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Zhang Y, Shen Z, Pei H, Wang G, Wang Z, Wei X, Yu J, Wang C, Hua J, He B. Impact of particulate-matter air pollution on 25-hydroxyvitamin D levels: a mendelian randomisation study. Public Health 2024; 230:190-197. [PMID: 38565065 DOI: 10.1016/j.puhe.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/12/2024] [Accepted: 03/01/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES In observational studies, the 25-hydroxyvitamin D (25(OH)D) level in body has been found to be closely related to particulate matter (PM) air pollution. In this study, we used the two-sample mendelian randomisation (MR) method to investigate and discuss the potential causal relationship and mode of influence. STUDY DESIGN MR study. METHODS PM data (PM10, PM2.5-10, PM2.5, PM2.5 absorbance) came from the UK Biobank database, and 25(OH)D data came from European Bioinformatics Institute (EBI) database. The analysis was conducted utilising three prominent methods (inverse-variance-weighted [IVW], MR-Egger, weighted median, weighted mode, and simple mode). The primary emphasis was placed on IVW, accompanied by heterogeneity and horizontal pleiotropy tests. Furthermore, sensitivity analysis was undertaken. RESULTS The MR analysis revealed a significant association between exposure to PM10 and a decrease in levels of 25(OH)D (odds ratio [OR]: 0.878, 95% confidence interval [CI]: 0.789-0.977). However, no significant relationship was observed between PM2.5 exposure and 25(OH)D (OR: 0.943, 95%CI: 0.858-1.037). Further analysis indicated that the main contributor to the decline in 25(OH)D levels is linked to PM2.5-10 exposure (OR: 0.840, 95%CI: 0.751-0.940) and PM2.5 absorbance (OR: 0.875, 95%CI: 0.824-0.929). No heterogeneity and horizontal pleiotropy existed. CONCLUSIONS The MR results suggest that PM (PM10, PM2.5-10 and PM2.5 absorbance) exposure lowers vitamin D (VD) levels, but PM2.5 was not found to have a significant effect on VD in humans.
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Affiliation(s)
- Yi Zhang
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zan Shen
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hang Pei
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Guanyin Wang
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ziyue Wang
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xinshi Wei
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jinsheng Yu
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chao Wang
- Anji County Hospital of Chinese Medicine, Zhejiang, China
| | - Jiang Hua
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.
| | - Bangjian He
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.
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Ji Y, Huang Z, Yuan Z, Xiong J, Li L. Exposure to low humidex increases the risk of hip fracture admissions in a subtropical coastal Chinese city. Bone 2024; 181:117032. [PMID: 38307177 DOI: 10.1016/j.bone.2024.117032] [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] [Received: 12/06/2023] [Revised: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE The adverse impacts of meteorological factors on human health have attracted great attention. However, no studies have investigated the nonlinear effects of humidex on hip fractures (HF), particularly in middle-aged and older adults. This study aimed to quantify the impacts of humidex, a comprehensive index of temperature and relative humidity, on HF admissions. METHODS Daily HF admissions, meteorological variables and air pollutants in the subtropical coastal city of Shantou, China, from 2015 to 2020 were collected. A generalized linear regression model combined with a distributed lag nonlinear model was applied to explore the exposure-lag-response relationship between humidex and HF admissions. Subgroup analyses were also conducted by gender, age and season. Attributable fractions (AF) and attributable numbers (AN) were used to represent the burden of disease. RESULTS A total of 6200 HF admissions were identified during the study period. Taking the median humidex (31.9) as a reference, the single-day lag effects of low humidex (13, 2.5th percentile) were significant at lag 0 [relative risk (RR) = 1.145, 95 % confidence interval (CI): 1.041-1.259] to lag 2 (RR = 1.049, 95 % CI: 1.010-1.089). The cumulative lag effects of low humidex were significant at lag 0-0 (RR = 1.145, 95 % CI: 1.041-1.259) to lag 0-6 (RR = 1.258, 95 % CI: 1.010-1.567) and reached a maximum at lag 0-3 (RR = 1.330, 95 % CI: 1.113-1.590). High humidex (44, 97.5th percentile) was not associated with the risk of HF. Females and people over the age of 75 appeared to be more susceptible to low humidex. In addition, the adverse effects of low humidex were more pronounced in the cold season. The AF and AN of low humidex on HF admissions were 24.8 % (95 % CI: 10.2-37.1 %) and 1538, respectively. CONCLUSION Low humidex was associated with an increased risk of HF admissions. The government should take timely measures to prevent people from being exposed to low humidex to effectively reduce HF admissions.
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Affiliation(s)
- Yanhu Ji
- School of Public Health, Shantou University, 515063 Shantou, China
| | - Zepeng Huang
- The Second Affiliated Hospital of Shantou University Medical College, 515041 Shantou, China
| | | | - Jianping Xiong
- The First Affiliated Hospital of Shantou University Medical College, 515041 Shantou, China
| | - Liping Li
- School of Public Health, Shantou University, 515063 Shantou, China.
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Zhang Y, Yu J, Pei H, Zhao X, Wang C, Wang G, Shen Z, Hua J, He B. Potential causal associations of PM2.5 and osteoporosis: a two-sample mendelian randomization study. Front Genet 2024; 15:1263916. [PMID: 38463167 PMCID: PMC10921569 DOI: 10.3389/fgene.2024.1263916] [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] [Received: 09/09/2023] [Accepted: 02/12/2024] [Indexed: 03/12/2024] Open
Abstract
Background: Observational studies suggest a potential association between atmospheric particulate matter 2.5 (PM2.5) and osteoporosis, but a causal association is unclear due to the presence of confounding factors. Methods: We utilized bone mineral density indices at four specific sites to represent osteoporosis: femoral neck (FN-BMD), lumbar spine (LS-BMD), forearm (FA-BMD), and heel (HE-BMD). The PM2.5 data was obtained from the UK Biobank database, while the datasets for FN-BMD, LS-BMD, and FA-BMD were obtained from the GEFOS database, and the dataset for HE-BMD was obtained from the EBI database. A two-sample Mendelian randomization analysis was conducted using mainly the inverse variance weighted method, horizontal pleiotropy and heterogeneity were also assessed. Results: The results indicated that PM2.5 was not correlated with a decrease in FN-BMD (β: -0.305, 95%CI: -0.762, 0.153), LS-BMD (β: 0.134, 95%CI: -0.396, 0.666), FA-BMD (β: -0.056, 95%CI: -1.172,1.060), and HE-BMD (β: -0.084, 95%CI: -0.261,0.093). Additionally, acceptable levels of horizontal pleiotropy and heterogeneity were observed. Conclusion: In contrast to most observational studies, our research did not discover a potential causal relationship between PM2.5 and the development of osteoporosis.
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Affiliation(s)
- Yi Zhang
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Jinsheng Yu
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Hang Pei
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Xinzheng Zhao
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Chao Wang
- Anji County Hospital of Traditional Chinese Medicine, Anji, China
| | - Guanyin Wang
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Zan Shen
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiang Hua
- First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Bangjian He
- First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
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Tian Y, Hu Y, Hou X, Tian F. Impacts and mechanisms of PM 2.5 on bone. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 0:reveh-2023-0024. [PMID: 37527559 DOI: 10.1515/reveh-2023-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 06/28/2023] [Indexed: 08/03/2023]
Abstract
Osteoporosis is a metabolic bone disease, which is characterized by a decreased bone mass and deterioration of bone microstructure, resulting in increased bone fragility and a higher risk of fracture. The main pathological process of osteoporosis is the dynamic imbalance between bone absorption and bone formation, which can be caused by various factors such as air pollution. Particulate matter (PM)2.5 refers to the fine particles in the atmosphere, which are small in volume and large in specific surface area. These particles are prone to carrying toxic substances and have negative effects on several extrapulmonary organs, including bones. In this review, we present relevant data from studies, which show that PM2.5 is associated with abnormal bone turnover and osteoporosis. PM2.5 may cause or aggravate bone loss by stimulating an inflammatory response, inducing oxidative damage, reducing estrogen efficiency by competitive binding to estrogen receptors, or endocrine disorder mediated by binding with aromatic hydrocarbon receptors, and affecting the synthesis of vitamin D to reduce calcium absorption. The cellular and molecular mechanisms involved in these processes are also summarized in this review.
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Affiliation(s)
- Yuqing Tian
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yunpeng Hu
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiaoli Hou
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Faming Tian
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
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Ye Y, Zhu YT, Zhang JC, Zhang HL, Fan RW, Jin YX, Hu HQ, Xin XY, Li D. Burden and attributable risk factors of ischemic stroke in China from 1990 to 2019: an analysis from the Global Burden of Disease Study 2019. Front Neurol 2023; 14:1216777. [PMID: 37564738 PMCID: PMC10409994 DOI: 10.3389/fneur.2023.1216777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/12/2023] [Indexed: 08/12/2023] Open
Abstract
Background The epidemiologic characteristics and attributable risk factors of ischemic stroke in China have changed over the past three decades. An up-to-date analysis on deaths, disability-adjusted life-years (DALYs), prevalence, incidence, and attributable risk factors of ischemic stroke for China is needed. This study aims to provide a comprehensive analysis of burden and attributable risk factors of ischemic stroke at national level in China by sex from 1990 to 2019. Methods This is a secondary analysis of the Global Burden of Disease (GBD) study 2019. All data used in this study was derived from the 2019 GBD study. Deaths, DALYs, prevalence, incidence, and attributable risk factors of ischemic stroke in China by sex from 1990 to 2019 were analyzed. Results From 1990 to 2019, the age-standardized deaths rate decreased by 3.3%, age-standardized DALYs rate decreased by 4%, age-standardized prevalence rate increased by 33.5%, and age-standardized incidence rate of ischemic stroke in China increased by 34.7%. In 2019, ambient particulate matter pollution became an important risk factor, whereas household air pollution from solid fuels was no longer a major risk factor for ischemic stroke in China. Burden of ischemic stroke was higher in China compared to other regions. Ambient particulate matter pollution among men, and diet high in sodium, smoking, household air pollution from solid fuels among women account for the increased deaths/DALYs due to ischemic stroke in China. Conclusion Our study revealed that great changes have occurred in burden and attributable risk factors of ischemic stroke in China in the past three decades. Distinct sex-specific differences are observed in burden and attributable risk factors.
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Affiliation(s)
| | | | | | | | | | | | | | - Xi-Yan Xin
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Dong Li
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
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Zhang X, Yu S, Zhang F, Zhu S, Zhao G, Zhang X, Li T, Yu B, Zhu W, Li D. Association between traffic-related air pollution and osteoporotic fracture hospitalizations in inland and coastal areas: evidences from the central areas of two cities in Shandong Province, China. Arch Osteoporos 2023; 18:96. [PMID: 37452267 DOI: 10.1007/s11657-023-01308-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
Our result showed that short-term exposure to traffic-related air pollutants (TRAPs) might increase the risk of hospitalizations for osteoporotic fractures. It was suggested that government should formulate emission reduction policies to protect the health of citizens. INTRODUCTION As the main source of urban air pollution in China, exhaust emissions of motor vehicles have been linked to adverse health outcomes, but evidence of the relationship between short-term exposure to TRAPs and osteoporotic fractures is still relatively rare. METHODS In this study, a total of 5044 inpatients from an inland city (Jinan) and a coastal city (Qingdao), two cities with developed transportation in Shandong Province, were included. A generalized additive model (GAM) was used to investigate the association between TRAPs and hospitalizations for osteoporotic fractures. The stratified analyses were performed by gender and age. RESULTS Positive associations between TRAPs and osteoporotic fracture hospitalizations were observed. We found that short-term exposure to TRAPs was associated with increased numbers of hospitalizations for osteoporotic fractures. PM2.5 and PM10 were statistically significant associated with hospitalizations for osteoporotic fractures at both single-day and multiday lag structures only in Qingdao, with the strongest associations at lag06 and lag07 [RR=1.0446(95%CI: 1.0018,1.0891) for PM2.5, RR=1.0328(95%CI: 1.0084,1.0578) for PM10]. For NO2 and CO, we found significant associations at lag4 in the single lag structure in Jinan [RR=1.0354 (95%CI: 1.0071, 1.0646) for NO2, RR=1.0014 (95%CI: 1.0002, 1.0025) for CO], while only CO at lag4 was significantly associated with hospitalizations for osteoporotic fractures in Qingdao [1.0038 (1.0012, 1.0063)]. Stratified analyses indicated that the associations were stronger in females and older individuals (65 + years). CONCLUSION This study implied that short-term exposure to TRAPs pollution was associated with an increased risk of hospitalizations for osteoporotic fractures. Female patients and patients aged 65 + years appeared to be more vulnerable to TRAPs, suggesting that poor air quality is a modifiable risk factor for osteoporotic fractures.
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Affiliation(s)
- Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Shengwen Yu
- Department of Orthopedics, Qingdao Hospital of Traditional Chinese Medicine (Qingdao Hiser hospital), Qingdao, 266033, China
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Gaichan Zhao
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Xiaowei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Tianzhou Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Bo Yu
- Department of Orthopedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
| | - Dejia Li
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
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Lu S, Liu X, Niu Y, Li F, Gong M, Zha Y, Chao Q, Lu B, Zhang B, Li N, Chen J, Liu Q, Yuan R, Jiang X. Short-term effect of apparent temperature on daily hospitalizations for osteoporotic fractures in Beijing, China: A retrospective observational study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 874:162583. [PMID: 36870481 DOI: 10.1016/j.scitotenv.2023.162583] [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: 09/06/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Studies on the associations between temperature and osteoporotic fractures (OF) hospitalizations are limited. This study aimed to assess the short-term effect of apparent temperature (AT) on the risk of OF hospitalizations. METHODS This retrospective observational study was conducted in Beijing Jishuitan Hospital from 2004 to 2021. Daily OF hospitalizations, meteorological variables and fine particulate matter were collected. A Poisson generalized linear regression model combined with a distributed lag non-linear model was applied to analyze the lag-exposure-response relationship between AT and the number of OF hospitalizations. Subgroup analysis by gender, age and fracture type was also conducted. RESULTS Total daily hospitalization visits for OF during the studied period were 35,595. The exposure-response curve of AT and OF presented a non-linear relationship, with optimum apparent temperature (OAT) at 28.40 °C. Taking OAT as the reference, the cold effect (-10.58 °C, 2.5th percentage) on single lag day had statistical significance from the current day of exposure (RR = 1.18, 95 % CI: 1.08-1.28) to lag 4 day (RR = 1.04, 95 % CI: 1.01-1.08), while the cumulative cold effect increased the risk of OF hospitalization visits from lag 0 to 14 days, with the maximum RR over lag 0-14 days (RR = 1.84, 95 % CI: 1.21-2.79). There were no significant risks of OF hospitalizations for warm effects (32.53 °C, 97.5th percentage) on single or cumulative lag days. The cold effect might be more evident among females, patients aged 80 years or older, and patients with hip fractures. CONCLUSION Exposure to cold temperatures is associated with an increased risk of OF hospitalizations. Females, patients aged 80 years or older and patients with hip fractures might be more vulnerable to the cold effect of AT.
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Affiliation(s)
- Shuai Lu
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xuejiao Liu
- Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Yanlin Niu
- Beijing Center for Disease Prevention and Control, Institute for Nutrition and Food Hygiene, Beijing 100035, China
| | - Feng Li
- Department of Orthopedics, The Third People's Hospital of Xiao Shan Hangzhou, Hangzhou 311251, China
| | - Maoqi Gong
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Yejun Zha
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Qingchen Chao
- China National Climate Center, Beijing 100081, China
| | - Bo Lu
- China National Climate Center, Beijing 100081, China
| | - Baichao Zhang
- China National Climate Center, Beijing 100081, China
| | - Ning Li
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Jia Chen
- Department of Endocrinology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Rui Yuan
- Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xieyuan Jiang
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China.
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Gherscovici ED, Mayer JM. Relationship of Healthy Building Determinants With Musculoskeletal Disorders of the Extremities: A Systematic Review. Cureus 2023; 15:e37456. [PMID: 37091490 PMCID: PMC10115431 DOI: 10.7759/cureus.37456] [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] [Accepted: 04/11/2023] [Indexed: 04/25/2023] Open
Abstract
Musculoskeletal disorders (MSDs) are a substantial societal burden and various factors affect their causation, recovery, and prognosis. Management of MSDs is complex and requires multifaceted interventions. Given the challenges of MSDs and their continued burden, it is possible that additional elements could impact these disorders that have not been fully researched, for example, indoor environmental quality. Our previous review provided preliminary evidence that healthy building determinants (HBDs) are associated with the risk of back and neck pain. However, the relationship of HBDs with extremity MSDs and general MSDs (i.e., MSDs involving multiple body regions or in which body regions were unspecified in the original reports) has not been formally studied. The purpose of this review was to conduct a systematic literature review to assess the relationship of HBDs with extremity and general MSDs (PROSPERO ID: CRD42022314832). PubMed, CINAHL, Embase, and PEDRo databases were searched through April 2022. Inclusion criteria for study eligibility were as follows: humans of ages ≥18 years, reported on one or more of eight HBDs (1. air quality and ventilation, 2. dust and pests, 3. lighting and views, 4. moisture, 5. noise, 6. safety and security, 7. thermal health, 8. water quality), and compared these HBDs with extremity MSDs or general MSDs, original research, English. Exclusion criteria were as follows: articles not published in peer-reviewed journals, full-text articles unavailable. Review procedures were conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Empirical evidence statements were developed for 33 pairwise comparisons of HBDs with MSDs. The search uncovered 53 eligible studies with 178,532 participants. A total of 74.6% (39/53) of the studies were cross-sectional and 81.1% (43/53) were fair quality. Overall, the majority of uncovered evidence indicates that HBDs are related to risk of extremity and general MSDs. Nineteen comparisons support that as HBDs worsen, the risk of MSDs increases. Six comparisons had conflicting evidence. Three comparisons support that poor HBDs are not related to increased risk of extremity and general MSDs. Five comparisons had no evidence. This systematic review builds upon previous work to provide useful starting points to enhance awareness about the HBD-MSD relationship. These findings can help inform research and public health efforts aimed at addressing suboptimal HBDs through appropriate interventions to improve the lives of those suffering from MSDs.
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Affiliation(s)
| | - John M Mayer
- Research and Development, Healthy Buildings LLC, Malibu, USA
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Mousavibaygei SR, Bisadi A, ZareSakhvidi F. Outdoor air pollution exposure, bone mineral density, osteoporosis, and osteoporotic fractures: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 865:161117. [PMID: 36586679 DOI: 10.1016/j.scitotenv.2022.161117] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/08/2022] [Accepted: 12/18/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The prevalence of osteoporosis and osteoporotic fractures is expected to increase with the aging of the population in the coming decades. In this study, we systematically reviewed the evidence on the association between exposure to air pollution and osteoporosis-related outcomes. METHODS We systematically searched evidence according to the PRISMA on PubMed, Scopus, and Web of Science (until August 2022). The risk of bias (RoB) was assessed using the Risk of Bias in the Non-randomized Studies of Exposures (ROBINS-E) tool. Random effects meta-analysis was applied to calculate combined estimates. We evaluated the heterogeneity using Cochran's Q test and quantified it by I2 and tau2 statistics. The overall body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) tool. RESULTS Out of 5254 retrieved articles, 19 studies (11 cross-sectional, seven cohorts, and one case-control) met our inclusion criteria. Most of the studies had a high probability of RoB (n = 17), and only two had a moderate RoB. Different outcomes including bone mineral density, bone mineral content, osteoporotic fracture, osteoporosis, and osteopenia were reported across the studies. The associations were reported for different air pollutants including PM2.5, PM10, nitrogen oxides, nitrogen dioxide, ozone, black carbon, carbon monoxide, sulfur dioxide, nitrogen oxide, and coarse particulate matter. Evidence was suggestive of the negative role of PM10, PM2.5, and nitrogen dioxide (e.g. bone mineral density pooled estimate: -0.02, 95%CI: -0.03: -0.01). The overall body of evidence for most of the exposure-outcome pairs was low and very low. CONCLUSIONS The evidence on the association between air pollution exposure and osteoporosis-related outcomes is heterogenic. However, the evidence suggests an increased risk of osteoporotic fracture and osteoporosis in outdoor air pollutants. Due to the small number of studies in each group, also observed heterogeneity, and publication bias, the results should be interpreted with caution.
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Affiliation(s)
- Seyed Rohallah Mousavibaygei
- Assistant professor of orthopedic surgery, Department of orthopedic surgery Qom University of Medical Sciences, Qom, Iran
| | - Amir Bisadi
- Assistant professor of orthopedic surgery, Department of orthopedic surgery Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Epidemiological characteristics of fractures of spine, hip, proximal humerus and forearm during the haze epidemic period. Injury 2022; 53:3139-3148. [PMID: 35973869 DOI: 10.1016/j.injury.2022.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/27/2022] [Accepted: 08/06/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Air pollutants have an impact on the occurrence of spine fractures, hip fractures, proximal humerus fractures and forearm fractures. This study aimed at evaluating the short-term impact of particulate matter with aerodynamic diameters of less than 2.5 µm (PM2.5) on the occurrence of those fractures in Shijiazhuang, Hebei, China. METHODS The daily meteorological, pollution, and fracture data of Shijiazhuang from 2014 to 2019 were collected. Distribution characteristics of fractures were described using descriptive epidemiological methods. The distributed lag nonlinear model (DLNM) was used to reveal the description of those fractures in the exposed and lag dimensions at the same time. Based on gender and age (<18 years old, 18-69 years old and >69 years old), stratified analysis was performed. Sensitivity analysis was performed to ascertain the robustness of the results. RESULTS Between 2014 and 2019, fracture incidences in Shijiazhuang exhibited an overall increasing trend, with an obvious seasonality. PM2.5 was positively related to daily fracture cases and the effects were more obvious in women, adolescents and people of working age. When PM2.5 concentrations increased by one interquartile range (IQR) (70 μg/m3), RR exhibited a unimodal distribution. Its peak appeared on the 16th day of lag (RR=1.005987, 95% CI:1.002472,1.009652), and the RRs were also statistically significant from the 10th to 22nd day of lag. Similarly, cumulative effects of each increase in the concentration of PM2.5 IQR also showed a unimodal distribution. The largest cumulative effect occurred on the 28th day of lag (RR=1.084457, 95% CI:1.012207,1.161864), and the cumulative RRs were also statistically significant from the 19th day to 30nd days. In the dose-response relationship, as PM2.5 concentrations increased, RR increased. CONCLUSION Year by year, fractures in Shijiazhuang City exhibited an increasing trend. PM2.5 can affect the occurrence of those fractures. The impact on women, adolescents and people of working age is even greater. The supervision of PM2.5 should be strengthened while large-scale emissions should be limited.
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Zhang F, Zhang X, Zhou G, Zhao G, Zhu S, Zhang X, Xiang N, Zhu W. Is Cold Apparent Temperature Associated With the Hospitalizations for Osteoporotic Fractures in the Central Areas of Wuhan? A Time-Series Study. Front Public Health 2022; 10:835286. [PMID: 35284367 PMCID: PMC8904880 DOI: 10.3389/fpubh.2022.835286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/26/2022] [Indexed: 12/19/2022] Open
Abstract
Osteoporosis is alarming problem due to aggravation of global aging, especially in China. Osteoporotic fracture (OF) is one of the most severe consequents of osteoporosis. Many previous studies found that environmental factors had adverse effects on human health. Cold temperature was associated with OF and bone metabolism in prior observational and experimental researches. However, few studies had been conducted on the acute effect of low temperature and OF. Data on daily meteorological factors and hospitalizations for OF were collected from Wuhan, China, between January 1, 2017 to December 24, 2019. Apparent temperature (AT), comprehensively considered a variety of environmental factors, was calculated by ambient temperature, relative humidity and wind speed. A generalized linear regression model combined with distributed lag non-linear regression model (DLNM) with quasi-Poisson link was used to explore the association between AT and the number of hospitalizations for OF. Subgroup analyses stratified by gender, age and the history of fracture were applied for detecting susceptible people. The exposure-response curve of AT and OF were generally U-shaped with lowest point at 25.8°C. The significant relationship of AT-OF existed only in cold effect (-2.0 vs. 25.8°C) while not in warm effect (37.0 vs. 25.8°C). Statistically significant risks of OF for cold effects were only found in females [RR = 1.12 (95%CI: 1.02, 1.24) at lag 2 day], aged <75 years old [RR = 1.18 (95%CI: 1.04, 1.33) and 1.17 (95%CI: 1.04, 1.33) at lag 2 and 3 days, respectively] and people with history of fracture [RR = 1.39 (95%CI: 1.02, 1.90) and 1.27 (95%CI: 1.05, 1.53) at lag 1 and 2 days, respectively]. The significant associations of AT on OF were only found in cold effect. The females, people aged <75 years and people with history of fracture possibly appeared to be more vulnerable. Public health departments should pay attention to the negative effect of cold AT and take measures in time.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Guangwen Zhou
- Department of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Gaichan Zhao
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Xiaowei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Nan Xiang
- Department of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
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Heo S, Kim H, Kim S, Choe SA, Byun G, Lee JT, Bell ML. Associations between Long-Term Air Pollution Exposure and Risk of Osteoporosis-Related Fracture in a Nationwide Cohort Study in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2404. [PMID: 35206592 PMCID: PMC8872590 DOI: 10.3390/ijerph19042404] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/03/2022] [Accepted: 02/17/2022] [Indexed: 01/27/2023]
Abstract
Bone health is a major concern for aging populations globally. Osteoporosis and bone mineral density are associated with air pollution, but less is known about the impacts of air pollution on osteoporotic fracture. We aimed to assess the associations between long-term air pollution exposure and risk of osteoporotic fracture in seven large Korean cities. We used Cox proportional hazard models to estimate hazard rations (HRs) of time-varying moving window of past exposures of particulate matter (PM10), sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), and ozone (O3) for osteoporotic fracture in Korean adults (age ≥ 50 years) in the National Health Insurance Service-National Sample Cohort data, followed 2002 to 2015. HRs were calculated for an interquartile range (IQR) increase. Comorbidity and prescription associated with osteoporosis, age, sex, body mass index, health behaviors, and income were adjusted in the models. Effect modification by age, sex, exercise, and income was examined. We assessed 56,467 participants over 535,481 person-years of follow up. Linear and positive exposure-response associations were found for SO2, while PM10 and NO2 showed nonlinear associations. SO2 was associated with osteoporosis-related fracture with marginal significance (HR for an IQR [2 ppb] increase = 1.04, 95% CI: 1.00, 1.09). The SO2 HR estimates were robust in analyses applying various moving windows of exposure (from one to three years of past exposure) and two-pollutant models. The central HR estimate of O3 implied positive associations but was not significant (HR for 0.007 ppm increase = 1.01, 95% CI: 0.97, 1.06). PM10, CO, and NO2 did not show associations. Vulnerable groups by sex, age, exercise, and income varied across air pollutants and there was no evidence of effect modifications. Long-term exposure to SO2, but not PM10, CO, NO2 and O3, was associated with increased osteoporotic fracture risks in Korean adults.
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Affiliation(s)
- Seulkee Heo
- School of the Environment, Yale University, New Haven, CT 06511, USA; (H.K.); (M.L.B.)
| | - Honghyok Kim
- School of the Environment, Yale University, New Haven, CT 06511, USA; (H.K.); (M.L.B.)
| | - Sera Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Korea; (S.K.); (G.B.); (J.-T.L.)
| | - Seung-Ah Choe
- College of Medicine, Korea University, Seoul 02841, Korea;
| | - Garam Byun
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Korea; (S.K.); (G.B.); (J.-T.L.)
| | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Korea; (S.K.); (G.B.); (J.-T.L.)
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, CT 06511, USA; (H.K.); (M.L.B.)
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