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Huang W, Xu H, Wu J, Ren M, Ke Y, Qiao J. Toward cleaner air and better health: Current state, challenges, and priorities. Science 2024; 385:386-390. [PMID: 39052781 DOI: 10.1126/science.adp7832] [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: 04/16/2024] [Accepted: 06/17/2024] [Indexed: 07/27/2024]
Abstract
The most up-to-date estimate of the global burden of disease indicates that ambient air pollution, including fine particulate matter and ozone, contributes to an estimated 5.2 million deaths each year. In this review, we highlight the challenges in estimating population exposure to air pollution and attributable health risks, particularly in low- and middle-income countries and among vulnerable populations. To protect public health, the evidence so far confirms urgent needs to prioritize interdisciplinary research on air pollution exposure and risk assessment and to develop evidence-based intervention policies and risk communication strategies. Here, we synthesize the emerging evidence supporting the monitoring and evaluation of the progress in implementation of the Global Air Quality Guidelines prepared by the World Health Organization.
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Affiliation(s)
- Wei Huang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
- Peking University Institute for Global Health, Beijing, China
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Minghui Ren
- Peking University Institute for Global Health, Beijing, China
- Department of Global Health, Peking University School of Public Health, and China Center for Health Development Studies, Peking University, Beijing, China
| | - Yang Ke
- Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital and Institute, Beijing, China
| | - Jie Qiao
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
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Shaw GM, Gonzalez DJX, Goin DE, Weber KA, Padula AM. Ambient Environment and the Epidemiology of Preterm Birth. Clin Perinatol 2024; 51:361-377. [PMID: 38705646 DOI: 10.1016/j.clp.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Preterm birth (PTB) is associated with substantial mortality and morbidity. We describe environmental factors that may influence PTB risks. We focus on exposures associated with an individual's ambient environment, such as air pollutants, water contaminants, extreme heat, and proximities to point sources (oil/gas development or waste sites) and greenspace. These exposures may further vary by other PTB risk factors such as social constructs and stress. Future examinations of risks associated with ambient environment exposures would benefit from consideration toward multiple exposures - the exposome - and factors that modify risk including variations associated with the structural genome, epigenome, social stressors, and diet.
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Affiliation(s)
- Gary M Shaw
- Epidemiology and Population Health, Obstetrics & Gynecology - Maternal Fetal Medicine, Department of Pediatrics, Stanford University School of Medicine, Center for Academic Medicine (CAM), 453 Quarry Road, Stanford, CA 94304, USA.
| | - David J X Gonzalez
- Division of Environmental Health Sciences, School of Public Health, University of California, 2121 Berkeley Way, CA 94720, USA
| | - Dana E Goin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA
| | - Kari A Weber
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, RAHN 6219, Rock, AR 72205, USA
| | - Amy M Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 490 Illinois Street, #103N, San Francisco, CA 94158, USA
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3
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Yang L, Gutierrez DE, Guthrie OW. Systemic health effects of noise exposure. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2024; 27:21-54. [PMID: 37957800 DOI: 10.1080/10937404.2023.2280837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Noise, any unwanted sound, is pervasive and impacts large populations worldwide. Investigators suggested that noise exposure not only induces auditory damage but also produces various organ system dysfunctions. Although previous reviews primarily focused on noise-induced cardiovascular and cerebral dysfunctions, this narrow focus has unintentionally led the research community to disregard the importance of other vital organs. Indeed, limited studies revealed that noise exposure impacts other organs including the liver, kidneys, pancreas, lung, and gastrointestinal tract. Therefore, the aim of this review was to examine the effects of noise on both the extensively studied organs, the brain and heart, but also determine noise impact on other vital organs. The goal was to illustrate a comprehensive understanding of the systemic effects of noise. These systemic effects may guide future clinical research and epidemiological endpoints, emphasizing the importance of considering noise exposure history in diagnosing various systemic diseases.
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Affiliation(s)
- Li Yang
- Cell & Molecular Pathology Laboratory, Communication Sciences and Disorders, Northern Arizona University, Flagstaff, AZ, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Daniel E Gutierrez
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
| | - O'neil W Guthrie
- Cell & Molecular Pathology Laboratory, Communication Sciences and Disorders, Northern Arizona University, Flagstaff, AZ, USA
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Heo S, Afanasyeva Y, Trasande L, Bell ML, Ghassabian A. Residential mobility in pregnancy and potential exposure misclassification of air pollution, temperature, and greenness. Environ Epidemiol 2023; 7:e273. [PMID: 38912392 PMCID: PMC11189681 DOI: 10.1097/ee9.0000000000000273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/06/2023] [Indexed: 06/25/2024] Open
Abstract
Introduction Epidemiological studies commonly use residential addresses at birth to estimate exposures throughout pregnancy, ignoring residential mobility. Lack of consideration for residential mobility during pregnancy might lead to exposure misclassification that should be addressed in environmental epidemiology. Methods We investigated potential exposure misclassification from estimating exposure during pregnancy by residence at delivery utilizing a prospective cohort of pregnant women in New York, United States (n = 1899; 2016-2019). We calculated exposure during pregnancy corresponding to each address for fine particles (PM2.5), temperature, and greenness (Enhanced Vegetation Index [EVI]). Results Twenty-two percent of participants moved at least once during pregnancy; 82.3% of movers changed residences during the second or third trimesters. Participants with better health, lower parity, and higher socioeconomic status were more likely to move. Exposures based on address at delivery rather than residential history overestimated exposure for PM2.5 (exposure error: range -5.7 to 4.6 µg/m3, average -0.6 µg/m3) and EVI (range -0.305 to 0.307, average -0.013), but not temperature. Overestimations were significantly larger for mothers with higher socioeconomic status. Our findings indicate that the error for prenatal exposure can occur when residential mobility is not considered and is disproportional by maternal characteristics. Conclusions Epidemiological studies should consider residential mobility in exposure assessments based on geolocation when possible, and results based on mother's residence at birth should be interpreted with understanding of potential differential exposure misclassification.
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Affiliation(s)
- Seulkee Heo
- School of the Environment, Yale University, New Haven, Connecticut
| | - Yelena Afanasyeva
- Department of Population Health at NYU Grossman School of Medicine, New York University, New York, New York
- Department of Pediatrics at NYU Grossman School of Medicine, New York University, New York, New York
| | - Leonardo Trasande
- Department of Population Health at NYU Grossman School of Medicine, New York University, New York, New York
- Department of Pediatrics at NYU Grossman School of Medicine, New York University, New York, New York
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, Connecticut
| | - Akhgar Ghassabian
- Department of Population Health at NYU Grossman School of Medicine, New York University, New York, New York
- Department of Pediatrics at NYU Grossman School of Medicine, New York University, New York, New York
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Soppa V, Lucht S, Ogurtsova K, Buschka A, López-Vicente M, Guxens M, Weinhold K, Winkler U, Wiedensohler A, Held A, Lüchtrath S, Cyrys J, Kecorius S, Gastmeier P, Wiese-Posselt M, Hoffmann B. The Berlin-Brandenburg Air Study-A Methodological Study Paper of a Natural Experiment Investigating Health Effects Related to Changes in Airport-Related Exposures. Int J Public Health 2023; 68:1606096. [PMID: 38045993 PMCID: PMC10689260 DOI: 10.3389/ijph.2023.1606096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/19/2023] [Indexed: 12/05/2023] Open
Abstract
Objectives: This paper presents the study design of the Berlin-Brandenburg Air study (BEAR-study). We measure air quality in Berlin and Brandenburg before and after the relocation of aircraft (AC) traffic from Tegel (TXL) airport to the new Berlin-Brandenburg airport (BER) and investigate the association of AC-related ultrafine particles (UFP) with health outcomes in schoolchildren. Methods: The BEAR-study is a natural experiment examining schoolchildren attending schools near TXL and BER airports, and in control areas (CA) away from both airports and associated air corridors. Each child undergoes repeated school-based health-examinations. Total particle number concentration (PNC) and meteorological parameters are continuously monitored. Submicrometer particle number size distribution, equivalent black carbon, and gas-phase pollutants are collected from long-term air quality monitoring stations. Daily source-specific UFP concentrations are modeled. We will analyze short-term effects of UFP on respiratory, cardiovascular, and neurocognitive outcomes, as well as medium and long-term effects on lung growth and cognitive development. Results: We examined 1,070 children (as of 30 November 2022) from 16 schools in Berlin and Brandenburg. Conclusion: The BEAR study increases the understanding of how AC-related UFP affect children's health.
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Affiliation(s)
- Vanessa Soppa
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sarah Lucht
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Cardinal Health Real-World Evidence and Insights, Dublin, OH, United States
| | - Katherine Ogurtsova
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Anna Buschka
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Mónica López-Vicente
- ISGlobal, Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Kay Weinhold
- Leibniz Institute for Tropospheric Research, Leipzig, Germany
| | - Ulf Winkler
- Leibniz Institute for Tropospheric Research, Leipzig, Germany
| | | | - Andreas Held
- Environmental Chemistry and Air Research, Institute of Environmental Science and Technology, Technische Universität Berlin, Berlin, Germany
| | - Sabine Lüchtrath
- Environmental Chemistry and Air Research, Institute of Environmental Science and Technology, Technische Universität Berlin, Berlin, Germany
| | - Josef Cyrys
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Simonas Kecorius
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Petra Gastmeier
- Institute of Hygiene and Environmental Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Miriam Wiese-Posselt
- Institute of Hygiene and Environmental Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Meng Q, Liu J, Shen J, Del Rosario I, Lakey PS, Shiraiwa M, Su J, Weichenthal S, Zhu Y, Oroumiyeh F, Paulson SE, Jerrett M, Ritz B. Fine Particulate Matter Metal Composition, Oxidative Potential, and Adverse Birth Outcomes in Los Angeles. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:107012. [PMID: 37878796 PMCID: PMC10599636 DOI: 10.1289/ehp12196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 07/11/2023] [Accepted: 09/18/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Although many studies have linked prenatal exposure to PM 2.5 to adverse birth outcomes, little is known about the effects of exposure to specific constituents of PM 2.5 or mechanisms that contribute to these outcomes. OBJECTIVES Our objective was to investigate effects of oxidative potential and PM 2.5 metal components from non-exhaust traffic emissions, such as brake and tire wear, on the risk of preterm birth (PTB) and term low birth weight (TLBW). METHODS For a birth cohort of 285,614 singletons born in Los Angeles County, California, in the period 2017-2019, we estimated speciated PM 2.5 exposures modeled from land use regression with cokriging, including brake and tire wear related metals (barium and zinc), black carbon, and three markers of oxidative potential (OP), including modeled reactive oxygen species based on measured iron and copper (ROS), OH formation (OP OH ), and dithiothreitol (DTT) loss (OP DTT ). Using logistic regression, we estimated odds ratios (OR) and 95% confidence intervals (CI) for PTB and TLBW with speciated PM 2.5 exposures and PM 2.5 mass as continuous variables scaled by their interquartile range (IQR). RESULTS For both metals and oxidative potential metrics, we estimated increased risks for PTB (ORs ranging from 1.01 to 1.03) and TLBW (ORs ranging from 1.02 to 1.05) per IQR exposure increment that were robust to adjustment for PM 2.5 mass. Associations for PM 2.5 mass, black carbon, metal components, and oxidative potential (especially ROS and OP OH ) with adverse birth outcomes were stronger in Hispanic, Black, and mixed-race or Native American women. DISCUSSION Our results indicate that exposure to PM 2.5 metals from brake and tire wear and particle components that contribute to oxidative potential were associated with an increased risk of PTB and TLBW in Los Angeles County, particularly among Hispanic, Black, and mixed-race or Native American women. Thus, reduction of PM 2.5 mass only may not be sufficient to protect the most vulnerable pregnant women and children from adverse effects due to traffic source exposures. https://doi.org/10.1289/EHP12196.
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Affiliation(s)
- Qi Meng
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Jonathan Liu
- Department of Environmental Health Sciences, Fielding School of Public Health, UCLA, Los Angeles, California, USA
| | - Jiaqi Shen
- Department of Atmospheric & Oceanic Sciences, UCLA, Los Angeles, California, USA
| | - Irish Del Rosario
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Pascale S.J. Lakey
- Department of Chemistry, University of California, Irvine, Irvine, California, USA
| | - Manabu Shiraiwa
- Department of Chemistry, University of California, Irvine, Irvine, California, USA
| | - Jason Su
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Scott Weichenthal
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Yifang Zhu
- Department of Environmental Health Sciences, Fielding School of Public Health, UCLA, Los Angeles, California, USA
| | - Farzan Oroumiyeh
- Department of Environmental Health Sciences, Fielding School of Public Health, UCLA, Los Angeles, California, USA
| | - Suzanne E. Paulson
- Department of Atmospheric & Oceanic Sciences, UCLA, Los Angeles, California, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, UCLA, Los Angeles, California, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
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Yang F, Bi S, Shen X, Li Z, Zhang X, Wang E, Yang X, Peng W, Huang C, Liang P, Sun G. Adjustable Sound Absorber of Multiple Parallel-Connection Helmholtz Resonators with Tunable Apertures Prepared by Low-Force Stereolithography of Photopolymer Resin. Polymers (Basel) 2022; 14:polym14245434. [PMID: 36559802 PMCID: PMC9786290 DOI: 10.3390/polym14245434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
The variable noise spectrum for many actual application scenarios requires a sound absorber to adapt to this variation. An adjustable sound absorber of multiple parallel-connection Helmholtz resonators with tunable apertures (TA-MPCHRs) is prepared by the low-force stereolithography of photopolymer resin, which aims to improve the applicability of the proposed sound absorber for noise with various frequency ranges. The proposed TA-MPCHR metamaterial contains five metamaterial cells. Each metamaterial cell contains nine single Helmholtz resonators. It is treated as a basic structural unit for an array arrangement. The tunable aperture is realized by utilizing four segments of extendable cylindrical chambers with length l0, which indicates that the length of the aperture l is in the range of [l0, 4l0], and that it is tunable. With a certain group of specific parameters for the proposed TA-MPCHR, the influence of the tunable aperture with a variable length is investigated by acoustic finite element simulation with a two-dimensional rotational symmetric model. For the given noise spectrum of certain actual equipment with four operating modes, the TA-MPCHR sample with a limited total thickness of 40 mm is optimized, which is made of photopolymer resin by the low-force stereolithography, and its actual average sound absorption coefficients for the frequency ranges of 500-800 Hz, 550-900 Hz, 600-1000 Hz and 700-1150 Hz reach 0.9203, 0.9202, 0.9436 and 0.9561, respectively. Relative to common non-adjustable metamaterials, the TA-MPCHR made of photopolymer resin can reduce occupied space and improve absorption efficiency, which is favorable in promoting its practical applications in the noise pollution prevention.
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Affiliation(s)
- Fei Yang
- Field Engineering College, Army Engineering University of PLA, Nanjing 210007, China
| | - Shaohua Bi
- Field Engineering College, Army Engineering University of PLA, Nanjing 210007, China
| | - Xinmin Shen
- Field Engineering College, Army Engineering University of PLA, Nanjing 210007, China
- Correspondence: (X.S.); (Z.L.); Tel.: +86-025-8082-1451 (X.S.)
| | - Zhizhong Li
- State Key Laboratory of Disaster Prevention & Mitigation of Explosion & Impact, College of Defense Engineering, Army Engineering University of PLA, Nanjing 210007, China
- Correspondence: (X.S.); (Z.L.); Tel.: +86-025-8082-1451 (X.S.)
| | - Xiangpo Zhang
- Field Engineering College, Army Engineering University of PLA, Nanjing 210007, China
| | - Enshuai Wang
- Field Engineering College, Army Engineering University of PLA, Nanjing 210007, China
| | - Xiaocui Yang
- Engineering Training Center, Nanjing Vocational University of Industry Technology, Nanjing 210023, China
- MIIT Key Laboratory of Multifunctional Lightweight Materials and Structures (MLMS), Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Wenqiang Peng
- College of Aerospace Science and Engineering, National University of Defense Technology, Changsha 410073, China
| | - Changchuang Huang
- Field Engineering College, Army Engineering University of PLA, Nanjing 210007, China
| | - Peng Liang
- Field Engineering College, Army Engineering University of PLA, Nanjing 210007, China
| | - Guoxin Sun
- Field Engineering College, Army Engineering University of PLA, Nanjing 210007, China
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Wang Z, Qian R, Xiang W, Sun L, Xu M, Zhang B, Yang L, Zhu S, Zeng L, Yang W. Association between noise exposure during pregnancy and pregnancy complications: A meta-analysis. Front Psychol 2022; 13:1026996. [DOI: 10.3389/fpsyg.2022.1026996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022] Open
Abstract
BackgroundNoise exposure has a significant impact on human health. However, the effect of occupational and residential noise on the risk of pregnancy complications was controversial in the literature. This study looked at previous research and performed a meta-analysis to determine how noise exposure during pregnancy affected the risk of pregnancy complications.MethodsSystematic searches were conducted in PubMed, Web of Science, Scopus, Embase, Ovid, and Cochrane, and all relevant studies were included. Two investigators independently evaluated the eligibility of these studies. The risk of bias in each study and the quality and strength of each outcome was evaluated by using the GRADE approach and Navigation Guide. Random effects meta-analysis model was used.ResultsThe meta-analysis retrieved 1,461 study records and finally included 11 studies. Occupational noise exposure during pregnancy was associated with preeclampsia (RR = 1.07, 95%CI: 1.04, 1.10). Neither occupational nor residential noise exposure was associated with hypertensive disorders of pregnancy (HDP) (RR = 1.10, 95%CI: 0.96, 1.25 and RR = 1.05, 95%CI: 0.98, 1.11) or gestational diabetes mellitus (GDM) (RR = 0.94, 95%CI: 0.88, 1.00 and RR = 1.06, 95%CI: 0.98, 1.16). Further bias analysis showed that the results were reliable. All outcomes were rated as low in quality and inadequate evidence of harmfulness in strength.ConclusionsOccupational noise exposure could increase the risk of preeclampsia, according to the findings. There was no clear evidence of a harmful effect of noise exposure during pregnancy on HDP or GDM.
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