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Cook KM, De Asis-Cruz J, Sitrin C, Barnett SD, Krishnamurthy D, Limperopoulos C. Greater Neighborhood Disadvantage Is Associated with Alterations in Fetal Functional Brain Network Structure. J Pediatr 2024; 274:114201. [PMID: 39032768 DOI: 10.1016/j.jpeds.2024.114201] [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: 05/15/2024] [Revised: 07/10/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
OBJECTIVE To determine the association between neighborhood disadvantage (ND) and functional brain development of in utero fetuses. STUDY DESIGN We conducted an observational study using Social Vulnerability Index (SVI) scores to assess the impact of ND on a prospectively recruited sample of healthy pregnant women from Washington, DC. Using 79 functional magnetic resonance imaging scans from 68 healthy pregnancies at a mean gestational age of 33.12 weeks, we characterized the overall functional brain network structure using a graph metric approach. We used linear mixed effects models to assess the relationship between SVI and gestational age on 5 graph metrics, adjusting for multiple scans. RESULTS Exposure to greater ND was associated with less well integrated functional brain networks, as observed by longer characteristic path lengths and diminished global efficiency (GE), as well as diminished small world propensity (SWP). Across gestational ages, however, the association between SVI and network integration diminished to a negligible relationship in the third trimester. Conversely, SWP was significant across pregnancy, but the relationship changed such that there was a negative association with SWP earlier in the second trimester that inverted around the transition to the third trimester to a positive association. CONCLUSIONS These data directly connect ND and altered functional brain maturation in fetuses. Our results suggest that, even before birth, proximity to environmental stressors in the wider neighborhood environment are associated with altered brain development.
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Affiliation(s)
- Kevin Michael Cook
- Developing Brain Institute, Children's National Hospital, Washington, DC
| | | | - Chloe Sitrin
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI
| | - Scott D Barnett
- Developing Brain Institute, Children's National Hospital, Washington, DC
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Trees IR, Saha A, Putnick DL, Clayton PK, Mendola P, Bell EM, Sundaram R, Yeung EH. Prenatal exposure to air pollutant mixtures and birthweight in the upstate KIDS cohort. ENVIRONMENT INTERNATIONAL 2024; 187:108692. [PMID: 38677086 DOI: 10.1016/j.envint.2024.108692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/02/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Single-pollutant models have linked prenatal PM2.5 exposure to lower birthweight. However, analyzing air pollutant mixtures better captures pollutant interactions and total effects. Unfortunately, strong correlations between pollutants restrict traditional methods. OBJECTIVES We explored the association between exposure to a mixture of air pollutants during different gestational age windows of pregnancy and birthweight. METHODS We included 4,635 mother-infant dyads from a New York State birth cohort born 2008-2010. Air pollution data were sourced from the EPA's Community Multiscale Air Quality model and matched to the census tract centroid of each maternal home address. Birthweight and gestational age were extracted from vital records. We applied linear regression to study the association between prenatal exposure to PM2.5, PM10, NOX, SO2, and CO and birthweight during six sensitive windows. We then utilized Bayesian kernel machine regression to examine the non-linear effects and interactions within this five-pollutant mixture. Final models adjusted for maternal socio-demographics, infant characteristics, and seasonality. RESULTS Single-pollutant linear regression models indicated that most pollutants were associated with a decrement in birthweight, specifically during the two-week window before birth. An interquartile range increase in PM2.5 exposure (IQR: 3.3 µg/m3) from the median during this window correlated with a 34 g decrement in birthweight (95 % CI: -54, -14), followed by SO2 (IQR: 2.0 ppb; β: -31), PM10 (IQR: 4.6 µg/m3; β: -29), CO (IQR: 60.8 ppb; β: -27), and NOX (IQR: 7.9 ppb; β: -26). Multi-pollutant BKMR models revealed that PM2.5, NOX, and CO exposure were negatively and non-linearly linked with birthweight. As the five-pollutant mixture increased, birthweight decreased until the median level of exposure. DISCUSSION Prenatal exposure to air pollutants, notably PM2.5, during the final two weeks of pregnancy may negatively impact birthweight. The non-linear relationships between air pollution and birthweight highlight the importance of studying pollutant mixtures and their interactions.
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Affiliation(s)
- Ian R Trees
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States
| | - Abhisek Saha
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States
| | - Diane L Putnick
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States
| | - Priscilla K Clayton
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, University at Buffalo, United States
| | - Erin M Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, United States
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States.
| | - Edwina H Yeung
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States.
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Fu J, Lin Q, Ai B, Li M, Luo W, Huang S, Yu H, Yang Y, Lin H, Wei J, Su X, Zhang Z. Associations between maternal exposure to air pollution during pregnancy and trajectories of infant growth: A birth cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 269:115792. [PMID: 38064789 DOI: 10.1016/j.ecoenv.2023.115792] [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: 08/27/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE We examined the relationships between infants' growth trajectories and prenatal exposure to air pollution, which is still under-investigated. METHODS A birth cohort study was constructed using medical records of pregnant women and infants born between 2015 and 2019 in Foshan, China. Using satellite-based spatial-temporal models, prenatal exposure to air pollutants including particulate matter with an aerodynamic dimension of < 2.5 µm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) was assessed at each woman's residence. Latent class growth modeling was used to identify trajectories of physical (body length and weight) growth and neurodevelopment, which were repeatedly measured within 1 year after birth. Logistic regression models were used to investigate the associations between prenatal exposure to air pollution and the risks of growth disorders, adjusting for an array of potential confounders. RESULTS We identified two growth trajectories for body length [normal: 3829 (93%); retardation: 288 (7%)], three for weight [normal: 2475 (59.6%); retardation: 390 (9.4%); overgrowth: 1287 (31%)], and two for neurodevelopment [normal: 956 (66.1%); retardation: 491 (33.9%)]. For exposure over whole pregnancy, SO2 was associated with an increased risk of body length retardation (OR for per 1 µg/m3 increment: 1.09, 95%CI: 1.01-1.17); PM2.5 (OR: 1.05, 95%CI: 1.03-1.07), SO2 (OR: 1.15, 95%CI: 1.08-1.22), and NO2 (OR: 1.05, 95%CI: 1.03-1.07) were positively associated with neurodevelopmental retardation. Such associations appeared stronger for exposures over the first and second trimesters. No significant associations were detected for weight growth. CONCLUSIONS Maternal exposure to air pollution during pregnancy was associated with higher risks of impairments in both physical growth, particularly body length, and neurodevelopment.
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Affiliation(s)
- Jiaying Fu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qingmei Lin
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Baozhuo Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meijun Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weidong Luo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Saijun Huang
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Hong Yu
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Wei
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China; Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Xi Su
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China.
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Ji N, Johnson M, Eckel SP, Gauderman WJ, Chavez TA, Berhane K, Faham D, Lurmann F, Pavlovic NR, Grubbs BH, Lerner D, Habre R, Farzan SF, Bastain TM, Breton CV. Prenatal ambient air pollution exposure and child weight trajectories from the 3rd trimester of pregnancy to 2 years of age: a cohort study. BMC Med 2023; 21:341. [PMID: 37674158 PMCID: PMC10483706 DOI: 10.1186/s12916-023-03050-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Prenatal air pollution exposure may increase risk for childhood obesity. However, few studies have evaluated in utero growth measures and infant weight trajectories. This study will evaluate the associations of prenatal exposure to ambient air pollutants with weight trajectories from the 3rd trimester through age 2 years. METHODS We studied 490 pregnant women who were recruited from the Maternal and Development Risks from Environmental and Social Stressors (MADRES) cohort, which comprises a low-income, primarily Hispanic population in Los Angeles, California. Nitrogen dioxide (NO2), particulate matter < 10 µm (PM10), particulate matter < 2.5 µm (PM2.5), and ozone (O3) concentrations during pregnancy were estimated from regulatory air monitoring stations. Fetal weight was estimated from maternal ultrasound records. Infant/child weight measurements were extracted from medical records or measured during follow-up visits. Piecewise spline models were used to assess the effect of air pollutants on weight, overall growth, and growth during each period. RESULTS The mean (SD) prenatal exposure concentrations for NO2, PM2.5, PM10, and O3 were 16.4 (2.9) ppb, 12.0 (1.1) μg/m3, 28.5 (4.7) μg/m3, and 26.2 (2.9) ppb, respectively. Comparing an increase in prenatal average air pollutants from the 10th to the 90th percentile, the growth rate from the 3rd trimester to age 3 months was significantly increased (1.55% [95%CI 1.20%, 1.99%] for PM2.5 and 1.64% [95%CI 1.27%, 2.13%] for NO2), the growth rate from age 6 months to age 2 years was significantly decreased (0.90% [95%CI 0.82%, 1.00%] for NO2), and the attained weight at age 2 years was significantly lower (- 7.50% [95% CI - 13.57%, - 1.02%] for PM10 and - 7.00% [95% CI - 11.86%, - 1.88%] for NO2). CONCLUSIONS Prenatal ambient air pollution was associated with variable changes in growth rate and attained weight from the 3rd trimester to age 2 years. These results suggest continued public health benefits of reducing ambient air pollution levels, particularly in marginalized populations.
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Affiliation(s)
- Nan Ji
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | | | - Sandrah P Eckel
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - William J Gauderman
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Thomas A Chavez
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Dema Faham
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Fred Lurmann
- Sonoma Technology Inc., Petaluma, CA, 94954, USA
| | | | - Brendan H Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | | | - Rima Habre
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Shohreh F Farzan
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Theresa M Bastain
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Carrie V Breton
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA.
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Muruganandam N, Mahalingam S, Narayanan R, Rajadurai E. Meandered and muddled: a systematic review on the impact of air pollution on ocular health. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:64872-64890. [PMID: 37097565 DOI: 10.1007/s11356-023-27079-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Abstract
From the years 1970-2023, a systematic overview of the diverse consequences of particulate matter on eye health and a disease classification according to acute, chronic, and genetic are presented using the PubMed, Research Gate, Google Scholar, and Science Direct databases. Various studies on medical aspects correlate with the eye and health. However, from an application perspective, there is limited research on the ocular surface and air pollution. The main objective of the study is to uncover the relationship between eye health and air pollution, particularly particulate matter, along with other external factors acting as aggravators. The secondary goal of the work is to examine the existing models for mimicking human eyes. The study is followed by a questionnaire survey in a workshop, in which the exposure-based investigation was tagged based on their activity. This paper establishes a relationship between particulate matter and its influence on human health, leading to numerous eye diseases like dry eyes, conjunctivitis, myopia, glaucoma, and trachoma. The results of the questionnaire survey indicate that about 68% of the people working in the workshop are symptomatic with tears, blurred vision, and mood swings, while 32% of the people were asymptomatic. Although there are approaches for conducting experiments, the evaluation is not well defined; empirical and numerical solutions for particle deposition on the eye are needed. There prevails a broad gap in the arena of ocular deposition modeling.
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Affiliation(s)
- Niveditha Muruganandam
- Department of Civil Engineering, Kumaraguru College of Technology, Anna University, Coimbatore, Tamil Nadu, India
- Department of Civil Engineering, Kumaraguru College of Technology, Coimbatore, Tamil Nadu, India
| | - Sneha Mahalingam
- Department of Civil Engineering, Kumaraguru College of Technology, Anna University, Coimbatore, Tamil Nadu, India
- Department of Civil Engineering, Kumaraguru College of Technology, Coimbatore, Tamil Nadu, India
| | - Ramsundram Narayanan
- Department of Civil Engineering, Kumaraguru College of Technology, Coimbatore, Tamil Nadu, India.
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Fazakas E, Neamtiu IA, Gurzau ES. Health effects of air pollutant mixtures (volatile organic compounds, particulate matter, sulfur and nitrogen oxides) - a review of the literature. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 0:reveh-2022-0252. [PMID: 36932657 DOI: 10.1515/reveh-2022-0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
The health risks associated with individual air pollutant exposures have been studied and documented, but in real-life, the population is exposed to a multitude of different substances, designated as mixtures. A body of literature on air pollutants indicated that the next step in air pollution research is investigating pollutant mixtures and their potential impacts on health, as a risk assessment of individual air pollutants may actually underestimate the overall risks. This review aims to synthesize the health effects related to air pollutant mixtures containing selected pollutants such as: volatile organic compounds, particulate matter, sulfur and nitrogen oxides. For this review, the PubMed database was used to search for articles published within the last decade, and we included studies assessing the associations between air pollutant mixtures and health effects. The literature search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A number of 110 studies were included in the review from which data on pollutant mixtures, health effects, methods used, and primary results were extracted. Our review emphasized that there are a relatively small number of studies addressing the health effects of air pollutants as mixtures and there is a gap in knowledge regarding the health effects associated with these mixtures. Studying the health effects of air pollutant mixtures is challenging due to the complexity of components that mixtures may contain, and the possible interactions these different components may have.
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Affiliation(s)
- Emese Fazakas
- Health Department, Environmental Health Center, Cluj-Napoca, Romania
- Faculty of Environmental Science and Engineering, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Iulia A Neamtiu
- Health Department, Environmental Health Center, Cluj-Napoca, Romania
- Faculty of Environmental Science and Engineering, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Eugen S Gurzau
- Health Department, Environmental Health Center, Cluj-Napoca, Romania
- Research Center for functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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7
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Zhou W, Ming X, Yang Y, Hu Y, He Z, Chen H, Li Y, Cheng J, Zhou X. Associations between maternal exposure to ambient air pollution and very low birth weight: A birth cohort study in Chongqing, China. Front Public Health 2023; 11:1123594. [PMID: 36960371 PMCID: PMC10028238 DOI: 10.3389/fpubh.2023.1123594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/15/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction There have been many researches done on the association between maternal exposure to ambient air pollution and adverse pregnancy outcomes, but few studies related to very low birth weight (VLBW). This study thus explores the association between maternal exposure to ambient air pollutants and the risk of VLBW, and estimates the sensitive exposure time window. Methods A retrospective cohort study analyzed in Chongqing, China, during 2015-2020. The Generalized Additive Model were applied to estimate exposures for each participant during each trimester and the entire pregnancy period. Results For each 10 μg/m3 increase in PM2.5 during pregnancy, the relative risk of VLBW increased on the first trimester, with RR = 1.100 (95% CI: 1.012, 1.195) in the single-pollutant model. Similarly, for each 10 μg/m3 increase in PM10, there was a 12.9% (RR = 1.129, 95% CI: 1.055, 1.209) increase for VLBW on the first trimester in the single-pollutant model, and an 11.5% (RR = 1.115, 95% CI: 1.024, 1.213) increase in the multi-pollutant model, respectively. The first and second trimester exposures of NO2 were found to have statistically significant RR values for VLBW. The RR values on the first trimester were 1.131 (95% CI: 1.037, 1.233) and 1.112 (95% CI: 1.015, 1.218) in the single-pollutant model and multi-pollutant model, respectively; The RR values on the second trimester were 1.129 (95% CI: 1.027, 1.241) and 1.146 (95% CI: 1.038, 1.265) in the single-pollutant model and multi-pollutant model, respectively. The RR of O3 exposure for VLBW on the entire trimester was 1.076 (95% CI: 1.010-1.146), and on the second trimester was 1.078 (95% CI: 1:016, 1.144) in the single-pollutant model. Conclusion This study indicates that maternal exposure to high levels of PM2.5, PM10, NO2, and O3 during pregnancy may increase the risk of very low birth weight, especially for exposure on the first and second trimester. Reducing the risk of early maternal exposure to ambient air pollution is thus necessary for pregnant women.
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Affiliation(s)
- Wenzheng Zhou
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Xin Ming
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yunping Yang
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yaqiong Hu
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Ziyi He
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Hongyan Chen
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yannan Li
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jin Cheng
- Institute of Toxicology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
- Jin Cheng
| | - Xiaojun Zhou
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
- *Correspondence: Xiaojun Zhou
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8
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Chen WJ, Rector AM, Guxens M, Iniguez C, Swartz MD, Symanski E, Ibarluzea J, Ambros A, Estarlich M, Lertxundi A, Riano-Galán I, Sunyer J, Fernandez-Somoano A, Chauhan SP, Ish J, Whitworth KW. Susceptible windows of exposure to fine particulate matter and fetal growth trajectories in the Spanish INMA (INfancia y Medio Ambiente) birth cohort. ENVIRONMENTAL RESEARCH 2023; 216:114628. [PMID: 36279916 PMCID: PMC9847009 DOI: 10.1016/j.envres.2022.114628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
While prior studies report associations between fine particulate matter (PM2.5) exposure and fetal growth, few have explored temporally refined susceptible windows of exposure. We included 2328 women from the Spanish INMA Project from 2003 to 2008. Longitudinal growth curves were constructed for each fetus using ultrasounds from 12, 20, and 34 gestational weeks. Z-scores representing growth trajectories of biparietal diameter, femur length, abdominal circumference (AC), and estimated fetal weight (EFW) during early (0-12 weeks), mid- (12-20 weeks), and late (20-34 weeks) pregnancy were calculated. A spatio-temporal random forest model with back-extrapolation provided weekly PM2.5 exposure estimates for each woman during her pregnancy. Distributed lag non-linear models were implemented within the Bayesian hierarchical framework to identify susceptible windows of exposure for each outcome and cumulative effects [βcum, 95% credible interval (CrI)] were aggregated across adjacent weeks. For comparison, general linear models evaluated associations between PM2.5 averaged across multi-week periods (i.e., weeks 1-11, 12-19, and 20-33) and fetal growth, mutually adjusted for exposure during each period. Results are presented as %change in z-scores per 5 μg/m3 in PM2.5, adjusted for covariates. Weeks 1-6 [βcum = -0.77%, 95%CrI (-1.07%, -0.47%)] were identified as a susceptible window of exposure for reduced late pregnancy EFW while weeks 29-33 were positively associated with this outcome [βcum = 0.42%, 95%CrI (0.20%, 0.64%)]. A similar pattern was observed for AC in late pregnancy. In linear regression models, PM2.5 exposure averaged across weeks 1-11 was associated with reduced late pregnancy EFW and AC; but, positive associations between PM2.5 and EFW or AC trajectories in late pregnancy were not observed. PM2.5 exposures during specific weeks may affect fetal growth differentially across pregnancy and such associations may be missed by averaging exposure across multi-week periods, highlighting the importance of temporally refined exposure estimates when studying the associations of air pollution with fetal growth.
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Affiliation(s)
- Wei-Jen Chen
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alison M Rector
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Monica Guxens
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; ISGlobal, Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre (Erasmus MC), Rotterdam, the Netherlands
| | - Carmen Iniguez
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Statistics and Operational Research, Universitat de València, València, Spain; Epidemiology and Environmental Health Joint Research Unit, The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Universitat Jaume I-Universitat de València, València, Spain
| | - Michael D Swartz
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Elaine Symanski
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA; Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
| | - Jesús Ibarluzea
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastian, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastian, Spain; Faculty of Psychology, Universidad del País Vasco (UPV/EHU), San Sebastian, Spain
| | - Albert Ambros
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; ISGlobal, Barcelona, Spain
| | - Marisa Estarlich
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Universitat Jaume I-Universitat de València, València, Spain; Faculty of Nursing and Chiropody, Universitat de València, València, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastian, Spain; Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Isolina Riano-Galán
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Servicio de Pediatría, Endocrinología pediátrica, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Jordi Sunyer
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; ISGlobal, Barcelona, Spain
| | - Ana Fernandez-Somoano
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; IUOPA-Área de Medicina Preventiva y Salud Pública, Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Suneet P Chauhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Jennifer Ish
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Durham, NC, USA
| | - Kristina W Whitworth
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA; Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.
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9
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Zhou S, Li T, Han N, Zhang Y, Chen G, Ji Y, Li Q, Liu J, Wang H, Hu J, Liu T, Guo Y, Wang HJ. The associations of prenatal exposure to PM 2.5 and its constituents with fetal growth: A prospective birth cohort in Beijing, China. ENVIRONMENTAL RESEARCH 2022; 214:114196. [PMID: 36029842 DOI: 10.1016/j.envres.2022.114196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/09/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Limited studies investigated the association of prenatal exposure to PM2.5 and fetal growth measured by ultrasound with inconsistent results. No study evaluated the effect of PM2.5 constituents on fetal growth in utero. We aimed to investigated whether prenatal exposure to PM2.5 and its constituents was associated with fetal growth measured by ultrasound. METHODS A total of 4319 eligible pregnant women in Peking University Birth Cohort in Tongzhou (PKUBC-T) were included in the study. Based on mothers' residential addresses, we estimated prenatal PM2.5 concentrations with a satellite-based spatiotemporal model and PM2.5 constituents concentrations with a modified Community Multiscale Air Quality model. Fetal growth parameters of abdominal circumference (AC), head circumference (HC), and femur length (FL) were measured by ultrasound and then estimated fetal weight (EFW) was calculated. We calculated sex and gestational age-specific fetal growth Z-score and then defined the corresponding fetal undergrowth. Generalized estimating equation was used to investigate the association of PM2.5 and its constituents with fetal growth Z-score and fetal undergrowth. RESULTS Prenatal exposure to PM2.5, OC, EC, SO42-, NH4+, or NO3- was consistently associated with decreased Z-scores of fetal growth parameters (AC, HC, FL, EFW). One IQR increase of PM2.5, OC, EC, SO42-, NH4+, or NO3- was associated with -0.183 [95% confident interval (CI): -0.225, -0.141], -0.144 (95%CI: -0.181, -0.107), -0.123 (95%CI: -0.160, -0.085), -0.035 (95%CI: -0.055, -0.015), -0.095 (95%CI: -0.126, -0.064), and -0.124 (95%CI: -0.159, -0.088) decrease in EFW Z-score, respectively. Prenatal exposure to PM2.5, OC, EC, SO42-, NH4+, or NO3- was also associated with higher risk of fetal AC, HC, FL or EFW undergrowth. CONCLUSION The study identified that prenatal exposure to PM2.5 or its constituents was associated with impaired fetal growth. The findings provided evidence that control measures for PM2.5 constituents should be implemented for further promoting fetal growth.
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Affiliation(s)
- Shuang Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Na Han
- Tongzhou Maternal and Child Health Care Hospital of Beijing, 101101, China
| | - Yi Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Hui Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Jianlin Hu
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Ting Liu
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
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10
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Gheissari R, Liao J, Garcia E, Pavlovic N, Gilliland FD, Xiang AH, Chen Z. Health Outcomes in Children Associated with Prenatal and Early-Life Exposures to Air Pollution: A Narrative Review. TOXICS 2022; 10:toxics10080458. [PMID: 36006137 PMCID: PMC9415268 DOI: 10.3390/toxics10080458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 06/04/2023]
Abstract
(1) Background: The developmental origins of health and disease (DOHaD) hypothesis links adverse fetal exposures with developmental mal-adaptations and morbidity later in life. Short- and long-term exposures to air pollutants are known contributors to health outcomes; however, the potential for developmental health effects of air pollution exposures during gestation or early-childhood have yet to be reviewed and synthesized from a DOHaD lens. The objective of this study is to summarize the literature on cardiovascular and metabolic, respiratory, allergic, and neuropsychological health outcomes, from prenatal development through early childhood, associated with early-life exposures to outdoor air pollutants, including traffic-related and wildfire-generated air pollutants. (2) Methods: We conducted a search using PubMed and the references of articles previously known to the authors. We selected papers that investigated health outcomes during fetal or childhood development in association with early-life ambient or source-specific air pollution exposure. (3) Results: The current literature reports that prenatal and early-childhood exposures to ambient and traffic-related air pollutants are associated with a range of adverse outcomes in early life, including cardiovascular and metabolic, respiratory and allergic, and neurodevelopmental outcomes. Very few studies have investigated associations between wildfire-related air pollution exposure and health outcomes during prenatal, postnatal, or childhood development. (4) Conclusion: Evidence from January 2000 to January 2022 supports a role for prenatal and early-childhood air pollution exposures adversely affecting health outcomes during development. Future studies are needed to identify both detrimental air pollutants from the exposure mixture and critical exposure time periods, investigate emerging exposure sources such as wildfire, and develop feasible interventional tools.
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Affiliation(s)
- Roya Gheissari
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Jiawen Liao
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Nathan Pavlovic
- Sonoma Technology Inc., 1450 N. McDowell Blvd., Suite 200, Petaluma, CA 94954, USA
| | - Frank D. Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Anny H. Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91107, USA
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
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11
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Whitworth KW, Rector A, Ish J, Chauhan SPJ, Ibarluzea J, Guxens M, Swartz MD, Symanski E, Iñiguez C. Identifying Sensitive Windows of Exposure to NO2 and Fetal Growth Trajectories in a Spanish Birth Cohort. Epidemiology 2022; 33:318-324. [PMID: 35213509 PMCID: PMC8983941 DOI: 10.1097/ede.0000000000001468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/24/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND We previously identified associations between trimester-specific NO2 exposures and reduced fetal growth in the Spanish INfancia y Medio Ambiente (INMA) project. Here, we use temporally refined exposure estimates to explore the impact of narrow (weekly) windows of exposure on fetal growth. METHODS We included 1,685 women from INMA with serial ultrasounds at 12, 20, and 34 gestational weeks. We measured biparietal diameter (BPD), femur length, and abdominal circumference (AC) and from them calculated estimated fetal weight (EFW). We calculated z-scores describing trajectories of each parameter during early (0-12 weeks), mid (12-20 weeks), and late (20-34 weeks) pregnancy, based on longitudinal growth curves from mixed-effects models. We estimated weekly NO2 exposures at each woman's residence using land-use regression models. We applied distributed lag nonlinear models to identify sensitive windows of exposure. We present effect estimates as the percentage change in fetal growth per 10 μg/m3 increase in NO2 exposure, and we calculated cumulative effect estimates by aggregating estimates across adjacent lags. RESULTS We identified weeks 5-12 as a sensitive window for NO2 exposure on late EFW (cumulative β = -3.0%; 95% CI = -4.1%, -1.9%). We identified weeks 6-19 as a sensitive window for late growth in BPD (cumulative β = -2.0%; 95% CI = -2.7%, -1.4%) and weeks 8-13 for AC (cumulative β = -0.68%; 95% CI = -0.97%, -0.40%). We found suggestive evidence that third trimester NO2 exposure is associated with increased AC, BPD, and EFW growth in late pregnancy. CONCLUSIONS Our findings are consistent with the hypothesis that NO2 exposure is associated with alterations in growth of EFW, BPD, and AC dependent on the specific timing of exposure during gestation.
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Affiliation(s)
- Kristina W. Whitworth
- From the Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Alison Rector
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Jennifer Ish
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Southwest Center for Occupational and Environmental Health (SWCOEH), Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health in San Antonio, San Antonio, TX, USA
| | - Suneet P. J. Chauhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, UTHealth, Houston, Texas, USA
| | - Jesús Ibarluzea
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Biodonostia, Environmental Epidemiology and Child Development Group, San Sebastian, Spain
- Departamento de Salud del Gobierno Vasco, Subdirección de Salud Pública de Gipuzkoa, San Sebastián, Spain
- Faculty of Psychology, Universidad del País Vasco (UPV/EHU), San Sebastian, Spain
| | - Mònica Guxens
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- ISGlobal, Barcelona, Spain
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Michael D. Swartz
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Elaine Symanski
- From the Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Carmen Iñiguez
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Department of Statistics and Operational Research, Universitat de València, Spain
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12
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Shang L, Yang L, Yang W, Xie G, Wang R, Sun L, Xu M, Zhang B, Li J, Yue J, Chung MC. Prenatal exposure to air pollution and the risk of macrosomia: Identifying windows of susceptibility. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 818:151775. [PMID: 34808172 DOI: 10.1016/j.scitotenv.2021.151775] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/14/2021] [Accepted: 11/14/2021] [Indexed: 06/13/2023]
Abstract
This study explores the effects of prenatal exposure to air pollution on the risk of macrosomia and its window of susceptibility. We conducted a retrospective cohort study utilizing records of birth certificates for all full-term live newborns born in Xi'an city, China from January 1, 2015, to December 31, 2018.Weekly- and trimester-specific exposures of PM2.5, PM10, NO2, and O3 during pregnancy were calculated by inverse distance weighting (IDW) based on their residences. Cox proportional hazard model and distributed lag models (DLMs) were performed to estimate the effects of air pollution exposure during pregnancy on macrosomia risk and its window of susceptibility. In total, 318,323 full-term newborns were identified, including 24,996 (7.8%) cases of macrosomia. An IQR increase in PM2.5 exposure (45.46 μg/m3) from the 33rd until the 37th weeks of gestation was positively associated with an elevated risk of macrosomia, with the strongest effect in the 37th weeks (HR = 1.007, 95%CI: 1.002-1.013). The window of susceptibility for NO2 exposure on macrosomia risk was in the 29th-35th gestational weeks, with the strongest effect in the 34th weeks (IQR = 21.96 μg/m3, HR = 1.006, 95%CI:1.000-1.013). For prenatal exposure to O3, 5th-24th weeks of gestation was identified as susceptible windows for elevated risk of macrosomia, with the strongest associations observed in the 15th weeks (IQR = 80.53 μg/m3, HR = 1.022, 95%CI: 1.011-1.033). However, we did not observe any associations between weekly exposure of PM10 and macrosomia. Our findings imply that the windows of susceptibility to PM2.5 and NO2 exposure on macrosomia are mainly in late pregnancy, whereas the windows of susceptibility to O3 exposure are in early and middle pregnancy.
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Affiliation(s)
- Li Shang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China; Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong 518028, PR China
| | - Liren Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China.
| | - Guilan Xie
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Ruiqi Wang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Landi Sun
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Mengmeng Xu
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Boxing Zhang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Jing Li
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China
| | - Jie Yue
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, PR China
| | - Mei Chun Chung
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, MA, Boston, United States
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13
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Gong C, Wang J, Bai Z, Rich DQ, Zhang Y. Maternal exposure to ambient PM 2.5 and term birth weight: A systematic review and meta-analysis of effect estimates. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:150744. [PMID: 34619220 DOI: 10.1016/j.scitotenv.2021.150744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/18/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
Effect estimates of prenatal exposure to ambient PM2.5 on change in grams (β) of birth weight among term births (≥37 weeks of gestation; term birth weight, TBW) vary widely across studies. We present the first systematic review and meta-analysis of evidence regarding these associations. Sixty-two studies met the eligibility criteria for this review, and 31 studies were included in the meta-analysis. Random-effects meta-analysis was used to assess the quantitative relationships. Subgroup analyses were performed to gain insight into heterogeneity derived from exposure assessment methods (grouped by land use regression [LUR]-models, aerosol optical depth [AOD]-based models, interpolation/dispersion/Bayesian models, and data from monitoring stations), study regions, and concentrations of PM2.5 exposure. The overall pooled estimate involving 23,925,941 newborns showed that TBW was negatively associated with PM2.5 exposure (per 10 μg/m3 increment) during the entire pregnancy (β = -16.54 g), but with high heterogeneity (I2 = 95.6%). The effect estimate in the LUR-models subgroup (β = -16.77 g) was the closest to the overall estimate and with less heterogeneity (I2 = 18.3%) than in the other subgroups of AOD-based models (β = -41.58 g; I2 = 95.6%), interpolation/dispersion models (β = -10.78 g; I2 = 86.6%), and data from monitoring stations (β = -11.53 g; I2 = 97.3%). Even PM2.5 exposure levels of lower than 10 μg/m3 (the WHO air quality guideline value) had adverse effects on TBW. The LUR-models subgroup was the only subgroup that obtained similar significant of negative associations during the three trimesters as the overall trimester-specific analyses. In conclusion, TBW was negatively associated with maternal PM2.5 exposures during the entire pregnancy and each trimester. More studies based on relatively standardized exposure assessment methods need to be conducted to further understand the precise susceptible exposure time windows and potential mechanisms.
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Affiliation(s)
- Chen Gong
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Jianmei Wang
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhipeng Bai
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Yujuan Zhang
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China; State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China.
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14
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Correlation between Parturients' Uterine Artery Blood Flow Spectra in the First and Second Trimesters of Pregnancy and Fetal Growth Restriction. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:2129201. [PMID: 34950439 PMCID: PMC8692016 DOI: 10.1155/2021/2129201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/15/2021] [Indexed: 01/01/2023]
Abstract
Objective To explore the correlation between parturients' uterine artery blood flow spectra in the first and second trimesters of pregnancy and fetal growth restriction (FGR). Methods The data of parturients treated in our hospital from February 2018 to February 2020 were retrospectively analyzed, 50 parturients with FGR were selected as the FGR group, and other 50 healthy cases were selected as the control group. In the first trimester (11-12 weeks of gestation) and the second trimester of pregnancy (13–24 weeks of gestation), the parturients of the two groups accepted the color Doppler ultrasonography (CDS), their hemodynamics indicators of uterine artery were recorded, and the correlation between their uterine artery blood flow spectra in the two periods and FGR was analyzed with the Receiver Operating Characteristic (ROC) curve. Results No statistical differences in the parturients' general information including age, gestational weeks, gravidity, and parity between the two groups were observed (P > 0.05); the newborn's body weight, Apgar scores, number of preterm infants, and the number of infants transferring to the neonatal intensive care unit (NICU) were significantly different between the two groups (P < 0.05); in the first and second trimesters of pregnancy, the uterine artery pulsatility index (UtA-PI), uterine artery resistance index (UtA-RI), maximal systolic flow velocity, and systolic/diastolic (UtA-S/D) ratio were significantly higher in the FGR group than in the control group (P < 0.05), and the time-averaged maximal velocity (TAMX) was significantly lower in the FGR group than in the control group (P < 0.001); in early pregnancy, the incidence of early diastolic notch at bilateral uterine arteries between the two groups was not significantly different (P > 0.05), and the unilateral and total incidence in the first trimester as well as the unilateral, bilateral, and total incidence in the second trimester were significantly higher in the FGR group than in the control group (P < 0.05); in the first trimester, the sensitivity of detecting FGR with a uterine artery blood flow spectrum was 0.820, AUC (95% CI) = 0.840 (0.757–0.923), and in the second trimester, it was 0.860, AUC (95% CI) = 0.900 (0.832–0.968). Conclusion There is a correlation between uterine artery blood flow spectra in the first and second trimesters of pregnancy and FGR, and the sensitivity of spectrum in the first trimester is higher than that in the second trimester, presenting a better clinical application value.
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15
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Racial and Ethnic Disparities in Health Care and Health Outcomes for Pregnant Women With Diabetes. Nurs Womens Health 2021; 25:437-449. [PMID: 34634249 DOI: 10.1016/j.nwh.2021.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 08/14/2021] [Accepted: 09/21/2021] [Indexed: 11/20/2022]
Abstract
This article summarizes the current literature on racial and ethnic differences among women with diabetes in pregnancy. The PubMed, Scopus, CINAHL, and Embase databases were searched for original qualitative or quantitative studies published in English from January 1, 2009, to May 31, 2020. Consensus statements were excluded. Results of this synthesis indicate that racial and ethnic differences exist among pregnant women with diabetes, including social determinants of health, disparities in maternity care and perinatal care, and maternal and neonatal health outcomes. Health care providers should implement tailored interventions that specifically target racial and ethnic disparities in maternal and neonatal health to promote health equity in pregnant women with diabetes and their offspring, including later in life.
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16
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Liang Z, Xu C, Liang S, Cai TJ, Yang N, Li SD, Wang WT, Li YF, Wang D, Ji AL, Zhou LX, Liang ZQ. Short-term ambient nitrogen dioxide exposure is associated with increased risk of spontaneous abortion: A hospital-based study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 224:112633. [PMID: 34411816 DOI: 10.1016/j.ecoenv.2021.112633] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
There are increasing concerns with regard to spontaneous abortion (SAB), the loss of pregnancy without external intervention before 20 weeks of gestation, among reproductive-aged women. To date, limited evidence is available concerning the association between SAB and air pollutants, especially in developing countries. Daily baseline outpatient data for SAB from January 1, 2014, to December 31, 2018 (1826 days) were obtained in Chongqing, a metropolis of southwest China. The over-dispersed Poisson generalized additive model with control of meteorological conditions and day of week was used to estimate the short-term effects of ambient air pollution on the daily number of SAB outpatients. A total of 42,334 SAB outpatient visits for SAB were recorded. No statistically significant association was observed between SAB and CO, PM2.5, PM10, O3, and SO2. The positive association only appeared for NO2: positive associations between SAB and NO2 were observed in both single-day models (lag 0, lag 1, lag 3, and lag 4) and cumulative exposure models (lag 01, lag 03, and lag 05) and the most significant effects were observed at lag 05 (3.289%; 95% CI: 1.568%, 5.011%). Moreover, the women with higher ages (30-39 and > 39) were more sensitive than those with lower ages (18-29), and the effect estimates were more evident in cool seasons. Collectively, our results suggested that short-term NO2 exposure was associated with higher risk of SAB, especially in elder women and cool seasons, which may contribute to further understand the role of air pollution on SAB and other adverse obstetric outcomes.
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Affiliation(s)
- Zhen Liang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chen Xu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China; Department of Hepatobiliary Surgery, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - Shi Liang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Chemistry, Brigham Young University-Idaho, Rexburg, ID, USA
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China.
| | - Neng Yang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Si-Di Li
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wen-Ting Wang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dan Wang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Lai-Xin Zhou
- Medical Department, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhi-Qing Liang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
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Zhang J, Cheng H, Wang D, Zhu Y, Yang C, Shen Y, Yu J, Li Y, Xu S, Song X, Zhou Y, Chen J, Fan L, Jiang J, Wang C, Hao K. Revealing consensus gene pathways associated with respiratory functions and disrupted by PM2.5 nitrate exposure at bulk tissue and single cell resolution. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 280:116951. [PMID: 33780843 DOI: 10.1016/j.envpol.2021.116951] [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: 12/28/2020] [Revised: 02/28/2021] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Nitrate is a major pollutant component in ambient PM2.5. It is known that chronic exposure to PM2.5 NO3- damages respiratory functions. We aim to explore the underlying toxicological mechanism at single cell resolution. METHODS We systematically conducted exposure experiments on forty C57BL/6 mice, assessed respiratory functions, and profiled lung transcriptome. . Afterward, we estimated the cell type compositions from RNA-seq data using deconvolution analysis. The genes and pathways associated with respiratory function and dysregulated by to PM2.5 NO3- exposure were characterized at bulk-tissue and single-cell resolution. RESULTS PM2.5 NO3- exposure did not significantly modify the cell type composition in lung, but profoundly altered the gene expression within each cell type. At ambient concentration (22 μg/m3), exposure significantly (FDR<10%) altered 95 genes' expression. Among the genes associated with respiratory functions, a large fraction (74.6-91.7%) were significantly perturbed by PM2.5 NO3- exposure. For example, among the 764 genes associated with peak expiratory flow (PEF), 608 (79.6%) were affected by exposure (p = 1.92e-345). Pathways known to play role in lung disease pathogenesis, including circadian rhythms, sphingolipid metabolism, immune response and lysosome, were found significantly associated with respiratory functions and disrupted by PM2.5 NO3- exposure. CONCLUSIONS This study extended our knowledge of PM2.5 NO3- exposure's effect to the levels of lung gene expression, pathways, lung cell type composition and cell specific transcriptome. At single cell resolution, we provided insights in toxicological mechanism of PM2.5 NO3- exposure and subsequent pulmonary disease risks.
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Affiliation(s)
- Jushan Zhang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China; College of Environmental Science and Engineering, Tongji University, Shanghai, China
| | - Haoxiang Cheng
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dongbin Wang
- School of Environment, Tsinghua University, Beijing, China
| | - Yujie Zhu
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Chun Yang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yuan Shen
- Department of Psychiatry, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Jing Yu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaolian Song
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yang Zhou
- School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Jia Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lihong Fan
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Jingkun Jiang
- School of Environment, Tsinghua University, Beijing, China
| | - Changhui Wang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Ke Hao
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China; College of Environmental Science and Engineering, Tongji University, Shanghai, China; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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18
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Perception and Demands of Pregnant and Breastfeeding Women Regarding Their Role as Participants in Environmental Research Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084149. [PMID: 33919934 PMCID: PMC8070940 DOI: 10.3390/ijerph18084149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 11/17/2022]
Abstract
A significant proportion of scientific studies consider pregnant and breastfeeding women as vulnerable subjects. The objective of this study was to analyse the perception of pregnant and breastfeeding women regarding their participation in environmental research studies. Our work is a descriptive and interpretative observational study that has been developed under the qualitative research paradigm following a phenomenological and ethnographic perspective. The study involved 173 women selected intentionally in two Spanish autonomous communities. To obtain the primary data, we relied upon 111 interviews, four focused ethnographies and eight focus groups. The data encoding and analysis was carried out with the help of NVivo 12 software (QSR International, Boston, MA, USA). We evidenced the need of pregnant and breastfeeding women for more detailed and accurate information on the risk of environmental pollutant exposure during their crucial life stage. In addition, these women claimed for a more participatory role in research studies. Pregnant and breastfeeding women in Spain ask for greater interaction with researchers and propose a dialogical relationship between valid partners. We conclude that our pregnant and breastfeeding women claim more research focused on their collective, as well as clearer, more accessible and structured information on the risks of exposure to environmental contaminants. In addition, they do not want to simply be informants; rather, they ask to be active and empowered members by providing their opinions and arguments throughout the research process.
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19
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Vaginal Probiotics for Reproductive Health and Related Dysbiosis: Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10071461. [PMID: 33918150 PMCID: PMC8037567 DOI: 10.3390/jcm10071461] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 12/11/2022] Open
Abstract
The use of probiotics in reproductive-related dysbiosis is an area of continuous progress due to the growing interest from clinicians and patients suffering from recurrent reproductive microbiota disorders. An imbalance in the natural colonization sites related to reproductive health—vaginal, cervicovaginal, endometrial, and pregnancy-related altered microbiota—could play a decisive role in reproductive outcomes. Oral and vaginal administrations are in continuous discussion regarding the clinical effects pursued, but the oral route is used and studied more often despite the need for further transference to the colonization site. The aim of the present review was to retrieve the standardized protocols of vaginal probiotics commonly used for investigating their microbiota modulation capacities. Most of the studies selected focused on treating bacterial vaginosis (BV) as the most common dysbiosis; a few studies focused on vulvovaginal candidiasis (VVC) and on pretreatment during in vitro fertilization (IVF). Vaginal probiotic doses administered were similar to oral probiotics protocols, ranging from ≥107 CFU/day to 2.5 × 1010 CFU/day, but were highly variable regarding the treatment duration timing. Moderate vaginal microbiota modulation was achieved; the relative abundance of abnormal microbiota decreased and Lactobacillus species increased.
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20
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Zhang J, Cheng H, Wang D, Zhu Y, Yang C, Shen Y, Yu J, Li Y, Xu S, Zhang S, Song X, Zhou Y, Chen J, Jiang J, Fan L, Wang C, Hao K. Chronic Exposure to PM 2.5 Nitrate, Sulfate, and Ammonium Causes Respiratory System Impairments in Mice. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:3081-3090. [PMID: 33566583 DOI: 10.1021/acs.est.0c05814] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Water-soluble inorganic (WSI) ions are major components of ambient air PM2.5 (particulate matter of diameter ≤2.5 μm); however, their potential health effects are understudied. On C57BL/6 mice, we quantified the effect of three major PM2.5 WSIs (NO3-, SO42-, and NH4+) on respiratory systems. Exposure scenarios include different WSI types, concentrations, animal development stages (young vs adult), and sex. The exposure effects were comprehensively assessed, with special focus on the respiratory function and tissue/cell level changes. Chronic PM2.5 NO3- exposure produced significant respiratory function decline, mainly presented as airflow obstruction. The decline was more profound in young mice than in adult mice. In young mice, exposure to 22 μg/m3 PM2.5 NO3- reduced FEV0.05 (forced expiratory volume in 0.05 s) by 11.3% (p = 9.6 × 10-3) and increased pulmonary neutrophil infiltration by 7.9% (p = 7.1 × 10-3). Causality tests identified that neutrophil infiltration was involved in the biological mechanism underlying PM2.5 NO3- toxicity. In contrast, the effects of PM2.5 SO42- were considerably weaker than NO3-. PM2.5 NO3- exposure was 3.4 times more potent than PM2.5 SO42- in causing reduction of the peak expiratory flow. PM2.5 NH4+ exposure had no statistically significant effects on the respiratory function. In summary, this study provided strong evidence on the adverse impacts of PM2.5 WSIs, where the impacts were most profound in young mice exposed to PM2.5 NO3-. If confirmed in humans, toxicity of PM2.5 WSI will have broad implications in environment health and policy making.
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Affiliation(s)
- Jushan Zhang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
- College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China
| | - Haoxiang Cheng
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York 10029, New York, United States
| | - Dongbin Wang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Yujie Zhu
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Chun Yang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Yuan Shen
- Department of Psychiatry, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200092, China
| | - Jing Yu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200092, China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Shumin Zhang
- School of Pharmacy, Binzhou Medical University, Yantai 264003, Shandong, China
| | - Xiaolian Song
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Yang Zhou
- School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Jia Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York 10029, New York, United States
| | - Jingkun Jiang
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Lihong Fan
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Changhui Wang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Ke Hao
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
- College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York 10029, New York, United States
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