Quantitative assessments of indoor air pollution and the risk of childhood acute leukemia in Shanghai

Population attributable fractions of cancer mortality related to indoor air pollution, animal contact, and water source as environmental risk factors: Findings from the Golestan Cohort Study

BACKGROUND

Environmental risk factors are significant contributors to cancer mortality, which are neglected.

PURPOSE

This study aimed to estimate the population attributable fraction of cancer mortality due to the environmental risk factors.

METHODS

Golestan cohort study is a population-base cohort on 50045 participants between 40-75 with about 18 years of follow up. We detected 2,196 cancer mortality and applied a multiple Cox model to compute the hazard ratio of environmental risk factor on all cancer and cancer-specific mortality. The population attributable fraction was calculated, accordingly.

RESULTS

Biomass fuels for cooking, as an indoor air pollution, increased the risk of colorectal, esophageal, gastric cancer, and all-cancer mortality by 84%, 66%, 37%, and 17% respectively. Using gas for cooking, particularly in rural areas, could save 6% [Population Attributable Fraction: 6.36(95%CI: 1.82, 10.70)] of esophageal cancer, 3% [Population Attributable Fraction: 3.43 (0, 7.33)] of gastric cancer, and 6% [Population Attributable Fraction: 6.25 (1.76, 13.63)] of colorectal cancer mortality. Using a healthy tap water source could save 5% [Population Attributable Fraction:5.50(0, 10.93)] of esophageal cancer mortality, particularly in rural areas. There was no significant association between indoor air pollution for heating purposes and animal contact with cancer mortality.

CONCLUSION

Considering the results of this study, eliminating solid fuel for most daily usage, among the population with specific cancer types, is required to successfully reduce cancer related mortality. Adopting appropriate strategies and interventions by policymakers such as educating the population, allocating resources for improving the healthy environment of the community, and cancer screening policies among susceptible populations could reduce cancer related mortalities.

The association between clustering based on composition of volatile organic compound in indoor air and building-related symptoms

Volatile organic compounds (VOCs) have been suspected to cause building-related symptoms (BRSs). Although some studies investigated the association between BRSs and VOCs in indoor air, those results were inconsistent. This study investigated the contamination status of VOCs in the indoor air of 154 houses in Japan. Additionally, these samples were grouped by hierarchical clustering analysis based on the VOC composition, and the relationship between a VOC cluster and the BRSs was investigated. The median concentration of the sum of VOCs (ΣVOCs) was 140 μg m-3 (range: 18-3500 μg m-3). The levels of acetaldehyde in four samples and p-dichlorobenzene in one sample exceeded the guideline value. As a result of the hierarchical clustering analysis, the samples in this study were divided into six characteristic clusters based on the VOC composition. The ΣVOCs in cluster 1 were significantly lower than those in other clusters. In cluster 2, acyclic and aromatic hydrocarbons were dominant. Cluster 3 had a relatively high proportion of limonene. In cluster 4, the concentrations and composition ratios of α-pinene were higher than those of other clusters. In cluster 5, p-dichlorobenzene accounted for 42 %-72 % of the total VOCs. Cluster 6 had a relatively high proportion of decamethyl cyclopentasiloxane. This clustering likely depended on the construction of houses and lifestyles. As a result of logistic regression analysis, cluster 5 was associated with the cough symptoms of the BRSs. The results of the present study suggest that investigating the association between VOCs and BRSs is necessary to consider not only total concentrations such as TVOC and ΣVOCs but also VOC composition.

Early-life exposure to air pollution associated with food allergy in children: Implications for 'one allergy' concept

BACKGROUND

The rapid increase of food allergy (FA) has become the "second wave" of allergy epidemic and is now a major global public health concern. Mounting evidence indicates that early life exposure to air pollution is associated with the "first wave" of allergy epidemic (including asthma, allergic rhinitis and eczema) in children, but little is known about its association with FA.

OBJECTIVES

We hypothesize FA has triple exposure pathways, gut-skin-airway, and investigate the effects of airway exposure to outdoor and indoor air pollution on childhood FA.

METHODS

A cohort study of 2598 preschool children aged 3-6 years old was conducted in Changsha, China. The prevalence of FA was surveyed using a standard questionnaire by International Study of Asthma and Allergies in Childhood (ISAAC). Exposure to indoor air pollution was assessed by four indicators: new furniture, redecoration, mold or dampness, and window condensation. Exposure to outdoor air pollution was evaluated by the concentrations of PM10, SO2 and NO2, which were obtained from the monitored stations. Both prenatal and postnatal exposure windows were considered. The association between exposure to outdoor/indoor air pollution and childhood FA was estimated by multiple logistic regression models using odds ratio (OR) and a 95% confidence interval (CI).

RESULTS

A total of 14.9% children reported FA. The prevalence was significantly associated with exposure to indoor air pollution, OR (95% CI) = 1.93 (1.35-2.75) for prenatal exposure to mold/dampness and 1.49 (1.07-2.10) and 1.41 (1.04-1.89) respectively for postnatal exposure to new furniture and window condensation. The prevalence of FA was also associated with prenatal and postnatal exposure to outdoor air pollution, particularly the traffic-related air pollutant NO2, with adjusted ORs (95% Cls) respectively 1.24 (1.00-1.54) and 1.38 (1.03-1.85) per interquartile range (IQR) increase. Sensitivity analysis showed that the association between outdoor/indoor air pollution and childhood FA was significant only in young children aged 3-4 years.

CONCLUSION

Early-life exposure to high levels of outdoor and indoor air pollution in China due to the rapid economic growth and fast urbanization in the past decades may contribute to the rapid increase of food allergy (FA) in children. Our study indicates that, in addition to gut and skin, airway may be a new route of food sensitization. Air pollution leads to the first and second waves of allergy epidemics, suggesting a concept of 'one allergy' disease.

Indoor exposure levels and risk assessment of volatile organic compounds in residences, schools, and offices in China from 2000 to 2021: A systematic review

The last two decades have witnessed rapid urbanization and economic growth accompanied by severe indoor air pollution of volatile organic compounds (VOCs) in China. However, indoor VOC pollution across China has not been well characterized and documented. This study is a systematic review of field measurements of eight target VOCs (benzene, toluene, xylenes, acetaldehyde, p-dichlorobenzene, butadiene, trichloroethylene, and tetrachloroethylene) in residences, offices, and schools in China from 2000 to 2021. The results show that indoor pollution of benzene, toluene, and xylenes has been more serious in China than in other countries. Spatiotemporal distribution shows lower indoor VOC levels in east and south-east regions and a declining trend from 2000 to 2021. Moving into a dwelling more than 1 year after decoration and improving ventilation could significantly reduce exposure to indoor VOCs. Reducing benzene exposure is urgently needed because it is associated with greater health risks (4.5 × 10^-4 for lifetime cancer risk and 8.3 for hazard quotient) than any other VOCs. The present study enriches the database of indoor VOC levels and provides scientific evidence for improving national indoor air quality standards as well as estimating the attributable disease burden caused by VOCs in China.

Indoor Air Pollution and the Health of Vulnerable Groups: A Systematic Review Focused on Particulate Matter (PM), Volatile Organic Compounds (VOCs) and Their Effects on Children and People with Pre-Existing Lung Disease

Air pollution affects health, but much of the focus to this point has been on outdoor air. Higher indoor pollution is anticipated due to increasingly energy-efficient and less leaky buildings together with more indoor activities. Studies of indoor air pollution focusing on children and people with respiratory disease from the database Web of Science (1991–2021) were systemically reviewed according to the PRISMA guidelines, with 69 studies included in the final selection. Emissions from building materials affected indoor air quality, and ventilation also had an influence. The main indoor air pollutants are Volatile Organic Compounds (VOCs) and Particulate Matter (PM). PM sources included smoking, cooking, heating, candles, and insecticides, whereas sources of coarse particles were pets, housework and human movements. VOC sources included household products, cleaning agents, glue, personal care products, building materials and vehicle emissions. Formaldehyde levels were particularly high in new houses. Personal exposure related to both indoor and outdoor pollutant levels, highlighting home characteristics and air exchange rates as important factors. Temperature, humidity, educational level, air purifiers and time near sources were also related to personal exposure. There was an association between PM and Fractional exhaled Nitric Oxide (FeNO), lung function, oxygen saturation, childhood asthma and symptoms of chronic obstructive pulmonary disease (COPD) patients. High VOCs were associated with upper airways and asthma symptoms and cancer. Effective interventional studies for PM in the future might focus on human behavior together with air purifiers and increased ventilation, whereas VOC interventions might center more on building materials and household products, alongside purification and ventilation.

Multiple air pollutants exposure and leukaemia incidence in Tehran, Iran from 2010 to 2016: a retrospective cohort study

OBJECTIVE

Leukaemia is one of the most common cancers and may be associated with exposure to environmental carcinogens, especially outdoor air pollutants. The objective of this study was to investigate the association of ambient air pollution and leukaemia in Tehran, Iran.

DESIGN

In this retrospective cohort study, data about the residential district of leukaemia cases diagnosed from 2010 to 2016 were inquired from the Ministry of Health cancer database. Data from a previous study were used to determine long-term average exposure to different air pollutants in 22 districts of Tehran. Latent profile analysis (LPA) was used to classify pollutants in two exposure profiles. The association between air pollutants and leukaemia incidence was analysed by negative binomial regression.

SETTING

Twenty-two districts of Tehran megacity.

PARTICIPANTS

Patients with leukaemia.

OUTCOME MEASURES

The outcome variables were incidence rate ratios (IRR) of acute myeloid and lymphoid leukaemia across the districts of Tehran.

RESULTS

The districts with higher concentrations for all pollutants were near the city centre. The IRR was positive but non-significant for most of the air pollutants. However, annual mean NOx was directly and significantly associated with total leukaemia incidence in the fully adjusted model (IRR (95% CI): 1.03 (1.003 to 1.06) per 10 ppb increase). Based on LPA, districts with a higher multiple air-pollutants profile were also associated with higher leukaemia incidence (IRR (95% CI): 1.003 (0.99 to 1.007) per 1 ppb increase).

CONCLUSIONS

Our study shows that districts with higher air pollution (nitrogen oxides and multipollutants) have higher incidence rates of leukaemia in Tehran, Iran. This study warrants conducting further research with individual human data and better control of confounding.

Effects of environmental conditions on the emission and odor-active compounds from Fraxinus mandshurica Rupr

Being one of the most common wood in furniture and decoration, Fraxinus mandshurica Rupr. (F. mandshurica) is a frequently used material for wood products. However, the resulting odor problem has not yet been solved so far. Thus, this study focused on exploring odor-active compounds and investigating the effect of environmental conditions on emission and odor attributes. F. mandshurica was studied via TD-GC-MS/O combined with microchamber. Totally, 15 kinds of key odor-active compounds were detected from F. mandshurica. The main odorous components were found to be aromatics, aldehydes and ketones, esters, alcohols and acids. Six kinds of attributes played a key role in the overall odor character of F. mandshurica. Fragrant was the predominant odor impressions, followed by vinegar and antiseptic solution. The proportion of the odor-active compounds concentration to total concentration decreased with an increase in the temperature and relative humidity, while the ratio of air exchange rate to the loading factor had little effect on this. The total concentration of F. mandshurica increased as the temperature and relative humidity increased, but these decreased as the ratio of air exchange rate to the loading factor increased, while the total odor intensity reduced with the rise in the ratio of air exchange rate to the loading factor. Time was found to be the most effective factor for eliminating emissions. Considering the environmental conditions in this study, 40 °C, 60% relative humidity and a 1.0 m³·m^-2 h^-1 ratio of air exchange rate to loading factor are recommended to accelerate the emission of F. mandshurica. The optimum condition was found to be higher temperature, higher relative humidity and higher ratio of air exchange rate to loading factor.

A review of volatile organic compounds (VOCs) degradation by vacuum ultraviolet (VUV) catalytic oxidation

Volatile organic compounds (VOCs), one of the most important gaseous air pollutants, are getting more and more attention, and a lot of technologies have been studied and applied to eliminate VOCs emissions. Advanced oxidation processes (AOPs) are considered as one of the most promising techniques used for the degradation of VOCs. Vacuum ultraviolet (VUV) catalytic oxidation system is a typical composite AOPs system involving several processes such as VUV photodegradation, photocatalytic oxidation (PCO), ozone catalytic oxidation (OZCO) and their combinations. VUV based catalytic oxidation processes have been intensively studied for degrading VOCs. This review summarizes the recent studies on the use of VUV catalytic oxidation for degrading VOCs. All the processes involved in VUV catalytic oxidation and their combinations have been reviewed. Studies of VOCs degradation by VUV catalytic oxidation can be generally divided into two aspects: developments of catalysts and mechanistic studies. Principles of different processes, strategies of catalyst development and reaction mechanism are summarized in this review. Two directions of prospective future work were also proposed.

Kinetic and reaction mechanism of generated by-products in a photocatalytic oxidation reactor: Model development and validation

Photocatalytic oxidation is a promising technology to control air pollution. However, the formation of hazardous by-products hinders the commercialization application of this technology. This paper reports the development of a novel by-products predictive model considering the mass transfer of the pollutant in the gas phase and kinetic reaction in the solid phase. Two challenge compounds from ketone group (acetone and methyl ethyl ketone) were examined for model validation in a continuous Photocatalytic Oxidation (PCO) reactor with TiO₂ coated on silica fiber felts. A possible reaction pathway for degradation of each challenge compound was proposed based on identified by-products using analytical methods (GC-MS and HPLC). Formaldehyde, Acetaldehyde, Propionaldehyde, Ethanol, and acetic acid were detected as by-products of the Acetone and Methyl Ethyl Ketone in the PCO reactor. Different possible reaction rate scenarios were evaluated to find the best expression fitted to experimental data at the steady-state condition. The obtained reaction coefficients were then used to validate the model under various operating conditions, namely concentration, relative humidity, irradiation, and velocity variations. Higher concentration and irradiation, as well as lower relative humidity and velocity, resulted in more by-products generation. It was also observed that with enhancing residence time, mineralization efficiency (or CO₂ formation) and by-products generation increases through PCO reaction. The model validation provided acceptable accuracy for both steady-state and transient conditions. Finally, the Health Risk Index was used to investigate the implications of generated by-products on human health under varying operating conditions.

Estimating household exposure to moth repellents p-dichlorobenzene and naphthalene and the relative contribution of inhalation pathway in a sample of Japanese children

p-Dichlorobenzene (DCB) and naphthalene (NP) used as moth repellents in indoor environments are suspected to be carcinogenic. To evaluate their adverse effects on health with chronic exposure in the general population, especially children, we need to know their amounts absorbed by the body and the relationships between their amounts and air quality in residences. At present, little is known worldwide about them. This study examined the daily intakes of DCB and NP by Japanese children via all exposure pathways and the contribution of indoor air quality to the intakes. First-morning void urine samples from the subjects aged 6 to 15 years and air samples in their bedrooms were collected. Airborne NP and DCB and their urinary metabolites were measured. Significant correlations were detected between their airborne concentrations and the urinary excretion amounts of their corresponding metabolites. The absorption amounts of DCB and NP by inhalation of the children while at home were calculated to be 26 and 2.0 ng/kg b.w./h, respectively, as median values. The daily intake was estimated to be 2.4 and 0.90 μg/kg b.w./d (median), respectively. The fractions (median) of inhalation absorption amounts to overall absorption amounts for DCB and NP were 30% and 5%, respectively. In children living in residences where the indoor air concentrations of these compounds were more than half the level of each guideline value for indoor air quality, the main exposure route for their absorption was considered to be inhalation while at home. The indoor concentrations of DCB exceeded the lifetime excess cancer risk level of 10^-4 in 22% of the residences and 10^-3 in 9% of them. Our findings indicate the need to further reduce airborne concentrations of DCB in Japanese residences to prevent its adverse effects on the health of Japanese children.

Indoor volatile organic compounds exposures and risk of childhood acute leukemia: a case-control study in shanghai

A case-control study was conducted to investigate the relationship between indoor air pollution and childhood acute leukemia (AL) in Shanghai. 97 cases and 148 gender-, age-, and residence-matched controls were included. Indoor air pollution was evaluated by questionnaires and quantitative measurement including 14 volatile organic compounds (VOCs) and nitrogen dioxide (NO₂) in the homes of the two groups. The levels of individual VOCs, VOC families, TVOC (sum of the concentrations of the individual VOCs) and NO₂ were compared between the two groups. Exposure to styrene and butyl alcohol were associated with an increased risk of childhood AL (styrene: odds ratio (OR)=2.33, 95% confidence interval (CI): 1.07-5.07; butyl alcohol: OR = 2.51, 95%CI: 1.19-5.28); 4th quartile of chlorinated hydrocarbons (OR = 2.52, 95%CI: 1.02-6.26) and 3rd quartile of TVOC (OR = 4.03, 95%CI: 1.06-6.81) had significant higher ORs for childhood AL compared with that in the lowest quartiles. Elevated levels of individual VOCs, VOC families and TVOC were also associated with self-reported risk factors. Our findings suggest that VOCs exposure was associated with an elevated risk of childhood AL, underscore that more attention should be paid to indoor air pollution as a risk factor of childhood AL.

The association between air pollution and cancers: controversial evidence of a systematic review

There are inconsistent reports on the association between air pollution and cancers. This systematic review was, therefore, conducted to ascertain the relationship between air pollution and some cancers. This is a systematic review study, which all articles published in this area were extracted from January 1, 1950 to December 31, 2018 from Web of Science, PubMed, Scopus, Cochrane Library, MEDLINE, EMBASE, Science Direct, Google scholar. Searching was performed independently by two search-method experts. The required data were extracted from the articles by an author-made questionnaire. Forty-eight articles were investigated. Evidence linking air pollution to some cancers is limited. Leukemia had the highest association with exposure to various air pollutants and bladder cancer had the lowest association. It is noteworthy that the specific type of pollutants in all studies was not specified. Based on the findings, the results are contradictory, and the role of air pollution in some cancers cannot be supported. Accordingly, studies are recommended to be performed at the individual level or multifactorial studies to specifically investigate the relationship between air pollution and these types of cancers. In this way, the role of air pollution in the incidence of these cancers can be determined more accurately.

Toxicological Study and Genetic Basis of BTEX Susceptibility in Drosophila melanogaster

Benzene, toluene, ethylbenzene and xylene, also known as BTEX, are released into environmental media by petroleum product exploratory and exploitative activities and are harmful to humans and animals. Testing the effects of these chemicals on a significantly large scale requires an inexpensive, rapidly developing model organism such as Drosophila melanogaster. In this study, the toxicological profile of benzene, toluene, ethylbenzene, p-xylene, m-xylene, and o-xylene in D. melanogaster was evaluated. Adult animals were monitored for acute toxicity effects. Similarly, first instar larvae reared separately on the same compounds were monitored for the ability to develop into adult flies (eclosion). Further, the impact of fixed concentrations of benzene and xylene on apoptosis and mitosis were investigated in adult progenitor tissues found in third instar larvae. Toluene is the most toxic to adult flies with an LC₅₀ of 0.166 mM, while a significant and dose-dependent decrease in fly eclosion was observed with benzene, p-xylene, and o-xylene. An increase in apoptosis and mitosis was also observed in animals exposed to benzene and p-xylene. Through Genome Wide Association Screening (GWAS), 38 regions of the D. melanogaster genome were identified as critical for responses to p-xylene. This study reveals the strength of D. Melanogaster genetics as an accessible approach to study BTEX compounds.

Formaldehyde and VOC emissions from plywood panels bonded with bio-oil phenolic resins

Pyrolysis bio-oil was used to partially substitute for phenol in reacting with formaldehyde for the production of bio-oil phenol formaldehyde plywood (BPFP) panels, with the phenol substitution ratio being 20%, 40%, or 60%. Emissions of formaldehyde and volatile organic compounds (VOCs) from the BPFP panels were studied using solid-phase micro-extraction (SPME) followed by headspace gas chromatography/mass spectrometry (GC/MS), and were compared to those from the phenol formaldehyde plywood (PFP) panels. The sources for VOCs were analyzed, and the health risks associated with the BPFP were examined. Results showed that at 80 °C: (1) Formaldehyde emissions from the BPFP panels were increased to about 4 times that of PFP; (2) VOCs emissions were significantly reduced by up to 84.9% mainly due to the greatly reduced phenol emissions, although the total number of VOCs was increased from 20 to 35; (3) BPFP presents greatly increased carcinogenic and non-carcinogenic health risks because of its much stronger emissions of formaldehyde, N,N-dimethylformamide, benzofuran, furfural, and many chemicals from the bio-oil. It is highly advisable that the health risks are properly taken care of before the wide application of BPFP, or similar bio-oil based engineered wood products.

Predicting the emission characteristics of VOCs in a simulated vehicle cabin environment based on small-scale chamber tests: Parameter determination and validation

Volatile organic compounds (VOCs) emitted from vehicle parts and interior materials can seriously affect in-cabin air quality. Prior studies mainly focused on indoor material emissions, while studies of emissions in-cabins were relatively scarce. The emission behaviors of VOCs from vehicle cabin materials can be characterized by three key emission parameters: the initial emittable concentration (C₀), diffusion coefficient (D_m), and partition coefficient (K). Based on a C-history method, we have performed a series of tests with a 30 L small-scale chamber to determine these three key emission parameters for six VOCs, benzene, toluene, ethylbenzene, xylene, formaldehyde, and acetaldehyde, from typical vehicle cabin materials, car roof upholstery, carpet, and seat. We found that acetaldehyde had the highest level in the gas-phase concentration and C₀, which differs from residential indoor environments where formaldehyde is usually the most prevalent pollutant. The influence of temperature on the key emission parameters was also investigated. When the temperature rose from 25 °C to 65 °C, C₀ increased by 40-640%, D_m increased by 40-170%, but K decreased by 38-71% for different material-VOC combinations. We then performed an independent validation to demonstrate the accuracy of the measured key emission parameters. Furthermore, considering that in reality, several materials coexist in vehicle cabins, we made a first attempt at applying a multi-source model to predict VOC emission behaviors in a simulated 3 m³ vehicle cabin, using the key emission parameters obtained from the small-scale chamber tests. The good agreement between the predictions and experiments (R² = 0.82-0.99) demonstrated that the three key emission parameters measured via chamber tests can be scaled to estimate emission scenarios in realistic vehicle cabin environments. A pollution contribution analysis for the tested materials indicated that the car seat could significantly contribute to the total emissions.

A new insight into acute lymphoblastic leukemia in children: influences of changed intestinal microfloras

Background

Previous studies have shown that changes in intestinal microfloras are associated with both gastrointestinal (GI) and non-GI tumors. It is not clear whether there is an association between GI microflora changes and hematological malignancies.

Methods

In the current study, we used 16S rDNA gene sequencing techniques to profile the GI microbiome in children with lymphoblastic leukemia (ALL, n = 18) and matched healthy control (n = 18). Using multiple specialized software [Heatmap, Principal coordinates analysis (PCoA), Claster and Metastates], we analyzed the sequencing data for microfloral species classification, abundance and diversity.

Results

A total of 27 genera between the ALL and control groups (FDR ≤ 0.05 and/or P ≤ 0.05) showed significantly different abundance between ALL patients and healthy controls: 12 of them were predominant in healthy group and other 15 species were significantly higher in ALL group. In addition, we compared the abundance and diversity of microfloral species in ALL patients prior to and during remission stage after chemotherapy, and no significant difference was detected.

Conclusions

Compared to healthy controls, ALL patient showed significant changes of GI microfloras. Further explorations of the intestinal micro-ecology in ALL patients may provide important information to understand relationship between microfloras and ALL.

Critical windows for maternal fine particulate matter exposure and adverse birth outcomes: The Shanghai birth cohort study

BACKGROUND

Prenatal exposure to ambient levels of air pollution has been reported to adversely affect birth outcomes, yet few studies have investigated refined susceptible windows for adverse birth outcomes.

OBJECTIVES

The study aimed at estimating associations between maternal exposure to ambient fine particulate matter (PM_2.5; particles with an aerodynamic diameter ≤ 2.5 μm) and birth outcomes, including birth weight, low birth weight (LBW) and preterm birth (PTB), and identify specific susceptible windows.

METHODS

A total of 3692 singleton live births were enrolled between 2013 and 2016 in Shanghai Birth Cohort, China. Based on mothers' residential addresses, weekly mean concentrations of PM_2.5 over gestation were estimated based on an incorporated evaluating approach combining satellite-based estimates and ground-level measurements. Distributed lag non-liner models (DLNMs) were fitted by incorporating with multiple liner models and Cox proportional hazard models to evaluate weekly-as well as trimester-exposure-lag-response associations between average PM_2.5 level and birth weight, LBW and PTB, and to identify critical windows.

RESULTS

In this study, gestational exposure to PM_2.5 was associated with adverse birth outcomes in infants, and critical windows were identified as 31st-34th gestational weeks for reduced birth weight, 38th-42 nd weeks for LBW and 27th-30th weeks for PTB, respectively. Trimester-specific associations were found for all birth outcomes during the third trimester.

CONCLUSIONS

Ambient PM_2.5 exposure exhibited adverse impacts on multiple outcomes including reduced birth weight, LBW and PTB in the late pregnancy. The study provides further evidence supporting harmful effects of maternal PM_2.5 exposure on birth outcomes and identifying critical windows.

Children's environmental health based on birth cohort studies of Asia (2) - air pollution, pesticides, and heavy metals

The life style and child raising environment in Asia are quite different compared with Western countries. Besides, the children's environmental threats and difficulties in conducting studies could be different. To address children's environmental health in Asia area, the Birth Cohort Consortium of Asia (BiCCA) was co-established in 2011. We reviewed the mercury, polychlorinated biphenyls, perfluoroalkyl substances, phthalates, and environmental tobacco smoke in pervious based on birth cohort studies in Asia. The aim of this study was to summarize the traditional environmental pollution and the target subjects were also based on the birth cohort in Asia area. Environmental pollutants included air pollutants, pesticides focusing on organochlorine pesticides, diakylphosphates, and pyrethroid, and heavy metals including lead, arsenic, cadmium, manganese, vanadium, and thallium. Fetal growth and pregnancy outcomes, childhood growth and obesity, neurodevelopment and behavioral problems, and allergic disease and immune function were classified to elucidate the children's health effects. In total, 106 studies were selected in this study. The evidences showed air pollution or pesticides may affect growth during infancy or childhood, and associated with neurodevelopmental or behavioral problems. Prenatal exposure to lead or manganese was associated with neurodevelopmental or behavioral problems, while exposure to arsenic or cadmium may influence fetal growth. In addition to the harmonization and international collaboration of birth cohorts in Asia; however, understand the whole picture of exposure scenario and consider more discipline in the research are necessary.

Maternal prenatal exposure to environmental factors and risk of childhood acute lymphocytic leukemia: A hospital-based case-control study in China

OBJECTIVE

To investigate an association between maternal prenatal exposure to several environmental factors and risk of childhood acute lymphocytic leukemia (ALL), and the possible interactions in the Chinese population.

METHODS

345 cases with ALL and their 1:1 age, gender, residence region matched controls aged 0-15 years were recruited from four hospitals in Henan Province from 2014 to 2016. Information was collected by interviews using a questionnaire. Unconditional logistic regression adjusted for age, gender, residence region and relevant confounders was carried out to generate the odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Our data indicate that maternal prenatal exposure to interior housing renovation (adjusted OR: 2.98, 95% CI: 1.51-5.86) or pesticides (adjusted OR: 1.48, 95% CI: 1.67-2.28) increased the risk of childhood ALL. Various subgroup analyses stratified by child's gender, age at diagnosis and other factors also supported these results. However, no interaction was detected between exposure to internal housing renovation and pesticides using an additive model. No significant links between maternal exposures to, environmental tobacco smoking (ETS), antipyretic analgesia intake, or viral infectious diseases with risk of ALL were detected.

CONCLUSION

Findings in our study are in line with the existing literatures, which support the hypothesis that maternal prenatal exposure to interior housing renovation and pesticides are risk factors for childhood ALL. Notably, we found no interaction between these two risk factors, these findings may inform prevention and early detection strategies.

Risks and burden of lung cancer incidence for residential petrochemical industrial complexes: A meta-analysis and application

BACKGROUND

Lung cancer is one of the most common cancers in the world. Higher incidence of lung cancer may be associated with residential proximity to a petrochemical industrial complex (PIC) due to exposure to various carcinogens, although results from previous epidemiologic studies remain inconclusive. Because disease burden due to residential inequality is a public health and societal concern, this study analyzed published data to estimate lung cancer incidence in association with residential proximity to PICs.

METHODS

We performed a meta-analysis on selected epidemiologic studies that met the following criteria: lung cancer incidence was coded by the International Classification of Diseases; exposure groups were clearly defined as residents living near PICs; and confidence intervals were available or calculable from original articles. We further applied a population attributable factor (PAF) method to estimate disease burden attributable to living near PICs in 22 European Union (EU) countries.

RESULTS

Meta-analysis included six studies with a total of 466,066 residents living near PICs in six countries. Residents living near PICs had a 19% higher risk of lung cancer compared to those who lived farther away (95% CI = 1.06-1.32). By sex, risks were higher and more significant for females (RR = 1.29; 95% CI = 1.09-1.54; P = 0.004) than males (RR = 1.12; 95% CI = 0.95-1.33; P = 0.173). By location, only groups in Europe had a significantly greater risk of lung cancer with exposure to PICs (95% CI = 1.03-1.33; P = 0.019), although groups in other locations showed similar trends. By bona fide observation, observation of residents for at least seven years provided sufficient latency to estimate risk (RR = 1.25; 95% CI = 1.17-1.34; P < 0.001). Regarding burden of lung cancer in 22 EU countries, 494 males and 478 females were attributed to living in the vicinity of a PIC annually.

CONCLUSIONS

Lung cancer incidence is significantly higher in individuals living near PICs. This result provides strong epidemiologic evidence for further policy to regulate potential pollutants near PICs.

HIGHLIGHTS

Higher incident rates of lung cancer for residents living close to petrochemical industry complex.

Meta-prediction of MTHFR gene polymorphism-mutations, air pollution, and risks of leukemia among world populations

The major objective of this study was to examine the association between Methylenetetrahydrofolate Reductase (MTHFR) polymorphisms and the risk of various types of leukemias across the lifespans of children and adults by using the meta-predictive techniques. The secondary objective was to examine the interactions among epigenetic risk factors (including air pollution), MTHFR polymorphisms, and the risks of developing leukemia. We completed a comprehensive search of 6 databases to find 54 studies (10,033 leukemia cases and 15,835 controls) for MTHFR 677, and 43 studies (8,868 cases and 14,301 controls) for MTHFR 1298, published from 1999 to 2014. The results revealed that, in European populations; childhood populations; children from Europe, East Asia, and America; and children with acute lymphocytic leukemia (ALL), MTHFR 677 polymorphisms (both TT and CT types together and individually) are protective, while CC wildtype was leukemogenic. In addition, MTHFR 1298 polymorphisms were protective against ALL and acute myeloid leukemia in European children, and in chronic myeloid leukemia in all adults worldwide and American adults. Air pollution played a role in the increased polymorphisms of MTHFR 677 genotypes in childhood leukemia.

Spatial clustering of childhood leukaemia with the integration of the Paediatric Environmental History

BACKGROUND

Leukaemia remains the most common type of paediatric cancer and its aetiology remains unknown, but considered to be multifactorial. It is suggested that the initiation in utero by relevant exposures and/or inherited genetic variants and, other promotional postnatal exposures are probably required to develop leukaemia. This study aimed to map the incidence and analyse possible clusters in the geographical distribution of childhood acute leukaemia during the critical periods and to evaluate the factors that may be involved in the aetiology by conducting community and individual risk assessments.

MATERIALS AND METHODS

We analysed all incident cases of acute childhood leukaemia (<15 years) diagnosed in a Spanish region during the period 1998-2013. At diagnosis, the addresses during pregnancy, early childhood and diagnosis were collected and codified to analyse the spatial distribution of acute leukaemia. Scan statistical test methodology was used for the identification of high-incidence spatial clusters. Once identified, individual and community risk assessments were conducted using the Paediatric Environmental History.

RESULTS

A total of 158 cases of acute leukaemia were analysed. The crude rate for the period was 42.7 cases per million children. Among subtypes, acute lymphoblastic leukaemia had the highest incidence (31.9 per million children). A spatial cluster of acute lymphoblastic leukaemia was detected using the pregnancy address (p<0.05). The most common environmental risk factors related with the aetiology of acute lymphoblastic leukaemia, identified by the Paediatric Environmental History were: prenatal exposure to tobacco (75%) and alcohol (50%); residential and community exposure to pesticides (62.5%); prenatal or neonatal ionizing radiation (42.8%); and parental workplace exposure (37.5%) CONCLUSIONS: Our study suggests that environmental exposures in utero may be important in the development of childhood leukaemia. Due to the presence of high-incidence clusters using pregnancy address, it is necessary to introduce this address into the childhood cancer registers. The Paediatric Environmental History which includes pregnancy address and a careful and comprehensive evaluation of the environmental exposures will allow us to build the knowledge of the causes of childhood leukaemia.

Association of outdoor air pollution and indoor renovation with early childhood ear infection in China

BACKGROUND

Otitis media (OM) is a common infection in early childhood with repeated attacks that lead to long-term complications and sequelae, but its risk factors still remain unclear.

OBJECTIVE

To examine the risk of childhood OM for different indoor and outdoor air pollutants during different timing windows, with a purpose to identify critical windows of exposure and key components of air pollution in the development of OM.

METHODS

We conducted a retrospective cohort study of 1617 children aged 3-4 years in Changsha, China (2011-2012). Children's life-time prevalence of OM and exposure to indoor air pollution related to home renovation activities were surveyed by a questionnaire administered by the parents. Children's exposure to outdoor air pollution, including nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and particulate matter with an aerodynamic diameter ≤ 10 μm (PM₁₀), was estimated using the measured concentrations at municipal monitoring stations. The odds ratio (OR) and 95% confidence interval (CI) of childhood OM for prenatal and postnatal exposure to indoor and outdoor air pollution were examined by using logistic regression model.

RESULTS

Life-time prevalence of OM in preschool children (7.3%) was associated not only with prenatal exposure to industrial air pollutant with adjusted OR (95% CI) = 1.44 (1.09-1.88) for a 27 μg/m³ increase in SO₂ but also with postnatal exposure to indoor renovations with OR (95% CI) = 1.62 (1.05-2.49) for new furniture and 1.81 (1.12-2.91) for redecoration, particularly in girls. Combined exposure to outdoor SO₂ and indoor renovation significantly increased OM risk. Furthermore, we found that exposure to outdoor SO₂ and indoor renovation were significantly associated with the onset but not repeated attacks of OM.

CONCLUSION

Prenatal exposure to outdoor industrial air pollution and postnatal exposure to indoor renovation are independently associated with early childhood OM in China and may cause the OM onset.

VOC characteristics and inhalation health risks in newly renovated residences in Shanghai, China

BACKGROUND

Exposure to indoor VOCs is expected to link to a variety of negative health outcome. The popularity of decorations and refurbishment in homes in China has given rise to indoor elevated VOC levels, potentially posing health threats to residents.

METHODS

In this study, concentrations of 101 VOC compounds and associated health risks were investigated in newly renovated homes in Shanghai. The potential excess inhalation health risks from home exposure of 17 health-related VOCs were estimated by the Inhalation Unit Risk (IUR) and Reference Concentration (RfC) proposed by US EPA. Monte Carlo simulation and sensitivity analysis were used to assess the uncertainty associated with the estimates of health risks.

RESULTS

The dominant groups by mass concentration were oxygenated VOCs (o-VOCs), aromatics, alkanes and halogenated VOCs (x-VOCs) .12 VOCs with IARC's confirmed or probable carcinogens ratings were detected with a >60% detection frequency in the total samples. The mean concentrations of BTEX (benzene, toluene, m/p-xylene, o-xylene, ethylbenzene) were 2.32μg/m³, 200.13μg/m³, 39.56μg/m³, 32.59μg/m³ and 26.33μg/m³ respectively, generally higher than those in older homes reported in previous studies except benzene. The mean concentration of methylene chloride (47.43μg/m³) and 1,2-dichloroethane (33.83μg/m³) were noticeably higher than the levels reported in previous studies in Hong Kong, Japan and Canada. Whereas the mean concentration of 1,4-dichlorobenzene (5.53μg/m³) were similar to the results of Canadian national survey but lower than those in Japan. The concentrations of 1,2-dichloroethane, 1,4-dichlorobenzene, and methylene chloride, ethylbenzene presented a mean cancer risk at 7.39×10^-6, 1.95×10^-6, 1.62×10^-6, 1.04×10^-6 respectively, above the US EPA proposed acceptable risk level of 1×10^-6. Sensitivity analyses indicated that the VOC exposure concentration have a greater impact than the IUR values on the risk assessment.

CONCLUSION

This study highlights the characteristics of VOCs in recently renovated homes and has implications for the adverse health effects that result from exposure to chlorinated hydrocarbons in indoor air.

Indoor concentrations of nitrogen dioxide and sulfur dioxide from burning solid fuels for cooking and heating in Yunnan Province, China

The Chinese national pollution census has indicated that the domestic burning of solid fuels is an important contributor to nitrogen dioxide (NO2 ) and sulfur dioxide (SO2 ) emissions in China. To characterize indoor NO2 and SO2 air concentrations in relation to solid fuel use and stove ventilation in the rural counties of Xuanwei and Fuyuan, in Yunnan Province, China, which have among the highest lung cancer rates in the nation, a total of 163 participants in 30 selected villages were enrolled. Indoor 24-h NO2 and SO2 samples were collected in each household over two consecutive days. Compared to smoky coal, smokeless coal use was associated with higher NO2 concentrations [geometric mean (GM) = 132 μg/m(3) for smokeless coal and 111 μg/m(3) for smoky coal, P = 0.065] and SO2 [limit of detection = 24 μg/m(3) ; percentage detected (%Detect) = 86% for smokeless coal and 40% for smoky coal, P < 0.001]. Among smoky coal users, significant variation of NO2 and SO2 air concentrations was observed across different stove designs and smoky coal sources in both counties. Model construction indicated that the measurements of both pollutants were influenced by stove design. This exposure assessment study has identified high levels of NO2 and SO2 as a result of burning solid fuels for cooking and heating.

Health risk equations and risk assessment of airborne benzene homologues exposure to drivers and passengers in taxi cabins

Interior air environment and health problems of vehicles have attracted increasing attention, and benzene homologues (BHs) including benzene, toluene, ethylbenzene, xylenes, and styrene are primary hazardous gases in vehicular cabins. The BHs impact on the health of passengers and drivers in 38 taxis is assessed, and health risk equations of in-car BHs to different drivers and passengers are induced. The health risk of in-car BHs for male drivers is the highest among all different receptors and is 1.04, 6.67, and 6.94 times more than ones for female drivers, male passengers, and female passengers, respectively. In-car BHs could not lead to the non-cancer health risk to all passengers and drivers as for the maximal value of non-cancer indices is 0.41 and is less than the unacceptable value (1.00) of non-cancer health risk from USEPA. However, in-car BHs lead to cancer health risk to drivers as for the average value of cancer indices is 1.21E-04 which is 1.21 times more than the unacceptable value (1.00E-04) of cancer health risk from USEPA. Finally, for in-car airborne benzene concentration (X, μg/m(3)) to male drivers, female drivers, male passengers, and female passengers, the cancer health risk equations are Y = 1.48E-06X, Y = 1.42E-06X, Y = 2.22E-07X, and Y = 2.13E-07X, respectively, and the non-cancer health risk equations are Y = 1.70E-03X, Y = 1.63E-03X, Y = 2.55E-04X, and Y = 2.45E-04X, respectively.