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Johnston FH, Williamson G, Borchers-Arriagada N, Henderson SB, Bowman DMJS. Climate Change, Landscape Fires, and Human Health: A Global Perspective. Annu Rev Public Health 2024; 45:295-314. [PMID: 38166500 DOI: 10.1146/annurev-publhealth-060222-034131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Landscape fires are an integral component of the Earth system and a feature of prehistoric, subsistence, and industrial economies. Specific spatiotemporal patterns of landscape fire occur in different locations around the world, shaped by the interactions between environmental and human drivers of fire activity. Seven distinct types of landscape fire emerge from these interactions: remote area fires, wildfire disasters, savanna fires, Indigenous burning, prescribed burning, agricultural burning, and deforestation fires. All can have substantial impacts on human health and well-being directly and indirectly through (a) exposure to heat flux (e.g., injuries and destructive impacts), (b) emissions (e.g., smoke-related health impacts), and (c) altered ecosystem functioning (e.g., biodiversity, amenity, water quality, and climate impacts). Minimizing the adverse effects of landscape fires on population health requires understanding how human and environmental influences on fire impacts can be modified through interventions targeted at individual, community, and regional levels.
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Affiliation(s)
- Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia;
- National Health and Medical Research Council (NHMRC) Centre for Safe Air, Hobart, Tasmania, Australia
| | - Grant Williamson
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
- National Health and Medical Research Council (NHMRC) Centre for Safe Air, Hobart, Tasmania, Australia
| | | | - Sarah B Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - David M J S Bowman
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
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Lee SA, Corbett GA, McAuliffe FM. Obstetric care for environmental migrants. Ir J Med Sci 2024; 193:797-812. [PMID: 37715828 PMCID: PMC10961262 DOI: 10.1007/s11845-023-03481-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/26/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Migration due to environmental factors is an international crisis affecting many nations globally. Pregnant people are a vulnerable subgroup of migrants. AIM This article explores the potential effects of environmental migration on pregnancy and aims to draw attention to this rising concern. METHODS Based on the study aim, a semi-structured literature review was performed. The following databases were searched: MEDLine (PubMed) and Google Scholar. The search was originally conducted on 31st January 2021 and repeated on 22nd September 2022. RESULTS Pregnant migrants are at increased risk of mental health disorders, congenital anomalies, preterm birth, and maternal mortality. Pregnancies exposed to natural disasters are at risk of low birth weight, preterm birth, hypertensive disorders, gestational diabetes, and mental health morbidity. Along with the health risks, there are additional complex social factors affecting healthcare engagement in this population. CONCLUSION Maternity healthcare providers are likely to provide care for environmental migrants over the coming years. Environmental disasters and migration as individual factors have complex effects on perinatal health, and environmental migrants may be at risk of specific perinatal complications. Obstetricians and maternity healthcare workers should be aware of these challenges and appreciate the individualised and specialised care that these patients require.
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Affiliation(s)
- Sadhbh A Lee
- National Maternity Hospital, Holles St., Dublin 2, Ireland
| | | | - Fionnuala M McAuliffe
- National Maternity Hospital, Holles St., Dublin 2, Ireland.
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
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Ziou M, Gao CX, Wheeler AJ, Zosky GR, Stephens N, Knibbs LD, Melody SM, Venn AJ, Dalton MF, Dharmage SC, Johnston FH. Contrasting Health Outcomes following a Severe Smoke Episode and Ambient Air Pollution in Early Life: Findings from an Australian Data Linkage Cohort Study of Hospital Utilization. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:117005. [PMID: 37962441 PMCID: PMC10644899 DOI: 10.1289/ehp12238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Episodic spikes in air pollution due to landscape fires are increasing, and their potential for longer term health impacts is uncertain. OBJECTIVE Our objective is to evaluate associations between exposure in utero and in infancy to severe pollution from a mine fire, background ambient air pollution, and subsequent hospital care. METHODS We linked health records of births, emergency department (ED) visits, and hospitalizations of children born in the Latrobe Valley, Australia, 2012-2015, which included a severe pollution episode from a mine fire (9 February 2014 to 25 March 2014). We assigned modeled exposure estimates for fire-related and ambient particulate matter with an aerodynamic diameter of 2.5 μ m (PM 2.5 ) to residential address. We used logistic regression to estimate associations with hospital visits for any cause and groupings of infectious, allergic, and respiratory conditions. Outcomes were assessed for the first year of life in the in utero cohort and the year following the fire in the infant cohort. We estimated exposure-response for both fire-related and ambient PM 2.5 and also employed inverse probability weighting using the propensity score to compare exposed and not/minimally exposed children. RESULTS Prenatal exposure to fire-related PM 2.5 was associated with ED presentations for allergies/skin rash [odds ratio ( OR ) = 1.34 , 95% confidence interval (CI): 1.01, 1.76 per 240 μ g / m 3 increase]. Exposure in utero to ambient PM 2.5 was associated with overall presentations (OR = 1.18 , 95% CI: 1.05, 1.33 per 1.4 μ g / m 3 ) and visits for infections (ED: OR = 1.13 , 95% CI: 0.98, 1.29; hospitalizations: OR = 1.23 , 95% CI: 1.00, 1.52). Exposure in infancy to fire-related PM 2.5 compared to no/minimal exposure, was associated with ED presentations for respiratory (OR = 1.37 , 95% CI: 1.05, 1.80) and infectious conditions (any: OR = 1.21 , 95% CI: 0.98, 1.49; respiratory-related: OR = 1.39 , 95% CI: 1.05, 1.83). Early life exposure to ambient PM 2.5 was associated with overall ED visits (OR = 1.17 , 95% CI: 1.05, 1.30 per 1.4 μ g / m 3 increase). DISCUSSION Higher episodic and lower ambient concentrations of PM 2.5 in early life were associated with visits for allergic, respiratory, and infectious conditions. Our findings also indicated differences in associations at the two developmental stages. https://doi.org/10.1289/EHP12238.
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Affiliation(s)
- Myriam Ziou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Caroline X. Gao
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Amanda J. Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Oceans and Atmosphere, Aspendale, Victoria, Australia
| | - Graeme R. Zosky
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Nicola Stephens
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Luke D. Knibbs
- School of Public Health, The University of Sydney, New South Wales, Australia
- Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Shannon M. Melody
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Alison J. Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Marita F. Dalton
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Fay H. Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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McDonald VM, Archbold G, Beyene T, Brew BK, Franklin P, Gibson PG, Harrington J, Hansbro PM, Johnston FH, Robinson PD, Sutherland M, Yates D, Zosky GR, Abramson MJ. Asthma and landscape fire smoke: A Thoracic Society of Australia and New Zealand position statement. Respirology 2023; 28:1023-1035. [PMID: 37712340 PMCID: PMC10946536 DOI: 10.1111/resp.14593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/14/2023] [Indexed: 09/16/2023]
Abstract
Landscape fires are increasing in frequency and severity globally. In Australia, extreme bushfires cause a large and increasing health and socioeconomic burden for communities and governments. People with asthma are particularly vulnerable to the effects of landscape fire smoke (LFS) exposure. Here, we present a position statement from the Thoracic Society of Australia and New Zealand. Within this statement we provide a review of the impact of LFS on adults and children with asthma, highlighting the greater impact of LFS on vulnerable groups, particularly older people, pregnant women and Aboriginal and Torres Strait Islander peoples. We also highlight the development of asthma on the background of risk factors (smoking, occupation and atopy). Within this document we present advice for asthma management, smoke mitigation strategies and access to air quality information, that should be implemented during periods of LFS. We promote clinician awareness, and the implementation of public health messaging and preparation, especially for people with asthma.
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Affiliation(s)
- Vanessa M. McDonald
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
- Department of Sleep and Respiratory MedicineHunter New England Local Health DistrictNewcastleNew South WalesAustralia
| | - Gregory Archbold
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
| | - Tesfalidet Beyene
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
| | - Bronwyn K. Brew
- National Perinatal Epidemiology and Biostatistics Unit, Centre for Big Data Research in Health, Discipline of Women's Health, Faculty of MedicineUNSWSydneyNew South WalesAustralia
| | - Peter Franklin
- School of Population and Global HealthThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Peter G. Gibson
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
- Department of Sleep and Respiratory MedicineHunter New England Local Health DistrictNewcastleNew South WalesAustralia
| | - John Harrington
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
- Department of Sleep and Respiratory MedicineHunter New England Local Health DistrictNewcastleNew South WalesAustralia
| | - Philip M. Hansbro
- Centre for InflammationCentenary Institute and University of Technology Sydney, School of Life Sciences, Faculty of ScienceSydneyNew South WalesAustralia
- Immune HealthHunter Medical Research Institute and The University of NewcastleCallaghanNew South WalesAustralia
| | - Fay H. Johnston
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Paul D. Robinson
- Department of Respiratory and Sleep MedicineQueensland Children's HospitalBrisbaneQueenslandAustralia
- Children's Health and Environment Program, Child Health Research CentreUniversity of QueenslandBrisbaneQueenslandAustralia
| | | | - Deborah Yates
- Department of Thoracic MedicineSt Vincent's HospitalDarlinghurstNew South WalesAustralia
- School of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Graeme R. Zosky
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
- Tasmanian School of MedicineUniversity of TasmaniaHobartTasmaniaAustralia
| | - Michael J. Abramson
- School of Public Health & Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
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Ziou M, Gao CX, Wheeler AJ, Zosky GR, Stephens N, Knibbs LD, Williamson GJ, Melody SM, Venn AJ, Dalton MF, Dharmage SC, Johnston FH. Primary and pharmaceutical care usage concurrent associations with a severe smoke episode and low ambient air pollution in early life. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 883:163580. [PMID: 37100138 DOI: 10.1016/j.scitotenv.2023.163580] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/10/2023] [Accepted: 04/15/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Due to climate change, landscape fires account for an increasing proportion of air pollution emissions, and their impacts on primary and pharmaceutical care are little understood. OBJECTIVES To evaluate associations between exposure in two early life periods to severe levels of PM2.5 from a mine fire, background PM2.5, and primary and pharmaceutical care. METHODS We linked records of births, general practitioner (GP) presentations and prescription dispensing for children born in the Latrobe Valley, Australia, 2012-2014, where a severe mine fire occurred in February-March 2014 in an area with otherwise low levels of ambient PM2.5. We assigned modelled exposure estimates for fire-related (cumulative over the fire and peak 24-hour average) and annual ambient PM2.5 to residential address. Associations with GP presentations and dispensing of prescribed medications in the first two years of life (exposure in utero) and in the two years post-fire (exposure in infancy) were estimated using two-pollutant quasi-Poisson regression models. RESULTS Exposure in utero to fire-related PM2.5 was associated with an increase in systemic steroid dispensing (Cumulative: IRR = 1.11, 95%CI = 1.00-1.24 per 240 μg/m3; Peak: IRR = 1.15, 95%CI = 1.00-1.32 per 45 μg/m3), while exposure in infancy was associated with antibiotic dispensing (Cumulative: IRR = 1.05, 95%CI = 1.00-1.09; Peak: IRR = 1.06, 95%CI = 1.00-1.12). Exposure in infancy to ambient PM2.5, despite relatively low levels from a global perspective (Median = 6.1 μg/m3), was associated with an increase in antibiotics (IRR = 1.10, 95%CI = 1.01-1.19 per 1.4 μg/m3) and in GP presentations (IRR = 1.05, 95%CI = 1.00-1.11), independently from exposure to the fire. We also observed differences in associations between sexes with GP presentations (stronger in girls) and steroid skin cream dispensing (stronger in boys). DISCUSSION Severe medium-term concentrations of PM2.5 were linked with increased pharmaceutical treatment for infections, while chronic low levels were associated with increased prescriptions dispensed for infections and primary care usage. Our findings also indicated differences between sexes.
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Affiliation(s)
- Myriam Ziou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Caroline X Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Amanda J Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia; Commonwealth Scientific and Industrial Research Organisation (CSIRO) Oceans and Atmosphere, Aspendale, Victoria 3195, Australia
| | - Graeme R Zosky
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania 7000, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Nicola Stephens
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, NSW 2006, Australia; Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Sandy Bay, Tasmania 7005, Australia
| | - Shannon M Melody
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Marita F Dalton
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Carlton, Victoria 3052, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia.
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Alvarado-Jiménez D, Donzelli G, Morales-Suárez-Varela M. A systematic review on the association between exposure to air particulate matter during pregnancy and the development of hypertensive disorders of pregnancy and gestational diabetes mellitus. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 0:reveh-2022-0258. [PMID: 37141623 DOI: 10.1515/reveh-2022-0258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
Particulate matter (PM) is considered an intrauterine toxin that can cross the blood-placental barrier and circulate in fetal blood, affecting fetal development, and implicating placental and intrauterine inflammation, and oxidative damage. However, the relationship between PM exposure and adverse pregnancy outcomes is still unclear and our aim was to systematically review toxicological evidence on the link between PM exposure during pregnancy and the development of gestational diabetes mellitus or hypertensive disorders of pregnancy, including gestational hypertension and pre-eclampsia. PubMed and Science Direct were searched until January 2022. Of the 204 studies identified, 168 were excluded. The remaining articles were assessed in full-text, and after evaluation, 27 were included in the review. Most of the studies showed an association between PM exposure and gestational hypertension, systolic and diastolic blood pressure, pre-eclampsia, and gestational diabetes mellitus. These results should be interpreted with caution due to the heterogeneity of baseline concentrations, which ranged from 3.3 μg/m3 to 85.9 μg/m3 and from 21.8 μg/m3 to 92.2 μg/m3, respectively for PM2.5 and PM10. Moreover, critical exposure periods were not consistent among studies, with five out of ten observational studies reporting the second trimester as the critical period for hypertensive disorders of pregnancy, and ten out of twelve observational studies reporting the first or second trimester as the critical period for gestational diabetes mellitus. Overall, the findings support an association between PM exposure during pregnancy and adverse pregnancy outcomes, highlighting the need for further research to identify the critical exposure periods and underlying mechanisms.
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Affiliation(s)
| | - Gabriele Donzelli
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - María Morales-Suárez-Varela
- Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine, School of Pharmacy, University of Valencia, Burjassot, Valencia, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Liang W, Zhu H, Xu J, Zhao Z, Zhou L, Zhu Q, Cai J, Ji L. Ambient air pollution and gestational diabetes mellitus: An updated systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 255:114802. [PMID: 36934545 DOI: 10.1016/j.ecoenv.2023.114802] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/23/2023] [Accepted: 03/15/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE We aimed to evaluate the relationship between the composition of particulate matter (PM) and gestational diabetes mellitus (GDM) by a comprehensively review of epidemiological studies. METHODS We systematically identified cohort studies related to air pollution and GDM risk before February 8, 2023 from six databases (PubMed, Embase, Web of Science Core Collection, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform and Chongqing VIP Chinese Science and Technology Periodical databases). We calculated the relative risk (RR) and its 95% confidence intervals (CIs) to assess the overall effect by using a random effects model. RESULTS This meta-analysis of 31 eligible cohort studies showed that exposure to PM2.5, PM10, SO2, and NO2 was associated with a significantly increased risk of GDM, especially in preconception and first trimester. Analysis of the components of PM2.5 found that the risk of GDM was strongly linked to black carbon (BC) and nitrates (NO3-). Specifically, BC exposure in the second trimester and NO3- exposure in the first trimester elevated the risk of GDM, with the RR of 1.128 (1.032-1.231) and 1.128 (1.032-1.231), respectively. The stratified analysis showed stronger correlations of GDM risk with higher levels of pollutants in Asia, except for PM2.5 and BC, which suggested that the specific composition of particulate pollutants had a greater effect on the exposure-outcome association than the concentration. CONCLUSIONS Our study found that ambient air pollutant is a critical factor for GDM and further studies on specific particulate matter components should be considered in the future.
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Affiliation(s)
- Weiqi Liang
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo, China
| | - Hui Zhu
- Department of Internal Medicine, School of Medicine, Ningbo University, Ningbo, China
| | - Jin Xu
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo, China; Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Zhijia Zhao
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo, China
| | - Liming Zhou
- Center for Reproductive Medicine, Ningbo Women and Children's Hospital, Ningbo, China
| | - Qiong Zhu
- Department of Pediatrics, Affiliated People's Hospital of Ningbo University, Ningbo, China
| | - Jie Cai
- Center for Reproductive Medicine, Ningbo Women and Children's Hospital, Ningbo, China.
| | - Lindan Ji
- Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China; Department of Biochemistry, School of Medicine, Ningbo University, Ningbo, China.
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Brew BK, Donnolley N, Henry A, Dahlen H, Jalaludin B, Chambers GM. Double jeopardy-pregnancy and birth during a catastrophic bushfire event followed by a pandemic lockdown, a natural experiment. ENVIRONMENTAL RESEARCH 2022; 214:113752. [PMID: 35777439 DOI: 10.1016/j.envres.2022.113752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/01/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND From November 2019 to January 2020, eastern Australia experienced the worst bushfires in recorded history. Two months later, Sydney and surrounds were placed into lockdown for six weeks due to the COVID-19 pandemic, followed by ongoing restrictions. Many pregnant women at this time were exposed to both the bushfires and COVID-19 restrictions. OBJECTIVE To assess the impact of exposure to bushfires and pandemic restrictions on perinatal outcomes. METHODS The study included 60 054 pregnant women who gave birth between November 2017 and December 2020 in South Sydney. Exposure cohorts were based on conception and birthing dates: 1) bushfire late pregnancy, born before lockdown; 2) bushfires in early-mid pregnancy, born during lockdown or soon after; 3) conceived during bushfires, lockdown in second trimester; 4) conceived after bushfires, pregnancy during restrictions. Exposure cohorts were compared with pregnancies in the matching periods in the two years prior. Associations between exposure cohorts and gestational diabetes, preeclampsia, hypertension, stillbirth, mode of birth, birthweight, preterm birth and small for gestational age were assessed using generalised estimating equations, adjusting for covariates. RESULTS A decrease in low birth weight was observed for cohort 1 (aOR 0.81, 95%CI 0.69, 0.95). Conversely, cohort 2 showed an increase in low birth weight, and increases in prelabour rupture of membranes, and caesarean sections (aOR 1.18, 95%CI 1.03, 1.37; aOR 1.21, 95%CI 1.07, 1.37; aOR 1.10 (1.02, 1.18) respectively). Cohort 3 showed an increase in unplanned caesarean sections and high birth weight babies (aOR 1.15, 95%CI 1.04, 1.27 and aOR 1.16, 95%CI 1.02, 1.31 respectively), and a decrease in gestational diabetes mellitus was observed for both cohorts 3 and 4. CONCLUSION Pregnancies exposed to both severe climate events and pandemic disruptions appear to have increased risk of adverse perinatal outcomes beyond only experiencing one event, but further research is needed.
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Affiliation(s)
- Bronwyn K Brew
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health & School of Clinical Medicine, UNSW, Australia.
| | - Natasha Donnolley
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health & School of Clinical Medicine, UNSW, Australia
| | - Amanda Henry
- Discipline of Women's Health, School of Clinical Medicine, UNSW, Australia; Department of Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia
| | - Hannah Dahlen
- School of Nursing and Midwifery, Western Sydney University, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, UNSW Sydney, Australia
| | - Georgina M Chambers
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health & School of Clinical Medicine, UNSW, Australia
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Liu R, Zhang J, Chu L, Zhang J, Guo Y, Qiao L, Niu Z, Wang M, Farhat Z, Grippo A, Zhang Y, Ma C, Zhang Y, Zhu K, Mu L, Lei L. Association of ambient fine particulate matter exposure with gestational diabetes mellitus and blood glucose levels during pregnancy. ENVIRONMENTAL RESEARCH 2022; 214:114008. [PMID: 35931192 DOI: 10.1016/j.envres.2022.114008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 07/12/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Previous studies have examined the associations between ambient fine particulate matter (PM2.5) exposure and gestational diabetes mellitus (GDM). However, limited studies explored the relationships between PM2.5 exposure and blood glucose levels during pregnancy, especially in highly polluted areas. OBJECTIVES To examine the associations of prenatal ambient PM2.5 exposure with GDM and blood glucose levels, and to identify the sensitive exposure windows in a highly air-polluted area. METHODS From July 2016 to October 2017, a birth cohort study was conducted in Beijing, China. Participants were interviewed in each trimester regarding demographics, lifestyle, living and working environment, and medical conditions. Participant's daily ambient PM2.5 levels from 3 m before last menstrual period (LMP) to the third trimester was estimated by a hybrid spatiotemporal model. Indoor air quality index was calculated based on environmental tobacco smoke, ventilation, cooking, painting, pesticide, and herbicide use. Distributed lag non-linear model was applied to explore the sensitive weeks of PM2.5 exposure. RESULTS Of 165 pregnant women, 23 (13.94%) developed GDM. After adjusting for potential confounders, PM2.5 exposure during the 1st trimester was associated with higher odds of GDM (10 μg/m3 increase: OR = 1.89, 95% CI: 1.04-3.49). Each 10 μg/m3 increase in PM2.5 during the 2nd trimester was associated with 17.70% (2.21-33.20), 15.99% (2.96-29.01), 18.82% (4.11-33.52), and 17.10% (3.28-30.92) increase in 1-h, 2-h, Δ1h-fasting (1-h minus fasting), and Δ2h-fasting (2-h minus fasting) blood glucose levels, respectively. PM2.5 exposure at 24th-27th weeks after LMP was associated with increased GDM risk. We identified sensitive exposure windows of 21st-24th weeks for higher 1-h and 2-h blood glucose levels and of 20th-22nd weeks for increased Δ1h-fasting and Δ2h-fasting. CONCLUSIONS Ambient PM2.5 exposure during the second trimester was associated with higher odds of GDM and higher blood glucose levels. Avoiding exposure to high air pollution levels during the sensitive windows might prevent women from developing GDM.
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Affiliation(s)
- Rujie Liu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jun Zhang
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Li Chu
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jun Zhang
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yanjun Guo
- Department of Obstetrics and Gynecology, Aerospace Center Hospital, Beijing, China
| | - Lihua Qiao
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Zhongzheng Niu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Zeinab Farhat
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Alexandra Grippo
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Yifan Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Changxing Ma
- Department of Biostatistics, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Yingying Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA.
| | - Lijian Lei
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
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10
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Eberle C, Stichling S. Environmental health influences in pregnancy and risk of gestational diabetes mellitus: a systematic review. BMC Public Health 2022; 22:1572. [PMID: 35982427 PMCID: PMC9389831 DOI: 10.1186/s12889-022-13965-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications globally. Environmental risk factors may lead to increased glucose levels and GDM, which in turn may affect not only the health of the mother but assuming hypotheses of "fetal programming", also the health of the offspring. In addition to traditional GDM risk factors, the evidence is growing that environmental influences might affect the development of GDM. We conducted a systematic review analyzing the association between several environmental health risk factors in pregnancy, including climate factors, chemicals and metals, and GDM. Methods We performed a systematic literature search in Medline (PubMed), EMBASE, CINAHL, Cochrane Library and Web of Science Core Collection databases for research articles published until March 2021. Epidemiological human and animal model studies that examined GDM as an outcome and / or glycemic outcomes and at least one environmental risk factor for GDM were included. Results Of n = 91 studies, we classified n = 28 air pollution, n = 18 persistent organic pollutants (POP), n = 11 arsenic, n = 9 phthalate n = 8 bisphenol A (BPA), n = 8 seasonality, n = 6 cadmium and n = 5 ambient temperature studies. In total, we identified two animal model studies. Whilst we found clear evidence for an association between GDM and air pollution, ambient temperature, season, cadmium, arsenic, POPs and phthalates, the findings regarding phenols were rather inconsistent. There were clear associations between adverse glycemic outcomes and air pollution, ambient temperature, season, POPs, phenols, and phthalates. Findings regarding cadmium and arsenic were heterogeneous (n = 2 publications in each case). Conclusions Environmental risk factors are important to consider in the management and prevention of GDM. In view of mechanisms of fetal programming, the environmental risk factors investigated may impair the health of mother and offspring in the short and long term. Further research is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13965-5.
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Affiliation(s)
- Claudia Eberle
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany.
| | - Stefanie Stichling
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany
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11
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Williamson R, Banwell C, Calear AL, LaBond C, Leach LS, Olsen A, Phillips C, Walsh EI, Zulfiqar T. ‘I didn’t feel safe inside’: navigating public health advice, housing and living with bushfire smoke. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2022.2082923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Rebecca Williamson
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Cathy Banwell
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Alison L. Calear
- Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Christine LaBond
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Liana S. Leach
- The National Centre for Epidemiology and Population Health (NCEPH), College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Anna Olsen
- ANU Medical School, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Christine Phillips
- ANU Medical School, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Erin I. Walsh
- Population Health Exchange (PHXchange), Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Tehzeeb Zulfiqar
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
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12
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Cheng X, Ji X, Yang D, Zhang C, Chen L, Liu C, Meng X, Wang W, Li H, Kan H, Huang H. Associations of PM 2.5 exposure with blood glucose impairment in early pregnancy and gestational diabetes mellitus. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 232:113278. [PMID: 35131583 DOI: 10.1016/j.ecoenv.2022.113278] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/22/2022] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
Exposure to fine particulate matter (PM2.5) during pregnancy has been linked to the risk of gestational diabetes mellitus (GDM), while conclusions are inconsistent. In this study we aimed to estimate the effects of prenatal PM2.5 exposure with blood glucose in early pregnancy and the GDM risk. Participants were recruited from the SH-IPMCH-BTH cohort (n = 41,929), a study of air pollution and birth outcome. All participants provided serum samples for analyses of fasting blood glucose (FBG) and HbA1c during early pregnancy. GDM was diagnosed using an oral glucose tolerance test (OGTT) with the time interval of 1 h. Prenatal exposure to PM2.5 was estimated using gap-filled satellite exposure assessments in Shanghai, China. Both FBG and HbA1c levels were significantly and positively associated with PM2.5 exposure during early pregnancy. A 10 μg/m3 increase of PM2.5 exposure from early to middle pregnancy was associated with the risk of GDM (first trimester OR=1.09, 95% CI: 1.02, 1.16; second trimester OR=1.09, 95% CI: 1.03, 1.16; first two trimester OR=1.15, 95%CI: 1.04, 1.28). The combined effects were greater among elevated FBG and HbA1c women with higher PM2.5 exposure in middle trimester (P for interaction=0.037 and 0.001, respectively). This study found that exposure to PM2.5 exposure in the 1st and 2nd trimesters was related to GDM. FBG and HbA1c played roles in the relationship between PM2.5 exposure in the 2nd trimester and GDM.
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Affiliation(s)
- Xiaoyue Cheng
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Xinhua Ji
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Dongjian Yang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Chen Zhang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Chen
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Huichu Li
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China
| | - Hefeng Huang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
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13
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Williamson R, Banwell C, Calear AL, LaBond C, Leach LS, Olsen A, Walsh EI, Zulfiqar T, Sutherland S, Phillips C. Bushfire Smoke in Our Eyes: Community Perceptions and Responses to an Intense Smoke Event in Canberra, Australia. Front Public Health 2022; 10:793312. [PMID: 35284396 PMCID: PMC8907569 DOI: 10.3389/fpubh.2022.793312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/18/2022] [Indexed: 02/05/2023] Open
Abstract
The 2019–20 bushfires that raged in eastern Australia were an overwhelming natural disaster leading to lives lost or upended, and communities destroyed. For almost a month, Canberra, Australia's capital city in the Australian Capital Territory (ACT), was obscured by smoke from fires which threatened the outer suburbs. While smoke itself is experientially different from many natural disasters, it nevertheless poses a significant public health threat. As the impact of extended bushfire smoke in an urban setting is relatively unexplored we aimed to capture the individual and community-level experiences of the event and their importance for community and social functioning. We responded rapidly by conducting semi-structured interviews with a range of Canberra residents who, due to their personal or social circumstances, were potentially vulnerable to the effects of the smoke. Three major themes emerging from the narratives depicted disruption to daily life, physical and psychological effects, and shifting social connectedness. This study highlighted the ambiguous yet impactful nature of a bushfire smoke event, and identified four simple key messages that may be critically relevant to policy making in preparation for similar smoke events in the future.
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Affiliation(s)
- Rebecca Williamson
- The National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Cathy Banwell
- The National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
- *Correspondence: Cathy Banwell
| | - Alison L. Calear
- Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Christine LaBond
- The National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Liana S. Leach
- The National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Anna Olsen
- Australian National University (ANU) Medical School, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Erin I. Walsh
- Population Health Exchange (PHXchange), Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Tehzeeb Zulfiqar
- Australian National University (ANU) Medical School, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Stewart Sutherland
- The National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Christine Phillips
- Australian National University (ANU) Medical School, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
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14
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Melody SM, Wheeler AJ, Dalton M, Williamson GJ, Negishi K, Willis G, Shao J, Zhao B, Chappell K, Wills K, Reeves M, Emmerson KM, Ford J, Dennekamp M, Foong RE, Abramson MJ, Ikin J, Walker J, Venn A, Dharmage S, Hall G, Zosky G, Johnston F. Cohort Profile: The Hazelwood Health Study Latrobe Early Life Follow-Up (ELF) Study. Int J Epidemiol 2021; 49:1779-1780. [PMID: 33083835 DOI: 10.1093/ije/dyaa136] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/06/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Shannon M Melody
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Amanda J Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Marita Dalton
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Kazuaki Negishi
- Sydney Medical School Nepean, Charles Perkins Centre Nepean, University of Sydney, NSW, Australia
| | - Gabriela Willis
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jingyi Shao
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Bing Zhao
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Katherine Chappell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Melanie Reeves
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kathryn M Emmerson
- Climate Science Centre, CSIRO Oceans & Atmosphere, Aspendale, VIC, Australia
| | - Jane Ford
- Clinical and Population Perinatal Health Research, Kolling Institute, St Leonards, NSW, Australia
| | - Martine Dennekamp
- Environmental Public Health, Environment Protection Authority Victoria, Melbourne, VIC, Australia
| | - Rachel E Foong
- Children's Lung Health, Telethon Kids Institute, Perth, WA, Australia.,School of Physiotherapy and Exercise Sciences, Curtin University, Perth, WA, Australia
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jillian Ikin
- School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Judi Walker
- School of Rural Health, Monash University, Melbourne, VIC, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Shyamali Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Graham Hall
- Children's Lung Health, Telethon Kids Institute, Perth, WA, Australia.,School of Physiotherapy and Exercise Sciences, Curtin University, Perth, WA, Australia
| | - Graeme Zosky
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,School of Medicine, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
| | - Fay Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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15
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Respiratory Impacts of Wildland Fire Smoke: Future Challenges and Policy Opportunities. An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2021; 18:921-930. [PMID: 33938390 PMCID: PMC8456726 DOI: 10.1513/annalsats.202102-148st] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Wildland fires are diminishing air quality on a seasonal and regional basis, raising concerns about respiratory health risks to the public and occupational groups. This American Thoracic Society (ATS) workshop was convened in 2019 to meet the growing health threat of wildland fire smoke. The workshop brought together a multidisciplinary group of 19 experts, including wildland fire managers, public health officials, epidemiologists, toxicologists, and pediatric and adult pulmonologists. The workshop examined the following four major topics: 1) the science of wildland fire incidence and fire management, 2) the respiratory and cardiovascular health effects of wildland fire smoke exposure, 3) communication strategies to address these health risks, and 4) actions to address wildland fire health impacts. Through formal presentations followed by group discussion, workshop participants identified top priorities for fire management, research, communication, and public policy to address health risks of wildland fires. The workshop concluded that short-term exposure to wildland smoke causes acute respiratory health effects, especially among those with asthma and chronic obstructive pulmonary disease. Research is needed to understand long-term health effects of repeated smoke exposures across fire seasons for children, adults, and highly exposed occupational groups (especially firefighters). Other research priorities include fire data collection and modeling, toxicology of different fire fuel sources, and the efficacy of health protective measures to prevent respiratory effects of smoke exposure. The workshop committee recommends a unified federal response to the growing problem of wildland fires, including investment in fire behavior and smoke air quality modeling, research on the health impacts of smoke, and development of robust clinical and public health communication tools.
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16
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Zhang H, Zhao Y. Ambient air pollution exposure during pregnancy and gestational diabetes mellitus in Shenyang, China: a prospective cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:7806-7814. [PMID: 33037545 DOI: 10.1007/s11356-020-11143-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. Reports of the association between air pollution exposure and GDM have been inconsistent in previous studies. We conducted a cohort study to investigate the associations between air pollution exposure and GDM in the city of Shenyang in Northeast China for the first time. We studied interactions with different air pollutant exposures and conducted a stratified analysis according to folic acid intake, age, body mass index (BMI), primiparity, and sleep quality. We found significant associations between prenatal exposure to NOx and SO2 and the development of GDM during the second trimester: the largest effect on GDM was exposure to SO2 (odds ratio (OR): 1.77, 95% confidence interval (CI): 1.23-2.56) in the largest quartile compared with the lowest quartile. Significant interactions between age, BMI, parity, sleep quality, and air pollution exposures were observed; stratified analysis showed stronger associations between GDM and high air pollutant exposure in pregnant women with older age, larger BMI, poorer sleep quality, and more parity. We found that air pollution exposure during the second trimester was significantly associated with GDM in a prospective birth cohort study in Northeast China. SO2, oxynitride (NOX, NO2, NO), CO, and O3 all showed a linear trend effect on GDM. Interactions between prenatal air pollution exposure and other factors, such as age at pregnancy, BMI before pregnancy, primiparity, folic acid intake, and sleep quality, during the second trimester might exist.
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Affiliation(s)
- Hehua Zhang
- Clinical Reserch Center, Shengjing Hospital of China Medical University, Huaxiang Road No. 39, Tiexi District, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Sanhao Street, No. 36, Heping District, China.
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17
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Willis GA, Chappell K, Williams S, Melody SM, Wheeler A, Dalton M, Dharmage SC, Zosky GR, Johnston FH. Respiratory and atopic conditions in children two to four years after the 2014 Hazelwood coalmine fire. Med J Aust 2020; 213:269-275. [PMID: 32770850 DOI: 10.5694/mja2.50719] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate associations between exposure during early life to mine fire smoke and parent-reported indicators of respiratory and atopic illness 2-4 years later. DESIGN, SETTING The Hazelwood coalmine fire exposed a regional Australian community to markedly increased air pollution during February - March 2014. During June 2016 - October 2018 we conducted a prospective cohort study of children from the Latrobe Valley. PARTICIPANTS Seventy-nine children exposed to smoke in utero, 81 exposed during early childhood (0-2 years of age), and 129 children conceived after the fire (ie, unexposed). EXPOSURE Individualised mean daily and peak 24-hour fire-attributable fine particulate matter (PM2.5 ) exposure during the fire period, based on modelled air quality and time-activity data. MAIN OUTCOME MEASURES Parent-reported symptoms, medications use, and contacts with medical professionals, collected in monthly online diaries for 29 months, 2-4 years after the fire. RESULTS In the in utero exposure analysis (2678 monthly diaries for 160 children exposed in utero or unexposed), each 10 μg/m3 increase in mean daily PM2.5 exposure was associated with increased reports of runny nose/cough (relative risk [RR], 1.09; 95% CI, 1.02-1.17), wheeze (RR, 1.56; 95% CI, 1.18-2.07), seeking health professional advice (RR, 1.17; 95% CI 1.06-1.29), and doctor diagnoses of upper respiratory tract infections, cold or flu (RR, 1.35; 95% CI, 1.14-1.60). Associations with peak 24-hour PM2.5 exposure were similar. In the early childhood exposure analysis (3290 diaries for 210 children exposed during early childhood, or unexposed), each 100 μg/m3 increase in peak 24-hour PM2.5 exposure was associated with increased use of asthma inhalers (RR, 1.26; 95% CI, 1.01-1.58). CONCLUSIONS Exposure to mine fire smoke in utero was associated with increased reports by parents of respiratory infections and wheeze in their children 2-4 years later.
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Affiliation(s)
- Gabriela A Willis
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS.,National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Kate Chappell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS
| | - Stephanie Williams
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Shannon M Melody
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS
| | - Amanda Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC
| | - Marita Dalton
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS
| | - Shyamali C Dharmage
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Graeme R Zosky
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS
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18
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Ikin J, Carroll MTC, Walker J, Borg B, Brown D, Cope M, del Monaco A, Dennekamp M, Dimitriadis C, Gao CX, Guo Y, Johnston F, Liew D, Maybery D, Thompson B, Sim M, Abramson MJ. Cohort Profile: The Hazelwood Health Study Adult Cohort. Int J Epidemiol 2020; 49:1777-1778. [DOI: 10.1093/ije/dyaa083] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/20/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jillian Ikin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | - Judi Walker
- Monash Rural Health, Monash University, Churchill, VIC, Australia
| | - Brigitte Borg
- Respiratory Medicine, The Alfred, Melbourne, VIC, Australia
| | - David Brown
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Martin Cope
- CSIRO Climate Science Centre, Oceans and Atmosphere, Aspendale, VIC, Australia
| | - Anthony del Monaco
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Martine Dennekamp
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Christina Dimitriadis
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Caroline X Gao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Fay Johnston
- Environmental Health Research Group, Menzies Institute of Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Danny Liew
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Darryl Maybery
- Monash Rural Health, Monash University, Churchill, VIC, Australia
| | - Bruce Thompson
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Malcolm Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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19
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Kunovac A, Hathaway QA, Pinti MV, Taylor AD, Hollander JM. Cardiovascular adaptations to particle inhalation exposure: molecular mechanisms of the toxicology. Am J Physiol Heart Circ Physiol 2020; 319:H282-H305. [PMID: 32559138 DOI: 10.1152/ajpheart.00026.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ambient air, occupational settings, and the use and distribution of consumer products all serve as conduits for toxicant exposure through inhalation. While the pulmonary system remains a primary target following inhalation exposure, cardiovascular implications are exceptionally culpable for increased morbidity and mortality. The epidemiological evidence for cardiovascular dysfunction resulting from acute or chronic inhalation exposure to particulate matter has been well documented, but the mechanisms driving the resulting disturbances remain elusive. In the current review, we aim to summarize the cellular and molecular mechanisms that are directly linked to cardiovascular health following exposure to a variety of inhaled toxicants. The purpose of this review is to provide a comprehensive overview of the biochemical changes in the cardiovascular system following particle inhalation exposure and to highlight potential biomarkers that exist across multiple exposure paradigms. We attempt to integrate these molecular signatures in an effort to provide direction for future investigations. This review also characterizes how molecular responses are modified in at-risk populations, specifically the impact of environmental exposure during critical windows of development. Maternal exposure to particulate matter during gestation can lead to fetal epigenetic reprogramming, resulting in long-term deficits to the cardiovascular system. In both direct and indirect (gestational) exposures, connecting the biochemical mechanisms with functional deficits outlines pathways that can be targeted for future therapeutic intervention. Ultimately, future investigations integrating "omics"-based approaches will better elucidate the mechanisms that are altered by xenobiotic inhalation exposure, identify biomarkers, and guide in clinical decision making.
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Affiliation(s)
- Amina Kunovac
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia.,Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia.,Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Quincy A Hathaway
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia.,Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia.,Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Mark V Pinti
- Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia.,West Virginia University School of Pharmacy, Morgantown, West Virginia
| | - Andrew D Taylor
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia.,Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia
| | - John M Hollander
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia.,Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia.,Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, West Virginia
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Maternal Exposure to Ambient Air Pollution and Pregnancy Complications in Victoria, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072572. [PMID: 32283665 PMCID: PMC7178226 DOI: 10.3390/ijerph17072572] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 12/12/2022]
Abstract
The relationship between maternal exposure to ambient air pollution and pregnancy complications is not well characterized. We aimed to explore the relationship between maternal exposure to ambient nitrogen dioxide (NO2) and fine particulate matter (PM2.5) and hypertensive disorders of pregnancy, gestational diabetes mellitus (GDM) and placental abruption. Using administrative data, we defined a state-wide cohort of singleton pregnancies born between 1 March 2012 and 31 December 2015 in Victoria, Australia. Annual average NO2 and PM2.5 was assigned to maternal residence at the time of birth. 285,594 singleton pregnancies were included. An IQR increase in NO2 (3.9 ppb) was associated with reduced likelihood of hypertensive disorders of pregnancy (RR 0.89; 95%CI 0.86, 0.91), GDM (RR 0.92; 95%CI 0.90, 0.94) and placental abruption (RR 0.81; 95%CI 0.69, 0.95). Mixed observations and smaller effect sizes were observed for IQR increases in PM2.5 (1.3 µg/m3) and pregnancy complications; reduced likelihood of hypertensive disorders of pregnancy (RR 0.95; 95%CI 0.93, 0.97), increased likelihood of GDM (RR 1.02; 95%CI 1.00, 1.03) and no relationship for placental abruption. In this exploratory study using an annual metric of exposure, findings were largely inconsistent with a priori expectations and further research involving temporally resolved exposure estimates are required.
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Vardoulakis S, Jalaludin BB, Morgan GG, Hanigan IC, Johnston FH. Bushfire smoke: urgent need for a national health protection strategy. Med J Aust 2020; 212:349-353.e1. [PMID: 32088929 PMCID: PMC7318141 DOI: 10.5694/mja2.50511] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT
| | - Bin B Jalaludin
- Ingham Institute for Applied Medical Research, University of New South Wales
| | - Geoffrey G Morgan
- School of Public Health and University Centre for Rural Health, University of Sydney, Sydney, NSW
| | - Ivan C Hanigan
- School of Public Health and University Centre for Rural Health, University of Sydney, Sydney, NSW.,Health Research Institute, University of Canberra, ACT
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS
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