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Kao CM, Chen YM, Huang WN, Chen YH, Chen HH. Association between air pollutants and initiation of biological therapy in patients with ankylosing spondylitis: a nationwide, population-based, nested case-control study. Arthritis Res Ther 2023; 25:75. [PMID: 37147678 PMCID: PMC10161550 DOI: 10.1186/s13075-023-03060-4] [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: 03/09/2023] [Accepted: 04/29/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Outdoor air pollution has been found to trigger systemic inflammatory responses and aggravate the activity of certain rheumatic diseases. However, few studies have explored the influence of air pollution on the activity of ankylosing spondylitis (AS). As patients with active AS in Taiwan can be reimbursed through the National Health Insurance programme for biological therapy, we investigated the association between air pollutants and the initiation of reimbursed biologics for active AS. METHODS Since 2011, hourly concentrations of ambient air pollutants, including PM2.5, PM10, NO2, CO, SO2, and O3, have been estimated in Taiwan. Using Taiwanese National Health Insurance Research Database, we identified patients with newly diagnosed AS from 2003 to 2013. We selected 584 patients initiating biologics from 2012 to 2013 and 2336 gender-, age at biologic initiation-, year of AS diagnosis- and disease duration-matched controls. We examined the associations of biologics initiation with air pollutants exposure within 1 year prior to biologic use whilst adjusting for potential confounders, including disease duration, urbanisation level, monthly income, Charlson comorbidity index (CCI), uveitis, psoriasis and the use of medications for AS. Results are shown as adjusted odds ratio (aOR) with 95% confidence intervals (CIs). RESULTS The initiation of biologics was associated with exposure to CO (per 1 ppm) (aOR, 8.57; 95% CI, 2.02-36.32) and NO2 (per 10 ppb) (aOR, 0.23; 95% CI, 0.11-0.50). Other independent predictors included disease duration (incremental year, aOR, 8.95), CCI (aOR, 1.31), psoriasis (aOR, 25.19), use of non-steroidal anti-inflammatory drugs (aOR, 23.66), methotrexate use (aOR, 4.50; 95% CI, 2.93-7.00), sulfasalazine use (aOR, 12.16; 95% CI, 8.98-15.45) and prednisolone equivalent dosages (mg/day, aOR, 1.12). CONCLUSIONS This nationwide, population-based study revealed the initiation of reimbursed biologics was positively associated with CO levels, but negatively associated with NO2 levels. Major limitations included lack of information on individual smoking status and multicollinearity amongst air pollutants.
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Affiliation(s)
- Chung-Mao Kao
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan
- Division of Translational Medicine, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Ming Chen
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan
- Division of Translational Medicine, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Wen-Nan Huang
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Business Administration, Ling-Tung University, Taichung, Taiwan
| | - Yi-Hsing Chen
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hsin-Hua Chen
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec.4, Taiwan Boulevard, Taichung, 40705, Taiwan.
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan.
- Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Big Data Center, National Chung Hsing University, Taichung, Taiwan.
- Division of General Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
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Gui SY, Wang XC, Qiao JC, Xiao DC, Hu CY, Tao FB, Liu DW, Yi XL, Jiang ZX. Short-term exposure to air pollution and outpatient visits for conjunctivitis: a time-series analysis in Urumqi, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:66400-66416. [PMID: 37095216 DOI: 10.1007/s11356-023-26995-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/07/2023] [Indexed: 05/03/2023]
Abstract
Conjunctivitis is an inflammatory disease of the conjunctival tissue caused by a variety of causes; despite the conjunctiva being directly exposed to the external atmospheric environment, the important role of air pollution is not fully evaluated, especially in areas with poor air quality undergoing rapid economic and industrial development. Information on 59,731 outpatient conjunctivitis visits from 1 January 2013 to 31 December 2020 was obtained from the Ophthalmology Department of the First Affiliated Hospital of Xinjiang Medical University (Urumqi, Xinjiang, China), and data on six air pollutants including particulate matter with a median aerometric diameter of less than 10 and 2.5 mm (PM10 and PM2.5, respectively), carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) from eleven standard urban background fixed air quality monitors were also recorded. A time-series analysis design and a quasi-Poisson generalized linear regression model combined with a distributed lagged nonlinear model (DLNM) were used to fit the effect of exposure to air pollutants on the risk of conjunctivitis outpatient visits. Further subgroup analyses were conducted for gender, age, and season, as well as the type of conjunctivitis. Single and multi-pollutant models showed that exposure to PM2.5, PM10, NO2, CO, and O3 was associated with increased risk of outpatient conjunctivitis visits on the lag 0 day and various other lag days. Variations in the effect estimates on direction and magnitude were found in different subgroup analyses. We conducted the first time-series analysis with the longest duration as well as the largest sample size in Northwest China, which provides evidence that outpatient conjunctivitis visits is significantly associated with air pollution in Urumqi, China. Meanwhile, our results demonstrate the effectiveness of SO2 reduction in reducing the risk of outpatient conjunctivitis visits in the Urumqi region and reaffirm the need to implement special air pollution control measures.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xin-Chen Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Dun-Cheng Xiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Dong-Wei Liu
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Xiang-Long Yi
- Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, 137 Liyu Shan Road, Ürümqi, 830011, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
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Gu Y, Xu H, Feng R, Cheng Y, Han B, Ho KF, Wang Z, He Y, Qu L, Ho SSH, Sun J, Shen Z, Cao J. Associations of personal exposure to domestic heating and cooking fuel emissions and epidemiological effects on rural residents in the Fenwei Plain, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:159217. [PMID: 36206913 DOI: 10.1016/j.scitotenv.2022.159217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Solid fuel combustion for domestic heating in northern China in the wintertime is of great environmental and health concern. This study assesses personal exposure to particulate matter with different aerodynamic diameters and multiple gaseous pollutants from 123 rural residents in Yuncheng, the Fenwei Plain. The subjects are divided into groups based on the unique energy source applied, including biomass, coal, and electricity/no heating activities. The health effects of the exposures are expressed with four urinary biomarkers. The personal exposure levels to three different aerodynamic particle sizes (i.e., PM10, PM2.5, and PM1) of the electricity/no heating group are 5.1 % -12 % lower than those of the coal group. In addition, the exposure levels are 25 %-40 % lower for carbon monoxide (CO) and 10.8 %-20.3 % lower for ozone (O3) in the electricity/no heating group than the other two fuel groups. C-reactive protein (CRP) in the urine of the participants in biomass and coal groups is significantly higher than that in the electricity/no heating group, consistent with the observations on other biomarkers. Increases in 8-hydroxy-2 deoxyguanosine (8-OHdG), interleukin-8 (IL-8), and vascular endothelial growth factor (VEGF) are observed for the exposures to higher concentrations of air pollutants. For instance, PMs and nitrogen dioxide (NO2) show significant impacts on positive correlations with 8-OHdG and IL-8, while O3 positively correlates with CRP. PM1 exhibits higher effects on the biomarkers than the gaseous pollutants, especially on VEGF and IL-8. The study indicates that excessive use of traditional domestic solid fuels could pose severe health effects on rural residents. The promotion of using clean energy is urgently needed in the rural areas of northern China.
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Affiliation(s)
- Yunxuan Gu
- Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Hongmei Xu
- Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China; SKLLQG, Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an 710061, China.
| | - Rong Feng
- Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Yue Cheng
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710049, China
| | - Bei Han
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710049, China
| | - Kin Fai Ho
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zexuan Wang
- Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Yansu He
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Linli Qu
- Hong Kong Premium Services and Research Laboratory, Kowloon, Hong Kong, China
| | - Steven Sai Hang Ho
- Division of Atmospheric Sciences, Desert Research Institute, Reno, NV 89512, United States
| | - Jian Sun
- Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Zhenxing Shen
- Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an 710049, China; SKLLQG, Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an 710061, China
| | - Junji Cao
- SKLLQG, Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an 710061, China
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Hu X, Nie Z, Ou Y, Qian Z, McMillin SE, Aaron HE, Zhou Y, Dong G, Dong H. Air quality improvement and cognitive function benefit: Insight from clean air action in China. ENVIRONMENTAL RESEARCH 2022; 214:114200. [PMID: 36030909 DOI: 10.1016/j.envres.2022.114200] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Epidemiological evidence suggests associations between long-term exposure to air pollution and accelerated cognitive decline. China implemented a strict clean air action plan in 2013; however, it is unclear whether the improvement of air quality has alleviated cognitive impairment in the population. METHODS From the China Health and Retirement Longitudinal Study, 8536 Chinese adults were enrolled in 2011 and followed up in 2015. Satellite-based spatiotemporal models were used to estimate exposure to air pollutants (including particles with diameters ≤1.0 μm [PM1], ≤2.5 μm [PM2.5], ≤10 μm [PM10], nitrogen dioxide [NO2], and ozone [O3]). Cognitive function was evaluated using a structured questionnaire in three dimensions: episodic memory, orientation and attention, and visuoconstruction. The associations between changes in the levels of air pollutants and cognitive function were elucidated by a logistic model. The Bayesian Kernel Machine Regression (BKMR) model was applied to evaluate the cumulative effect of air pollutants. RESULTS The mean (standard deviation) age of all participants was 58.6 (8.7) years. The odds ratio (95% confidence interval) between the highest and the lowest quartile of PM1 exposure reduction for cognitive impairment was 0.46 (0.41, 0.53) after adjusting for confounders. Similar protective effects of cognitive function were observed with the decrease in the level of PM2.5 (0.34 [0.30, 0.39]), PM10 (0.54 [0.48, 0.62]), and NO2 (0.59 [0.51, 0.67]), while the reduction in O3 appeared to be less related to changes in cognitive function (OR: 0.97 [0.85, 1.10]). The protective association of PM1 reduction was stronger in males than in females. Decreased in PM2.5 dominate the cognitive function benefit relative to PM1, PM10, NO2. CONCLUSIONS The implementation of the clean air action plan led to a significant reduction in PM1, PM2.5, PM10, and NO2, which could slow the decline of cognitive function, while a reduction in O3 may not.
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Affiliation(s)
- Xiangming Hu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Zhiqiang Nie
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Yanqiu Ou
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63103, USA
| | - Hannah E Aaron
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Yingling Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Haojian Dong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
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Kim JH, Woo HD, Choi S, Song DS, Lee JH, Lee K. Long-Term Effects of Ambient Particulate and Gaseous Pollutants on Serum High-Sensitivity C-Reactive Protein Levels: A Cross-Sectional Study Using KoGES-HEXA Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811585. [PMID: 36141854 PMCID: PMC9517608 DOI: 10.3390/ijerph191811585] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 05/23/2023]
Abstract
Ambient air pollutants reportedly increase inflammatory responses associated with multiple chronic diseases. We investigated the effects of long-term exposure to ambient air pollution on high-sensitivity C-reactive protein (hs-CRP) using data from 60,581 participants enrolled in the Korean Genome and Epidemiology Study-Health Examinees Study between 2012 and 2017. Community Multiscale Air Quality System with surface data assimilation was used to estimate the participants' exposure to criteria air pollutants based on geocoded residential addresses. Long-term exposure was defined as the 2-year moving average concentrations of PM10, PM2.5, SO2, NO2, and O3. Multivariable linear and logistic regression models were utilized to estimate the percent changes in hs-CRP and odds ratios of systemic low-grade inflammation (hs-CRP > 3 mg/L) per interquartile range increment in air pollutants. We identified positive associations between hs-CRP and PM10 (% changes: 3.75 [95% CI 2.68, 4.82]), PM2.5 (3.68, [2.57, 4.81]), SO2 (1.79, [1.10, 2.48]), and NO2 (3.31, [2.12, 4.52]), while negative association was demonstrated for O3 (-3.81, [-4.96, -2.65]). Elevated risks of low-grade inflammation were associated with PM10 (odds ratio: 1.07 [95% CI 1.01, 1.13]), PM2.5 (1.08 [1.02, 1.14]), and SO2 (1.05 [1.01, 1.08]). The odds ratios reported indicated that the exposures might be risk factors for inflammatory conditions; however, they did not reflect strong associations. Our findings suggest that exposure to air pollutants may play a role in the inflammation process.
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He H, Pan L, Hu Y, Tu J, Zhang L, Zhang M, Liu G, Yuan J, Ou Q, Sun Z, Nai J, Cui Z, Zhang J, Wang J, Wu J, Han X, Niu Y, Li X, Hou D, Yu C, Jiang C, Liu Q, Lin B, Shan G. The diverse life-course cohort (DLCC): protocol of a large-scale prospective study in China. Eur J Epidemiol 2022; 37:871-880. [PMID: 35856127 PMCID: PMC9294835 DOI: 10.1007/s10654-022-00894-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/21/2022] [Indexed: 01/24/2023]
Abstract
The Diverse Life-Course Cohort (DLCC) is a large-scale prospective study including around 130,000 participants in mainland China. The primary aims of DLCC include contributing to knowledge on noncommunicable chronic disease determinants, particularly cardiometabolic diseases, and exploring the long-term effect of ambient air pollutants or other environmental risk factors on health among all-age populations. The cohort consists of several sub-populations that cover the whole life-course and diverse resources: from premarital to adolescents, adults from workplace and communities ranged from 18 to 93 years old. Baseline assessment (2017–2021) included face-to-face standardized questionnaire interview and measurements to assess social and biological factors of health. Blood samples were collected from each participant (except for children younger than 6) to establish the biobank. DLCC consists of two visits. Visit 1 was conducted from 2017, and 114850 individuals from one of the world-class urban agglomerations: Beijing, Tianjin, and Hebei area were recruited. By the end of 2021, at least one follow-up was carried out, with an overall follow-up rate of 92.33%. In 2021, we initiated Visit 2, newly recruited 9,866 adults from Guangdong province (South China) and Hebei province (Central China), with research focuses on the comparations on ambient pollution hazards and other unique dietary or environmental risks for health. The baseline survey of Visit 2 was finished in July 2021. DLCC is still ongoing with a long-term follow-up design, and not limited by the current funding period. With reliable data and the well-established biobank which consists of over 120,000 individuals’ blood samples, DLCC will provide invaluable resources for scientific research.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yaoda Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ji Tu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Minying Zhang
- School of Medicine, Nankai University, Tianjin, China
| | - Gongshu Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Juxiang Yuan
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
- Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, North China University of Science and Technology, Tangshan, Hebei, China
| | - Qiong Ou
- Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Zhiwei Sun
- Department of Preventive Medicine, School of Public Health, Hebei University, Baoding, Hebei, China
| | - Jing Nai
- Clinical Laboratory, Bejing Hepingli Hospital, Beijing, China
| | - Ze Cui
- Hebei Provicel Center for Diseases Prevention and Control, Shijiazhuang, Hebei, China
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing, China
| | - Jing Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Jianhui Wu
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
- Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiaoyan Han
- Chaoyang District Center for Disease Control and Prevention, Beijing, China
| | - Yujie Niu
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, China
| | - Xiaoming Li
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
- Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, North China University of Science and Technology, Tangshan, Hebei, China
| | - Dongqing Hou
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Chengdong Yu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Chenchen Jiang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Qihang Liu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Binbin Lin
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
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Abstract
PURPOSE OF REVIEW There is increasing interest in the links between exposure to air pollution and a range of health outcomes. The association with mental health however is much less established. This article reviews developments in the field over the past 12 months, highlighting the evidence for causation, associations between multiple air pollutants and mental health outcomes, and assesses the challenges of researching this topic. RECENT FINDINGS Increasingly rigorous methods are being applied to the investigation of a broader range of mental health outcomes. These methods include basic science, neuroimaging, and observational studies representing diverse geographical locations. Cohort studies with linked high-resolution air pollutant exposure data are common, facilitating advanced analytic methods. To date, meta-analyses have demonstrated small and significant positive associations between long-term exposure to fine particulate matter and depressive symptoms and cognitive decline. Methodological complexities in measuring exposure and outcome pose ongoing difficulties for the field. SUMMARY Literature on this topic has recently seen an appreciable expansion. Work that better estimates daily exposure, controls for complex confounders, and is driven by hypotheses founded in candidate causal mechanisms would help clarify associations, and inform targeted interventions and policymakers.
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