Ambient fine particulate matter and ozone higher than certain thresholds associated with myopia in the elderly aged 50 years and above

Joint Effect of Short-Term Exposure to Fine Particulate Matter and Ozone on Mortality: A Time Series Study in 272 Chinese Cities

Short-term exposure to PM2.5 or O3 can increase mortality risk; however, limited studies have evaluated their interaction. A multicity time series study was conducted to investigate the synergistic effect of PM2.5 and O3 on mortality in China, using mortality data and high-resolution pollutant predictions from 272 cities in 2013-2015. Generalized additive models were applied to estimate associations of PM2.5 and O3 with mortality. Modification and interaction effects were explored by stratified analyses and synergistic indexes. Deaths attributable to PM2.5 and O3 were evaluated with or without modification of the other pollutant. The risk of total nonaccidental mortality increased by 0.70% for each 10 μg/m3 increase in PM2.5 when O3 levels were high, compared to 0.12% at low O3 levels. The effect of O3 on total nonaccidental mortality at high PM2.5 levels (1.26%) was also significantly higher than that at low PM2.5 levels (0.59%). Similar patterns were observed for cardiovascular or respiratory diseases. The relative excess risk of interaction and synergy index of PM2.5 and O3 on nonaccidental mortality were 0.69% and 1.31 with statistical significance, respectively. Nonaccidental deaths attributable to short-term exposure of PM2.5 or O3 when considering modification of the other pollutant were 28% and 31% higher than those without considering modification, respectively. Our results found synergistic effects of short-term coexposure to PM2.5 and O3 on mortality and suggested underestimations of attributable risks without considering their synergistic effects.

The Minhang Pediatric Biobank cohort study: protocol overview and baseline characteristics

BACKGROUND

Little has been done to establish biobanks for studying the environment and lifestyle risk factors for diseases among the school-age children. The Minhang Pediatric Biobank (MPB) cohort study aims to identify factors associated with health and diseases of school-aged children living in the urban or suburban area of Shanghai.

METHODS

This population-based cohort study was started in all sub-districts/towns of Minhang district of Shanghai in 2014. First-grade students in elementary school were enrolled during the time of their routine physical examinations, with self-administered questionnaires completed by their primary caregivers. Additional information was extracted from multiple health information systems. Urine and saliva samples were collected during the baseline survey and follow-up visits.

RESULTS

At the end of 2014 academic year, a total number of 8412 children and their parents were recruited, including 4339 boys and 4073 girls. All the participants completed the baseline survey and physical examination, and 7128 urine and 2767 saliva samples were collected. The five most prevalent childhood diseases in this population were dental caries, bronchitis, pneumonia, asthma and overweight/obese.

CONCLUSIONS

The MPB cohort has been successfully established, serving as a useful platform for future research relating to the genetic, environmental and lifestyle risk factors for childhood diseases.

Machine learning analysis of socioeconomic drivers in urban ozone pollution in Chinese cities

The escalation of ground-level ozone (O3) pollution presents a significant challenge to the sustainable growth of Chinese cities. This study utilizes advanced machine learning algorithms to investigate the intricate interplay between urban socioeconomic growth and O3 levels. Surpassing traditional environmental chemistry, it assesses the effectiveness of these algorithms in interpreting socioeconomic and environmental data, while elucidating urban development's environmental impacts from a novel socioeconomic perspective. Key findings indicate that factors such as urban infrastructure, industrial activities, and demographic dynamics significantly influence O3 pollution. The study highlights the particular sensitivity of urban public transportation and population density, each exerting a unique and substantial effect on O3 levels. Additionally, the research identifies nuanced interactions among these factors, indicating a complex web of influences on urban O3 pollution. These interactions suggest that the impact of individual socioeconomic elements on O3 pollution is interdependent, being either amplified or mitigated by other factors. The study emphasizes the crucial need to integrate socioeconomic variables into urban O3 pollution strategies, advocating for policies tailored to each city's distinct characteristics, informed by the detailed analysis provided by machine learning. This approach is essential for developing effective and nuanced urban pollution management strategies.

The influence of the environment and lifestyle on myopia

BACKGROUND

Myopia, commonly known as near-sightedness, has emerged as a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood has heightened the risk of developing high myopia and related sight-threatening eye conditions in adulthood. This surge in myopia rates, occurring within a relatively stable genetic framework, underscores the profound influence of environmental and lifestyle factors on this condition. In this comprehensive narrative review, we shed light on both established and potential environmental and lifestyle contributors that affect the development and progression of myopia.

MAIN BODY

Epidemiological and interventional research has consistently revealed a compelling connection between increased outdoor time and a decreased risk of myopia in children. This protective effect may primarily be attributed to exposure to the characteristics of natural light (i.e., sunlight) and the release of retinal dopamine. Conversely, irrespective of outdoor time, excessive engagement in near work can further worsen the onset of myopia. While the exact mechanisms behind this exacerbation are not fully comprehended, it appears to involve shifts in relative peripheral refraction, the overstimulation of accommodation, or a complex interplay of these factors, leading to issues like retinal image defocus, blur, and chromatic aberration. Other potential factors like the spatial frequency of the visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, and education have debatable independent influences on myopia development.

CONCLUSION

The environment exerts a significant influence on the development and progression of myopia. Improving the modifiable key environmental predictors like time spent outdoors and engagement in near work can prevent or slow the progression of myopia. The intricate connections between lifestyle and environmental factors often obscure research findings, making it challenging to disentangle their individual effects. This complexity underscores the necessity for prospective studies that employ objective assessments, such as quantifying light exposure and near work, among others. These studies are crucial for gaining a more comprehensive understanding of how various environmental factors can be modified to prevent or slow the progression of myopia.

Association of Short-Term Co-Exposure to Particulate Matter and Ozone with Mortality Risk

A complex regional air pollution problem dominated by particulate matter (PM) and ozone (O3) needs drastic attention since the levels of O3 and PM are not decreasing in many parts of the world. Limited evidence is currently available regarding the association between co-exposure to PM and O3 and mortality. A multicounty time-series study was used to investigate the associations of short-term exposure to PM1, PM2.5, PM10, and O3 with daily mortality from different causes, which was based on data obtained from the Mortality Surveillance System managed by the Jiangsu Province Center for Disease Control and Prevention of China and analyzed via overdispersed generalized additive models with random-effects meta-analysis. We investigated the interactions of PM and O3 on daily mortality and calculated the mortality fractions attributable to PM and O3. Our results showed that PM1 is more strongly associated with daily mortality than PM2.5, PM10, and O3, and percent increases in daily all-cause nonaccidental, cardiovascular, and respiratory mortality were 1.37% (95% confidence interval (CI), 1.22-1.52%), 1.44% (95% CI, 1.25-1.63%), and 1.63% (95% CI, 1.25-2.01%), respectively, for a 10 μg/m3 increase in the 2 day average PM1 concentration. We found multiplicative and additive interactions of short-term co-exposure to PM and O3 on daily mortality. The risk of mortality was greatest among those with higher levels of exposure to both PM (especially PM1) and O3. Moreover, excess total and cardiovascular mortality due to PM1 exposure is highest in populations with higher O3 exposure levels. Our results highlight the importance of the collaborative governance of PM and O3, providing a scientific foundation for pertinent standards and regulatory interventions.

Effect of Air Pollution on the Basal DNA Damage of Mother-Newborn Couples of México City

Environmental pollution of megacities can cause early biological damage such as DNA strand breaks and micronuclei formation. Comet assay tail length (TL) reflects exposure in the uterus to high levels of air pollution, primarily ozone and air particles (PM10), including mothers' smoking habits during pregnancy, conditions which can lead to low birth weight. In this biomonitoring study, we evaluated basal DNA damage in the cord blood cells of newborn children from Mexico City. We found a correlation between DNA damage in mothers and their newborns, including various parameters of environmental exposure and complications during pregnancy, particularly respiratory difficulties, malformations, obstetric trauma, neuropathies, and nutritional deficiencies. Mothers living in the southern part of the city showed double DNA damage compared to those living in the northern part (TL 8.64 μm vs. 4.18 μm, p < 0.05). Additionally, mothers' DNA damage correlates with exposure to NOx (range 0.77-1.52 ppm) and PM10 (range 58.32-75.89 μg/m3), as well maternal age >29. These results highlight the sensitivity of the comet assay in identifying differential in utero exposure for newborns whose mothers were exposed during pregnancy. They also suggest the importance of antioxidants during pregnancy and the role of the placental barrier in protecting the newborn from the DNA-damaging effects of oxidative pollution.

Environmental influences on ophthalmic conditions: A scoping review

BACKGROUND

Environmental factors have been implicated in various eye pathologies. The purpose of this review is to synthesise the published research on environmental effects on eye disease.

METHODS

Four databases were searched for terms relating to environmental exposures and ophthalmic disease. Titles and abstracts were screened followed by full-text review. Data was extracted from 118 included studies. Quality assessment was conducted for each study.

RESULTS

Air pollutants, including nitrogen dioxide, nitrites, sulphur dioxide, particulate matter, carbon monoxide, ozone and hydrocarbons are associated with ocular conditions ranging from corneal damage to various retinopathies, including central retinal artery occlusion. Certain chemicals and metals, such as cadmium, are associated with increased risk of age-related macular degeneration. Climate factors, such as sun exposure, have been associated with the development of cataracts. Living in rural areas was associated with various age-related eye diseases whereas people living in urban settings had higher risk for dry eye disease and uveitis.

CONCLUSION

Environmental exposures in every domain are associated with various ophthalmic conditions. These findings underscore the importance of continued research on the interplay between the environment and eye health.

Ozone exposure and health risks of different age structures in major urban agglomerations in People's Republic of China from 2013 to 2018

High concentration of surface ozone (O₃) will cause health risks to people. In order to analyze the spatiotemporal characteristics of O₃ and assess O₃ exposure and health risks for different age groups in China, we applied multiple methods including standard deviation ellipse, spatial autocorrelation, and exposure-response functions. Results show that O₃ concentrations increased in 64.5% of areas in China from 2013 to 2018. The central plain urban agglomeration (CPU), Beijing-Tianjin-Hebei (BTH), and Yangtze River Delta (YRD) witnessed the greatest incremental rates of O₃ by 16.7%, 14.3%, and 13.1%. Spatially, the trend of O₃ shows a significant positive autocorrelation, and high trend values primarily in central and east China. The proportion of the total population exposed to high O₃ (above 160 μg/m³) increased annually. Compared to 2013, the proportion of the young, adult, and old populations exposed to high O₃ increased to different extents in 2018 by 26.8%, 29.6%, and 27.2%, respectively. The extent of population exposure risk areas in China expanded in size, particularly in north and east China. The total premature respiratory mortalities attributable to long-term O₃ exposure in six urban agglomerations were about 177,000 in 2018 which has increased by 16.4% compared to that in 2013. Among different age groups, old people are more vulnerable to O₃ pollution, so we need to strengthen their relevant health protection of them.

Size-specific particulate matter and outpatient visits for allergic conjunctivitis in children: a time-stratified case-crossover study in Guangzhou, China

This time-stratified case-crossover study aims to quantify the risk of allergic conjunctivitis (AC) associated with short-term exposure to PMs (i.e., PM₁, PM_2.5, PM_c, and PM₁₀) among children in Guangzhou, China. We collected data on children's daily AC outpatient visits from the Guangzhou Women and Children Medical Center during February 20, 2016 to December 31, 2018, and also extracted air pollution and meteorological data in the same time frame. We used conditional logistic regression model to estimate the associations between PMs and AC outpatient visits, and conducted subgroup analyses stratified by sex, age, and season. During the study period, we recorded 39,330 children's outpatient visits for AC, including 27,638 boys and 11,692 girls. The associations between PMs and AC were general linear with no clear threshold, which were largest at the current days but remained positive for lag 1 to 3 days. For every 10 μg/m³ increase in daily PM₁, PM_2.5, PM_c, and PM₁₀ concentrations, the estimated risks of AC outpatient visits at the current days increased by 2.5% (OR = 1.025, 95% CI: 1.011-1.039), 1.8% (OR = 1.018, 95% CI: 1.009-1.027), 2.1% (OR = 1.021, 95% CI: 1.004-1.039), and 1.3% (OR = 1.013, 95% CI: 1.007-1.020), respectively. In addition, our stratified analyses revealed that girls and children aged 1 to 6 years were more sensitive to PM exposure, and the PM-associated risks for AC were more apparent in autumn and winter. Our study suggests that short-term exposure to PMs may induce AC in children.

Associations between conjunctivitis and ambient PM2.5 and physical activity: A nationwide prospective cohort study

BACKGROUND

Currently, there is no evidence of fine particulate matter pollution (PM_2.5) altering the relationship between physical activity (PA) and the risk of conjunctivitis.

METHODS

Based on the UK Biobank study, we included 308,507 participants aged 40-69 years at baseline (2006 to 2010) and prospectively followed up for conjunctivitis diagnosis till 2020. Annual concentrations of PM_2.5 in 2010 were estimated for each participant using Land Use Regression models. PA levels during work and leisure time were reported via the International Physical Activity Questionnaire at baseline. We used Cox proportional hazards models to examine the associations of PM_2.5 and PA with incident conjunctivitis, as well as their interaction at both multiplicative and additive scales.

RESULTS

During the 11.6 years of follow up, we identified 4002 incident conjunctivitis cases. High-PA (≥3000 metabolic equivalent of task [MET]-mins/week) was associated with lower risk of conjunctivitis (hazard ratio [HR]: 0.79, 95% confidence interval [CI]: 0.73-0.86) compared to low-PA (0 to <600 MET-mins/week), while every 1 μg/m³ increment in PM_2.5 was associated with a 16% higher risk of conjunctivitis (HR = 1.16, 95% CI: 1.09-1.23). We did not observe statistically significant interactions between PM_2.5 and PA on their associations with conjunctivitis.

CONCLUSION

Habitual PA and PM_2.5 exposure were oppositely related to incident conjunctivitis. The benefits of PA remain in people irrespective of exposure to air pollution.

Effects of air pollution on myopia: an update on clinical evidence and biological mechanisms

Myopia is one of the most common forms of refractive eye disease and considered as a worldwide pandemic experienced by half of the global population by 2050. During the past several decades, myopia has become a leading cause of visual impairment, whereas several factors are believed to be associated with its occurrence and development. In terms of environmental factors, air pollution has gained more attention in recent years, as exposure to ambient air pollution seems to increase peripheral hyperopia defocus, affect the dopamine pathways, and cause retinal ischemia. In this review, we highlight epidemiological evidence and potential biological mechanisms that may link exposure to air pollutants to myopia. A thorough understanding of these mechanisms is a key for establishing and implementing targeting strategies. Regulatory efforts to control air pollution through effective policies and limit individual exposure to preventable risks are required in reducing this global public health burden.

Spatiotemporal variation of ozone pollution and health effects in China

With the rapid urbanization and industrialization in China, ozone pollution has become increasingly serious and poses a greater threat to human health. In this study, the spatiotemporal distribution of ozone pollution in China's cities and urban agglomerations from 2015 to 2019 was analyzed. The health effects and health economic costs of ozone pollution in China were estimated by applying the environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) model. The results are as follows: (1) ozone pollution was more serious in Chinese urban agglomerations from 2015 to 2019; (2) the hot spots of ozone concentration mainly distributed in the North China Plain, expanding from north to south; the cold spots decreased year by year and were located in the northeast, northwest, and southwest of China, shifting from northwest to southwest; (3) the seasonal average of ozone concentration in China was the highest in summer, followed by spring and autumn, and the lowest in winter; (4) the number of all-cause premature deaths of ozone pollution in China increased slowly from 2015 to 2019, and the average of urban agglomerations was significantly higher than cities, with similar spatial distribution characteristics as ozone concentration; (5) the health economic costs of ozone pollution from 2015 to 2019 slowly expanded to surrounding cities with Beijing, Shanghai, Xi'an, and Chongqing as the centers of high values, while the low value areas decreased year by year and were mainly concentrated in southwest and northeast China. The health economic costs of ozone pollution at urban agglomerations scale were higher in the eastern coastal regions and lower in the northwest inland regions. Thus, this study presents policy recommendations to provide decision-making reference for realizing the inter-regional prevention and control of ozone pollution.

Use of unclean cooking fuels and visual impairment of older adults in India: A nationally representative population-based study

Despite widespread use of unclean cooking fuels (UCF) in India, evidence from nationally representative data on its association with visual impairment was lacking. We used a population-based nationwide survey of adults aged 45 years and older that included reported UCF and measured visual impairment. We estimated that 44.8% (95% CI: 42.6, 47.1) of older adults in India lived in households that used UCF. Age- and sex-adjusted prevalence of visual impairment was estimated to be 33.0% (95% CI: 31.0, 34.9) in the older population that did not use UCF and 9.0 percentage points (pp) (95% CI: 8.9, 9.1) higher among those who did. Among those who used UCF, age- and sex-adjusted prevalence of low distance vision was 4.3 pp (95% CI: 4.2, 4.4) higher, prevalence of low near vision was 8.0 pp (95% CI: 7.9, 8.1) higher, and prevalence of blindness was 1.0 pp (95% CI: 0.9, 1.0) higher. After controlling for a rich array of sociodemographic characteristics and state fixed effects, we estimated that use of UCF was associated with higher prevalence of visual impairment by 3.2 pp (95% CI: 1.4, 5.0), low distance vision by 1.8 pp (95% CI: 0.7, 2.9), and low near vision by 3.2 pp (95% CI: 1.3, 5.0). Doubly robust estimates of these differences were slightly larger. Blindness was not significantly partially associated with use of UCF (95% CI: -0.4, 0.6). We did not find support for the hypotheses that the visual impairment risk associated with use of UCF was even larger for females and in households without a separate kitchen or ventilation. The older population of India is highly reliant on UCF that is very strongly associated with visual impairment. Impaired vision should not be overlooked among the harms associated with UCF.

Constituents of fine particulate matter and asthma in six low- and middle-income countries

BACKGROUND

Evidence concerning the effects of different chemical components of PM_2.5 on asthma is limited, and the methodology to compare the relative importance of different PM_2.5 components is lacking.

OBJECTIVES

To examine the associations between PM_2.5 components and asthma, and investigate which constituent of PM_2.5 possessed the most harmful effect on asthma.

METHODS

A total of 45,690 subjects were surveyed in six countries from 2007 to 2010. We geo-coded the residential community address of the participants, and used satellite remote sensing and chemical transport modeling to estimate their annual average concentrations. Mixed-effects generalized additive models were utilized to examine the associations between PM_2.5 constituents and prevalence of asthma. We further used counterfactual analyses to determine the potential number of asthma cases.

RESULTS

We identified 6,178 asthma cases among the participants, producing a prevalence of 13.5%. The odds ratio (OR) for asthma associated with per standard deviation (SD) increment was 1.12 for PM_2.5 mass, 1.12 for organic carbon (OC), 1.18 for black carbon (BC), 1.19 for sulfate, 1.28 for ammonium, and 1.21 for nitrate after controlling for potential confounders. Our counterfactual analyses suggested that ammonium was responsible for a substantial decline in asthma cases (1382, corresponding to 22.37% of overall cases) if the concentration was reduced to the 5th percentile of the current level.

CONCLUSIONS

Our study suggests that some chemical components (including BC, OC, sulfate, ammonium, and nitrate) of PM_2.5 might be hazardous constituents contributing to the prevalence of asthma, among them, ammonium might be responsible for substantial proportion of asthma cases if reduced to a certain level.

Greenness Surrounding Schools and Visual Impairment in Chinese Children and Adolescents

BACKGROUND

Evidence concerning the effects of greenness on childhood visual impairment is scarce.

OBJECTIVES

We aimed to assess whether greenness surrounding schools was associated with visual impairment prevalence and visual acuity levels in Chinese schoolchildren and whether the associations might be explained by reduced air pollution.

METHODS

In September 2013, we recruited 61,995 children and adolescents 6-18 years of age from 94 schools in seven provinces/municipalities in China. Greenness exposure was assessed using the normalized difference vegetation index (NDVI) and the soil-adjusted vegetation index (SAVI) from July to August 2013. Visual impairment was defined as at least one visual acuity level (dimensionless) lower than 4.9 (Snellen 5/6 equivalent). Three-year annual averages of particulate matter (PM) with an aerodynamic diameter of ≤1μm (PM1) and nitrogen dioxide (NO2) at each school were assessed using machine learning methods. We used generalized linear mixed models to estimate the associations between greenness and prevalent visual impairment and visual acuity levels and used mediation analyses to explore the potential mediating role of air pollution.

RESULTS

In the adjusted model, an interquartile range increase in NDVI500m was associated with lower odds of prevalent visual impairment [odds ratio (OR)=0.95; 95% confidence interval (CI): 0.93, 0.97]. The same increase in NDVI500m was also associated with 0.012 (95% CI: 0.008, 0.015) and 0.011 (95% CI: 0.007, 0.015) increases in visual acuity levels for left- and right-eye, respectively. Our results also suggested that PM1 and NO2 significantly mediated the association between NDVI500m and visual impairment. Similar effect estimates were observed for SAVI500m, and our estimates were generally robust in several sensitivity analyses.

DISCUSSION

These findings suggest higher greenness surrounding schools might reduce the risk of visual impairment, possibly owing in part to lower PM1 and NO2 in vegetated areas. Further longitudinal studies with more precise greenness assessment are warranted to confirm these findings. https://doi.org/10.1289/EHP8429.

Heavy ozone pollution episodes in urban Beijing during the early summertime from 2014 to 2017: Implications for control strategy

Ground-level ozone (O₃) has become the principal air pollutant in Beijing during recent summers. In this context, an investigation of ambient concentrations and variation characteristics of O₃ and its precursors in May and June from 2014 to 2017 in a typical urban area of Beijing was carried out, and the formation sensitivity and different causes of heavy O₃ pollution (HOP, daily maximum 8-h O₃ (MDA8h O₃)>124 ppbv) were analyzed. The results showed that the monthly assessment values of the O₃ concentrations (the 90^th percentile MDA8h O₃ within one month) were highest in May or June from 2014 to 2017, and the values presented an overall increasing trend. During this period, the number of O₃ pollution days (MDA8h O₃ > 75 ppbv) also showed an increasing trend. During the HOP episodes, the concentrations of volatile organic compounds (VOCs), nitrogen oxides (NO_X), and carbon monoxide (CO) were higher than their respective mean values in May and June, and the meteorological conditions were more conducive to atmospheric photochemical reactions. The HOP episodes were mainly caused by local photochemical formation. From 2014 to 2017, O₃ formation during the HOP episodes shifted from VOC and NO_X mixed-limited to VOC-limited conditions, and O₃ formation was most sensitive to anthropogenic VOCs. Six categories of VOC sources were identified, among which vehicular exhaust contributed the most to anthropogenic VOCs. The VOC concentrations and OFPs of anthropogenic sources have decreased significantly in recent years, indicating that VOC control measures have been effective in Beijing. Nevertheless, NO_X concentrations did not show an evident decreasing trend in the same period. Therefore, more attention should be devoted to O₃ pollution control in May and June; control measure adjustments are needed according to the changes in O₃ precursors, and coordinated control of VOCs and NO_X should be strengthened in long-term planning.

Ambient air pollution and hospital visits for peptic ulcer disease in China: A three-year analysis

BACKGROUND

Peptic ulcer disease (PUD) continued to be a source of significant morbidity and mortality worldwide. Recently, it has been reported that exposure to air pollution is a potential risk factor for PUD, but evidence on the association still remains inconsistent.

METHODS

We performed an ecological study to examine the association between short-term exposure to air pollution and daily hospital visits for PUD in Yinzhou, China from January 1st, 2017 to December 31st, 2019. Distributed lag nonlinear models were used to estimate the nonlinear and lag-response effects of air pollutants. Subgroup analyses stratified by sex, age and season were conducted to examine the effect modifications.

RESULTS

Overall, we found that short-term exposure to air pollution including SO₂, NO₂, CO, O₃ and PM_2.5 was significantly associated with hospital visits for PUD among all subjects. The lag-response effects of SO₂, NO₂ and O₃ varied at different concentrations and lag days. The cumulative risk ratios of CO and PM_2.5 showed nearly linear adverse effects and increased to maxima of 2.68 (95% CI: 1.49-4.78) and 2.40 (95% CI: 1.36-4.24) with their ranges from the references to the maximum concentrations, respectively. Moreover, the cumulative risks of particulate matters on hospital visits for PUD increased significantly in cold seasons, but not in warm seasons.

CONCLUSIONS

Our findings could provide growing evidence regarding the adverse health effects of air pollution on PUD, thereby strengthening the hypothesis that air pollutants have harmful impacts on digestive system.

Exposure to ambient air pollution and visual impairment in children: A nationwide cross-sectional study in China

Evidence concerning exposure to air pollution and visual impairment is scarce. We evaluated the associations of ambient air pollution with visual impairment and visual acuity levels in Chinese schoolchildren. We recruited 61,995 children from 7 provinces/municipalities across China. Concentrations of air pollutants (i.e., particulate matter with an aerodynamic diameter of ≤ 1.0 µm [PM₁], ≤ 2.5 µm [PM_2.5], and 10 µm [PM₁₀] as well as nitrogen dioxides [NO₂]) were measured using machine learning methods. Visual acuity levels were measured using standard protocols. We used SAS PROC SURVEYLOGISTIC to assess the association between air pollution and visual impairment. An interquartile range increase in PM₁, PM_2.5, PM₁₀, and NO₂ was associated with a 1.133- (95% CI, 1.035-1.240), 1.267- (95% CI, 1.082-1.484), 1.142- (95% CI, 1.019-1.281), and 1.276-fold (95% CI, 1.173-1.388) increased odds of visual impairment, and the associations were stronger in children being boys, older, living in rural areas, and born to parents who had a lower educational level or smoked, compared to their counterparts. These results suggest that exposure to air pollution were positively associated with the odds of visual impairment, and the association may be modified by children's age, sex, and residential area as well as parental education level and cigarette smoking.

Refractive error, axial length, environmental and hereditary factors associated with myopia in Swedish children

Clinical relevance: Investigation of refractive errors amongst Swedish schoolchildren will help identify risk factors associated with myopia development.Background: Genetic and hereditary aspects have been linked with the development of myopia. Nevertheless, in the case of 'school myopia' some authors suggest that environmental factors may affect gene expression, causing school myopia to soar. Additional understanding about which environmental factors play a relevant role can be gained by studying refractive errors in countries like Sweden, where prevalence of myopia is expected to be low.Methods: Swedish schoolchildren aged 8-16 years were invited to participate. Participants underwent an eye examination, including cycloplegic refraction and axial length (AL) measurements. Predictors such as time spent in near work, outdoor activities and parental myopia were obtained using a questionnaire. Myopia was defined as spherical equivalent refraction (SER) ≤ -0.50D and hyperopia as SER ≥ +0.75D.Results: A total of 128 children (70 females and 58 males) participated in this study with mean age of 12.0 years (SD = 2.4). Based on cycloplegic SER of the right eye, the distribution of refractive errors was: hyperopia 48.0% (CI95 = 38.8-56.7), emmetropia 42.0% (CI95 = 33.5-51.2) and myopia 10.0%. (CI95 = 4.4-14.9). The mean AL was 23.1 mm (SD = 0.86), there was a correlation between SER and AL, r = -0.65 (p < 0.001). Participants with two myopic parents had higher myopia and increased axial length than those with one or no myopic parents. The mean time spent in near work, outside of school, was 5.3 hours-per-day (SD = 3.1), and mean outdoor time reported was 2.6 hours-per-day (SD = 2.2) for all the participants. The time spent in near work and outdoor time were different for different refractive error categories.Conclusion: The prevalence of myopia amongst Swedish schoolchildren is low. Hereditary and environmental factors are associated with refractive error categories. Further studies with this sample are warranted to investigate how refractive errors and environmental factors interact over time.

Earth Observation Data Supporting Non-Communicable Disease Research: A Review

A disease is non-communicable when it is not transferred from one person to another. Typical examples include all types of cancer, diabetes, stroke, or allergies, as well as mental diseases. Non-communicable diseases have at least two things in common—environmental impact and chronicity. These diseases are often associated with reduced quality of life, a higher rate of premature deaths, and negative impacts on a countries’ economy due to healthcare costs and missing work force. Additionally, they affect the individual’s immune system, which increases susceptibility toward communicable diseases, such as the flu or other viral and bacterial infections. Thus, mitigating the effects of non-communicable diseases is one of the most pressing issues of modern medicine, healthcare, and governments in general. Apart from the predisposition toward such diseases (the genome), their occurrence is associated with environmental parameters that people are exposed to (the exposome). Exposure to stressors such as bad air or water quality, noise, extreme heat, or an overall unnatural surrounding all impact the susceptibility to non-communicable diseases. In the identification of such environmental parameters, geoinformation products derived from Earth Observation data acquired by satellites play an increasingly important role. In this paper, we present a review on the joint use of Earth Observation data and public health data for research on non-communicable diseases. We analyzed 146 articles from peer-reviewed journals (Impact Factor ≥ 2) from all over the world that included Earth Observation data and public health data for their assessments. Our results show that this field of synergistic geohealth analyses is still relatively young, with most studies published within the last five years and within national boundaries. While the contribution of Earth Observation, and especially remote sensing-derived geoinformation products on land surface dynamics is on the rise, there is still a huge potential for transdisciplinary integration into studies. We see the necessity for future research and advocate for the increased incorporation of thematically profound remote sensing products with high spatial and temporal resolution into the mapping of exposomes and thus the vulnerability and resilience assessment of a population regarding non-communicable diseases.