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Marín D, Basagaña X, Amaya F, Aristizábal LM, Muñoz DA, Domínguez A, Molina F, Ramos CD, Morales-Betancourt R, Hincapié R, Rodríguez-Villamizar L, Rojas Y, Morales O, Cuellar M, Corredor A, Villamil-Osorio M, Bejarano MA, Vidal D, Narváez DM, Groot H, Builes JJ, López L, Henao EA, Lopera V, Hernández LJ, Bangdiwala SI, Marín-Ochoa B, Oviedo AI, Sánchez-García OE, Toro MV, Riaño W, Rueda ZV. Early-life external exposome in children 2-5 years old in Colombia. ENVIRONMENTAL RESEARCH 2024; 252:118913. [PMID: 38643821 DOI: 10.1016/j.envres.2024.118913] [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: 02/10/2024] [Revised: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024]
Abstract
Exposome studies are advancing in high-income countries to understand how multiple environmental exposures impact health. However, there is a significant research gap in low- and middle-income and tropical countries. We aimed to describe the spatiotemporal variation of the external exposome, its correlation structure between and within exposure groups, and its dimensionality. A one-year follow-up cohort study of 506 children under 5 in two cities in Colombia was conducted to evaluate asthma, acute respiratory infections, and DNA damage. We examined 48 environmental exposures during pregnancy and 168 during childhood in eight exposure groups, including atmospheric pollutants, natural spaces, meteorology, built environment, traffic, indoor exposure, and socioeconomic capital. The exposome was estimated using geographic information systems, remote sensing, spatiotemporal modeling, and questionnaires. The median age of children at study entry was 3.7 years (interquartile range: 2.9-4.3). Air pollution and natural spaces exposure decreased from pregnancy to childhood, while socioeconomic capital increased. The highest median correlations within exposure groups were observed in meteorology (r = 0.85), traffic (r = 0.83), and atmospheric pollutants (r = 0.64). Important correlations between variables from different exposure groups were found, such as atmospheric pollutants and meteorology (r = 0.76), natural spaces (r = -0.34), and the built environment (r = 0.53). Twenty principal components explained 70%, and 57 explained 95% of the total variance in the childhood exposome. Our findings show that there is an important spatiotemporal variation in the exposome of children under 5. This is the first characterization of the external exposome in urban areas of Latin America and highlights its complexity, but also the need to better characterize and understand the exposome in order to optimize its analysis and applications in local interventions aimed at improving the health conditions and well-being of the child population and contributing to environmental health decision-making.
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Affiliation(s)
- Diana Marín
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia.
| | - Xavier Basagaña
- ISGlobal, Barcelona, 08003, España, Spain; Universitat Pompeu Fabra (UPF), Barcelona, 08003, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain
| | - Ferney Amaya
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | | | - Diego Alejandro Muñoz
- Department of Mathematics, National University of Colombia, Medellín, 050034, Colombia
| | - Alan Domínguez
- ISGlobal, Barcelona, 08003, España, Spain; Universitat Pompeu Fabra (UPF), Barcelona, 08003, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain
| | - Francisco Molina
- Environmental School, School of Engineering, Universidad de Antioquia UdeA, Medellin, 050010, Colombia
| | - Carlos Daniel Ramos
- Environmental School, School of Engineering, Universidad de Antioquia UdeA, Medellin, 050010, Colombia
| | | | - Roberto Hincapié
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | - Laura Rodríguez-Villamizar
- Department of Public Health, School of Medicine, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Yurley Rojas
- School of Engineering, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Olga Morales
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic Medellin, 050010, Colombia; Department of Pediatrics, Hospital San Vicente Fundación, Medellín, 050010, Colombia
| | - Martha Cuellar
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic Medellin, 050010, Colombia; Department of Pediatrics, SOMER Clinic, Medellín, Colombia
| | - Andrea Corredor
- Department of Pediatrics, ONIROS Centro Especializado en Medicina Integral del Sueño, Bogotá, Colombia
| | - Milena Villamil-Osorio
- Department of Pediatrics, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
| | | | - Dolly Vidal
- Department of Pediatrics, Hospital Universitario San José, Popayán, 190003, Colombia
| | - Diana M Narváez
- Human Genetics Laboratory, Universidad de los Andes, Bogotá, 111711, Colombia
| | - Helena Groot
- Human Genetics Laboratory, Universidad de los Andes, Bogotá, 111711, Colombia
| | - Juan José Builes
- Department of Paternity Testing. GENES Laboratory, Medellín, 050024, Colombia
| | - Lucelly López
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | | | - Verónica Lopera
- Secretariat of Health, Medellin Mayor's Office, Medellin, 050015, Colombia
| | | | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, L8S 4K1, Canada; Statistics Department, Population Health Research Institute, McMaster University, Hamilton, ON, L8L 2X2, Canada
| | - Beatriz Marín-Ochoa
- School of Social Sciences, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | - Ana Isabel Oviedo
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | | | - María Victoria Toro
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | - Will Riaño
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia; School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic Medellin, 050010, Colombia
| | - Zulma Vanessa Rueda
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, R3E 0J9, Canada
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Hazlehurst MF, Carroll KN, Moore PE, Szpiro AA, Adgent MA, Dearborn LC, Sherris AR, Loftus CT, Ni Y, Zhao Q, Barrett ES, Nguyen RHN, Swan SH, Wright RJ, Bush NR, Sathyanarayana S, LeWinn KZ, Karr CJ. Associations of prenatal ambient air pollution exposures with asthma in middle childhood. Int J Hyg Environ Health 2024; 258:114333. [PMID: 38460460 PMCID: PMC11042473 DOI: 10.1016/j.ijheh.2024.114333] [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: 09/01/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 03/11/2024]
Abstract
We examined associations between prenatal fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) exposures and child respiratory outcomes through age 8-9 years in 1279 ECHO-PATHWAYS Consortium mother-child dyads. We averaged spatiotemporally modeled air pollutant exposures during four fetal lung development phases: pseudoglandular (5-16 weeks), canalicular (16-24 weeks), saccular (24-36 weeks), and alveolar (36+ weeks). We estimated adjusted relative risks (RR) for current asthma at age 8-9 and asthma with recent exacerbation or atopic disease, and odds ratios (OR) for wheezing trajectories using modified Poisson and multinomial logistic regression, respectively. Effect modification by child sex, maternal asthma, and prenatal environmental tobacco smoke was explored. Across all outcomes, 95% confidence intervals (CI) included the null for all estimates of associations between prenatal air pollution exposures and respiratory outcomes. Pseudoglandular PM2.5 exposure modestly increased risk of current asthma (RRadj = 1.15, 95% CI: 0.88-1.51); canalicular PM2.5 exposure modestly increased risk of asthma with recent exacerbation (RRadj = 1.26, 95% CI: 0.86-1.86) and persistent wheezing (ORadj = 1.28, 95% CI: 0.86-1.89). Similar findings were observed for O3, but not NO2, and associations were strengthened among mothers without asthma. While not statistically distinguishable from the null, trends in effect estimates suggest some adverse associations of early pregnancy air pollution exposures with child respiratory conditions, warranting confirmation in larger samples.
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Affiliation(s)
- Marnie F Hazlehurst
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Kecia N Carroll
- Department of Pediatrics, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Logan C Dearborn
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Allison R Sherris
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, and Environmental and Occupational Health Sciences Institute, Piscataway, NJ and Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J Wright
- Department of Pediatrics, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences and Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, School of Medicine and Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, and Seattle Children's Research Institute, Seattle, WA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Catherine J Karr
- Department of Pediatrics, School of Medicine and Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
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Saxena K. Association Between Maternal Prenatal Exposure to Household Air Pollution and Child Respiratory Health: A Systematic Review and Meta-analysis. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2024; 97:29-40. [PMID: 38559464 PMCID: PMC10964821 DOI: 10.59249/tavr4964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Maternal prenatal exposure to household air pollution (HAP) is a critical public health concern with potential long-term implications for child respiratory health. The objective of this study is to assess the level of association between prenatal household air pollution and child respiratory health, and to identify which HAP pollutants are associated with specific respiratory illnesses or symptoms and to what degree. Relevant studies were retrieved from PubMed databases up to April 27, 2010, and their reference lists were reviewed. Random effects models were applied to estimate summarized relative risks (RRs) and 95% confidence intervals (CIs). The analysis involved 11 studies comprising 387 767 mother-child pairs in total, assessing various respiratory health outcomes in children exposed to maternal prenatal HAP. Children with prenatal exposure to HAP pollutants exhibited a summary RR of 1.26 (95% CI=1.08-1.33) with moderate between-study heterogeneity (I²=49.22%) for developing respiratory illnesses. Specific associations were found between prenatal exposure to carbon monoxide (CO) (RR=1.11, 95% CI: 1.09-1.13), Nitrogen Oxides (NOx) (RR=1.46, 95% CI: 1.09-1.60), and particulate matter (PM) (RR=1.26, 95% CI: 1.2186-1.3152) and child respiratory illnesses (all had I² close to 0%, indicating no heterogeneity). Positive associations with child respiratory illnesses were also found with ultrafine particles (UFP), polycyclic aromatic hydrocarbons (PAH), and ozone (O3). However, no significant association was observed for prenatal exposure to sulfur dioxide (SO2). In summary, maternal prenatal exposure to HAP may contribute to a higher risk of child respiratory health issues, emphasizing the need for interventions to reduce this exposure during pregnancy. Targeted public health strategies such as improved ventilation, cleaner cooking technologies, and awareness campaigns should be implemented to minimize adverse respiratory effects on children.
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Martin-Bassols N, de New SC, Shields MA, Johnston DW. Effect of In utero Exposure to Air Pollution on Adulthood Hospitalizations. J Urban Health 2024; 101:92-108. [PMID: 38064154 PMCID: PMC10897095 DOI: 10.1007/s11524-023-00803-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 02/28/2024]
Abstract
Empirical analyses have demonstrated that individuals exposed to severe air pollution in utero have worse health outcomes during childhood. However, there is little evidence on the long-term health impacts of air pollution exposure. The objective of this paper is to estimate the effect of in utero exposure to the Great London Smog of 1952 (GLS) on five health outcomes identified through a scoping review to be those most likely affected: respiratory, circulatory, neoplasms, mental health, and nervous system conditions. We use the GLS, an extreme air pollution event in December 1952, as a quasi-natural experiment to estimate the effect of exposure to air pollution in utero on adulthood health. Data from the UK Biobank is analysed for a cohort of participants born from December 1952 to July 1956. Differences in health outcomes between adults exposed and not exposed to the GLS due to their birth dates, born inside and outside London, were explored. Our primary focus is hospitalization events between 1997 and 2020 (corresponding to ages 40 to 69), as recorded in linked administrative data from the National Health Service (NHS). Specifically, the five primary outcomes are binary variables indicating that the individual had at least one hospitalization where the main cause of hospitalization is related to respiratory, circulatory, neoplasms, mental health, or nervous system conditions. The analytical sample comprised 36,281 individuals. A positive effect on adulthood hospitalizations due to respiratory conditions was observed. If exposed to the GLS in utero, the probability of at least one respiratory health-related hospitalization between 1997 and 2020 increased by 2.58 percentage points (95% CI 0.08, 4.30, p = 0.03), a 23% increase relative to the sample mean. Small effects were found for all other outcomes, suggesting that these conditions were not affected by the GLS. We do not find heterogeneous effects by sex or childhood socioeconomic status. This study found that a 5-day pollution exposure event while in utero significantly increased respiratory-related hospitalizations at ages 40 to 69 but had no impact on hospitalizations due to circulatory, neoplasms, mental health, and nervous system conditions.
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Affiliation(s)
- Nicolau Martin-Bassols
- Centre for Health Economics, Monash Business School, 900 Dandenong Rd, Caulfield East, VIC, 3145, Australia.
| | - Sonja C de New
- Centre for Health Economics, Monash Business School, 900 Dandenong Rd, Caulfield East, VIC, 3145, Australia
- ARC Life Course Centre, Brisbane, Australia
- Institute of Labour Economics, Bonn, Germany
| | - Michael A Shields
- Centre for Health Economics, Monash Business School, 900 Dandenong Rd, Caulfield East, VIC, 3145, Australia
| | - David W Johnston
- Centre for Health Economics, Monash Business School, 900 Dandenong Rd, Caulfield East, VIC, 3145, Australia
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Qiu T, Zang T, Fang Q, Xu Z, Cao Y, Fan X, Liu J, Zeng X, Li Y, Tu Y, Li G, Bai J, Huang J, Liu Y. Cumulative and lagged effects of varying-sized particulate matter exposure associates with toddlers' gut microbiota. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 336:122389. [PMID: 37595737 DOI: 10.1016/j.envpol.2023.122389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/30/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023]
Abstract
Particulate matter (PM) is an important component of air pollutants and is associated with various health risks. However, the impact of PM on toddlers' gut microbiota is rarely investigated. This study aimed to assess the cumulative and lagged effects of varying-sized PMs on toddlers' gut microbiota. We collected demographic information, stool samples, and exposure to PM from 36 toddlers aged 2-3 years. The toddlers were divided into warm season group and cooler season group according to the collection time of stool samples. The gut microbiota was processed and analyzed using 16S rRNA V3-V4 gene regions. The concentration of PM was calculated using China High Air Pollutants (CHAP) database. To assess the mixed effects of varying-sized PM, multiple-PM models were utilized. There were significant differences between the community composition, α- and β-diversity between two groups. In multiple-PM models, there was a significant effect of weight quantile sum (PM1, PM2.5, and PM10) on α-diversity indices. In weight quantile sum models, after adjusting for a priori confounders, we found a negative effect of weight quantile sum on Enterococcus (β = -0.134, 95% CI -0.263 to -0.006), positive effects of weight quantile sum on unclassified_f__Ruminococcaceae (β = 0.247, 95% CI 0.102 to 0.393), Ruminococcus_1 (β = 0.444, 95% CI 0.238 to 0.650), unclassified_f__Lachnospiraceae (β = 0.278, 95% CI 0.099 to 0.458), and Family_XIII_AD_3011_group (β = 0.254, 95% CI 0.086 to 0.422) in WSG and CSG. In lagged weight quantile sum models, the correlation between lag time PM levels and the gut microbiota showed seasonal trends, and weights of PM changed with lag periods. This is the first study to highlight that cumulative and lagged effects of PMs synergistically affect the diversities (α- and β-diversity) and abundance of the gut microbiota in toddlers. Further research is needed to explore the mediating mechanism of varying-sized PMs exposure on the gut microbiota in toddlers.
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Affiliation(s)
- Tianlai Qiu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Tianzi Zang
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Qingbo Fang
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, 100191, China
| | - Yanan Cao
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Xiaoxiao Fan
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Jun Liu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Xueer Zeng
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Yanting Li
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Yiming Tu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, 100191, China; Environmental Research Group, Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, 100191, China
| | - Yanqun Liu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan, 430071, China.
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Buxton MA, Castillo-Castrejon M, Godines-Enriquez M, Valentín-Cortés M, Morales-Hernández V, de Arellano LMR, Sánchez BN, Osornio-Vargas A, O'Neill MS, Vadillo-Ortega F. The pregnancy research on inflammation, nutrition, & city environment: systematic analyses study (PRINCESA) cohort, 2009-2015. Eur J Epidemiol 2023; 38:1009-1018. [PMID: 37642793 PMCID: PMC10530497 DOI: 10.1007/s10654-023-01040-1] [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: 12/10/2022] [Accepted: 08/02/2023] [Indexed: 08/31/2023]
Abstract
The Pregnancy Research on Inflammation, Nutrition, & City Environment: Systematic Analyses Study (PRINCESA) cohort was set up to evaluate associations between air pollution and birth outcomes among pregnant persons in Mexico City. Specifically, the study was designed to improve air pollution exposure assessment and elucidate biological mechanisms underlying associations between maternal exposures and adverse pregnancy outcomes. Pregnant persons (all women) (N = 935) between ages 18-45 who lived and/or worked in metropolitan Mexico City, Mexico, from 2009 to 2015 and liveborn singleton infants (N = 815) of participants who completed follow-up were enrolled in the cohort. We followed participants monthly from enrollment to delivery and the following categories of data were obtained: demographic, medical and obstetric history, geo-referenced data, repeated measures on daily activity patterns, reported food intake, anthropometric, clinical and obstetric data, 20 serum and 20 cervicovaginal cytokines, and lower reproductive tract infection. Repeated ultrasound measures of fetal parameters and infant birth data are also included in the study's database. In addition, PRINCESA investigators calculated air pollution exposure measures for six pollutants measured by the Mexico City Atmospheric Monitoring System (SIMAT). These estimates utilize participants' addresses to account for spatial variation in exposure (nearest monitor, inverse distance weighting, and kriging) and are available daily during pregnancy for participants. To date, associations between environmental and nutritional impacts on maternal and child health outcomes have been evaluated. PRINCESA has a comprehensive database of maternal and infant data and biological samples and offers collaboration opportunities to study associations between environmental and other factors, including nutrition and pregnancy outcomes.
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Affiliation(s)
- Miatta A Buxton
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Mislael Valentín-Cortés
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Brisa N Sánchez
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Alvaro Osornio-Vargas
- Department of Pediatrics, School of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Marie S O'Neill
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Felipe Vadillo-Ortega
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Unidad de Vinculación Científica de la Facultad de Medicina, UNAM en el Instituto Nacional de Medicina Genómica, Mexico City, Mexico
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Sarno G, Stanisci I, Maio S, Williams S, Ming KE, Diaz SG, Ponte EV, Lan LTT, Soronbaev T, Behera D, Tagliaferro S, Baldacci S, Viegi G. Issue 2 - "Update on adverse respiratory effects of indoor air pollution". Part 2): Indoor air pollution and respiratory diseases: Perspectives from Italy and some other GARD countries. Pulmonology 2023:S2531-0437(23)00083-1. [PMID: 37211526 DOI: 10.1016/j.pulmoe.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/20/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVE to synthesize the Italian epidemiological contribution to knowledge on indoor pollution respiratory impact, and to analyze the perspective of some GARD countries on the health effects of indoor air pollution. RESULTS Italian epidemiological analytical studies confirmed a strong relationship between indoor air pollution and health in general population. Environmental tobacco smoke, biomass (wood/coal) fuel for cooking/heating and indoor allergens (house dust mites, cat and dog dander, mold/damp) are the most relevant indoor pollution sources and are related to respiratory and allergic symptoms/diseases in Italy and in other GARD countries such as Mexico, Brazil, Vietnam, India, Nepal and Kyrgyzstan. Community-based global health collaborations are working to improve prevention, diagnosis and care of respiratory diseases around the world, specially in low- and middle-income countries, through research and education. CONCLUSIONS in the last thirty years, the scientific evidence produced on respiratory health effects of indoor air pollution has been extensive, but the necessity to empower the synergies between scientific community and local administrations remains a challenge to address in order to implement effective interventions. Based on abundant evidence of indoor pollution health effect, WHO, scientific societies, patient organizations and other members of the health community should work together to pursue the GARD vision of "a world where all people breathe freely" and encourage policy makers to increase their engagement in advocacy for clean air.
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Affiliation(s)
- G Sarno
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - I Stanisci
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - S Maio
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - S Williams
- International Primary Care Respiratory Group (IPCRG), 19 Armour Mews, Larbert FK5 4FF, Scotland, United Kingdom
| | - K E Ming
- International Primary Care Respiratory Group (IPCRG), 19 Armour Mews, Larbert FK5 4FF, Scotland, United Kingdom
| | - S G Diaz
- Universidad Autónoma de Nuevo León, Faculty of Medicine and University Hospital "Dr. José Eleuterio González", Regional Center of Allergy and Clinical Immunology, Av. Dr. José Eleuterio González 235, Mitras Centro, 64460 Monterrey, N.L., Mexico
| | - E V Ponte
- Faculdade de Medicina de Jundiaí - Department of Internal Medicine, R. Francisco Teles, 250, Vila Arens II, Jundiaí SP, 13202-550, Brazil
| | - L T T Lan
- University Medical Center, 217 Hong Bang, dist.5, Ho Chi Minh City 17000, Vietnam
| | - T Soronbaev
- Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Togolok Moldo str., Bishkek 720040, Kyrgyzstan
| | - D Behera
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases (NITRD), Sri Aurobindo Marg Near Qutub Minar, Mehrauli, New Delhi 110030, India
| | - S Tagliaferro
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - S Baldacci
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - G Viegi
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy.
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Peterson AK, Habre R, Niu Z, Amin M, Yang T, Eckel SP, Farzan SF, Lurmann F, Pavlovic N, Grubbs BH, Walker D, Al-Marayati LA, Grant E, Lerner D, Bastain TM, Breton CV. Identifying pre-conception and pre-natal periods in which ambient air pollution exposure affects fetal growth in the predominately Hispanic MADRES cohort. Environ Health 2022; 21:115. [PMID: 36434705 PMCID: PMC9701016 DOI: 10.1186/s12940-022-00925-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/24/2022] [Indexed: 05/20/2023]
Abstract
BACKGROUND It is well documented that persons of color experience disproportionate exposure to environmental contaminants, including air pollution, and have poorer pregnancy outcomes. This study assessed the critical windows of exposure to ambient air pollution on in utero fetal growth among structurally marginalized populations in urban Los Angeles. METHODS Participants (N = 281) from the larger ongoing MADRES pregnancy cohort study were included in this analysis. Fetal growth outcomes were measured on average at 32 [Formula: see text] 2 weeks of gestation by a certified sonographer and included estimated fetal weight, abdominal circumference, head circumference, biparietal diameter and femur length. Daily ambient air pollutant concentrations were estimated for four pollutants (particulate matter less than 2.5 µm (PM2.5) and less than 10 µm (PM10) in aerodynamic diameter, nitrogen dioxide (NO2), and 8-h maximum ozone (O3)) at participant residences using inverse-distance squared spatial interpolation from ambient monitoring data. Weekly gestational averages were calculated from 12 weeks prior to conception to 32 weeks of gestation (44 total weeks), and their associations with growth outcomes were modeled using adjusted distributed lag models (DLMs). RESULTS Participants were on average 29 years [Formula: see text] 6 old and predominately Hispanic (82%). We identified a significant sensitive window of PM2.5 exposure (per IQR increase of 6 [Formula: see text]3) between gestational weeks 4-16 for lower estimated fetal weight [Formula: see text] averaged4-16 = -8.7 g; 95% CI -16.7, -0.8). Exposure to PM2.5 during gestational weeks 1-23 was also significantly associated with smaller fetal abdominal circumference ([Formula: see text] averaged1-23 = -0.6 mm; 95% CI -1.1, -0.2). Additionally, prenatal exposure to PM10 (per IQR increase of 13 [Formula: see text]3) between weeks 6-15 of pregnancy was significantly associated with smaller fetal abdominal circumference ([Formula: see text] averaged6-15 = -0.4 mm; 95% CI -0.8, -0.1). DISCUSSION These results suggest that exposure to particulate matter in early to mid-pregnancy, but not preconception or late pregnancy, may have critical implications on fetal growth.
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Affiliation(s)
- Alicia K Peterson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Monica Amin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Fred Lurmann
- Sonoma Technology Inc., Petaluma, CA, 94954, USA
| | | | - Brendan H Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Daphne Walker
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Laila A Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Edward Grant
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Deborah Lerner
- Eisner Health Medical Center, Los Angeles, CA, 90015, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA.
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Gheissari R, Liao J, Garcia E, Pavlovic N, Gilliland FD, Xiang AH, Chen Z. Health Outcomes in Children Associated with Prenatal and Early-Life Exposures to Air Pollution: A Narrative Review. TOXICS 2022; 10:toxics10080458. [PMID: 36006137 PMCID: PMC9415268 DOI: 10.3390/toxics10080458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 06/04/2023]
Abstract
(1) Background: The developmental origins of health and disease (DOHaD) hypothesis links adverse fetal exposures with developmental mal-adaptations and morbidity later in life. Short- and long-term exposures to air pollutants are known contributors to health outcomes; however, the potential for developmental health effects of air pollution exposures during gestation or early-childhood have yet to be reviewed and synthesized from a DOHaD lens. The objective of this study is to summarize the literature on cardiovascular and metabolic, respiratory, allergic, and neuropsychological health outcomes, from prenatal development through early childhood, associated with early-life exposures to outdoor air pollutants, including traffic-related and wildfire-generated air pollutants. (2) Methods: We conducted a search using PubMed and the references of articles previously known to the authors. We selected papers that investigated health outcomes during fetal or childhood development in association with early-life ambient or source-specific air pollution exposure. (3) Results: The current literature reports that prenatal and early-childhood exposures to ambient and traffic-related air pollutants are associated with a range of adverse outcomes in early life, including cardiovascular and metabolic, respiratory and allergic, and neurodevelopmental outcomes. Very few studies have investigated associations between wildfire-related air pollution exposure and health outcomes during prenatal, postnatal, or childhood development. (4) Conclusion: Evidence from January 2000 to January 2022 supports a role for prenatal and early-childhood air pollution exposures adversely affecting health outcomes during development. Future studies are needed to identify both detrimental air pollutants from the exposure mixture and critical exposure time periods, investigate emerging exposure sources such as wildfire, and develop feasible interventional tools.
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Affiliation(s)
- Roya Gheissari
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Jiawen Liao
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Nathan Pavlovic
- Sonoma Technology Inc., 1450 N. McDowell Blvd., Suite 200, Petaluma, CA 94954, USA
| | - Frank D. Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Anny H. Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91107, USA
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
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10
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Ferrante G, Fasola S, Cilluffo G, Piacentini G, Viegi G, La Grutta S. Addressing Exposome: An Innovative Approach to Environmental Determinants in Pediatric Respiratory Health. Front Public Health 2022; 10:871140. [PMID: 35774568 PMCID: PMC9237327 DOI: 10.3389/fpubh.2022.871140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/24/2022] [Indexed: 11/20/2022] Open
Abstract
Developmental age is particularly vulnerable to impacts of environmental exposures. Until recent years, the field of environment and child health has predominantly relied on the study of single exposure-health effect relationships. The exposome is an emerging concept in epidemiology, encompassing the totality of the exposures experienced by an individual throughout life and their changes over time. This innovative approach provides a risk profile instead of individual predictors. Exposome research may contribute to better understand the complex relationships between environmental exposures and childhood respiratory health, in order to implement prevention strategies and mitigate adverse health outcomes across the life span. Indeed, an accurate assessment of the exposome needs several measurements as well as different technologies. High-throughput "omics" technologies may be promising tools to integrate a wide range of exposures. However, analyzing large and complex datasets requires the development of advanced statistical tools. This narrative review summarizes the current knowledge on exposome-based approaches in pediatric respiratory health. Further, it explores practical implementation, associated evidence gaps, research limitations and future research perspectives.
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Affiliation(s)
- Giuliana Ferrante
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - Salvatore Fasola
- Institute of Translational Pharmacology, National Research Council, Palermo, Italy
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Giovanna Cilluffo
- Department of Earth and Marine Sciences, University of Palermo, Palermo, Italy
| | - Giorgio Piacentini
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - Giovanni Viegi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Stefania La Grutta
- Institute of Translational Pharmacology, National Research Council, Palermo, Italy
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
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11
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Sousa AC, Pastorinho MR, Masjedi MR, Urrutia-Pereira M, Arrais M, Nunes E, To T, Ferreira AJ, Robalo-Cordeiro C, Borrego C, Teixeira JP, Taborda-Barata L. Issue 1 - "Update on adverse respiratory effects of outdoor air pollution" Part 2): Outdoor air pollution and respiratory diseases: Perspectives from Angola, Brazil, Canada, Iran, Mozambique and Portugal. Pulmonology 2022; 28:376-395. [PMID: 35568650 DOI: 10.1016/j.pulmoe.2021.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/12/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To analyse the GARD perspective on the health effects of outdoor air pollution, and to synthesise the Portuguese epidemiological contribution to knowledge on its respiratory impact. RESULTS Ambient air pollution has deleterious respiratory effects which are more apparent in larger, densely populated and industrialised countries, such as Canada, Iran, Brazil and Portugal, but it also affects people living in low-level exposure areas. While low- and middle-income countries (LMICs), are particularly affected, evidence based on epidemiological studies from LMICs is both limited and heterogeneous. While nationally, Portugal has a relatively low level of air pollution, many major cities face with substantial air pollution problems. Time series and cross-sectional epidemiological studies have suggested increased respiratory hospital admissions, and increased risk of respiratory diseases in people who live in urban areas and are exposed to even a relatively low level of air pollution. CONCLUSIONS Adverse respiratory effects due to air pollution, even at low levels, have been confirmed by epidemiological studies. However, evidence from LMICs is heterogeneous and relatively limited. Furthermore, longitudinal cohort studies designed to study and quantify the link between exposure to air pollutants and respiratory diseases are needed. Worldwide, an integrated approach must involve multi-level stakeholders including governments (in Portugal, the Portuguese Ministry of Health, which hosts GARD-Portugal), academia, health professionals, scientific societies, patient associations and the community at large. Such an approach not only will garner a robust commitment, establish strong advocacy and clear objectives, and raise greater awareness, it will also support a strategy with adequate measures to be implemented to achieve better air quality and reduce the burden of chronic respiratory diseases (CRDs).
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Affiliation(s)
- A C Sousa
- Comprehensive Health Research Centre (CHRC) and Department of Biology, University of Évora, Pólo da Mitra, Apartado 94, Évora 7002-554, Portugal; NuESA-Health and Environment Study Unit, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, Covilhã 6200-506, Portugal
| | - M R Pastorinho
- NuESA-Health and Environment Study Unit, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, Covilhã 6200-506, Portugal; Comprehensive Health Research Centre (CHRC), Department of Medical and Health Sciences, University of Évora, Colégio Luís António Verney, Rua Romão Ramalho, 59, Évora 7000-671, Portugal
| | - M R Masjedi
- Department of Pulmonary Medicine, Shahid Beheshti University of Medical Sciences, 7th Floor, Bldg n 2, SBUMS, Arabi Avenue, Daneshjoo Boulevard, Velenjak, Tehran 19839-63113, Iran
| | - M Urrutia-Pereira
- Universidade Federal do Pampa, BR 472 - Km 585, Caixa Postal 118, Uruguaiana (RS) CEP 97501-970, Brazil
| | - M Arrais
- Department of Pulmonology, Military Hospital, Rua 17 de Setembro, 27/29, Cidade Alta, Luanda, Angola; Centro de Investigação em Saúde de Angola - CISA, Caxito, Bengo, Angola
| | - E Nunes
- Department of Pulmonology, Central Hospital of Maputo, Agostinho Neto, 64, Maputo 1100, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Avenida Dr. Salvador Allende, Caixa Postal 257, Maputo, Mozambique
| | - T To
- The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5G 1 × 8, Canada
| | - A J Ferreira
- Department of Pulmonology, Centro Hospitalar Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra 3004-561, Portugal; Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, Coimbra 3000-548, Portugal
| | - C Robalo-Cordeiro
- Department of Pulmonology, Centro Hospitalar Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra 3004-561, Portugal; Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, Coimbra 3000-548, Portugal
| | - C Borrego
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro 3810-193, Portugal; IDAD - Instituto do Ambiente e Desenvolvimento, Campus Universitário de Santiago, Aveiro 3810-193, Portugal
| | - J P Teixeira
- EPIUnit - Instituto de Saúde Pública, University of Porto, Rua das Taipas, 135, Porto 4050-091, Portugal; Department of Environmental Health, Portuguese National Institute of Health, Rua Alexandre Herculano, 321, Porto 4000-055, Portugal
| | - L Taborda-Barata
- NuESA-Health and Environment Study Unit, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, Covilhã 6200-506, Portugal; UBIAir-Clinical & Experimental Lung Centre, UBIMedical, University of Beira Interior, EM506 Covilhã 6200-000, Portugal; CICS-Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, Covilhã 6200-506, Portugal.
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Wu H, Sun J, Xi B. Parental tobacco and indoor secondhand smoking exposure and the risk of offspring under-five mortality in low- and middle-income countries. INDOOR AIR 2021; 31:2188-2199. [PMID: 34181764 DOI: 10.1111/ina.12897] [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: 04/07/2021] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
Children are vulnerable to exposure of secondhand smoking (SHS) which is a major preventable cause of disease and death. This study aimed to investigate the association between parental tobacco use or SHS exposure, respectively, and under-five mortality. Data were obtained from the nationally representative and population-based Demographic and Health Surveys in low- and middle-income countries (LMICs) between 2000 and 2018. Cox proportional hazard regression models with complex survey design were conducted to examine the adjusted associations between parental smoking and SHS exposure and child under-five mortality. In the pooled analysis of parental smoking, 437 322 children were included. Compared with children whose parents are not smoking, those whose father or both parents smoked any form of tobacco had higher risks of mortality (hazard ratio [HR] = 1.08, 95% confidence interval [CI] = 1.03-1.13; HR = 1.18, 95% CI = 1.06-1.32, respectively). In addition, parental using smokeless tobacco, smoking tobacco, and using smokeless tobacco and smoking tobacco simultaneously was significantly associated with child under-five mortality (HR = 1.07, 95% CI = 1.01-1.12; HR = 1.12, 95%CI = 1.04-1.21; and HR = 1.17, 95%CI = 1.06-1.30, respectively). In the pooled analysis of SHS exposure, 605 442 children were included, and weekly and daily SHS exposure were significantly associated with child under-five mortality (HR = 1.11, 95% CI = 1.03-1.20, and HR = 1.10, 95% CI = 1.06-1.15, respectively). The results were robust in most stratification analyses and sensitivity analyses. Parental tobacco use and indoor SHS exposure were associated with increased risk of under-five mortality in LMICs. Comprehensive tobacco control programs should be considered by policymakers in LMICs to promote smoke-free environments for children.
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Affiliation(s)
- Han Wu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiahong Sun
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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13
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von Holst H, Nayak P, Dembek Z, Buehler S, Echeverria D, Fallacara D, John L. Perfluoroalkyl substances exposure and immunity, allergic response, infection, and asthma in children: review of epidemiologic studies. Heliyon 2021; 7:e08160. [PMID: 34712855 PMCID: PMC8529509 DOI: 10.1016/j.heliyon.2021.e08160] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/19/2021] [Accepted: 10/08/2021] [Indexed: 02/05/2023] Open
Abstract
Background Increased exposure to perfluoroalkyl substances (PFAS) potentially affects infant and childhood health through immunosuppression. Given rapidly evolving research on PFAS, it is important to comprehensively examine the impact of PFAS exposure among the pediatric population as new research becomes available due to potential fragility of the developing immune system. Objectives This review assessed the effects of PFAS fetal, infant and childhood exposures upon the development of immune function during early life stages. Methods Researchers completed a literature review, searching PubMed for human studies published since 2010 for PFAS and health outcomes among infants and children. Included articles incorporated key search terms in the title or abstract; non-research reports and non-English papers were excluded. The search identified 518 studies for possible inclusion. Following hands-on review, 34 were determined relevant. Subsequent analyses found 8 additional relevant articles, totaling 42 studies. Results Major immune-related sequelae from PFAS exposures on infant and child health outcomes documented in recent literature include: • Strong indication of immunosuppression, with diminished childhood antibody response to vaccination, particularly with PFOA, PFOS and PFHxS exposures. • Some indication of increased risks of childhood infectious diseases/infections, particularly from PFOS exposures. • Limited indication of an effect of PFAS exposure on allergic reactions/allergen specific IgE antibodies. • Limited indication of an effect of PFAS exposure on atopic dermatitis (AD). • Limited indication of an effect of PFAS exposure on asthma and lung function. Conclusion This review summarizes recent findings of PFAS effects on infant and childhood immune health. Evidence of immunosuppression, diminished vaccine efficacy, and increased risk of infections, allergies, asthma and AD were described following in utero, infant, and early childhood PFAS exposures. Further investigation is warranted to characterize PFAS exposure pathways and potential modes of action in relation to PFAS effects on the developing immune system. Incontrovertible proof of PFAS immunotoxic effects could optimally be obtained by a large prospective study cohort of mothers and children from infancy through school-age. Regular assessments of circulating antibodies and response to infant and childhood vaccines during growth years could prove invaluable. This review summarizes findings of PFAS effects on infant and child immune health. In utero, infant, and early childhood PFAS exposures were examined. Strong evidence of PFAS exposure on diminished childhood antibody vaccination response. Moderate evidence of PFAS exposure on increased risk of childhood infectious diseases. Limited evidence of PFAS exposure on allergic reactions, atopic dermatitis, asthma.
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Affiliation(s)
- Haley von Holst
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | - Pratibha Nayak
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | - Zygmunt Dembek
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | | | - Diana Echeverria
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | - Dawn Fallacara
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | - Lisa John
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
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Joint effects of ambient air pollution and maternal smoking on neonatal adiposity and childhood BMI trajectories in the Healthy Start study. Environ Epidemiol 2021; 5:e142. [PMID: 34131612 PMCID: PMC8196098 DOI: 10.1097/ee9.0000000000000142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/12/2021] [Indexed: 12/14/2022] Open
Abstract
Coexposure to air pollution and tobacco smoke may influence early-life growth, but few studies have investigated their joint effects. We examined the interaction between fetal exposure to maternal smoking and ozone (O3) or fine particulate matter (PM2.5) on birth weight, neonatal adiposity, and body mass index (BMI) trajectories through age 3 years. Methods Participants were 526 mother-child pairs, born ≥37 weeks. Cotinine was measured at ~27 weeks gestation. Whole pregnancy and trimester-specific O3 and PM2.5 were estimated via. inverse-distance weighted interpolation from stationary monitors. Neonatal adiposity (fat mass percentage) was measured via. air displacement plethysmography. Child weight and length/height were abstracted from medical records. Interaction was assessed by introducing cotinine (<31.5 vs. ≥31.5 ng/mL [indicating active smoking]), O3/PM2.5 (low [tertiles 1-2] vs. high [tertile 3]), and their product term in linear regression models for birth weight and neonatal adiposity and mixed-effects models for BMI trajectories. Results The rate of BMI growth among offspring jointly exposed to maternal smoking and high PM2.5 (between 8.1 and 12.7 μg/m3) in the third trimester was more rapid than would be expected due to the individual exposures alone (0.8 kg/m2 per square root year; 95% CI = 0.1, 1.5; P for interaction = 0.03). We did not detect interactions between maternal smoking and O3 or PM2.5 at any other time on birth weight, neonatal adiposity, or BMI trajectories. Conclusions Although PM2.5 was generally below the EPA annual air quality standards of 12.0 μg/m3, exposure during the third trimester may influence BMI trajectories when combined with maternal smoking.
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