Associations between particulate matter composition and childhood blood pressure--The PIAMA study

Sex-specific associations between the environmental exposures and low-grade inflammation and increased blood pressure in young, healthy subjects

Long-term exposures to environmental factors including airborne as well as noise pollutants, are associated with cardiovascular risk. However, the influence of environmental pollution on the young population is controversial. Accordingly, we aimed to investigate the relationships between long-term exposures to different environmental factors and major cardiovascular and inflammatory parameters and biomarkers in young, healthy subjects. Representative sample of permanent residents of two cities differing in air and noise pollution levels, aged 15-21 years, were recruited. Krakow and Lublin, both located in southern Poland, were chosen in relation to their similarities in demographic and geopolitical characteristics, but differences in air pollution (higher in Krakow) and noise parameters (higher in Lublin). A total of 576 subjects were studied: 292 in Krakow and 284 in Lublin. All subjects underwent health questionnaire, blood pressure measurements and biomarker determinations. Inflammatory biomarkers, such as CRP, hs-CRP, fibrinogen as well as homocysteine were all significantly higher in subjects living in Krakow as opposed to subjects living in Lublin (for hsCRP: 0.52 (0.32-0.98) mg/l vs. 0.35 (0.22-0.67) mg/l; p < 0.001). Increased inflammatory biomarker levels were observed in Krakow in both male and female young adults. Interestingly, significant differences were observed in blood pressure between male and female subjects. Males from Krakow had significantly higher mean systolic blood pressure (127.7 ± 10.4 mm/Hg vs. 122.4 ± 13.0 mm/Hg; p = 0.001), pulse pressure (58.7 ± 8.9 mm/Hg vs. 51.4 ± 12.3 mm/Hg; p < 0.001) and lower heart rate (p < 0.001) as compared to males living in Lublin. This was not observed in young adult females. Long-term exposure to environmental factors related to the place of residence can significantly influence inflammatory and cardiovascular parameters, even in young individuals. Interestingly, among otherwise healthy young adults, blood pressure differences exhibited significant variations based on biological sex.

Associations between plasma metal/metalloid mixtures and the risk of central obesity: A prospective cohort study of Chinese adults

Central obesity has increased rapidly over the past decade and posed a substantial disease burden worldwide. Exposure to metals/metalloids has been acknowledged to be involved in the development of central obesity through regulation of cortisol, insulin resistance, and glucocorticoid receptor reduction. Despite the importance, it is lack of prospective study which comprehensively evaluate the relations between multiple metals exposure and central obesity. We explored the prospective associations of plasma metal concentrations with central obesity in a prospective study of the Dongfeng-Tongji cohort. The present study included 2127 participants with a 6.87-year mean follow-up duration. We measured 23 plasma metal/metalloid concentrations at baseline. The associations between metals and incident central obesity were examined utilizing the Cox proportional hazard regression in single and multiple metals models. Additionally, we applied elastic net (ENET), Bayesian kernel machine regression (BKMR), plasma metal score (PMS), and quantile-based g-computation (Qgcomp) models to explore the joint associations of metal mixtures with central obesity. After adjusting potential confounders, we found significant associations of plasma manganese (Mn) and thallium (Tl) concentrations with a higher risk of central obesity, whereas plasma rubidium (Rb) concentration was associated with a lower risk of central obesity both in single and multiple metals models (all FDR <0.05). The ENET and Qqcomp models verified similar metals (Mn, Rb, and Tl) as important predictors for central obesity. The results of both BKMR model and PMS suggested cumulative exposure to metal mixtures was associated with a higher risk of central obesity. Our findings suggested that co-exposure to metals was associated with a higher risk of central obesity. This study expands our knowledge that the management of metals/metalloids exposure may be beneficial for the prevention of new-onset central obesity, which may subsequently alleviate the disease burden of late-life health outcomes.

Associations between air pollutants and blood pressure in an ethnically diverse cohort of adolescents in London, England

Longitudinal evidence on the association between air pollution and blood pressure (BP) in adolescence is scarce. We explored this association in an ethnically diverse cohort of schoolchildren. Sex-stratified, linear random-effects modelling was used to examine how modelled residential exposure to annual average nitrogen dioxide (NO2), particulate matter (PM2.5, PM10) and ozone (O3), measures in μg/m3, associated with blood pressure. Estimates were based on 3,284 adolescents; 80% from ethnic minority groups, recruited from 51 schools, and followed up from 11-13 to 14-16 years old. Ethnic minorities were exposed to higher modelled annual average concentrations of pollution at residential postcode level than their White UK peers. A two-pollutant model (NO2 & PM2.5), adjusted for ethnicity, age, anthropometry, and pubertal status, highlighted associations with systolic, but not diastolic BP. A μg/m3 increase in NO2 was associated with a 0.30 mmHg (95% CI 0.18 to 0.40) decrease in systolic BP for girls and 0.19 mmHg (95% CI 0.07 to 0.31) decrease in systolic BP for boys. In contrast, a 1 μg/m3 increase in PM2.5 was associated with 1.34 mmHg (95% CI 0.85 to 1.82) increase in systolic BP for girls and 0.57 mmHg (95% CI 0.04 to 1.03) increase in systolic BP for boys. Associations did not vary by ethnicity, body size or socio-economic advantage. Associations were robust to adjustments for noise levels and lung function at 11-13 years. In summary, higher ambient levels of NO2 were associated with lower and PM2.5 with higher systolic BP across adolescence, with stronger associations for girls.

Association of Ambient Air Pollution with Blood Pressure in Adolescence: A Systematic-review and Meta-analysis

We systematically reviewed the association of ambient air pollution with blood pressure (BP) as a primary outcome in adolescents (10-19 years). Five databases (Ovid Medline, Ovid Embase, Web of Science, The Cochrane Library, and LILACS) were searched for relevant articles published up to August 2022. Meta-analyses were conducted using STATA v17 (Protocol - OSF Registries https://doi.org/10.17605/OSF.IO/96G5Q). Eight studies (5 cohort, 3 cross-sectional) with approximately 15,000 adolescents were included. Data from 6 studies were suitable for inclusion in the meta-analyses. In sub-group analyses, non-significant positive associations were observed for cohort studies assessing long-term exposure to PM₁₀, PM_2.5, and NO₂ on systolic and diastolic BP. At age 12 years old (3702 adolescents), we found significant positive associations for long-term exposure to PM_2.5(β=5.33 (1.56, 9.09) mmHg) and PM₁₀ (β=2.47 (0.10, 4.85) mmHg) on diastolic BP. Significant positive associations were observed (3,592 adolescents) for long-term exposure to PM₁₀(β=0.34 (0.19, 0.50) mmHg) and NO₂ on diastolic BP (β=0.40 (0.09, 0.71) mmHg), and PM₁₀ on systolic BP (β=0.48 (0.19, 0.77) mmHg). The overall quality of evidence analysed was graded as "low/very low." Insufficient data for short-term exposures to PM₂.₅, PM₁₀, NO₂, CO on BP led to their exclusion from the meta-analysis. Inconsistent associations were reported for gender-stratified results. The evidence, though of low-quality and limited, indicated that ambient air pollution was positively associated with adolescent BP. Future studies need improved measures of air pollutant exposures, consideration of gender and socio-economic circumstances on the observed pollution effects, as well as adjustment for other potential confounding factors.

Associations of fine particulate matter and its metal constituents with blood pressure: A panel study during the seventh World Military Games

Evidence is needed to elucidate the association of blood pressure (BP) changes with metal constituents in fine particulate matter (PM_2.5). Therefore, we designed a longitudinal panel study enrolling 70 healthy students from Wuhan University in the context of the seventh World Military Games (the 7th WMG) from September 2019 to January 2020. A total of eight visits were conducted before, during, and after the 7th WMG. During every visit, each participant was asked to carry a personal PM_2.5 monitor to measure hourly PM_2.5 levels for three consecutive days. Questionnaire investigation and physical examination were completed on the fourth day. We analyzed ten metal constituents of ambient PM_2.5 collected from the fixed station, and blood pressure was recorded during each visit. The linear mixed-effects models were performed to evaluate associations of metal constituents and blood pressure measurements. We observed a dramatic variation of PM_2.5 concentration ranging from 7.38 to 132.04 μg/m³. A 10 μg/m³ increment of PM_2.5 was associated with an increase of 0.64 mmHg (95% CI: 0.44, 0.84) in systolic BP (SBP), 0.40 mmHg (0.26, 0.54) in diastolic BP (DBP), 0.31 mmHg (0.15, 0.47) in pulse pressure (PP) and 0.44 mmHg (0.26, 0.62) in mean artery pressure (MAP), respectively. For metal constituents in PM_2.5, robust positive associations were observed between BP and selenium, manganese, arsenic, cadmium, and thallium. For example, for an IQR (0.93 ng/m³) increment of selenium, SBP and MAP elevated by 0.98 mmHg (0.09, 1.87) and 0.71 mmHg (0.03, 1.39), respectively. Aluminum was found to be robustly associated with decreased SBP, DBP, and MAP. The study indicated that exposure to PM_2.5 total mass and metal constituents including selenium, manganese, arsenic, cadmium, and thallium were associated with the elevated BP.

Life-course exposure to ambient fine particulate matter and hypertension in adulthood: a longitudinal cohort study

PM_2.5-hypertension association were well documented in adults, while the effects of life-course exposure to PM_2.5 on adulthood hypertension remained unclear. This study aimed to investigate the associations between life-course exposure to ambient PM_2.5 and incident hypertension in adulthood in Asia. We included 4272 participants with 17,814 medical visits from two open cohorts in Taiwan and Hong Kong between 2000 and 2018. We used a satellite-based model to assess 2-year average PM_2.5 exposure at a resolution of 1 km². A linear mixed model was used to examine the association with blood pressure. A Cox regression model with time-dependent covariates was used to examine the overall association with the development of hypertension in adulthood. Life-course mixed models were used to examine the effects of PM_2.5 exposure at different life stages on blood pressure and hypertension. For every 10 μg/m³ increase in PM_2.5, the overall risk of adulthood hypertension increased by 40% (95% confidence interval [CI] 8-80%). The health effects of PM_2.5 exposure at different life-stages on incident hypertension were generally independent of each other. In critical model, the risk of developing hypertension increased 23%, 27%, and 55% for each 10 μg/m³ increase in PM_2.5 exposure during school age, adolescence, and adulthood, respectively. Similar associations were found between life-course PM_2.5 exposure and blood pressure. Association between PM_2.5 and adulthood hypertension can be traced back to childhood. Our study suggests that life-course control of air pollution exposure should be implemented to alleviate the huge burden of adulthood hypertension.

Heme oxygenase-1 protects against PM2.5 induced endothelial dysfunction through inhibition of HIF1α

PM2.5 has been accepted as a strong risk factor for cardiovascular diseases. Activation of the renin-angiotensin system (RAS) has been proved to be a key factor in triggering vascular endothelial dysfunction upon PM2.5 exposure in our previous reports. In the current study, we observed the concurrent induction of hemoxygenase (HO)- 1 and RAS components (ANGII and AT1R) expression both in the vascular endothelial cell lines and in rat lung tissue after PM2.5 exposure. Furthermore, HO-1 inhibited RAS activation by suppressing the expression and activity of HIF1α, the upstream transcriptional activator of ANGII and AT1R. In addition, HO-1 blocked significantly increased the release of cell adhesion molecules and chemokines (VCAM-1, E-Selectin, P-Selectin, IL-8, MCP-1) that drive monocyte-endothelium adhesion, along with the enhanced the generation of oxidative stress response mediators in the vascular endothelium. These data together indicate that PM2.5 induced HO-1 upregulation functions as a self-defense response to antagonize endothelial dysfunction by inhibiting HIF1α-mediated RAS activation. Targeting endogenous protective pathway might be helpful to protect from PM2.5-induced cardiovascular injury.

Urban Fine Particulate Matter and Elements Associated with Subclinical Atherosclerosis in Adolescents and Young Adults

The relationships between the elemental constituents of PM_2.5 and atherosclerosis remain limited, especially in young populations. This study included 755 subjects aged 12-30 years in the Taipei metropolis. A land use regression model was used to estimate residential annual mean concentrations of PM_2.5 and eight elemental constituents. We evaluated the percent differences in carotid intima-media thickness (CIMT) with PM_2.5 and elemental constituent exposures by linear regressions. Interquartile range increments for PM_2.5 (4.5 μg/m³), sulfur (108.6 ng/m³), manganese (2.0 ng/m³), iron (34.5 ng/m³), copper (3.6 ng/m³), and zinc (20.7 ng/m³) were found to associate with 0.92% (95% confidence interval (CI): 0.17-1.66), 0.51% (0.02-1.00), 0.36% (0.05-0.67), 0.98% (0.15-1.82), 0.74% (0.01-1.48), and 1.20% (0.33-2.08) higher CIMTs, respectively. Factor analysis identified four air pollution source-related factors, and the factors interpreted as traffic and industry sources were associated with higher CIMTs. Stratified analyses showed the estimates were more evident in subjects who were ≥18 years old, females, or who had lower household income. Our study results provide new insight into the impacts of source-specific air pollution, and future research on source-specific air pollution effects in young populations, especially in vulnerable subpopulations, is warranted.

Long-term effects of PM2.5 components on blood pressure and hypertension in Chinese children and adolescents

Growing evidence has linked fine particulate matter (PM_2.5) exposure to elevated blood pressure, but the effects of PM_2.5 components are unclear, particularly in children and adolescents. Based on a cross-sectional investigation in China, we analyzed the associations between long-term exposure to PM_2.5 and its major components with elevated blood pressure in children and adolescents. A representative sample (N = 37,610) of children and adolescents with age 7-18 years was collected in seven Chinese provinces. Exposures to PM_2.5 and five of its major components, including black carbon (BC), organic matter (OM), inorganic nitrate (NO₃^-), sulfate (SO₄^2-), and soil particles (SOIL), were estimated using satellite-based spatiotemporal models. The associations between long-term exposures to PM_2.5 and its components and diastolic blood pressure (DBP), systolic blood pressure (SBP), and hypertension were investigated using mixed-effects logistic and linear regression models. Within the populations, 11.5 % were classified as hypertension. After adjusting for a variety of covariates, per interquartile range (IQR) increment in PM_2.5 mass and BC levels were significantly associated with a higher hypertension prevalence with odds ratios (ORs) of 1.56 (95% confidence interval (CI): 1.08, 2.25) for PM_2.5 and 1.19 (95% CI: 1.04, 1.35) for BC. Long-term exposures to PM_2.5 and BC have also been associated with elevated SBP and DBP. Additionally, OM and NO₃^- were significantly associated with increased SBP, while SOIL was significantly associated with increased DBP. In the subgroup analysis, the associations between long-term exposures to BC and blood pressure vary significantly by urbanicity of residential area and diet habits. Our study suggests that long-term exposure to PM_2.5 mass and specific PM_2.5 components, especially for BC, are significantly associated with elevated blood pressure and a higher hypertension prevalence in Chinese children and adolescents.

Percutaneous metals absorption following exposure to road dust powder

The skin constitutes a protective barrier to external physical and chemical aggressions. Although it is constantly exposed to various xenobiotics, it is generally considered poorly permeable to them, as for example metal ions, becoming unfortunately an entry route of such substances. Metals may penetrate inside the skin inducing more or less local effects such as skin sensitization and potential metals diffusion into the bloodstream. The objective of the study was to investigate the percutaneous penetration of metals in vitro - ex vivo in Franz cell with intact as well damaged skin applying a road dust powder. Moreover, porcine and human skins were compared. This study demonstrated that, after the application of a road dust powder on the skin, metals can penetrate and permeate this cutaneous membrane. From this experimental analysis, in intact skin lead (Pb) achieved the highest skin absorption in both human and porcine skin, while skin absorption profile of cobalt (Co) was the lowest in human skin than the one in porcine model. The concentrations of Ni present in receiving solution were higher compared to other metals in all experiments performed. The present work, definitely shows that metals permeation through damaged skin is accelerated than intact skin, as a result of the weaker cutaneous barrier function. According to published data, pig skin appeared as a suitable model for human skin. Our results confirmed that skin absorption of metals can be relevant in environmental exposures.

The impact of PM2.5 on children's blood pressure growth curves: A prospective cohort study

OBJECTIVE

The aim of this study was to explore the association between exposure to particulate matter with an aerodynamic diameter of 2.5 mm or less (PM2.5) and blood pressure (BP) levels in children and adolescents and to illustrate the impact of PM2.5 levels on BP growth curves in a cohort study.

METHODS

A longitudinal study was designed and included 4303 children (7617 BP measurements) living in the selected areas, and evaluations were conducted in 2014-2015 (visit 1) and followed up in 2019 (visit 2). Two-stage stratified cluster sampling was used to include urban-rural areas. A mixed linear regression model and mixed logistic regression model were used to analyze the effect of PM2.5 exposure on BP and the incidence of prehypertension and hypertension in children.

RESULTS

After adjusting for covariates, systolic blood pressure (SBP) (2.21 (95% CIs: 0. 81, 3.62), mmHg), diastolic blood pressure (DBP) (1.92 (95% CIs: 0.74, 3.11), mmHg), mean arterial pressure (MAP) (2.03 (95% CIs: 0.89, 3.17), mmHg) and heart rate (HR) (2.24 (95% CIs: 0.11, 4.37), beats/min) increased significantly in the fourth quartile of PM2.5 exposure levels compared with the first quartile (all P < 0.01). In addition, long-term exposure to PM2.5 was significantly positively correlated with SBP, DBP and MAP, and the effect was more notable in urban areas than that in rural areas. Moreover, the risk of prehypertension and hypertension incidence increased by 1.17 (95% CIs: 1.03, 1.33) fold with a one-quartile increase in PM2.5 exposure. The long-term effects of annual mean PM2.5 exposure on SBP, DBP and MAP were significant from pregnancy to 7, 3 and 4 years of age, respectively.

CONCLUSION

Long-term exposure to PM2.5 was positively associated with growth curves of hemodynamics indexed from pregnancy to childhood and adolescence, and the effect was more significant in urban areas than in rural areas.

Association between ambient particulate matter exposure and metabolic syndrome risk: A systematic review and meta-analysis

Although the association between ambient particulate matter and metabolic syndrome (MetS) has been investigated, the effect of particulate matter (PM) on MetS is inconclusive. We conducted a systematic review and meta-analysis to study the association between long-term ambient PM exposure and MetS risk. The data from five databases were extracted to analyze the association between ambient PM exposure and MetS risk. A random-effects model was performed to estimate the overall risk effect. The present systematic review and meta-analysis illustrated that an increase of 5 μg/m³ in annual PM_2.5 or PM₁₀ concentration was associated with 14% or 9% increases of MetS risk, respectively (PM_2.5, RR = 1.14, 95%CI [1.03, 1.25]; PM₁₀, RR = 1.09, 95%CI [1.00, 1.19]). The population-attributable risk (PAR) was 12.28% for PM_2.5 exposure or 8.26% for PM₁₀ exposure, respectively. There was statistical association between PM_2.5 exposure and risk of MetS in male proportion ≥50%, Asia, related disease or medication non-adjustment subgroup as well as cohort study subgroups, respectively. The significant association between PM₁₀ exposure and risk of MetS was observed in male proportion ≥50% and calories intake adjustment subgroups, respectively. Sensitivity analyses showed the robustness of our results. No publication bias was detected. In conclusion, there was positive association between long-term PM exposure and MetS risk. 12.28% of MetS risk could be attributable to PM_2.5 exposure.

Air pollution-associated blood pressure may be modified by diet among children in Guangzhou, China

OBJECTIVES

To assess the associations between long-term air pollution exposure and blood pressure in children, and to explore the modifying effects of diet on prehypertension and hypertension.

METHODS

We evaluated 7225 primary school children aged 6-12 years from Guangzhou, China, in 2017. The blood pressure was measured objectively. The individual 1-year average concentration of particles with an aerodynamic diameter of 2.5 μm or less or 10 μm or less (PM2.5, PM10), sulfur dioxide (SO2), and ozone (O3) before each blood pressure measurement were calculated by inverse distance weighting interpolation according to each home address. Generalized linear mixed-effects models were used to examine the health effects and potential effect modifications by diet factors after adjusting for covariates.

RESULTS

The results showed that the estimated increase in mean SBP was 0.92 mmHg (95% CI 0.05-1.79) per interquartile range increase in O3. An interquartile range increase in the 1-year mean of SO2 and O3 was associated with odds ratios of 1.26 (95% CI 1.04-1.52) and 1.20 (95% CI 1.06-1.35) for prehypertension, respectively. In addition, an interquartile range increase in PM2.5, SO2, and O3 exposure was positively associated with hypertension, with odds ratios of 1.33 (95% CI 1.11-1.61), 1.70 (95% CI 1.33-2.16), and 1.48 (95% CI 1.20-1.83), respectively. Stronger effect estimates between PM2.5, SO2, and O3 concentration on prehypertension were exhibited among subgroups of children with a higher intake of sugar-sweetened beverages.

CONCLUSION

Long-term exposure to PM2.5, SO2, and O3 were associated with higher blood pressure levels in children, and dietary intake might modify these associations.

Effects of Ambient Air Pollution on Blood Pressure Among Children and Adolescents: A Systematic Review and Meta-Analysis

Background

Previous studies have investigated the association of ambient air pollution with blood pressure (BP) in children and adolescents, however, the results are not consistent. We conducted a systematic review and meta‐analysis to assess the relationship between short‐term and long‐term ambient air pollutant exposure with BP values among children and adolescents.

Methods and Results

We searched PubMed, Web of Science, and Embase before September 6, 2020. Two reviewers independently searched and selected studies, extracted data, and assessed study quality. The studies were divided into groups by composition of air pollutants (NO₂, particulate matter (PM) with diameter ≤10 μm or ≤2.5 μm) and length of exposure. The beta regression coefficients (β) and their 95% CIs were calculated to evaluate the strength of the effect with each 10 μg/m³ increase in air pollutants. Out of 36 650 articles, 14 articles were included in this meta‐analysis. The meta‐analysis showed short‐term exposure to PM with diameter ≤10 μm (β=0.267; 95% CI, 0.033‒0.501) was significantly associated with elevated systolic BP values. In addition, long‐term exposure to PM with diameter ≤2.5 μm (β=1.809; 95% CI, 0.962‒2.655), PM with diameter ≤10 μm (β=0.526; 95% CI, 0.095‒0.958), and NO₂ (β=0.754; 95% CI, 0.541‒0.968) were associated with systolic BP values and long‐term exposure to PM with diameter ≤2.5 μm (β=0.931; 95% CI, 0.157‒1.705), and PM with diameter ≤10 μm (β=0.378; 95% CI, 0.022‒0.735) was associated with diastolic BP.

Conclusions

Our study indicates that both short‐term and long‐term exposure to some ambient air pollutants may increase BP values among children and adolescents.

Exposure to metal mixtures in relation to blood pressure among children 5-7 years old: An observational study in Bangladesh

Hypertension in later life, a significant risk factor for cardiovascular disease, has been linked to elevated blood pressure in early life. Exposure to metals may influence childhood blood pressure; however, previous research is limited and has mainly focused on evaluating the toxicity of single metal exposures. This study evaluates the associations between exposure to metal mixtures and blood pressure among Bangladeshi children age 5-7 years.

METHODS

We investigated the associations of 17 toenail metal concentrations with blood pressure using linear regression models. Principal component analysis (PCA), weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were conducted as secondary analyses.

RESULTS

Associations were observed for selenium with diastolic blood pressure (per doubling of exposure β = 2.91, 95% confidence interval [CI] = 1.08, 4.75), molybdenum with systolic (β = 0.33, 95% CI = 0.05, 0.61) and diastolic blood pressure (β = 0.39, 95% CI = 0.12, 0.66), tin with systolic blood pressure (β = -0.33, 95% CI = -0.60, -0.06), and mercury with systolic (β = -0.83, 95% CI = -1.49, -0.17) and diastolic blood pressure (β = -0.89, 95% CI = -1.53, -0.26). Chromium was associated with diastolic blood pressure among boys only (β = 1.10, 95% CI = 0.28, 1.92, P for interaction = 0.02), and copper was associated with diastolic blood pressure among girls only (β = -1.97, 95% CI = -3.63, -0.32, P for interaction = 0.01). These findings were largely robust to the secondary analyses that utilized mixture modeling approaches (PCA, WQS, and BKMR).

CONCLUSIONS

Future prospective studies are needed to investigate further the impact of early life exposure to metal mixtures on children's blood pressure trajectories and cardiovascular disease risk later in life.

Associations of Pre- and Postnatal Air Pollution Exposures with Child Blood Pressure and Modification by Maternal Nutrition: A Prospective Study in the CANDLE Cohort

BACKGROUND

Limited data suggest air pollution exposures may contribute to pediatric high blood pressure (HBP), a known predictor of adult cardiovascular diseases.

METHODS

We investigated this association in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study, a sociodemographically diverse pregnancy cohort in the southern United States with participants enrolled from 2006 to 2011. We included 822 mother-child dyads with available address histories and a valid child blood pressure measurement at 4-6 y. Systolic (SBP) and diastolic blood pressures (DBP) were converted to age-, sex-, and height-specific percentiles for normal-weight U.S. children. HBP was classified based on SBP or DBP ≥ 90 th percentile. Nitrogen dioxide (NO 2 ) and particulate matter ≤ 2.5 μ m in aerodynamic diameter (PM 2.5 ) estimates in both pre- and postnatal windows were obtained from annual national models and spatiotemporal models, respectively. We fit multivariate Linear and Poisson regressions and explored multiplicative joint effects with maternal nutrition, child sex, and maternal race using interaction terms.

RESULTS

Mean PM 2.5 and NO 2 in the prenatal period were 10.8 [standard deviation (SD): 0.9] μ g / m 3 and 10.0 (SD: 2.4) ppb, respectively, and 9.9 (SD: 0.6) μ g / m 3 and 8.8 (SD: 1.9) ppb from birth to the 4-y-old birthday. On average, SBP percentile increased by 14.6 (95% CI: 4.6, 24.6), and DBP percentile increased by 8.7 (95% CI: 1.4, 15.9) with each 2 - μ g / m 3 increase in second-trimester PM 2.5 . PM 2.5 averaged over the prenatal period was only significantly associated with higher DBP percentiles [β = 11.6 (95% CI: 2.9, 20.2)]. Positive associations of second-trimester PM 2.5 with SBP and DBP percentiles were stronger in children with maternal folate concentrations in the lowest quartile (p interaction = 0.05 and 0.07, respectively) and associations with DBP percentiles were stronger in female children (p interaction = 0.05). We did not detect significant association of NO 2 , road proximity, and postnatal PM 2.5 with any outcomes.

CONCLUSIONS

The findings suggest that higher prenatal PM 2.5 exposure, particularly in the second trimester, is associated with elevated early childhood blood pressure. This adverse association could be modified by pregnancy folate concentrations. https://doi.org/10.1289/EHP7486.

Internal metal(loid)s are potentially involved in the association between ambient fine particulate matter and blood pressure: A repeated-measurement study in north China

The effects of ambient fine particulate matter (PM_2.5) exposure on blood pressure have been widely reported. However, there remains uncertainty regarding the underlying roles of particulate matter components. We aimed to investigate the association between ambient PM_2.5 exposure and blood pressure, as well as the potential effects of trace metal(loid)s, in a repeated-measurement study that enrolled women of childbearing age. Our study included 35 participants from Hebei Province, China, each of whom was visited for five times. During each visit, we conducted questionnaire surveys, measured blood pressure, and collected blood. The daily PM_2.5 exposure of participants was estimated according to their residential addresses using a spatiotemporal model that combined monitoring data with satellite measurements and chemical-transport model simulations. This model was used to calculate average PM_2.5 concentrations in 1, 3, 7, 15, 30, and 60 days prior to each visit. Serum concentrations of various trace metal(loid)s were measured. A linear mixed-effects model was used to investigate associations among study variables. Overall, the mean (standard deviation) 60 days PM_2.5 concentration over all five visits was 108.1(43.3) μg/m³. PM_2.5 concentration was positively associated with both systolic and diastolic blood pressures. Likewise, ambient PM_2.5 concentration was positively associated with serum concentrations of manganese and arsenic, and negatively associated with serum concentrations of nickel, tin, and chromium. Only the serum concentration of molybdenum was negatively associated with systolic blood pressure. We concluded that ambient PM_2.5 exposure may contribute to elevated blood pressure, potentially by interfering with internal intake of various metal(loid)s in the human body.

The association between serum copper concentrations and elevated blood pressure in US children and adolescents: National Health and Nutrition Examination Survey 2011-2016

BACKGROUND

Copper is an essential trace metal with potential interest for cardiovascular effects. Few studies have explored the association between copper and blood pressure in children and adolescents.

METHOD

We conducted a cross-sectional analysis of 1242 children and adolescents aged 8-17 years who participated in the 2011 to 2016 National Health and Nutrition Examination Survey. Using 2017 American Academy of Pediatrics guidelines, elevated blood pressure (EBP) was defined as a mean systolic and/or diastolic blood pressure (BP) ≥ 90th percentile for sex, age, and height for children aged 1-12 years and systolic BP ≥ 120 mmHg or diastolic BP ≥ 80 mmHg for adolescent age 13-17 years. Mean serum copper was 114.17 μg/dL.

RESULTS

After multiple adjustments, dose-response analyses revealed that EBP was associated with progressively higher serum copper concentrations in a nonlinear trend. In comparison with the lowest quartile of serum copper concentrations, the adjusted odds of EBP for the highest quartile was 5.26 (95% confidence interval, 2.76-10.03).

CONCLUSION

Our results suggested that high serum copper concentrations were significantly associated with EBP in US children and adolescents.

Factors Associated with Primary Hypertension in Pediatric Patients: An Up-to-Date

BACKGROUND

Arterial hypertension in children is considered a common alteration nowadays, mainly because obesity is a growing worldwide problem closely related to increased blood pressure. Childhood hypertension can be classified as primary or secondary, depending on the etiology. Primary or essential hypertension still has its pathophysiology not fully elucidated, and there is no consensus in the literature on most underlying mechanisms. In this review, genetic and environmental factors, including sodium and potassium intake, socioeconomic status, ethnicity, family structure, obesity, sedentary lifestyle, prematurity and low birth weight, prenatal and postnatal exposures are highlighted.

OBJECTIVE

The present study aimed to perform an update on primary hypertension in childhood, providing clinicians and researchers an overview of the current state of the literature regarding the influence of genetic and environmental factors.

METHODS

This integrative review searched for articles on genetic and environmental factors related to primary hypertension in pediatric patients. The databases evaluated were PubMed and Scopus.

RESULTS

The studies have provided insights regarding many genetic and environmental factors, in addition to their association with the pathophysiology of primary hypertension in childhood. Findings corroborated the idea that primary hypertension is a multifactorial disease. Further studies in the pediatric population are needed to elucidate the underlying mechanisms.

CONCLUSION

The study of primary hypertension in pediatrics has utmost importance for the adoption of preventive measures and the development of more efficient treatments, therefore reducing childhood morbidity and the incidence of cardiovascular diseases and other health consequences later in life.

Urban environment during early-life and blood pressure in young children

BACKGROUND

The urban environment is characterised by many exposures that may influence hypertension development from early life onwards, but there is no systematic evaluation of their impact on child blood pressure (BP).

METHODS

Systolic and diastolic blood pressure were measured in 4,279 children aged 4-5 years from a multi-centre European cohort (France, Greece, Spain, and UK). Urban environment exposures were estimated during pregnancy and childhood, including air pollution, built environment, natural spaces, traffic, noise, meteorology, and socioeconomic deprivation index. Single- and multiple-exposure linear regression models and a cluster analysis were carried out.

RESULTS

In multiple exposure models, higher child BP, in particular diastolic BP, was observed in association with higher exposure to air pollution, noise and ambient temperature during pregnancy, and with higher exposure to air pollution and higher building density during childhood (e.g., mean change [95% confidence interval] for an interquartile range increase in prenatal NO₂ = 0.7 mmHg[0.3;1.2]). Lower BP was observed in association with higher temperature and better street connectivity during childhood (e.g., temperature = -1.1[-1.6;-0.6]). Some of these associations were not robust in the sensitivity analyses. Mother-child pairs were grouped into six urban environment exposure clusters. Compared to the cluster representing the least harmful urban environment, the two clusters representing the most harmful environment (high in air pollution, traffic, noise, and low in green space) were both associated with higher diastolic BP (1.3[0.1;2.6] and 1.5[0.5;2.5]).

CONCLUSION

This first large systematic study suggests that living in a harmful urban environment may impact BP regulation in children. These findings reinforce the importance of designing cities that promote healthy environments to reduce long-term risk of hypertension and other cardiovascular diseases.

Ambient Particle Components and Newborn Blood Pressure in Project Viva

Background

Both elemental metals and particulate air pollution have been reported to influence adult blood pressure (BP). The aim of this study is to examine which elemental components of particle mass with diameter ≤2.5 μm (PM_2.5) are responsible for previously reported associations between PM_2.5 and neonatal BP.

Methods and Results

We studied 1131 mother‐infant pairs in Project Viva, a Boston‐area prebirth cohort. We measured systolic BP (SBP) and diastolic BP (DBP) at a mean age of 30 hours. We calculated average exposures during the 2 to 7 days before birth for the PM_2.5 components—aluminum, arsenic, bromine, sulfur, copper, iron, zinc, nickel, vanadium, titanium, magnesium, potassium, silicon, sodium, chlorine, calcium, and lead—measured at the Harvard supersite. Adjusting for covariates and PM_2.5, we applied regression models to examine associations between PM_2.5 components and median SBP and DBP, and used variable selection methods to select which components were more strongly associated with each BP outcome. We found consistent results with higher nickel associated with significantly higher SBP and DBP, and higher zinc associated with lower SBP and DBP. For an interquartile range increase in the log Z score (1.4) of nickel, we found a 1.78 mm Hg (95% CI, 0.72–2.84) increase in SBP and a 1.30 (95% CI, 0.54–2.06) increase in DBP. Increased zinc (interquartile range log Z score 1.2) was associated with decreased SBP (−1.29 mm Hg; 95% CI, −2.09 to −0.50) and DBP (−0.85 mm Hg; 95% CI: −1.42 to −0.29).

Conclusions

Our findings suggest that prenatal exposures to particulate matter components, and particularly nickel, may increase newborn BP.

Utilization of road dust chemical profiles for source identification and human health impact assessment

This study investigated the chemical profiles of fine urban road dust as a set of indicators for major air pollutants at sampling sites or as proxies for potential human health impacts. We examined the chemical compositions of fine particles (< 100 μm) or re-suspended ultrafine particles (< 2.5 μm) in the urban road dust collected from the cities with major emission sources of CO, NH₃, NO_x, PM_2.5, SO_x, and volatile organic compounds. The elemental compositions, including metal contents and volatile or semi-volatile organic compound species were determined to constitute comprehensive chemical profiles of the solid road dust samples. The water-extractable organic compounds and fluorescent species of the size-fractionated re-suspended fine particulate matter (RPM) were also incorporated in the chemical profiles. The metal content and aliphatic hydrocarbons could partly distinguish emission sources, and clearer distinctions were achieved with the inclusion of fluorescence excitation-emission matrix (EEM) results. The dose–response test results showed positive correlations between cytotoxicity and relative abundance of hydrocarbons or metal contents of urban road dust. The set of chemical profiles suggested in this study could be further utilized for site identification or human health impact assessment using urban road dust.

Latin American Consensus on the management of hypertension in the patient with diabetes and the metabolic syndrome

: The prevalence of hypertension, type 2 diabetes mellitus (DM2) and the metabolic syndrome continues to increase in Latin America, while the rates of diagnosis, treatment and control of these disorders remain low. The frequency of the risk factors that constitute the metabolic syndrome and are associated with an increased risk of cardiovascular disease has not diminished since the publication of the previous consensus. This document discusses the socioeconomic, demographic, environmental and cultural characteristics of most associated Latin American countries and partially explains the lack of better results in improving clinical and public health actions that allow high morbidity and mortality rates caused by cardiovascular diseases and DM2 to be reduced through programs aligned with the so-called precision medicine, which should be predictive, preventive, personalized and participatory. The Consensus ratifies the diagnostic criteria expressed in the previous consensus to define hypertension and DM2 but, for the metabolic syndrome, and in the absence of evidence, the recommendation is to implement a cohort study that determines the abdominal perimeter value associated with hard outcomes, such as DM2 and CVD. Meanwhile, we recommend modifying the criterion to more than 94 cm in men and more than 84 cm in women according to WHO recommendations. We also recommend the carrying out of a study that identifies the situation of hypertension and DM2 in people of African ancestry who, in Latin America, exceed 75 million and whose epidemiology does not include solid studies. With respect to the proposed therapeutic targets, we recommended maintaining those defined in the previous consensus, but insisting that early pharmacological management of prediabetes with metformin should be introduced, as should the treatment of diabetic hypertensive patients with a combination therapy of two fixed-dose antihypertensive drugs and management with statins. To increase adherence, the use of different drugs combined in a single pill (polypill) is recommended. The simplification of the therapeutic regimen is accompanied by greater control of cardiovascular risk factors, both in primary and secondary prevention, and has been shown to be cost-effective. The consensus recommends the use of the currently available polypill combining an angiotensin-converting enzyme inhibitor, a statin and aspirin for secondary cardiovascular prevention and in patients with a high cardiovascular risk, such as hypertension patients with DM2.

Association of urinary metal concentrations with blood pressure and serum hormones in Spanish male adolescents

OBJECTIVE

To examine the association of urinary concentrations of arsenic (As), cadmium (Cd), mercury (Hg), nickel (Ni), lead (Pb), manganese (Mn), and chromium (Cr) with blood pressure (BP) and serum hormone levels in male adolescents.

METHODS

Participants were selected from the INMA (Environment and Childhood)-Granada cohort at their follow-up visit when aged 15-17 years. Metal concentrations were measured in urine samples using inductively coupled plasma mass spectrometry. Outcomes were BP measurements (systolic, diastolic, and pulse pressure) recorded during the visit and concurrent serum levels of thyroid hormones, sex hormones, and adrenal hormones. Associations were assessed by regression analysis in a sub-sample of 133 boys with available data on urinary metals, outcomes, and relevant covariates.

RESULTS

Models simultaneously adjusted for all metals and other potential confounders showed that urinary As and Cd were both associated with slight elevations in systolic BP (0.70 mmHg, 95%CI = 0.11; 1.29 and 1.47, 95%CI = 0.30; 2.63, respectively, per each 50% increase in metal concentrations), and urinary As was also associated with an increased risk of elevated systolic BP (≥120 mmHg) (OR = 1.28, 95%CI = 1.04; 1.56). The presence of detectable levels of 4 and 5 versus 2-3 non-essential metals (As, Cd, Hg, Ni, Pb) per boy was associated with elevations in systolic BP of 5.84 mmHg (95%CI = 0.40; 11.3) and 7.01 mmHg (95%CI = 1.01; 13.0), respectively (p-trend = 0.05). Significant associations were also found between Hg and increased testosterone and luteinizing hormone (LH) and decreased thyroid-stimulating hormone (TSH); between the combination of As and Hg and increased LH and insulin-like growth factor 1; between Cr and decreased TSH; and between Cd and increased adrenocorticotropic hormone.

CONCLUSIONS

These findings suggest that combined exposure to toxic metals, especially As and Cd, may contribute to BP elevation in male adolescents and that exposure to Hg, As, Cd, and Cr may affect their hormone levels.

Comparative analysis of urban road dust compositions in relation to their potential human health impacts

This study investigated the chemical components of fine urban road dust from seven sampling sites, based on which we could predict potential human health effects. The elemental compositions, including the contents of metals and volatile or semivolatile organic compounds, were determined to establish comprehensive chemical profiles of solid road dust. The chemical profiles, consisting of C: H ratio, metal contents, and relative abundances of organic compounds, provided a chemical signature for road dust. To overall cytotoxicity values ranging between 7 and 58%, water extracts contributed less than 15%, and cell death mainly occurred via direct contact with solid-phase components, which possibly indicates that the selected chemical profile of solid-phase road dust components could serve as a strong predictor for BJ and WI-38 cytotoxicity. Pure metal oxides (Cr₂O₃, CuO, Fe₂O₃, MnO₂, NiO, or ZnO) exhibited a positive dose-response, and the corresponding metal contents in solid road dust were well correlated with cell viability. The principal component analysis (PCA) results suggested that the metal contents were stronger predictors of cytotoxicity than the benzene derivative or hydrocarbon contents. The chemical profiles established in this study could be further utilized to identify candidate health hazard factors in road dust.

Seasonality of airborne trace element sources in Aracaju, Northeastern, Brazil

In this work the urban area of Aracaju city, located in the State of Sergipe, Northeastern Brazil was the site for simultaneous collection of suspended particles (TSP) and inhalable particulate matter (PM₁₀) aiming an evaluation of the air quality parameters. Concentrations of Cd, Co, Cu, Fe, Mn, Ni, Pb and V in TSP and PM₁₀ were determined by inductively coupled plasma mass spectrometry (ICP-MS). Iron was the most abundant element found in both particulate samples. Through chemometric tools, it was possible to point out that the contributions to the TSP and PM₁₀ formation are similar, and strong correlations were observed between Fe-Mn (0.83) and Cd-Pb (0.93) in TSP, and Fe-Mn (0.90), Fe-Cu (0.81) and Cd-Pb (0.97) in PM₁₀, an evidence that these species are from sources related mainly to soil resuspension and vehicular traffic. Enrichment factor (EF) and geoaccumulation index (I_geo) showed an influence of fossil fuel burning in the composition of TSP and PM₁₀. Through principal component analysis (PCA) and hierarchical cluster analysis (HCA) it was observed particle size distribution groupings according to its aerodynamic size. Evaluation of the concentrations obtained for the collected samples according to the seasons (dry and rainy), indicated the influence of both, biogenic (resuspension of soil and marine aerosols) and anthropic (vehicle traffic and biomass burning) sources.

Association of School Residential PM2.5 with Childhood High Blood Pressure: Results from an Observational Study in 6 Cities in China

OBJECTIVE

To investigate the association of long-term PM_2.5 exposure with blood pressure (BP) outcomes in children aged 6-18 years, and to examine the population attributable risk (PAR) of PM_2.5 exposure.

METHODS

A total of 53,289 participants aged 6-18 years with full record of age, sex, BP, height, and local PM_2.5 exposure from a cross-sectional survey conducted in 6 cities of China in 2013 were involved in the present study. PM_2.5 data from 18 January 2013 to 31 December 2013 were obtained from the nearest environmental monitoring station for each selected school. Two-level linear and logistic regression models were used to evaluate the influence of PM_2.5 on children's BP, and PAR was calculated in each sex and age group.

RESULTS

Participants had a mean age of 10.8 (standard deviation: 3.4) years at enrollment, 51.7% of them were boys. U-shaped trends along with increased PM_2.5 concentration were found for both systolic blood pressure (SBP) and diastolic blood pressure (DBP), with the thresholds of 57.8 and 65.0 μg/m³, respectively. Both increased annual mean of PM_2.5 concentration and ratio of polluted days were associated with increased BP levels and high blood pressure (HBP), with effect estimates for BP ranging from 2.80 (95% CI: -0.51, 6.11) mmHg to 5.78 (95% CI: 2.32, 9.25) mmHg for SBP and from 0.77 (95% CI: -1.98, 3.52) mmHg to 2.66 (-0.35, 5.66) mmHg for DBP, and the odds ratios for HBP from 1.21 (0.43, 3.38) to 1.92 (0.65, 5.67) in the highest vs. the lowest quartiles. Overall, 1.16% of HBP in our participants could be attributed to increased annual mean of PM_2.5 concentration, while 2.82% could be attributed to increased ratio of polluted days. These proportions increased with age.

CONCLUSIONS

The association between long-term PM_2.5 exposure and BP values appeared to be U-shaped in Chinese children aged 6-18 years, and increased PM_2.5 exposure was associated with higher risk of HBP.

Exposure to ambient particulate matter air pollution, blood pressure and hypertension in children and adolescents: A national cross-sectional study in China

BACKGROUND

Air pollution has been associated with elevated blood pressure in adults. However, epidemiological evidence from children and adolescents is limited. We investigated the associations between long-term exposure to particulate matter (PM) air pollution and blood pressure in a large population of children and adolescents.

METHODS

A cross-sectional analysis was performed in a nationally representative sample consisting of 43,745 children and adolescents aged 7 to 18 years in seven provinces in China. Exposure to ambient fine particles (PM_2.5) and thoracic particles (PM₁₀) was estimated using spatiotemporal models based on satellite remote sensing, meteorological data and land use information. Mixed-effects (two-level) linear and logistic regression models were used to investigate the associations between PM exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension.

RESULTS

After adjustment for a wide range of covariates, every 10 μg/m³ increment in PM_2.5 and PM₁₀ concentration was associated with 1.46 [95% confidence interval (CI): 0.05, 2.88] and 1.36 (95% CI: 0.34, 2.39) mmHg increases in SBP, respectively. PM₁₀ was also associated with higher prevalence of hypertension [odds ratio per 10 μg/m³ increment: 1.45 (95% CI: 1.07, 1.95)].

CONCLUSIONS

Long-term exposure to ambient PM air pollution was associated with increased blood pressure and higher prevalence of hypertension in children and adolescents. Our findings support air pollution reduction strategies as a prevention measure of childhood hypertension, a well-recognized risk factor of future cardiovascular health.

Different health effects of indoor- and outdoor-originated PM2.5 on cardiopulmonary function in COPD patients and healthy elderly adults

Numerous research has explored the associations of outdoor or indoor fine particulate matter (PM_2.5 ) and health effects; however, few studies compared the effects of indoor PM_2.5 originated from outdoor (PM_2.5,os ) and indoor sources (PM_2.5,is ). To assess the associations of PM_2.5,os and PM_2.5,is with cardiopulmonary function in patients with chronic obstructive pulmonary disease (COPD) and healthy elderly adults, blood pressure (BP) and pulmonary function were repeatedly examined in 43 COPD patients and their 32 healthy spouses in Beijing, China. Iron was used as tracer element to separate PM_2.5,os and PM_2.5,is . Mixed-effects models were applied to assess the associations of PM_2.5,os or PM_2.5,is and health effects after controlling for potential confounders. There was a reduction in forced expiratory volume in first second (FEV₁ ) in COPD patients associated with PM_2.5,is during the heating season. PM_2.5,os was positively associated with diastolic BP (DBP) in healthy elderly adults during the heating season. There was a reduction in peak expiratory flow (PEF) in healthy elderly adults associated with PM_2.5,os during the non-heating season. Exposure to indoor- and outdoor-originated PM_2.5 had different health effects on cardiopulmonary function in different populations. The results provide supporting evidence for improving indoor air quality to promote public health among susceptible population.

A real time QSAR-driven toxicity evaluation and monitoring of iron containing fine particulate matters in indoor subway stations

A fine particulate matter less than 2.5 µm (PM_2.5) in the underground subway system are the cause of many diseases. The iron containing PMs frequently confront in underground stations, which ultimately have an impact on the health of living beings especially in children. Hence, it is necessary to conduct toxicity assessment of chemical species and regularized the indoor air pollutants to ensure the good health of children. Therefore, in this study, a new indoor air quality (IAQ) index is proposed based on toxicity assessment by quantitative structure-activity relationship (QSAR) model. The new indices called comprehensive indoor air toxicity (CIAT) and cumulative comprehensive indoor air toxicity (CCIAT) suggests the new standards based on toxicity assessment of PM_2.5. QSAR based deep neural network (DNN) exhibited the best model in predicting the toxicity assessment of chemical species in particulate matters, which yield lowest RMSE and Q_F3² values of 0.6821 and 0.8346, respectively, in the test phase. After integration with a standard concentration of PM_2.5, two health risk indices of CIAT and CCIAT are introduced based on toxicity assessment results, which can be use as the toxicity standard of PM_2.5 for detail IAQ management in a subway station. These new health risk indices suggest more sensitive air pollutant level of iron containing fine particulate matters or molecular level contaminants in underground spaces, alerting the health risk of adults and children in "unhealthy for sensitive group".

Perinatal and childhood exposure to environmental chemicals and blood pressure in children: a review of literature 2007-2017

Exposure to environmental chemicals during periods of renal development from embryogenesis to birth and through childhood can inform critical windows of nephrotoxicity, including changes in childhood blood pressure. This review assessed recent studies that examined the relationship of air pollution, metals, and other organic pollutants with children's blood pressure outcomes. We restricted this review to peer-reviewed studies published in English between January 2007 and July 2017. We identified a total of 36 articles that estimated associations with childhood blood pressure, of which 14 studies examined the effects of air pollution, 10 examined metals, and 12 examined other organic pollutants including phthalates (n = 4), Bisphenol A (n = 3), polychlorinated biphenols (n = 2), organophosphate pesticides (n = 2), or perfluoroalkyl acids (n = 1). Similar to the established relationship between tobacco smoke exposure and childhood blood pressure, the majority of studies that examined air pollutants, particularly exposure to PM10 and PM2.5, reported associations with increased childhood blood pressure. The literature reported conflicting evidence for metals, and putative evidence of the effects of exposure to phthalates, Bisphenol A, polychlorinated biphenols, and pesticides. Overall, our review underscores the need for additional studies that assess the impact of nephrotoxicant exposure during early life, particularly the perinatal period, and blood pressure in childhood.

Estimating Acute Cardiovascular Effects of Ambient PM2.5 Metals

BACKGROUND

Few epidemiologic studies have investigated health effects of water-soluble fractions of PM_2.5 metals, the more biologically accessible fractions of metals, in their attempt to identify health-relevant components of ambient PM_2.5.

OBJECTIVES

In this study, we estimated acute cardiovascular effects of PM_2.5 components in an urban population, including a suite of water-soluble metals that are not routinely measured at the ambient level.

METHODS

Ambient concentrations of criteria gases, PM_2.5, and PM_2.5 components were measured at a central monitor in Atlanta, Georgia, during 1998-2013, with some PM_2.5 components only measured during 2008-2013. In a time-series framework using Poisson regression, we estimated associations between these pollutants and daily counts of emergency department (ED) visits for cardiovascular diseases in the five-county Atlanta area.

RESULTS

Among the PM_2.5 components we examined during 1998-2013, water-soluble iron had the strongest estimated effect on cardiovascular outcomes [R͡R=1.012 (95% CI: 1.005, 1.019), per interquartile range increase (20.46ng/m³)]. The associations for PM_2.5 and other PM_2.5 components were consistent with the null when controlling for water-soluble iron. Among PM_2.5 components that were only measured during 2008-2013, water-soluble vanadium was associated with cardiovascular ED visits [R͡R=1.012 (95% CI: 1.000, 1.025), per interquartile range increase (0.19ng/m³)].

CONCLUSIONS

Our study suggests cardiovascular effects of certain water-soluble metals, particularly water-soluble iron. The observed associations with water-soluble iron may also point to certain aspects of traffic pollution, when processed by acidifying sulfate, as a mixture harmful for cardiovascular health. https://doi.org/10.1289/EHP2182.

Environmental exposure to metals and the risk of hypertension: A cross-sectional study in China

Metal pollution is a severe environmental issue in China, which has been recently linked with the risk of hypertension. However, relevant epidemiological studies are limited. The present exploratory study was conducted to assess the associations of environmental exposure to metals with the odds of hypertension as well as blood pressure (BP) levels using urine samples in a Chinese general population. From May 2016 to April 2017, a total of 823 eligible participants were consecutively enrolled in our study in Wuhan, China. Hypertension was defined as systolic BP (SBP) of ≥140 mmHg or diastolic BP (DBP) of ≥90 mmHg, a self-reported physician diagnosis, or current use of antihypertensive medication. We used urine samples as biomarkers to reflect the levels of environmental exposure to 20 metals. Multivariable regression models were applied to assess the potential association. Multi-metal models were conducted to investigate the impacts of co-exposure to various metals. Based on the results from various models, positive trends for increased odds of hypertension with increasing quartiles of vanadium (V), iron (Fe), zinc (Zn) and selenium (Se) were suggested. Compared with those in the lowest quartiles, participants in the highest quartiles of V, Fe, Zn and Se had a 4.4-fold, 4.9-fold, 4.2-fold and 2.5-fold increased odds of having hypertension, respectively. High urinary Hg level was found to increase the levels of DBP. Individuals in the highest group of Hg were found to have a 4.3 mmHg higher level of DBP. Our findings suggest that environmental exposure to V, Fe, Zn, Se and Hg might increase the risk of hypertension or elevate the levels of BP. These findings warrant further prospective studies in a larger population.

Association of individual-level concentrations and human respiratory tract deposited doses of fine particulate matter with alternation in blood pressure

Fine particulate matter (PM_2.5) contributes to the risk of cardiovascular events, partially owing to its deposition in the human respiratory tract. To investigate short-term effects of ambient PM_2.5 exposure on alternation of blood pressure (BP), this study was conducted during the winter-summer period between 2014 and 2015. The study included 106 community residents in Wuhan city, China. We repeatedly monitored the household and outdoor PM_2.5 concentrations as well as individual-level PM_2.5 in each season, and then assessed personal PM_2.5 exposure (including deposited doses of PM_2.5 in the human respiratory tract) by using different methodology (such as using a dosimetry model). All participants took part in the physical examination, including the inflammatory indicators, BP and lung function parameters measurements. Subsequently, we assessed the health damage of exposure to PM_2.5 using generalized additive models. We observed increased BP at 2-day lag for an interquartile range increase in ambient fixed-site, households, individual-level PM_2.5 exposure and the corresponding lung deposited doses of each exposure concentration (p < 0.05), decreased BP at 3-day lag for an interquartile range increase in ambient fixed-site, households PM_2.5 and the corresponding lung deposited doses of each exposure concentration (p < 0.05). The estimated deposited doses of PM_2.5 by the deposition fractions in this study and the referenced deposition fractions by previous reported method were equivalent associated with alternation in BP. In conclusion, lung deposited dose of PM_2.5 as a quantitative indicator may be used to assess adverse cardiovascular effects following the systemic inflammation. However, we require careful assessment of acute adverse cardiovascular effects using ambient fixed-site PM_2.5 after short-term PM_2.5 exposure.

Exposure of in-pram babies to airborne particles during morning drop-in and afternoon pick-up of school children

In-pram babies are more susceptible to air pollution effects, yet studies assessing their exposure are limited. We measured size-resolved particle mass (PMC; 0.25-32 μm) and number (PNC; 0.2-1 μm) concentrations on a 2.7 km route. The instruments were placed inside a baby pram. The route passed through 4 traffic intersections (TIs) and a bus stand. A total of ∼87 km road length was covered through 64 trips, made during school drop-in (morning) and pick-up (afternoon) hours. The objectives were to assess PMC and PNC exposure to in-pram babies at different route segments, understand their physicochemical characteristics and exposure differences between in-pram babies and adults carrying them. Over 5-fold variability (14.1-78.2 μg m^-3) was observed in PMCs. Small-sized particles, including ultrafine particles, were always higher by 66% (PM₁), 29% (PM_2.5) and 31% (PNC) during the morning than afternoon. Coarse particles (PM_2.5-10) showed an opposite trend with 70% higher concentration during afternoon than morning. TIs emerged as pollution hotspots for all the particle types. For example, PM_2.5, PM_2.5-10 and PNCs during the morning (afternoon) at TIs were 7 (10)%, 19 (10)% and 68 (62)% higher, respectively, compared with the rest of the route. Bus stand was also a section of enhanced exposure to PNC and PM_2.5, although not so much for PM_2.5-10. EDX analyses revealed Cl, Na and Fe as dominant elements. Road salt might be a source of NaCl due to de-icing during the measurements while Fe contributed by non-exhaust emissions from brake abrasion. The respiratory deposition rates imitated the trend of PMC, with higher doses of coarse and fine particles during the afternoon and morning runs, respectively. Special protection measures during conveyance of in-pram babies, especially at pollution hotspots such as traffic intersections and bus stands, could help to limit their exposure.

In-vivo assesment of the genotoxic and oxidative stress effects of particulate matter on Echinogammarus veneris

Seven types of atmospheric dusts (road dust, soil dust, brake dust, desert dust, pellet ash and coke and certified material NIST1648a - urban dust) have been tested for their genotoxicity on specimens of Echinogammarus veneris, a small aquatic amphipod. Experiments were carried out in vivo, by exposing the animals for 24 h to water containing 25 mg/L of dust. Each dust has been chemically analyzed for ions, elemental carbon, organic carbon and for the soluble and insoluble fractions of elements. Non-specific damages to DNA have been evaluated by the comet test, while oxidative damages have been estimated by coupling the comet test with formamido pyrimidine DNA glycosylase reaction. The animal tissues have been acid digested and analyzed for their elemental content to evaluate the bioaccumulation. All the considered dusts have caused a significant non-specific DNA damage, while the oxidative stress was shown only by dust types containing high concentration of elements. Furthermore, the oxidative damage has shown a positive correlation with the total bio-accumulated elemental concentration. For all the dust samples, the correlation with bio-accumulation in the tissues was more satisfactory for the insoluble fraction than for the soluble fraction of elements. Elements contained in solid particles seem then to be the main responsible bioaccumulation and for the oxidative stress.

Chocolate, Air Pollution and Children's Neuroprotection: What Cognition Tools should be at Hand to Evaluate Interventions?

Millions of children across the world are exposed to multiple sources of indoor and outdoor air pollutants, including high concentrations of fine particulate matter (PM_2.5) and ozone (O₃). The established link between exposure to PM_2.5, brain structural, volumetric and metabolic changes, severe cognitive deficits (1.5-2 SD from average IQ) in APOE 4 heterozygous females with >75 − < 94% BMI percentiles, and the presence of Alzheimer's disease (AD) hallmarks in urban children and young adults necessitates exploration of ways to protect these individuals from the deleterious neural effects of pollution exposure. Emerging research suggests that cocoa interventions may be a viable option for neuroprotection, with evidence suggesting that early cocoa interventions could limit the risk of cognitive and developmental concerns including: endothelial dysfunction, cerebral hypoperfusion, neuroinflammation, and metabolic detrimental brain effects. Currently, however, it is not clear how early we should implement consumption of cocoa to optimize its neuroprotective effects. Moreover, we have yet to identify suitable instruments for evaluating cognitive responses to these interventions in clinically healthy children, teens, and young adults. An approach to guide the selection of cognitive tools should take into account neuropsychological markers of cognitive declines in patients with Alzheimer's neuropathology, the distinct patterns of memory impairment between early and late onset AD, and the key literature associating white matter integrity and poor memory binding performance in cases of asymptomatic familial AD. We highlight potential systemic and neural benefits of cocoa consumption. We also highlight Working Memory Capacity (WMC) and attention control tasks as opened avenues for exploration in the air pollution scenario. Exposures to air pollutants during brain development have serious brain consequences in the short and long term and reliable cognition tools should be at hand to evaluate interventions.

Quantifying the impact of PM2.5 and associated heavy metals on respiratory health of children near metallurgical facilities

The aim of this study was to link the concentrations of particulate matter with an aerodynamic diameter below 2.5 μm (PM2.5) and associated heavy metals with occurrence of wheezing and hospitalizations due to wheezing in 111 children who live near metallurgical plants in Targoviste City, Romania. A group of 72 children with high levels of immunoglobulin E (IgE) and eosinophils, as well as frequent wheezing episodes, was geolocated on digital thematic maps. Monitoring campaigns and medical assessments were performed over two consecutive years (2013-2014). The multiannual average concentrations of PM2.5 ranged from 4.6 to 22.5 μg m(-3), up to a maximum value of 102 μg m(-3). Significant correlations (p < 0.01) were observed between the locations of the children with respiratory issues and the PM2.5 multiannual average (r = 0.985) and PM2.5 maximum (r = 0.813). Fe, Ni, Cd, and Cr were the main marker elements of the emissions from steel production and metal-working facilities in the Targoviste area. The results support the hypothesis that increased PM2.5 levels directly influence wheezing symptom and asthma attacks in the analyzed group. IgE, eosinophils, and wheezing episodes may be considered key indicators with which to evaluate the adverse effects of PM2.5 air pollution on children's health.

Health Impact Assessment of Air Pollution in São Paulo, Brazil

Epidemiological research suggests that air pollution may cause chronic diseases, as well as exacerbation of related pathologies such as cardiovascular and respiratory morbidity and mortality. This study evaluates air pollution scenarios considering a Health Impact Assessment approach in São Paulo, Brazil. We have analyzed abatement scenarios of Particulate Matter (PM) with an aerodynamic diameter <10 μm (PM₁₀), <2.5 μm (PM_2.5) and ozone concentrations and the health effects on respiratory and cardiovascular morbidity and mortality in the period from 2009 to 2011 through the APHEKOM tool, as well as the associated health costs. Considering World Health Organization (WHO) standards of PM_2.5 (10 μg/m³), São Paulo would avoid more than 5012 premature deaths (equivalent to 266,486 life years’ gain) and save US$15.1 billion annually. If São Paulo could even diminish the mean of PM_2.5 by 5 μg/m³, nearly 1724 deaths would be avoided, resulting in a gain of US$ 4.96 billion annually. Reduced levels of PM₁₀, PM_2.5 and ozone could save lives and an impressive amount of money in a country where economic resources are scarce. Moreover, the reduced levels of air pollution would also lower the demand for hospital care, since hospitalizations would diminish. In this sense, Brazil should urgently adopt WHO air pollution standards in order to improve the quality of life of its population.