 and 24 μg/m3 in December and July, respectively) with a wider range of relative disparities. Results indicate that the urban region would be overrepresented by regulatory measurements, where regulatory measurements reported that 60.0-84.7% of inhabitants were exposed to PM2.5 higher than PWA, while taxi-based ones reported a smaller portion (22.6-35.2%). Significant seasonal variability in PM2.5 exposure levels was found by taxi-based measurements but not regulatory measurements. The results highlight the need for providing complementary measurements (e.g., low-cost) for exposure assessment because the rural regions could be disproportionately exposed and overlooked by existing regulatory measurements.
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Affiliation(s)
- Yu Ting Yu
- School of Environment, State Key Joint Laboratory of Environment Simulation and Pollution Control, Tsinghua University, Beijing 100084, PR China
| | - Sheng Xiang
- School of Environment, State Key Joint Laboratory of Environment Simulation and Pollution Control, Tsinghua University, Beijing 100084, PR China
| | - Tong Zhang
- Department of Atmospheric Environment, Xi'an Ecological Environment Bureau, Xi'an 710021, PR China
| | - Yan You
- National Observation and Research Station of Coastal Ecological Environments in Macao, Macao SAR 999078, China
- Environmental Research Institute, Macau University of Science and Technology, Macao SAR 999078, China
| | - Shuchun Si
- School of Physics, Shandong University, Jinan 250100, P.R. China
| | - Shaojun Zhang
- School of Environment, State Key Joint Laboratory of Environment Simulation and Pollution Control, Tsinghua University, Beijing 100084, PR China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, P. R. China
| | - Ye Wu
- School of Environment, State Key Joint Laboratory of Environment Simulation and Pollution Control, Tsinghua University, Beijing 100084, PR China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, P. R. China
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61
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Dobbs TE, Carson AP. The Hidden Factors Associated With Poor Health Outcomes. JAMA Netw Open 2022; 5:e2234325. [PMID: 36190734 DOI: 10.1001/jamanetworkopen.2022.34325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Thomas E Dobbs
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson
| | - April P Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson
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62
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O’Sharkey K, Xu Y, Chavez T, Johnson M, Cabison J, Rosales M, Grubbs B, Toledo-Corral CM, Farzan SF, Bastain T, Breton CV, Habre R. In-utero personal exposure to PM 2.5 impacted by indoor and outdoor sources and birthweight in the MADRES cohort. ENVIRONMENTAL ADVANCES 2022; 9:100257. [PMID: 36778968 PMCID: PMC9912940 DOI: 10.1016/j.envadv.2022.100257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND In-utero exposure to outdoor particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) is linked with low birthweight. However, previous results are mixed, likely due to measurement error introduced by estimating personal exposure from ambient data. This study investigated the effect of total personal PM2.5 exposure on birthweight and whether it differed when it was more heavily impacted by sources of indoor vs outdoor origin in the MADRES cohort study. METHODS Personal PM2.5 exposure was measured in 205 pregnant women in the 3rd trimester using 48 h integrated, filter-based sampling. Linear regression was used to test the association between personal PM2.5 exposure and birthweight, adjusting for key covariates. Interactions of PM2.5 with variables representing indoor sources of PM2.5, home ventilation, or time spent indoors tested whether the effect of total PM2.5 on birthweight varied when it was more impacted by sources of indoor vs outdoor origin. RESULTS In a sample of largely Hispanic (81%) pregnant women, total personal PM2.5 was not significantly associated with birthweight (β = 38.6 per 1SD increase in PM2.5; 95% CI:-21.1, 98.2). This association however, differed by home type (single family home: 156.9 (26.9, 287.0), 2-4 attached units:-16.6 (-111.9, 78.7), 5+ units:-62.6 (-184.9, 59.6), missing: 145.4 (-4.1, 294.9), interaction p = 0.028) and by household air conditioner use (none of the time: -27.6 (-101.5, 46.3) vs. some of the time: 139.9 (42.9, 237.0), interaction p = 0.008) Additionally, the effect of personal PM2.5 on birthweight varied by time spent indoors (none or little of the time: - 45.1 (-208.3, 118.1) vs. most or all of the time: 57.1 (-7.3, 121.6), interaction p = 0.255). CONCLUSIONS While no significant association between total personal PM2.5 exposure and birthweight was found, there was evidence that multi-unit housing (vs. single-family homes), candle and/or incense smoke, and greater outdoor source contributions to personal PM2.5 were more strongly associated with lower birthweight.
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Affiliation(s)
- Karl O’Sharkey
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Yan Xu
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, United States
| | - Thomas Chavez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Mark Johnson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Jane Cabison
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Marisela Rosales
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Brendan Grubbs
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Claudia M. Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
- Department of Health Sciences, California State University Northridge, Northridge, CA, United States
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Theresa Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, United States
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Schuyler AJ, Wenzel SE. Historical Redlining Impacts Contemporary Environmental and Asthma-related Outcomes in Black Adults. Am J Respir Crit Care Med 2022; 206:824-837. [PMID: 35612914 PMCID: PMC9799280 DOI: 10.1164/rccm.202112-2707oc] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/25/2022] [Indexed: 01/02/2023] Open
Abstract
Rationale: Environmental threats and poorly controlled asthma disproportionately burden Black people. Some have attributed this to socioeconomic or biologic factors; however, racism, specifically historical redlining, a U.S. discriminatory mortgage lending practice in existence between the 1930s and the 1970s, may have actuated and then perpetuated poor asthma-related outcomes. Objectives: To link historical redlining (institutional racism) to contemporary environmental quality- and lung health-related racial inequity. Methods: Leveraging a broadly recruited asthma registry, we geocoded 1,034 registry participants from Pittsburgh/Allegheny County, Pennsylvania, to neighborhoods subjected to historical redlining, as defined by a 1930s Home Owners' Loan Corporation (HOLC) map. Individual-level clinical/physiologic data, residential air pollution, demographics, and socioeconomic factors provided detailed characterization. We determined the prevalence of uncontrolled and/or severe asthma and other asthma-related outcomes by HOLC (neighborhood) grade (A-D). We performed a stratified analysis by self-identified race to assess the distribution of environmental and asthma risk within each HOLC grade. Measurements and Main Results: The registry sampling overall reflected Allegheny County neighborhood populations. The emissions of carbon monoxide, filterable particulate matter <2.5 μm, sulfur dioxide, and volatile organic compounds increased across HOLC grades (all P ⩽ 0.004), with grade D neighborhoods encumbered by the highest levels. The persistent, dispersive socioenvironmental burden peripherally extending from grade D neighborhoods, including racialized access to healthy environments (structural racism), supported a long-term impact of historical/HOLC redlining. The worst asthma-related outcomes, including uncontrolled and/or severe asthma (P < 0.001; Z = 3.81), and evidence for delivery of suboptimal asthma care occurred among registry participants from grade D neighborhoods. Furthermore, elevated exposure to filterable particulate matter <2.5 μm, sulfur dioxide, and volatile organic compound emissions (all P < 0.050) and risk of uncontrolled and/or severe asthma (relative risk [95% confidence interval], 2.30 [1.19, 4.43]; P = 0.009) demonstrated inequitable distributions within grade D neighborhood boundaries, disproportionately burdening Black registry participants. Conclusions: The racist practice of historical/HOLC redlining profoundly contributes to long-term environmental and asthma-related inequities in Black adults. Acknowledging the role racism has in these outcomes should empower more specific and novel interventions targeted at reversing these structural issues.
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Affiliation(s)
- Alexander J. Schuyler
- University of Pittsburgh Asthma and Environmental Lung Health Institute@UPMC and
- Department of Environmental & Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sally E. Wenzel
- University of Pittsburgh Asthma and Environmental Lung Health Institute@UPMC and
- Department of Environmental & Occupational Health, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Tu P, Tian Y, Hong Y, Yang L, Huang J, Zhang H, Mei X, Zhuang Y, Zou X, He C. Exposure and Inequality of PM 2.5 Pollution to Chinese Population: A Case Study of 31 Provincial Capital Cities from 2000 to 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912137. [PMID: 36231437 PMCID: PMC9564533 DOI: 10.3390/ijerph191912137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 05/02/2023]
Abstract
Fine particulate matter (PM2.5) exposure has been linked to numerous adverse health effects, with some disadvantaged subgroups bearing a disproportionate exposure burden. Few studies have been conducted to estimate the exposure and inequality of different subgroups due to a lack of adequate characterization of disparities in exposure to air pollutants in urban areas, and a mechanistic understanding of the causes of these exposure inequalities. Based on a long-term series of PM2.5 concentrations, this study analyzed the spatial and temporal characteristics of PM2.5 in 31 provincial capital cities of China from 2000 to 2016 using the coefficient of variation and trend analyses. A health risk assessment of human exposure to PM2.5 from 2000 to 2016 was then undertaken. A cumulative population-weighted average concentration method was applied to investigate exposures and inequality for education level, job category, age, gender and income population subgroups. The relationships between socioeconomic factors and PM2.5 exposure concentrations were quantified using the geographically and temporally weighted regression model (GTWR). Results indicate that the PM2.5 concentrations in most of the capital cities in the study experienced an increasing trend at a rate of 0.98 μg m-3 per year from 2000 to 2016. The proportion of the population exposed to high PM2.5 (above 35 μg m-3) increased annually, mainly due to the increase of population migrating into north, east, south and central China. The higher educated, older, higher income and urban secondary industry share (SIS) subgroups suffered from the most significant environmental inequality, respectively. The per capita GDP, population size, and the share of the secondary industry played an essential role in unequal exposure to PM2.5.
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Affiliation(s)
- Peiyue Tu
- Faculty of Resources and Environmental Science, Hubei University, Wuhan 430062, China
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430079, China
| | - Ya Tian
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430079, China
| | - Yujia Hong
- Wuhan Britain-China School, Wuhan 430034, China
| | - Lu Yang
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430079, China
| | - Jiayi Huang
- Woodsworth College, University of Toronto, Toronto, ON M5S1A9, Canada
| | - Haoran Zhang
- Department of Geography, University of Washington, Seattle, WA 98195, USA
- Correspondence: (H.Z.); (C.H.); Tel.: +86-15727359013 (C.H.); Fax: +86-2769111990 (C.H.)
| | - Xin Mei
- Faculty of Resources and Environmental Science, Hubei University, Wuhan 430062, China
| | - Yanhua Zhuang
- Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan 430077, China
| | - Xin Zou
- Faculty of Resources and Environmental Science, Hubei University, Wuhan 430062, China
| | - Chao He
- College of Resources and Environment, Yangtze University, Wuhan 430100, China
- Correspondence: (H.Z.); (C.H.); Tel.: +86-15727359013 (C.H.); Fax: +86-2769111990 (C.H.)
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Hu J, Yao J, Deng S, Balasubramanian R, Jiménez MC, Li J, Guo X, Cruz DE, Gao Y, Huang T, Zeleznik OA, Ngo D, Liu S, Rosal MC, Nassir R, Paynter NP, Albert CM, Tracy RP, Durda P, Liu Y, Taylor KD, Johnson WC, Sun Q, Rimm EB, Eliassen AH, Rich SS, Rotter JI, Gerszten RE, Clish CB, Rexrode KM. Differences in Metabolomic Profiles Between Black and White Women and Risk of Coronary Heart Disease: an Observational Study of Women From Four US Cohorts. Circ Res 2022; 131:601-615. [PMID: 36052690 PMCID: PMC9473718 DOI: 10.1161/circresaha.121.320134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 08/13/2022] [Accepted: 08/21/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Racial differences in metabolomic profiles may reflect underlying differences in social determinants of health by self-reported race and may be related to racial disparities in coronary heart disease (CHD) among women in the United States. However, the magnitude of differences in metabolomic profiles between Black and White women in the United States has not been well-described. It also remains unknown whether such differences are related to differences in CHD risk. METHODS Plasma metabolomic profiles were analyzed using liquid chromatography-tandem mass spectrometry in the WHI-OS (Women's Health Initiative-Observational Study; 138 Black and 696 White women), WHI-HT trials (WHI-Hormone Therapy; 156 Black and 1138 White women), MESA (Multi-Ethnic Study of Atherosclerosis; 114 Black and 219 White women), JHS (Jackson Heart Study; 1465 Black women with 107 incident CHD cases), and NHS (Nurses' Health Study; 2506 White women with 136 incident CHD cases). First, linear regression models were used to estimate associations between self-reported race and 472 metabolites in WHI-OS (discovery); findings were replicated in WHI-HT and validated in MESA. Second, we used elastic net regression to construct a racial difference metabolomic pattern (RDMP) representing differences in the metabolomic patterns between Black and White women in the WHI-OS; the RDMP was validated in the WHI-HT and MESA. Third, using conditional logistic regressions in the WHI (717 CHD cases and 719 matched controls), we examined associations of metabolites with large differences in levels by race and the RDMP with risk of CHD, and the results were replicated in Black women from the JHS and White women from the NHS. RESULTS Of the 472 tested metabolites, levels of 259 (54.9%) metabolites, mostly lipid metabolites and amino acids, significantly differed between Black and White women in both WHI-OS and WHI-HT after adjusting for baseline characteristics, socioeconomic status, lifestyle factors, baseline health conditions, and medication use (false discovery rate <0.05); similar trends were observed in MESA. The RDMP, composed of 152 metabolites, was identified in the WHI-OS and showed significantly different distributions between Black and White women in the WHI-HT and MESA. Higher RDMP quartiles were associated with an increased risk of incident CHD (odds ratio=1.51 [0.97-2.37] for the highest quartile comparing to the lowest; Ptrend=0.02), independent of self-reported race and known CHD risk factors. In race-stratified analyses, the RDMP-CHD associations were more pronounced in White women. Similar patterns were observed in Black women from the JHS and White women from the NHS. CONCLUSIONS Metabolomic profiles significantly and substantially differ between Black and White women and may be associated with CHD risk and racial disparities in US women.
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Affiliation(s)
- Jie Hu
- Division of Women’s Health (J.H., M.C.J., K.M.R.), Harvard Medical School, Boston, MA
- Department of Epidemiology (J.H., M.C.J., J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jie Yao
- Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA (J.Y., X.G., K.D.T., J.I.R.)
| | - Shuliang Deng
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.D., D.E.C., R.E.G.)
| | - Raji Balasubramanian
- Department of Biostatistics and Epidemiology, University of Massachusetts – Amherst (R.B.)
| | - Monik C. Jiménez
- Division of Women’s Health (J.H., M.C.J., K.M.R.), Harvard Medical School, Boston, MA
- Department of Epidemiology (J.H., M.C.J., J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jun Li
- Division of Preventive Medicine (J.L., N.P.P.), Harvard Medical School, Boston, MA
- Department of Epidemiology (J.H., M.C.J., J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Nutrition (J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Xiuqing Guo
- Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA (J.Y., X.G., K.D.T., J.I.R.)
| | - Daniel E. Cruz
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.D., D.E.C., R.E.G.)
| | - Yan Gao
- Department of Medicine, University of Mississippi Medical Center, Jackson (Y.G.)
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine (T.H., O.A.Z., Q.S., E.B.R., A.H.E.), Harvard Medical School, Boston, MA
| | - Oana A. Zeleznik
- Channing Division of Network Medicine, Department of Medicine (T.H., O.A.Z., Q.S., E.B.R., A.H.E.), Harvard Medical School, Boston, MA
| | - Debby Ngo
- Brigham and Women’s Hospital and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center (D.N.), Harvard Medical School, Boston, MA
| | - Simin Liu
- Department of Epidemiology, Brown University School of Public Health, Providence, RI (S.L.)
- Division of Endocrinology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI (S.L.)
| | - Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Sciences, University of Massachusetts Medical School, Worcester (M.C.R.)
| | - Rami Nassir
- Department of Pathology, School of Medicine, Umm Al-Qura University, Saudi Arabia (R.N.)
| | - Nina P. Paynter
- Division of Preventive Medicine (J.L., N.P.P.), Harvard Medical School, Boston, MA
| | - Christine M. Albert
- Department of Cardiology, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA (C.M.A.)
| | - Russell P. Tracy
- Department of Pathology and Laboratory Medicine (R.P.T., P.D.), Larner College of Medicine, University of Vermont, Burlington
- Department of Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington
| | - Peter Durda
- Department of Pathology and Laboratory Medicine (R.P.T., P.D.), Larner College of Medicine, University of Vermont, Burlington
| | - Yongmei Liu
- Divisions of Cardiology and Neurology, Department of Medicine, Duke University Medical Center, Durham, NC (Y.L.)
| | - Kent D. Taylor
- Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA (J.Y., X.G., K.D.T., J.I.R.)
| | - W. Craig Johnson
- Department of Biostatistics, University of Washington, Seattle (W.C.J.)
| | - Qi Sun
- Channing Division of Network Medicine, Department of Medicine (T.H., O.A.Z., Q.S., E.B.R., A.H.E.), Harvard Medical School, Boston, MA
- Department of Epidemiology (J.H., M.C.J., J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Nutrition (J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eric B. Rimm
- Channing Division of Network Medicine, Department of Medicine (T.H., O.A.Z., Q.S., E.B.R., A.H.E.), Harvard Medical School, Boston, MA
- Department of Epidemiology (J.H., M.C.J., J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Nutrition (J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine (T.H., O.A.Z., Q.S., E.B.R., A.H.E.), Harvard Medical School, Boston, MA
- Department of Epidemiology (J.H., M.C.J., J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Nutrition (J.L., Q.S., E.B.R., A.H.E.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville (S.S.R.)
| | - Jerome I. Rotter
- Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA (J.Y., X.G., K.D.T., J.I.R.)
| | - Robert E. Gerszten
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.D., D.E.C., R.E.G.)
- Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge (R.E.G., C.B.C.)
| | - Clary B. Clish
- Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge (R.E.G., C.B.C.)
| | - Kathryn M. Rexrode
- Division of Women’s Health (J.H., M.C.J., K.M.R.), Harvard Medical School, Boston, MA
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Koman PD, Billmire M, Baker KR, Carter JM, Thelen BJ, French NHF, Bell SA. Using wildland fire smoke modeling data in gerontological health research (California, 2007-2018). THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156403. [PMID: 35660427 DOI: 10.1016/j.scitotenv.2022.156403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/06/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Widespread population exposure to wildland fire smoke underscores the urgent need for new techniques to characterize fire-derived pollution for epidemiologic studies and to build climate-resilient communities especially for aging populations. Using atmospheric chemical transport modeling, we examined air quality with and without wildland fire smoke PM2.5. In 12-km gridded output, the 24-hour average concentration of all-source PM2.5 in California (2007-2018) was 5.16 μg/m3 (S.D. 4.66 μg/m3). The average concentration of fire-PM2.5 in California by year was 1.61 μg/m3 (~30% of total PM2.5). The contribution of fire-source PM2.5 ranged from 6.8% to 49%. We define a "smokewave" as two or more consecutive days with modeled levels above 35 μg/m3. Based on model-derived fire-PM2.5, 99.5% of California's population lived in a county that experienced at least one smokewave from 2007 to 2018, yet understanding of the impact of smoke on the health of aging populations is limited. Approximately 2.7 million (56%) of California residents aged 65+ years lived in counties representing the top 3 quartiles of fire-PM2.5 concentrations (2007-2018). For each year (2007-2018), grid cells containing skilled nursing facilities had significantly higher mean concentrations of all-source PM2.5 than cells without those facilities, but they also had generally lower mean concentrations of wildland fire-specific PM2.5. Compared to rural monitors in California, model predictions of wildland fire impacts on daily average PM2.5 carbon (organic and elemental) performed well most years but tended to overestimate wildland fire impacts for high-fire years. The modeling system isolated wildland fire PM2.5 from other sources at monitored and unmonitored locations, which is important for understanding exposures for aging population in health studies.
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Affiliation(s)
- Patricia D Koman
- University of Michigan, School of Public Health, Environmental Health Sciences, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Michael Billmire
- Michigan Technological University, Michigan Tech Research Institute, 3600 Green Court, Suite 100, Ann Arbor, MI 48105, USA.
| | - Kirk R Baker
- U.S. Environmental Protection Agency, Office of Air and Radiation, Office of Air Quality Planning & Standards, Research Triangle Park, NC 27709, USA.
| | - Julie M Carter
- University of Michigan, School of Public Health, Environmental Health Sciences, 1415 Washington Heights, Ann Arbor, MI 48109, USA; Michigan Technological University, Michigan Tech Research Institute, 3600 Green Court, Suite 100, Ann Arbor, MI 48105, USA.
| | - Brian J Thelen
- Michigan Technological University, Michigan Tech Research Institute, 3600 Green Court, Suite 100, Ann Arbor, MI 48105, USA.
| | - Nancy H F French
- Michigan Technological University, Michigan Tech Research Institute, 3600 Green Court, Suite 100, Ann Arbor, MI 48105, USA.
| | - Sue Anne Bell
- University of Michigan, School of Nursing, Ann Arbor, MI 48109, USA.
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Liu RA, Wei Y, Qiu X, Kosheleva A, Schwartz JD. Short term exposure to air pollution and mortality in the US: a double negative control analysis. Environ Health 2022; 21:81. [PMID: 36068579 PMCID: PMC9446691 DOI: 10.1186/s12940-022-00886-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 07/29/2022] [Indexed: 05/21/2023]
Abstract
RATIONALE Studies examining the association of short-term air pollution exposure and daily deaths have typically been limited to cities and used citywide average exposures, with few using causal models. OBJECTIVES To estimate the associations between short-term exposures to fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) and all-cause and cause-specific mortality in multiple US states using census tract or address exposure and including rural areas, using a double negative control analysis. METHODS We conducted a time-stratified case-crossover study examining the entire population of seven US states from 2000-2015, with over 3 million non-accidental deaths. Daily predictions of PM2.5, O3, and NO2 at 1x1 km grid cells were linked to mortality based on census track or residential address. For each pollutant, we used conditional logistic regression to quantify the association between exposure and the relative risk of mortality conditioning on meteorological variables, other pollutants, and using double negative controls. RESULTS A 10 μg/m3 increase in PM2.5 exposure at the moving average of lag 0-2 day was significantly associated with a 0.67% (95%CI: 0.34-1.01%) increase in all-cause mortality. 10 ppb increases in NO2 or O3 exposure at lag 0-2 day were marginally associated with and 0.19% (95%CI: -0.01-0.38%) and 0.20 (95% CI-0.01, 0.40), respectively. The adverse effects of PM2.5 persisted when pollution levels were restricted to below the current global air pollution standards. Negative control models indicated little likelihood of omitted confounders for PM2.5, and mixed results for the gases. PM2.5 was also significantly associated with respiratory mortality and cardiovascular mortality. CONCLUSIONS Short-term exposure to PM2.5 and possibly O3 and NO2 are associated with increased risks for all-cause mortality. Our findings delivered evidence that risks of death persisted at levels below currently permissible.
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Affiliation(s)
- Rongqi Abbie Liu
- Department of Environmental Health, Harvard T H Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Yaguang Wei
- Department of Environmental Health, Harvard T H Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Xinye Qiu
- Department of Environmental Health, Harvard T H Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Anna Kosheleva
- Department of Environmental Health, Harvard T H Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T H Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
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Shao S, Liu L, Tian Z. Does the environmental inequality matter? A literature review. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:3133-3156. [PMID: 33847864 DOI: 10.1007/s10653-021-00921-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
The environmental inequality theory reveals that the risk of environmental pollution exposure varies among regions and groups and that particular groups face a higher threat of environmental pollution. In recent years, studies on the environmental inequality issue in developed countries have been increasing, while related literature on developing countries is very scarce. It has been found that some factors, such as race and economic status, have a close relationship with the risk of environmental pollution exposure faced by individuals. For the first time, this paper provides an extensive review of existing theoretical and empirical studies on environmental inequality. We review, in detail, the evolution of the environmental inequality theory, including the definition and measurement of environmental inequality. Further, we provide a systematic refresher on the main performance of environmental inequality, including health, education, labor productivity, and real estate prices. We also identify several causes of environmental inequality, such as ethnic differences, economic status, human capital, and household registration systems. Finally, we discuss prospects for the future research on this issue.
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Affiliation(s)
- Shuai Shao
- School of Business, East China University of Science and Technology, Shanghai, 200237, China
- School of Urban and Regional Science, Institute of Finance and Economics Research, Shanghai University of Finance and Economics, Shanghai, 200433, China
| | - Liwen Liu
- School of Urban and Regional Science, Institute of Finance and Economics Research, Shanghai University of Finance and Economics, Shanghai, 200433, China
| | - Zhihua Tian
- School of Economics, Zhejiang University of Technology, Hangzhou, 310023, China.
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Casey JA, Kioumourtzoglou MA, Ogburn EL, Melamed A, Shaman J, Kandula S, Neophytou A, Darwin KC, Sheffield JS, Gyamfi-Bannerman C. Long-Term Fine Particulate Matter Concentrations and Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2: Differential Relationships by Socioeconomic Status Among Pregnant Individuals in New York City. Am J Epidemiol 2022; 191:1897-1905. [PMID: 35916364 PMCID: PMC9384549 DOI: 10.1093/aje/kwac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
We aimed to determine whether long-term ambient concentrations of fine particulate matter (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5)) were associated with increased risk of testing positive for coronavirus disease 2019 (COVID-19) among pregnant individuals who were universally screened at delivery and whether socioeconomic status (SES) modified this relationship. We used obstetrical data collected from New-York Presbyterian Hospital/Columbia University Irving Medical Center in New York, New York, between March and December 2020, including data on Medicaid use (a proxy for low SES) and COVID-19 test results. We linked estimated 2018-2019 PM2.5 concentrations (300-m resolution) with census-tract-level population density, household size, income, and mobility (as measured by mobile-device use) on the basis of residential address. Analyses included 3,318 individuals; 5% tested positive for COVID-19 at delivery, 8% tested positive during pregnancy, and 48% used Medicaid. Average long-term PM2.5 concentrations were 7.4 (standard deviation, 0.8) μg/m3. In adjusted multilevel logistic regression models, we saw no association between PM2.5 and ever testing positive for COVID-19; however, odds were elevated among those using Medicaid (per 1-μg/m3 increase, odds ratio = 1.6, 95% confidence interval: 1.0, 2.5). Further, while only 22% of those testing positive showed symptoms, 69% of symptomatic individuals used Medicaid. SES, including unmeasured occupational exposures or increased susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to concurrent social and environmental exposures, may explain the increased odds of testing positive for COVID-19 being confined to vulnerable pregnant individuals using Medicaid.
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Affiliation(s)
- Joan A Casey
- Correspondence Address: Correspondence to Joan A. Casey, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, 722 W 168th St, Rm 1206 New York, NY 10032-3727 ()
| | - Marianthi-Anna Kioumourtzoglou
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Elizabeth L Ogburn
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Alexander Melamed
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, United States
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Andreas Neophytou
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Kristin C Darwin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jeanne S Sheffield
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cynthia Gyamfi-Bannerman
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, United States,Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego School of Medicine and UC San Diego Health
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70
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Declet-Barreto J, Rosenberg AA. Environmental justice and power plant emissions in the Regional Greenhouse Gas Initiative states. PLoS One 2022; 17:e0271026. [PMID: 35857722 PMCID: PMC9299318 DOI: 10.1371/journal.pone.0271026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
Policies to reduce greenhouse gases associated with electricity generation have been a major focus of public policy in the United States, but their implications for achieving environmental justice among historically overburdened communities inappropriately remains a marginal issue. In this study we address research gaps in historical and current ambient air emissions burdens in environmental justice communities from power plants participating in the Regional Greenhouse Gases Initiative (RGGI), the country's first market-based power sector emissions reduction program. We find that in RGGI states the percentage of people of color that live within 0-6.2 miles from power plants is up to 23.5 percent higher than the percent of the white population that lives within those same distance bands, and the percentage of people living in poverty that live within 0-5 miles from power plants is up to 15.3 percent higher than the percent of the population not living in poverty within those same distance bands. More importantly, the transition from coal to natural gas underway before RGGI formally started resulted in large increases in both the number of electric-generating units burning natural gas and total net generation from natural gas in environmental justice communities hosting electric-generating units, compared to other communities. Our findings indicate that power sector carbon mitigation policies' focusing on aggregate emissions reductions have largely benefitted non-environmental justice communities and have not redressed the fundamental problem of disparities in pollutant burdens between EJ and non-EJ communities. These must be directly addressed in climate change and carbon emissions mitigation policy.
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Affiliation(s)
- Juan Declet-Barreto
- Climate & Energy Program, Union of Concerned Scientists, Washington, DC, United States of America
| | - Andrew A. Rosenberg
- Center for Science and Democracy, Union of Concerned Scientists, Cambridge, MA, United States of America
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Landrigan PJ, Fisher S, Kenny ME, Gedeon B, Bryan L, Mu J, Bellinger D. A replicable strategy for mapping air pollution's community-level health impacts and catalyzing prevention. Environ Health 2022; 21:70. [PMID: 35843932 PMCID: PMC9288863 DOI: 10.1186/s12940-022-00879-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Air pollution was responsible for an estimated 6.7 million deaths globally in 2019 and 197,000 deaths in the United States. Fossil fuel combustion is the major source. HYPOTHESIS Mapping air pollution's health impacts at the community level using publicly available data and open-source software will provide a replicable strategy for catalyzing pollution prevention. METHODS Using EPA's Environmental Benefits Mapping and Analysis (BenMAP-CE) software and state data, we quantified the effects of airborne fine particulate matter (PM2.5) pollution on disease, death and children's cognitive function (IQ Loss) in each city and town in Massachusetts. To develop a first-order estimate of PM2.5 pollution's impact on child IQ, we derived a concentration-response coefficient through literature review. FINDINGS The annual mean PM2.5 concentration in Massachusetts in 2019 was 6.3 μg/M3, a level below EPA's standard of 12 μg/M3 and above WHO's guideline of 5 μg/M3. In adults, PM2.5 pollution was responsible for an estimated 2780 (Confidence Interval [CI] 2726 - 2853) deaths: 1677 (CI, 1346 - 1926) from cardiovascular disease, 2185 (CI, 941-3409) from lung cancer, 200 (CI, 66-316) from stroke, and 343 (CI, 222-458) from chronic respiratory disease. In children, PM2.5 pollution was responsible for 308 (CI, 105-471) low-weight births, 15,386 (CJ, 5433-23,483) asthma cases, and a provisionally estimated loss of nearly 2 million Performance IQ points; IQ loss impairs children's school performance, reduces graduation rates and decreases lifetime earnings. Air-pollution-related disease, death and IQ loss were most severe in low-income, minority communities, but occurred in every city and town in Massachusetts regardless of location, demographics or median family income. CONCLUSION Disease, death and IQ loss occur at air pollution exposure levels below current EPA standards. Prevention of disease and premature death and preservation of children's cognitive function will require that EPA air quality standards be tightened. Enduring prevention will require government-incentivized transition to renewable energy coupled with phase-outs of subsidies and tax breaks for fossil fuels. Highly localized information on air pollution's impacts on health and on children's cognitive function has potential to catalyze pollution prevention.
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Affiliation(s)
- Philip J Landrigan
- Global Observatory on Pollution and Health, Boston College, Boston, MA, USA.
- Centre Scientifique de Monaco, Monaco, MC, Monaco.
| | - Samantha Fisher
- Global Observatory on Pollution and Health, Boston College, Boston, MA, USA
- Environmental; Epidemiology Program, City University of New York, New York, USA
| | - Maureen E Kenny
- Lynch School of Education and Human Development, Boston College, Boston, MA, USA
| | - Brittney Gedeon
- Morrissey College of Arts and Sciences, Boston College, Boston, MA, USA
| | - Luke Bryan
- Morrissey College of Arts and Sciences, Boston College, Boston, MA, USA
| | - Jenna Mu
- Morrissey College of Arts and Sciences, Boston College, Boston, MA, USA
| | - David Bellinger
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, USA
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Belz DC, Woo H, Putcha N, Paulin LM, Koehler K, Fawzy A, Alexis NE, Barr RG, Comellas AP, Cooper CB, Couper D, Dransfield M, Gassett AJ, Han M, Hoffman EA, Kanner RE, Krishnan JA, Martinez FJ, Paine R, Peng RD, Peters S, Pirozzi CS, Woodruff PG, Kaufman JD, Hansel NN. Ambient ozone effects on respiratory outcomes among smokers modified by neighborhood poverty: An analysis of SPIROMICS AIR. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 829:154694. [PMID: 35318050 PMCID: PMC9117415 DOI: 10.1016/j.scitotenv.2022.154694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Neighborhood poverty has been associated with poor health outcomes. Previous studies have also identified adverse respiratory effects of long-term ambient ozone. Factors associated with neighborhood poverty may accentuate the adverse impact of ozone on respiratory health. OBJECTIVES To evaluate whether neighborhood poverty modifies the association between ambient ozone exposure and respiratory morbidity including symptoms, exacerbation risk, and radiologic parameters, among participants of the SPIROMICS AIR cohort study. METHODS Spatiotemporal models incorporating cohort-specific monitoring estimated 10-year average outdoor ozone concentrations at participants' homes. Adjusted regression models were used to determine the association of ozone exposure with respiratory outcomes, accounting for demographic factors, education, individual income, body mass index (BMI), and study site. Neighborhood poverty rate was defined by percentage of families living below federal poverty level per census tract. Interaction terms for neighborhood poverty rate with ozone were included in covariate-adjusted models to evaluate for effect modification. RESULTS 1874 participants were included in the analysis, with mean (± SD) age 64 (± 8.8) years and FEV1 (forced expiratory volume in one second) 74.7% (±25.8) predicted. Participants resided in neighborhoods with mean poverty rate of 9.9% (±10.3) of families below the federal poverty level and mean 10-year ambient ozone concentration of 24.7 (±5.2) ppb. There was an interaction between neighborhood poverty rate and ozone concentration for numerous respiratory outcomes, including COPD Assessment Test score, modified Medical Research Council Dyspnea Scale, six-minute walk test, and odds of COPD exacerbation in the year prior to enrollment, such that adverse effects of ozone were greater among participants in higher poverty neighborhoods. CONCLUSION Individuals with COPD in high poverty neighborhoods have higher susceptibility to adverse respiratory effects of ambient ozone exposure, after adjusting for individual factors. These findings highlight the interaction between exposures associated with poverty and their effect on respiratory health.
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Affiliation(s)
- Daniel C Belz
- Department of Medicine, Johns Hopkins University, 1830 E. Monument, 5th Floor, Baltimore, MD 21205, USA.
| | - Han Woo
- Department of Medicine, Johns Hopkins University, 1830 E. Monument, 5th Floor, Baltimore, MD 21205, USA.
| | - Nirupama Putcha
- Department of Medicine, Johns Hopkins University, 1830 E. Monument, 5th Floor, Baltimore, MD 21205, USA.
| | - Laura M Paulin
- Dartmouth-Hitchcock Medical Center/Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Pulmonary 5C Ste, Lebanon, NH 03756, USA.
| | - Kirsten Koehler
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Ashraf Fawzy
- Department of Medicine, Johns Hopkins University, 1830 E. Monument, 5th Floor, Baltimore, MD 21205, USA.
| | - Neil E Alexis
- University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - R Graham Barr
- Columbia University Medical Center, 630 W. 168th St., New York, NY 10032, USA.
| | - Alejandro P Comellas
- University of Iowa Department of Internal Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Christopher B Cooper
- University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
| | - David Couper
- University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Mark Dransfield
- University of Alabama, Birmingham, 1720 2nd Ave South, Birmingham, AL 35294, USA.
| | - Amanda J Gassett
- University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - MeiLan Han
- University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA.
| | - Eric A Hoffman
- University of Iowa Department of Internal Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Richard E Kanner
- University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USA.
| | - Jerry A Krishnan
- University of Illinois at Chicago, 1853 West Polk Street, Chicago, IL 60612, USA.
| | | | - Robert Paine
- University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USA.
| | - Roger D Peng
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Stephen Peters
- Wake Forest University, 475 Vine St, Winston-Salem, NC 27101, USA.
| | - Cheryl S Pirozzi
- University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USA.
| | - Prescott G Woodruff
- University of California, San Francisco, 513 Parnassus Ave, HSE, San Francisco, CA 94143, USA.
| | - Joel D Kaufman
- University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Nadia N Hansel
- Department of Medicine, Johns Hopkins University, 1830 E. Monument, 5th Floor, Baltimore, MD 21205, USA.
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Daouda M, Henneman L, Goldsmith J, Kioumourtzoglou MA, Casey JA. Racial/Ethnic Disparities in Nationwide PM2.5 Concentrations: Perils of Assuming a Linear Relationship. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:77701. [PMID: 35857400 PMCID: PMC9258345 DOI: 10.1289/ehp11048] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/13/2022] [Indexed: 05/20/2023]
Affiliation(s)
- Misbath Daouda
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA
| | - Lucas Henneman
- Department of Civil, Environmental, and Infrastructure Engineering, George Mason University, Fairfax, Virginia, USA
| | - Jeff Goldsmith
- Department of Biostatistics, Columbia Mailman School of Public Health, New York, New York, USA
| | | | - Joan A. Casey
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA
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74
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Bravo MA, Warren JL, Leong MC, Deziel NC, Kimbro RT, Bell ML, Miranda ML. Where Is Air Quality Improving, and Who Benefits? A Study of PM2.5 and Ozone Over 15 Years. Am J Epidemiol 2022; 191:1258-1269. [PMID: 35380633 PMCID: PMC9989362 DOI: 10.1093/aje/kwac059] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 03/02/2022] [Accepted: 03/24/2022] [Indexed: 01/26/2023] Open
Abstract
In the United States, concentrations of criteria air pollutants have declined in recent decades. Questions remain regarding whether improvements in air quality are equitably distributed across subpopulations. We assessed spatial variability and temporal trends in concentrations of particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) and ozone (O3) across North Carolina from 2002-2016, and associations with community characteristics. Estimated daily PM2.5 and O3 concentrations at 2010 Census tracts were obtained from the Fused Air Quality Surface Using Downscaling archive and averaged to create tract-level annual PM2.5 and O3 estimates. We calculated tract-level measures of: racial isolation of non-Hispanic Black individuals, educational isolation of non-college educated individuals, the neighborhood deprivation index (NDI), and percentage of the population in urban areas. We fitted hierarchical Bayesian space-time models to estimate baseline concentrations of and time trends in PM2.5 and O3 for each tract, accounting for spatial between-tract correlation. Concentrations of PM2.5 and O3 declined by 6.4 μg/m3 and 13.5 ppb, respectively. Tracts with lower educational isolation and higher urbanicity had higher PM2.5 and more pronounced declines in PM2.5. Racial isolation was associated with higher PM2.5 but not with the rate of decline in PM2.5. Despite declines in pollutant concentrations, over time, disparities in exposure increased for racially and educationally isolated communities.
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Affiliation(s)
- Mercedes A Bravo
- Correspondence to Dr. Mercedes A. Bravo, Global Health Institute, Duke University, 310 Trent Drive, Durham, NC 27708 (e-mail: )
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75
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O'Leary H, Parr S, El-Sayed MMH. The breathing human infrastructure: Integrating air quality, traffic, and social media indicators. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 827:154209. [PMID: 35240171 DOI: 10.1016/j.scitotenv.2022.154209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Abstract
Outdoor air pollution is a complex system that is responsible for the deaths of millions of people annually, yet the integration of interdisciplinary data necessary to assess air quality's multiple metrics is still lacking. This case study integrates atmospheric indicators (concentrations of criteria pollutants including particulate matter and gaseous pollutants), traffic indicators (permanent traffic monitoring station data), and social indicators (community responses in Twitter archives) representing the interplay of the three critical pillars of the United Nations' Triple Bottom Line: environment, economy, and society. During the watershed moment of the COVID-19 pandemic lockdowns in Florida, urban centers demonstrated the gaps and opportunities for understanding the relationships, through correlations rather than causations, between urban air quality, traffic emissions, and public perceptions. The relationship between the perception and the traffic variables were strongly correlated, however no correlation was observed between the perception and actual air quality indicators, except for NO2. These observations might consequently infer that traffic serves as people's proxy for air quality, regardless of actual air quality, suggesting that social media messaging around asthma may be a way to monitor traffic patterns in areas where no infrastructure currently exists or is prohibited to build. It also indicates that people are less likely to be reliable sensors to accurately measure air quality due to bias in their observations of traffic volume and/or confirmation biases in broader social discourse. Results presented herein are of significance in demonstrating the capacity for interdisciplinary studies to consider the predictive capacities of social media and air pollution, its use as both lever and indicator of public support for air quality legislation and clean-air transitions, and its ability to overcome limitations of surface monitoring stations.
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Affiliation(s)
- Heather O'Leary
- Department of Anthropology, University of South Florida, St. Petersburg, FL 33701, USA
| | - Scott Parr
- Department of Civil Engineering, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USA
| | - Marwa M H El-Sayed
- Department of Civil Engineering, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USA.
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76
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Li X, Baumgartner J, Barrington-Leigh C, Harper S, Robinson B, Shen G, Sternbach T, Tao S, Zhang X, Zhang Y, Carter E. Socioeconomic and Demographic Associations with Wintertime Air Pollution Exposures at Household, Community, and District Scales in Rural Beijing, China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:8308-8318. [PMID: 35675631 DOI: 10.1021/acs.est.1c07402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Chinese government implemented a national household energy transition program that replaced residential coal heating stoves with electricity-powered heat pumps for space heating in northern China. As part of a baseline assessment of the program, this study investigated variability in personal air pollution exposures within villages and between villages and evaluated exposure patterns by sociodemographic factors. We randomly recruited 446 participants in 50 villages in four districts in rural Beijing and measured 24 h personal exposures to fine particulate matter (PM2.5) and black carbon (BC). The geometric mean personal exposure to PM2.5 and BC was 72 and 2.5 μg/m3, respectively. The variability in PM2.5 and BC exposures was greater within villages than between villages. Study participants who used traditional stoves as their dominant source of space heating were exposed to the highest levels of PM2.5 and BC. Wealthier households tended to burn more coal for space heating, whereas less wealthy households used more biomass. PM2.5 and BC exposures were almost uniformly distributed by socioeconomic status. Future work that combines these results with PM2.5 chemical composition analysis will shed light on whether air pollution source contributors (e.g., industrial, traffic, and household solid fuel burning) follow similar distributions.
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Affiliation(s)
- Xiaoying Li
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1G1, Canada
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, Colorado 80521, United States
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1G1, Canada
- Institute for Health and Social Policy, McGill University, Montreal, Quebec H3A 1G1, Canada
| | - Christopher Barrington-Leigh
- Institute for Health and Social Policy, McGill University, Montreal, Quebec H3A 1G1, Canada
- Bieler School of Environment, McGill University, Montreal, Quebec H3A 2A7, Canada
| | - Sam Harper
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1G1, Canada
| | - Brian Robinson
- Department of Geography, McGill University, Montreal, Quebec H3A 0B9, Canada
| | - Guofeng Shen
- Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Talia Sternbach
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1G1, Canada
- Institute for Health and Social Policy, McGill University, Montreal, Quebec H3A 1G1, Canada
| | - Shu Tao
- Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Xiang Zhang
- Department of Geography, McGill University, Montreal, Quebec H3A 0B9, Canada
| | - Yuanxun Zhang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
- CAS Center for Excellence in Regional Atmospheric Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Ellison Carter
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, Colorado 80521, United States
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Chakraborty J, Collins TW, Grineski SE, Aun JJ. Air pollution exposure disparities in US public housing developments. Sci Rep 2022; 12:9887. [PMID: 35701654 PMCID: PMC9198080 DOI: 10.1038/s41598-022-13942-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
Fine particulate matter 2.5 microns or less in diameter (PM2.5) is widely recognized to be a major public health concern. While ethnic/racial minority and lower socioeconomic status individuals in the US experience higher PM2.5 exposure, previous research on social disparities in PM2.5 exposure has not examined residents of federally-assisted public housing developments (PHDs). Here we present the first national-scale analysis of the relationship between outdoor PM2.5 exposure and PHD residency in the US, as well as exposure disparities within the population of households residing in PHDs. We integrated data on average annual PM2.5 concentrations (2011–2015) with US Department of Housing and Urban Development data on PHDs (2015), and socio-demographic information from the 2011–2015 American Community Survey. Results from multivariable generalized estimating equations indicated that PHD locations, units, and residents are significantly overrepresented in neighborhoods with greater PM2.5 exposure, after accounting for clustering, urbanization, and other socio-demographic factors. Additionally, significantly higher percentages of Black, Hispanic, disabled, and extremely low-income households reside in PHDs with greater PM2.5 exposure. Findings represent an important starting point for future research and emphasize the urgent need to identify gaps in environmental, public health, and housing policies that contribute to disproportionate air pollution exposures among PHD residents.
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Affiliation(s)
- Jayajit Chakraborty
- Department of Sociology and Anthropology, University of Texas at El Paso, El Paso, TX, USA.
| | - Timothy W Collins
- Department of Geography, University of Utah, Salt Lake City, UT, USA
| | - Sara E Grineski
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Jacob J Aun
- Department of Sociology and Anthropology, University of Texas at El Paso, El Paso, TX, USA
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Song J, Qu R, Sun B, Chen R, Kan H, An Z, Jiang J, Li J, Zhang Y, Wu W. Associations of Short-Term Exposure to Fine Particulate Matter with Neural Damage Biomarkers: A Panel Study of Healthy Retired Adults. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:7203-7213. [PMID: 34964348 DOI: 10.1021/acs.est.1c03754] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Exposure to fine particulate matter (PM2.5) is associated with various adverse health effects, such as respiratory and cardiovascular diseases. This study aimed to evaluate the association of PM2.5 with neural damage biomarkers. A total of 34 healthy retirees were recruited from Xinxiang Medical University from December 2018 to April 2019. Concentrations of PM2.5 constituents including 24 metals and nonmetallic elements and 6 ions, and 5 biomarkers of neural damage including brain-derived neurotrophic factor (BDNF), neurofilament light chain (NfL), neuron-specific enolase (NSE), protein gene product 9.5 (PGP9.5), and S100 calcium-binding protein B (S100B) in serum were measured. A linear mixed-effect model was employed to estimate the association of PM2.5 and its constituents with neural damage biomarkers. Modification effects of glutathione S-transferase theta 1 gene (GSTT1) polymorphism, sex, education, and physical activity on PM2.5 exposure with neural damage were explored. PM2.5 and its key constituents were significantly associated with neural damage biomarkers. A 10 μg/m3 increase in PM2.5 concentration was associated with 2.09% (95% CI, 39.3-76.5%), 100% (95% CI, 1.73-198%), and 122% (95% CI, 20.7-222%) increments in BDNF, NfL, and PGP9.5, respectively. Several constituents such as Cu, Zn, Ni, Mn, Sn, V, Rb, Pb, Al, Be, Cs, Co, Th, U, Cl-, and F- were significantly associated with NfL. The estimated association of PM2.5 with NSE in GSTT1-sufficient volunteers was significantly higher than that in GSTT1-null volunteers. Therefore, short-term PM2.5 exposure was associated with neural damage, and GSTT1 expression levels modified the PM2.5-induced adverse neural effects.
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Affiliation(s)
- Jie Song
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Rongrong Qu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Beibei Sun
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Renjie Chen
- School of Public Health, Fudan University, Shanghai 200437, China
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai 200437, China
| | - Zhen An
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Jing Jiang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Juan Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Yange Zhang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Weidong Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
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Letellier N, Zamora S, Spoon C, Yang JA, Mortamais M, Escobar GC, Sears DD, Jankowska MM, Benmarhnia T. Air pollution and metabolic disorders: Dynamic versus static measures of exposure among Hispanics/Latinos and non-Hispanics. ENVIRONMENTAL RESEARCH 2022; 209:112846. [PMID: 35120894 PMCID: PMC8976727 DOI: 10.1016/j.envres.2022.112846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/14/2022] [Accepted: 01/25/2022] [Indexed: 05/11/2023]
Abstract
INTRODUCTION Exposure to air pollution disproportionately affects racial/ethnic minorities that could contribute to health inequalities including metabolic disorders. However, most existing studies used a static assessment of air pollution exposure (mostly using the residential address) and do not account for activity space when modelling exposure to air pollution. The aim of this study is to understand how exposure to air pollution impacts metabolic disorders biomarkers, how this effect differs according to ethnicity, and for the first time compare these findings with two methods of exposure assessment: dynamic and static measures. METHODS Among the Community of Mine study, a cross-sectional study conducted in San Diego County, insulin resistance, diabetes, hypertension, obesity, dyslipidemia, and metabolic syndrome (MetS) were assessed. Exposure to air pollution (PM2.5, NO2, traffic) was calculated using static measures around the home, and dynamic measures of mobility derived from Global Positioning Systems (GPS) traces using kernel density estimators to account for exposure variability across space and time. Associations of air pollution with metabolic disorders were quantified using generalized estimating equation models to account for the clustered nature of the data. RESULTS Among 552 participants (mean age 58.7 years, 42% Hispanic/Latino), Hispanics/Latinos had a higher exposure to PM2.5 compared to non-Hispanics using static measures. In contrast, Hispanics/Latinos had less exposure to PM2.5 using dynamic measures. For all participants, higher dynamic exposure to PM2.5 and NO2 was associated with increased insulin resistance and cholesterol levels, and increased risk of obesity, dyslipidemia and MetS (RR 1.17, 95% CI: 1.07-1.28; RR 1.21, 95% CI: 1.12-1.30, respectively). The association between dynamic PM2.5 exposure and MetS differed by Hispanic/Latino ethnicity. CONCLUSION These results highlight the importance of considering people's daily mobility in assessing the impact of air pollution on health.
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Affiliation(s)
- Noémie Letellier
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, 8885 Biological Grade, La Jolla, CA, 92037, USA.
| | - Steven Zamora
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, 8885 Biological Grade, La Jolla, CA, 92037, USA
| | - Chad Spoon
- UC San Diego, Department of Family Medicine, USA
| | - Jiue-An Yang
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA
| | | | - Gabriel Carrasco Escobar
- Health Innovation Laboratory, Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Dorothy D Sears
- UC San Diego, Department of Family Medicine, USA; Arizona State University, College of Health Solutions, USA; UC San Diego, Department of Medicine, USA; UC San Diego, Moores Cancer Center, USA
| | - Marta M Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, 8885 Biological Grade, La Jolla, CA, 92037, USA
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80
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Rauscher E, Song H. Learning to Value Girls: Balanced Infant Sex Ratios at Higher Parental Education in the United States, 1969-2018. Demography 2022; 59:1143-1171. [PMID: 35575584 PMCID: PMC9791645 DOI: 10.1215/00703370-9968420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Infant sex ratios that differ from the biological norm provide a measure of gender status inequality that is not susceptible to social desirability bias. Ratios may become less biased with educational expansion through reduced preference for male children. Alternatively, bias could increase with education through more access to sex-selective medical technologies. Using National Vital Statistics data on the population of live births in the United States for 1969-2018, we examine trends in infant sex ratios by parental race/ethnicity, education, and birth parity over five decades. We find son-biased infant sex ratios among Chinese and Asian Indian births that have persisted in recent years, and regressions suggest son-biased ratios among births to Filipino and Japanese mothers with less than a high school education. Infant sex ratios are more balanced at higher levels of maternal education, particularly when both parents are college educated. Results suggest greater equality of gender status with higher education in the United States.
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Affiliation(s)
- Emily Rauscher
- Department of Sociology, Brown University, Providence, RI, USA
| | - Haoming Song
- Department of Sociology, Brown University, Providence, RI, USA
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81
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Wang Y, Wang Y, Xu H, Zhao Y, Marshall JD. Ambient Air Pollution and Socioeconomic Status in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:67001. [PMID: 35674427 PMCID: PMC9175641 DOI: 10.1289/ehp9872] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 05/02/2023]
Abstract
BACKGROUND Air pollution disparities by socioeconomic status (SES) are well documented for the United States, with most literature indicating an inverse relationship (i.e., higher concentrations for lower-SES populations). Few studies exist for China, a country accounting for 26% of global premature deaths from ambient air pollution. OBJECTIVE Our objective was to test the relationship between ambient air pollution exposures and SES in China. METHODS We combined estimated year 2015 annual-average ambient levels of nitrogen dioxide (NO 2 ) and fine particulate matter [PM ≤ 2.5 μ m in aerodynamic diameter (PM 2.5 )] with national demographic information. Pollution estimates were derived from a national empirical model for China at 1 -km spatial resolution; demographic estimates were derived from national gridded gross national product (GDP) per capita at 1 -km resolution, and (separately) a national representative sample of 21,095 individuals from the China Health and Retirement Longitudinal Study (CHARLS) 2015 cohort. Our use of global data on population density and cohort data on where people live helped avoid the spatial imprecision found in publicly available census data for China. We quantified air pollution disparities among individual's rural-to-urban migration status; SES factors (education, occupation, and income); and minority status. We compared results using three approaches to SES measurement: individual SES score, community-averaged SES score, and gridded GDP per capita. RESULTS Ambient NO 2 and PM 2.5 levels were higher for higher-SES populations than for lower-SES population, higher for long-standing urban residents than for rural-to-urban migrant populations, and higher for the majority ethnic group (Han) than for the average across nine minority groups. For the three SES measurements (individual SES score, community-averaged SES score, gridded GDP per capita), a 1-interquartile range higher SES corresponded to higher concentrations of 6 - 9 μ g / m 3 NO 2 and 3 - 6 μ g / m 3 PM 2.5 ; average concentrations for the highest and lowest 20th percentile of SES differed by 41-89% for NO 2 and 12-25% for PM 2.5 . This pattern held in rural and urban locations, across geographic regions, across a wide range of spatial resolution, and for modeled vs. measured pollution concentrations. CONCLUSIONS Multiple analyses here reveal that in China, ambient NO 2 and PM 2.5 concentrations are higher for high-SES than for low-SES individuals; these results are robust to multiple sensitivity analyses. Our findings are consistent with the idea that in China's current industrialization and urbanization stage, economic development is correlated with both SES and air pollution. To our knowledge, our study provides the most comprehensive picture to date of ambient air pollution disparities in China; the results differ dramatically from results and from theories to explain conditions in the United States. https://doi.org/10.1289/EHP9872.
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Affiliation(s)
- Yuzhou Wang
- Department of Civil and Environmental Engineering, University of Washington, Seattle, Washington, USA
| | - Yafeng Wang
- Institute of Social Survey Research, Peking University, Beijing, China
| | - Hao Xu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China
| | - Julian D. Marshall
- Department of Civil and Environmental Engineering, University of Washington, Seattle, Washington, USA
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Spatio-Temporal Variation-Induced Group Disparity of Intra-Urban NO 2 Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105872. [PMID: 35627409 PMCID: PMC9141847 DOI: 10.3390/ijerph19105872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
Previous studies on exposure disparity have focused more on spatial variation but ignored the temporal variation of air pollution; thus, it is necessary to explore group disparity in terms of spatio-temporal variation to assist policy-making regarding public health. This study employed the dynamic land use regression (LUR) model and mobile phone signal data to illustrate the variation features of group disparity in Shanghai. The results showed that NO2 exposure followed a bimodal, diurnal variation pattern and remained at a high level on weekdays but decreased on weekends. The most critical at-risk areas were within the central city in areas with a high population density. Moreover, women and the elderly proved to be more exposed to NO2 pollution in Shanghai. Furthermore, the results of this study showed that it is vital to focus on land-use planning, transportation improvement programs, and population agglomeration to attenuate exposure inequality.
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83
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Payne-Sturges DC, Puett R, Cory-Slechta DA. Both parents matter: a national-scale analysis of parental race/ethnicity, disparities in prenatal PM 2.5 exposures and related impacts on birth outcomes. Environ Health 2022; 21:47. [PMID: 35513869 PMCID: PMC9074320 DOI: 10.1186/s12940-022-00856-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/12/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Most U.S. studies that report racial/ethnic disparities in increased risk of low birth weight associated with air pollution exposures have been conducted in California or northeastern states and/or urban areas, limiting generalizability of study results. Few of these studies have examined maternal racial/ethnic groups other than Non-Hispanic Black, non-Hispanic White and Hispanic, nor have they included paternal race. We aimed to examine the independent effects of PM2.5 on birth weight among a nationally representative sample of U.S. singleton infants and how both maternal and paternal race/ethnicity modify relationships between prenatal PM2.5 exposures and birth outcomes. METHODS We used data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), a longitudinal nationally representative cohort of 10,700 U.S. children born in 2001, which we linked to U.S.EPA's Community Multi-scale Air Quality (CMAQ)-derived predicted daily PM2.5 concentrations at the centroid of each Census Bureau Zip Code Tabulation Area (ZCTA) for maternal residences. We examined relationships between term birthweight (TBW), term low birthweight rate (TLBW) and gestational PM2.5 pollutant using multivariate regression models. Effect modification of air pollution exposures on birth outcomes by maternal and paternal race was evaluated using stratified models. All analyses were conducted with sample weights to provide national-scale estimates. RESULTS The majority of mothers were White (61%). Fourteen percent of mothers identified as Black, 21% as Hispanic, 3% Asian American and Pacific Islander (AAPI) and 1% American Indian and Alaskan Native (AIAN). Fathers were also racially/ethnically diverse with 55% identified as White Non-Hispanic, 10% as Black Non-Hispanic, 19% as Hispanic, 3% as AAPI and 1% as AIAN. Results from the chi-square and ANOVA tests of significance for racial/ethnic differences indicate disparities in prenatal exposures and birth outcomes by both maternal and paternal race/ethnicity. Prenatal PM2.5 was associated with reduced birthweights during second and third trimester and over the entire gestational period in adjusted regression models, although results did not reach statistical significance. In models stratified by maternal race and paternal race, one unit increase in PM2.5 was statistically significantly associated with lower birthweights among AAPI mothers, -5.6 g (95% CI:-10.3, -1.0 g) and AAPI fathers, -7.6 g (95% CI: -13.1, -2.1 g) during 3rd trimester and among births where father's race was not reported, -14.2 g (95% CI: -24.0, -4.4 g). CONCLUSIONS These data suggest that paternal characteristics should be used, in addition to maternal characteristics, to describe the risks of adverse birth outcomes. Additionally, our study suggests that serious consideration should be given to investigating environmental and social mechanisms, such as air pollution exposures, as potential contributors to disparities in birth outcomes among AAPI populations.
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Affiliation(s)
- Devon C Payne-Sturges
- School of Public Health, Maryland Institute for Applied Environmental Health, University of Maryland, 255 Valley Drive, College Park, MD, 20742, USA.
| | - Robin Puett
- School of Public Health, Maryland Institute for Applied Environmental Health, University of Maryland, 255 Valley Drive, College Park, MD, 20742, USA
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Boing AF, deSouza P, Boing AC, Kim R, Subramanian SV. Air Pollution, Socioeconomic Status, and Age-Specific Mortality Risk in the United States. JAMA Netw Open 2022; 5:e2213540. [PMID: 35608861 PMCID: PMC9131742 DOI: 10.1001/jamanetworkopen.2022.13540] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
IMPORTANCE Prior studies on the association between fine particulate matter with diameters 2.5 μm or smaller (PM2.5) and probability of death have not applied multilevel analysis disaggregating data for US census tract, states, and counties, nor tested its interaction by socioeconomic status (SES). Such an approach could provide a more refined identification and targeting of populations exposed to increased risk from PM2.5. OBJECTIVE To assess the association between PM2.5 and age-specific mortality risk (ASMR) using disaggregated data at the census tract level and evaluate such association according to census tract SES. DESIGN, SETTING, AND PARTICIPANTS This nationwide cross-sectional study used a linkage of 3 different data sets. ASMR for the period of 2010 to 2015 was obtained from the National Center for Health Statistic, SES data covering a period from 2006 to 2016 came from the American Community Survey, and mean PM2.5 exposure levels from 2010 to 2015 were derived from well-validated atmospheric chemistry and machine learning models. Data were analyzed in April 2021. EXPOSURES The main exploratory variable was mean census tract-level long-term exposure to PM2.5 from 2010 to 2015. MAIN OUTCOMES AND MEASURES The primary outcome was census tract-level ASMR. Multilevel models were used to quantify the geographic variation in ASMR at levels of census tract, county, and state. Additional analysis explored the interaction of SES in the association of ASMR with PM2.5 exposure. RESULTS Data from 67 148 census tracts nested in 3087 counties and 50 states were analyzed. The association between exposure to PM2.5 and ASMR varied substantially across census tracts. The magnitude of such association also varied across age groups, being higher among adults and older adults. Census tracts accounted for most of the total geographic variation in mortality risk (range, 77.0%-94.2%). ASMR was higher in deciles with greater PM2.5 concentration. For example, ASMR for age 75 to 84 years was 54.6 per 1000 population higher in the decile with the second-highest PM2.5 concentration than in the decile with the lowest PM2.5 concentration. The ASMR, PM2.5 concentrations, and magnitude of the association between both were higher in the census tracts with the lowest SES. CONCLUSIONS AND RELEVANCE This cross-sectional study found that census tracts with lower SES presented higher PM2.5 concentrations. ASMR and air pollution varied substantially across census tracts. There was an association between air pollution and ASMR across all age groups in the United States. These findings suggest that equitable public policies aimed at improving air quality are needed and important to increase life expectancy.
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Affiliation(s)
- Antonio Fernando Boing
- Post-Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Priyanka deSouza
- Urban and Regional Planning Department, University of Colorado Denver, Denver
| | - Alexandra Crispim Boing
- Post-Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Rockli Kim
- Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul, South Korea
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts
| | - S. V. Subramanian
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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85
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Mailloux NA, Abel DW, Holloway T, Patz JA. Nationwide and Regional PM 2.5-Related Air Quality Health Benefits From the Removal of Energy-Related Emissions in the United States. GEOHEALTH 2022; 6:e2022GH000603. [PMID: 35599962 PMCID: PMC9109601 DOI: 10.1029/2022gh000603] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/30/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
Clean energy policy can provide substantial health benefits through improved air quality. As ambitious clean energy proposals are increasingly considered and adopted across the United States (US), quantifying the benefits of removal of such large air pollution emissions sources is crucial to understanding potential societal impacts of such policy. In this study, we estimate health benefits resulting from the elimination of emissions of fine particulate matter (PM2.5), sulfur dioxide, and nitrogen oxides from the electric power, transportation, building, and industrial sectors in the contiguous US. We use EPA's CO-Benefits Risk Assessment screening tool to estimate health benefits resulting from the removal of PM2.5-related emissions from these energy-related sectors. We find that nationwide efforts to eliminate energy-related emissions could prevent 53,200 (95% CI: 46,900-59,400) premature deaths each year and provide $608 billion ($537-$678 billion) in benefits from avoided PM2.5-related illness and death. We also find that an average of 69% (range: 32%-95%) of the health benefits from emissions removal remain in the emitting region. Our study provides an indication of the potential scale and distribution of public health benefits that could result from ambitious regional and nationwide clean energy and climate mitigation policy.
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Affiliation(s)
- Nicholas A. Mailloux
- Center for Sustainability and the Global EnvironmentNelson Institute for Environmental StudiesUniversity of Wisconsin–MadisonMadisonWIUSA
| | - David W. Abel
- Center for Sustainability and the Global EnvironmentNelson Institute for Environmental StudiesUniversity of Wisconsin–MadisonMadisonWIUSA
| | - Tracey Holloway
- Center for Sustainability and the Global EnvironmentNelson Institute for Environmental StudiesUniversity of Wisconsin–MadisonMadisonWIUSA
- Department of Atmospheric and Oceanic SciencesUniversity of Wisconsin–MadisonMadisonWIUSA
| | - Jonathan A. Patz
- Center for Sustainability and the Global EnvironmentNelson Institute for Environmental StudiesUniversity of Wisconsin–MadisonMadisonWIUSA
- Department of Population Health SciencesUniversity of Wisconsin–MadisonMadisonWIUSA
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New Homogeneous Spatial Areas Identified Using Case-Crossover Spatial Lag Grid Differences between Aerosol Optical Depth-PM2.5 and Respiratory-Cardiovascular Emergency Department Visits and Hospitalizations. ATMOSPHERE 2022; 13:1-33. [PMID: 36003277 PMCID: PMC9393882 DOI: 10.3390/atmos13050719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Optimal use of Hierarchical Bayesian Model (HBM)-assembled aerosol optical depth (AOD)-PM2.5 fused surfaces in epidemiologic studies requires homogeneous temporal and spatial fused surfaces. No analytical method is available to evaluate spatial heterogeneity. The temporal case-crossover design was modified to assess the spatial association between four experimental AOD-PM2.5 fused surfaces and four respiratory–cardiovascular hospital events in 12 km2 grids. The maximum number of adjacent lag grids with significant odds ratios (ORs) identified homogeneous spatial areas (HOSAs). The largest HOSA included five grids (lag grids 04; 720 km2) and the smallest HOSA contained two grids (lag grids 01; 288 km2). Emergency department asthma and inpatient asthma, myocardial infarction, and heart failure ORs were significantly higher in rural grids without air monitors than in urban grids with air monitors at lag grids 0, 1, and 01. Rural grids had higher AOD-PM2.5 concentration levels, population density, and poverty percentages than urban grids. Warm season ORs were significantly higher than cold season ORs for all health outcomes at lag grids 0, 1, 01, and 04. The possibility of elevated fine and ultrafine PM and other demographic and environmental risk factors synergistically contributing to elevated respiratory–cardiovascular chronic diseases in persons residing in rural areas was discussed.
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87
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Environmental inequality in the neighborhood networks of urban mobility in US cities. Proc Natl Acad Sci U S A 2022; 119:e2117776119. [PMID: 35446711 PMCID: PMC9169920 DOI: 10.1073/pnas.2117776119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Exposure to air pollution within one’s residential neighborhood has detrimental consequences on health and well-being. Yet, this effect may be mitigated or exacerbated because individuals spend much of their time outside of their residential neighborhood to travel to neighborhoods across a city for work, errands, and leisure. Using mobile phone data to track neighborhood mobility in large US cities, I find that residents from minority and poor neighborhoods travel to neighborhoods that have greater air pollution levels than the neighborhoods that residents from White and nonpoor neighborhoods visit. These results reveal that minority and poor residents face environmental inequalities at three geographic scales: the neighborhoods they live in, their bordering neighborhoods, and the neighborhoods they visit. Research has made clear that neighborhoods impact the health and well-being of their residents. A related strand of research shows that neighborhood disadvantage is geographically clustered. Because the neighborhoods of low-income and minority populations tend to be more disadvantaged, neighborhood conditions help explain racial and socioeconomic inequalities. These strands of research restrict processes of neighborhood influence to operate only within and between geographically contiguous neighbors. However, we are underestimating the role of neighborhood conditions in explaining inequality if disadvantage extends beyond the residential and extralocal environments into a network of neighborhoods spanning the urban landscape based on where residents move within a city. I use anonymized mobile phone data to measure exposure to air pollution among residents of poor and minority neighborhoods in 88 of the most populous US cities. I find that residents from minority and poor neighborhoods travel to neighborhoods that have greater air pollution levels than the neighborhoods that residents from White and nonpoor neighborhoods visit. Hispanic neighborhoods exhibit the greatest overall pollution burden, Black/White and Asian/White disparities are greatest at the network than residential scale, and the socioeconomic advantage of lower risk exposure is highest for residents from White neighborhoods. These inequalities are notable given recent declines in segregation and air pollution levels in American cities.
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Chen C, Chan A, Dominici F, Peng RD, Sabath B, Di Q, Schwartz J, Bell ML. Do temporal trends of associations between short-term exposure to fine particulate matter (PM 2.5) and risk of hospitalizations differ by sub-populations and urbanicity-a study of 968 U.S. counties and the Medicare population. ENVIRONMENTAL RESEARCH 2022; 206:112271. [PMID: 34710436 PMCID: PMC8810624 DOI: 10.1016/j.envres.2021.112271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 05/29/2023]
Abstract
While associations between short-term exposure to fine particulate matter (PM2.5) and risk of hospitalization are well documented and evidence suggests that such associations change over time, it is unclear whether these temporal changes exist in understudied less-urban areas or differ by sub-population. We analyzed daily time-series data of 968 continental U.S. counties for 2000-2016, with cause-specific hospitalization from Medicare claims and population-weighted PM2.5 concentrations originally estimated at 1km × 1 km from a hybrid model. Circulatory and respiratory hospitalizations were categorized based on primary diagnosis codes at discharge. Using modified Bayesian hierarchical modelling, we evaluated the temporal trend in association between PM2.5 and hospitalizations and whether disparities in this trend exist across individual-level characteristics (e.g., sex, age, race, and Medicaid eligibility as a proxy for socio-economic status) and urbanicity. Urbanicity was categorized into three levels by county-specific percentage of urban population based on urban rural delineation from the U.S. Census. In this cohort with understudied less-urban areas without regulatory monitors, we still found positive association between circulatory and respiratory hospitalization and short-term exposure to PM2.5, with higher effect estimates towards the end of study period. Consistent with current literature, we identified significant disparity in associations by race, socioeconomic status and urbanicity. We found that the percentage change in circulatory hospitalization rate per 10 μg/m3 increase in PM2.5 was higher in the 2008-2016 time period compared to the 2000-2007 period by 0.33% (95% posterior credible interval 0.22, 0.44%), 0.52% (0.33, 0.69%), and 0.67% (0.53, 0.83%) for low, medium and high tertiles of urban areas, respectively. We also observed significant differences in temporal trends of associations across socioeconomic status, sex, and age, indicating a possible widening in disparity of PM2.5-related health burden. This study raises the importance of considering environmental justice issues in PM2.5-related health impacts with respect to how associations may change over time.
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Affiliation(s)
- Chen Chen
- School of the Environment, Yale University, New Haven, USA.
| | - Alisha Chan
- School of Engineering and Applied Science, Yale University, New Haven, USA
| | | | - Roger D Peng
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Ben Sabath
- Harvard T.H. Chan School of Public Health, Boston, USA
| | - Qian Di
- School of Medicine, Tsinghua University, Beijing, China
| | - Joel Schwartz
- Harvard T.H. Chan School of Public Health, Boston, USA
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Wolf MJ, Esty DC, Kim H, Bell ML, Brigham S, Nortonsmith Q, Zaharieva S, Wendling ZA, de Sherbinin A, Emerson JW. New Insights for Tracking Global and Local Trends in Exposure to Air Pollutants. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:3984-3996. [PMID: 35255208 PMCID: PMC8988294 DOI: 10.1021/acs.est.1c08080] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Over six million people die prematurely each year from exposure to air pollution. Current air quality metrics insufficiently monitor exposure to air pollutants. This gap hinders the ability of decisionmakers to address the public health impacts of air pollution. To spur new emissions control policies and ensure implemented solutions realize meaningful gains in environmental health, we develop a framework of public-health-focused air quality indicators that quantifies over 200 countries' trends in exposure to particulate matter, ozone, nitrogen oxides, sulfur dioxide, carbon monoxide, and volatile organic compounds. We couple population density to ground-level pollutant concentrations to derive population-weighted exposure metrics that quantify the pollutant levels experienced by the average resident in each country. Our analyses demonstrate that most residents in 171 countries experience pollutant levels exceeding international health guidelines. In addition, we find a negative correlation between temporal trends in ozone and nitrogen oxide concentrations, which─when qualitatively interpreted with a simple atmospheric chemistry box model─can help describe the apparent tradeoff between the mitigation of these two pollutants on local scales. These novel indicators and their applications enable regulators to identify their most critical pollutant exposure trends and allow countries to track the performance of their emission control policies over time.
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Affiliation(s)
- Martin J. Wolf
- Yale
Center for Environmental Law & Policy, New Haven, Connecticut 06511, United States
- School
of the Environment, Yale University, New Haven, Connecticut 06511, United States
- Yale
Law School, Yale University, New Haven, Connecticut 06511, United States
- . Phone: +1 203
436 9566
| | - Daniel C. Esty
- Yale
Center for Environmental Law & Policy, New Haven, Connecticut 06511, United States
- School
of the Environment, Yale University, New Haven, Connecticut 06511, United States
- Yale
Law School, Yale University, New Haven, Connecticut 06511, United States
| | - Honghyok Kim
- School
of the Environment, Yale University, New Haven, Connecticut 06511, United States
| | - Michelle L. Bell
- School
of the Environment, Yale University, New Haven, Connecticut 06511, United States
- Yale
School of Public Health, Environmental Health
Sciences Division, New Haven, Connecticut 06520, United States
- Department
of Chemical and Environmental Engineering, Yale University, New Haven, Connecticut 06520, United States
| | - Sam Brigham
- Department
of Economics, Yale University, New Haven, Connecticut 06511, United States
| | - Quinn Nortonsmith
- Department
of Economics, Yale University, New Haven, Connecticut 06511, United States
| | - Slaveya Zaharieva
- Department
of Economics, Yale University, New Haven, Connecticut 06511, United States
| | - Zachary A. Wendling
- Yale
Center for Environmental Law & Policy, New Haven, Connecticut 06511, United States
- Sustainable
Development Solutions Network, New York, New York 10115, United States
| | - Alex de Sherbinin
- Center
for International Earth Science Information Network, The Earth Institute, Columbia University, New York, New York 10025, United States
| | - John W. Emerson
- Department
of Statistics and Data Science, Yale University, New Haven, Connecticut 06511, United States
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90
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Weaver AK, Head JR, Gould CF, Carlton EJ, Remais JV. Environmental Factors Influencing COVID-19 Incidence and Severity. Annu Rev Public Health 2022; 43:271-291. [PMID: 34982587 PMCID: PMC10044492 DOI: 10.1146/annurev-publhealth-052120-101420] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Emerging evidence supports a link between environmental factors-including air pollution and chemical exposures, climate, and the built environment-and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and coronavirus disease 2019 (COVID-19) susceptibility and severity. Climate, air pollution, and the built environment have long been recognized to influence viral respiratory infections, and studies have established similar associations with COVID-19 outcomes. More limited evidence links chemical exposures to COVID-19. Environmental factors were found to influence COVID-19 through four major interlinking mechanisms: increased risk of preexisting conditions associated with disease severity; immune system impairment; viral survival and transport; and behaviors that increase viral exposure. Both data and methodologic issues complicate the investigation of these relationships, including reliance on coarse COVID-19 surveillance data; gaps in mechanistic studies; and the predominance of ecological designs. We evaluate the strength of evidence for environment-COVID-19 relationships and discuss environmental actions that might simultaneously address the COVID-19 pandemic, environmental determinants of health, and health disparities.
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Affiliation(s)
- Amanda K Weaver
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA; ,
| | - Jennifer R Head
- Department of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, USA;
| | - Carlos F Gould
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA;
- Department of Earth System Science, Stanford University, Stanford, California, USA
| | - Elizabeth J Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz, Aurora, Colorado, USA;
| | - Justin V Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA; ,
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91
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A Critical Review on the Complex Interplay between Social Determinants of Health and Maternal and Infant Mortality. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030394. [PMID: 35327766 PMCID: PMC8947729 DOI: 10.3390/children9030394] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 12/21/2022]
Abstract
Background: U.S. maternal and infant mortality rates constitute an important public health problem, because these rates surpass those in developed countries and are characterized by stark disparities for racial/ethnic minorities, rural residents, and individuals with less privileged socioeconomic status due to social determinants of health (SDoH). Methods: A critical review of the maternal and infant mortality literature was performed to determine multilevel SDoH factors leading to mortality disparities with a life course lens. Results: Black mothers and infants fared the worst in terms of mortality rates, likely due to the accumulation of SDoH experienced as a result of structural racism across the life course. Upstream SDoH are important contributors to disparities in maternal and infant mortality. More research is needed on the effectiveness of continuous quality improvement initiatives for the maternal–infant dyad, and expanding programs such as paid maternity leave, quality, stable and affordable housing, and social safety-nets (Medicaid, CHIP, WIC), in reducing maternal and infant mortality. Finally, it is important to address research gaps in individual, interpersonal, community, and societal factors, because they affect maternal and infant mortality and related disparities. Conclusion: Key SDoH at multiple levels affect maternal and infant health. These SDoH shape and perpetuate disparities across the lifespan and are implicated in maternal and infant mortality disparities.
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92
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Gardner-Frolick R, Boyd D, Giang A. Selecting Data Analytic and Modeling Methods to Support Air Pollution and Environmental Justice Investigations: A Critical Review and Guidance Framework. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:2843-2860. [PMID: 35133145 DOI: 10.1021/acs.est.1c01739] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Given the serious adverse health effects associated with many pollutants, and the inequitable distribution of these effects between socioeconomic groups, air pollution is often a focus of environmental justice (EJ) research. However, EJ analyses that aim to illuminate whether and how air pollution hazards are inequitably distributed may present a unique set of requirements for estimating pollutant concentrations compared to other air quality applications. Here, we perform a scoping review of the range of data analytic and modeling methods applied in past studies of air pollution and environmental injustice and develop a guidance framework for selecting between them given the purpose of analysis, users, and resources available. We include proxy, monitor-based, statistical, and process-based methods. Upon critically synthesizing the literature, we identify four main dimensions to inform method selection: accuracy, interpretability, spatiotemporal features of the method, and usability of the method. We illustrate the guidance framework with case studies from the literature. Future research in this area includes an exploration of increasing data availability, advanced statistical methods, and the importance of science-based policy.
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Affiliation(s)
- Rivkah Gardner-Frolick
- Department of Mechanical Engineering, University of British Columbia, Vancouver V6T 1Z4, Canada
| | - David Boyd
- Institute for Resources, Environment and Sustainability, University of British Columbia, Vancouver V6T 1Z4, Canada
| | - Amanda Giang
- Department of Mechanical Engineering, University of British Columbia, Vancouver V6T 1Z4, Canada
- Institute for Resources, Environment and Sustainability, University of British Columbia, Vancouver V6T 1Z4, Canada
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93
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Freisthler MS, Robbins CR, Benbrook CM, Young HA, Haas DM, Winchester PD, Perry MJ. Association between increasing agricultural use of 2,4-D and population biomarkers of exposure: findings from the National Health and Nutrition Examination Survey, 2001-2014. Environ Health 2022; 21:23. [PMID: 35139875 PMCID: PMC8830015 DOI: 10.1186/s12940-021-00815-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/08/2021] [Indexed: 05/15/2023]
Abstract
BACKGROUND 2,4-Dichlorophenoxyacetic acid (2,4-D) is one of the most extensively used herbicides in the United States. In 2012, 2,4-D was the most widely used herbicide in non-agricultural settings and the fifth most heavily applied pesticide in the US agricultural sector. The objective of this study was to examine trends in 2,4-D urinary biomarker concentrations to determine whether increases in 2,4-D application in agriculture are associated with increases in biomonitoring levels of urine 2,4-D. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) with available urine 2,4-D biomarker measurements from survey cycles between 2001 and 2014 were utilized. Urine 2,4-D values were dichotomized using the highest limit of detection (LOD) across all cycles (0.40 μg/L or 0.4 ppb). Agricultural use of 2,4-D was estimated by compiling publicly available federal and private pesticide application data. Logistic regression models adjusted for confounders were fitted to evaluate the association between agricultural use of 2,4-D and urine 2,4-D level above the dichotomization threshold. RESULTS Of the 14,395 participants included in the study, 4681 (32.5%) had urine 2,4-D levels above the dichotomization threshold. The frequency of participants with high 2,4-D levels increased significantly (p < .0001), from a low of 17.1% in 2001-2002 to a high of 39.6% in 2011-2012. The adjusted odds of high urinary 2,4-D concentrations associated with 2,4-D agricultural use (per ten million pounds applied) was 2.268 (95% CI: 1.709, 3.009). Children ages 6-11 years (n = 2288) had 2.1 times higher odds of having high 2,4-D urinary concentrations compared to participants aged 20-59 years. Women of childbearing age (age 20-44 years) (n = 2172) had 1.85 times higher odds than men of the same age. CONCLUSIONS Agricultural use of 2,4-D has increased substantially from a low point in 2002 and it is predicted to increase further in the coming decade. Because increasing use is likely to increase population level exposures, the associations seen here between 2,4-D crop application and biomonitoring levels require focused biomonitoring and epidemiological evaluation to determine the extent to which rising use and exposures cause adverse health outcomes among vulnerable populations (particularly children and women of childbearing age) and highly exposed individuals (farmers, other herbicide applicators, and their families).
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Affiliation(s)
- Marlaina S Freisthler
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - C Rebecca Robbins
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | | | - Heather A Young
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Paul D Winchester
- Neonatology, Indiana University School of Medicine/Riley Hospital, Indianapolis, Indiana, USA
| | - Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA.
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94
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Reuben A, Manczak EM, Cabrera LY, Alegria M, Bucher ML, Freeman EC, Miller GW, Solomon GM, Perry MJ. The Interplay of Environmental Exposures and Mental Health: Setting an Agenda. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:25001. [PMID: 35171017 PMCID: PMC8848757 DOI: 10.1289/ehp9889] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/06/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND To date, health-effects research on environmental stressors has rarely focused on behavioral and mental health outcomes. That lack of research is beginning to change. Science and policy experts in the environmental and behavioral health sciences are coming together to explore converging evidence on the relationship-harmful or beneficial-between environmental factors and mental health. OBJECTIVES To organize evidence and catalyze new findings, the National Academy of Sciences, Engineering, and Medicine (NASEM) hosted a workshop 2-3 February 2021 on the interplay of environmental exposures and mental health outcomes. METHODS This commentary provides a nonsystematic, expert-guided conceptual review and interdisciplinary perspective on the convergence of environmental and mental health, drawing from hypotheses, findings, and research gaps presented and discussed at the workshop. Featured is an overview of what is known about the intersection of the environment and mental health, focusing on the effects of neurotoxic pollutants, threats related to climate change, and the importance of health promoting environments, such as urban green spaces. DISCUSSION We describe what can be gained by bridging environmental and psychological research disciplines and present a synthesis of what is needed to advance interdisciplinary investigations. We also consider the implications of the current evidence for a) foundational knowledge of the etiology of mental health and illness, b) toxicant policy and regulation, c) definitions of climate adaptation and community resilience, d) interventions targeting marginalized communities, and e) the future of research training and funding. We include a call to action for environmental and mental health researchers, focusing on the environmental contributions to mental health to unlock primary prevention strategies at the population level and open equitable paths for preventing mental disorders and achieving optimal mental health for all. https://doi.org/10.1289/EHP9889.
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Affiliation(s)
- Aaron Reuben
- Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, USA
| | - Erika M. Manczak
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Laura Y. Cabrera
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Margarita Alegria
- Departments of Medicine and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Meghan L. Bucher
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | | | - Gary W. Miller
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Gina M. Solomon
- Department of Medicine, University of California San Francisco, San Francisco, CA
- Public Health Institute, Oakland, CA
| | - Melissa J. Perry
- Department of Environmental and Occupational Health, George Washington University, Washington, District of Colombia, USA
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95
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Jones DH, Yu X, Guo Q, Duan X, Jia C. Racial Disparities in the Heavy Metal Contamination of Urban Soil in the Southeastern United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031105. [PMID: 35162130 PMCID: PMC8834334 DOI: 10.3390/ijerph19031105] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 11/24/2022]
Abstract
(1) Background: Field monitoring data for addressing the disproportional burden of exposure to soil contamination in communities of minority and low socioeconomic status (SES) are sparse. This study aims to examine the association between soil heavy metal levels, SES, and racial composition. (2) Methods: A total of 423 soil samples were collected in the urban areas of eight cities across six Southern states in the U.S., in 2015. Samples were analyzed using inductively coupled plasma–mass spectrometry (ICP–MS) for eight heavy metals. The association was examined with mixed models with the log-transformed metal concentrations as the dependent variables and rankings of low-income or minority percentages as the explanatory variables. (3) Results: Model results showed that soil metal concentrations were significantly associated with rankings of poverty and minority percentages. The cadmium concentration significantly increased by 4.7% (p-value < 0.01), for every 10 percentiles of increase in poverty rank. For every 10 percentiles of increase in minority rank, the soil concentrations were significantly up (p-values < 0.01) for arsenic (13.5%), cadmium (5.5%), and lead (10.6%). Minority rank had significant direct effects on both arsenic and lead. (4) Conclusions: The findings confirmed elevated heavy metal contamination in urban soil in low-income and/or predominantly minority communities.
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Affiliation(s)
- Daleniece Higgins Jones
- Department of Public Health, University of Tennessee, Knoxville, TN 37996, USA
- Correspondence: (D.H.J.); (C.J.)
| | - Xinhua Yu
- School of Public Health, University of Memphis, Memphis, TN 38152, USA;
| | - Qian Guo
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China; (Q.G.); (X.D.)
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China; (Q.G.); (X.D.)
| | - Chunrong Jia
- School of Public Health, University of Memphis, Memphis, TN 38152, USA;
- Correspondence: (D.H.J.); (C.J.)
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96
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DeRouen MC, Canchola AJ, Thompson CA, Jin A, Nie S, Wong C, Lichtensztajn D, Allen L, Patel MI, Daida YG, Luft HS, Shariff-Marco S, Reynolds P, Wakelee HA, Liang SY, Waitzfelder BE, Cheng I, Gomez SL. Incidence of Lung Cancer Among Never-Smoking Asian American, Native Hawaiian, and Pacific Islander Females. J Natl Cancer Inst 2022; 114:78-86. [PMID: 34345919 PMCID: PMC8755498 DOI: 10.1093/jnci/djab143] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/17/2021] [Accepted: 07/16/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Although lung cancer incidence rates according to smoking status, sex, and detailed race/ethnicity have not been available, it is estimated that more than half of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) females with lung cancer have never smoked. METHODS We calculated age-adjusted incidence rates for lung cancer according to smoking status and detailed race/ethnicity among females, focusing on AANHPI ethnic groups, and assessed relative incidence across racial/ethnic groups. We used a large-scale dataset that integrates data from electronic health records from 2 large health-care systems-Sutter Health in Northern California and Kaiser Permanente Hawai'i-linked to state cancer registries for incident lung cancer diagnoses between 2000 and 2013. The study population included 1 222 694 females (n = 244 147 AANHPI), 3297 of which were diagnosed with lung cancer (n = 535 AANHPI). RESULTS Incidence of lung cancer among never-smoking AANHPI as an aggregate group was 17.1 per 100 000 (95% confidence interval [CI] = 14.9 to 19.4) but varied widely across ethnic groups. Never-smoking Chinese American females had the highest rate (22.8 per 100 000, 95% CI = 17.3 to 29.1). Except for Japanese American females, incidence among every never-smoking AANHPI female ethnic group was higher than that of never-smoking non-Hispanic White females, from 66% greater among Native Hawaiian females (incidence rate ratio = 1.66, 95% CI = 1.03 to 2.56) to more than 100% greater among Chinese American females (incidence rate ratio = 2.26, 95% CI = 1.67 to 3.02). CONCLUSIONS Our study revealed high rates of lung cancer among most never-smoking AANHPI female ethnic groups. Our approach illustrates the use of innovative data integration to dispel the myth that AANHPI females are at overall reduced risk of lung cancer and demonstrates the need to disaggregate this highly diverse population.
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Affiliation(s)
- Mindy C DeRouen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Alison J Canchola
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Caroline A Thompson
- San Diego State University School of Public Health, San Diego, CA, USA
- University of California San Diego School of Medicine, San Diego, CA, USA
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Anqi Jin
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Sixiang Nie
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Carmen Wong
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Daphne Lichtensztajn
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Laura Allen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | | | - Yihe G Daida
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Harold S Luft
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Peggy Reynolds
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Heather A Wakelee
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Su-Ying Liang
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Beth E Waitzfelder
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Scarlett L Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
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97
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Evaluating the Utility of High-Resolution Spatiotemporal Air Pollution Data in Estimating Local PM2.5 Exposures in California from 2015–2018. ATMOSPHERE 2022. [DOI: 10.3390/atmos13010085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Air quality management is increasingly focused not only on across-the-board reductions in ambient pollution concentrations but also on identifying and remediating elevated exposures that often occur in traditionally disadvantaged communities. Remote sensing of ambient air pollution using data derived from satellites has the potential to better inform management decisions that address environmental disparities by providing increased spatial coverage, at high-spatial resolutions, compared to air pollution exposure estimates based on ground-based monitors alone. Daily PM2.5 estimates for 2015–2018 were estimated at a 1 km2 resolution, derived from NASA’s Moderate Resolution Imaging Spectroradiometer (MODIS) satellite instrument and the Multi-Angle Implementation of Atmospheric Correction (MAIAC) algorithm in order to assess the utility of highly refined spatiotemporal air pollution data in 92 California cities and in the 13 communities included in the California Community Air Protection Program. The identification of pollution hot-spots within a city is typically not possible relying solely on the regulatory monitoring networks; however, day-to-day temporal variability was shown to be generally well represented by nearby ground-based monitoring data even in communities with strong spatial gradients in pollutant concentrations. An assessment of within-ZIP Code variability in pollution estimates indicates that high-resolution pollution estimates (i.e., 1 km2) are not always needed to identify spatial differences in exposure but become increasingly important for larger geographic areas (approximately 50 km2). Taken together, these findings can help inform strategies for use of remote sensing data for air quality management including the screening of locations with air pollution exposures that are not well represented by existing ground-based air pollution monitors.
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98
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Eneanya ND, Tiako MJN, Novick TK, Norton JM, Cervantes L. Disparities in Mental Health and Well-Being Among Black and Latinx Patients With Kidney Disease. Semin Nephrol 2022; 41:563-573. [PMID: 34973700 DOI: 10.1016/j.semnephrol.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Black and Latinx individuals in the United States are afflicted disproportionately with kidney disease. Because of structural racism, social risk factors drive disparities in disease prevalence and result in worse outcomes among these patient groups. The impact of social and economic oppression is pervasive in physical and emotional aspects of health. In this review, we describe the history of race and ethnicity among black and Latinx individuals in the United States and discuss how these politicosocial constructs impact disparities in well-being and mental health. Lastly, we outline future research, clinical considerations, and policy considerations to eliminate racial and ethnic disparities in well-being among black and Latinx individuals with kidney disease.
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Affiliation(s)
- Nwamaka D Eneanya
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
| | | | - Tessa K Novick
- Division of Nephrology, Department of Internal Medicine, University of Texas, Austin Dell Medical School, Austin, TX
| | - Jenna M Norton
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - Lilia Cervantes
- Division of Hospital Medicine, Department of Medicine, University of Colorado, Aurora, CO
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99
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A multiscale analysis of social and spatial determinants of cancer and noncancer hazards from on-road air pollution in Texas. Spat Spatiotemporal Epidemiol 2022; 41:100484. [DOI: 10.1016/j.sste.2022.100484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 11/22/2022]
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Abstract
The twenty-first century has witnessed a wave of severe infectious disease outbreaks, not least the COVID-19 pandemic, which has had a devastating impact on lives and livelihoods around the globe. The 2003 severe acute respiratory syndrome coronavirus outbreak, the 2009 swine flu pandemic, the 2012 Middle East respiratory syndrome coronavirus outbreak, the 2013-2016 Ebola virus disease epidemic in West Africa and the 2015 Zika virus disease epidemic all resulted in substantial morbidity and mortality while spreading across borders to infect people in multiple countries. At the same time, the past few decades have ushered in an unprecedented era of technological, demographic and climatic change: airline flights have doubled since 2000, since 2007 more people live in urban areas than rural areas, population numbers continue to climb and climate change presents an escalating threat to society. In this Review, we consider the extent to which these recent global changes have increased the risk of infectious disease outbreaks, even as improved sanitation and access to health care have resulted in considerable progress worldwide.
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