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Alshiban NM, Aleyiydi MS, Nassar MS, Alhumaid NK, Almangour TA, Tawfik YM, Damiati LA, Almutairi AS, Tawfik EA. Epidemiologic and clinical updates on viral infections in Saudi Arabia. Saudi Pharm J 2024; 32:102126. [PMID: 38966679 PMCID: PMC11223122 DOI: 10.1016/j.jsps.2024.102126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024] Open
Abstract
In the past two decades, the world has witnessed devastating pandemics affecting the global healthcare infrastructure and disrupting society and the economy worldwide. Among all pathogens, viruses play a critical role that is associated with outbreaks due to their wide range of species, involvement of animal hosts, easily transmitted to humans, and increased rates of infectivity. Viral disease outbreaks threaten public health globally due to the challenges associated with controlling and eradicating them. Implementing effective viral disease control programs starts with ongoing surveillance data collection and analyses to detect infectious disease trends and patterns, which is critical for maintaining public health. Viral disease control strategies include improved hygiene and sanitation facilities, eliminating arthropod vectors, vaccinations, and quarantine. The Saudi Ministry of Health (MOH) and the Public Health Authority (also known as Weqayah) in Saudi Arabia are responsible for public health surveillance to control and prevent infectious diseases. The notifiable viral diseases based on the Saudi MOH include hepatitis diseases, viral hemorrhagic fevers, respiratory viral diseases, exanthematous viral diseases, neurological viral diseases, and conjunctivitis. Monitoring trends and detecting changes in these viral diseases is essential to provide proper interventions, evaluate the established prevention programs, and develop better prevention strategies. Therefore, this review aims to highlight the epidemiological updates of the recently reported viral infections in Saudi Arabia and to provide insights into the recent clinical treatment and prevention strategies.
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Affiliation(s)
- Noura M. Alshiban
- Advanced Diagnostics and Therapeutics Institute, Health Sector, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Munirah S. Aleyiydi
- Advanced Diagnostics and Therapeutics Institute, Health Sector, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Majed S. Nassar
- Advanced Diagnostics and Therapeutics Institute, Health Sector, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Nada K. Alhumaid
- Advanced Diagnostics and Therapeutics Institute, Health Sector, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Thamer A. Almangour
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Yahya M.K. Tawfik
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Laila A. Damiati
- Department of Biological Sciences, College of Science, University of Jeddah, Jeddah 23218, Saudi Arabia
| | | | - Essam A. Tawfik
- Advanced Diagnostics and Therapeutics Institute, Health Sector, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
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Liu M, Yu J, Zhu A, Ling J, Chen R, Zhang Y, Ruan Y. Association Between Air Pollution and Coronary Heart Disease Hospitalizations in Lanzhou City, 2013-2020: a Time Series Analysis. J Urban Health 2023; 100:1246-1257. [PMID: 38010484 PMCID: PMC10728394 DOI: 10.1007/s11524-023-00797-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 11/29/2023]
Abstract
Coronary heart disease (CHD) is one of the most serious public health problems. However, few studies have focused on the effects of exposure to particulate matter and gaseous air pollutants on CHD. This study aimed to explore the relationship between air pollutants and the number of hospitalized patients with CHD in Lanzhou, and we collected daily data on the number of hospitalized patients with CHD, daily air pollutants, and meteorological factors from 2013 to 2020. A distributed lag nonlinear model (DLNM) combined with a quasi-Poisson regression model was applied to evaluate the relationship between air pollutants and the number of hospitalized patients with CHD. The results indicated that the hysteresis effect of all pollutants except O38h reached its maximum at lag3, and the relative risk of coronary heart disease admission was 1.0014 (95%CI: 1.0004, 1.0023), 1.0003 (95%CI: 1.0000, 1.0006), 1.0020 (95%CI: 1.0004, 1.0035), and 1.0053 (95%CI: 1.0026, 1.0080) when PM2.5, PM10, NO2, and SO2 concentrations were increased by 10 μg/m3, respectively. Each 1 mg/m3 increase in CO concentration was associated with a relative risk of coronary heart disease; hospitalization risk was 1.1076 (95%CI: 1.0530, 1.1650). We observed a relative risk of 0.9991 (95%CI: 0.9986, 0.9999) for each 10 μg/m3 increase in O38h for coronary heart disease admission at lag1. Women and elderly were more susceptible to the impact of air pollution, and the impact was greater during cold seasons. Our results indicate that air pollution increased the risk of hospitalization for CHD in a short term. The research findings can provide strategic insights into the impact of current and future air pollution on CHD.
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Affiliation(s)
- Miaoxin Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Jingze Yu
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Anning Zhu
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Jianglong Ling
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Rentong Chen
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Yaoyi Zhang
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Ye Ruan
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China.
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Wang H, Huang S, Wang Z, Zhen H, Li Z, Fan W, Lu M, Han X, Du L, Zhao M, Yan Y, Zhang X, Zhen Q, Shui T. Association between meteorological factors and varicella incidence: a multicity study in Yunnan Province, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:117817-117828. [PMID: 37874521 DOI: 10.1007/s11356-023-30457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
This multicenter study aimed to investigate the relationship between varicella incidence and meteorological factors including mean temperature, relative humidity, sunshine duration, diurnal temperature difference, wind speed, and rainfall, as previous studies have produced varying results. Our study also sought to identify potential sources of heterogeneity. Data on reported daily varicella numbers and meteorological factors were collected for 14 cities in Yunnan Province from 2017 to 2021. A distribution-lagged nonlinear model was constructed to explore the relationship between meteorological conditions and varicella incidence in each included city. We then used multiple meta-regression to explore sources of heterogeneity using demographic economics indicators, air pollutants, and geographic location as potential modifiers. The cumulative hazard effect plot showed an inverted S-shape for the relationship between temperature and varicella, with the smallest RR (relative risk) (0.533, 95% CI: 0.401-0.708) at temperatures up to 27.2 °C. The maximum RR (1.171, 95% CI: 1.001-1.371) was obtained when the relative humidity was equal to 98.5%. The RR (1.164, 95% CI: 1.002-1.352) was greatest at a diurnal temperature range of 2 °C (1.164, 95% CI: 1.002-1.352) and least (0.913, 95% CI: 0.834-0.999) at a diurnal temperature range of 16.1 °C. The maximum RR (1.214, 95% CI: 1.089-1.354) was obtained at 0 h of sunshine, and the minimum RR (0.808, 95% CI: 0.675-0.968) was obtained at 12.4 h of sunshine. The RR (0.792, 95% CI: 0.633-0.992) was minimum at a wind velocity of 4.8 m/s. Residual heterogeneity ranged from 1 to 42.7%, with PM10 (particles with an aerodynamic diameter less than 10 μm), GDP (gross domestic product), and population density explaining some of this heterogeneity. The temperature has a dual effect on varicella incidence. Varicella cases are negatively correlated with diurnal temperature range, sunshine duration, and wind speed, and positively correlated with relative humidity. GDP and PM10 may have a significant role in altering the association between temperature and varicella, while PM10 and population density may alter the association between wind velocity and varicella.
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Affiliation(s)
- Hao Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonoses Research of the Ministry of Education, Changchun, China
| | - Shanjun Huang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zhaohan Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Hua Zhen
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zhuo Li
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Wenqi Fan
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Menghan Lu
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xin Han
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Lanping Du
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Meifang Zhao
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yuke Yan
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xinyao Zhang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
- Department of Social Medicine and Health Care Management, School of Public Health, Jilin University, Changchun, China
| | - Qing Zhen
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China.
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonoses Research of the Ministry of Education, Changchun, China.
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China
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Zhang W, Yang Y, Liu Y, Zhou L, Yang Y, Pan L, Ba Y, Wang R, Huo Y, Ren X, Bai Y, Cheng N. Associations between congenital heart disease and air pollutants at different gestational weeks: a time-series analysis. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:2213-2228. [PMID: 35869374 DOI: 10.1007/s10653-022-01315-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Exposure to air pollution during pregnancy has been linked to birth defects. But the directions of studies on the associations between air pollutants exposure and effect on the incidence of congenital heart disease (CHDs) were inconsistent. To date, few studies were concentrated on the effects of both particulate matter and gaseous air pollutant exposure on CHDs across the full gestational week simultaneously. Our study aimed to investigate the critical exposure windows for each air pollutant throughout 40 gestational weeks. Data on CHDs, air pollution, and meteorological factors from 2013 to 2019 were collected in Lanzhou, China. A distributed lag nonlinear model combined with a quasi-Poisson regression model was applied to evaluate the weekly exposure-lag-response association between air pollutants levels and CHDs, and the subgroup analyses were conducted by gender (baby boy and baby girl). The study included 1607 mother-infant pairs. The results demonstrated that exposure of pregnant women to particulate matter ≤ 5 μm (PM2.5) at lag 1-4 weeks was significantly associated with the risk of CHDs, and the strongest effects were observed in the lag 1 week (1.150, 95%CI 1.059-1.248). For exposure to particulate matter ≤ 10 μm (PM10) at lag 1-3 weeks, the strongest effects were observed in the lag 1 week (1.075, 95% CI 1.026-1.128). For exposure to sulfur dioxide (SO2) at lag 1-4 weeks, the strongest effects were observed in the lag 1 week (1.154, 95% CI 1.025-1.299). For exposure to carbon monoxide (CO) at lag 1-3 weeks, the strongest effects were observed in the lag 1 week (1.089, 95% CI 1.002-1.183). For exposure to ozone (O3) concentration at lag 9-15 weeks, the strongest effects were observed in the lag 15 weeks (1.628, 95% CI 1.001-2.649). The cumulative effects of PM2.5, PM10, SO2, and CO along weeks with a maximum of 1.609 (95%CI 1.000-2.589), 1.286 (95%CI 1.007-1.641), 1.648 (95%CI 1.018-2.668), and 1.368 (95%CI 1.003, 1.865), respectively. The effects were obvious in the initial gestational weeks too. Through the gender stratification analysis, the air pollutants with significant effects were PM2.5 for baby boys and PM2.5, PM10, SO2, CO, NO2, and O3 for baby girl. For the relationship between CHDs and air pollution in Lanzhou, PM2.5, PM10, SO2, CO, and O3 played an important role in the initial gestational weeks, especially for baby girl.
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Affiliation(s)
- Wenling Zhang
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yanjun Yang
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yanyan Liu
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Li Zhou
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yan Yang
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Li Pan
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yupei Ba
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Ruijuan Wang
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yanbei Huo
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Xiaoyu Ren
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yana Bai
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Ning Cheng
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
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Zhang T, Qin W, Nie T, Zhang D, Wu X. Effects of meteorological factors on the incidence of varicella in Lu'an, Eastern China, 2015-2020. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:10052-10062. [PMID: 36066801 DOI: 10.1007/s11356-022-22878-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Varicella (chickenpox) is a serious public health problem in China, with the most reported cases among childhood vaccine-preventable infectious diseases, and its reported incidence has increased over 20-fold since 2005. Few previous studies have explored the association of multiple meteorological factors with varicella and considered the potential confounding effects of air pollutants. It is the first study to investigate and analyze the effects of multiple meteorological factors on varicella incidence, controlling for the confounding effects of various air pollutants. Daily meteorological and air pollution data and varicella cases were collected from January 1, 2015, to December 31, 2020, in Lu'an, Eastern China. A combination of the quasi-Poisson generalized additive model (GAM) and distributed lag nonlinear model (DLNM) was used to evaluate the meteorological factor-lag-varicella relationship, and the risk of varicella in extreme meteorological conditions. The maximum single-day lag effects of varicella were 1.288 (95%CI, 1.201-1.381, lag 16 day), 1.475 (95%CI, 1.152-1.889, lag 0 day), 1.307 (95%CI, 1.196-1.427, lag 16 day), 1.271 (95%CI, 0.981-1.647, lag 4 day), and 1.266 (95%CI, 1.162-1.378, lag 21 day), when mean temperature, diurnal temperature range (DTR), mean air pressure, wind speed, and sunshine hours were -5.8°C, 13.5°C, 1035.5 hPa, 6 m/s, and 0 h, respectively. At the maximum lag period, the overall effects of mean temperature and pressure on varicella showed W-shaped curves, peaked at 17.5°C (RR=2.085, 95%CI: 1.480-2.937) and 1035.5 hPa (RR=5.481, 95%CI: 1.813-16.577), while DTR showed an M-shaped curve and peaked at 4.4°C (RR=6.131, 95%CI: 1.120-33.570). Sunshine hours were positively correlated with varicella cases at the lag of 0-8 days and 0-9 days when sunshine duration exceeded 10 h. Furthermore, the lag effects of extreme meteorological factors on varicella cases were statistically significant, except for the extremely high wind speed. We found that mean temperature, mean air pressure, DTR, and sunshine hours had significant nonlinear effects on varicella incidence, which may be important predictors of varicella early warning.
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Affiliation(s)
- Tingting Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wei Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, 237000, Anhui, China
| | - Tingyue Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Deyue Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xuezhong Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- The First Affiliated Hospital of Anhui University of Science and Technology, Huainan, 232000, Anhui, China.
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Huang J, Ma Y, Lv Q, Liu Y, Zhang T, Yin F, Shui T. Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study. BMJ Open 2022; 12:e067127. [PMID: 36450433 PMCID: PMC9716848 DOI: 10.1136/bmjopen-2022-067127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Hand, foot, and mouth disease (HFMD) is a viral infectious disease that poses a substantial threat in the Asia-Pacific region. It is widely reported that meteorological factors are associated with HFMD. However, the relationships between air pollutants and HFMD are still controversial. In addition, the interactive effects between meteorological factors and air pollutants on HFMD remain unknown. To fill this research gap, we conducted a time-series study. DESIGN A time-series study. SETTING AND PARTICIPANTS Daily cases of HFMD as well as meteorological and air pollution data were collected in Chengdu from 2011 to 2017. A total of 184 610 HFMD cases under the age of 15 were included in our study. OUTCOME MEASURES Distributed lag nonlinear models were used to investigate the relationships between HFMD and environmental factors, including mean temperature, relative humidity, SO2, NO2, and PM10. Then, the relative excess risk due to interaction (RERI) and the proportion attributable to interaction were calculated to quantitatively evaluate the interactions between meteorological factors and air pollutants on HFMD. Bivariate response surface models were used to visually display the interactive effects. RESULTS The cumulative exposure-response curves of SO2 and NO2 were inverted 'V'-shaped and 'M'-shaped, respectively, and the risk of HFMD gradually decreased with increasing PM10 concentrations. We found that there were synergistic interactions between mean temperature and SO2, relative humidity and SO2, as well as relative humidity and PM10 on HFMD, with individual RERIs of 0.334 (95% CI 0.119 to 0.548), 0.428 (95% CI 0.214 to 0.642) and 0.501 (95% CI 0.262 to 0.741), respectively, indicating that the effects of SO2 and PM10 on HFMD were stronger under high temperature (>17.3°C) or high humidity (>80.0%) conditions. CONCLUSIONS There were interactive effects between meteorological factors and air pollutants on HFMD. Our findings could provide guidance for targeted and timely preventive and control measures for HFMD.
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Affiliation(s)
- Jiaqi Huang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Yue Ma
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Qiang Lv
- Department of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yaqiong Liu
- Department of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Fei Yin
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Tiejun Shui
- Department of Leprosy Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China
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Sun S, Wang X, Ding L, Zhang Q, Li N, Sui X, Li C, Ju L, Zhao Q, Chen H, Ding R, Cao J. Association between preconceptional air pollution exposure and medical purposes for selective termination of pregnancy. ENVIRONMENTAL RESEARCH 2021; 202:111743. [PMID: 34331927 DOI: 10.1016/j.envres.2021.111743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Exposure to air pollutants is associated with adverse pregnancy outcomes. But evidence on the effects of preconceptional air pollution exposure on the risk of termination of pregnancy (TOP) caused by pregnancy losses and congenital malformations is lacking. METHODS The distributed lag nonlinear model (DLNM) was used to evaluate the impact of short-term air pollutants exposure on the risk of TOP. Stratified analyses by age (<35 years old, ≥ 35 years old) and season (warm season, cold season) were further conducted. Relative risk (RR) and 95 % confidential interval (95 % CI) were calculated for per interquartile range (IQR) increment in air pollutants during the study period. RESULTS PM2.5, PM10, and O3 exposure were significantly associated with elevated risk of TOP. The risk of TOP was associated with PM2.5 exposure from lag11 to lag15 in the single-pollutant model, and the strongest association was observed at lag13 (RR = 1.021, 95%CI:1.002-1.040). PM10 exposure from lag10 to lag15 was associated with increased TOP risk, with the corresponding peak association being at lag13 (RR = 1.020, 95%CI: 1.004-1.037). For O3, the single-day lag association appeared to be statistically significant from lag26 to lag27, with the highest RR of TOP cases being at lag27 (RR = 1.044, 95%CI: 1.005-1.084). Similar results were observed for pregnancy losses (PL). However, no significantly association between air pollution exposure and the risk of congenital malformations (CM) was found in this study. Stratified analyses showed that pregnant women with more advanced ages were more susceptible to PM2.5, PM10, and O3 exposure. The effect of PM2.5 exposure was statistically significant in cold season subgroups. CONCLUSION The findings suggest that exposure to PM2.5, PM10, and O3 before pregnancy are associated with the risk of TOP in Lu'an, China, reflecting the significance of preconceptional environmental exposure in the development of adverse pregnancy outcomes.
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Affiliation(s)
- Shu Sun
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Xiaoyu Wang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China; Department of Obstetrics and Gynecology, Lu'an Hospital Affiliated to Anhui Medical University, 21 West Wanxi Road, Lu'an, China
| | - Liu Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Qi Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Na Li
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xinmiao Sui
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Changlian Li
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Liangliang Ju
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Qihong Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Hongbo Chen
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital Affiliated to Anhui Medical University, 15 Yimin Road, Hefei, China.
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Jiyu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China; Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
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Yang D, Chen L, Yang Y, Shi J, Xu J, Li C, Wu Y, Ji X. Influence of ambient temperature and diurnal temperature variation on the premature rupture of membranes in East China: A distributed lag nonlinear time series analysis. ENVIRONMENTAL RESEARCH 2021; 202:111145. [PMID: 33844967 DOI: 10.1016/j.envres.2021.111145] [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: 02/04/2021] [Revised: 03/17/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Extreme ambient temperature has an adverse effect on pregnancy outcomes, but the conclusions have been inconsistent. The influence of ambient temperature and diurnal temperature variation on the premature rupture of membranes (PROM) needs further study. METHODS AND FINDINGS The daily data of PROMs, daily meteorological and air pollutant were obtained. After controlling for potential confounding factors, the quasi-Poisson generalized additive model (GAM) combined with the distributed lag nonlinear model (DLNM) was used to analyze the association between temperature or diurnal temperature variation and PROM, including preterm premature rupture of membranes (PPROM) and term premature rupture of membranes (term PROM). Compared with the median temperature(18.7 °C), the mean temperature of 5-7 days lagging beyond 31.5 °C and below -1.5 °C was positively correlated with PROM; the mean temperature had more sensitive effect on the term PROM. Exposure to extremely high temperatures (97.5th percentile, 32 °C) had a 6-day lagging relative risk (RR) (95% CI: 1.005-1.160) of 1.08 for PROM and a 6-day lagging RR of 1.079 (95% CI: 1.005-1.159) for term PROM; Exposure to a high diurnal temperature variation (diurnal temperature variation greater than 16 °C) was positively correlated with the term PROM. Compared with the 2.5th percentile diurnal temperature variation (2 °C), exposure to the 95th percentile diurnal temperature variation (17 °C) significantly increased the risk of term PROM (RR: 1.229, 95% CI: 1.029-1.467). CONCLUSIONS Exposure to a high-temperature and a high diurnal temperature variation environment will increase the relative risks of PROM. For pregnant women in the 3rd trimester, it is important to reduce exposure to extremely high-temperatures and greater diurnal temperature changes.
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Affiliation(s)
- 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
| | - Lei Chen
- 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
| | - Ya Yang
- Department of Infection control, Renji Hospital, School of Medicine, Shanghai Jiao tong University, Shanghai, China
| | - Jingjin Shi
- 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
| | - Jingjing Xu
- 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
| | - Cheng Li
- 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
| | - Yanting Wu
- Institute of Reproduction and Development, Obstetrics and Gynecology Hospital, Fudan University, 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.
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Sun S, Zhang Q, Sui X, Ding L, Liu J, Yang M, Zhao Q, Zhang C, Hao J, Zhang X, Lin S, Ding R, Cao J. Associations between air pollution exposure and birth defects: a time series analysis. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:4379-4394. [PMID: 33864585 DOI: 10.1007/s10653-021-00886-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
Air pollution is a serious environmental problem in China. Birth defects are particularly vulnerable to outdoor air pollution. Our study was to evaluate the association between short-term exposure to air pollutants and the risk of birth defects. Daily data including the air pollutants, meteorological characteristics, and birth records were obtained in Hefei, China, during January 2013 to December 2016. The findings showed that PM2.5, PM10, SO2, NO2, and O3 exposures were positively correlated with the risk of birth defects. Maternal exposure to PM2.5 and SO2 during the 4th to 13th gestational weeks was observed to have a significant association with the risk of birth defects, with the maximum effect in the 7th or 8th week for PM2.5 and the maximum effect in the 7th week for SO2. The positively significant exposure windows were the 4th to 14th weeks for PM10, the 4th to 12th weeks for NO2, and the 26th to 35th weeks for O3, respectively. The strongest associations were observed in the 8th week for PM10, the 7th week for NO2, and in the 31st or 32nd week for O3. The findings of this study demonstrate that air pollutants increase the risk of birth defects among women during pregnancy in Hefei, China, which provide evidence for improving the health of pregnant women and neonates in developing countries, and uncovered potential opportunities to reduce or prevent birth defects by proactive measures during pregnancy.
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Affiliation(s)
- Shu Sun
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qi Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xinmiao Sui
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Liu Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jie Liu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Mei Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Qihong Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chao Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Jiahu Hao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Xiujun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Shilei Lin
- Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Jiyu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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Wang Z, Li X, Hu P, Li S, Guan J, Wang B, Yang F, Zhang D. Influence of air pollutants on varicella among adults. Sci Rep 2021; 11:21020. [PMID: 34697367 PMCID: PMC8546085 DOI: 10.1038/s41598-021-00507-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/08/2021] [Indexed: 11/09/2022] Open
Abstract
Little attention has been paid to the relationship between air pollutants and varicella among adults. We used data collected in Qingdao, China from 2014 to 2019. A combination of quasi-Poisson generalized linear model (GLM) and distributed lag non-linear model (DLNM) was applied to evaluate the association between exposure to air pollutants and varicella. And the effects of exposure to extremely high concentration (at 97.5th percentile) and low concentration (at 2.5th percentile) of air pollutants on varicella were also calculated. The level II of GB3095-2012 was used as the reference. A 10 μg/m3 increase of PM2.5 was significantly associated with an increased risk of varicella (lag day: 4, 5 and 6). The negative associations were found for NO2 per 10 μg/m3 increase from lag 15 to 19 day. The high PM2.5 concentration (135 μg/m3) was significantly associated with the increased risk of varicella (lag day: 6, 7). For NO2, the negative association was found at high concentration (75 μg/m3) on lag 15 to 20 day; and the positive relationship was shown at low concentration (10 μg/m3) on lag 15 to 20 day. Exposure to PM2.5 and NO2 were significantly associated with the risk of varicella among adults.
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Affiliation(s)
- Zixuan Wang
- Department of Epidemiology and Health Statistics, The School of Public Health, Qingdao University, No. 308 Ningxia Road, QingdaoShandong, 266021, China
| | - Xiaofan Li
- Qingdao Municipal Center for Disease Control and Prevention of Qingdao, Qingdao, Institute of Preventive Medicine, Qingdao, 266034, Shandong, China
| | - Ping Hu
- Qingdao Municipal Center for Disease Control and Prevention of Qingdao, Qingdao, Institute of Preventive Medicine, Qingdao, 266034, Shandong, China
| | - Shanpeng Li
- Qingdao Municipal Center for Disease Control and Prevention of Qingdao, Qingdao, Institute of Preventive Medicine, Qingdao, 266034, Shandong, China
| | - Jing Guan
- Qingdao Municipal Center for Disease Control and Prevention of Qingdao, Qingdao, Institute of Preventive Medicine, Qingdao, 266034, Shandong, China
| | - Bingling Wang
- Qingdao Municipal Center for Disease Control and Prevention of Qingdao, Qingdao, Institute of Preventive Medicine, Qingdao, 266034, Shandong, China
| | - Feng Yang
- Qingdao Municipal Center for Disease Control and Prevention of Qingdao, Qingdao, Institute of Preventive Medicine, Qingdao, 266034, Shandong, China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health, Qingdao University, No. 308 Ningxia Road, QingdaoShandong, 266021, China.
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Li K, Wang L, Feng M. Relationship between built environments and risks of ischemic stroke based on meteorological factors: A case study of Wuhan's main urban area. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 769:144331. [PMID: 33736230 DOI: 10.1016/j.scitotenv.2020.144331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/14/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
Ischemic stroke is one of the most common causes of death worldwide, and uncomfortable meteorological and built environments may increase its risk. Residents in different built environments are exposed to different risks of ischemic stroke in cold and hot weather. By using the data from 3547 patients hospitalized, a distributed lag non-linear model was established to compare the differences in the risk of ischemic stroke in urban areas with respect to different Building Height, Building Density, Normalized Differential Vegetation Index, and Distance to Water under the meteorological condition. The results showed that lower Building Height is related to the negative cold effects in winter, and higher Building Height is related to increased risks at high temperatures. Built environments with Building Heights of 10-15 m in hot weather and above 15 m in cold weather have low risks. Higher Building Density was found to be associated with reduced negative cold effects; however, the negative hot effects increased in summer. Built environments with a Building Density of more than 0.3 showed low risks, regardless of the weather conditions. Increasing NDVI seemed to mitigate negative effects in uncomfortable weather, and built environments with higher NDVI were found to be associated with lower risks of ischemic stroke. Built environments with shorter Distance to Water seemed to pose higher risks in summer, and longer Distance to Water was correlated with higher risks in winter. Built environments with Distance to Water in the range of 0.65-2.30 km showed low risks. The research results could have some implications for urban planners to form reasonable built environments under certain meteorological factors which can be beneficial for the mitigation of incidence of ischemic stroke.
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Affiliation(s)
- Kun Li
- School of Urban Design, Wuhan University, Wuhan, China.
| | - Lantao Wang
- School of Urban Design, Wuhan University, Wuhan, China.
| | - Maohui Feng
- Zhongnan Hospital of Wuhan University, Wuhan, China.
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