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Oh H, Stickley A, Lincoln KD, Koyanagi A. Allergies, infections, and psychiatric disorders among Black Americans: findings from the National Survey of American Life. ETHNICITY & HEALTH 2022; 27:74-82. [PMID: 31441320 DOI: 10.1080/13557858.2019.1658184] [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: 04/02/2019] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
Objectives: An emerging body of literature shows that allergies and infections are associated with psychiatric disorders, though there is little research to confirm these associations among Black Americans in the United States.Design: We analyzed data from the National Survey of American Life, and used multivariable logistic regression models to examine the associations between past 12-month allergies/infections and past 12-month psychiatric disorders, adjusting for socio-demographic characteristics, tobacco use, lifetime diabetes, and body mass index.Results: We found that allergies/infections were associated with mood, anxiety, and eating disorders, but not alcohol or substance use disorders. We detected effect modification by ethnicity, with stronger odds for mood, anxiety disorders, and alcohol use disorders, with no significant associations for substance use or eating disorders among Caribbean Blacks.Conclusions: Our findings underscore the importance of screening for psychiatric disorders among Black individuals complaining of allergies/infections, and the need to also treat allergies/infections among people with psychiatric disorders.
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Affiliation(s)
- Hans Oh
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Sweden
| | - Karen D Lincoln
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Deu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Burnor E, Cserbik D, Cotter DL, Palmer CE, Ahmadi H, Eckel SP, Berhane K, McConnell R, Chen JC, Schwartz J, Jackson R, Herting MM. Association of Outdoor Ambient Fine Particulate Matter With Intracellular White Matter Microstructural Properties Among Children. JAMA Netw Open 2021; 4:e2138300. [PMID: 34882178 PMCID: PMC8662373 DOI: 10.1001/jamanetworkopen.2021.38300] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/14/2021] [Indexed: 11/23/2022] Open
Abstract
Importance Outdoor particulate matter 2.5 μm or less in diameter (PM2.5) is a ubiquitous environmental neurotoxicant that may affect the developing brain. Little is known about associations between PM2.5 and white matter connectivity. Objectives To assess associations between annual residential PM2.5 exposure and white matter microstructure health in a US sample of children 9 to 10 years of age and to examine whether associations are specific to certain white matter pathways or vary across neuroimaging diffusion markers reflective of intracellular and extracellular microstructural processes. Design, Setting, and Participants This cross-sectional study, the Adolescent Brain and Cognitive Development (ABCD) Study, was composed of 21 study sites across the US and used baseline data collected from children 9 to 10 years of age from September 1, 2016, to October 15, 2018. Data analysis was performed from September 15, 2020, to June 30, 2021. Exposures Annual mean PM2.5 exposure estimated by ensemble-based models and assigned to the primary residential addresses at baseline. Main Outcomes and Measures Diffusion-weighted imaging (DWI) and tractography were used to delineate white matter tracts. The biophysical modeling technique of restriction spectrum imaging (RSI) was implemented to examine total hindered diffusion and restricted isotropic and anisotropic intracellular diffusion in each tract. Hierarchical mixed-effects models with natural splines were used to analyze the associations between PM2.5 exposure and DWI. Results In a study population of 7602 children (mean [SD] age, 119.1 [7.42] months; 3955 [52.0%] female; 160 [ 21.%] Asian, 1025 [13.5%] Black, 1616 [21.3%] Hispanic, 4025 [52.9%] White, and 774 [10.2%] other [identified by parents as American Indian/Native American or Alaska Native; Native Hawaiian, Guamanian, Samoan, other Pacific Islander; Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or other Asian; or other race]), associations were seen between annual ambient PM2.5 and hemispheric differences in white matter microstructure. Hemisphere-stratified models revealed significant associations between PM2.5 exposure and restricted isotropic intracellular diffusion in the left cingulum, in the left superior longitudinal fasciculus, and bilaterally in the fornix and uncinate fasciculus. In tracts with strong positive associations, a PM2.5 increase from 8 to 12 μg/m3 was associated with increases of 2.16% (95% CI, 0.49%-3.84%) in the left cingulum, 1.95% (95% CI, 0.43%-3.47%) in the left uncinate, and 1.68% (95% CI, 0.01%-3.34%) in the right uncinate. Widespread negative associations were observed between PM2.5 and mean diffusivity. Conclusions and Relevance The findings of this cross-sectional study suggest that annual mean PM2.5 exposure during childhood is associated with increased restricted isotropic diffusion and decreased mean diffusivity of specific white matter tracts, potentially reflecting differences in the composition of white matter microarchitecture.
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Affiliation(s)
- Elisabeth Burnor
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles
| | - Dora Cserbik
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles
| | - Devyn L. Cotter
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles
| | - Clare E. Palmer
- Center for Human Development, University of California, San Diego, La Jolla
| | - Hedyeh Ahmadi
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles
| | - Sandrah P. Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles
| | - Kiros Berhane
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York
| | - Rob McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles
- Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Raymond Jackson
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles
| | - Megan M. Herting
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles
- Children’s Hospital Los Angeles, Los Angeles, California
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103
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Jonidi Jafari A, Charkhloo E, Pasalari H. Urban air pollution control policies and strategies: a systematic review. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:1911-1940. [PMID: 34900316 PMCID: PMC8617239 DOI: 10.1007/s40201-021-00744-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/20/2021] [Indexed: 06/01/2023]
Abstract
A wide range of policies, strategies, and interventions have been implemented to improve air quality all over the world. This systematic review comprehensively appraises the policies and strategies on air pollutants controls enacted in different countries, worldwide. Three databases, Web of Science, PubMed and Scopus, were used for the search. After screening, a total of 114 eligible manuscripts were selected from 2219 documents for further analysis. Selected articles were divided into two categories: (1) articles focusing on introducing the policies and strategies enacted for controlling air pollution in different countries, and (2) articles which focused on different policies and strategies to control one or more specific pollutants. In the former one, urban air pollution control strategies and policies were divided into four categories, namely, general strategies and policies, transportation, energy, and industry. In case of latter category, policies and strategies focused on controlling six pollutants (PM, SO2, NO2, VOCS, O3 and photochemical smog). The results indicated that, the most common policies and strategies enacted in most countries are pertinent to the transportation sector. Changing energy sources, in particular elimination or limited use of solid fuels, was reported as an effective action by governments to reduce air pollution. Overall, most policies enacted by governments can be divided into three general categories: (a) incentive policies such as implementing a free public transportation program to use fewer private cars, (b) supportive policies such as paying subsidies to change household fuels, and (c) punitive policies such as collecting tolls for cars to enter the congestion charging areas. Depending on the circumstances, these policies are implemented alone or jointly. In addition to the acceptance of international agreements to reduce air pollution by governments, greater use of renewable energy, clean fuels, and low-pollution or no-pollution vehicles such as electric vehicles play an important role in reducing air pollution.
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Affiliation(s)
- Ahmad Jonidi Jafari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Esmail Charkhloo
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Pasalari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Excess Morbidity and Mortality Associated with Air Pollution above American Thoracic Society Recommended Standards, 2017-2019. Ann Am Thorac Soc 2021; 19:603-613. [PMID: 34847333 DOI: 10.1513/annalsats.202107-860oc] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rationale: Over the past year, the American Thoracic Society (ATS), led by its Environmental Health Policy Committee, has reviewed the most current air quality scientific evidence and has revised their recommendations to 8 µg/m3 and 25 µg/m3 for long- and short-term fine particulate matter (PM2.5) and reaffirmed the recommendation of 60 ppb for ozone to protect the American public from the known adverse health effects of air pollution. The current EPA standards, in contrast, expose the American public to pollution levels that are known to result in significant morbidity and mortality. Objectives: To provide county-level estimates of annual air pollution-related health outcomes across the United States using the most recent federal air quality data, and to support the ATS's recent update to the long-term PM2.5 recommended standard. This study is presented as part of the annual ATS/Marron Institute "Health of the Air" report. Methods: Daily air pollution values were obtained from the U.S. Environmental Protection Agency's (EPA) Air Quality System for monitored counties in the United States from 2017-2019. Concentration-response functions used in the EPA's regulatory review process were applied to pollution increments corresponding to differences between the rolling 3-year design values and ATS-recommended levels for long-term PM2.5 (8 µg/m3), short-term PM2.5 (25 µg/m3), and ground-level ozone (O3; 60 ppb). Health impacts were estimated at the county level in locations with valid monitoring data. Results: Meeting ATS recommendations throughout the country prevents an estimated 14,650 (95% CI: 8,660 - 22,610) deaths; 2,950 (95% CI: 1,530 - 4,330) lung cancer incidence events; 33,100 (95% CI: 7,300 - 71,000) morbidities, and 39.8 million (95% CI: 14.6 - 63.3 million) impacted days annually (see Table 1). This prevents 11,850 more deaths; 2,580 more lung cancer incidence events; 25,400 more morbidities; and 27.2 million more impacted days than meeting EPA standards alone. Conclusions: Significant health benefits to be gained by U.S. communities that work to meet ATS-recommended air quality standards have now been identified under scenarios meeting the new ATS recommendation for long-term PM2.5 (8 µg/m3). The "Health of the Air" report presents an opportunity for air quality managers to quantify local health burdens and EPA officials to update their standards to reflect the latest science.
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105
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Bastain TM, Chavez T, Habre R, Hernandez-Castro I, Grubbs B, Toledo-Corral CM, Farzan SF, Lurvey N, Lerner D, Eckel SP, Lurmann F, Lagomasino I, Breton C. Prenatal ambient air pollution and maternal depression at 12 months postpartum in the MADRES pregnancy cohort. Environ Health 2021; 20:121. [PMID: 34838014 PMCID: PMC8626870 DOI: 10.1186/s12940-021-00807-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 11/15/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Depression is the leading cause of mental health-related morbidity and affects twice as many women as men. Hispanic/Latina women in the US have unique risk factors for depression and they have lower utilization of mental health care services. Identifying modifiable risk factors for maternal depression, such as ambient air pollution, is an urgent public health priority. We aimed to determine whether prenatal exposure to ambient air pollutants was associated with maternal depression at 12 months after childbirth. METHODS One hundred eighty predominantly low-income Hispanic/Latina women participating in the ongoing MADRES cohort study in Los Angeles, CA were followed from early pregnancy through 12 months postpartum through a series of phone questionnaires and in-person study visits. Daily prenatal ambient pollutant estimates of nitrogen dioxide (NO2), ozone (O3), and particulate matter (PM10 and PM2.5) were assigned to participant residences using inverse-distance squared spatial interpolation from ambient monitoring data. Exposures were averaged for each trimester and across pregnancy. The primary outcome measure was maternal depression at 12 months postpartum, as reported on the 20-item Center for Epidemiologic Studies-Depression (CES-D) scale. We classified each participant as depressed (n = 29) or not depressed (n = 151) based on the suggested cutoff of 16 or above (possible scores range from 0 to 60) and fitted logistic regression models, adjusting for potential confounders. RESULTS We found over a two-fold increased odds of depression at 12 months postpartum associated with second trimester NO2 exposure (OR = 2.63, 95% CI: 1.41-4.89) and pregnancy average NO2 (OR = 2.04, 95% CI: 1.13-3.69). Higher second trimester PM2.5 exposure also was associated with increased depression at 12 months postpartum (OR = 1.56, 95% CI: 1.01-2.42). The effect for second trimester PM10 was similar and was borderline significant (OR = 1.58, 95% CI: 0.97-2.56). CONCLUSIONS In a low-income cohort consisting of primarily Hispanic/Latina women in urban Los Angeles, we found that prenatal ambient air pollution, especially mid-pregnancy NO2 and PM2.5, increased the risk of depression at 12 months after childbirth. These results underscore the need to better understand the contribution of modifiable environmental risk factors during potentially critical exposure periods.
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Affiliation(s)
- Theresa M. Bastain
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Thomas Chavez
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Rima Habre
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Ixel Hernandez-Castro
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Brendan Grubbs
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
| | - Claudia M. Toledo-Corral
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
- Department of Health Sciences, California State University, Northridge, USA
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | | | | | - Sandrah P. Eckel
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | | | - Isabel Lagomasino
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, USA
| | - Carrie Breton
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
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106
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Bai H, Capitanio JP, Miller LA, Clougherty JE. Social status and susceptibility to wildfire smoke among outdoor-housed female rhesus monkeys: A natural experiment. Heliyon 2021; 7:e08333. [PMID: 34816037 PMCID: PMC8591456 DOI: 10.1016/j.heliyon.2021.e08333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/30/2021] [Accepted: 11/04/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Wildfire smoke (WFS) exposure is a growing threat to human health, and lower socioeconomic position (SEP) has been shown to increase pollution susceptibility. Studies of SEP-related susceptibility, however, are often compromised due to spatial confounding between lower-SEP and pollution. Here we examine outdoor-housed nonhuman primates, living in natural social hierarchy in a common location, born during years of high vs. low WFS, to examine the separate and combined effects of WFS and social rank, an analog to SEP, on lung and immune function. Methods Twenty-one females were born during extreme WFS events in summer 2008; 22 were born in summer 2009, during low WFS. Pulmonary function and circulating cytokines were measured three years later, in adolescence. We estimated fine particulate (PM2.5) and ozone exposures during each animal's first 90 days and three years of age using regulatory data. Early-life social status was estimated using maternal rank at birth, as rank in females is relatively stable throughout life, and closely approximates mother's rank. We tested associations among WFS exposure, rank, and endpoints using linear regression and ANOVA. Results Higher WFS exposure in infancy was, on average, associated with lower functional residual capacity (FRC), residual volume (RV), tissue compliance (Ct), and IL-8 secretion in adolescence. Higher social rank conferred significantly higher expiratory reserve volume (ERV) and functional residual capacity (FRC) solely among those born in the high-WFS year (2008). Differences in effects of rank between years were not significant after adjustment for multiple comparisons. Conclusions Exposure to WFS in infancy generally conferred lower adolescent respiratory volumes and inflammatory cytokines. Higher rank conferred higher respiratory volumes only among females born during WFS, suggesting the possibility that the health benefits of rank may be more apparent under environmental challenge.
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Affiliation(s)
- Heng Bai
- Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - John P Capitanio
- California National Primate Research Center, Davis, CA, USA.,Department of Psychology, University of California Davis, Davis, CA, USA
| | - Lisa A Miller
- California National Primate Research Center, Davis, CA, USA.,Department of Anatomy, Physiology, and Cell Biology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Jane E Clougherty
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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107
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Greenberg MR. Ports and Environmental Justice in the United States: An Exploratory Statistical Analysis. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:2112-2126. [PMID: 33565657 DOI: 10.1111/risa.13697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 01/06/2021] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
A screening environmental justice analysis was conducted of 50 United States ports that manage more than 10 million tons of products. Using the U.S. EPA's EJSCREEN tool, the author examined seven demographic and 11 environmental metrics at distances of 2, 5, and 10 miles from the port centroids. The 2-mile zones were found to have higher values for 13 of the 18 environmental inequity indicators, including all three measures of air toxics, fine particles, proximity to hazardous waste sites, and facilities with risk management plans, as well as indicators of low socioeconomic status and minority populations. With ports expanding, the author discusses the need for maintaining and upgrading EPA's screening tool and considers that alternative futures for port neighborhoods depend upon the strength of their civic groups and elected officials, the role of their government port authorities, and civic values of their commercial users.
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Affiliation(s)
- Michael R Greenberg
- Bloustein School of Planning and Public, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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108
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Longitudinal atopic dermatitis endotypes: An atopic march paradigm that includes Black children. J Allergy Clin Immunol 2021; 149:1702-1710.e4. [PMID: 34673050 PMCID: PMC9275099 DOI: 10.1016/j.jaci.2021.09.036] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The atopic march has been studied mostly in White populations, biasing our current paradigms. OBJECTIVE We sought to define the atopic march in Black and White children and explore mechanisms for racial differences. METHODS Utilizing the Mechanisms of Progression of Atopic Dermatitis to Asthma in Children (MPAACH) cohort (n = 601), we assessed longitudinal sensitization, food allergy (FA), allergic rhinitis, risk of asthma development (through the Pediatric Asthma Risk Score), Scoring for Atopic Dermatitis (SCORAD), transepidermal water loss, skin filaggrin (FLG) expression, exposures, and genetic heritability to define AD progression endotypes in Black and White children. RESULTS White MPAACH children were more likely to be sensitized to aero and food allergens (P = .0001) and over 3 times more likely to develop FA and/or allergic rhinitis (AR) without asthma risk (P < .0001). In contrast, Black children were over 6 times more likely to proceed to high asthma risk without FA, sensitization, or AR (P < .0001). White children had higher lesional and nonlesional transepidermal water loss (both P < .001) as well as decreased nonlesional keratinocyte FLG expression (P = .02). Black children had increased genetic heritability for asthma risk and higher rates of exposures to secondhand smoke and traffic-related air pollution. CONCLUSIONS Black and White children with AD have distinct allergic trajectories defined by different longitudinal endotypes. Black children exhibit higher asthma risk despite a more intact skin barrier and less sensitization, FA, and AR. White children have less asthma risk, despite a more dysfunctional skin barrier, and more FA, AR, and sensitization. The observed racial differences are likely due in part to increased genetic heritability for asthma risk and harmful environmental exposures in Black children. Collectively, our findings provide a new paradigm for an atopic march that is inclusive of Black children.
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109
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Mendoza DL, Benney TM, Bares R, Crosman ET. Intra-city variability of fine particulate matter during COVID-19 lockdown: A case study from Park City, Utah. ENVIRONMENTAL RESEARCH 2021; 201:111471. [PMID: 34102162 PMCID: PMC8178539 DOI: 10.1016/j.envres.2021.111471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 06/12/2023]
Abstract
Urban air quality is a growing concern due a range of social, economic, and health impacts. Since the SARS-CoV-19 pandemic began in 2020, governments have produced a range of non-medical interventions (NMIs) (e.g. lockdowns, stay-at-home orders, mask mandates) to prevent the spread of COVID-19. A co-benefit of NMI implementation has been the measurable improvement in air quality in cities around the world. Using the lockdown policy of the COVID-19 pandemic as a natural experiment, we traced the changing emissions patterns produced under the pandemic in a mid-sized, high-altitude city to isolate the effects of human behavior on air pollution. We tracked air pollution over time periods reflecting the Pre-Lockdown, Lockdown, and Reopening stages, using high quality, research grade sensors in both commercial and residential areas to better understand how each setting may be uniquely impacted by pollution downturn events. Based on this approach, we found the commercial area of the city showed a greater decrease in air pollution than residential areas during the lockdown period, while both areas experienced a similar rebound post lockdown. The easing period following the lockdown did not lead to an immediate rebound in human activity and the air pollution increase associated with reopening, took place nearly two months after the lockdown period ended. We hypothesize that differences in heating needs, travel demands, and commercial activity, are responsible for the corresponding observed changes in the spatial distribution of pollutants over the study period. This research has implications for climate policy, low-carbon energy transitions, and may even impact local policy due to changing patterns in human exposure that could lead to important public health outcomes, if left unaddressed.
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Affiliation(s)
- Daniel L Mendoza
- Department of Atmospheric Sciences, University of Utah, 135 S 1460 E, Room 819, Salt Lake City, UT 84112, USA; Department of City & Metropolitan Planning, University of Utah, 375 S 1530 E, Suite 220, Salt Lake City, UT 84112, USA; University of Utah School of Medicine, Pulmonary Division, 26 N 1900 E, Salt Lake City, UT 84132, USA.
| | - Tabitha M Benney
- Department of Political Science and Environmental Studies Program, University of Utah, 260 S Central Campus Drive, Salt Lake City, UT 84112, USA
| | - Ryan Bares
- Department of Atmospheric Sciences, University of Utah, 135 S 1460 E, Room 819, Salt Lake City, UT 84112, USA
| | - Erik T Crosman
- Department of Life, Earth and Environmental Sciences, West Texas A&M University, Natural Sciences Building 324, Canyon, TX 79016, USA
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Gaffney AW, McCormick D, Woolhandler S, Christiani DC, Himmelstein DU. Prognostic implications of differences in forced vital capacity in black and white US adults: Findings from NHANES III with long-term mortality follow-up. EClinicalMedicine 2021; 39:101073. [PMID: 34458707 PMCID: PMC8379634 DOI: 10.1016/j.eclinm.2021.101073] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Because Forced Vital Capacity (FVC) is reduced in Black relative to White Americans of the same age, sex, and height, standard lung function prediction equations assign a lower "normal" range for Black patients. The prognostic implications of this race correction are uncertain. METHODS We analyzed 5,294 White and 3,743 Black participants age 20-80 in NHANES III, a nationally-representative US survey conducted 1988-94, which we linked to the National Death Index to assess mortality through December 31, 2015. We calculated the FVC-percent predicted among Black and White participants, first applying NHANES III White prediction equations to all persons, and then using standard race-specific prediction equations. We used Cox proportional hazard models to calculate the association between race and all-cause mortality without and with adjustment for FVC (using each FVC metric), smoking, socioeconomic factors, and comorbidities. FINDINGS Black participants' age- and sex-adjusted mortality was greater than White participants (HR 1.46; 95%CI:1.29, 1.65). With adjustment for FVC in liters (mean 3.7 L for Black participants, 4.3 L for White participants) or FVC percent-predicted using White equations for everyone, Black race was no longer independently predictive of higher mortality (HR∼1.0). When FVC-percent predicted was "corrected" for race, Black individuals again showed increased mortality hazard. Deaths attributed to chronic respiratory disease were infrequent for both Black and White individuals. INTERPRETATION Lower FVC in Black people is associated with elevated risk of all-cause mortality, challenging the standard assumption about race-based normal limits. Black-White disparities in FVC may reflect deleterious social/environmental exposures, not innate differences. FUNDING No funding.
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Affiliation(s)
- Adam W Gaffney
- Cambridge Health Alliance, Cambridge, USA
- Harvard Medical School, Boston, USA
- Corresponding author.
| | - Danny McCormick
- Cambridge Health Alliance, Cambridge, USA
- Harvard Medical School, Boston, USA
| | - Steffie Woolhandler
- Cambridge Health Alliance, Cambridge, USA
- Harvard Medical School, Boston, USA
- City University of New York at Hunter College, New York, USA
| | - David C. Christiani
- Harvard Medical School, Boston, USA
- Harvard T.H. Chan School of Public Health, Boston, USA
| | - David U. Himmelstein
- Cambridge Health Alliance, Cambridge, USA
- Harvard Medical School, Boston, USA
- City University of New York at Hunter College, New York, USA
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Abstract
Purpose of Review During the past century, exposure to particulate matter (PM) air pollution < 2.5 μm in diameter (PM2.5) has emerged as an all-pervading element of modern-day society. This increased exposure has come at the cost of heightened risk for cardiovascular (CV) morbidity and mortality. Not only can short-term PM2.5 exposure trigger acute CV events in susceptible individuals, but longer-term exposure over years augments CV risk to a greater extent in comparison with short-term exposure. The purpose of this review is to examine the available evidence for how ambient air pollution exposure may precipitate events at various time frames. Recent Findings Recent epidemiological studies have demonstrated an association between ambient PM2.5 exposure and the presence and progression of atherosclerosis in humans. Multiple animal exposure experiments over two decades have provided strong corroborative evidence that chronic exposure in fact does enhance the progression and perhaps vulnerability characteristics of atherosclerotic lesions. Summary Evidence from epidemiological studies including surrogates of atherosclerosis, human translational studies, and mechanistic investigations utilizing animal studies have improved our understanding of how ambient air pollution may potentiate atherosclerosis and precipitate cardiovascular events. Even so, future research is needed to fully understand the contribution of different constituents in ambient air pollution–mediated atherosclerosis as well as how other systems may modulate the impact of exposure including adaptive immunity and the gut microbiome. Nevertheless, due to the billions of people continually exposed to PM2.5, the long-term pro-atherosclerotic effects of this ubiquitous air pollutant are likely to be of enormous and growing global public health importance. Supplementary Information The online version contains supplementary material available at 10.1007/s11883-021-00958-9.
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112
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Chen JM, Zovko M, Šimurina N, Zovko V. Fear in a Handful of Dust: The Epidemiological, Environmental, and Economic Drivers of Death by PM 2.5 Pollution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8688. [PMID: 34444435 PMCID: PMC8393768 DOI: 10.3390/ijerph18168688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/03/2021] [Accepted: 08/14/2021] [Indexed: 01/13/2023]
Abstract
This study evaluates numerous epidemiological, environmental, and economic factors affecting morbidity and mortality from PM2.5 exposure in the 27 member states of the European Union. This form of air pollution inflicts considerable social and economic damage in addition to loss of life and well-being. This study creates and deploys a comprehensive data pipeline. The first step consists of conventional linear models and supervised machine learning alternatives. Those regression methods do more than predict health outcomes in the EU-27 and relate those predictions to independent variables. Linear regression and its machine learning equivalents also inform unsupervised machine learning methods such as clustering and manifold learning. Lower-dimension manifolds of this dataset's feature space reveal the relationship among EU-27 countries and their success (or failure) in managing PM2.5 morbidity and mortality. Principal component analysis informs further interpretation of variables along economic and health-based lines. A nonlinear environmental Kuznets curve may describe the fuller relationship between economic activity and premature death from PM2.5 exposure. The European Union should bridge the historical, cultural, and economic gaps that impair these countries' collective response to PM2.5 pollution.
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Affiliation(s)
- James Ming Chen
- College of Law, Michigan State University, East Lansing, MI 48824, USA
| | - Mira Zovko
- Ministry of Economy and Sustainable Development, 10000 Zagreb, Croatia;
| | - Nika Šimurina
- Faculty of Economics & Business, University of Zagreb, 10000 Zagreb, Croatia;
| | - Vatroslav Zovko
- Faculty of Teacher Education, University of Zagreb, 10000 Zagreb, Croatia;
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113
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Younan D, Wang X, Gruenewald T, Gatz M, Serre ML, Vizuete W, Braskie MN, Woods NF, Kahe K, Garcia L, Lurmann F, Manson JE, Chui HC, Wallace RB, Espeland MA, Chen JC. Racial/Ethnic Disparities in Alzheimer's Disease Risk: Role of Exposure to Ambient Fine Particles. J Gerontol A Biol Sci Med Sci 2021; 77:977-985. [PMID: 34383042 PMCID: PMC9071399 DOI: 10.1093/gerona/glab231] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Whether racial/ethnic disparities in Alzheimer's disease (AD) risk may be explained by ambient fine particles (PM2.5) has not been studied. METHOD We conducted a prospective, population-based study on a cohort of Black (n = 481) and White (n = 6 004) older women (aged 65-79) without dementia at enrollment (1995-1998). Cox models accounting for competing risk were used to estimate the hazard ratio (HR) for racial/ethnic disparities in AD (1996-2010) defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition and the association with time-varying annual average PM2.5 (1999-2010) estimated by spatiotemporal model. RESULTS Over an average follow-up of 8.3 (±3.5) years with 158 incident cases (21 in Black women), the racial disparities in AD risk (range of adjusted HRBlack women = 1.85-2.41) observed in various models could not be explained by geographic region, age, socioeconomic characteristics, lifestyle factors, cardiovascular risk factors, and hormone therapy assignment. Estimated PM2.5 exposure was higher in Black (14.38 ± 2.21 µg/m3) than in White (12.55 ± 2.76 µg/m3) women, and further adjustment for the association between PM2.5 and AD (adjusted HRPM2.5 = 1.18-1.28) slightly reduced the racial disparities by 2%-6% (HRBlack women = 1.81-2.26). The observed association between PM2.5 and AD risk was ~2 times greater in Black (HRPM2.5 = 2.10-2.60) than in White (HRPM2.5 = 1.07-1.15) women (range of interaction ps: <.01-.01). We found similar results after further adjusting for social engagement (social strain, social support, social activity, living alone), stressful life events, Women's Health Initiative's clinic sites, and neighborhood socioeconomic characteristics. CONCLUSIONS PM2.5 may contribute to racial/ethnic disparities in AD risk and its associated increase in AD risk was stronger among Black women.
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Affiliation(s)
- Diana Younan
- University of Southern California, Los Angeles, USA
| | - Xinhui Wang
- University of Southern California, Los Angeles, USA
| | | | | | | | | | | | - Nancy F Woods
- University of Washington School of Nursing, Seattle, USA
| | - Ka Kahe
- Columbia University Irving Medical Center, New York, New York, USA
| | | | - Fred Lurmann
- Sonoma Technology, Inc., Petaluma, California, USA
| | - JoAnn E Manson
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Mark A Espeland
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jiu-Chiuan Chen
- Address correspondence to: Jiu-Chiuan Chen, MD, ScD, University of Southern California, 2001 N Soto Street, Los Angeles, CA 90032, USA. E-mail:
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114
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Wesselink AK, Rosenberg L, Wise LA, Jerrett M, Coogan PF. A prospective cohort study of ambient air pollution exposure and risk of uterine leiomyomata. Hum Reprod 2021; 36:2321-2330. [PMID: 33984861 DOI: 10.1093/humrep/deab095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/02/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION To what extent are ambient concentrations of particulate matter <2.5 microns (PM2.5), nitrogen dioxide (NO2) and ozone (O3) associated with risk of self-reported physician-diagnosed uterine leiomyomata (UL)? SUMMARY ANSWER In this large prospective cohort study of Black women, ambient concentrations of O3, but not PM2.5 or NO2, were associated with increased risk of UL. WHAT IS KNOWN ALREADY UL are benign tumors of the myometrium that are the leading cause of gynecologic inpatient care among reproductive-aged women. Black women are clinically diagnosed at two to three times the rate of white women and tend to exhibit earlier onset and more severe disease. Two epidemiologic studies have found positive associations between air pollution exposure and UL risk, but neither included large numbers of Black women. STUDY DESIGN, SIZE, DURATION We conducted a prospective cohort study of 21 998 premenopausal Black women residing in 56 US metropolitan areas from 1997 to 2011. PARTICIPANTS/MATERIAL, SETTING, METHODS Women reported incident UL diagnosis and method of confirmation (i.e. ultrasound, surgery) on biennial follow-up questionnaires. We modeled annual residential concentrations of PM2.5, NO2 and O3 throughout the study period. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for a one-interquartile range (IQR) increase in air pollutant concentrations, adjusting for confounders and co-pollutants. MAIN RESULTS AND THE ROLE OF CHANCE During 196 685 person-years of follow-up, 6238 participants (28.4%) reported physician-diagnosed UL confirmed by ultrasound or surgery. Although concentrations of PM2.5 and NO2 were not appreciably associated with UL (HRs for a one-IQR increase: 1.01 (95% CI: 0.93, 1.10) and 1.05 (95% CI: 0.95, 1.16), respectively), O3 concentrations were associated with increased UL risk (HR for a one-IQR increase: 1.19, 95% CI: 1.07, 1.32). The association was stronger among women age <35 years (HR: 1.26, 95% CI: 0.98, 1.62) and parous women (HR: 1.28, 95% CI: 1.11, 1.48). LIMITATIONS, REASONS FOR CAUTION Our measurement of air pollution is subject to misclassification, as monitoring data are not equally spatially distributed and we did not account for time-activity patterns. Our outcome measure was based on self-report of a physician diagnosis, likely resulting in under-ascertainment of UL. Although we controlled for several individual- and neighborhood-level confounding variables, residual confounding remains a possibility. WIDER IMPLICATIONS OF THE FINDINGS Inequitable burden of air pollution exposure has important implications for racial health disparities, and may be related to disparities in UL. Our results emphasize the need for additional research focused on environmental causes of UL. STUDY FUNDING/COMPETING INTEREST(S) This research was funded by the National Cancer Institute (U01-CAA164974) and the National Institute of Environmental Health Sciences (R01-ES019573). L.A.W. is a fibroid consultant for AbbVie, Inc. and accepts in-kind donations from Swiss Precision Diagnostics, Sandstone Diagnostics, FertilityFriend.com and Kindara.com for primary data collection in Pregnancy Study Online (PRESTO). M.J. declares consultancy fees from the Health Effects Institute (as a member of the review committee). The remaining authors declare they have no actual or potential competing financial interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Lynn Rosenberg
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Slone Epidemiology Center, Boston University, Boston, MA, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, University of California, Los Angeles, CA, USA
| | - Patricia F Coogan
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Slone Epidemiology Center, Boston University, Boston, MA, USA
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115
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Abstract
We leverage the unparalleled changes in human activity during COVID-19 and the unmatched capabilities of the TROPOspheric Monitoring Instrument to understand how lockdowns impact ambient nitrogen dioxide (NO2) pollution disparities in the United States. The least White communities experienced the largest NO2 reductions during lockdowns; however, disparities between the least and most White communities are so large that the least White communities still faced higher NO2 levels during lockdowns than the most White communities experienced prior to lockdowns, despite a ∼50% reduction in passenger vehicle traffic. Similar findings hold for ethnic, income, and educational attainment population subgroups. Future strategies to reduce NO2 disparities will need to target emissions from heavy-duty vehicles. The unequal spatial distribution of ambient nitrogen dioxide (NO2), an air pollutant related to traffic, leads to higher exposure for minority and low socioeconomic status communities. We exploit the unprecedented drop in urban activity during the COVID-19 pandemic and use high-resolution, remotely sensed NO2 observations to investigate disparities in NO2 levels across different demographic subgroups in the United States. We show that, prior to the pandemic, satellite-observed NO2 levels in the least White census tracts of the United States were nearly triple the NO2 levels in the most White tracts. During the pandemic, the largest lockdown-related NO2 reductions occurred in urban neighborhoods that have 2.0 times more non-White residents and 2.1 times more Hispanic residents than neighborhoods with the smallest reductions. NO2 reductions were likely driven by the greater density of highways and interstates in these racially and ethnically diverse areas. Although the largest reductions occurred in marginalized areas, the effect of lockdowns on racial, ethnic, and socioeconomic NO2 disparities was mixed and, for many cities, nonsignificant. For example, the least White tracts still experienced ∼1.5 times higher NO2 levels during the lockdowns than the most White tracts experienced prior to the pandemic. Future policies aimed at eliminating pollution disparities will need to look beyond reducing emissions from only passenger traffic and also consider other collocated sources of emissions such as heavy-duty vehicles.
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116
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Kerr GH, Goldberg DL, Anenberg SC. COVID-19 pandemic reveals persistent disparities in nitrogen dioxide pollution. Proc Natl Acad Sci U S A 2021; 118:2022409118. [PMID: 34285070 DOI: 10.1002/essoar.10504561.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
The unequal spatial distribution of ambient nitrogen dioxide ([Formula: see text]), an air pollutant related to traffic, leads to higher exposure for minority and low socioeconomic status communities. We exploit the unprecedented drop in urban activity during the COVID-19 pandemic and use high-resolution, remotely sensed [Formula: see text] observations to investigate disparities in [Formula: see text] levels across different demographic subgroups in the United States. We show that, prior to the pandemic, satellite-observed [Formula: see text] levels in the least White census tracts of the United States were nearly triple the [Formula: see text] levels in the most White tracts. During the pandemic, the largest lockdown-related [Formula: see text] reductions occurred in urban neighborhoods that have 2.0 times more non-White residents and 2.1 times more Hispanic residents than neighborhoods with the smallest reductions. [Formula: see text] reductions were likely driven by the greater density of highways and interstates in these racially and ethnically diverse areas. Although the largest reductions occurred in marginalized areas, the effect of lockdowns on racial, ethnic, and socioeconomic [Formula: see text] disparities was mixed and, for many cities, nonsignificant. For example, the least White tracts still experienced ∼1.5 times higher [Formula: see text] levels during the lockdowns than the most White tracts experienced prior to the pandemic. Future policies aimed at eliminating pollution disparities will need to look beyond reducing emissions from only passenger traffic and also consider other collocated sources of emissions such as heavy-duty vehicles.
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Affiliation(s)
- Gaige Hunter Kerr
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052;
| | - Daniel L Goldberg
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052
- Energy Systems Division, Argonne National Laboratory, Lemont, IL 60439
| | - Susan C Anenberg
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052
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117
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Dhana K, Barnes LL, Liu X, Agarwal P, Desai P, Krueger KR, Holland TM, Halloway S, Aggarwal NT, Evans DA, Rajan KB. Genetic risk, adherence to a healthy lifestyle, and cognitive decline in African Americans and European Americans. Alzheimers Dement 2021; 18:572-580. [PMID: 34310036 DOI: 10.1002/alz.12435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION We investigated the role of genetic risk and adherence to lifestyle factors on cognitive decline in African Americans and European Americans. METHODS Using data from the Chicago Health and Aging Project (1993-2012; n = 3874), we defined the genetic risk based on presence of apolipoprotein E (APOE) ε 4 allele and determined a healthy lifestyle using a scoring of five factors: non-smoking, exercising, being cognitively active, having a high-quality diet, and limiting alcohol use. We used linear mixed-effects models to estimate cognitive decline by genetic risk and lifestyle score. RESULTS APOE ε 4 allele was associated with faster cognitive decline in both races. However, within APOE ε 4 carriers, adherence to a healthy lifestyle (eg., 4 to 5 healthy factors) was associated with a slower cognitive decline by 0.023 (95% confidence interval [CI] 0.004, 0.042) units/year in African Americans and 0.044 (95% CI 0.008, 0.080) units/year in European Americans. DISCUSSION A healthy lifestyle was associated with a slower cognitive decline in African and European Americans.
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Affiliation(s)
- Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kristin R Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Thomas M Holland
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Shannon Halloway
- Department of Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
| | - Neelum T Aggarwal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
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118
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Tsai J, Lindo E, Bridges K. Seeing the Window, Finding the Spider: Applying Critical Race Theory to Medical Education to Make Up Where Biomedical Models and Social Determinants of Health Curricula Fall Short. Front Public Health 2021; 9:653643. [PMID: 34327185 PMCID: PMC8313803 DOI: 10.3389/fpubh.2021.653643] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022] Open
Abstract
A professional and moral medical education should equip trainees with the knowledge and skills necessary to effectively advance health equity. In this Perspective, we argue that critical theoretical frameworks should be taught to physicians so they can interrogate structural sources of racial inequities and achieve this goal. We begin by elucidating the shortcomings in the pedagogic approaches contemporary Biomedical and Social Determinants of Health (SDOH) curricula use in their discussion of health disparities. In particular, current medical pedagogy lacks self-reflexivity; encodes social identities like race and gender as essential risk factors; neglects to examine root causes of health inequity; and fails to teach learners how to challenge injustice. In contrast, we argue that Critical Race Theory (CRT) is a theoretical framework uniquely adept at addressing these concerns. It offers needed interdisciplinary perspectives that teach learners how to abolish biological racism; leverage historical contexts of oppression to inform interventions; center the scholarship of the marginalized; and understand the institutional mechanisms and ubiquity of racism. In sum, CRT does what biomedical and SDOH curricula cannot: rigorously teach physician trainees how to combat health inequity. In this essay, we demonstrate how the theoretical paradigms operationalized in discussions of health injustice affect the ability of learners to confront health inequity. We expound on CRT tenets, discuss their application to medical pedagogy, and provide an in-depth case study to ground our major argument that theory matters. We introduce MedCRT: a CRT-based framework for medical education, and advocate for its implementation into physician training.
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Affiliation(s)
- Jennifer Tsai
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Edwin Lindo
- Office of Healthcare Equity, University of Washington School of Medicine, Seattle, WA, United States
| | - Khiara Bridges
- University of California, Berkeley School of Law, Berkeley, CA, United States
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119
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Mendoza DL, Benney TM, Boll S. Long-term analysis of the relationships between indoor and outdoor fine particulate pollution: A case study using research grade sensors. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 776:145778. [PMID: 33647662 PMCID: PMC9753328 DOI: 10.1016/j.scitotenv.2021.145778] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 05/03/2023]
Abstract
The growing concern of air quality and its associated health-related impacts has led to increased awareness of pollutant exposure. Most human populations spend the majority of their time indoors and the COVID-19 pandemic has likely exacerbated this behavior. While significant amounts of research have focused on outdoor air quality, to date there have been no studies that examined simultaneous long-term trends on indoor and outdoor air quality on a site using research-grade sensors. We measured fine particulate matter (PM2.5) for a year using sensors located on the rooftop, air handling room, and indoor office space in a building and captured the impacts of three types of regularly occurring elevated pollution events: wintertime atmospheric inversions, wildfires, and fireworks. The events had different magnitudes and durations, and infiltration rates varied for each event leading to dissimilar indoor air pollution levels. The building's air handling unit and different environmental conditions (lower indoor humidity and temperature during the winter) combined to reduce indoor pollution from inversion events however, particulate matter from wildfires and fireworks infiltrated at higher rates. Together, this suggests possible intervention strategies, such as ventilation rates and filter upgrades, that could be used to mitigate contaminant intrusion during elevated pollution events. This year-long study illustrates an array of ways that elevated pollution events interact with the protective effects that buildings have against air pollution for its occupants. Furthermore, we show that outdoor air pollution is an important variable to consider when studying indoor air quality as contaminant infiltration is strongly dependent on the specific pollution source.
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Affiliation(s)
- Daniel L Mendoza
- Department of Atmospheric Sciences, University of Utah, 135 S 1460 E, Room 819, Salt Lake City, UT 84112, USA; Department of City & Metropolitan Planning, University of Utah, 375 S 1530 E, Suite 220, Salt Lake City, Utah 84112, USA; University of Utah School of Medicine, Pulmonary Division, 26 N 1900 E, Salt Lake City, UT 84132, USA.
| | - Tabitha M Benney
- Department of Political Science, University of Utah, 260 S Central Campus Drive, Salt Lake City, UT 84112, USA
| | - Sarah Boll
- State of Utah, Division of Facilities Construction and Management, 4315 S 2700 W, Floor 3, Salt Lake City, UT 84129, USA
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Liu M, Saari RK, Zhou G, Li J, Han L, Liu X. Recent trends in premature mortality and health disparities attributable to ambient PM 2.5 exposure in China: 2005-2017. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 279:116882. [PMID: 33756244 DOI: 10.1016/j.envpol.2021.116882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
In the past decade, particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) has reached unprecedented levels in China and posed a significant threat to public health. Exploring the long-term trajectory of the PM2.5 attributable health burden and corresponding disparities across populations in China yields insights for policymakers regarding the effectiveness of efforts to reduce air pollution exposure. Therefore, we examine how the magnitude and equity of the PM2.5-related public health burden has changed nationally, and between provinces, as economic growth and pollution levels varied during 2005-2017. We derive long-term PM2.5 exposures in China from satellite-based observations and chemical transport models, and estimate attributable premature mortality using the Global Exposure Mortality Model (GEMM). We characterize national and interprovincial inequality in health outcomes using environmental Lorenz curves and Gini coefficients over the study period. PM2.5 exposure is linked to 1.8 (95% CI: 1.6, 2.0) million premature deaths over China in 2017, increasing by 31% from 2005. Approximately 70% of PM2.5 attributable deaths were caused by stroke and IHD (ischemic heart disease), though COPD (chronic obstructive pulmonary disease) and LRI (lower respiratory infection) disproportionately affected poorer provinces. While most economic gains and PM2.5-related deaths were concentrated in a few provinces, both gains and deaths became more equitably distributed across provinces over time. As a nation, however, trends toward equality were more recent and less clear cut across causes of death. The rise in premature mortality is due primarily to population growth and baseline risks of stroke and IHD. This rising health burden could be alleviated through policies to prevent pollution, exposure, and disease. More targeted programs may be warranted for poorer provinces with a disproportionate share of PM2.5-related premature deaths due to COPD and LRI.
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Affiliation(s)
- Ming Liu
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada; School of Land Engineering, Chang'an University, Xi'an, Shaanxi, 710064, China.
| | - Rebecca K Saari
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada; Department of Civil and Environmental Engineering, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada.
| | - Gaoxiang Zhou
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada; School of Information Engineering, China University of Geosciences, Beijing, 100083, China
| | - Jonathan Li
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada; Fujian Key Laboratory of Sensing and Computing for Smart Cities, School of Informatics, Xiamen University, Xiamen, FJ, 361005, China
| | - Ling Han
- Shaanxi Key Laboratory of Land Consolidation, School of Land Engineering, Chang'an University, Xi'an, Shaanxi, 710064, China
| | - Xiangnan Liu
- School of Information Engineering, China University of Geosciences, Beijing, 100083, China
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Borowski E, Cedillo VL, Stathopoulos A. Dueling emergencies: Flood evacuation ridesharing during the COVID-19 pandemic. TRANSPORTATION RESEARCH INTERDISCIPLINARY PERSPECTIVES 2021; 10:100352. [PMID: 34514370 PMCID: PMC8422270 DOI: 10.1016/j.trip.2021.100352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 05/07/2023]
Abstract
Volunteered sharing of resources is often observed in response to disaster events. During evacuations the sharing of resources and vehicles is a crucial mechanism for expanding critical capacity and enabling inclusive disaster response. This paper examines the complexity of rideshare decision-making in the wake of simultaneous emergencies. Specifically, the need for physical distancing measures during the coronavirus (COVID-19) pandemic complicates face-to-face resource sharing between strangers. The ability of on-demand ridesharing to provide emergency transportation to individuals without access to alternatives calls for an understanding of how evacuees weigh risks of contagion against benefits of spontaneous resource sharing. In this research, we examine both sociodemographic and situational factors that contribute to a willingness to share flood evacuation rides with strangers during the COVID-19 pandemic. We hypothesize that the willingness to share is significantly correlated with traditional emergency resource sharing motivations and current COVID-19 risk factors. To test these hypotheses, we distributed an online survey during the pandemic surge in July 2020 to 600 individuals in three midwestern and three southern states in the United States with high risk of flooding. We estimate a random parameter multinomial logit model to determine the willingness to share a ride as a driver or passenger. Our findings show that willingness to share evacuation rides is associated with individual sociodemographics (such as being female, under 36 years old, Black, or republican-identifying) and the social environment (such as households with children, social network proximity, and neighborly sharing attitudes). Moreover, our findings suggest higher levels of income, COVID-19 threat perception, evacuation fear, and household preparedness all correspond with a lower willingness to share rides. We discuss the broader implications of emergency on-demand mobility during concurrent disasters to formulate strategies for transportation agencies and on-demand ridehailing providers.
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Affiliation(s)
- Elisa Borowski
- Department of Civil and Environmental Engineering, Northwestern University, Technological Institute, 2145 Sheridan Road, Evanston, IL 60208, USA
| | - Victor Limontitla Cedillo
- Department of Civil and Environmental Engineering, Northwestern University, Technological Institute, 2145 Sheridan Road, Evanston, IL 60208, USA
| | - Amanda Stathopoulos
- Department of Civil and Environmental Engineering, Northwestern University, Technological Institute, 2145 Sheridan Road, Evanston, IL 60208, USA
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Kelly JT, Jang C, Timin B, Di Q, Schwartz J, Liu Y, van Donkelaar A, Martin RV, Berrocal V, Bell ML. Examining PM 2.5 concentrations and exposure using multiple models. ENVIRONMENTAL RESEARCH 2021; 196:110432. [PMID: 33166538 PMCID: PMC8102649 DOI: 10.1016/j.envres.2020.110432] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/22/2020] [Accepted: 11/03/2020] [Indexed: 05/07/2023]
Abstract
Epidemiologic studies have found associations between fine particulate matter (PM2.5) exposure and adverse health effects using exposure models that incorporate monitoring data and other relevant information. Here, we use nine PM2.5 concentration models (i.e., exposure models) that span a wide range of methods to investigate i) PM2.5 concentrations in 2011, ii) potential changes in PM2.5 concentrations between 2011 and 2028 due to on-the-books regulations, and iii) PM2.5 exposure for the U.S. population and four racial/ethnic groups. The exposure models included two geophysical chemical transport models (CTMs), two interpolation methods, a satellite-derived aerosol optical depth-based method, a Bayesian statistical regression model, and three data-rich machine learning methods. We focused on annual predictions that were regridded to 12-km resolution over the conterminous U.S., but also considered 1-km predictions in sensitivity analyses. The exposure models predicted broadly consistent PM2.5 concentrations, with relatively high concentrations on average over the eastern U.S. and greater variability in the western U.S. However, differences in national concentration distributions (median standard deviation: 1.00 μg m-3) and spatial distributions over urban areas were evident. Further exploration of these differences and their implications for specific applications would be valuable. PM2.5 concentrations were estimated to decrease by about 1 μg m-3 on average due to modeled emission changes between 2011 and 2028, with decreases of more than 3 μg m-3 in areas with relatively high 2011 concentrations that were projected to experience relatively large emission reductions. Agreement among models was closer for population-weighted than uniformly weighted averages across the domain. About 50% of the population was estimated to experience PM2.5 concentrations less than 10 μg m-3 in 2011 and PM2.5 improvements of about 2 μg m-3 due to modeled emission changes between 2011 and 2028. Two inequality metrics were used to characterize differences in exposure among the four racial/ethnic groups. The metrics generally yielded consistent information and suggest that the modeled emission reductions between 2011 and 2028 would reduce absolute exposure inequality on average.
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Affiliation(s)
- James T Kelly
- Office of Air Quality Planning and Standards, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA.
| | - Carey Jang
- Office of Air Quality Planning and Standards, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Brian Timin
- Office of Air Quality Planning and Standards, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Aaron van Donkelaar
- Department of Energy, Environmental & Chemical Engineering, Washington University, St. Louis, MO, USA; Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Randall V Martin
- Department of Energy, Environmental & Chemical Engineering, Washington University, St. Louis, MO, USA; Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada; Harvard-Smithsonian Centre for Astrophysics, Cambridge, MA, USA
| | - Veronica Berrocal
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, CA, USA
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
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Williams PC, Krafty R, Alexander T, Davis Z, Gregory AV, Proby R, Troxel W, Coutts C. Greenspace redevelopment, pressure of displacement, and sleep quality among Black adults in Southwest Atlanta. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:412-426. [PMID: 33714980 PMCID: PMC8134046 DOI: 10.1038/s41370-021-00313-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/10/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Little is known on how greenspace redevelopment-creating or improving existing parks and trails-targeted for low-income and/or majority Black neighborhoods could amplify existing social environmental stressors, increase residents' susceptibility to displacement, and impact their sleep quality. OBJECTIVE To examine the relationship between social environmental stressors associated with displacement and sleep quality among Black adults. METHODS Linear regression models were employed on survey data to investigate the association between social environmental stressors, independently and combined, on sleep quality among Black adults residing in block groups targeted for greenspace redevelopment (i.e., exposed) and matched with block groups that were not (i.e., unexposed). RESULTS The independent associations between everyday discrimination, heightened vigilance, housing unaffordability, and subjective sleep quality were not modified by greenspace redevelopment, controlling for other factors. The association between financial strain and subjective sleep quality was different for exposed and unexposed participants with exposed participants having a poorer sleep quality. The combined model revealed that the association between financial strain and sleep quality persisted. However, for different financial strain categories exposed participants slept poorer and/or better than unexposed participants. SIGNIFICANCE Our findings suggest a nuanced relationship between social environmental stressors, pressure of displacement related to greenspace redevelopment, and sleep quality among Black adults.
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Affiliation(s)
- Patrice C Williams
- Department of Urban & Regional Planning, Florida State University, Tallahassee, FL, USA.
| | - Robert Krafty
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Terrence Alexander
- Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA, USA
| | - Zipporah Davis
- Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA, USA
| | - Akil-Vuai Gregory
- Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA, USA
| | - Raven Proby
- Master of Public Health Program, Morehouse School of Medicine, Atlanta, GA, USA
| | | | - Christopher Coutts
- Department of Urban & Regional Planning, Florida State University, Tallahassee, FL, USA
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de Schrijver E, Folly CL, Schneider R, Royé D, Franco OH, Gasparrini A, Vicedo‐Cabrera AM. A Comparative Analysis of the Temperature-Mortality Risks Using Different Weather Datasets Across Heterogeneous Regions. GEOHEALTH 2021; 5:e2020GH000363. [PMID: 34084982 PMCID: PMC8143899 DOI: 10.1029/2020gh000363] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 06/01/2023]
Abstract
New gridded climate datasets (GCDs) on spatially resolved modeled weather data have recently been released to explore the impacts of climate change. GCDs have been suggested as potential alternatives to weather station data in epidemiological assessments on health impacts of temperature and climate change. These can be particularly useful for assessment in regions that have remained understudied due to limited or low quality weather station data. However to date, no study has critically evaluated the application of GCDs of variable spatial resolution in temperature-mortality assessments across regions of different orography, climate, and size. Here we explored the performance of population-weighted daily mean temperature data from the global ERA5 reanalysis dataset in the 10 regions in the United Kingdom and the 26 cantons in Switzerland, combined with two local high-resolution GCDs (HadUK-grid UKPOC-9 and MeteoSwiss-grid-product, respectively) and compared these to weather station data and unweighted homologous series. We applied quasi-Poisson time series regression with distributed lag nonlinear models to obtain the GCD- and region-specific temperature-mortality associations and calculated the corresponding cold- and heat-related excess mortality. Although the five exposure datasets yielded different average area-level temperature estimates, these deviations did not result in substantial variations in the temperature-mortality association or impacts. Moreover, local population-weighted GCDs showed better overall performance, suggesting that they could be excellent alternatives to help advance knowledge on climate change impacts in remote regions with large climate and population distribution variability, which has remained largely unexplored in present literature due to the lack of reliable exposure data.
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Affiliation(s)
- Evan de Schrijver
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Oeschger Center for Climate Change Research (OCCR)University of BernBernSwitzerland
- Graduate school of Health Sciences (GHS)University of BernBernSwitzerland
| | - Christophe L. Folly
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Graduate school of Health Sciences (GHS)University of BernBernSwitzerland
| | - Rochelle Schneider
- Ф‐LabEuropean Space Agency (ESA/ESRIN)FrascatiItaly
- Forecast DepartmentEuropean Centre for Medium‐Range Weather Forecast (ECMWF)ReadingUK
- Centre on Climate Change and Planetary HealthLondon School of Hygiene & Tropical Medicine, London (LSHTM)LondonUK
- Department of Public HealthEnvironments and Society, London School of Hygiene & Tropical MedicineLondonUK
| | - Dominic Royé
- Department of GeographyUniversity of Santiago de CompostelaSantiago de CompostelaSpain
- CIBER of Epidemiology and Public Health (CIBERESP)Spain
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Antonio Gasparrini
- Centre on Climate Change and Planetary HealthLondon School of Hygiene & Tropical Medicine, London (LSHTM)LondonUK
- Department of Public HealthEnvironments and Society, London School of Hygiene & Tropical MedicineLondonUK
- Centre for Statistical MethodologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Ana M. Vicedo‐Cabrera
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Oeschger Center for Climate Change Research (OCCR)University of BernBernSwitzerland
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deSouza P, Kinney PL. On the distribution of low-cost PM 2.5 sensors in the US: demographic and air quality associations. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:514-524. [PMID: 33958706 DOI: 10.1038/s41370-021-00328-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND Low-cost sensors have the potential to democratize air pollution information and supplement regulatory networks. However, differentials in access to these sensors could exacerbate existing inequalities in the ability of different communities to respond to the threat of air pollution. OBJECTIVE Our goal was to analyze patterns of deployments of a commonly used low-cost sensor, as a function of demographics and pollutant concentrations. METHODS We used Wilcoxon rank sum tests to assess differences between socioeconomic characteristics and PM2.5 concentrations of locations with low-cost sensors and those with regulatory monitors. We used Kolomogorov-Smirnov tests to examine how representative census tracts with sensors were of the United States. We analyzed predictors of the presence, and number of, sensors in a tract using regressions. RESULTS Census tracts with low-cost sensors were higher income more White and more educated than the US as a whole and than tracts with regulatory monitors. For all states except for California they are in locations with lower annual-average PM2.5 concentrations than regulatory monitors. The existing presence of a regulatory monitor, the percentage of people living above the poverty line and PM2.5 concentrations were associated with the presence of low-cost sensors in a tract. SIGNIFICANCE Strategies to improve access to low-cost sensors in less-privileged communities are needed to democratize air pollution data.
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Affiliation(s)
- Priyanka deSouza
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA, USA.
- World Health Organization, Geneva, Switzerland.
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
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Amaro H, Sanchez M, Bautista T, Cox R. Social vulnerabilities for substance use: Stressors, socially toxic environments, and discrimination and racism. Neuropharmacology 2021; 188:108518. [PMID: 33716076 PMCID: PMC8126433 DOI: 10.1016/j.neuropharm.2021.108518] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/17/2021] [Accepted: 03/05/2021] [Indexed: 12/13/2022]
Abstract
Applying a social determinants of health framework, this review brings attention to evidence from social sciences and neuroscience on the role of selected social factors in individual and population-level vulnerability to substance use and substance use disorders (SUDs). The understanding that social vulnerability to substance use and SUDs is multifaceted and occurs across different levels of influence (individual, interpersonal, community, and societal) is underscored. We propose that socially based stressors play a critical role in creating vulnerability to substance use and SUDs, and as such, deserve greater empirical attention to further understand how they "get under the skin." Current knowledge from social sciences and neuroscience on the relationships among vulnerability to substance use resulting from stressors, exposure to socially toxic childhood environments, and racism and discrimination are summarized and discussed, as are implications for future research, practice, and policy. Specifically, we propose using a top-down approach to the examination of known, yet often unexplored, relationships between vulnerability to substance use and SUDs, related inequities, and potential differential effects across demographic groups. Finally, research gaps and promising areas of research, practice, and policy focused on ameliorating social vulnerabilities associated with substance use and SUDs across the lifespan are presented. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.
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Affiliation(s)
- Hortensia Amaro
- Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, Florida International University, United States.
| | - Mariana Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, United States.
| | - Tara Bautista
- Yale Stress Center, School of Medicine, Yale University, United States.
| | - Robynn Cox
- Suzanne Dworak-Peck School of Social Work, Schaeffer Center for Health Policy and Economics, And Edward R. Roybal Institute on Aging, University of Southern California, United States.
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Reuben A, Arseneault L, Beddows A, Beevers SD, Moffitt TE, Ambler A, Latham RM, Newbury JB, Odgers CL, Schaefer JD, Fisher HL. Association of Air Pollution Exposure in Childhood and Adolescence With Psychopathology at the Transition to Adulthood. JAMA Netw Open 2021; 4:e217508. [PMID: 33909054 PMCID: PMC8082321 DOI: 10.1001/jamanetworkopen.2021.7508] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
IMPORTANCE Air pollution exposure damages the brain, but its associations with the development of psychopathology are not fully characterized. OBJECTIVE To assess whether air pollution exposure in childhood and adolescence is associated with greater psychopathology at 18 years of age. DESIGN, SETTING, AND PARTICIPANTS The Environmental-Risk Longitudinal Twin Study is a population-based cohort study of 2232 children born from January 1, 1994, to December 4, 1995, across England and Wales and followed up to 18 years of age. Pollution data generation was completed on April 22, 2020; data were analyzed from April 27 to July 31, 2020. EXPOSURES High-resolution annualized estimates of outdoor nitrogen oxides (NOx) and particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) linked to home addresses at the ages of 10 and 18 years and then averaged. MAIN OUTCOMES AND MEASURES Mental health disorder symptoms assessed through structured interview at 18 years of age and transformed through confirmatory factor analysis into continuous measures of general psychopathology (primary outcome) and internalizing, externalizing, and thought disorder symptoms (secondary outcomes) standardized to a mean (SD) of 100 (15). Hypotheses were formulated after data collection, and analyses were preregistered. RESULTS A total of 2039 participants (1070 [52.5%] female) had full data available. After adjustment for family and individual factors, each interquartile range increment increase in NOx exposure was associated with a 1.40-point increase (95% CI, 0.41-2.38; P = .005) in general psychopathology. There was no association between continuously measured PM2.5 and general psychopathology (b = 0.45; 95% CI, -0.26 to 1.11; P = .22); however, those in the highest quartile of PM2.5 exposure scored 2.04 points higher (95% CI, 0.36-3.72; P = .02) than those in the bottom 3 quartiles. Copollutant models, including both NOx and PM2.5, implicated NOx alone in these significant findings. NOx exposure was associated with all secondary outcomes, although associations were weakest for internalizing (adjusted b = 1.07; 95% CI, 0.10-2.04; P = .03), medium for externalizing (adjusted b = 1.42; 95% CI, 0.53-2.31; P = .002), and strongest for thought disorder symptoms (adjusted b = 1.54; 95% CI, 0.50-2.57; P = .004). Despite NOx concentrations being highest in neighborhoods with worse physical, social, and economic conditions, adjusting estimates for neighborhood characteristics did not change the results. CONCLUSIONS AND RELEVANCE Youths exposed to higher levels of outdoor NOx experienced greater psychopathology at the transition to adulthood. Air pollution may be a nonspecific risk factor for the development of psychopathology.
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Affiliation(s)
- Aaron Reuben
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Louise Arseneault
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
- Economic and Social Research Council Centre for Society and Mental Health, King’s College London, London, United Kingdom
| | - Andrew Beddows
- Environmental Research Group, School of Public Health, Imperial College London, London, United Kingdom
| | - Sean D. Beevers
- Environmental Research Group, School of Public Health, Imperial College London, London, United Kingdom
- Medical Research Council Centre for Environment and Health, Imperial College London, United Kingdom
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
- PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
| | - Antony Ambler
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
| | - Rachel M. Latham
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
- Economic and Social Research Council Centre for Society and Mental Health, King’s College London, London, United Kingdom
| | - Joanne B. Newbury
- Bristol Medical School: Population and Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Candice L. Odgers
- Department of Psychological Science, University of California, Irvine
- Social Science Research Institute, Duke University, Durham, North Carolina
| | | | - Helen L. Fisher
- King’s College London, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
- Economic and Social Research Council Centre for Society and Mental Health, King’s College London, London, United Kingdom
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Jirau-Colón H, Toro-Heredia J, Layuno J, Calderon ED, Gioda A, Jiménez-Vélez BD. Distribution of toxic metals and relative toxicity of airborne PM 2.5 in Puerto Rico. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:16504-16516. [PMID: 33389579 PMCID: PMC7778501 DOI: 10.1007/s11356-020-11673-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 11/12/2020] [Indexed: 06/12/2023]
Abstract
The exposure to airborne particulate matter (PM) and its constituents is an important factor to be considered when evaluating their potential health risk. Transition metals found in PM are known to contribute significantly to the exacerbation of respiratory ailments. Exposure to these constituents results in the induction of oxidative stress in the bronchial epithelium, thus promoting the secretion of inflammatory mediators. Therefore, it is important to know the contributions of PM2.5 constituents to further investigate their relationship with toxic responses and associated health risks. PM2.5 samples from three rural (Humacao, Guayama, and Guayanilla) and two urban (more populated) sites (Bayamón and Ponce) from Puerto Rico were analyzed for various inorganic constituents. A total of 59 trace elements were analyzed, of which eight were considered with the greatest toxic potential. The highest annual average concentration of PM2.5 was reported at the urban site of Ponce (5.82 ± 1.40 μg m-3), while Bayamón's average concentration was not as high (4.69 ± 1.30 μg m-3) compared to concentrations at the rural sites Humacao, Guayama, and Guayanilla (4.33 ± 1.20 μg m-3, 4.93 ± 1.50 μg m-3, and 4.88 ± 1.20 μg m-3 respectively. The concentration at the Ponce site exhibited the highest summer value (7.57 μg m-3) compared to that of all the rural sites (~ 6.40 μg m-3). The lowest summer PM2.5 values were obtained at the Humacao site with an average of 5.76 μg m-3. Average Cu and Zn concentrations were 3- and 2-fold higher at the urban sites (0.68 ng m-3 and 6.74 ng m-3 respectively) compared to the rural sites (0.17 ng m-3 and 4.11 ng m-3). Relative toxicity of inorganic PM extract indicates Bayamón (urban) and Guayama with similar low LC50 followed by Humacao, Guayanilla, and finally Ponce (urban) with the highest LC50. Of the eight potential toxic metals considered, only Fe was found to be higher at the rural sites. To our understanding, there are different sources of emission for these metals which potentially indicate main anthropogenic sources, together with the trade winds adding periodically volcanic and African Dust Storm particulates that affect Puerto Rico. These results are the first of their kind to be reported in Puerto Rico.
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Affiliation(s)
- Héctor Jirau-Colón
- School of Medicine, Department of Biochemistry, University of Puerto Rico Medical Sciences Campus, Main Bldg. 2nd Floor B210, San Juan, 00936, Puerto Rico
- Center for Environment and Toxicological Research, San Juan, Puerto Rico
| | - Jannette Toro-Heredia
- Center for Environment and Toxicological Research, San Juan, Puerto Rico
- Universidad Ana G. Méndez de Gurabo, Gurabo, Puerto Rico
| | - Josué Layuno
- Center for Environment and Toxicological Research, San Juan, Puerto Rico
| | | | - Adriana Gioda
- Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Braulio D Jiménez-Vélez
- School of Medicine, Department of Biochemistry, University of Puerto Rico Medical Sciences Campus, Main Bldg. 2nd Floor B210, San Juan, 00936, Puerto Rico.
- Center for Environment and Toxicological Research, San Juan, Puerto Rico.
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Kim J, Kwan MP. Assessment of sociodemographic disparities in environmental exposure might be erroneous due to neighborhood effect averaging: Implications for environmental inequality research. ENVIRONMENTAL RESEARCH 2021; 195:110519. [PMID: 33253702 DOI: 10.1016/j.envres.2020.110519] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/17/2020] [Accepted: 11/19/2020] [Indexed: 05/14/2023]
Abstract
The neighborhood effect averaging problem (NEAP) is a major methodological problem that might affect the accuracy of assessments of individual exposure to mobility-dependent environmental factors (e.g., air/noise pollution, green/blue spaces, or healthy food environments). Focusing on outdoor ground-level ozone as a major air pollutant, this paper examines the NEAP in the evaluation of sociodemographic disparities in people's air pollution exposures in Los Angeles using one-day activity-travel diary data of 3790 individuals. It addresses two questions: (1) How does the NEAP affect the evaluation of sociodemographic disparities in people's air pollution exposures? (2) Which social groups with high residence-based exposures do not experience neighborhood effect averaging? The results of our spatial regression models indicate that assessments of sociodemographic disparities in people's outdoor ground-level ozone exposures might be erroneous when people's daily mobility is ignored because of the different manifestations of neighborhood effect averaging for different social/racial groups. The results of our spatial autologistic regression model reveal that non-workers (e.g., the unemployed, homemakers, the retired, and students) do not experience downward averaging: they have significantly lower odds of experiencing downward averaging that could have attenuated their high exposures experienced in their residential neighborhoods while traveling to other neighborhoods (thus, being doubly disadvantaged). Therefore, to avoid erroneous conclusions in environmental inequality research and ineffective public policies, it would be critical to take the NEAP into account in future studies of sociodemographic disparities related to mobility-dependent environmental factors.
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Affiliation(s)
- Junghwan Kim
- Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Mei-Po Kwan
- Department of Geography and Resource Management and Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands.
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Tessum CW, Paolella DA, Chambliss SE, Apte JS, Hill JD, Marshall JD. PM 2.5 polluters disproportionately and systemically affect people of color in the United States. SCIENCE ADVANCES 2021; 7:7/18/eabf4491. [PMID: 33910895 DOI: 10.1126/sciadv.abf4491] [Citation(s) in RCA: 189] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/10/2021] [Indexed: 05/17/2023]
Abstract
Racial-ethnic minorities in the United States are exposed to disproportionately high levels of ambient fine particulate air pollution (PM2.5), the largest environmental cause of human mortality. However, it is unknown which emission sources drive this disparity and whether differences exist by emission sector, geography, or demographics. Quantifying the PM2.5 exposure caused by each emitter type, we show that nearly all major emission categories-consistently across states, urban and rural areas, income levels, and exposure levels-contribute to the systemic PM2.5 exposure disparity experienced by people of color. We identify the most inequitable emission source types by state and city, thereby highlighting potential opportunities for addressing this persistent environmental inequity.
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Affiliation(s)
- Christopher W Tessum
- Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - David A Paolella
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA 98195, USA
| | - Sarah E Chambliss
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, TX 78712, USA
| | - Joshua S Apte
- Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, CA 94720, USA
- School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Jason D Hill
- Department of Bioproducts and Biosystems Engineering, University of Minnesota, St. Paul, MN 55108, USA
| | - Julian D Marshall
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA 98195, USA
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Payne-Sturges DC, Cory-Slechta DA, Puett RC, Thomas SB, Hammond R, Hovmand PS. Defining and Intervening on Cumulative Environmental Neurodevelopmental Risks: Introducing a Complex Systems Approach. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:35001. [PMID: 33688743 PMCID: PMC7945198 DOI: 10.1289/ehp7333] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND The combined effects of multiple environmental toxicants and social stressor exposures are widely recognized as important public health problems contributing to health inequities. However cumulative environmental health risks and impacts have received little attention from U.S. policy makers at state and federal levels to develop comprehensive strategies to reduce these exposures, mitigate cumulative risks, and prevent harm. An area for which the inherent limitations of current approaches to cumulative environmental health risks are well illustrated is children's neurodevelopment, which exhibits dynamic complexity of multiple interdependent and causally linked factors and intergenerational effects. OBJECTIVES We delineate how a complex systems approach, specifically system dynamics, can address shortcomings in environmental health risk assessment regarding exposures to multiple chemical and nonchemical stressors and reshape associated public policies. DISCUSSION Systems modeling assists in the goal of solving problems by improving the "mental models" we use to make decisions, including regulatory and policy decisions. In the context of disparities in children's cumulative exposure to neurodevelopmental stressors, we describe potential policy insights about the structure and behavior of the system and the types of system dynamics modeling that would be appropriate, from visual depiction (i.e., informal maps) to formal quantitative simulation models. A systems dynamics framework provides not only a language but also a set of methodological tools that can more easily operationalize existing multidisciplinary scientific evidence and conceptual frameworks on cumulative risks. Thus, we can arrive at more accurate diagnostic tools for children's' environmental health inequities that take into consideration the broader social and economic environment in which children live, grow, play, and learn. https://doi.org/10.1289/EHP7333.
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Affiliation(s)
- Devon C. Payne-Sturges
- Maryland Institute for Applied Environmental Health, University of Maryland School of UMD Public Health, College Park, Maryland, USA
| | | | - Robin C. Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of UMD Public Health, College Park, Maryland, USA
| | - Stephen B. Thomas
- Department of Health Policy and Management and Maryland Center for Health Equity, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Ross Hammond
- Brown School of Social Work, Washington University, St. Louis, Missouri, USA
- Center on Social Dynamics and Policy, The Brookings Institution, Washington, DC, USA
| | - Peter S. Hovmand
- Center for Community Health Integration, Case Western Reserve University, Cleveland, Ohio, USA
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Chakraborty J. Convergence of COVID-19 and chronic air pollution risks: Racial/ethnic and socioeconomic inequities in the U.S. ENVIRONMENTAL RESEARCH 2021; 193:110586. [PMID: 33309819 PMCID: PMC7728411 DOI: 10.1016/j.envres.2020.110586] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/17/2020] [Accepted: 12/02/2020] [Indexed: 05/07/2023]
Abstract
Recent research suggests greater COVID-19 prevalence in areas burdened with higher exposure to chronic air pollution, but previous studies have not examined if socially disadvantaged populations are more likely to reside in communities located at the convergence of both COVID-19 and air pollution health risks. This article presents a national scale U.S. study that investigates whether racial/ethnic minorities, socioeconomically deprived residents, and other vulnerable groups are significantly overrepresented in counties where significantly higher COVID-19 incidence spatially coincides with higher respiratory health risks from outdoor exposure to hazardous air pollutants (HAPs). COVID-19 data from the Johns Hopkins Center for Systems Science and Engineering database are linked to respiratory risk estimates from the U.S. Environmental Protection Agency's National Air Toxics Assessment and variables from the 2018 American Community Survey. Bivariate local measures of spatial association are implemented to identify county clusters representing relationships between COVID-19 incidence rate and respiratory risk from HAP exposure. Socio-demographic characteristics of these clusters are compared using bivariate statistical tests and multivariable generalized estimating equations. Counties where greater COVID-19 incidence coincides significantly with higher HAP respiratory risk contain disproportionately higher percentages of non-Hispanic Black, socioeconomically deprived, and uninsured residents than all other U.S. counties, after controlling for spatial clustering, population density, older age, and other contextual factors. These significant socio-demographic inequities represent an important starting point for more detailed investigations of places facing the double burden of elevated COVID-19 prevalence and air pollution exposure, and also emphasize the urgent need to develop mitigation strategies for addressing both COVID-19 and chronic air pollution in socially vulnerable communities.
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Affiliation(s)
- Jayajit Chakraborty
- Department of Sociology and Anthropology, University of Texas at El Paso; 500 West University Avenue, El Paso, TX 79968, USA.
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Tsai J. COVID-19 is Not a Story of Race, but a Record of Racism-Our Scholarship Should Reflect That Reality. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:43-47. [PMID: 33534670 DOI: 10.1080/15265161.2020.1861377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Farzan SF, Howe CG, Chavez TA, Hodes TL, Johnston JE, Habre R, Dunton G, Bastain TM, Breton CV. Demographic predictors of urinary arsenic in a low-income predominantly Hispanic pregnancy cohort in Los Angeles. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:94-107. [PMID: 32719440 PMCID: PMC7796897 DOI: 10.1038/s41370-020-0251-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 07/08/2020] [Accepted: 07/15/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND Arsenic (As) is a contaminant of top public health concern, due to its range of detrimental health effects. Arsenic exposure has not been well-characterized among the US Hispanic populations and has been particularly understudied in this population during pregnancy. METHODS As part of the MADRES ongoing pregnancy cohort of predominantly lower-income, Hispanic women in Los Angeles, CA, we examined levels of maternal first trimester urinary As, including total As and As metabolites (inorganic (iAs), monomethylated (MMA) and dimethylated As (DMA)), in relation to participant demographics, lifestyle characteristics, and rice/seafood consumption, to identify factors that may influence As exposure and its metabolites during pregnancy (N = 241). RESULTS Total As concentrations ranged from low to high (0.8-506.2 μg/L, mean: 9.0 μg/L, SD: 32.9) in our study population. Foreign-born Hispanic women had 8.6% higher %DMA (95% CI: 3.3%, 13.9%) and -7.7% lower %iAs (95% CI: -12.6%, -2.9%) than non-Hispanic women. A similar trend was observed for US-born Hispanic women. In addition, maternal age was associated with 0.4% higher %iAs (95% CI: 0.1%, 0.6%) and 0.4% lower %DMA (95% CI: -0.7%, -0.1%) per year, which may indicate poor As methylation capacity. CONCLUSION Individual factors may predict As exposure and metabolism in pregnancy, and in turn, greater risk of adverse health effects.
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Affiliation(s)
- Shohreh F Farzan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA.
| | - Caitlin G Howe
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Thomas A Chavez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Tahlia L Hodes
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Jill E Johnston
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Rima Habre
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Genevieve Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Theresa M Bastain
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | - Carrie V Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
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Silva GS, Rosenbach M. Climate change and dermatology: An introduction to a special topic, for this special issue. Int J Womens Dermatol 2021; 7:3-7. [PMID: 32838016 PMCID: PMC7435281 DOI: 10.1016/j.ijwd.2020.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/02/2020] [Accepted: 08/06/2020] [Indexed: 01/22/2023] Open
Abstract
Anthropogenic global climate change is a well-documented phenomenon that has led to average global temperatures climbing to approximately 1 °C above preindustrial (1850-1900) levels, with even higher regional deviations in some areas and significantly increased average warming in densely populated urban centers. In 2018, the United Nations Intergovernmental Panel on Climate Change set a threshold of 1.5 °C of average warming (above the preindustrial baseline), beyond which our planet will become significantly less hospitable to human life. However, adverse human health impacts are already occurring due to current levels of global climate change, as summarized by publications such as The Lancet's annual "Countdown on Health and Climate Change," initiated in 2016. The human health impacts of climate change are truly cross-disciplinary, with nearly every medical specialty either already facing or set to face effects. The field of dermatology is not immune to these risks. This special issue of the International Journal of Women's Dermatology is dedicated to the cross section of dermatology and climate change. This initial article will serve as an overview to introduce readers to the topic and to lay the groundwork for the rest of the issue. We are delighted to work with the Women's Dermatological Society and welcome their support for this dedicated issue. Herein, you will read from up-and-coming stars in the field and established experts, including articles on the following key areas: infectious diseases, environmentally friendly office practices, sunscreens and the environment, refugee health, heat-related illness, the effect of air pollution on the skin, the impact of climate change on pediatric dermatology, implications for skin cancer, and skin issues related to flooding and extreme weather events.
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Affiliation(s)
- Genevieve S. Silva
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Misha Rosenbach
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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deSouza P, Braun D, Parks RM, Schwartz J, Dominici F, Kioumourtzoglou MA. Nationwide Study of Short-term Exposure to Fine Particulate Matter and Cardiovascular Hospitalizations Among Medicaid Enrollees. Epidemiology 2021; 32:6-13. [PMID: 33009251 PMCID: PMC7896354 DOI: 10.1097/ede.0000000000001265] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Fine particulate matter (PM2.5) has been consistently linked to cardiovascular disease (CVD). Although studies have reported modification by income, to our knowledge, no study to date has examined this relationship among adults in Medicaid, which provides health coverage to low-income and/or disabled Americans. METHODS We estimated the association between short-term PM2.5 exposure (average of PM2.5 on the day of hospitalization and the preceding day) and CVD admissions rates among adult Medicaid enrollees in the continental United States (2000-2012) using a time-stratified case-crossover design. We repeated this analysis at PM2.5 concentrations below the World Health Organization daily guideline of 25 μg/m. We compared the PM2.5-CVD association in the Medicaid ≥65 years old versus non-Medicaid-eligible Medicare enrollees (≥65 years old). RESULTS Using information on 3,666,657 CVD hospitalizations among Medicaid adults, we observed a 0.9% (95% CI = 0.6%, 1.1%) increase in CVD admission rates per 10 μg/m PM2.5 increase. The association was stronger at low PM2.5 levels (1.3%; 95% CI = 0.9%, 1.6%). Among Medicaid enrollees ≥65 years old, the association was 0.9% (95% CI = 0.6%, 1.3%) vs. 0.8% (95% CI = 0.6%, 0.9%) among non-Medicaid-eligible Medicare enrollees ≥65 years old. CONCLUSION We found robust evidence of an association between short-term PM2.5 and CVD hospitalizations among the vulnerable subpopulation of adult Medicaid enrollees. Importantly, this association persisted even at PM2.5 levels below the current national standards.
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Affiliation(s)
- Priyanka deSouza
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA
| | - Danielle Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA
| | - Robbie M Parks
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
- The Earth Institute, Columbia University, New York, NY
| | - Joel Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
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Abstract
In this chapter we provide a broad overview of three dominant ways environmental justice is framed within the scholarship and consider how Indigenous peoples’ understanding and demands for environmental justice necessitate a decolonising approach. Despite critiques, many scholars and policymakers still conceive of environment justice through a singular approach (as distributive equity, procedural inclusion, or recognition of cultural difference). Such a narrow reading fails to appreciate the intersecting and interacting processes that underpin environmental (in)justices faced by Indigenous peoples. We argue that the theoretical discussions and empirical research into environmental (in)justice need to extend beyond Western liberal philosophies and instead consider pluralistic approach to Indigenous environment justice which is founded on Indigenous ontologies and epistemologies, which include intergenerational and more-human-human justice requirements.
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Pei S, Dahl KA, Yamana TK, Licker R, Shaman J. Compound Risks of Hurricane Evacuation Amid the COVID-19 Pandemic in the United States. GEOHEALTH 2020. [PMID: 33299960 DOI: 10.1101/2020.08.07.20170555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The 2020 Atlantic hurricane season was extremely active and included, as of early November, six hurricanes that made landfall in the United States during the global coronavirus disease 2019 (COVID-19) pandemic. Such an event would necessitate a large-scale evacuation, with implications for the trajectory of the pandemic. Here we model how a hypothetical hurricane evacuation from four counties in southeast Florida would affect COVID-19 case levels. We find that hurricane evacuation increases the total number of COVID-19 cases in both origin and destination locations; however, if transmission rates in destination counties can be kept from rising during evacuation, excess evacuation-induced case numbers can be minimized by directing evacuees to counties experiencing lower COVID-19 transmission rates. Ultimately, the number of excess COVID-19 cases produced by the evacuation depends on the ability of destination counties to meet evacuee needs while minimizing virus exposure through public health directives. These results are relevant to disease transmission during evacuations stemming from additional climate-related hazards such as wildfires and floods.
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Affiliation(s)
- Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health Columbia University New York NY USA
| | - Kristina A Dahl
- Climate and Energy Program, Union of Concerned Scientists Oakland CA USA
| | - Teresa K Yamana
- Department of Environmental Health Sciences, Mailman School of Public Health Columbia University New York NY USA
| | - Rachel Licker
- Climate and Energy Program, Union of Concerned Scientists Washington DC USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health Columbia University New York NY USA
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Pei S, Dahl KA, Yamana TK, Licker R, Shaman J. Compound Risks of Hurricane Evacuation Amid the COVID-19 Pandemic in the United States. GEOHEALTH 2020; 4:e2020GH000319. [PMID: 33299960 PMCID: PMC7704390 DOI: 10.1029/2020gh000319] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/02/2020] [Accepted: 11/06/2020] [Indexed: 05/18/2023]
Abstract
The 2020 Atlantic hurricane season was extremely active and included, as of early November, six hurricanes that made landfall in the United States during the global coronavirus disease 2019 (COVID-19) pandemic. Such an event would necessitate a large-scale evacuation, with implications for the trajectory of the pandemic. Here we model how a hypothetical hurricane evacuation from four counties in southeast Florida would affect COVID-19 case levels. We find that hurricane evacuation increases the total number of COVID-19 cases in both origin and destination locations; however, if transmission rates in destination counties can be kept from rising during evacuation, excess evacuation-induced case numbers can be minimized by directing evacuees to counties experiencing lower COVID-19 transmission rates. Ultimately, the number of excess COVID-19 cases produced by the evacuation depends on the ability of destination counties to meet evacuee needs while minimizing virus exposure through public health directives. These results are relevant to disease transmission during evacuations stemming from additional climate-related hazards such as wildfires and floods.
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Affiliation(s)
- Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Kristina A. Dahl
- Climate and Energy Program, Union of Concerned ScientistsOaklandCAUSA
| | - Teresa K. Yamana
- Department of Environmental Health Sciences, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Rachel Licker
- Climate and Energy Program, Union of Concerned ScientistsWashingtonDCUSA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
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140
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Christian WJ, Walker CJ, Huang B, Levy JE, Durbin E, Arnold S. Using residential histories in case-control analysis of lung cancer and mountaintop removal coal mining in Central Appalachia. Spat Spatiotemporal Epidemiol 2020; 35:100364. [PMID: 33138948 DOI: 10.1016/j.sste.2020.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 06/19/2020] [Accepted: 07/20/2020] [Indexed: 01/09/2023]
Abstract
Population-based ecological and cross-sectional studies have observed high risk for several cancers in areas of Central Appalachia where mountaintop removal coal mines operate. Case-control studies could provide stronger evidence of such relationships, but misclassification of exposure is likely when based on current residence, since individuals could have inhabited several residences with varying environmental exposures over many years. To address this, we used residential histories for individuals enrolled in a previous case-control study of lung cancer to assess residential proximity to mountaintop removal coal mining over a 30-year period, using both survey data and proprietary data from LexisNexis, Inc. Supplementing the survey data with LexisNexis data improved precision and completeness of geographic coordinates. Final logistic regression models revealed higher odds of high exposure among cases. These findings suggest that living in close proximity to mountaintop removal coal mining sites could increase risk for lung cancer, after adjusting for other relevant factors.
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Affiliation(s)
- W J Christian
- Dept. of Epidemiology College of Public Health, University of Kentucky, Lexington, Kentucky, USA.
| | - C J Walker
- Dept. of Epidemiology College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - B Huang
- Kentucky Cancer Registry, Lexington, Kentucky, USA
| | - J E Levy
- Dept. of Geography College of Arts & Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - E Durbin
- Kentucky Cancer Registry, Lexington, Kentucky, USA
| | - S Arnold
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
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Guo H, Li W, Yao F, Wu J, Zhou X, Yue Y, Yeh AGO. Who are more exposed to PM2.5 pollution: A mobile phone data approach. ENVIRONMENT INTERNATIONAL 2020; 143:105821. [PMID: 32702593 DOI: 10.1016/j.envint.2020.105821] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Few studies have examined exposure disparity to ambient air pollution outside North America and Europe. Moreover, very few studies have investigated exposure disparity in terms of individual-level data or at multi-temporal scales. OBJECTIVES This work aims to examine the associations between individual- and neighbourhood-level economic statuses and individual exposure to PM2.5 across multi-temporal scales. METHODS The study population included 742,220 mobile phone users on a weekday in Shenzhen, China. A geo-informed backward propagation neural network model was developed to estimate hourly PM2.5 concentrations by the use of remote sensing and geospatial big data, which were then combined with individual trajectories to estimate individual total exposure during weekdays at multi-temporal scales. Coupling the estimated PM2.5 exposure with housing price, we examined the associations between individual- and neighbourhood-level economic statuses and individual exposure using linear regression and two-level hierarchical linear models. Furthermore, we performed five sensitivity analyses to test the robustness of the two-level effects. RESULTS We found positive associations between individual- and neighbourhood-level economic statuses and individual PM2.5 exposure at a daytime, daily, weekly, monthly, seasonal or annual scale. Findings on the effects of the two-level economic statuses were generally robust in the five sensitivity analyses. In particular, despite the insignificant effects observed in three of newly selected time periods in the sensitivity analysis, individual- and neighbourhood-level economic statuses were still positively associated with individual total exposure during each of other newly selected periods (including three other seasons). CONCLUSIONS There are statistically positive associations of individual PM2.5 exposure with individual- and neighbourhood-level economic statuses. That is, people living in areas with higher residential property prices are more exposed to PM2.5 pollution. Findings emphasize the need for public health intervention and urban planning initiatives targeting socio-economic disparity in ambient air pollution exposure, thus alleviating health disparities across socioeconomic groups.
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Affiliation(s)
- Huagui Guo
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, PR China.
| | - Weifeng Li
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, PR China.
| | - Fei Yao
- School of GeoSciences, The University of Edinburgh, Edinburgh EH9 3FF, United Kingdom.
| | - Jiansheng Wu
- Key Laboratory for Urban Habitat Environmental Science and Technology, Shenzhen Graduate School, Peking University, Shenzhen 518055, PR China; Key Laboratory for Earth Surface Processes, Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, PR China.
| | - Xingang Zhou
- College of Architecture and Urban Planning, Tongji University, Shanghai 200092, PR China.
| | - Yang Yue
- Department of Urban Informatics, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518052, PR China.
| | - Anthony G O Yeh
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, PR China.
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Thayamballi N, Habiba S, Laribi O, Ebisu K. Impact of Maternal Demographic and Socioeconomic Factors on the Association Between Particulate Matter and Adverse Birth Outcomes: a Systematic Review and Meta-analysis. J Racial Ethn Health Disparities 2020; 8:743-755. [PMID: 32901434 DOI: 10.1007/s40615-020-00835-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Numerous studies conducted in the United States found associations between prenatal exposure to particulate matter (PM) and adverse birth outcomes, and some studies identified vulnerable populations, including certain racial/ethnic groups and people with low-socioeconomic status. However, their findings are not always consistent. In this review, we compared the risk of adverse birth outcomes due to PM exposures among subpopulations and investigated whether any particular population is more vulnerable. METHODS We selected U.S. studies examining associations between PM exposure during pregnancy and birth outcomes that included results for effect modification by race/ethnicity and/or maternal education. We summarized the findings for various sizes of PM and birth outcomes. Meta-analysis was conducted to quantify vulnerable race/ethnicity for the association between fine PM (PM2.5) and birthweight. RESULTS In total, 19 studies were assessed, and PM-related risks of adverse birth outcomes, particularly those related to fetal growth, likely differ across subpopulations. A meta-analysis from five studies showed that a 10 μg/m3 increase of PM2.5 during the full-gestation reduced birthweight by 21.9 g (95% confidence interval 11.7, 32.0), 15.7 g (10.1, 21.4), 9.3 g (2.7, 15.8), and 5.8 g (- 9.0, 20.7) for Black, White, Hispanic, and Asian mothers, respectively. CONCLUSION Our review indicated that Black mothers and mothers with low educational attainment are more vulnerable subpopulations. More investigation is needed for effect modification by other maternal factors, such as household income. Characterizing and quantifying vulnerable subpopulations are essential for addressing environmental justice since it can help regulatory agencies allocate resources and design policy interventions.
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Affiliation(s)
- Neil Thayamballi
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, 1515 Clay Street, 16th floor, Oakland, CA, 94612, USA.,School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Room 5302, Berkeley, CA, 94720-7360, USA
| | - Sara Habiba
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, 1515 Clay Street, 16th floor, Oakland, CA, 94612, USA.,School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Room 5302, Berkeley, CA, 94720-7360, USA
| | - Ouahiba Laribi
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, 1515 Clay Street, 16th floor, Oakland, CA, 94612, USA
| | - Keita Ebisu
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, 1515 Clay Street, 16th floor, Oakland, CA, 94612, USA.
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Woo SHL, Liu JC, Yue X, Mickley LJ, Bell ML. Air pollution from wildfires and human health vulnerability in Alaskan communities under climate change. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2020; 15:094019. [PMID: 34413900 PMCID: PMC8372693 DOI: 10.1088/1748-9326/ab9270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Alaskan wildfires are becoming more frequent and severe, but very little is known regarding exposure to wildfire smoke, a risk factor for respiratory and cardiovascular illnesses. We estimated long-term, present-day and future exposure to wildfire-related fine particulate matter (PM2.5) across Alaska for the general population and subpopulations to assess vulnerability using observed data for the present day (1997-2010), modelled estimates for the present day (1997-2001), and modelled estimates for the future (2047-2051). First, we assessed wildfire-PM2.5 exposure by estimating monthly-average wildfire-specific PM2.5 levels across 1997-2010 for 158 Alaskan census tracts, using atmospheric transport modelling based on observed area-burned data. Second, we estimated changes in future (2047-2051) wildfire-PM2.5 exposure compared to the present-day (1997-2001) by estimating the monthly-average wildfire-specific PM2.5 levels for 29 boroughs/census areas (county-equivalent areas), under the Intergovernmental Panel on Climate Change (IPCC) A1B scenario from an ensemble of 13 climate models. Subpopulation risks for present and future exposure levels were estimated by summing area-weighted exposure levels utilizing the 2000 Census and State of Alaska's population projections. We assessed vulnerability by several subpopulation characteristics (e.g. race/ethnicity, urbanicity). Wildfire-PM2.5 exposure levels during 1997-2010 were highest in interior Alaska during July. Among subpopulations, average summer (June-August) exposure levels for urban dwellers and African-American/Blacks were highest at 9.1 μg m-3 and 10 μg m-3, respectively. Estimated wildfire-PM2.5 varied by Native American tribe, ranging from average summer levels of 2.4 μg m-3 to 13 μg m-3 for Tlingit-Haida and Alaskan Athabascan tribes, respectively. Estimates indicate that by the mid-21st century, under climate change, almost all of Alaska could be exposed to increases of 100% or more in levels of wildfire-specific PM2.5 levels. Exposure to wildfire-PM2.5 likely presents a substantial public health burden in the present day for Alaska communities, with different impacts by subpopulation. Under climate change, wildfire smoke could pose an even greater public health risks for most Alaskans.
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Affiliation(s)
- Seung Hyun Lucia Woo
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, United States of America
| | - Jia Coco Liu
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, United States of America
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Xu Yue
- Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - Loretta J Mickley
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States of America
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, United States of America
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Yitshak-Sade M, Lane KJ, Fabian MP, Kloog I, Hart JE, Davis B, Fong KC, Schwartz JD, Laden F, Zanobetti A. Race or racial segregation? Modification of the PM2.5 and cardiovascular mortality association. PLoS One 2020; 15:e0236479. [PMID: 32716950 PMCID: PMC7384646 DOI: 10.1371/journal.pone.0236479] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 07/07/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Many studies have identified an inequitable distribution of exposure to PM2.5 (particulate matter less than 2.5 microns) by race. We investigated the association of PM2.5 and cardiovascular mortality considering both the decedents' race and neighborhood racial composition as potential modifiers. METHODS We obtained geocoded cardiovascular mortality records of all black and white decedents from urban block-groups in Massachusetts between 2001 and 2011 (n = 130,863). We examined the association between PM2.5 and cardiovascular mortality, and assessed effect modification by three types of racial modifiers: decedents' race, census block-group percent black and white, and two novel measures of racial segregation. The Racial Residential Segregation (RRS) quantifies the concentration of non-Hispanic blacks and whites in each block-group. The Index of Racial Dissimilarity measures dissimilarity in non-Hispanic black and white racial distribution between the smaller census block-group and larger tract. RESULTS We found a 2.35%(95%CI: 0.92%;3.79%) increase in mortality for each 10μg/m3 increase in two-day average exposure to PM2.5. The effect was modified by the block-group racial composition, with higher risks in block-groups with the highest percentage of black residents (interaction p-value = 0.04), and in block-groups with the lowest RRS (i.e. higher black to white resident ratio, interaction p-value = 0.072). Racial dissimilarity did not modify the associations. CONCLUSION Current levels of PM2.5 are associated with increased cardiovascular deaths in Massachusetts, with different risks between areas with different racial composition and segregation. This suggests that pollution reductions in neighborhoods with the highest percentage of non-Hispanic blacks would be most beneficial in reducing cardiovascular mortality and disparities.
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Affiliation(s)
- Maayan Yitshak-Sade
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Kevin J. Lane
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
| | - M. Patricia Fabian
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Jaime E. Hart
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Brigette Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Kelvin C. Fong
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- School of Forestry & Environmental Sciences, Yale University, New Haven, CT, United States of America
| | - Joel D. Schwartz
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Francine Laden
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Antonella Zanobetti
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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145
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Womack JA, Justice AC. The OATH Syndemic: opioids and other substances, aging, alcohol, tobacco, and HIV. Curr Opin HIV AIDS 2020; 15:218-225. [PMID: 32487817 PMCID: PMC7422477 DOI: 10.1097/coh.0000000000000635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Persons living with HIV (PLWH) are aging, continue to use alcohol and other substances, and experience age-associated adverse effects. We explore a new syndemic: OATH (opioids and other substances, aging, alcohol, tobacco, and HIV). RECENT FINDINGS Frailty and falls are important problems that affect the health status of PLWH who continue to use alcohol and other substances. HIV, alcohol and other substance use, and aging each contributes to inflammaging. Multimorbidity and polypharmacy are also important pathways as alcohol and other substances interact with prescribed medications resulting in adverse-drug interactions leading to potentially serious consequences. Social conditions including racism, poverty, sex bias, stress, and stigma contribute to the existence and persistence of this syndemic. SUMMARY Substance use, HIV, and aging are linked in a new syndemic (OATH) that drives age-related outcomes such as frailty and falls. We need to expand our understanding of the 'healthcare team' so that we include social and political advocates who can support necessary structural change. Treatment of substance use should be better incorporated into the management of HIV, including a focus on potential medication/substance interactions. Finally, we need to explore treatment of frailty rather than individual manifestations of frailty (e.g., atherosclerosis, neurodegeneration).
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Affiliation(s)
- Julie A. Womack
- VA Connecticut Healthcare System, West Haven, CT
- Yale School of Nursing, Orange, CT
| | - Amy C. Justice
- VA Connecticut Healthcare System, West Haven, CT
- Yale School of Medicine, New Haven, CT
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146
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Sergi BJ, Adams PJ, Muller NZ, Robinson AL, Davis SJ, Marshall JD, Azevedo IL. Optimizing Emissions Reductions from the U.S. Power Sector for Climate and Health Benefits. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:7513-7523. [PMID: 32392045 DOI: 10.1021/acs.est.9b06936] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Improved air quality and human health are often discussed as "co-benefits" of mitigating climate change, yet they are rarely considered when designing or implementing climate policies. We analyze the implications of integrating health and climate when determining the best locations for replacing power plants with new wind, solar, or natural gas to meet a CO2 reduction target in the United States. We employ a capacity expansion model with integrated assessment of climate and health damages, comparing portfolios optimized for benefits to climate alone or both health and climate. The model estimates county-level health damages and accounts for uncertainty by using a range of air quality models (AP3, EASIUR, and InMAP) and concentration-response functions (American Cancer Society and Harvard Six Cities). We find that reducing CO2 by 30% yields $21-68 billion in annual health benefits, with an additional $9-36 billion possible when co-optimizing for climate and health benefits. Additional benefits accrue from prioritizing emissions reductions in counties with high population exposure. Total health benefits equal or exceed climate benefits across a wide range of modeling assumptions. Our results demonstrate the value of considering health in climate policy design and the need for interstate cooperation to achieve additional health benefits equitably.
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Affiliation(s)
- Brian J Sergi
- Department of Engineering & Public Policy, Carnegie Mellon University, Pittsburgh, PA 15213, United States
| | - Peter J Adams
- Department of Engineering & Public Policy, Carnegie Mellon University, Pittsburgh, PA 15213, United States
- Department of Civil & Environmental Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, United States
| | - Nicholas Z Muller
- Department of Engineering & Public Policy, Carnegie Mellon University, Pittsburgh, PA 15213, United States
- Tepper School of Business, Carnegie Mellon University, Pittsburgh, PA 15213, United States
- National Bureau of Economic Research, Cambridge, MA 02138, United States
| | - Allen L Robinson
- Department of Engineering & Public Policy, Carnegie Mellon University, Pittsburgh, PA 15213, United States
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, United States
| | - Steven J Davis
- Department of Earth System Science, University of California, Irvine, CA 92697 United States
- Department of Civil & Environmental Engineering, University of California, Irvine, CA 92697, United States
| | - Julian D Marshall
- Department of Civil & Environmental Engineering, University of Washington, Seattle, WA 98115, United States
| | - Inês L Azevedo
- Department of Engineering & Public Policy, Carnegie Mellon University, Pittsburgh, PA 15213, United States
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147
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A Framework to Classify Environmental Inequity in Absolute and Relative Terms, and Its Application in Beijing. SUSTAINABILITY 2020. [DOI: 10.3390/su12114757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Although reducing environmental inequities is widely recognized as an essential step towards sustainable cities, decision-makers frequently lack the tools to identify inequity distribution patterns and designing effective intervention policies. This study seeks to present a framework that can help decision-making processes by classifying environmental inequity districts in multiple perspectives, especially in absolute and relative terms. This framework includes four steps: (A) variable selection, (B) data normalization, (C) ranking indicators, (D) summarizing inequity classification, which then assign results to selected areas. The framework aims to classify and compare environmental inequities in multiple perspectives, and can be applied in various environmental problems, with advantages such as high acceptability and clear comprehensibility. To show the potential use of this framework, a case application in Beijing, China, was conducted to evaluate the environmental inequity of air pollution. The results suggest that decision-makers should focus on the central urban area and some southern regions of Beijing to implement various improvement policies. Based on the results from Beijing, how the framework can be used to help decision-makers, the future roles of this framework with the government and the public, as well as the framework’s limitations are further discussed.
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148
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Munoz-Pizza DM, Villada-Canela M, Reyna MA, Texcalac-Sangrador JL, Osornio-Vargas ÁR. Air pollution and children’s respiratory health: a scoping review of socioeconomic status as an effect modifier. Int J Public Health 2020; 65:649-660. [DOI: 10.1007/s00038-020-01378-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 11/30/2022] Open
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Richmond-Bryant J, Mikati I, Benson AF, Luben TJ, Sacks JD. Disparities in Distribution of Particulate Matter Emissions from US Coal-Fired Power Plants by Race and Poverty Status After Accounting for Reductions in Operations Between 2015 and 2017. Am J Public Health 2020; 110:655-661. [PMID: 32191524 PMCID: PMC7144440 DOI: 10.2105/ajph.2019.305558] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2019] [Indexed: 11/04/2022]
Abstract
Objectives. To investigate potential changes in burdens from coal-fired electricity-generating units (EGUcfs) that emit fine particulate matter (PM2.5, defined as matter with a nominal mean aerodynamic diameter of ≤ 2.5 µm) among racial/ethnic and economic groups after reduction of operations in 92 US EGUcfs.Methods. PM2.5 burdens calculated for EGUs listed in the 2008, 2011, and 2014 National Emissions Inventory were recalculated for 2017 after omitting emissions from 92 EGUcfs. The combined influence of race/ethnicity and poverty on burden estimates was characterized.Results. Omission of 92 EGUcfs decreased PM2.5 burdens attributable to EGUs by 8.6% for the entire population and to varying degrees for every population subgroup. Although the burden decreased across all subgroups, the decline was not equitable. After omission of the 92 EGUcfs, burdens were highest for the below-poverty and non-White subgroups. Proportional disparities between White and non-White subgroups increased. In our combined analysis, the burden was highest for the non-White-high-poverty subgroup.Conclusions. Our results indicate that subgroups living in poverty experience the greatest absolute burdens from EGUcfs. Changes as a result of EGUcf closures suggest a shift in burden from White to non-White subgroups. Policymakers could use burden analyses to jointly promote equity and reduce emissions.
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Affiliation(s)
- Jennifer Richmond-Bryant
- At the start of the study, Jennifer Richmond-Bryant, Thomas J. Luben, and Jason D. Sacks were with the National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC. Ihab Mikati and Adam F. Benson were with the Oak Ridge Institute for Science and Education, Research Triangle Park, NC. Jennifer Richmond-Bryant is with the Department of Forestry and Environmental Resources and the Center for Geospatial Analytics, North Carolina State University, Raleigh. Ihab Mikati is with New York University School of Law, New York, NY. Adam F. Benson is with The Schroeder Institute at the TRUTH Initiative, Washington, DC
| | - Ihab Mikati
- At the start of the study, Jennifer Richmond-Bryant, Thomas J. Luben, and Jason D. Sacks were with the National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC. Ihab Mikati and Adam F. Benson were with the Oak Ridge Institute for Science and Education, Research Triangle Park, NC. Jennifer Richmond-Bryant is with the Department of Forestry and Environmental Resources and the Center for Geospatial Analytics, North Carolina State University, Raleigh. Ihab Mikati is with New York University School of Law, New York, NY. Adam F. Benson is with The Schroeder Institute at the TRUTH Initiative, Washington, DC
| | - Adam F Benson
- At the start of the study, Jennifer Richmond-Bryant, Thomas J. Luben, and Jason D. Sacks were with the National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC. Ihab Mikati and Adam F. Benson were with the Oak Ridge Institute for Science and Education, Research Triangle Park, NC. Jennifer Richmond-Bryant is with the Department of Forestry and Environmental Resources and the Center for Geospatial Analytics, North Carolina State University, Raleigh. Ihab Mikati is with New York University School of Law, New York, NY. Adam F. Benson is with The Schroeder Institute at the TRUTH Initiative, Washington, DC
| | - Thomas J Luben
- At the start of the study, Jennifer Richmond-Bryant, Thomas J. Luben, and Jason D. Sacks were with the National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC. Ihab Mikati and Adam F. Benson were with the Oak Ridge Institute for Science and Education, Research Triangle Park, NC. Jennifer Richmond-Bryant is with the Department of Forestry and Environmental Resources and the Center for Geospatial Analytics, North Carolina State University, Raleigh. Ihab Mikati is with New York University School of Law, New York, NY. Adam F. Benson is with The Schroeder Institute at the TRUTH Initiative, Washington, DC
| | - Jason D Sacks
- At the start of the study, Jennifer Richmond-Bryant, Thomas J. Luben, and Jason D. Sacks were with the National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC. Ihab Mikati and Adam F. Benson were with the Oak Ridge Institute for Science and Education, Research Triangle Park, NC. Jennifer Richmond-Bryant is with the Department of Forestry and Environmental Resources and the Center for Geospatial Analytics, North Carolina State University, Raleigh. Ihab Mikati is with New York University School of Law, New York, NY. Adam F. Benson is with The Schroeder Institute at the TRUTH Initiative, Washington, DC
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150
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Lipfert FW, Wyzga RE. Environmental predictors of survival in a cohort of U.S. military veterans: A multi-level spatio-temporal analysis stratified by race. ENVIRONMENTAL RESEARCH 2020; 183:108842. [PMID: 31818475 DOI: 10.1016/j.envres.2019.108842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 06/10/2023]
Abstract
We analyzed racial differences in all-cause mortality rates associated with air pollution in a cohort of military veterans in which 37% of the 70,000 members identified as African-American (black). In this comprehensive analysis, spatial levels comprised individuals, zip-codes, and counties. Temporal levels comprised the 26-y follow-up period (1976-2001) and 4 subperiods. Proportional hazard regression models were used, controlling for individual age, race (white, black), smoking (current, ever), education, height, body-mass index, and systolic and diastolic blood pressure; zipcode-average socioeconomic indicators; and county-average climate. County-level air quality measures included vehicular traffic density as a surrogate for all traffic-related pollutants including noise. The model accounted for nonlinear mortality relationships with age, body-mass index, blood pressure and zip-code racial composition. Relative to whites, more of the black veterans smoked, had slightly higher blood pressure, and lived in predominately black zip-codes that had more poverty than whites. The black veterans lived in counties that had slightly worse ambient air quality and substantially higher levels of vehicular traffic density. We analyzed all-cause mortality associations with county-level average ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide for 1975-81, and subsequent data on particulates by particle size. We also considered sulfate and elemental carbon particles, benzene, SO2, and NOx based on nationwide modeling for 2002. We had no information on indoor air quality or personal exposures; our risk estimates should thus be regarded as characterizing the counties of residence rather than individual exposures of inhabitants. In addition to age, the strongest predictors of veterans' survival were residence in high-poverty zip-codes, smoking, and diastolic blood pressure, to all of which black veterans were less sensitive than whites. Black veterans had significantly lower mortality risks from aging, smoking, and elevated diastolic blood pressure, but larger risks from excessive body-mass index. They were less at risk from living a high-poverty zip-code than whites. We assumed these risk factors to be stable during follow-up and thus applicable to chronic health effects. After controlling for them, the all-cause mortality risk for black veterans was 10% lower than whites. In an effort to reduce random scatter we computed mean risks associated with overlapping groups of similar pollutants. These means were statistically significant for both black and white veterans for traffic-related, gaseous, and NOx-O3 pollutants, for which the overall mean relative risk was 1.076 (1.057-1.090). Grouped mean risks for particulate pollutants, sulfur compounds, and non-traffic pollutants were not significant for either race. Black veterans carried more of the traffic-related risks than whites because of their greater exposures and risk coefficients. PM2.5 risk estimates were negative for black veterans (0.82 [0.75-0.89]) but positive for whites (1.05 [1.005-1.10]) which is consistent with regional differences in overall mortality. The temporal analyses compared mortality rates by follow-up subperiod for the pollutants measured at enrollment. We expected increasing (cumulative) risks for chronic effects and decreasing risks for delayed acute effects, but found no significant trend for either race. We concluded that the higher exposures and mortality risks associated with vehicular traffic posed environmental injustice for the black veterans.
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