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Orina F, Amukoye E, Bowyer C, Chakaya J, Das D, Devereux G, Dobson R, Dragosits U, Gray C, Kiplimo R, Lesosky M, Loh M, Meme H, Mortimer K, Ndombi A, Pearson C, Price H, Twigg M, West S, Semple S. Household carbon monoxide (CO) concentrations in a large African city: An unquantified public health burden? ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 351:124054. [PMID: 38677455 DOI: 10.1016/j.envpol.2024.124054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/10/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024]
Abstract
Carbon monoxide (CO) is a poisonous gas produced by incomplete combustion of carbon-based fuels that is linked to mortality and morbidity. Household air pollution from burning fuels on poorly ventilated stoves can lead to high concentrations of CO in homes. There are few datasets available on household concentrations of CO in urban areas of sub-Saharan African countries. CO was measured every minute over 24 h in a sample of homes in Nairobi, Kenya. Data on household characteristics were gathered by questionnaire. Metrics of exposure were summarised and analysis of temporal changes in concentration was performed. Continuous 24-h data were available from 138 homes. The mean (SD), median (IQR) and maximum 24-h CO concentration was 4.9 (6.4), 2.8 (1.0-6.3) and 44 ppm, respectively. 50% of homes had detectable CO concentrations for 847 min (14h07m) or longer during the 24-h period, and 9% of homes would have activated a CO-alarm operating to European specifications. An association between a metric of total CO exposure and self-reported exposure to vapours >15 h per week was identified, however this were not statistically significant after adjustment for the multiple comparisons performed. Mean concentrations were broadly similar in homes from a more affluent area and an informal settlement. A model of typical exposure suggests that cooking is likely to be responsible for approximately 60% of the CO exposure of Nairobi schoolchildren. Household CO concentrations are substantial in Nairobi, Kenya, despite most homes using gas or liquid fuels. Concentrations tend to be highest during the evening, probably associated with periods of cooking. Household air pollution from cooking is the main source of CO exposure of Nairobi schoolchildren. The public health impacts of long-term CO exposure in cities in sub-Saharan Africa may be considerable and should be studied further.
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Affiliation(s)
- F Orina
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - E Amukoye
- Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - C Bowyer
- Faculty of Creative and Cultural Industries, University of Portsmouth, Portsmouth, UK
| | - J Chakaya
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - D Das
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh EH14 4AP, UK; Department of Environment and Geography, University of York, YO10 5NG, UK
| | - G Devereux
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - R Dobson
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, UK
| | - U Dragosits
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, Midlothian EH26 0QB, UK
| | - C Gray
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - R Kiplimo
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - M Lesosky
- National Heart and Lung Institute, Imperial College London, London, SW3 6LR, UK
| | - M Loh
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh EH14 4AP, UK
| | - H Meme
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - K Mortimer
- Cambridge Africa, Department of Pathology, University of Cambridge, Cambridge, UK; Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - A Ndombi
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - C Pearson
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, Midlothian EH26 0QB, UK
| | - H Price
- Biological and Environmental Sciences, University of Stirling, Stirling, FK9 4LA, UK
| | - M Twigg
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, Midlothian EH26 0QB, UK
| | - S West
- Stockholm Environment Institute, University of York, YO10 5NG, UK
| | - S Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, UK.
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Oliverio S, Ferger MC, Yegles M. Postmortem concentrations for total blood carbon monoxide (TBCO) as a novel biomarker for carbon monoxide (CO) poisonings. J Anal Toxicol 2024; 48:289-298. [PMID: 38662395 DOI: 10.1093/jat/bkae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/25/2024] [Accepted: 04/17/2024] [Indexed: 04/26/2024] Open
Abstract
Total blood carbon monoxide (TBCO) showed promising results in improving accuracy of CO determinations in blood and presenting better stability to different storage conditions. Therefore, it was proposed as an alternative biomarker to carboxyhemoglobin (COHb) for CO poisoning diagnosis. However, given that current interpretation reference values exist for COHb only, it is difficult to implement TBCO analysis in routine. Therefore, we aimed at determining TBCO reference values for postmortem CO poisoning cases. A previously validated method for TBCO analysis via gas chromatography-mass spectrometry was applied to cardiac, peripheral, cranial and spleen blood samples collected from 92 autopsies. Autopsy cases included 21 non-CO-related and 71 CO-related cases with varying postmortem intervals (PMIs). Statistical analyses were performed using statistical software R Studio. When comparing lower to higher PMIs for non-CO-related cases, no significant differences were found, which suggests that CO formation or degradation at low PMIs does not occur. Spleen blood showed potential as an alternative matrix to CO determinations in cases with sample availability issues but needs to be evaluated for CO-positive cases. Results for cardiac blood in CO-related autopsies showed a positive correlation between COHb and TBCO values (R = 0.78). This value is lower than what is found in the literature, suggesting that even though COHb and TBCO are correlated, a potential underestimation of the true CO exposure might occur if only COHb values are taken into consideration. Samples were divided into CO exposure groups based on COHb concentrations, and with the data obtained, classification into the following TBCO concentration groups is proposed: no significant CO exposure case <6 µmol/mL, medium CO exposure case 6-20 µmol/mL and high CO exposure case >20 µmol/mL. Even if a higher number of samples in each group would enable to increase the confidence, these results are very promising and highlight the importance of TBCO measurement.
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Affiliation(s)
- Stefania Oliverio
- Department of Forensic Medicine, Laboratoire National de Santé, 1 Rue Louis Rech, Dudelange 3555, Luxemburg
- Forensic Toxicology and Chemistry Unit, University Center of Legal Medicine Lausanne-Geneva, Chemin de la Vuillette 4, Lausanne 1000 Switzerland
| | - Marie-Caroline Ferger
- Department of Forensic Medicine, Laboratoire National de Santé, 1 Rue Louis Rech, Dudelange 3555, Luxemburg
| | - Michel Yegles
- Department of Forensic Medicine, Laboratoire National de Santé, 1 Rue Louis Rech, Dudelange 3555, Luxemburg
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Williams ME, Corn EA, Martinez Ransanz S, Berl MM, Andringa-Seed R, Mulkey SB. Neurodevelopmental assessments used to measure preschoolers' cognitive development in Latin America: a systematic review. J Pediatr Psychol 2024; 49:321-339. [PMID: 38244996 PMCID: PMC11098046 DOI: 10.1093/jpepsy/jsad089] [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: 05/02/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE The objective of this study was to systematically review the standardized neurodevelopmental assessments used to study preschool-aged children's cognitive development in Spanish-speaking Latin America. METHODS The authors systematically searched PubMed, PsycINFO, and ERIC databases for peer-reviewed articles from Spanish-speaking Latin American countries. Articles were included if they measured cognitive development among children aged 2-6 years using at least one standardized assessment tool; 97 articles were included and reviewed in accordance with PRISMA guidelines to assess their use of these tools. RESULTS Ninety-seven studies across 13 countries used a total of 41 assessments to measure cognitive development; most widely used were the Wechsler intelligence scales (n = 46/97), particularly the Wechsler Preschool and Primary Scale of Intelligence and Wechsler Intelligence Scale for Children (n = 23 and 29, respectively). Other common assessments included the McCarthy Scales of Children's Abilities (n = 9), Raven's Progressive Matrices (n = 9), Child Neuropsychological Assessment (n = 8), and Peabody Picture Vocabulary Test (n = 7). In regions where normative data for a given assessment were unpublished, authors commonly used norms from the United States, Mexico, or Spain or did not report standard scores in their analyses. CONCLUSIONS The wide range of tools used in these studies presents a challenge for generalizing results when measuring the neurodevelopment of Latin American preschool-aged children. The low availability of normative data for specific regions reveals concerns if some tools are culturally and linguistically appropriate even when Spanish is a common language, particularly in low-resource settings. Future work to forge greater consistency in the use of validated measures, clarity in reporting research methods, and publication of regional normative data would benefit the field.
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Affiliation(s)
- Meagan E Williams
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
| | - Elizabeth A Corn
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
| | - Santiago Martinez Ransanz
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
- Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Madison M Berl
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
- Department of Psychiatry and Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Regan Andringa-Seed
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
| | - Sarah B Mulkey
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC, United States
- Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
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Lai PS, Lam NL, Gallery B, Lee AG, Adair-Rohani H, Alexander D, Balakrishnan K, Bisaga I, Chafe ZA, Clasen T, Díaz-Artiga A, Grieshop A, Harrison K, Hartinger SM, Jack D, Kaali S, Lydston M, Mortimer KM, Nicolaou L, Obonyo E, Okello G, Olopade C, Pillarisetti A, Pinto AN, Rosenthal JP, Schluger N, Shi X, Thompson C, Thompson LM, Volckens J, Williams KN, Balmes J, Checkley W, Ozoh OB. Household Air Pollution Interventions to Improve Health in Low- and Middle-Income Countries: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2024; 209:909-927. [PMID: 38619436 DOI: 10.1164/rccm.202402-0398st] [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] [Indexed: 04/16/2024] Open
Abstract
Background: An estimated 3 billion people, largely in low- and middle-income countries, rely on unclean fuels for cooking, heating, and lighting to meet household energy needs. The resulting exposure to household air pollution (HAP) is a leading cause of pneumonia, chronic lung disease, and other adverse health effects. In the last decade, randomized controlled trials of clean cooking interventions to reduce HAP have been conducted. We aim to provide guidance on how to interpret the findings of these trials and how they should inform policy makers and practitioners.Methods: We assembled a multidisciplinary working group of international researchers, public health practitioners, and policymakers with expertise in household air pollution from within academia, the American Thoracic Society, funders, nongovernmental organizations, and global organizations, including the World Bank and the World Health Organization. We performed a literature search, convened four sessions via web conference, and developed consensus conclusions and recommendations via the Delphi method.Results: The committee reached consensus on 14 conclusions and recommendations. Although some trials using cleaner-burning biomass stoves or cleaner-cooking fuels have reduced HAP exposure, the committee was divided (with 55% saying no and 45% saying yes) on whether the studied interventions improved measured health outcomes.Conclusions: HAP is associated with adverse health effects in observational studies. However, it remains unclear which household energy interventions reduce exposure, improve health, can be scaled, and are sustainable. Researchers should engage with policy makers and practitioners working to scale cleaner energy solutions to understand and address their information needs.
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Li C, Xia Y, Wang L. Household unclean fuel use, indoor pollution and self-rated health: risk assessment of environmental pollution caused by energy poverty from a public health perspective. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:18030-18053. [PMID: 37217815 DOI: 10.1007/s11356-023-27676-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/11/2023] [Indexed: 05/24/2023]
Abstract
The lack of access to clean energy remains one of the major challenges in the global energy sector. Access to clean, sustainable and affordable energy, outlined in the seventh Sustainable Development Goals (SDG 7) of the United Nations, plays a crucial role in advancing health (SDG 3), as unclean cooking energy may endanger people's health by causing air pollution. However, due to endogeneity problems such as reverse causality, the health consequences of environmental pollution caused by unclean fuel usage are difficult to be scientifically and accurately evaluated. This paper aims to systematically assess the health cost of unclean fuel usage based on tackling endogeneity, using the data from Chinese General Social Survey. The ordinary least squares model, ordered regression methods, instrumental variable approach, penalized machine learning methods, placebo test, and mediation models are applied in this research. Analytical results demonstrate that households' unclean fuel use significantly damages people's health. Specifically, the use of dirty fuel leads to an average of about a one-standard-deviation decline in self-rated health, demonstrating its notable negative effect. The findings are robust to a series of robustness and endogeneity tests. The impact mechanism is that unclean fuel usage reduces people's self-rated health through increasing indoor pollution. Meanwhile, the negative effect of dirty fuel use on health has significant heterogeneity among different subgroups. The consequences are more prominent for the vulnerable groups who are female, younger, living in rural areas and older buildings, with lower socio-economic status and uncovered by social security. Therefore, necessary measures should be taken to improve energy infrastructure to make clean cooking energy more affordable and accessible as well as to enhance people's health. Besides, more attention should be paid to the energy needs of the above specific vulnerable groups faced with energy poverty.
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Affiliation(s)
- Chao Li
- Business School, Shandong University, No. 180 Wenhuaxi Road, Weihai, 264209, China.
| | - Yuxin Xia
- HSBC Business School, Peking University, Shenzhen, China
| | - Lin Wang
- Glorious Sun School of Business and Management, Donghua University, Shanghai, China
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Shupler M, Tawiah T, Nix E, Baame M, Lorenzetti F, Betang E, Chartier R, Mangeni J, Upadhya A, Anderson de Cuevas R, Sang E, Piedrahita R, Johnson M, Wilson D, Amenga-Etego S, Twumasi M, Ronzi S, Menya D, Puzzolo E, Quansah R, Asante KP, Pope D, Mbatchou Ngahane BH. Household concentrations and female and child exposures to air pollution in peri-urban sub-Saharan Africa: measurements from the CLEAN-Air(Africa) study. Lancet Planet Health 2024; 8:e95-e107. [PMID: 38331535 PMCID: PMC10864747 DOI: 10.1016/s2542-5196(23)00272-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Relatively clean cooking fuels such as liquefied petroleum gas (LPG) emit less fine particulate matter (PM2·5) and carbon monoxide (CO) than polluting fuels (eg, wood, charcoal). Yet, some clean cooking interventions have not achieved substantial exposure reductions. This study evaluates determinants of between-community variability in exposures to household air pollution (HAP) across sub-Saharan Africa. METHODS In this measurement study, we recruited households cooking primarily with LPG or exclusively with wood or charcoal in peri-urban Cameroon, Ghana, and Kenya from previously surveyed households. In 2019-20, we conducted monitoring of 24 h PM2·5 and CO kitchen concentrations (n=256) and female cook (n=248) and child (n=124) exposures. PM2·5 measurements used gravimetric and light scattering methods. Stove use monitoring and surveys on cooking characteristics and ambient air pollution exposure (eg, walking time to main road) were also administered. FINDINGS The mean PM2·5 kitchen concentration was five times higher among households cooking with charcoal than those using LPG in the Kenyan community (297 μg/m3, 95% CI 216-406, vs 61 μg/m3, 49-76), but only 4 μg/m3 higher in the Ghanaian community (56 μg/m3, 45-70, vs 52 μg/m3, 40-68). The mean CO kitchen concentration in charcoal-using households was double the WHO guideline (6·11 parts per million [ppm]) in the Kenyan community (15·81 ppm, 95% CI 8·71-28·72), but below the guideline in the Ghanaian setting (1·77 ppm, 1·04-2·99). In all communities, mean PM2·5 cook exposures only met the WHO interim-1 target (35 μg/m3) among LPG users staying indoors and living more than 10 min walk from a road. INTERPRETATION Community-level variation in the relative difference in HAP exposures between LPG and polluting cooking fuel users in peri-urban sub-Saharan Africa might be attributed to differences in ambient air pollution levels. Thus, mitigation of indoor and outdoor PM2·5 sources will probably be critical for obtaining significant exposure reductions in rapidly urbanising settings of sub-Saharan Africa. FUNDING UK National Institute for Health and Care Research.
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Affiliation(s)
- Matthew Shupler
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK.
| | | | - Emily Nix
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | - Federico Lorenzetti
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | | | | | - Adithi Upadhya
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | - Edna Sang
- School of Public Health, Moi University, Eldoret, Kenya
| | | | | | | | | | | | - Sara Ronzi
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Diana Menya
- School of Public Health, Moi University, Eldoret, Kenya
| | - Elisa Puzzolo
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | | | - Daniel Pope
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
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Girsha WD, Abebe AD, Habtewold EM, Komicha MA. Indoor air pollution prevention practices and associated factors among household mothers in Olenchiti town, Oromia, Ethiopia. PLoS One 2024; 19:e0296706. [PMID: 38241300 PMCID: PMC10798486 DOI: 10.1371/journal.pone.0296706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/16/2023] [Indexed: 01/21/2024] Open
Abstract
INTRODUCTION Most households in low- and middle-income countries still cook using solid fuels in poorly ventilated dwellings. Indoor air pollution causes various health problems, like pneumonia, lung cancer, stillbirth, low birth weight, impaired cognitive development, and cataracts. Nevertheless, a few evidences are available in Africa, including Ethiopia. Therefore, this study aimed to assess the level of indoor air pollution prevention practices and associated factors among household mothers in Olenchiti town, Oromia, Ethiopia. METHODS A community-based cross-sectional study was conducted. Four hundred twenty mothers were randomly selected by systematic random sampling. Data was collected through an interview and observation checklist. The collected data entered into Epi-Info version 7.2.5 was cleaned, edited, and then exported to SPSS version 23 for analysis. Descriptive statistics were used to describe the findings. Binary logistic regression was computed to analyze the effect of each variable on the outcome variable. Model adequacy fitness was checked with the Hosmer-Lemeshow test. The multicollinearity of independent variables was checked with the variance inflation factor. Adjusted odds ratio with 95% confidence interval and P -value <0.05 was used as cutoff points to declare significance in the final model. RESULTS The overall good practices of mothers towards the prevention of indoor air pollution was 188 (45.0%). Mothers who had under-five children (AOR = 0.49, 95%CI (0.31-0.76), mothers in grade 9-12 (AOR = 0.51, 95%CI (0.28-0.92)) were significantly associated with indoor air pollution prevention practices. CONCLUSION The overall good practices of mothers towards indoor air pollution were low compared to different findings. Under-five children and educational status were significantly associated with indoor air pollution prevention practices in the final model. Therefore, the high school curriculums should include indoor air pollution topics.
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Affiliation(s)
| | - Alem Deksisa Abebe
- Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
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Grippo A, Zhu K, Yeung EH, Bell EM, Bonner MR, Tian L, Mendola P, Mu L. Indoor air pollution exposure and early childhood development in the Upstate KIDS Study. ENVIRONMENTAL RESEARCH 2023; 234:116528. [PMID: 37419197 DOI: 10.1016/j.envres.2023.116528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/23/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Limited human studies have investigated the impact of indoor air pollution on early childhood neurodevelopment among the US population. We aimed to examine the associations between prenatal and postnatal indoor air pollution exposure and early childhood development in a population-based birth cohort. METHODS This analysis included 4735 mother-child pairs enrolled between 2008 and 2010 in the Upstate KIDS Study. Indoor air pollution exposure from cooking fuels, heating fuels, and passive smoke during pregnancy, and at 12 and 36 months after birth were assessed by questionnaires. Five domains of child development were assessed by the Ages and Stages Questionnaire at 4, 8, 12, 18, 24, 30, and 36 months. Generalized estimating equations were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for potential confounders. RESULTS Exposure to unclean cooking fuels (natural gas, propane, or wood) throughout the study period was associated with increased odds of failing any development domain (OR = 1.28, 95% CI 1.07, 1.53), the gross motor domain (OR = 1.52, 95% CI: 1.09, 2.13), and the personal-social domain (OR = 1.36, 95% CI: 1.00, 1.85), respectively. Passive smoke exposure throughout the study period increased the odds of failing the problem-solving domain by 71% (OR = 1.71, 95% CI 1.01, 2.91) among children of non-smoking mothers. No association was found between heating fuel use and failing any or specific domains. CONCLUSION Unclean cooking fuel use and passive smoke exposure during pregnancy and early life were associated with developmental delays in this large prospective birth cohort.
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Affiliation(s)
- Alexandra Grippo
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Edwina H Yeung
- Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Erin M Bell
- Department of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA
| | - Matthew R Bonner
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Lili Tian
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
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Christensen GM, Marcus M, Vanker A, Eick SM, Malcolm-Smith S, Smith ADAC, Dunn EC, Suglia SF, Chang HH, Zar HJ, Stein DJ, Hüls A. Sensitive periods for exposure to indoor air pollutants and psychosocial factors in association with symptoms of psychopathology at school-age in a South African birth cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.08.23293825. [PMID: 37609236 PMCID: PMC10441486 DOI: 10.1101/2023.08.08.23293825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Background Gestation and the first few months of life are important periods for brain development. During these periods, exposure to environmental toxicants and psychosocial stressors are particularly harmful and may impact brain development. Specifically, exposure to indoor air pollutants (IAP) and psychosocial factors (PF) during these sensitive periods has been shown to predict childhood psychopathology. Objectives This study aims to investigate sensitive periods for the individual and joint effects of IAP and PF on childhood psychopathology at 6.5 years. Methods We analyzed data from the Drakenstein Child Health Study (N=599), a South African birth cohort. Exposure to IAP and PF was measured during the second trimester of pregnancy and 4 months postpartum. The outcome of childhood psychopathology was assessed at 6.5 years old using the Childhood Behavior Checklist (CBCL). We investigated individual effects of either pre-or postnatal exposure to IAP and PF on CBCL scores using adjusted linear regression models, and joint effects of these exposures using quantile g-computation and self-organizing maps (SOM). To identify possible sensitive periods, we used a structured life course modeling approach (SLCMA) as well as exposure mixture methods (quantile g-computation and SOM). Results Prenatal exposure to IAP or PFs, as well as the total prenatal mixture assessed using quantile g-computation, were associated with increased psychopathology. SLCMA and SOM models also indicated that the prenatal period is a sensitive period for IAP exposure on childhood psychopathology. Depression and alcohol were associated in both the pre-and postnatal period, while CO was associated with the postnatal period. Discussion Pregnancy may be a sensitive period for the effect of indoor air pollution on childhood psychopathology. Exposure to maternal depression and alcohol in both periods was also associated with psychopathology. Determining sensitive periods of exposure is vital to ensure effective interventions to reduce childhood psychopathology.
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Kaur S, Morales-Hidalgo P, Arija V, Canals J. Prenatal Exposure to Air Pollutants and Attentional Deficit Hyperactivity Disorder Development in Children: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085443. [PMID: 37107725 PMCID: PMC10138804 DOI: 10.3390/ijerph20085443] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 05/11/2023]
Abstract
Up to 9.5% of the world's population is diagnosed with attention deficit/hyperactivity disorder (ADHD), making it one of the most common childhood disorders. Air pollutants could be considered an environmental risk condition for ADHD, but few studies have specifically investigated the effect of prenatal exposure. The current paper reviews the studies conducted on the association between prenatal air pollutants (PM, NOx, SO2, O3, CO and PAH) and ADHD development in children. From the 890 studies searched through PubMed, Google Scholar, Scopus, and Web of Science, 15 cohort studies met the inclusion criteria. NOS and WHO guidelines were used for quality and risk of bias assessment. The accumulative sample was 589,400 of children aged 3-15 years. Most studies reported an association between ADHD symptoms and prenatal PAH and PM exposure. Data available on NO2 and SO2 were inconsistent, whereas the effect of CO/O3 is barely investigated. We observed heterogeneity through an odd ratio forest plot, and discrepancies in methodologies across the studies. Eight of the fifteen studies were judged to be of moderate risk of bias in the outcome measurement. In a nutshell, future studies should aim to minimize heterogeneity and reduce bias by ensuring a more representative sample, standardizing exposure and outcome assessments.
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Affiliation(s)
- Sharanpreet Kaur
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, 43201 Reus, Spain; (S.K.); (P.M.-H.); (V.A.)
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - Paula Morales-Hidalgo
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, 43201 Reus, Spain; (S.K.); (P.M.-H.); (V.A.)
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, 43007 Tarragona, Spain
- Department of Psychology and Education Studies, Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain
- University Research Institute on Sustainablility, Climate Change and Energy Transition (IU-RESCAT) Universitat Rovira i Virgili, 43003 Tarragona, Spain
| | - Victoria Arija
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, 43201 Reus, Spain; (S.K.); (P.M.-H.); (V.A.)
- University Research Institute on Sustainablility, Climate Change and Energy Transition (IU-RESCAT) Universitat Rovira i Virgili, 43003 Tarragona, Spain
- Department of Basic Medical Sciences, Universitat Rovira i Virgili, 43002 Reus, Spain
| | - Josefa Canals
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, 43201 Reus, Spain; (S.K.); (P.M.-H.); (V.A.)
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, 43007 Tarragona, Spain
- University Research Institute on Sustainablility, Climate Change and Energy Transition (IU-RESCAT) Universitat Rovira i Virgili, 43003 Tarragona, Spain
- Correspondence:
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11
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Kvestad I, Chandyo RK, Schwinger C, Ranjitkar S, Hysing M, Ulak M, Shrestha M, Shrestha L, Strand TA. Biomass fuel use for cooking in Nepalese families and child cognitive abilities, results from a community-based study. ENVIRONMENTAL RESEARCH 2022; 212:113265. [PMID: 35500855 DOI: 10.1016/j.envres.2022.113265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Biomass fuel use for cooking is widespread in low to middle income countries. Studies on the association between biomass fuel use and cognitive abilities in children are limited. OBJECTIVE To examine the association between biomass fuel use for cooking and cognitive abilities in Nepalese children at 4 years of age. METHODS In a cohort design we have information on biomass fuel use in the households of 533 children in infancy and cognitive abilities when they were 4 years old from a community-based sample. Cognitive abilities were measured by the Wechsler Preschool and Primary Scale of Intelligence, 4th edition (WPPSI-IV) and the NEPSY-II. We examined the associations between biomass fuel use and scores on the WPPSI-IV Full-Scale IQ (FSIQ) (primary outcome), and WPPSI index and NEPSY-II subtest scores in multiple linear regression models. The associations were also examined in predefined subgroups. RESULTS Ninety-nine (18.6%) of the families used biomass fuel for cooking. Children in these families had lower mean FSIQ than children in families with no biomass use (83.3 (95%CI 81.7, 85.0) vs. 85.3 (95%CI 84.5, 86.0)), with a mean difference of -2.2 (95%CI -3.9, -0.5) adjusting for demographics and socio-economic status. The association between biomass fuel use and cognitive abilities was strongest in subgroups of children from households with more than three rooms, with separate kitchen and bedroom, and with higher wealth-score. These interactions were significant for number of rooms in the home (p = 0.04), if the household had separate bedroom and kitchen (p = 0.05), and for the wealth-score (p = 0.03). CONCLUSION Biomass fuel use for cooking in Nepalese families was associated with lower overall cognitive abilities at 4 years. Uncertainties include exposure misclassification and unmeasured confounding. The associations between biomass fuel use and neurodevelopment in children needs further investigation with more precise measurements of the exposure.
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Affiliation(s)
- Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | - Ram K Chandyo
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Catherine Schwinger
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Suman Ranjitkar
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Manjeswori Ulak
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Merina Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Laxman Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway; Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
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12
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Yi C, Wang Q, Qu Y, Niu J, Oliver BG, Chen H. In-utero exposure to air pollution and early-life neural development and cognition. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 238:113589. [PMID: 35525116 DOI: 10.1016/j.ecoenv.2022.113589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/19/2022] [Accepted: 04/28/2022] [Indexed: 05/06/2023]
Abstract
Air pollution remains one of the major health threats around the world. Compared to adults, foetuses and infants are more vulnerable to the effects of environmental toxins. Maternal exposure to air pollution causes several adverse birth outcomes and may lead to life-long health consequences. Given that a healthy intrauterine environment is a critical factor for supporting normal foetal brain development, there is a need to understand how prenatal exposure to air pollution affects brain health and results in neurological dysfunction. This review summarised the current knowledge on the adverse effects of prenatal air pollution exposure on early life neurodevelopment and subsequent impairment of cognition and behaviour in childhood, as well as the potential of early-onset neurodegeneration. While inflammation, oxidative stress, and endoplasmic reticulum are closely involved in the physiological response, sex differences also occur. In general, males are more susceptible than females to the adverse effect of in-utero air pollution exposure. Considering the evidence provided in this review and the rising concerns of global air pollution, any efforts to reduce pollutant emission or exposure will be protective for the next generation.
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Affiliation(s)
- Chenju Yi
- Research Centre, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China.
| | - Qi Wang
- Research Centre, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China
| | - Yibo Qu
- Guangdong-Hongkong-Macau Institute of CNS Regeneration, Ministry of Education CNS Regeneration Collaborative Joint Laboratory, Jinan University, Guangzhou 510632, China
| | - Jianqin Niu
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing 400038, China
| | - Brian G Oliver
- School of Life Sciences, Faculty of Science, University of Technology Sydney, NSW 2007, Australia; Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, NSW 2037, Australia
| | - Hui Chen
- School of Life Sciences, Faculty of Science, University of Technology Sydney, NSW 2007, Australia
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13
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Yuchi W, Brauer M, Czekajlo A, Davies HW, Davis Z, Guhn M, Jarvis I, Jerrett M, Nesbitt L, Oberlander TF, Sbihi H, Su J, van den Bosch M. Neighborhood environmental exposures and incidence of attention deficit/hyperactivity disorder: A population-based cohort study. ENVIRONMENT INTERNATIONAL 2022; 161:107120. [PMID: 35144157 DOI: 10.1016/j.envint.2022.107120] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Emerging studies have associated low greenspace and high air pollution exposure with risk of child attention deficit/hyperactivity disorder (ADHD). Population-based studies are limited, however, and joint effects are rarely evaluated. We investigated associations of ADHD incidence with greenspace, air pollution, and noise in a population-based birth cohort. METHODS We assembled a cohort from administrative data of births from 2000 to 2001 (N ∼ 37,000) in Metro Vancouver, Canada. ADHD was identified by hospital records, physician visits, and prescriptions. Cox proportional hazards models were applied to assess associations between environmental exposures and ADHD incidence adjusting for available covariates. Greenspace was estimated using vegetation percentage derived from linear spectral unmixing of Landsat imagery. Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were estimated using land use regression models; noise was estimated using a deterministic model. Exposure period was from birth until the age of three. Joint effects of greenspace and PM2.5 were analysed in two-exposure models and by categorizing values into quintiles. RESULTS During seven-year follow-up, 1217 ADHD cases were diagnosed. Greenspace was associated with lower incidence of ADHD (hazard ratio, HR: 0.90 [0.81-0.99] per interquartile range increment), while PM2.5 was associated with increased incidence (HR: 1.11 [1.06-1.17] per interquartile range increment). NO2 (HR: 1.01 [0.96, 1.07]) and noise (HR: 1.00 [0.95, 1.05]) were not associated with ADHD. There was a 50% decrease in the HR for ADHD in locations with the lowest PM2.5 and highest greenspace exposure, compared to a 62% increase in HR in locations with the highest PM2.5 and lowest greenspace exposure. Effects of PM2.5 were attenuated by greenspace in two-exposure models. CONCLUSIONS We found evidence suggesting environmental inequalities where children living in greener neighborhoods with low air pollution had substantially lower risk of ADHD compared to those with higher air pollution and lower greenspace exposure.
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Affiliation(s)
- Weiran Yuchi
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Michael Brauer
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Agatha Czekajlo
- Department of Forest Resource Management, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Hugh W Davies
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Zoë Davis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Martin Guhn
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Ingrid Jarvis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Michael Jerrett
- Fielding School of Public Health, University of California at Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, the United States
| | - Lorien Nesbitt
- Department of Forest Resource Management, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Tim F Oberlander
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; Department of Pediatrics, The University of British Columbia, 4480 Oak St. Vancouver, Canada
| | - Hind Sbihi
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; BC Centre for Disease Control, Vancouver, Canada
| | - Jason Su
- School of Public Health, University of California at Berkeley, 2121 Berkeley Way West, Berkeley, CA, the United States
| | - Matilda van den Bosch
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada; ISGlobal, Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; Centro de Investigación Biomédica en Red Instituto de Salud Carlos III, Calle de Melchor Fernández Almagro, 3, 28029, Madrid, Spain.
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14
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Pregnant Women's Exposure to Household Air Pollution in Rural Bangladesh: A Feasibility Study for Poriborton: The CHANge Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010482. [PMID: 35010741 PMCID: PMC8744871 DOI: 10.3390/ijerph19010482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 02/04/2023]
Abstract
The use of liquefied petroleum gas (LPG) for cooking is a strategy to reduce household air pollution (HAP) exposure and improve health. We conducted this feasibility study to evaluate personal exposure measurement methods to representatively assess reductions in HAP exposure. We enrolled 30 pregnant women to wear a MicroPEM for 24 h to assess their HAP exposure when cooking with a traditional stove (baseline) and with an LPG stove (intervention). The women wore the MicroPEM an average of 77% and 69% of the time during the baseline and intervention phases, respectively. Mean gravimetric PM2.5 mass and black carbon concentrations were comparable during baseline and intervention. Temporal analysis of the MicroPEM nephelometer data identified high PM2.5 concentrations in the afternoon, late evening, and overnight during the intervention phase. Likely seasonal sources present during the intervention phase were emissions from brick kiln and rice parboiling facilities, and evening kerosene lamp and mosquito coil use. Mean background adjusted PM2.5 concentrations during cooking were lower during intervention at 71 μg/m3, versus 105 μg/m3 during baseline. Representative real-time personal PM2.5 concentration measurements supplemented with ambient PM2.5 measures and surveys will be a valuable tool to disentangle external sources of PM2.5, other indoor HAP sources, and fuel-sparing behaviors when assessing the HAP reduction due to intervention with LPG stoves.
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15
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Honaker A, Kyntchev A, Foster E, Clough K, Hawk G, Asiedu E, Berling K, DeBurger E, Feltner M, Ferguson V, Forrest PT, Jenkins K, Massie L, Mullaguru J, Niang MD, Perry C, Sene Y, Towell A, Curran CP. The behavioral effects of gestational and lactational benzo[a]pyrene exposure vary by sex and genotype in mice with differences at the Ahr and Cyp1a2 loci. Neurotoxicol Teratol 2022; 89:107056. [PMID: 34890772 PMCID: PMC8763354 DOI: 10.1016/j.ntt.2021.107056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/20/2021] [Accepted: 12/03/2021] [Indexed: 01/03/2023]
Abstract
Benzo[a]pyrene (BaP) is a polycyclic aromatic hydrocarbon (PAH) and known carcinogen in the Top 10 on the United States' list of priority pollutants. Humans are exposed through a variety of sources including tobacco smoke, grilled foods and fossil fuel combustion. Recent studies of children exposed to higher levels of PAHs during pregnancy and early life have identified numerous adverse effects on the brain and behavior that persist into school age and adolescence. Our studies were designed to look for genotype and sex differences in susceptibility to gestational and lactational exposure to BaP using a mouse model with allelic differences in the aryl hydrocarbon receptor and the xenobiotic metabolizing enzyme CYP1A2. Pregnant dams were exposed to 10 mg/kg/day of BaP in corn oil-soaked cereal or the corn oil vehicle alone from gestational day 10 until weaning at postnatal day 25. Neurobehavioral testing began at P60 using one male and one female per litter. We found main effects of sex, genotype and treatment as well as significant gene x treatment and sex x treatment interactions. BaP-treated female mice had shorter latencies to fall in the Rotarod test. BaP-treated high-affinity AhrbCyp1a2(-/-) mice had greater impairments in Morris water maze. Interestingly, poor-affinity AhrdCyp1a2(-/-) mice also had deficits in spatial learning and memory regardless of treatment. We believe our findings provide future directions in identifying human populations at highest risk of early life BaP exposure, because our model mimics known human variation in our genes of interest. Our studies also highlight the value of testing both males and females in all neurobehavioral studies.
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Affiliation(s)
- Amanda Honaker
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Angela Kyntchev
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Emma Foster
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Katelyn Clough
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Greg Hawk
- University of Kentucky Applied Statistics Laboratory, Department of Statistics, University of Kentucky, 725 Rose Street, Lexington, KY 40536, USA
| | - Emmanuella Asiedu
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Kevin Berling
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Emma DeBurger
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Mackenzie Feltner
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Victoria Ferguson
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Philip Tyler Forrest
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Kayla Jenkins
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Lisa Massie
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Jayasree Mullaguru
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Mame Diarra Niang
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Connor Perry
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Yvonne Sene
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Aria Towell
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA
| | - Christine Perdan Curran
- Department of Biological Sciences, Northern Kentucky University, 100 Nunn Drive, Highland Heights, KY 41099, USA.
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16
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Saenz JL. Solid cooking fuel use and cognitive decline among older Mexican adults. INDOOR AIR 2021; 31:1522-1532. [PMID: 33896051 PMCID: PMC8380681 DOI: 10.1111/ina.12844] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/29/2021] [Accepted: 04/09/2021] [Indexed: 05/02/2023]
Abstract
Studies of air pollution and cognition often rely on measures from outdoor environments. Many individuals in low- and middle-income countries are exposed to indoor air pollution from combustion of solid cooking fuels. Little is known about how solid cooking fuel use affects cognitive decline over time. This study uses data from the 2012, 2015, and 2018 Mexican Health and Aging Study (n = 14 245, age 50+) to assess how use of wood or coal for cooking fuel affects cognition of older adults relative to use of gas. It uses latent change score modeling to determine how using solid cooking fuel affected performance in Verbal Learning, Verbal Recall, Visual Scanning, and Verbal Fluency. Solid cooking fuel was used by 17% of the full sample but was more common in rural areas. Solid fuel users also had lower socioeconomic status. Compared to those using gas, solid fuel users had lower baseline scores and faster decline in Verbal Learning (β = -0.18, p < 0.05), Visual Scanning (β = -1.00, p < 0.001), and Verbal Fluency (β = -0.33, p < 0.001). Indoor air pollution from solid cooking fuels may represent a modifiable risk factor for cognitive decline. Policy should focus on facilitating access to clean cooking fuels.
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Affiliation(s)
- Joseph L. Saenz
- University of Southern California, Leonard Davis School of Gerontology, Los Angeles, CA
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17
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Abstract
Pregnancy and early childhood are periods with high plasticity in neurological development. Environmental perturbations during these sensitive windows can have lifelong developmental consequences. This review summarizes key findings relevant to the effects of air pollution on neurological development. Mounting evidence suggests that exposure to air pollution, both during pregnancy and childhood, is associated with childhood developmental outcomes ranging from changes in brain structures to subclinical deficits in developmental test scores, and, ultimately, developmental disorders such as attention-deficit/hyperactivity disorders or autism spectrum disorders. Although the biological mechanisms of effects remain to be elucidated, multiple pathways are probably involved and include oxidative stress, inflammation, and/or endocrine disruption. Given the alarming global increase in developmental disorders in recent years, and increased human exposures to pollution, it is critical to reduce personal and community-level exposures through tight collaboration of interdisciplinary and multi-level bodies including community partners, physicians, industry partners, policy makers, public health practitioners, and researchers. WHAT THIS PAPER ADDS: Exposure to air pollution is associated with a range of childhood developmental complications. Biological mechanisms may include oxidative stress, inflammation, and endocrine disruption.
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Affiliation(s)
- Sandie Ha
- Department of Public Health, School of Social Sciences, Humanities and Arts, Health Science Research Institute, University of California, Merced, CA, USA
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18
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Rani R, Arokiasamy P, Meitei WB, Sikarwar A. Association between indoor air pollution and cognitive function of older adults in India: a cross-sectional multilevel analysis. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01521-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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19
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Abstract
Pollutant agents are exponentially increasing in modern society since industrialization processes and technology are being developed worldwide. Impact of pollution on public health is well known but little has been described on the association between environmental pollutants and mental health. A literature search on PubMed and EMBASE has been conducted and 134 articles published on the issue of pollution and mental health have been included, cited, reviewed, and summarized. Emerging evidences have been collected on association between major environmental pollutants (air pollutants, heavy metals, ionizing radiation [IR], organophosphate pesticides, light pollution, noise pollution, environmental catastrophes) and various mental health disorders including anxiety, mood, and psychotic syndromes. Underlying pathogenesis includes direct and indirect effects of these agents on brain, respectively, due to their biological effect on human Central Nervous System or related to some levels of stress generated by the exposure to the pollutant agents over the time. Most of emerging evidences are still nonconclusive. Further studies should clarify how industrial production, the exploitation of certain resources, the proximity to waste and energy residues, noise, and the change in lifestyles are connected with psychological distress and mental health problems for the affected populations.
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20
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Dórea JG. Exposure to environmental neurotoxic substances and neurodevelopment in children from Latin America and the Caribbean. ENVIRONMENTAL RESEARCH 2021; 192:110199. [PMID: 32941839 DOI: 10.1016/j.envres.2020.110199] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 05/24/2023]
Abstract
Environmental (and occupational) exposure to neurotoxic substances is a worldwide problem that can affect children's neurodevelopment (ND). In Latin American and Caribbean (LAC) countries there are over 300 million children living under the threat of neurodevelopmental delays due to toxic environmental exposure. Large industrial centers, intense mining and agricultural activities, along with changing complex ecosystems constitute a mosaic that drives contamination of air, water and the food chain. Neurotoxic contaminants such as pesticides (organochlorines, organophosphates, carbamates, pyrethroids, neonicotinoids, and manganese fungicides), chemicals of industrial use (phthalates), and metals (Hg, Pb, Al, As, F, Cd, Mo, Mn) are at the center of environmental exposure studies. Exposure to neurotoxic substances singly or in combination with other compounds or socioeconomic stressors (maternal education, socio-economic and nutritional status) intertwined with occupational and para-occupational exposure can affect ND (motor, cognition, behavior) of children. Significant negative effects of pesticides and neurotoxic elements on ND were found in all studied countries, affecting especially the less-privileged children from laboring families. Studies showed that exposures to the neurotoxicants in human milk are secondary to their more lasting effects during prenatal exposure. This review integrates exposure (prenatal and breastfeeding), metabolism, and ND effects of neurotoxicants. It highlights the overwhelming evidence showing that current levels of exposures are hazardous and detrimental to children's ND in LAC countries. The evidence indicates that a reduction in neurotoxicant exposure is essential to protect children's ND. Therefore, it is urgent to adopt policies and actions that prevent and remediate region-specific children's ND issues.
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Affiliation(s)
- José G Dórea
- Universidade de Brasília, Brasília, 70919-970, DF, Brazil.
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21
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Bangma JT, Hartwell H, Santos HP, O'Shea TM, Fry RC. Placental programming, perinatal inflammation, and neurodevelopment impairment among those born extremely preterm. Pediatr Res 2021; 89:326-335. [PMID: 33184498 PMCID: PMC7658618 DOI: 10.1038/s41390-020-01236-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/02/2020] [Accepted: 10/08/2020] [Indexed: 01/30/2023]
Abstract
Individuals born extremely preterm are at significant risk for impaired neurodevelopment. After discharge from the neonatal intensive care, associations between the child's well-being and factors in the home and social environment become increasingly apparent. Mothers' prenatal health and socioeconomic status are associated with neurodevelopmental outcomes, and emotional and behavioral problems. Research on early life risk factors and on mechanisms underlying inter-individual differences in neurodevelopment later in life can inform the design of personalized approaches to prevention. Here, we review early life predictors of inter-individual differences in later life neurodevelopment among those born extremely preterm. Among biological mechanisms that mediate relationships between early life predictors and later neurodevelopmental outcomes, we highlight evidence for disrupted placental processes and regulated at least in part via epigenetic mechanisms, as well as perinatal inflammation. In relation to these mechanisms, we focus on four prenatal antecedents of impaired neurodevelopment, namely, (1) fetal growth restriction, (2) maternal obesity, (3) placental microorganisms, and (4) socioeconomic adversity. In the future, this knowledge may inform efforts to detect and prevent adverse outcomes in infants born extremely preterm. IMPACT: This review highlights early life risk factors and mechanisms underlying inter-individual differences in neurodevelopment later in life. The review emphasizes research on early life risk factors (fetal growth restriction, maternal obesity, placental microorganisms, and socioeconomic adversity) and on mechanisms (disrupted placental processes and perinatal inflammation) underlying inter-individual differences in neurodevelopment later in life. The findings highlighted here may inform efforts to detect and prevent adverse outcomes in infants born extremely preterm.
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Affiliation(s)
- Jacqueline T Bangma
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hadley Hartwell
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hudson P Santos
- Biobehavioral Laboratory, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - T Michael O'Shea
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rebecca C Fry
- Biobehavioral Laboratory, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Curriculum in Toxicology and Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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22
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Finch CE, Morgan TE. Developmental Exposure to Air Pollution, Cigarettes, and Lead: Implications for Brain Aging. ACTA ACUST UNITED AC 2020. [DOI: 10.1146/annurev-devpsych-042320-044338] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Brain development is impaired by maternal exposure to airborne toxins from ambient air pollution, cigarette smoke, and lead. Shared postnatal consequences include gray matter deficits and abnormal behaviors as well as elevated blood pressure. These unexpectedly broad convergences have implications for later life brain health because these same airborne toxins accelerate brain aging. Gene-environment interactions are shown for ApoE alleles that influence the risk of Alzheimer disease. The multigenerational trace of these toxins extends before fertilization because egg cells are formed in the grandmaternal uterus. The lineage and sex-specific effects of grandmaternal exposure to lead and cigarettes indicate epigenetic processes of relevance to future generations from our current and recent exposure to airborne toxins.
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Affiliation(s)
- Caleb E. Finch
- Leonard Davis School of Gerontology and Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, California 90089-0191, USA;,
| | - Todd E. Morgan
- Leonard Davis School of Gerontology and Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, California 90089-0191, USA;,
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The Relationship Between Air Pollution and Cognitive Functions in Children and Adolescents: A Systematic Review. Cogn Behav Neurol 2020; 33:157-178. [PMID: 32889949 DOI: 10.1097/wnn.0000000000000235] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Air pollution has a negative impact on one's health and on the central nervous system. We decided to assess studies that evaluated the relationship between air pollution and cognitive functions in children and adolescents by reviewing studies that had been published between January 2009 and May 2019. We searched three major databases for original works (26 studies) and for studies using brain imaging methods based on MRI (six studies). Adverse effects of air pollutants on selected cognitive or psychomotor functions were found in all of the studies. Exposure to nitrogen dioxide, for example, was linked to impaired working memory, general cognitive functions, and psychomotor functions; particulate matter 2.5 was linked to difficulties in working memory, short-term memory, attention, processing speed, and fine motor function; black carbon was linked to poor verbal intelligence, nonverbal intelligence, and working memory; airborne copper was linked to impaired attentiveness and fine motor skills; isophorone was linked to lower mathematical skills; and polycyclic aromatic hydrocarbons in fetal life were linked to lower intelligence scores. The studies using MRI showed that high concentrations of air pollutants were linked to changes in the brain's white matter or lower functional integration and segregation in children's brain networks. In view of the global increase in air pollution, there is a need for further research to elucidate the relationship between air pollution and cognitive and motor development in children. According to some studies, neuroinflammation, the e4 allele of the apolipoprotein E gene, and gutathione-S-transferase gene polymorphism processes may play a role.
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Clasen T, Checkley W, Peel JL, Balakrishnan K, McCracken JP, Rosa G, Thompson LM, Barr DB, Clark ML, Johnson MA, Waller LA, Jaacks LM, Steenland K, Miranda JJ, Chang HH, Kim DY, McCollum ED, Davila-Roman VG, Papageorghiou A, Rosenthal JP. Design and Rationale of the HAPIN Study: A Multicountry Randomized Controlled Trial to Assess the Effect of Liquefied Petroleum Gas Stove and Continuous Fuel Distribution. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:47008. [PMID: 32347766 PMCID: PMC7228119 DOI: 10.1289/ehp6407] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Globally, nearly 3 billion people rely on solid fuels for cooking and heating, the vast majority residing in low- and middle-income countries (LMICs). The resulting household air pollution (HAP) is a leading environmental risk factor, accounting for an estimated 1.6 million premature deaths annually. Previous interventions of cleaner stoves have often failed to reduce exposure to levels that produce meaningful health improvements. There have been no multicountry field trials with liquefied petroleum gas (LPG) stoves, likely the cleanest scalable intervention. OBJECTIVE This paper describes the design and methods of an ongoing randomized controlled trial (RCT) of LPG stove and fuel distribution in 3,200 households in 4 LMICs (India, Guatemala, Peru, and Rwanda). METHODS We are enrolling 800 pregnant women at each of the 4 international research centers from households using biomass fuels. We are randomly assigning households to receive LPG stoves, an 18-month supply of free LPG, and behavioral reinforcements to the control arm. The mother is being followed along with her child until the child is 1 year old. Older adult women (40 to < 80 years of age) living in the same households are also enrolled and followed during the same period. Primary health outcomes are low birth weight, severe pneumonia incidence, stunting in the child, and high blood pressure (BP) in the older adult woman. Secondary health outcomes are also being assessed. We are assessing stove and fuel use, conducting repeated personal and kitchen exposure assessments of fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), carbon monoxide (CO), and black carbon (BC), and collecting dried blood spots (DBS) and urinary samples for biomarker analysis. Enrollment and data collection began in May 2018 and will continue through August 2021. The trial is registered with ClinicalTrials.gov (NCT02944682). CONCLUSIONS This study will provide evidence to inform national and global policies on scaling up LPG stove use among vulnerable populations. https://doi.org/10.1289/EHP6407.
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Affiliation(s)
- Thomas Clasen
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer L. Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, Tamil Nadu, India
| | - John P. McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Ghislaine Rosa
- Department of Disease Control, Faculty of Infections and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Lisa M. Thompson
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Dana Boyd Barr
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Maggie L. Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | | | - Lance A. Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lindsay M. Jaacks
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Kyle Steenland
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Dong-Yun Kim
- Office of Biostatistics Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Eric D. McCollum
- Eudowood Division of Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Victor G. Davila-Roman
- Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Aris Papageorghiou
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, UK
| | - Joshua P. Rosenthal
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - HAPIN Investigators
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, Tamil Nadu, India
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
- Department of Disease Control, Faculty of Infections and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Berkeley Air Monitoring Group, Berkeley, California, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Office of Biostatistics Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Eudowood Division of Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri, USA
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, UK
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
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Johnson MA, Steenland K, Piedrahita R, Clark ML, Pillarisetti A, Balakrishnan K, Peel JL, Naeher LP, Liao J, Wilson D, Sarnat J, Underhill LJ, Burrowes V, McCracken JP, Rosa G, Rosenthal J, Sambandam S, de Leon O, Kirby MA, Kearns K, Checkley W, Clasen T. Air Pollutant Exposure and Stove Use Assessment Methods for the Household Air Pollution Intervention Network (HAPIN) Trial. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:47009. [PMID: 32347764 PMCID: PMC7228125 DOI: 10.1289/ehp6422] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND High quality personal exposure data is fundamental to understanding the health implications of household energy interventions, interpreting analyses across assigned study arms, and characterizing exposure-response relationships for household air pollution. This paper describes the exposure data collection for the Household Air Pollution Intervention Network (HAPIN), a multicountry randomized controlled trial of liquefied petroleum gas stoves and fuel among 3,200 households in India, Rwanda, Guatemala, and Peru. OBJECTIVES The primary objectives of the exposure assessment are to estimate the exposure contrast achieved following a clean fuel intervention and to provide data for analyses of exposure-response relationships across a range of personal exposures. METHODS Exposure measurements are being conducted over the 3-y time frame of the field study. We are measuring fine particulate matter [PM < 2.5 μ m in aerodynamic diameter (PM 2.5 )] with the Enhanced Children's MicroPEM™ (RTI International), carbon monoxide (CO) with the USB-EL-CO (Lascar Electronics), and black carbon with the OT21 transmissometer (Magee Scientific) in pregnant women, adult women, and children < 1 year of age, primarily via multiple 24-h personal assessments (three, six, and three measurements, respectively) over the course of the 18-month follow-up period using lightweight monitors. For children we are using an indirect measurement approach, combining data from area monitors and locator devices worn by the child. For a subsample (up to 10%) of the study population, we are doubling the frequency of measurements in order to estimate the accuracy of subject-specific typical exposure estimates. In addition, we are conducting ambient air monitoring to help characterize potential contributions of PM 2.5 exposure from background concentration. Stove use monitors (Geocene) are being used to assess compliance with the intervention, given that stove stacking (use of traditional stoves in addition to the intervention gas stove) may occur. CONCLUSIONS The tools and approaches being used for HAPIN to estimate personal exposures build on previous efforts and take advantage of new technologies. In addition to providing key personal exposure data for this study, we hope the application and learnings from our exposure assessment will help inform future efforts to characterize exposure to household air pollution and for other contexts. https://doi.org/10.1289/EHP6422.
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Affiliation(s)
| | - Kyle Steenland
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Maggie L Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Ajay Pillarisetti
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Luke P Naeher
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Jiawen Liao
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Jeremy Sarnat
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lindsay J Underhill
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Vanessa Burrowes
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - John P McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Ghislaine Rosa
- Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Joshua Rosenthal
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Sankar Sambandam
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Oscar de Leon
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Miles A Kirby
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Katherine Kearns
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Thomas Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Brabhukumr A, Malhi P, Ravindra K, Lakshmi PVM. Exposure to household air pollution during first 3 years of life and IQ level among 6-8-year-old children in India - A cross-sectional study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 709:135110. [PMID: 31874342 DOI: 10.1016/j.scitotenv.2019.135110] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/02/2019] [Accepted: 10/20/2019] [Indexed: 06/10/2023]
Abstract
Many illnesses have been attributed to the exposure of solid biomass smoke but the effect on intelligence has largely been unexplored. The study aims to examine the effect of exposure to solid biomass smoke during the first 3 years of life on intelligence among 6-8-year-old children. Children aged 6-8 years were enrolled from a primary school and their houses were visited to collect data on socio-economic status and household exposure assessment. Households using LPG as cooking fuel were considered as the unexposed group. All the children were tested for their Intelligence Quotient (IQ) using Malin's Intelligence Scale for Indian Children (MISIC). The mean IQ was calculated as the average of Verbal and Performance score. Potential confounders were adjusted using multivariate general linear model. About 45% of children had average or above-average IQ while the rest had below-average IQ. The mean scores for the arithmetic component of IQ were found to be significantly lower among solid biomass fuel users as compared to LPG users after adjusting for confounders. The mean IQ of LPG users were 5.58 points higher (95% CI: 0.46-10.1) for the arithmetic component as compared to solid biomass users. Children living in the houses using solid biomass fuel for cooking have lower IQ as compared to the children living in the houses using LPG for cooking for arithmetic component even after adjusting for potential confounders.
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Affiliation(s)
- Ajith Brabhukumr
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | | | - Khaiwal Ravindra
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India.
| | - P V M Lakshmi
- Department of Paediatrics, PGIMER, Chandigarh, India.
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27
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Weaver AM, Gurley ES, Crabtree-Ide C, Salje H, Yoo EH, Mu L, Akter N, Ram PK. Air pollution dispersion from biomass stoves to neighboring homes in Mirpur, Dhaka, Bangladesh. BMC Public Health 2019; 19:425. [PMID: 31014315 PMCID: PMC6480710 DOI: 10.1186/s12889-019-6751-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 04/05/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Indoor air pollution, including fine particulate matter (PM2.5) and carbon monoxide (CO), is a major risk factor for pneumonia and other respiratory diseases. Biomass-burning cookstoves are major contributors to PM2.5 and CO concentrations. However, high concentrations of PM2.5 (> 1000 μg/m3) have been observed in homes in Dhaka, Bangladesh that do not burn biomass. We described dispersion of PM2.5 and CO from biomass burning into nearby homes in a low-income urban area of Dhaka, Bangladesh. METHODS We recruited 10 clusters of homes, each with one biomass-burning (index) home, and 3-4 neighboring homes that used cleaner fuels with no other major sources of PM2.5 or CO. We administered a questionnaire and recorded physical features of all homes. Over 24 h, we recorded PM2.5 and CO concentrations inside each home, near each stove, and outside one neighbor home per cluster. During 8 of these 24 h, we conducted observations for pollutant-generating activities such as cooking. For each monitor, we calculated geometric mean PM2.5 concentrations at 5-6 am (baseline), during biomass burning times, during non-cooking times, and over 24 h. We used linear regressions to describe associations between monitor location and PM2.5 and CO concentrations. RESULTS We recruited a total of 44 homes across the 10 clusters. Geometric mean PM2.5 and CO concentrations for all monitors were lowest at baseline and highest during biomass burning. During biomass burning, linear regression showed a decreasing trend of geometric mean PM2.5 and CO concentrations from the biomass stove (326.3 μg/m3, 12.3 ppm), to index home (322.7 μg/m3, 11.2 ppm), neighbor homes sharing a wall with the index home (278.4 μg/m3, 3.6 ppm), outdoors (154.2 μg/m3, 0.7 ppm), then neighbor homes that do not share a wall with the index home (83.1 μg/m3,0.2 ppm) (p = 0.03 for PM2.5, p = 0.006 for CO). CONCLUSION Biomass burning in one home can be a source of indoor air pollution for several homes. The impact of biomass burning on PM2.5 or CO is greatest in homes that share a wall with the biomass-burning home. Eliminating biomass burning in one home may improve air quality for several households in a community.
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Affiliation(s)
- Anne M. Weaver
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY USA
| | - Emily S. Gurley
- Programme for Emerging Infections, icddr,b, Dhaka, Bangladesh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Christina Crabtree-Ide
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY USA
| | - Henrik Salje
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
| | - Eun-Hye Yoo
- Department of Geography, University at Buffalo, Buffalo, NY USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY USA
| | - Nasrin Akter
- Programme for Emerging Infections, icddr,b, Dhaka, Bangladesh
| | - Pavani K. Ram
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY USA
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Abstract
Toxic chemicals, either from natural sources or man-made, are ubiquitous in our environment. Many of the synthetic chemicals make life more comfortable and therefore production continues to grow. Simultaneously with the increase in production, an increase in neurodevelopmental disorders has been observed. Some chemicals are not biodegradable or have a very long half-life time and, despite the fact that production of a number of those chemicals has been severely reduced, they are still ubiquitous in the environment. Fetal exposure to toxic chemicals is dependent on maternal exposure to those chemicals and the developing stage of the fetus. Human evidence from epidemiologic studies is described with regard to the effect of prenatal exposure to various groups of neurotoxicants (alcohol, particulate fine matter, metals, and endocrine disrupting chemicals) on neurobehavior development. Data indicate that prenatal exposure to alcohol, polycyclic aromatic hydrocarbons, lead, methylmercury (MeHg), organophosphate pesticides (OPPs), and polychlorinated biphenyl ethers (PBDEs) impair cognitive development, whereas exposure to alcohol, MeHg, organochlorine pesticides and OPPs, polychlorinated biphenyls, PBDEs, and bisphenol A increases the risk of developing either attention deficit/hyperactivity and/or autism spectrum disorders. Psychomotor development appears to be less affected. However, data are not conclusive, which may depend on the assessment of exposure and the exposure level, among other factors.
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Affiliation(s)
- Margot van de Bor
- Department of Environment and Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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Fordyce TA, Leonhard MJ, Chang ET. A critical review of developmental exposure to particulate matter, autism spectrum disorder, and attention deficit hyperactivity disorder. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2018; 53:174-204. [PMID: 29157090 DOI: 10.1080/10934529.2017.1383121] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Autism spectrum disorder (ASD) and attention deficit (hyperactivity) disorder (ADD/ADHD) are key focuses of current health research due to their increasing prevalence. The objective of this systematic literature search and critical review was to evaluate whether the human epidemiologic data indicate a pattern of association between ASD or ADD/ADHD and developmental exposure to particulate matter (PM), with a focus on exposures encountered before the age of three. A MEDLINE and EMBASE search was conducted; following preliminary and full-text screening, 14 relevant articles were identified for review. Three of the 14 studies were prospective cohort studies evaluating exposure to PM10; 11 studies had a case-control design. There was no consistent association between developmental PM exposure and ASD across the three of the cohort studies. Seven of the case-control studies examined the relationship between PM2.5 and/or PM10 and ASD; four examined the relationship between developmental diesel PM exposure and ASD. Overall, there was low external consistency in results among studies of PM2.5/PM10 and ASD, with some reporting high internal consistency without significant associations, others showing associations with high internal consistency for specific exposure windows only (e.g., third trimester), and still others showing high consistency for moderate to strong associations between PM and ASD. The majority of studies reporting significant results had low effect sizes in conjunction with small sample sizes. The four studies of diesel PM and ASD also had low external consistency of results. Only one study evaluated associations with ADD/ADHD, and it found no significant associations with PM10. The inconsistent findings across studies of developmental exposure to PM and ASD may be attributed to differences in the study populations, exposure assessments, outcome assessments, or chance. Further research is needed to understand the underlying biological mechanisms that lead to ASD and ADD/ADHD and how PM might be involved in those mechanisms, if at all. High-quality epidemiologic studies are also needed to conclusively determine whether developmental PM exposure is a causal factor for ASD or ADD/ADHD, with focus on a well-developed exposure assessment.
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Affiliation(s)
- Tiffani A Fordyce
- a Exponent, Inc., Center for Health Sciences , Menlo Park , California , USA
| | - Megan J Leonhard
- b Exponent, Inc., Center for Health Sciences , Bellevue , Washington , USA
| | - Ellen T Chang
- a Exponent, Inc., Center for Health Sciences , Menlo Park , California , USA
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Implications of Combined Exposure to Household Air Pollution and HIV on Neurocognition in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010163. [PMID: 29361707 PMCID: PMC5800262 DOI: 10.3390/ijerph15010163] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 01/16/2023]
Abstract
Air pollution exposure and HIV infection can each cause neurocognitive insult in children. The purpose of this study was to test whether children with combined high air pollution exposure and perinatal HIV infection have even greater risk of neurocognitive impairment. This was a cross-sectional study of HIV-uninfected unexposed (HUU) and HIV-infected children and their caregivers in Nairobi, Kenya. We used a detailed neuropsychological battery to evaluate neurocognitive functioning in several domains. We measured caregiver 24-h personal CO exposure as a proxy for child CO exposure and child urinary 1-hydroxypyrene (1-OHP), a biomarker for exposure to polycyclic aromatic hydrocarbons (PAHs). Median 24-h caregiver CO exposure was 6.1 and 3.7 ppm for 45 HIV-infected (mean age 6.6 years) and 49 HUU (mean age 6.7 years), respectively; 48.5% of HIV-infected and 38.6% of HUU had caregiver 24-h CO levels exceeding the WHO recommended level. Median 1-OHP exposure was 0.6 and 0.7 µmol/mol creatinine among HIV-infected and HUU children, respectively. HIV-infected children with high urinary 1-OHP (exceeding 0.68 µmol/mol creatinine) had significantly lower global cognition (p = 0.04), delayed memory (p = 0.01), and attention scores (p = 0.003). Among HUU children, urinary 1-OHP and caregiver 24-h caregiver CO were not significantly associated with neurocognitive function. Our findings suggest that combined chronic exposure to air pollutants and perinatal HIV infection may be associated with poorer neurocognitive outcomes. High prevalence of air pollution exposure highlights the need to reduce these exposures.
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Saenz JL, Wong R, Ailshire JA. Indoor air pollution and cognitive function among older Mexican adults. J Epidemiol Community Health 2017; 72:21-26. [PMID: 29101214 DOI: 10.1136/jech-2017-209704] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/13/2017] [Accepted: 10/20/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND A growing body of research suggests exposure to high levels of outdoor air pollution may negatively affect cognitive functioning in older adults, but less is known about the link between indoor sources of air pollution and cognitive functioning. We examine the association between exposure to indoor air pollution and cognitive function among older adults in Mexico, a developing country where combustion of biomass for domestic energy remains common. METHOD Data come from the 2012 Wave of the Mexican Health and Aging Study. The analytic sample consists of 13 023 Mexican adults over age 50. Indoor air pollution is assessed by the reported use of wood or coal as the household's primary cooking fuel. Cognitive function is measured with assessments of verbal learning, verbal recall, attention, orientation and verbal fluency. Ordinary least squares regression is used to examine cross-sectional differences in cognitive function according to indoor air pollution exposure while accounting for demographic, household, health and economic characteristics. RESULTS Approximately 16% of the sample reported using wood or coal as their primary cooking fuel, but this was far more common among those residing in the most rural areas (53%). Exposure to indoor air pollution was associated with poorer cognitive performance across all assessments, with the exception of verbal recall, even in fully adjusted models. CONCLUSIONS Indoor air pollution may be an important factor for the cognitive health of older Mexican adults. Public health efforts should continue to develop interventions to reduce exposure to indoor air pollution in rural Mexico.
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Affiliation(s)
- Joseph L Saenz
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Rebeca Wong
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jennifer A Ailshire
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
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An Assessment of Spatial Pattern Characterization of Air Pollution: A Case Study of CO and PM2.5 in Tehran, Iran. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2017. [DOI: 10.3390/ijgi6090270] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Statistically clustering air pollution can provide evidence of underlying spatial processes responsible for intensifying the concentration of contaminants. It may also lead to the identification of hotspots. The patterns can then be targeted to manage the concentration level of pollutants. In this regard, employing spatial autocorrelation indices as important tools is inevitable. In this study, general and local indices of Moran’s I and Getis-Ord statistics were assessed in their representation of the structural characteristics of carbon monoxide (CO) and fine particulate matter (PM2.5) polluted areas in Tehran, Iran, which is one of the most polluted cities in the world. For this purpose, a grid (200 m × 200 m) was applied across the city, and the inverse distance weighted (IDW) interpolation method was used to allocate a value to each pixel. To compare the methods of detecting clusters meaningfully and quantitatively, the pollution cleanliness index (PCI) was established. The results ascertained a high clustering level of the pollutants in the study area (with 99% confidence level). PM2.5 clusters separated the city into northern and southern parts, as most of the cold spots were situated in the north half and the hotspots were in the south. However, the CO hotspots also covered an area from the northeast to southwest of the city and the cold spots were spread over the rest of the city. The Getis-Ord’s PCI suggested a more polluted air quality than the Moran’s I PCI. The study provides a feasible methodology for urban planners and decision makers to effectively investigate and govern contaminated sites with the aim of reducing the harmful effects of air pollution on public health and the environment.
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Vaivada T, Gaffey MF, Bhutta ZA. Promoting Early Child Development With Interventions in Health and Nutrition: A Systematic Review. Pediatrics 2017; 140:peds.2016-4308. [PMID: 28771408 DOI: 10.1542/peds.2016-4308] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2017] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Although effective health and nutrition interventions for reducing child mortality and morbidity exist, direct evidence of effects on cognitive, motor, and psychosocial development is lacking. OBJECTIVE To review existing evidence for health and nutrition interventions affecting direct measures of (and pathways to) early child development. DATA SOURCES Reviews and recent overviews of interventions across the continuum of care and component studies. STUDY SELECTION We selected systematic reviews detailing the effectiveness of health or nutrition interventions that have plausible links to child development and/or contain direct measures of cognitive, motor, and psychosocial development. DATA EXTRACTION A team of reviewers independently extracted data and assessed their quality. RESULTS Sixty systematic reviews contained the outcomes of interest. Various interventions reduced morbidity and improved child growth, but few had direct measures of child development. Of particular benefit were food and micronutrient supplementation for mothers to reduce the risk of small for gestational age and iodine deficiency, strategies to reduce iron deficiency anemia in infancy, and early neonatal care (appropriate resuscitation, delayed cord clamping, and Kangaroo Mother Care). Neuroprotective interventions for imminent preterm birth showed the largest effect sizes (antenatal corticosteroids for developmental delay: risk ratio 0.49, 95% confidence interval 0.24 to 1.00; magnesium sulfate for gross motor dysfunction: risk ratio 0.61, 95% confidence interval 0.44 to 0.85). LIMITATIONS Given the focus on high-quality studies captured in leading systematic reviews, only effects reported within studies included in systematic reviews were captured. CONCLUSIONS These findings should guide the prioritization and scale-up of interventions within critical periods of early infancy and childhood, and encourage research into their implementation at scale.
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Affiliation(s)
- Tyler Vaivada
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada; and
| | - Michelle F Gaffey
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada; and
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada; and .,Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
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Carter E, Norris C, Dionisio KL, Balakrishnan K, Checkley W, Clark ML, Ghosh S, Jack DW, Kinney PL, Marshall JD, Naeher LP, Peel JL, Sambandam S, Schauer JJ, Smith KR, Wylie BJ, Baumgartner J. Assessing Exposure to Household Air Pollution: A Systematic Review and Pooled Analysis of Carbon Monoxide as a Surrogate Measure of Particulate Matter. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:076002. [PMID: 28886596 PMCID: PMC5744652 DOI: 10.1289/ehp767] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 12/19/2016] [Accepted: 12/20/2016] [Indexed: 05/08/2023]
Abstract
BACKGROUND Household air pollution from solid fuel burning is a leading contributor to disease burden globally. Fine particulate matter (PM2.5) is thought to be responsible for many of these health impacts. A co-pollutant, carbon monoxide (CO) has been widely used as a surrogate measure of PM2.5 in studies of household air pollution. OBJECTIVE The goal was to evaluate the validity of exposure to CO as a surrogate of exposure to PM2.5 in studies of household air pollution and the consistency of the PM2.5-CO relationship across different study settings and conditions. METHODS We conducted a systematic review of studies with exposure and/or cooking area PM2.5 and CO measurements and assembled 2,048 PM2.5 and CO measurements from a subset of studies (18 cooking area studies and 9 personal exposure studies) retained in the systematic review. We conducted pooled multivariate analyses of PM2.5-CO associations, evaluating fuels, urbanicity, season, study, and CO methods as covariates and effect modifiers. RESULTS We retained 61 of 70 studies for review, representing 27 countries. Reported PM2.5-CO correlations (r) were lower for personal exposure (range: 0.22-0.97; median=0.57) than for cooking areas (range: 0.10-0.96; median=0.71). In the pooled analyses of personal exposure and cooking area concentrations, the variation in ln(CO) explained 13% and 48% of the variation in ln(PM2.5), respectively. CONCLUSIONS Our results suggest that exposure to CO is not a consistently valid surrogate measure of exposure to PM2.5. Studies measuring CO exposure as a surrogate measure of PM exposure should conduct local validation studies for different stove/fuel types and seasons. https://doi.org/10.1289/EHP767.
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Affiliation(s)
- Ellison Carter
- Institute on the Environment, University of Minnesota , St. Paul, Minnesota, USA
| | - Christina Norris
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University , Montreal, Quebec, Canada
| | - Kathie L Dionisio
- National Exposure Research Laboratory, U.S. Environmental Protection Agency , Research Triangle Park, North Carolina, USA
| | - Kalpana Balakrishnan
- Department Environmental Health Engineering, Sri Ramachandra University , Porur, Chennai, India
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University , Baltimore, Maryland, USA
- Program in Global Disease Epidemiology and Control, Department of International Heath, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland, USA
| | - Maggie L Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University , Fort Collins, Colorado, USA
| | - Santu Ghosh
- Department Environmental Health Engineering, Sri Ramachandra University , Porur, Chennai, India
| | - Darby W Jack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University , New York, New York, USA
| | - Patrick L Kinney
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University , New York, New York, USA
| | - Julian D Marshall
- Department of Civil and Environmental Engineering, University of Washington , Seattle, Washington, USA
| | - Luke P Naeher
- Department of Environmental Health Science, College of Public Health, The University of Georgia , Athens, Georgia, USA
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University , Fort Collins, Colorado, USA
| | - Sankar Sambandam
- Department Environmental Health Engineering, Sri Ramachandra University , Porur, Chennai, India
| | - James J Schauer
- Environmental Chemistry & Technology Program, University of Wisconsin-Madison , Madison, Wisconsin, USA
- Department of Civil & Environmental Engineering, University of Wisconsin-Madison , Madison, Wisconsin, USA
| | - Kirk R Smith
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley , Berkeley, California, USA
| | - Blair J Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts, USA
| | - Jill Baumgartner
- Institute on the Environment, University of Minnesota , St. Paul, Minnesota, USA
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University , Montreal, Quebec, Canada
- Institute for Health and Social Policy, McGill University , Montreal Quebec, Canada
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Das I, Jagger P, Yeatts K. Biomass Cooking Fuels and Health Outcomes for Women in Malawi. ECOHEALTH 2017; 14:7-19. [PMID: 27800583 PMCID: PMC5357447 DOI: 10.1007/s10393-016-1190-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 09/05/2016] [Accepted: 09/26/2016] [Indexed: 05/05/2023]
Abstract
In sub-Saharan Africa, biomass fuels account for approximately 90% of household energy consumption. Limited evidence exists on the association between different biomass fuels and health outcomes. We report results from a cross-sectional sample of 655 households in Malawi. We calculated odds ratios between hypothesized determinants of household air pollution (HAP) exposure (fuel, stove type, and cooking location) and five categories of health outcomes (cardiopulmonary, respiratory, neurologic, eye health, and burns). Reliance on high- or low-quality firewood or crop residue (vs. charcoal) was associated with significantly higher odds of shortness of breath, difficulty breathing, chest pains, night phlegm, forgetfulness, dizziness, and dry irritated eyes. Use of high-quality firewood was associated with significantly lower odds of persistent phlegm. Cooks in rural areas (vs. urban areas) had significantly higher odds of experiencing shortness of breath, persistent cough, and phlegm, but significantly lower odds of phlegm, forgetfulness, and burns. With deforestation and population pressures increasing reliance on low-quality biomass fuels, prevalence of HAP-related cardiopulmonary and neurologic symptoms will likely increase among cooks. Short- to medium-term strategies are needed to secure access to high-quality biomass fuels given limited potential for scalable transitions to modern energy.
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Affiliation(s)
- Ipsita Das
- Department of Public Policy, University of North Carolina at Chapel Hill (UNC-CH), Campus Box #3435, Abernethy Hall, Chapel Hill, NC, 27599-3435, USA
| | - Pamela Jagger
- Department of Public Policy, University of North Carolina at Chapel Hill (UNC-CH), Campus Box #3435, Abernethy Hall, Chapel Hill, NC, 27599-3435, USA.
- Curriculum for the Environment and Ecology, UNC-CH, Campus Box #3435, Abernethy Hall, Chapel Hill, NC, USA.
- Carolina Population Center, UNC-CH, Chapel Hill, NC, USA.
| | - Karin Yeatts
- Department of Epidemiology, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA
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Bartington SE, Bakolis I, Devakumar D, Kurmi OP, Gulliver J, Chaube G, Manandhar DS, Saville NM, Costello A, Osrin D, Hansell AL, Ayres JG. Patterns of domestic exposure to carbon monoxide and particulate matter in households using biomass fuel in Janakpur, Nepal. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 220:38-45. [PMID: 27707597 PMCID: PMC5157800 DOI: 10.1016/j.envpol.2016.08.074] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 08/08/2016] [Accepted: 08/27/2016] [Indexed: 05/21/2023]
Abstract
Household Air Pollution (HAP) from biomass cooking fuels is a major cause of morbidity and mortality in low-income settings worldwide. In Nepal the use of open stoves with solid biomass fuels is the primary method of domestic cooking. To assess patterns of domestic air pollution we performed continuous measurement of carbon monoxide (CO) and particulate Matter (PM2.5) in 12 biomass fuel households in Janakpur, Nepal. We measured kitchen PM2.5 and CO concentrations at one-minute intervals for an approximately 48-h period using the TSI DustTrak II 8530/SidePak AM510 (TSI Inc, St. Paul MN, USA) or EL-USB-CO data logger (Lascar Electronics, Erie PA, USA) respectively. We also obtained information regarding fuel, stove and kitchen characteristics and cooking activity patterns. Household cooking was performed in two daily sessions (median total duration 4 h) with diurnal variability in pollutant concentrations reflecting morning and evening cooking sessions and peak concentrations associated with fire-lighting. We observed a strong linear relationship between PM2.5 measurements obtained by co-located photometric and gravimetric monitoring devices, providing local calibration factors of 4.9 (DustTrak) and 2.7 (SidePak). Overall 48-h average CO and PM2.5 concentrations were 5.4 (SD 4.3) ppm (12 households) and 417.6 (SD 686.4) μg/m3 (8 households), respectively, with higher average concentrations associated with cooking and heating activities. Overall average PM2.5 concentrations and peak 1-h CO concentrations exceeded WHO Indoor Air Quality Guidelines. Average hourly PM2.5 and CO concentrations were moderately correlated (r = 0.52), suggesting that CO has limited utility as a proxy measure for PM2.5 exposure assessment in this setting. Domestic indoor air quality levels associated with biomass fuel combustion in this region exceed WHO Indoor Air Quality standards and are in the hazardous range for human health.
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Affiliation(s)
- S E Bartington
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
| | - I Bakolis
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London W2 1PG, UK; Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK; Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - D Devakumar
- UCL Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - O P Kurmi
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Old Road Campus, Oxford OX3 7LF, UK
| | - J Gulliver
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London W2 1PG, UK
| | - G Chaube
- Mother and Infant Research Activities (MIRA), Kathmandu 44600, Nepal
| | - D S Manandhar
- Mother and Infant Research Activities (MIRA), Kathmandu 44600, Nepal
| | - N M Saville
- UCL Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - A Costello
- UCL Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - D Osrin
- UCL Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - A L Hansell
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London W2 1PG, UK; Imperial College Healthcare NHS Trust, London, UK
| | - J G Ayres
- Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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Wylie BJ, Matechi E, Kishashu Y, Fawzi W, Premji Z, Coull BA, Hauser R, Ezzati M, Roberts DJ. Placental Pathology Associated with Household Air Pollution in a Cohort of Pregnant Women from Dar es Salaam, Tanzania. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:134-140. [PMID: 27286442 PMCID: PMC5226703 DOI: 10.1289/ehp256] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 03/28/2016] [Accepted: 05/20/2016] [Indexed: 05/05/2023]
Abstract
BACKGROUND Smoke from the burning of biomass fuels has been linked with adverse pregnancy outcomes such as low birth weight, stillbirth, and prematurity. OBJECTIVE To identify potential underlying mechanisms of adverse perinatal outcomes, we explored the association of placental pathology with household air pollution in pregnant women from urban/periurban Tanzania who cook predominantly with charcoal. METHODS Between 2011 and 2013, we measured personal exposures to fine particulate matter (PM2.5) and carbon monoxide (CO) over 72 hr among a cohort of Tanzanian pregnant women. Placentas were collected after delivery for examination. Placental pathologies of inflammatory, hypoxic, ischemic/hypertensive, infectious and thrombotic etiologies were diagnosed, blinded to exposure levels. Using multiple logistic regression, we explored the association of PM2.5 and CO exposure with placental pathology. RESULTS One hundred sixteen women had personal air exposure measurements and placental histopathology available for analysis. PM2.5 and CO exposures were moderate [geometric means (GSD) were 40.5 μg/m3 (17.3) and 2.21 ppm (1.47) respectively]; 88.6% of PM2.5 measurements exceeded World Health Organization air quality guidelines. We observed an increase in the odds (per 1-unit increase in exposure on the ln-scale) of fetal thrombotic vasculopathy (FTV) both with increasing PM2.5 [adjusted odds ratio (aOR) = 5.5; 95% CI: 1.1, 26.8] and CO measurements (aOR = 2.5; 95% CI: 1.0, 6.4) in adjusted models only. FTV also was more common among pregnancies complicated by stillbirth or low birth weight. CONCLUSIONS Fetal thrombosis may contribute to the adverse outcomes associated with household air pollution from cook stoves during pregnancy. Larger studies are necessary for confirmation. Citation: Wylie BJ, Matechi E, Kishashu Y, Fawzi W, Premji Z, Coull BA, Hauser R, Ezzati M, Roberts D. 2017. Placental pathology associated with household air pollution in a cohort of pregnant women from Dar es Salaam, Tanzania. Environ Health Perspect 125:134-140; http://dx.doi.org/10.1289/EHP256.
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Affiliation(s)
- Blair J. Wylie
- Department of Obstetrics/Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Address correspondence to B.J. Wylie, Founders 4, 55 Fruit Street, Boston, MA, 02114, USA. Telephone: 617-643-4331. E-mail:
| | | | - Yahya Kishashu
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Zul Premji
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Brent A. Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, and
| | - Russ Hauser
- Department of Obstetrics/Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Majid Ezzati
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Drucilla J. Roberts
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Singh DK, Gupta T. Source apportionment and risk assessment of PM1 bound trace metals collected during foggy and non-foggy episodes at a representative site in the Indo-Gangetic plain. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 550:80-94. [PMID: 26808399 DOI: 10.1016/j.scitotenv.2016.01.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 12/31/2015] [Accepted: 01/07/2016] [Indexed: 06/05/2023]
Abstract
The concentration, spatial distribution and source of 13-PM1 bound trace metals (Fe, Cu, Mn, Cr, Zn, Cd, Ni, K, Mg, Na, Ca, Pb and V) and adverse health effects of 5-PM1 bound trace metals (Mn, Zn, Ni, Cr and Cd) collected during foggy and non-foggy episodes are presented. Twenty-four samples from each period (foggy and non-foggy episodes) were collected from Kanpur, a typical densely populated city and the most polluted representative site in the Indo-Gangetic plain of India, and were analyzed for carcinogenic (Ni, Cr and Cd) and non-carcinogenic metals (Mn and Zn). The average mass concentration of PM1 during foggy and non-foggy episodes was found to be 160.16±37.70 and 132.87±27.97μg/m(3). Source identification via principle component analysis suggested that vehicular emission and anthropogenic, industrial and crustal dust were the dominant sources in this region. During both episodes the decreasing order of hazard quotient (Hq) for adult and children was as Mn>Cr>Cd>Ni>Zn. In a non-foggy episode the hazardous index (Hi) values of these 5 trace metals were found to be ~3.5 times higher than a foggy episode's exposed population, respectively. In a foggy episode, due to the exposure to total carcinogenic trace metals (Ni, Cr and Cd) present in the ambient air, 95% probability total incremental lifetime cancer risks (TIlcR) were ~687 cancer cases and ~402 cancer cases per million in the adult population and children population respectively. These cancer cases were ~1.6 times higher than a non-foggy episode's exposed population.
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Affiliation(s)
- Dharmendra Kumar Singh
- Department of Civil Engineering & Center for Environmental Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, India
| | - Tarun Gupta
- Department of Civil Engineering & Center for Environmental Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, India.
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Singh DK, Gupta T. Effect through inhalation on human health of PM1 bound polycyclic aromatic hydrocarbons collected from foggy days in northern part of India. JOURNAL OF HAZARDOUS MATERIALS 2016; 306:257-268. [PMID: 26844782 DOI: 10.1016/j.jhazmat.2015.11.049] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/06/2015] [Accepted: 11/24/2015] [Indexed: 06/05/2023]
Abstract
We investigated the health risk from 16 polycyclic aromatic hydrocarbons (PAHs) adsorbed on submicron particles and also reported their concentrations, spatial distribution and possible sources during foggy days at Kanpur. Twenty-four urban foggy day's samples gathered from Kanpur, an urban center in North India and most densely populated city in the Indo-Gangetic plain of India, were examined for 16 PAHs (2-6 rings).The mean concentration of PM1 was found to be 160.16±37.70μg/m(3). ∑16PAHs concentrations were 529.17ng/m(3) with a mean of 33.07ng/m(3). The compounds of higher molecular weight (4-6 rings) added to 70.67% of ∑PAHs mass concentration in the foggy day's samples. The results of source identification by using principle component analysis (PCA) and diagnostic ratios proposed that the primary sources of PAHs were vehicular emission (primarily driven by diesel fuel) and coal combustion and the secondary source. Exposure to total PAHs in the ambient air resulted in, 95% probability total Incremental Lifetime Cancer Risk (TILCR) 3.57×10(-5) for adults and 2.08×10(-5) for children or (∼35 cancer case per million in adults and ∼20 cancer case per million in children) due to inhalation in terms of ILCR were higher than the baseline value of acceptable risk (one cancer case per million people) suggesting moderate health risk to resident human population.
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Affiliation(s)
- Dharmendra Kumar Singh
- Department of Civil Engineering and Center for Environmental Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, India
| | - Tarun Gupta
- Department of Civil Engineering and Center for Environmental Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, India.
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40
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Ingber SZ, Pohl HR. Dataset for human sensitivity to chemicals during development of motor function. Data Brief 2016; 6:445-55. [PMID: 26977428 PMCID: PMC4773568 DOI: 10.1016/j.dib.2015.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/18/2015] [Accepted: 12/23/2015] [Indexed: 11/15/2022] Open
Abstract
The authors reviewed human data related to motor development following exposure to a subset of chemicals thoroughly reviewed in Agency for Toxic Substances and Disease Registry (ATSDR) Toxicological Profiles and Addenda. The resulting dataset includes the following variables and confounders: chemical name, exposure route, exposure duration and frequency, study design, cohort name and/or geographic location, sex of cohort subjects, NOAEL, and LOAEL. This data summary can help validate motor development outcomes observed in animal exposure studies; it can also aid in determining whether these outcomes and corresponding exposure windows are relevant to humans.
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Zhang S, Li L, Gao W, Wang Y, Yao X. Interventions to reduce individual exposure of elderly individuals and children to haze: a review. J Thorac Dis 2016; 8:E62-8. [PMID: 26904254 DOI: 10.3978/j.issn.2072-1439.2016.01.17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Given rapid economic developments and urbanization over the last few decades, China has experienced frequent haze episodes, which have adverse effects on public health. Children and elderly individuals are more susceptible than the general population to air pollution. In this study, we introduce interventions to reduce the exposure of elderly individuals and children to air pollution during hazy weather. These interventions include avoiding outdoor activities, wearing a dust mask, reducing burning biomass fuels, reducing frying and smoking at home, using an air filtration unit and taking supplemental antioxidants. However, the actual benefits of these measures remain unproven and are unlikely to be adequate. Sustained clean air policies remain the most important and efficient solution to reduce air pollution-related health effects.
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Affiliation(s)
- Sini Zhang
- Department of Respiratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Lingling Li
- Department of Respiratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wei Gao
- Department of Respiratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yujie Wang
- Department of Respiratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xin Yao
- Department of Respiratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Calderón-Garcidueñas L, Leray E, Heydarpour P, Torres-Jardón R, Reis J. Air pollution, a rising environmental risk factor for cognition, neuroinflammation and neurodegeneration: The clinical impact on children and beyond. Rev Neurol (Paris) 2015; 172:69-80. [PMID: 26718591 DOI: 10.1016/j.neurol.2015.10.008] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 12/12/2022]
Abstract
Air pollution (indoors and outdoors) is a major issue in public health as epidemiological studies have highlighted its numerous detrimental health consequences (notably, respiratory and cardiovascular pathological conditions). Over the past 15 years, air pollution has also been considered a potent environmental risk factor for neurological diseases and neuropathology. This review examines the impact of air pollution on children's brain development and the clinical, cognitive, brain structural and metabolic consequences. Long-term potential consequences for adults' brains and the effects on multiple sclerosis (MS) are also discussed. One challenge is to assess the effects of lifetime exposures to outdoor and indoor environmental pollutants, including occupational exposures: how much, for how long and what type. Diffuse neuroinflammation, damage to the neurovascular unit, and the production of autoantibodies to neural and tight-junction proteins are worrisome findings in children chronically exposed to concentrations above the current standards for ozone and fine particulate matter (PM2.5), and may constitute significant risk factors for the development of Alzheimer's disease later in life. Finally, data supporting the role of air pollution as a risk factor for MS are reviewed, focusing on the effects of PM10 and nitrogen oxides.
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Affiliation(s)
- L Calderón-Garcidueñas
- The University of Montana, Missoula, MT, 59812, USA; Universidad del Valle de México, Mexico City 04850, Mexico
| | - E Leray
- EHESP Sorbonne Paris Cité, Rennes, France
| | - P Heydarpour
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - R Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - J Reis
- Service de Neurologie, Centre Hospitalier Universitaire, Hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg, France.
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Suades-González E, Gascon M, Guxens M, Sunyer J. Air Pollution and Neuropsychological Development: A Review of the Latest Evidence. Endocrinology 2015; 156:3473-82. [PMID: 26241071 PMCID: PMC4588818 DOI: 10.1210/en.2015-1403] [Citation(s) in RCA: 185] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
For the last decade, literature on the detrimental impacts of air pollution on brain, cognition and behavior has exponentially increased. Our aim is to review the latest epidemiologic literature on the association between outdoor air pollution and neuropsychological developmental in children. Two independent researchers searched for published studies between January 1, 2012 and June 12, 2015 in MEDLINE, Web of Science, and Science direct using defined keywords on outdoor air pollution and neuropsychological development. Selection of articles was based on study eligibility criteria. We encountered sufficient evidence of detrimental effects of pre- or postnatal exposure to polycyclic aromatic hydrocarbons on global intelligence quotient. The evidence was also sufficient for the association between pre- or postnatal exposure to fine particulate matter (PM2.5) and autism spectrum disorder, and limited evidence was encountered between nitrogen oxides and autism spectrum disorder. For other exposure-outcome associations reviewed, the evidence was inadequate or insufficient. Although evidence is not yet conclusive and further research is needed, the latest epidemiological studies support the hypothesis that pre- or postnatal exposure to ambient pollution, particularly polycyclic aromatic hydrocarbons, PM2.5, and nitrogen oxides has a negative impact on the neuropsychological development of children. The public health impact of air pollutants cannot be ignored and the precautionary principle should be applied to protect children.
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Affiliation(s)
- Elisabet Suades-González
- Centre for Research in Environmental Epidemiology (CREAL) (E.S.-G., M.Ga., M.Gu., J.S.), Barcelona, 08003 Spain; Department of Experimental and Health Sciences (E.S.-G., M.Ga., M.Gu., J.S.), Universitat Pompeu Fabra, Barcelona, 08003 Spain; Learning Disabilities Unit (UTAE) (E.S.-G.), Neuropediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Centro Investigación en red (CIBER) Epidemiología y Salud Pública (E.S.-G., M.Ga., M.Gu., J.S.), Barcelona, Spain; ISGlobal (M.Ga., J.S.), Barcelona Centre for International Health Research, Hospital Clínic- Universitat de Barcelona, Barcelona, 08950 Spain; Department of Child and Adolescent Psychiatry/Psychology (M.Gu.), Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, 3015 The Netherlands; and Hospital del Mar Medical Research Institute (J.S.), Barcelona, 08003 Spain
| | - Mireia Gascon
- Centre for Research in Environmental Epidemiology (CREAL) (E.S.-G., M.Ga., M.Gu., J.S.), Barcelona, 08003 Spain; Department of Experimental and Health Sciences (E.S.-G., M.Ga., M.Gu., J.S.), Universitat Pompeu Fabra, Barcelona, 08003 Spain; Learning Disabilities Unit (UTAE) (E.S.-G.), Neuropediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Centro Investigación en red (CIBER) Epidemiología y Salud Pública (E.S.-G., M.Ga., M.Gu., J.S.), Barcelona, Spain; ISGlobal (M.Ga., J.S.), Barcelona Centre for International Health Research, Hospital Clínic- Universitat de Barcelona, Barcelona, 08950 Spain; Department of Child and Adolescent Psychiatry/Psychology (M.Gu.), Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, 3015 The Netherlands; and Hospital del Mar Medical Research Institute (J.S.), Barcelona, 08003 Spain
| | - Mònica Guxens
- Centre for Research in Environmental Epidemiology (CREAL) (E.S.-G., M.Ga., M.Gu., J.S.), Barcelona, 08003 Spain; Department of Experimental and Health Sciences (E.S.-G., M.Ga., M.Gu., J.S.), Universitat Pompeu Fabra, Barcelona, 08003 Spain; Learning Disabilities Unit (UTAE) (E.S.-G.), Neuropediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Centro Investigación en red (CIBER) Epidemiología y Salud Pública (E.S.-G., M.Ga., M.Gu., J.S.), Barcelona, Spain; ISGlobal (M.Ga., J.S.), Barcelona Centre for International Health Research, Hospital Clínic- Universitat de Barcelona, Barcelona, 08950 Spain; Department of Child and Adolescent Psychiatry/Psychology (M.Gu.), Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, 3015 The Netherlands; and Hospital del Mar Medical Research Institute (J.S.), Barcelona, 08003 Spain
| | - Jordi Sunyer
- Centre for Research in Environmental Epidemiology (CREAL) (E.S.-G., M.Ga., M.Gu., J.S.), Barcelona, 08003 Spain; Department of Experimental and Health Sciences (E.S.-G., M.Ga., M.Gu., J.S.), Universitat Pompeu Fabra, Barcelona, 08003 Spain; Learning Disabilities Unit (UTAE) (E.S.-G.), Neuropediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Centro Investigación en red (CIBER) Epidemiología y Salud Pública (E.S.-G., M.Ga., M.Gu., J.S.), Barcelona, Spain; ISGlobal (M.Ga., J.S.), Barcelona Centre for International Health Research, Hospital Clínic- Universitat de Barcelona, Barcelona, 08950 Spain; Department of Child and Adolescent Psychiatry/Psychology (M.Gu.), Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, 3015 The Netherlands; and Hospital del Mar Medical Research Institute (J.S.), Barcelona, 08003 Spain
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Lassi ZS, Bhutta ZA. Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes. Cochrane Database Syst Rev 2015; 2015:CD007754. [PMID: 25803792 PMCID: PMC8498021 DOI: 10.1002/14651858.cd007754.pub3] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND While maternal, infant and under-five child mortality rates in developing countries have declined significantly in the past two to three decades, newborn mortality rates have reduced much more slowly. While it is recognised that almost half of the newborn deaths can be prevented by scaling up evidence-based available interventions (such as tetanus toxoid immunisation to mothers, clean and skilled care at delivery, newborn resuscitation, exclusive breastfeeding, clean umbilical cord care, and/or management of infections in newborns), many require facility-based and outreach services. It has also been stated that a significant proportion of these mortalities and morbidities could also be potentially addressed by developing community-based packaged interventions which should also be supplemented by developing and strengthening linkages with the local health systems. Some of the recent community-based studies of interventions targeting women of reproductive age have shown variable impacts on maternal outcomes and hence it is uncertain if these strategies have consistent benefit across the continuum of maternal and newborn care. OBJECTIVES To assess the effectiveness of community-based intervention packages in reducing maternal and neonatal morbidity and mortality; and improving neonatal outcomes. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2014), World Bank's JOLIS (25 May 2014), BLDS at IDS and IDEAS database of unpublished working papers (25 May 2014), Google and Google Scholar (25 May 2014). SELECTION CRITERIA All prospective randomised, cluster-randomised and quasi-randomised trials evaluating the effectiveness of community-based intervention packages in reducing maternal and neonatal mortality and morbidities, and improving neonatal outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion, assessed trial quality and extracted the data. Data were checked for accuracy. MAIN RESULTS The review included 26 cluster-randomised/quasi-randomised trials, covering a wide range of interventional packages, including two subsets from three trials. Assessment of risk of bias in these studies suggests concerns regarding insufficient information on sequence generation and regarding failure to adequately address incomplete outcome data, particularly from randomised controlled trials. We incorporated data from these trials using generic inverse variance method in which logarithms of risk ratio (RR) estimates were used along with the standard error of the logarithms of RR estimates.Our review showed a possible effect in terms of a reduction in maternal mortality (RR 0.80; 95% confidence interval (CI) 0.64 to 1.00, random-effects (11 studies, n = 167,311; random-effects, Tau² = 0.03, I² 20%). However, significant reduction was observed in maternal morbidity (average RR 0.75; 95% CI 0.61 to 0.92; four studies, n = 138,290; random-effects, Tau² = 0.02, I² = 28%); neonatal mortality (average RR 0.75; 95% CI 0.67 to 0.83; 21 studies, n = 302,646; random-effects, Tau² = 0.06, I² = 85%) including both early and late mortality; stillbirths (average RR 0.81; 95% CI 0.73 to 0.91; 15 studies, n = 201,181; random-effects, Tau² = 0.03, I² = 66%); and perinatal mortality (average RR 0.78; 95% CI 0.70 to 0.86; 17 studies, n = 282,327; random-effects Tau² = 0.04, I² = 88%) as a consequence of implementation of community-based interventional care packages.Community-based intervention packages also increased the uptake of tetanus immunisation by 5% (average RR 1.05; 95% CI 1.02 to 1.09; seven studies, n = 71,622; random-effects Tau² = 0.00, I² = 52%); use of clean delivery kits by 82% (average RR 1.82; 95% CI 1.10 to 3.02; four studies, n = 54,254; random-effects, Tau² = 0.23, I² = 90%); rates of institutional deliveries by 20% (average RR 1.20; 95% CI 1.04 to 1.39; 14 studies, n = 147,890; random-effects, Tau² = 0.05, I² = 80%); rates of early breastfeeding by 93% (average RR 1.93; 95% CI 1.55 to 2.39; 11 studies, n = 72,464; random-effects, Tau² = 0.14, I² = 98%), and healthcare seeking for neonatal morbidities by 42% (average RR 1.42; 95% CI 1.14 to 1.77, nine studies, n = 66,935, random-effects, Tau² = 0.09, I² = 92%). The review also showed a possible effect on increasing the uptake of iron/folic acid supplementation during pregnancy (average RR 1.47; 95% CI 0.99 to 2.17; six studies, n = 71,622; random-effects, Tau² = 0.26; I² = 99%).It has no impact on improving referrals for maternal morbidities, healthcare seeking for maternal morbidities, iron/folate supplementation, attendance of skilled birth attendance on delivery, and other neonatal care-related outcomes. We did not find studies that reported the impact of community-based intervention package on improving exclusive breastfeeding rates at six months of age. We assessed our primary outcomes for publication bias and observed slight asymmetry on the funnel plot for maternal mortality. AUTHORS' CONCLUSIONS Our review offers encouraging evidence that community-based intervention packages reduce morbidity for women, mortality and morbidity for babies, and improves care-related outcomes particularly in low- and middle-income countries. It has highlighted the value of integrating maternal and newborn care in community settings through a range of interventions, which can be packaged effectively for delivery through a range of community health workers and health promotion groups. While the importance of skilled delivery and facility-based services for maternal and newborn care cannot be denied, there is sufficient evidence to scale up community-based care through packages which can be delivered by a range of community-based workers.
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Affiliation(s)
- Zohra S Lassi
- The University of AdelaideARCH: Australian Research Centre for Health of Women and Babies, The Robinson Research Institute, Discipline of Obstetrics and GynaecologyAdelaideSouth AustraliaAustralia5005
- Aga Khan University HospitalDivision of Women and Child HealthStadium RoadPO Box 3500KarachiPakistan74800
| | - Zulfiqar A Bhutta
- Hospital for Sick ChildrenCenter for Global Child HealthTorontoONCanadaM5G A04
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Levy RJ. Carbon monoxide pollution and neurodevelopment: A public health concern. Neurotoxicol Teratol 2015; 49:31-40. [PMID: 25772154 DOI: 10.1016/j.ntt.2015.03.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 12/18/2022]
Abstract
Although an association between air pollution and adverse systemic health effects has been known for years, the effect of pollutants on neurodevelopment has been underappreciated. Recent evidence suggests a possible link between air pollution and neurocognitive impairment and behavioral disorders in children, however, the exact nature of this relationship remains poorly understood. Infants and children are uniquely vulnerable due to the potential for exposure in both the fetal and postnatal environments during critical periods in development. Carbon monoxide (CO), a common component of indoor and outdoor air pollution, can cross the placenta to gain access to the fetal circulation and the developing brain. Thus, CO is of particular interest as a known neurotoxin and a potential public health threat. Here we review overt CO toxicity and the policies regulating CO exposure, detail the evidence suggesting a potential link between CO-associated ambient air pollution, tobacco smoke, and learning and behavioral abnormalities in children, describe the effects of subclinical CO exposure on the brain during development, and provide mechanistic insight into a potential connection between CO exposure and neurodevelopmental outcome. CO can disrupt a number of critical processes in the developing brain, providing a better understanding of how this specific neurotoxin may impair neurodevelopment. However, further investigation is needed to better define the effects of perinatal CO exposure on the immature brain. Current policies regarding CO standards were established based on evidence of cardiovascular risk in adults with pre-existing comorbidities. Thus, recent and emerging data highlighted in this review regarding CO exposure in the fetus and developing child may be important to consider when the standards and guidelines are evaluated and revised in the future.
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Affiliation(s)
- Richard J Levy
- Department of Anesthesiology, Columbia University Medical Center, 622 W. 168th Street, New York, NY 10032, United States.
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46
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Kamal A, Cincinelli A, Martellini T, Malik RN. A review of PAH exposure from the combustion of biomass fuel and their less surveyed effect on the blood parameters. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2015; 22:4076-4098. [PMID: 25410307 DOI: 10.1007/s11356-014-3748-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/17/2014] [Indexed: 06/04/2023]
Abstract
Many epidemiological studies from all over the world have reported that populations of rural and urban environments differ in their health issues due to the differences in the countrywide pollution pattern. In developing countries, various occupational cohorts and subsections of the population in urban and rural areas are routinely exposed to several environmentally widespread contaminants. Polycyclic aromatic hydrocarbons (PAHs) are a group of over hundred different compounds and have ubiquitous presence in rural and urban environments. Smoke from the combustion of biomass fuel contains a high concentration of carcinogenic PAHs, which are related with several human morbidities. The sources and types of biomass fuel are diverse and wide in distribution. Limited numbers of literature reports have focused the significant impact of PAHs on several components of blood, both in human and wildlife. The toxicity of PAHs to rapidly dividing cells (e.g., bone marrow cells) and other tissues is largely attributed to their reactive oxygenated metabolites, potential of causing oxidative stress, and the adducts of their metabolites with DNA. This review aims to encompass the blood-related effects of PAHs and associated human health risks-an aspect that needs further research-on the population of developing countries of the world in particular.
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Affiliation(s)
- Atif Kamal
- Environmental Biology and Ecotoxicology Laboratory, Department of Environmental Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320, Pakistan,
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Northcross AL, Hwang N, Balakrishnan K, Mehta S. Assessing exposures to household air pollution in public health research and program evaluation. ECOHEALTH 2015; 12:57-67. [PMID: 25380652 PMCID: PMC4416115 DOI: 10.1007/s10393-014-0990-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 09/22/2014] [Accepted: 09/28/2014] [Indexed: 05/23/2023]
Abstract
Exposure to smoke from the use of solid fuels and inefficient stoves for cooking and heating is responsible for approximately 4 million premature deaths yearly. As increasing investments are made to tackle this important public health issue, there is a need for identifying and providing guidance on best practices for exposure and stove performance monitoring, particularly for public health research and evaluation studies. This paper, which builds upon the discussion at an expert consultation on exposure assessment convened by the Global Alliance for Clean Cookstoves, the Centers for Disease Control and Prevention, and PATH in late 2012, aims to provide general guidance on what to monitor, who and where to monitor, and how to monitor household air pollution exposures. In addition, we summarize information about commercially available monitoring equipment and the technical properties of these monitors most important for household air pollution exposure assessment. The target audience includes epidemiologists conducting health studies and program evaluators aiming to quantify changes in exposures to estimate the potential health benefits of cookstoves intervention projects.
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Affiliation(s)
- Amanda L Northcross
- Department of Environmental and Occupational Health, George Washington University Milken Institute School of Public Health, 950 New Hampshire Ave 7th Floor, 20057, Washington, DC, USA,
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Thompson LM, Yousefi P, Peñaloza R, Balmes J, Holland N. Genetic modification of the effect of maternal household air pollution exposure on birth weight in Guatemalan newborns. Reprod Toxicol 2014; 50:19-26. [PMID: 25305053 DOI: 10.1016/j.reprotox.2014.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 08/01/2014] [Accepted: 09/24/2014] [Indexed: 11/25/2022]
Abstract
Low birth weight is associated with exposure to air pollution during pregnancy. The purpose of this study was to evaluate whether null polymorphisms of Glutathione S-transferases (GSTs), specifically GSTM1 and GSTT1 genes in infants or mothers, modify the association between high exposures to household air pollution (HAP) from cooking fires and birth weight. Pregnant women in rural Guatemala were randomized to receive a chimney stove or continue to use open fires for cooking. Newborns were measured within 48 h of birth. 132 mother-infant pairs provided infant genotypes (n=130) and/or maternal genotypes (n=116). Maternal null GSTM1 was associated with a 144 g (95% CI, -291, 1) and combined maternal/infant null GSTT1 was associated with a 155 g (95% CI, -303, -8) decrease in birth weight. Although there was a trend toward higher birth weights with increasing number of expressed GST genes, the effect modification by chimney stove use was not demonstrated.
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Affiliation(s)
- Lisa M Thompson
- Family Health Care Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way, Box 0606, San Francisco, CA 94143-0606, United States.
| | - Paul Yousefi
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, 50 University Hall, Berkeley, CA 94720-7360, United States
| | - Reneé Peñaloza
- Family Health Care Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way, Box 0606, San Francisco, CA 94143-0606, United States
| | - John Balmes
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, 50 University Hall, Berkeley, CA 94720-7360, United States; Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, United States
| | - Nina Holland
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, 50 University Hall, Berkeley, CA 94720-7360, United States
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Exposure to Air Pollution From Traffic and Neurodevelopmental Disorders in Swedish Twins. Twin Res Hum Genet 2014; 17:553-62. [DOI: 10.1017/thg.2014.58] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: Recent studies have reported associations between air pollution exposure and neurodevelopmental disorders in children, but the role of pre- and postnatal exposure has not been elucidated. Aim: We aimed to explore the risk for autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD) among children in relation to pre- and postnatal exposure to air pollution from road traffic. Methods: Parents of 3,426 twins born in Stockholm during 1992–2000 were interviewed, when their children were 9 or 12 years old, for symptoms of neurodevelopmental disorders. Residence time-weighted concentrations of particulate matter with a diameter <10 μm (PM10) and nitrogen oxides (NOx) from road traffic were estimated at participants’ addresses during pregnancy, the first year, and the ninth year of life using dispersion modeling, controlling for seasonal variation. Multivariate regression models were used to examine the association between air pollution exposure and neurodevelopmental outcomes, adjusting for potential confounding factors. Results: No clear or consistent associations were found between air pollution exposure during any of the three time windows and any of the neurodevelopmental outcomes. For example, a 5–95% difference in exposure to NOx during pregnancy was associated with odds ratios (ORs) of 0.92 (95% confidence interval (CI): 0.44–1.96) and 0.90 (95% CI: 0.58–1.40) for ASD and ADHD respectively. A corresponding range in exposure to PM10 during pregnancy was related to ORs of 1.01 (95% CI: 0.52–1.96) and 1.00 (95% CI: 0.68–1.47) for ASD and ADHD. Conclusions: Our data do not provide support for an association between pre- or postnatal exposure to air pollution from road traffic and neurodevelopmental disorders in children.
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Perspectives in Household Air Pollution Research: Who Will Benefit from Interventions? Curr Environ Health Rep 2014. [DOI: 10.1007/s40572-014-0021-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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