Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action

Inhaled polystyrene microplastics impaired lung function through pulmonary flora/TLR4-mediated iron homeostasis imbalance

Microplastics (MPs) have been found in the air, human nasal cavity, and lung, suggesting that the respiratory tract is one of the important exposure routes for MPs. The lung is a direct target organ for injury from inhaled MPs, but data on lung injury from longer-term exposure to environmental doses of MPs are limited, and the mechanisms remain unclear. Here, C57BL/6 J mice were treated with 5 μm polystyrene (PS)-MPs by intratracheal instillation (0.6, 3, and 15 mg/kg) for 60 days to establish MPs exposure model. We found that PS-MPs lead to increased collagen fibers and decreased lung barrier permeability and lung function in lung tissue. Mechanistically, the abundance of gram-negative bacteria in the pulmonary flora increased after inhalation of PS-MPs, causing lipopolysaccharide (LPS) release. The expression of Toll-like receptor 4 (TLR4), the key receptor of LPS, was increased, and ferroptosis occurred in lung tissue cells. Further in vitro intervention experiments were performed, pulmonary flora/TLR4-induced imbalance of lung iron homeostasis is an important mechanism of PS-MPs-induced lung injury. Our study provides new evidence for lung injury caused by environmental doses of MPs and strategies to prevent it through longer-term dynamic observation.

m6A-mediated HDAC9 upregulation promotes particulate matter-induced airway inflammation via epigenetic control of DUSP9-MAPK axis and acts as an inhaled nanotherapeutic target

Exposure to particulate matter (PM) can cause airway inflammation and worsen various airway diseases. However, the underlying molecular mechanism by which PM triggers airway inflammation has not been completely elucidated, and effective interventions are lacking. Our study revealed that PM exposure increased the expression of histone deacetylase 9 (HDAC9) in human bronchial epithelial cells and mouse airway epithelium through the METTL3/m6A methylation/IGF2BP3 pathway. Functional assays showed that HDAC9 upregulation promoted PM-induced airway inflammation and activation of MAPK signaling pathway in vitro and in vivo. Mechanistically, HDAC9 modulated the deacetylation of histone 4 acetylation at K12 (H4K12) in the promoter region of dual specificity phosphatase 9 (DUSP9) to repress the expression of DUSP9 and resulting in the activation of MAPK signaling pathway, thereby promoting PM-induced airway inflammation. Additionally, HDAC9 bound to MEF2A to weaken its anti-inflammatory effect on PM-induced airway inflammation. Then, we developed a novel inhaled lipid nanoparticle system for delivering HDAC9 siRNA to the airway, offering an effective treatment for PM-induced airway inflammation. Collectively, we elucidated the crucial regulatory mechanism of HDAC9 in PM-induced airway inflammation and introduced an inhaled therapeutic approach targeting HDAC9. These findings contribute to alleviating the burden of various airway diseases caused by PM exposure.

Burden of non-communicable diseases in China and its provinces, 1990-2021: Results from the Global Burden of Disease Study 2021

BACKGROUND

Non-communicable diseases (NCDs) are the primary causes of disability and death. The aim of this study is to analyze the disease burden of NCDs in China from 1990 to 2021.

METHODS

This study used data on NCDs in China and its provinces from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The study analyzed the disease burden of NCDs in 2021 and its changes from 1990 to 2021 using indicators including deaths and disability-adjusted life years (DALYs).

RESULTS

Between 1990 and 2021, the NCD burden in China exhibited an upward trend. In 2021, China had 10.6 (95% uncertainty interval [UI]: 9.0-12.2) million deaths and 349.3 (95% UI: 301.5-401.2) million DALYs due to NCDs, accounting for 91.0% (95% UI: 90.4-91.7%) of all deaths and 86.7% (95% UI: 86.0-87.4%) of all DALYs. NCDs caused a lower disease burden in females than in males. Cardiovascular diseases and neoplasms were the main NCD level 2 causes of deaths and DALYs, resulting in 5.1 (95% UI: 4.3-5.9) and 2.8 (95% UI: 2.3-3.4) million deaths and 100.2 (95% UI: 84.6-116.6) million and 71.2 (95% UI: 59.3-85.2) million DALYs in 2021, respectively. Chronic respiratory diseases were the third leading cause of NCD deaths, while musculoskeletal disorders were the third leading cause of NCD DALYs. Qinghai, Xizang, and Heilongjiang had the highest age-standardized mortality rates and age-standardized DALY rates (per 100,000) for NCDs, while Hong Kong Special Administration Region (SAR), Macao SAR, and Shanghai recorded the lowest age-standardized mortality rates and age-standardized DALY rates.

CONCLUSIONS

NCDs disease burden in China and exhibited heterogeneity across sexes provinces. China needs to focus on addressing key NCDs and implement intervention measures tailored to the disease distribution characteristics to reduce the NCD burden.

COPD-Like Phenotypes in TBC-Treated Mice Can be Effectively Alleviated via Estrogen Supplement

Tris(2,3-dibromopropyl) isocyanurate (TBC), recognized as an endocrine disruptor, can cause inflammatory injury to the lung tissue of mice. To investigate the specific respiratory effects of TBC, male C57BL/6J mice were administered a daily dose of 20 mg/kg of TBC over 14 days. Postexposure, these mice developed chronic obstructive pulmonary disease (COPD)-like symptoms characterized by inflammatory lung damage and functional impairment. In light of the antiestrogenic properties of TBC, we administrated estradiol (E2) to investigate its potential protective role against TBC-induced damage and found that the coexposure of E2 notably mitigated the COPD-like phenotypes. Immunohistochemical analysis revealed that TBC exposure reduced estrogen receptor alpha (ERα) expression and increased nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) expression, while E2 treatment rebalanced the expression levels of ERα and NF-κB to their normative states. Our findings indicate that TBC, as an antiestrogenic agent, may contribute to the pathogenesis of COPD through an ERα-mediated inflammatory pathway, but that E2 treatment could reverse the impairment, providing a potentially promising remedial treatment. Given the lung status as a primary target of air pollution, the presence of antiestrogenic compounds like TBC in atmospheric particulates presents a significant concern, with the potential to exacerbate respiratory conditions such as COPD and pneumonia.

Associations between atmospheric PM2.5 exposure and carcinogenic health risks: Surveillance data from the year of lowest recorded levels in Beijing, China

Scant research has pinpointed the year of minimum PM2.5 concentration through extensive, uninterrupted monitoring, nor has it thoroughly assessed carcinogenic risks associated with analyzing numerous components during this nadir in Beijing. This study endeavored to delineate the atmospheric PM2.5 pollution in Beijing from 2015 to 2022 and to undertake comprehensive evaluation of carcinogenic risks associated with the composition of atmospheric PM2.5 during the year exhibiting the lowest concentration. PM2.5 concentrations were monitored gradually in 9 districts of Beijing for 7 consecutive days per month from 2015 to 2022, and 32 kinds of PM2.5 components collected in the lowest PM2.5 concentration year were analyzed. This comprehensive dataset served as the basis for carcinogenic risk assessment using Monte Carlo simulation. And we applied the Positive Matrix Factorization (PMF) method to identity the sources of atmospheric PM2.5. Furthermore, we integrated this source appointment model with risk assessment model to discern the origins of these risks. The findings revealed that the annual average PM2.5 concentration in 2022 stood at 43.1 μg/m3, marking the lowest level recorded. The mean carcinogenic risks of atmospheric PM2.5 exposure calculated at 6.30E-6 (empirical 95% CI 1.09E-6 to 2.25E-5) in 2022. The PMF model suggested that secondary sources (35.4%), coal combustion (25.6%), resuspended dust (15.1%), biomass combustion (14.1%), vehicle emissions (7.1%), industrial emissions (2.0%) and others (0.7%) were the main sources of atmospheric PM2.5 in Beijing. The mixed model revealed that coal combustion (2.41E-6), vehicle emissions (1.90E-6) and industrial emissions (1.32E-6) were the main sources of carcinogenic risks with caution. Despite a continual decrease in atmospheric PM2.5 concentration in recent years, the lowest concentration levels still pose non-negligible carcinogenic risks. Notably, the carcinogenic risks associated with metals and metalloids exceeded that of PAHs. And the distribution of risk sources did not align proportionally with the distribution of PM2.5 mass concentration.

Identifying the pollution risk pattern from industrial production to rural settlements and its countermeasures in China

Impacted by large-scale and rapid rural industrialization in the past few decades, China's rural settlements are confronted with the risk of heavy metal pollution stemming from industrial production, which might pose a significant threat to the rural habitat and the well-beings. This study devised a relative risk model for industrial heavy metal pollution to the rural settlements based on the source-pathway-receptor risk theory. Using this model, we assessed the risk magnitudes of heavy metal pollution from industrial production at a 10 km × 10 km grid scale and identified the characteristics of the risk pattern in China. Our finding reveals: (1) the relative risk values of wastewater, waste gas and total heavy metal pollution are notably concentrated within a confined spectrum, with only a small number of units are characterized by high-risk level; (2) Approximately 21.57 % of China's rural settlements contend with heavy metal pollution, with 4.17 %, 9.84 % and 7.55 % being subjected to high, medium and low risks, respectively; (3) The high-risk units mainly is concentrated in the developed areas such as Yangtze River Delta, Pearl River Delta, and the Beijing-Tianjin metropolitan area, also dispersed in the plain areas with high rural population density. Guided by these insights, this study puts forth regionally tailored prevention and control strategies, as well as distinct process prevention and control strategies.

Air Pollution Metabolomic Signatures and Chronic Respiratory Diseases Risk: A Longitudinal Study

BACKGROUND

Although evidence has documented the associations of ambient air pollution with chronic respiratory diseases (CRDs) and lung function, the underlying metabolic mechanisms remain largely unclear.

RESEARCH QUESTION

How does the metabolomic signature for air pollution relate to CRD risk, respiratory symptoms, and lung function?

STUDY DESIGN AND METHODS

We retrieved 171,132 participants free of COPD and asthma at baseline from the UK Biobank, who had data on air pollution and metabolomics. Exposures to air pollutants (particulate matter with diameter ≤ 2.5 μm [PM2.5], particulate matter with a diameter ≤ 10 μm, nitrogen oxide [NOX], and NO2) were assessed for 4 years before baseline considering residential address histories. We used 10-fold cross-validation elastic net regression to identify air pollution-associated metabolites. Multivariable Cox models were used to assess the associations between metabolomic signatures and CRD risk. Mediation and pathway analysis were conducted to explore the metabolic mechanism underlying the associations.

RESULTS

During a median follow-up of 12.51 years, 8,951 and 5,980 incident COPD and asthma cases were recorded. In multivariable Cox regressions, air pollution was positively associated with CRD risk (eg, hazard ratio per interquartile range increment in PM2.5, 1.09; 95% CI, 1.06-1.13). We identified 103, 86, 85, and 90 metabolites in response to PM2.5, particulate matter with a diameter ≤ 10 μm, NOX, and NO2 exposure, respectively. The metabolomic signatures showed significant associations with CRD risk (hazard ratio per SD increment in PM2.5 metabolomic signature, 1.11; 95% CI, 1.09-1.14). Mediation analysis showed that peripheral inflammatory and erythrocyte-related markers mediated the effects of metabolomic signatures on CRD risk. We identified 14 and 12 perturbed metabolic pathways (energy metabolism and amino acid metabolism pathways, etc) for PM2.5 and NOX metabolomic signatures.

INTERPRETATION

Our study identifies metabolomic signatures for air pollution exposure. The metabolomic signatures showed significant associations with CRD risk, and inflammatory- and erythrocyte-related markers partly mediated the metabolomic signatures-CRD links.

Effects of air pollution on global health: evidence from the global burden of disease study in the BRICS countries

PURPOSE

Considering the dynamic influence of environmental, social, economic, and political factors in the emergence and growth of the BRICS countries (Brazil, Russia, India, China, and South Africa) over the years and pre-existing differences, the adverse effects of air pollution on the health and well-being of the people have remained major areas of academic inquiry and policy interventions. The present study examines the global trend of deaths and Disability Adjusted Life Years (DALYs) attributable to air pollution with particular reference to the BRICS countries for the period 1990 to 2019.

METHODS

This study has used the global burden of disease estimates by using different rounds of the Global Burden of Disease (GBD) study report published by the Institute of Health Metrics Evaluation. This study has calculated the cause of death and DALYs due to environmental risk factors (i.e. Air pollution). Data analysis has been done by using the standard formula for the calculation of death (mortality) rate and DALYs rate. Similarly, we calculated the age and gender-wise death and DALYs rate by using the appropriate numerator and denominator.

RESULTS

The study discovered a significant shift in disease patterns over this period, as communicable diseases like respiratory infections and tuberculosis were replaced by non-communicable diseases such as ischemic heart disease (17.2 million), chronic obstructive pulmonary disease (14.59 million), and stroke (17.02 million) as the primary causes of air pollution-related deaths in 2019 at the global level. Additionally, the study identified a worrying increase in deaths linked to neonatal disorders and respiratory infections caused by ambient particulate matter pollution in South Africa, India, and Brazil. The impact of air pollution on public health is evident across different age groups and genders, with people aged 50-69 years, those aged 70 and above, and children under 5 years being more vulnerable. Furthermore, the male population is disproportionately affected by communicable and noncommunicable diseases caused by air pollution.

CONCLUSION

The study highlights the need for policymakers to implement evidence-based interventions to tackle this global health problem. The interventions should aim to reduce the emerging crisis of non-communicable diseases related to air pollution, particularly among vulnerable age groups and the male population, ultimately improving public health outcomes.

Evaluating the Kinetics and Molecular Mechanism for Biomimetic Metabolic Activation of PAHs by Surface-Enhanced Raman Scattering Spectroscopy

Biomimetic cytochrome P450 for chemical activation of environmental carcinogens is an efficient in vitro model for evaluating their mutagenicity and ultimately acquiring the metabolites that cannot be easily accessed by conventional routes of organic synthesis. Different kinds of mutagen derived from polyaromatic hydrocarbons (PAHs) by metalloporphyrin/oxidant model systems have been reported, but the underlying molecular mechanisms are poorly understood. Herein, we have for the first time demonstrated an effective surface-enhanced Raman scattering (SERS) protocol to study the dynamics and biomimetic metabolic behaviors of pyrene (Pyr) in the presence of various oxygen donors. Quantitative information on the relative concentration of Pyr and its metabolites in the biomimetic system can be extracted from the SERS spectra. On the basis of our results, we conclude that the oxidative metabolism of Pyr is highly influenced by the types and concentrations of oxygen donors, leading to the formation of 1-hydroxypyrene and dioxygenated products. Besides, the addition of an appropriate amount of an organic solvent can promote the formation of secondary oxidation products. These results offer valuable insights into the dynamics of PAHs metabolism and the regulation of their metabolic pathways in biomimetic activation. In comparison to traditional liquid chromatography-mass spectrometry, the present SERS approach is more suitable for high-throughput evaluation of the metabolic process and kinetics of PAHs. We anticipate that this approach will enable a more general and comprehensive tracking of metabolic dynamics and molecular mechanisms involved in the biomimetic activation of other xenobiotics, such as procarcinogens, promutagens, and drugs.

Environmental pollutants exposure-derived extracellular vesicles: crucial players in respiratory disorders

BACKGROUND

Individual exposure to environmental pollutants, as one of the most influential drivers of respiratory disorders, has received considerable attention due to its preventability and controllability. Considering that the extracellular vesicle (EV) was an emerging intercellular communication medium, recent studies have highlighted the crucial role of environmental pollutants derived EVs (EPE-EVs) in respiratory disorders.

METHODS

PubMed and Web of Science were searched from January 2018 to December 2023 for publications with key words of environmental pollutants, respiratory disorders and EVs.

RESULTS

Environmental pollutants could disrupt airway intercellular communication by indirectly stimulating airway barrier cells to secrete endogenous EVs, or directly transmitting exogenous EVs, mainly by biological pollutants. Mechanistically, EPE-EVs transferred specific contents to modulate biological functions of recipient cells, to induce respiratory inflammation and impair tissue and immune function, which consequently contributed to the development of respiratory diseases, such as asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, pulmonary hypertension, lung cancer and infectious lung diseases. Clinically, EVs could emerged as promising biomarkers and biological agents for respiratory diseases attributed by their specificity, convenience, sensibility and stability.

CONCLUSIONS

Further studies of EPE-EVs are helpful to understand the aetiology and pathology of respiratory diseases, and facilitate the precision respiratory medicine in risk screening, early diagnosis, clinical management and biotherapy.

Air pollution and cancer daily mortality in Hangzhou, China: an ecological research

BACKGROUND

Long-term exposure to air pollution has been linked to cancer incidence. However, the evidence is limited regarding the effect of short-term exposure to air pollution on cancer mortality.

OBJECTIVES

This study aimed to investigate associations between short-term exposure to air pollutants (sulfur dioxide (SO2), nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter <10 mm (PM10) and PM2.5) and cancer daily mortality.

METHODS

This study used air quality, meteorological and daily cancer death data from 2014 to 2019 in Hangzhou, China. Generalised additive models (GAM) with quasi-Poisson regression were used to analyse the associations between air pollutants and cancer mortality with adjustment for confounding factors including time trends, day of week, temperature and humidity. Then, we conducted stratified analyses by sex, age, season and education. In addition, stratified analyses of age, season and education were performed within each sex to determine whether sex difference was modified by such factors.

RESULTS

After adjusting for potential confounders, the GAM results indicated a statistically significant relationship between increased cancer mortality and elevated air pollution concentrations, but only in the female population. For every 10 μg/m3 rise in pollutant concentration, the increased risk of cancer death in females was 6.82% (95% CI 3.63% to 10.10%) for SO2 on lag 03, and 2.02% (95% CI 1.12% to 2.93%) for NO2 on lag 01 and 0.89% (95% CI 0.46% to 1.33%) for PM10 on lag 03 and 1.29% (95% CI 0.64% to 1.95%) for PM2.5 on lag 03. However, no statistically significant association was found among males. Moreover, the differences in effect sizes between males and females were more pronounced during the cold season, among the elderly and among subjects with low levels of education.

CONCLUSIONS

Increased cancer mortality was only observed in females with rising concentrations of air pollutants. Further research is required to confirm this sex difference. Advocate for the reduction of air pollutant emissions to protect vulnerable groups.

Atmospheric emissions of hexachlorobutadiene in fine particulate matter from industrial sources

Hexachlorobutadiene (HCBD) is a concerning chemical that is included in the United States Toxic Substances Control Act, and the Stockholm Convention. Knowledge of the sources of HCBD is insufficient and is pivotal for accurate inventory and implementing global action. In this study, unintentional HCBD release and source emission factors of 121 full-scale industrial plants from 12 industries are investigated. Secondary copper smelting, electric arc furnace steelmaking, and hazardous waste incineration show potential for large emission reductions, which are found of high HCBD emission concentrations of > 20 ng/g in fine particulate matter in this study. The highest HCBD emission concentration is observed for the secondary copper smelting industry (average: 1380 ng/g). Source emission factors of HCBD for the 12 industries range from 0.008 kg/t for coal fire power plants to 0.680 kg/t for secondary lead smelting, from which an estimation of approximately 8452.8 g HCBD emissions annually worldwide achieved. The carcinogenic risks caused by HCBD emissions from countries and regions with intensive 12 industrial sources are 1.0-80 times higher than that without these industries. These results will be useful for formulating effective strategies of HCBD control.

Optimal decision-making in relieving global high temperature-related disease burden by data-driven simulation

The rapid acceleration of global warming has led to an increased burden of high temperature-related diseases (HTDs), highlighting the need for advanced evidence-based management strategies. We have developed a conceptual framework aimed at alleviating the global burden of HTDs, grounded in the One Health concept. This framework refines the impact pathway and establishes systematic data-driven models to inform the adoption of evidence-based decision-making, tailored to distinct contexts. We collected extensive national-level data from authoritative public databases for the years 2010-2019. The burdens of five categories of disease causes - cardiovascular diseases, infectious respiratory diseases, injuries, metabolic diseases, and non-infectious respiratory diseases - were designated as intermediate outcome variables. The cumulative burden of these five categories, referred to as the total HTD burden, was the final outcome variable. We evaluated the predictive performance of eight models and subsequently introduced twelve intervention measures, allowing us to explore optimal decision-making strategies and assess their corresponding contributions. Our model selection results demonstrated the superior performance of the Graph Neural Network (GNN) model across various metrics. Utilizing simulations driven by the GNN model, we identified a set of optimal intervention strategies for reducing disease burden, specifically tailored to the seven major regions: East Asia and Pacific, Europe and Central Asia, Latin America and the Caribbean, Middle East and North Africa, North America, South Asia, and Sub-Saharan Africa. Sectoral mitigation and adaptation measures, acting upon our categories of Infrastructure & Community, Ecosystem Resilience, and Health System Capacity, exhibited particularly strong performance for various regions and diseases. Seven out of twelve interventions were included in the optimal intervention package for each region, including raising low-carbon energy use, increasing energy intensity, improving livestock feed, expanding basic health care delivery coverage, enhancing health financing, addressing air pollution, and improving road infrastructure. The outcome of this study is a global decision-making tool, offering a systematic methodology for policymakers to develop targeted intervention strategies to address the increasingly severe challenge of HTDs in the context of global warming.

Epidemiological characteristics of chronic non-communicable diseases in Dongfang, China, 2021: a cross-sectional survey

OBJECTIVES

The study aimed to understand the composition, epidemiological characteristics and disease burden of chronic non-communicable diseases and to evaluate the association between sociodemographic factors and chronic non-communicable diseases.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

Medical records of 196 761 residents were collected from Dongfang disease surveillance system from January to December 2021.

PRIMARY OUTCOME

Prevalence and disability burden were recorded. Logistic regression was used to investigate the relationship between sociodemography factors and diseases.

RESULTS

Cardiovascular diseases, chronic lower respiratory diseases and other upper respiratory tract diseases were the main chronic non-communicable diseases. In multivariable analysis, men were associated with increased risk of cardiovascular diseases (OR=1.210, 95% CI 1.162 to 1.261) and chronic lower respiratory diseases (OR=1.128, 95% CI 1.079 to 1.180). Older age was associated with increased risk of cardiovascular diseases (OR=83.952, 95% CI 58.954 to 119.550), whereas was associated with decreased risk of chronic lower respiratory diseases (OR=0.442, 95% CI 0.415 to 0.471) and other upper respiratory tract diseases (OR=0.450, 95% CI 0.411 to 0.493). The unemployed and poor household were associated with decreased risk of cardiovascular diseases (OR=0.463, 95% CI 0.412 to 0.521 and OR=0.390, 95% CI 0.342 to 0.444, respectively), whereas were associated with increased risk of chronic lower respiratory diseases (OR=12.219, 95% CI 6.343 to 23.539 and OR=10.954, 95% CI 5.666 to 21.177, respectively) and other upper respiratory tract diseases (OR=2.246, 95% CI 1.719 to 2.936 and OR=3.035, 95% CI 2.308 to 3.991, respectively). Gender and age moderated the association between personnel category and major diseases.

CONCLUSIONS

The spectrum and epidemiological characteristics of chronic diseases observed in Dongfang is good evidence for developing prevention guides and health policies for region.

The Protective Effects of Ganoderma lucidum Active Peptide GLP4 on Lung Injury Induced by Cadmium Poisoning in Mice

Ganoderma triterpenes and spore powder have shown promising results in mitigating cadmium-induced renal and hepatic injuries. Ganoderma lucidum active peptide GLP4 is a natural protein with dual antioxidant activities derived from the mycelium of Ganoderma lucidum. However, its efficacy in alleviating cadmium-induced lung injury remains unexplored. This study aims to investigate the protective effects of GLP4 against cadmium-induced lung injury in mice. Mice were exposed to cadmium chloride via nebulization to induce lung injury. The protective effect of GLP4 was assessed by measuring the total cell count in BALF, levels of inflammatory cytokines, and the expression of NLRP3 in lung tissues a through histopathological examination of lung tissue changes. The results showed that GLP4 significantly mitigated histopathological damage in lung tissues, decreased the secretion of inflammatory cytokines, and reduced the expression of NLRP3, which was elevated in cadmium-exposed mice. In vitro studies further revealed that GLP4 inhibited the cadmium-induced activation of the NLRP3 inflammasome. Notably, acute cadmium exposure by the respiratory tract did not affect the liver and kidneys of the mice. The findings suggest that GLP4 reduces cadmium-induced lung injury in mice by inhibiting the activation of the NLRP3 inflammasome, which provides a theoretical foundation for using Ganoderma lucidum as a preventive and therapeutic agent against cadmium poisoning.

Risk/benefit trade-off of habitual physical activity and air pollution on mortality: A large-scale prospective analysis in the UK Biobank

BACKGROUND

Previous observational studies have indicated associations of physical activity (PA) and air pollution with mortality. A few studies have evaluated air pollution and PA interactions for health. Still, the trade-off between the harmful effects of air pollution exposure and the protective effects of PA remains controversial and unclear.

OBJECTIVE

This study aimed to investigate the joint association of air pollution and PA with mortality risks.

METHODS

This prospective cohort study included 322,092 participants from 2006 to 2010 and followed up to 2021 in the UK Biobank study. The concentrations of air pollutants (2006-2010), including particulate matter (PM) with diameters <=2.5 mm (PM2.5), <=10 mm (PM10), and between 2.5 and 10 mm (PM2.5-10), and nitrogen oxides (NO2 and NOx) were obtained. Information on PA measured by the International Physical Activity Questionnaire short form (2006-2010) and wrist-worn accelerometer (2013-2015) were collected. All-cause and cause-specific mortalities were recorded. Cox proportional hazard models were used to investigate the associations of air pollution exposure and PA with mortality risks. The additive and multiplicative interactions were also examined.

RESULTS

During a mean follow-up of 11.83 years, 16629 deaths were recorded. Compared with participants reporting low PA, higher PA was negatively associated with all-cause [hazard ratio (HR), 0.74; 95% CI, 0.71-0.78], cancer (HR, 0.85; 95% CI, 0.80-0.90), CVD (HR, 0.79; 95% CI, 0.71-0.87), and respiratory disease-specific mortality (HR, 0.51; 95% CI, 0.44-0.60). Exposure to PM2.5 (HR, 1.05; 95% CI, 1.00-1.09) and NOx (HR, 1.06; 95% CI, 1.02-1.10) was connected with increased all-cause mortality risk, and significant PM2.5-associated elevated risks for CVD mortality and NOx-associated elevated risks for respiratory disease mortality were observed. No obvious interaction between PA and PM2.5 or NOx exposure was detected.

CONCLUSIONS

Our study provides additional evidence that higher PA and lower air pollutant levels are independently connected with reduced mortality risk. The benefits of PA are not significantly affected by long-term air pollution exposure, indicating PA can be recommended to prevent mortality regardless of air pollution levels. Our findings highlight the importance of public health policies and interventions facilitating PA and reducing air pollution in reducing mortality risks and maximizing health benefits. Future investigation is urgently needed to identify these findings in areas with severe air pollution conditions.

The effect of education expenditure on air pollution: Evidence from China

Education expenditure is essential in mitigating air pollution, but the relationship between education expenditure and air pollution lacks in-depth discussion. Utilizing data at the county level in China during 2007-2021, this study estimates the effect of education expenditure from local governments on air pollution. Our findings demonstrate that education expenditure significantly and negatively affects air pollution, which remains robust after addressing endogeneity. The mechanism analysis presents that education expenditure reduces air pollution through the composition, technique, and income effects. The heterogeneity analysis indicates that the impact of education expenditure exhibits marked regional heterogeneity. Specifically, the role of education expenditure is significant in strong regulation, key, eastern, and central regions. By considering interaction terms, we identify the moderating effects of human capital, economic development, infrastructure construction, and public service for education expenditure. The cost-benefit analysis emphasizes that education expenditure improves social welfare. Our findings can inspire local governments to place more emphasis on air quality and public education expenditure.

Association between PM10 pollution and the hospitalization of chronic obstructive pulmonary disease with comorbidity: evidence in 17 cities of Henan, Central China

Particulate matter (PM10) changes have been confirmed as one of the contributory factors affecting human health, the association between PM10 pollution and the hospitalization of chronic obstructive pulmonary disease (COPD) with comorbidity diseases was rarely reported. The same inpatient more than twice times admissions with COPD illness from January 1, 2016 to December 31, 2021 were identified from hospitals in the 17 cities of Henan, Central China. City-specific associations were firstly estimated using the case time series (CTS) model and then combined to obtain the regional average association. The multivariate meta-analytic model produces pooled estimates of the set of coefficients representing the PM10-COPD hospitalizations association across the 17 cities. Cause-specific hospitalization analyses were performed by COPD patients with different comorbidity combinations. A total of 34,348 elderly (age ≥ 65) subjects were analyzed and with a total of 35,122.35 person-years. These coefficients can be used to compute the linear exposure-response curve expressed as relative risk (RR) in per 10 µg/m3 increase in PM10 at lag03, which was 1.0091 (95% CI 1.0070-1.0112) for COPD with comorbidity, 1.0089 (95% CI 1.0067-1.0110) for COPD with circulatory system diseases, 1.0079 (95% CI 1.0052-1.0105) for COPD with respiratory system diseases, 1.0076 (95% CI 1.0032-1.0121) for COPD with endocrine system diseases, and 1.0087 (95% CI 1.0013-1.0162) for COPD with genitourinary system diseases, respectively. Some heterogeneity was found across cities, with estimates ranging from 1.0227 in the Puyang and Jiaozuo to 1.0053 in Henan Provance, China. The effect of higher PM10, on average, was higher in studies for northern cities, with a steeper raise in risk: per 10 µg/m3 increase in PM10, the RR from 1.0062 (95% CI 1.0030-1.0093) for the 10th percentile of latitude to 1.0124 (95% CI 1.0089-1.0160) for the 90th percentile. Our findings indicated that PM10 exposure may increase the risk of hospitalizations for COPD with comorbidity. Moreover, there might be a higher morbidity risk associated with PM10 in northern latitudes, indicating that stricter air quality standards could potentially reduce PM10-related morbidity among individuals with COPD. These findings have implications for the implementation of effective clean air interventions aligned with national climate policies.

Research in China about the biological mechanisms that potentially link socioenvironmental changes and mental health: a scoping review

China's rapid socioeconomic development since 1990 makes it a fitting location to summarise research about how biological changes associated with socioenvironmental changes affect population mental health and, thus, lay the groundwork for subsequent, more focused studies. An initial search identified 308 review articles in the international literature about biomarkers associated with 12 common mental health disorders. We then searched for studies conducted in China that assessed the association of the identified mental health related-biomarkers with socioenvironmental factors in English-language and Chinese-language databases. We located 1330 articles published between 1 January 1990 and 1 August 2021 that reported a total of 3567 associations between 56 specific biomarkers and 11 socioenvironmental factors: 3156 (88·5%) about six types of environmental pollution, 381 (10·7%) about four health-related behaviours (diet, physical inactivity, internet misuse, and other lifestyle factors), and 30 (0·8%) about socioeconomic inequity. Only 245 (18·4%) of the papers simultaneously considered the possible effect of the biomarkers on mental health conditions; moreover, most of these studies assessed biomarkers in animal models of mental disorders, not human subjects. Among the 245 papers, mental health conditions were linked with biomarkers of environmental pollution in 188 (76·7%), with biomarkers of health-related behaviours in 48 (19·6%), and with biomarkers of socioeconomic inequality in 9 (3·7%). The 604 biomarker-mental health condition associations reported (107 in human subjects and 497 in animal models) included 379 (62·7%) about cognitive functioning, 117 (19·4%) about anxiety, 56 (9·3%) about depression, 21 (3·5%) about neurodevelopmental conditions, and 31 (5·1%) about neurobehavioural symptoms. Improved understanding of the biological mechanisms linking socioenvironmental changes to community mental health will require expanding the range of socioenvironmental factors considered, including mental health outcomes in more of the studies about the association of biomarkers with socioenvironmental factors, and increasing the proportion of studies that assess mental health outcomes in humans.

Secondary inorganic aerosols and aerosol acidity at different PM2.5 pollution levels during winter haze episodes in the Sichuan Basin, China

Wintertime fine particle (PM2.5) pollution remains to be perplexing air quality problems in many parts of China. In this study, PM2.5 compositions and aerosol acidity at different pollution levels at an urban cite in the southwest China's Sichuan Basin were investigated during a sustained winter haze episode. Organic matter was the most abundant component of PM2.5, followed by nitrate, sulfate and ammonium. Shares of organic aerosol in PM2.5 mass decreased with the elevated PM2.5 levels, while the enhancements of sulfate and secondary organic aerosol were much less than that of nitrate and ammonium during heavy pollution with increased ratios of nitrate to sulfate, implying a significant role of nitrate in the haze formation. Results also suggest the nighttime chemistry might contribute substantially to the formation of nitrate under severe pollutions. The daily average aerosol pH showed a decreasing trend with the elevated levels of PM2.5, and this increased aerosl acidity was mainly due to the fast rising secondary inorganic aerosol (SIA) concentration, with the increase in hydronium ion concentration in air (Hair+) surpassing the dilution effect of elevated aerosol liquid water content (LWC). Thermodynamic model calculations revealed that the air environment was NH3-rich with total NHx (NH3 + NH4+) greater than required NHx, and the aerosol pH exponentially declined with the decreasing excess NHx (p < 0.01). This study demonstrated that under air stagnation and NH3-rich environment during winter, the raised relative humidity (RH) would lead to an increase in LWC and thereby facilitate the aqueous chemistry processes with the neutralization capacity of NH3 to form sulfate and nitrate, which would further increase the LWC and lower the pH. This self-amplifying SIA formation might be crucial to the severe PM2.5 pollution and haze events during winter, and therefore cutting both NOx and NH3 emissions would benefit stopping the self-amplification.

Medium-term exposure to size-fractioned particulate matter and asthma exacerbations in China: A longitudinal study of asthmatics with poor medication adherence

BACKGROUND

Studies have shown that short- and long-term exposure to particulate matter (PM) can increase the risk of asthma morbidity and mortality. However, the effect of medium-term exposure remains unknown. We aim to examine the effect of medium-term exposure to size-fractioned PM on asthma exacerbations among asthmatics with poor medication adherence.

METHODS

We conducted a longitudinal study in China based on the National Mobile Asthma Management System Project that specifically and routinely followed asthma exacerbations in asthmatics with poor medication adherence from April 2017 to May 2019. High-resolution satellite remote-sensing data were used to estimate each participant's medium-term exposure (on average 90 days) to size-fractioned PM (PM1, PM2.5, and PM10) based on the residential address and the date of the follow-up when asthma exacerbations (e.g., hospitalizations and emergency room visits) occurred or the end of the follow-up. The Cox proportional hazards model was employed to examine the hazard ratio of asthma exacerbations associated with each PM after controlling for sex, age, BMI, education level, geographic region, and temperature.

RESULTS

Modelling results revealed nonlinear exposure-response associations of asthma exacerbations with medium-term exposure to PM1, PM2.5, and PM10. Specifically, for emergency room visits, we found an increased hazard ratio for PM1 above 22.8 µg/m3 (1.060, 95 % CI: 1.025-1.096, per 1 µg/m3 increase), PM2.5 above 38.2 µg/m3 (1.032, 95 % CI: 1.010-1.054), and PM10 above 78.6 µg/m3 (1.019, 95 % CI: 1.006-1.032). For hospitalizations, we also found an increased hazard ratio for PM1 above 20.3 µg/m3 (1.055, 95 % CI: 1.001-1.111) and PM2.5 above 39.2 µg/m3 (1.038, 95 % CI: 1.003-1.074). Furthermore, the effects of PM were greater for a longer exposure window (90-180 days) and among participants with a high BMI.

CONCLUSION

This study suggests that medium-term exposure to PM is associated with an increased risk of asthma exacerbations in asthmatics with poor medication adherence, with a higher risk from smaller PM.

Cohort profile: China undergraduate cohort for environmental health study

The China Undergraduate Cohort (CUC) is an ambispective cohort study with its major purpose to better understand the effects of lifetime environmental exposures on health outcomes. We recruited 5322 college students with an average age of 18.3 ± 0.7 years in China from August 23, 2019 to October 28, 2019. Follow-up surveys were conducted annually. The dataset comprises individual demographic data (e.g. age, sex, height, weight, birth date, race, home address, annual family income, contact information), health-related behavior data (smoking status, smoking cessation, passive smoking exposure, drinking habit, physical activity, dietary status), lifestyle data (physical exercise, dietary habit, length of time spent outdoors), disease history (respiratory disease history, cardiovascular disease history, urinary system disease history, etc.), mental health status data (sleep quality, self-reported stress, anxiety and depression symptoms), lung function and blood samples data. Preliminary results from our cohort have found the association between air pollution, summer heat and mercury exposure and lung function among young adults in China.

Geographic differences in lung cancer: focus on carcinogens, genetic predisposition, and molecular epidemiology

Lung cancer poses a global health challenge and stands as the leading cause of cancer-related deaths worldwide. However, its incidence, mortality, and characteristics are not uniform across all regions worldwide. Understanding the factors contributing to this diversity is crucial in a prevalent disease where most cases are diagnosed in advanced stages. Hence, prevention and early diagnosis emerge as the most efficient strategies to enhance outcomes. In Western societies, tobacco consumption constitutes the primary risk factor for lung cancer, accounting for up to 90% of cases. In other geographic locations, different significant factors play a fundamental role in disease development, such as individual genetic predisposition, or exposure to other carcinogens such as radon gas, environmental pollution, occupational exposures, or specific infectious diseases. Comprehensive clinical and molecular characterization of lung cancer in recent decades has enabled us to distinguish different subtypes of lung cancer with distinct phenotypes, genotypes, immunogenicity, treatment responses, and survival rates. The ultimate goal is to prevent and individualize lung cancer management in each community and improve patient outcomes.

Short-term exposure to ambient air pollution and injuries due to external causes according to intentions and mechanisms

Although injuries are a leading cause of death and affect the life expectancy of individuals who live with disabilities globally, the potential role of air pollution exposure on injuries due to external causes has received little scientific attention, especially compared with that given to the association of air pollution and non-external causes of morbidity and mortality. We investigated the association between emergency department visits for externally caused injuries and short-term exposure to major ambient air pollutants, with focus on the intentions and mechanisms of injuries. We identified 2,049,855 injured patients in Seoul, South Korea between 2008 and 2016 using the National Emergency Database. Daily short-term exposure to air pollution including particles <10 μm (PM10) and <2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) was estimated based on hourly concentrations. We employed a time-stratified case-crossover study design using a conditional Poisson regression model adjusted for meteorological variables, influenza epidemics, and holidays. Immediate exposure (lag 0) to most pollutants significantly increased the risk of total injuries (PM2.5, 0.42 %; NO2, 0.68 %; SO2, 1.05 %; CO, 0.57 %; O3, 1.86 % per interquartile range increment), and the associations differed according to the intention and mechanism of injury. Unintentional and assault injuries were significantly associated with air pollution exposure, whereas self-harm injuries showed no association. In mechanism-specific analyses, injuries caused by falls, blunt objects, penetration, traffic accidents, machinery, and slips were associated with specific air pollutants, even in the co-pollutant models. The associations were stronger in injured patients aged <15 years, and in males than in their counterparts. Our results suggest that short-term air pollution exposure might play a role in the risk of externally caused injuries and the association may differ depending on the intention and mechanism of injury, which provide important evidence for injury prevention and air quality strategies.

Particulate matter 2.5 causally increased genetic risk of autism spectrum disorder

BACKGROUND

Growing evidence suggested that particulate matter (PM) exhibit an increased risk of autism spectrum disorder (ASD). However, the causal association between PM and ASD risk remains unclear.

METHODS

We performed two-sample Mendelian randomization (MR) analyses, using instrumental variables (IVs) sourced from the largest genome-wide association studies (GWAS) databases. We employed three MR methods: inverse-variance weighted (IVW), weighted median (WM), and MR-Egger, with IVW method serving as our primary MR method. Sensitivity analyses were performed to ensure the stability of these findings.

RESULTS

The MR results suggested that PM2.5 increased the genetic risk of ASD (β = 2.41, OR = 11.13, 95% CI: 2.54-48.76, P < 0.01), and similar result was found for PM2.5 absorbance (β = 1.54, OR = 4.67, 95% CI: 1.21-18.01, P = 0.03). However, no such association was found in PM10 (β = 0.27, OR = 1.30, 95% CI: 0.72-2.36, P = 0.38). After adjusting for the false discovery rate (FDR) correction, our MR results remain consistent. Sensitivity analyses did not find significant heterogeneity or horizontal pleiotropy.

CONCLUSIONS

Our findings indicate that PM2.5 is a potential risk factor for ASD. Effective strategies to mitigate air pollutants might lead to a reduced incidence of ASD.

Disease Burden and Prediction Analysis of Tracheal, Bronchus, and Lung Cancer Attributable to Residential Radon, Solid Fuels, and Particulate Matter Pollution Under Different Sociodemographic Transitions From 1990 to 2030

BACKGROUND

This study investigated the impact of epidemiologic and sociodemographic changes in tracheal, bronchus, and lung cancer associated with residential radon, solid fuels, and particulate matter.

RESEARCH QUESTION

What are the influencing factors of tracheal, bronchus, and lung cancer disease burden attributable to the three pollutants?

STUDY DESIGN AND METHODS

Data were obtained from the Global Burden of Disease 2019. Age-standardized mortality rate (ASMR) and sociodemographic index (SDI) values were collected from 21 regions, and restricted cubic splines and quantile regression were used to investigate the relationship between ASMR or age-standardized disability-adjusted life years rate (ASDR), and SDI. Additionally, five countries with different SDIs were selected, and the Bayesian age-period-cohort model was used to predict the ASMR trends from 2020 to 2030.

RESULTS

High SDI quintiles were associated with increased residential radon pollution. The disease burden attributed to these three pollutants was particularly severe in the middle SDI quintiles. Older adults aged 80 to 89 years had the highest age-specific mortality, and the disease burden was greater in male patients than in female patients with these cancers attributed to the pollutants. The highest ASMR attributable to particulate matter when the SDI was 0.7. As the SDI increased, the disease burden caused by radon increased, whereas the burden caused by solid fuels decreased. Projections have indicated a rise in the death burden in patients with this cancer from particulate pollution in China, India, and Uganda over the next decade.

INTERPRETATION

The disease burden of tracheal, bronchus, and lung cancer attributed to the three pollutants was influenced by SDI, sex, and age. Older men are more susceptible to be affected. More preventive interventions may be required for men at younger ages to reduce the high death burden of older men. However, it is necessary to give due attention to women in specific countries in the future.

Short-term effects of air pollutants on hospital admissions for asthma among older adults: a multi-city time series study in Southwest, China

Background

This study aimed to explore the relationship between air pollution and hospital admissions for asthma in older adults, and to further assess the health and economic burden of asthma admissions attributable to air pollution.

Methods

We collected information on asthma cases in people over 65 years of age from nine cities in Sichuan province, as well as air pollution and meteorological data. The relationship between short-term air pollutant exposure and daily asthma hospitalizations was analyzed using the generalized additive model (GAM), and stratified by gender, age, and season. In addition, we assessed the economic burden of hospitalization for air pollution-related asthma in older adults using the cost of disease approach.

Results

The single pollutant model showed that every 1 mg/m3 increase in CO was linked with an increase in daily hospitalizations for older adults with asthma, with relative risk values of 1.327 (95% CI: 1.116-1.577) at lag7. Each 10 μg/m3 increase in NO2, O3, PM10, PM2.5 and SO2, on asthma hospitalization, with relative risk values of 1.044 (95% CI: 1.011-1.078), 1.018 (95% CI: 1.002-1.034), 1.013 (95% CI: 1.004-1.022), 1.015 (95% CI: 1.003-1.028) and 1.13 (95% CI: 1.041-1.227), respectively. Stratified analysis shows that stronger associations between air pollution and asthma HAs among older adult in females, those aged 65-69 years, and in the warm season, although all of the differences between subgroups did not reach statistical significance. During the study period, the number of asthma hospitalizations attributable to PM2.5, PM10, and NO2 pollution was 764, 581 and 95, respectively, which resulted in a total economic cost of 6.222 million CNY, 4.73 million CNY and 0.776 million CNY, respectively.

Conclusion

This study suggests that short-term exposure to air pollutants is positively associated with an increase in numbers of asthma of people over 65 years of age in Sichuan province, and short-term exposure to excessive PM and NO2 brings health and economic burden to individuals and society.

Climate Change and Human Health in Africa in Relation to Opportunities to Strengthen Mitigating Potential and Adaptive Capacity: Strategies to Inform an African "Brains Trust"

Background

Africa faces diverse and complex population/human health challenges due to climate change. Understanding the health impacts of climate change in Africa in all its complexity is essential for implementing effective strategies and policies to mitigate risks and protect vulnerable populations. This study aimed to outline the major climate change-related health impacts in Africa in the context of economic resilience and to seek solutions and provide strategies to prevent or reduce adverse effects of climate change on human health and well-being in Africa.

Methods

For this narrative review, a literature search was conducted in the Web of Science, Scopus, CAB Abstracts, MEDLINE and EMBASE electronic databases. We also searched the reference lists of retrieved articles for additional records as well as reports. We followed a conceptual framework to ensure all aspects of climate change and health impacts in Africa were identified.

Results

The average temperatures in all six eco-regions of Africa have risen since the early twentieth century, and heat exposure, extreme events, and sea level rise are projected to disproportionately affect Africa, resulting in a larger burden of health impacts than other continents. Given that climate change already poses substantial challenges to African health and well-being, this will necessitate significant effort, financial investment, and dedication to climate change mitigation and adaptation. This review offers African leaders and decision-makers data-driven and action-oriented strategies that will ensure a more resilient healthcare system and safe, healthy populations-in ways that contribute to economic resiliency.

Conclusions

The urgency of climate-health action integrated with sustainable development in Africa cannot be overstated, given the multiple economic gains from reducing current impacts and projected risks of climate change on the continent's population health and well-being. Climate action must be integrated into Africa's development plan to meet the Sustainable Development Goals, protect vulnerable populations from the detrimental effects of climate change, and promote economic development.

A Multi-Modal Deep-Learning Air Quality Prediction Method Based on Multi-Station Time-Series Data and Remote-Sensing Images: Case Study of Beijing and Tianjin

The profound impacts of severe air pollution on human health, ecological balance, and economic stability are undeniable. Precise air quality forecasting stands as a crucial necessity, enabling governmental bodies and vulnerable communities to proactively take essential measures to reduce exposure to detrimental pollutants. Previous research has primarily focused on predicting air quality using only time-series data. However, the importance of remote-sensing image data has received limited attention. This paper proposes a new multi-modal deep-learning model, Res-GCN, which integrates high spatial resolution remote-sensing images and time-series air quality data from multiple stations to forecast future air quality. Res-GCN employs two deep-learning networks, one utilizing the residual network to extract hidden visual information from remote-sensing images, and another using a dynamic spatio-temporal graph convolution network to capture spatio-temporal information from time-series data. By extracting features from two different modalities, improved predictive performance can be achieved. To demonstrate the effectiveness of the proposed model, experiments were conducted on two real-world datasets. The results show that the Res-GCN model effectively extracts multi-modal features, significantly enhancing the accuracy of multi-step predictions. Compared to the best-performing baseline model, the multi-step prediction's mean absolute error, root mean square error, and mean absolute percentage error increased by approximately 6%, 7%, and 7%, respectively.

Association of ambient air pollution and pregnancy rate among women undergoing assisted reproduction technology in Fujian, China: A retrospective cohort study

BACKGROUND

Previous studies have reported the impact of ambient air pollutants on assisted reproduction. They concentrated on highly polluted environments and individual pollutants. It is unclear whether these effects continue at lower levels and as mixed effects. We aimed to study the influence of lower pollutant concentrations on pregnancy rates and identify vulnerable populations.

METHODS

We conducted a retrospective cohort study involving 9465 patients with infertility who received treatment from a local hospital between 2015 and 2021. Daily average levels of six pollutants (PM2.5, PM10, NO2, CO, SO2, and O3) were collected from air quality monitoring stations. We employed generalized linear regression models (logistic, linear, and lasso), weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) to assess the impact of pollutants on pregnancy rates. Additionally, stratified analyses were performed to identify potentially vulnerable populations.

RESULTS

Findings from the generalized linear models revealed a significant negative correlation between interquartile range increment exposure to PM2.5 (OR = 1.17, 95 % CI = 1.09-1.26), PM10 (OR = 1.18, 95 % CI = 1.11-1.26), NO2 (OR = 1.21, 95 % CI = 1.13-1.30), CO (OR = 1.02, 95 % CI = 1.00-1.03), SO2 (OR = 1.11, 95 % CI = 1.05-1.17) and pregnancy rate when considering the effects of individual pollutants. The WQS index exhibited a negative correlation with pregnancy rates and the number of oocytes retrieved (aOR = 1.20, 95 % CI = 1.08-1.34). BKMR analyses indicated an overall significant trend of decreasing pregnancy rates as pollutant concentrations increased across percentiles. Stratified analysis unveiled heightened sensitivity to pollutants among individuals aged ≥35 years.

CONCLUSIONS

By comparing results obtained from diverse models, we observed that exposure to lower levels of air pollutants led to decreased pregnancy rates. Notably, PM10, NO2, SO2, and CO emerged as the four most prominent pollutants in this context. Moreover, stratified analyses highlighted that individuals aged ≥35 years exhibited heightened susceptibility to pollutants.

Decoupling livestock and poultry pollution emissions from industrial development: A step towards reducing environmental emissions

China has implemented policies like Leading areas for Agricultural Green Development (LAGD) to mitigate livestock and poultry farming pollution while promoting industry growth. However, it remains uncertain whether LAGDs have successfully balanced emission reduction with stable development. This study examines 165 LAGDs to analyze changes in emissions, assess the decoupling of emission reduction from output value, and identify influencing factors. Findings reveal that emissions from livestock and poultry in LAGDs initially increased and then decreased between 2010 and 2019. Cattle were responsible for over 40% of fecal emissions, and pigs for more than 20%. Additionally, pigs contributed to over 61% of urine emissions. From 2010 to 2014, increases in chemical oxygen demand were mainly due to pigs and cattle. Total nitrogen levels were significantly impacted by cattle, while pigs were affected by total phosphorus. From 2014 to 2019, reductions in emissions were largely attributed to a decrease in pig-related pollutants. The decoupling status shifted from strong to weak and then back to strong between 2014 and 2019. Production efficiency played a crucial role in reducing emissions, while changes in industrial structure moved from supporting to hindering this reduction. Economic development was a primary factor in driving these changes. Standard emissions in Chinese regions showed a rising and then declining trend from 2010 to 2019. The Northeast and Northwest regions of China demonstrated emission trends that were in sync with the growth in rural income. This study offers insights into the successes and challenges of LAGDs in achieving a balance between reduced emissions and development, using quantitative analysis. The findings are instrumental in informing policies for a sustainable livestock and poultry industry. Recommendations include evaluating coordinated approaches to pollution reduction and industrial growth, setting decoupling goals, designing policies based on influential factors, conducting regional assessments of livestock and poultry demand, and implementing region-specific strategies.

Association of fine particulate matter (PM2.5) exposure and chronic kidney disease outcomes: a systematic review and meta-analysis

Several studies have reported an increased risk of chronic kidney disease (CKD) outcomes after long-term exposure (more than 1 year) to particulate matter with an aerodynamic diameter of ≤ 2.5 µm (PM2.5). However, the conclusions remain inconsistent. Therefore, we conducted this meta-analysis to examine the association between long-term PM2.5 exposure and CKD outcomes. A literature search was conducted in PubMed, Scopus, Cochrane Central Register of Controlled trials, and Embase for relevant studies published until August 10, 2023. The main outcomes were incidence and prevalence of CKD as well as incidence of end-stage kidney disease (ESKD). The random-effect model meta-analyses were used to estimate the risk of each outcome among studies. Twenty two studies were identified, including 14 cohort studies, and 8 cross-sectional studies, with a total of 7,967,388 participants. This meta-analysis revealed that each 10 μg/m3 increment in PM2.5 was significantly associated with increased risks of both incidence and prevalence of CKD [adjusted odds ratio (OR) 1.31 (95% confidence interval (CI) 1.24 to 1.40), adjusted OR 1.31 (95% CI 1.03 to 1.67), respectively]. In addition, the relationship with ESKD incidence is suggestive of increased risk but not conclusive (adjusted OR 1.16; 95% CI 1.00 to 1.36). The incidence and prevalence of CKD outcomes had a consistent association across all subgroups and adjustment variables. Our study observed an association between long-term PM2.5 exposure and the risks of CKD. However, more dedicated studies are required to show causation that warrants urgent action on PM2.5 to mitigate the global burden of CKD.

The impact of fine particulate matter on chronic obstructive pulmonary disease deaths in Pudong New Area, Shanghai, during a long period of air quality improvement

Chronic obstructive pulmonary disease (COPD) deaths attributed to fine particulate matter (with an aerodynamic equivalent diameter <2.5 μm, PM2.5) exposure are a common global public health concern. Recent improvements in air quality and the corresponding health benefits have received much attention. Thus, we have explored the trends of PM2.5 pollution improvement on COPD deaths during an important period of air pollution control (2008-2017) in Pudong New Area, Shanghai, China. Data, including daily COPD death counts, meteorological variables, and ambient air pollutants, were collected from 2008 to 2017. Generalized additive models were fitted to evaluate the percent change (%) in pollution-related COPD deaths. The results showed that the number of days with daily PM2.5 concentrations <35 μg/m3 increased from 19 days (5.19%) in 2008 to 166 days (45.48%) in 2017, and PM2.5 concentrations >75 μg/m3 decreased from 222 days (60.66%) in 2008 to 33 days (9.04%) in 2017. The associations in the overall period between 2008 and 2017 was significant. In subperiod analysis, each 10 μg/m3 increment in PM2.5 was associated with a percent change (%) of 0.89 (95% confidence interval [CI], 0.37, 1.42) at lag 5 and 0.78 (95% CI, 0.26, 1.30) at lag 6 during 2008-2013. Significant results were also found at lag 0-5 [percent change (%), 1.12 (95% CI, 0.09, 2.17)], lag 0-6 [percent change (%), 1.52 (95% CI, 0.43, 2.62)] and lag 0-7 [percent change (%), 1.72 (95% CI, 0.57, 2.88)] during 2008-2013. By contrast, no significant association was found between 2014 and 2017. In conclusion, the decreased COPD deaths associated with PM2.5 exposure were found, especially after the air quality improvement turning point in 2014.

Endoplasmic reticulum stress mediates environmental particle-induced inflammatory response in bronchial epithelium

While the detailed mechanisms for how particulate matter (PM) causes adverse health effects in the lungs remain largely unknown, endoplasmic reticulum (ER) stress has been implicated in PM-induced lung injury. The present study was undertaken to examine how/if ER stress might regulate PM-induced inflammation, and to begin to define potential underlying molecular mechanisms. Here, ER stress hallmarks were examined in human bronchial epithelial (HBE) cells exposed to PM. To confirm roles of certain pathways, siRNA targeting ER stress genes and an ER stress inhibitor were employed. Expression of select inflammatory cytokines and related signaling pathway components by the cells were assessed as well. The results showed that PM exposure induced elevations in two ER stress hallmarks, i.e. GRP78 and IRE1α, in time-and/or dose-related manners in the HBE cells. Inhibition of ER stress by siRNA for GRP78 or IRE1α significantly alleviated the PM-induced effects. Further, ER stress appeared to regulate PM-induced inflammation - likely through downstream autophagy and NF-κB pathways - as implied by studies showing that inhibition of ER stress by siRNA of GRP78 or IRE1α caused significant amelioration of PM-induced autophagy and subsequent activation of NF-κB pathways. Moreover, the ER stress inhibitor 4-PBA were used to confirm the protective effects against PM-induced outcomes. Together, the results suggest ER stress plays a deleterious role in PM-induced airway inflammation, possibly through activation of autophagy and NF-κB signaling. Accordingly, protocols/treatments that could lead to inhibited ER stress could potentially be effective for treatment of PM-related airway disorders.

Ambient carbon monoxide and relative risk of daily hospital outpatient visits for respiratory diseases in Lanzhou, China

At present, evidence of the associations between carbon monoxide (CO) and respiratory diseases (RD) in Northwest China is limited and controversial. The aim of this study is to evaluate the impact of ambient CO on outpatient visits for RD in Lanzhou, China. The daily amount of outpatient visits for total and cause-specific RD, air pollutant, and weather variables were collected in Lanzhou, China from 1st January 2013 to 31st December 2019. A generalized additive model and distributed lag nonlinear model were used to assess associations between CO and outpatient visits for RD. During the study period, a total of 1,623,361 RD outpatient visits were recorded. For each interquartile range (IQR) (0.77 mg/m3) increase in CO, the relative risk (RR) was 1.163 (95% CI: 1.138, 1.188) for total RD at lag07, 1.153 (95% CI: 1.128,1.179) for upper respiratory tract infection (URTI) at lag07, 1.379 (95% CI: 1.338,1.422) for pneumonia at lag07, 1.029 (95% CI: 0.997,1.062) for chronic obstructive pulmonary disease (COPD) lag04, 1.068 (95% CI: 1.028,1.110) for asthma lag03, and 1.212 (95% CI: 1.178,1.247) for bronchitis lag07, respectively. In the subgroup analyses, the impacts of CO were more pronounced on total RD, pneumonia, COPD, and bronchitis in males than females, while the opposite was true in URTI and asthma. The impact of CO on RD was the strongest for children under 15 years-of-age. We also found significantly stronger effects during cold seasons compared to warm seasons. In addition, we observed a roughly linear exposure-response curve between CO and RD with no threshold effect. This study in Lanzhou revealed a remarkable association between CO level and an elevated risk of total and cause-specific RD outpatient visits, especially for pneumonia.

Glucocorticoids alleviate particulate matter-induced COX-2 expression and mitochondrial dysfunction through the Bcl-2/GR complex in A549 cells

Exposure to particulate matter (PM) causes mitochondrial dysfunction and lung inflammation. The cyclooxygenase-2 (COX-2) pathway is important for inflammation and mitochondrial function. However, the mechanisms by which glucocorticoid receptors (GRs) suppress COX-2 expression during PM exposure have not been elucidated yet. Hence, we examined the mechanisms underlying the dexamethasone-mediated suppression of the PM-induced COX-2/prostaglandin E2 (PGE2) pathway in A549 cells. The PM-induced increase in COX-2 protein, mRNA, and promoter activity was suppressed by glucocorticoids; this effect of glucocorticoids was antagonized by the GR antagonist RU486. COX-2 induction was correlated with the ability of PM to increase reactive oxygen species (ROS) levels. Consistent with this, antioxidant treatment significantly abolished COX-2 induction, suggesting that ROS is involved in PM-mediated COX-2 induction. We also observed a low mitochondrial membrane potential in PM-treated A549 cells, which was reversed by dexamethasone. Moreover, glucocorticoids significantly enhanced Bcl-2/GR complex formation in PM-treated A549 cells. Glucocorticoids regulate the PM-exposed induction of COX-2 expression and mitochondrial dysfunction and increase the interaction between GR and Bcl-2. These findings suggest that the COX-2/PGE2 pathway and the interaction between GR and Bcl-2 are potential key therapeutic targets for the suppression of inflammation under PM exposure.

Cost-benefits analysis of ultra-low emissions standard on air quality and health impact in thermal power plants in China

As China's largest energy infrastructure, thermal power plant consumed approximately half of China's coal over the past decade and threatened air quality, human health and socioeconomic development. Thus, a series of control policies have been implemented to alleviate those impacts in China. Particularly, China has witnessed unprecedented declines in air pollutant emissions from thermal power plants since the ultra-low emissions (ULE) standards were implemented. In contrast, the effect of the ULE policy on air quality, health and cost benefits remains poorly understood. Therefore, this study estimates the improved air quality and associated health and economic benefits under the ULE standards in the thermal power sector by using a measure-specific approach, combining a bottom-up emission inventory, an atmospheric model, a health assessment model and a cost analysis model. The results show that all the control measures lead to reduced air pollution, and renovating pre-existing units (RPU) is the most effective. Compared to without implementing the ULE policy, the population-weighted average PM2.5 and O3 concentrations decreased by 1.50 μg/m3 and 0.87 ppm, and 67,831 premature deaths could be avoided nationally. Furthermore, the results also show the net economic benefits of combining health benefits and costs due to control measures are 109.92 billion Yuan (in 2015 value) in China. The comprehensive results reveal that the health benefits outweigh the direct policy. Based on these empirical findings and the specific circumstances of China, we suggest that RPU should be further promoted to the entire of China, and if necessary, establish a long-term compensation mechanism for inter-provincial interests and institute and enforce comprehensive policies that carefully consider the health impacts of policies. This study provides strong arguments for China's policy-making and considering tightening emission standards for thermal power plants worldwide.

ATM participates in fine particulate matter-induced airway inflammation through regulating DNA damage and DNA damage response

The relationship between fine particulate matter (PM2.5) and chronic airway inflammatory diseases, such as chronic obstructive pulmonary disease and asthma, have garnered public attention, while the detailed mechanisms of PM2.5-induced airway inflammation remain unclear. This study reveals that PM2.5 induces airway inflammation both in vivo and in vitro, and, moreover, identifies DNA damage and DNA damage repair (DDR) as results of this exposure. Ataxia telangiectasia-mutated heterozygous (ATM+/- ) and wild-type C57BL/6 (WT) mice were exposed to PM2.5. The results show that, following exposure to PM2.5, the number of neutrophils in broncho alveolar lavage fluid and the mRNA expression of CXCL-1 in lung tissues of the ATM+/- mice were lower than those of the WT mice. The mRNA expression of FANCD2 and FANCI were also down-regulated. Human bronchial epithelial (HBE) cells were transfected with ATM-siRNA to induce down-regulation of ATM gene expression and were subsequently stimulated with PM2.5. The results show that the mRNA expression of TNF-α decreased in the ATM-siRNA-transfected cells. The mRNA expression of CXCL-1 and CXCL-2 in peritoneal macrophages, derived from ATM-null mice in which experiments showed that the protein expression of FANCD2 and FANCI decreased, were also decreased after PM2.5 exposure in ATM-siRNA-transfected HBE cells. In conclusion, PM2.5-induced airway inflammation is alleviated in ATM+/- mice compared with WT mice. ATM promotes PM2.5-induced airway inflammation, which may be attributed to the regulation of DNA damage and DDR.

Early-immune development in asthma: A review of the literature

This review presents a comprehensive examination of the various factors contributing to the immunopathogenesis of asthma from the prenatal to preschool period. We focus on the contributions of genetic and environmental components as well as the role of the nasal and gut microbiome on immune development. Predisposing genetic factors, including inherited genes associated with increased susceptibility to asthma, are discussed alongside environmental factors such as respiratory viruses and pollutant exposure, which can trigger or exacerbate asthma symptoms. Furthermore, the intricate interplay between the nasal and gut microbiome and the immune system is explored, emphasizing their influence on allergic immune development and response to environmental stimuli. This body of literature underscores the necessity of a comprehensive approach to comprehend and manage asthma, as it emphasizes the interactions of multiple factors in immune development and disease progression.

Environmental pollutants increase the risks of acute exacerbation in patients with chronic airway disease

Objective

Respiratory infections are a common cause of acute exacerbations in patients with chronic airway disease, however, environmental factors such as air pollution can also contribute to these exacerbations. The study aimed to determine the correlation between pollutant levels and exacerbation risks in areas exposed to environmental pollution sources.

Methods

From 2015 to 2016, a total of 788 patients with chronic airway diseases were enrolled in a study. Their medical records, including hospital visits due to acute exacerbations of varying severity were analyzed. Additionally, data on daily pollutant levels from the Air Quality Monitoring Network from 2014 to 2016 was also collected and analyzed.

Results

Patients with chronic airway disease and poor lung function (FEV1 < 50% or obstructive ventilatory defect) have a higher risk of severe acute exacerbations and are more likely to experience more than two severe acute exacerbations within a year. The study found that in areas exposed to environmental pollution sources, there is a significant correlation between NO2, O3, and humidity with the main causes of severe acute exacerbation. When the levels of NO2 were higher than 16.65 ppb, O3 higher than 35.65 ppb, or humidity higher than 76.95%, the risk of severe acute exacerbation in patients with chronic airway disease increased.

Conclusion

Acute exacerbations of chronic airway disease can be triggered by both the underlying disease state and the presence of air pollution. Computer simulations and early warning systems should be developed to predict acute exacerbations of chronic airway disease based on dynamic changes in air pollution.

Relationship Between Outdoor Air Pollutant Exposure and Premature Delivery in China- Systematic Review and Meta-Analysis

Objective: Preterm birth (PTB) is considered as a public health problem and one of the main risk factors related to the global disease burden. The purpose of this study aims to explore the influence of exposure to major air pollutants at different pregnancies on PTB. Methods: The relationship between air pollutants and PTB in China was collected from cohort studies and case-control studies published before 30 April 2022. Meta-analysis was carried out with STATA 15.0 software. Results: A total of 2,115 papers were retrieved, of which 18 papers met the inclusion criteria. The comprehensive effect of pollutant exposure and PTB were calculated. PM2.5 during entire pregnancy and O3 exposure during third trimester were positively associated with preterm birth. Every 10 μg/m3 increase in the average concentration of PM2.5 during the whole pregnancy will increase the risk of premature delivery by 4%, and every 10 μg/m3 increase in the average concentration of O3 in the third trimester will increase the risk of premature delivery by 1%. Conclusion: Exposure to PM2.5 entire prenatal pregnancy and O3 in third trimester is associated with an increased risk of preterm birth occurrence.

Low-level ambient sulfur dioxide exposure and genetic susceptibility associated with incidence of idiopathic pulmonary fibrosis: A national prospective cohort study

BACKGROUND

The association between long-term air pollution exposure and the development of idiopathic pulmonary fibrosis (IPF) has been established, but the evidence regarding the effect of low levels of air pollution, especially ambient sulfur dioxide (SO2), is limited. Besides, the combined effect and interaction between genetic susceptibility and ambient SO2 on IPF remain uncertain.

METHODS

This study retrieved data from 402,042 participants who were free of IPF at baseline in the UK Biobank. The annual mean concentration of ambient SO2 was estimated for each participant based on their residential addresses using a bilinear interpolation method. Cox proportional hazard models were used to examine the relationship between ambient SO2 and incident IPF. We further generated a polygenic risk score (PRS) for IPF and estimated the combined effects of genetic susceptibility and ambient SO2 on incident IPF.

RESULTS

After a median follow-up of 11.78 years, 2562 cases of IPF were identified. The results indicated that each 1 μg/m3 increase in ambient SO2 was associated with a hazard ratio (HR) (95% confidence interval [CI]) of 1.67 (1.58, 1.76) for incident IPF. The study found statistically significant synergistic additive interaction between genetic susceptibility and ambient SO2. Individuals with high genetic risk and high ambient SO2 exposure had a higher risk of developing IPF (HR = 7.48, 95% CI:5.66, 9.90).

CONCLUSION

The study suggests that long-term exposure to ambient SO2, even at concentrations lower than current air quality guidelines set by the Word Health Organization and European Union, may be an important risk factor for IPF. This risk is more pronounced among people with a high genetic risk. Therefore, these findings emphasize the need to consider the potential health effects of SO2 exposure and the necessity for stricter air quality standards.

Global Chronic obstructive pulmonary disease burden attributable to air pollution from 1990 to 2019

BACKGROUND

The disease burden attributable to chronic obstructive pulmonary disease (COPD) is significant worldwide. Some studies have linked exposure to air pollution to COPD, but there has been little research on this.

METHODS

We aimed to assess the COPD-related disease burden attributable to air pollution from multiple epidemiological perspectives. This study conducted a three-stage analysis. Firstly, we reported on the burden of disease worldwide in 2019 by different subgroups including sex, age, region, and country. Secondly, we studied the trends in disease burden from 1990 to 2019. Finally, we explored the association of some national indicators with disease burden to look for risk factors.

RESULTS

In 2019, the death number of COPD associated with air pollution accounted for 2.32% of the total global death, and the number of DALY accounted for 1.12% of the global DALY. From 1990 to 2019, the death number of COPD associated with air pollution increased peaked at 1.41 million in 1993, fluctuated, and then declined. We found the same temporal pattern of DALY. The corresponding age-standardized rates had been falling. At the same time, the burden of COPD associated with air pollution was also affected by some national indicators.

CONCLUSIONS

This study indicated that air pollution-related COPD contributed to a significant global disease burden. We called for health policymakers to take action and interventions targeting vulnerable countries and susceptible populations.

The impact of ambient air pollutants on childhood respiratory system disease and the resulting disease burden: a time-series study

PURPOSE

The effects of air pollution on human health have long been a hot topic of research. For respiratory diseases, a large number of studies have proved that air pollution is one of the main causes. The purpose of this study was to investigate the risk of hospitalization of children with respiratory system diseases (CRSD) caused by six pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) in Hefei City, and further calculate the disease burden.

METHOD

In the first stage, the generalized additive models were combined with the distributed lag non-linear models to evaluate the impact of air pollution on the inpatients for CRSD in Hefei. In the second stage, this study used the cost-of-illness approach to calculate the attributable number of hospitalizations and the extra disease burden.

RESULT

Overall, all the six kinds of pollutants had the strongest effects on CRSD inpatients within lag10 days. SO2 and CO caused the highest and lowest harm, respectively, and the RR values were SO2 (lag0-5): 1.1 20 (1.053, 1.191), and CO (lag0-6): 1.002 (1.001, 1.003). During the study period (January 1, 2014 to December 30, 2020), the 7-year cumulative burden of disease was 36.19 million CNY under the WHO air pollution standards.

CONCLUSION

In general, we found that six air pollutants were risk factors for CRSD in Hefei City, and create a huge burden of disease.

The impact of the air pollution on health in New York City

New York City is attempting to find a solution to an issue that many states and cities face: how to minimize air pollution so that it has fewer negative impacts on human health. Despite having the highest population in the United States (US), New York City typically has reasonably clean air. As the City and State of New York have worked to reduce emissions from local and regional sources, the air quality in New York City has improved during the past few decades. Despite these advancements, air pollution still poses a severe hazard to the health of everyone living in New York's environment. Various diseases including respiratory, circulatory, neurological, gastrointestinal, and urinary illnesses, which can be fatal, are intimately associated with air pollution. This review article will concentrate on how air pollution affects respiratory diseases such as asthma in children. In addition to analyzing the severe effects of air pollution on the vulnerable population, this review article will highlight the health repercussions of air pollution on New York City and its residents. furthermore, we argue for potential ideas and discoveries while also putting up a policy option to lower air pollution.

Ozone Pollution and Acute Exacerbation of Asthma in Residents of China: An Ecological Study

Purpose

The evidence for a causal relationship between high-level ozone (O3) exposure and acute exacerbation of asthma among adults is limited, and the conclusions are less definitive.

Patients and methods

Here we collected the daily data on asthma cases, O3 exposure, and meteorological factors from 2010 to 2016 in Shijiazhuang, China. We investigated the risk of asthma exacerbation associated with high-level ozone exposure using a polynomial distributed lag model (PDLM). Using a generalized additive model (GAM), we estimated the interactive effects between O3 and other pollutants as well as meteorological factors on asthma exacerbation.

Results

A total of 7270 patients with asthma were enrolled from 22 governmental hospitals in 13 counties. Each 10 μg/m3 increase in O3 concentration on the exacerbation of asthma was associated with a 1.92% (95% CI = 0.80-3.03%) higher risk of asthma exacerbation on day lag 7. The cumulative risk of O3 on asthma exacerbation increased by 18.9% (95% CI = 12.8-25.4%) on the 14th day. High consecutive levels of O3 increase the risk of asthma exacerbation, and the interactive effect of O3 and sulfur dioxide (SO2) appears before the exacerbation onset.

Conclusion

These findings suggested that O3 should be an important risk factor for asthma exacerbation, and health benefits in reducing asthma exacerbation risk would be gained with continued efforts to improve the air quality in China.

Asymmetric effects of fine particulate matter and stringency policy on COVID-19 intensity

This study aims to examine the influence of environmental performance (PM2.5) on COVID-19 intensity . For this purpose, we employ the newly introduced Hidden Panel Cointegration test and Nonlinear Panel Autoregressive Distributed Lag model. Results indicate the asymmetric linkages between PM2.5 and COVID-19 intensity, as the positive shock in PM2.5 raises the COVID-19 intensity by 21%, whereas the negative shock in PM2.5 decreases COVID-19 intensity by 12% in long-run. On the contrary, the positive shock in stringency measures decreases COVID-19 intensity by 42.8%, while the negative shock in stringency policy increases COVID-19 intensity by 66.7%. These findings imply that higher pollution increases the COVID-19 severity while higher stringency measures slow down people's movement and reduce COVID-19 intensity. However, a sudden negative shock in lockdown increases people's interaction, leading to a higher spread of the virus. These results suggest that governments should adopt stringent action plans to contain the transmissibility of COVID-19.

Association of genetic polymorphisms with mercapturic acids in the urine of young healthy subjects before and after exposure to outdoor air pollution

We aimed to identify the relationship between variations in metabolic genes and human urinary changes in mercapturic acids (MAs), including CEMA, HMPMA, SPMA, HPMA and HEMA, before and after air pollution exposure. Genotype detection for 47 relevant single nucleotide polymorphisms (SNPs) collected by literature research was performed. Five MAs expression levels in the urinary samples of 50 young healthy individuals with short-term exposure to clean, polluted and purified air at five time points were detected by targeted online solid-phase extraction liquid chromatography tandem mass spectrometry (SPE-LC-MS/MS), followed with associations of SNPs with MAs changes. Difference in MAs between polluted and clean/purified air was significantly associated with 21 SNPs mapped into 9 genes. Five SNPs in GSTP1 showed the most prominent association with the changes in SPMA expression, indicating that those SNPs in GSTP1 and SPMA might serve as biomarkers for susceptibility and the prognosis of lung cancer.

Leisure-time physical activity mitigated the cognitive effect of PM2.5 and PM2.5 components exposure: Evidence from a nationwide longitudinal study

BACKGROUND

Exposure to fine particulate matter (PM2.5) impairs cognition, while physical activity (PA) improves cognitive function. However, whether taking PA with PM2.5 exposure is still beneficial to cognition remains unknown.

METHODS

We utilized national representative longitudinal data from the China Family Panel Study (CFPS), comprising a total sample of 108,099 from 2010 to 2018 in three waves. Cognitive performance and leisure-time PA were measured using the standard cognitive module and Godin-Shephard Leisure-Time Physical Activity Questionnaire. Gridded overall PM2.5 and major chemical components of PM2.5 were estimated using a two-stage machine learning model and matched to each participant based on their residential location. Mixed-effect models and difference-in-difference models were employed to investigate the individual and joint effects of total PM2.5, PM2.5 components, and leisure-time PA on cognition.

RESULTS

Every 1 μg/m3 increase in PM2.5 was associated with a -0.035 (95% confidence interval [CI] = -0.052, -0.018) point change in cognitive score. All PM2.5 components exhibited negative associations with cognitive change, with black carbon (BC) contributing the most significant cognitive decline (β = -1.025, 95% CI = -1.367, -0.683). Every one-time (or one-hour) increase in leisure-time PA frequency (or PA time) per week was associated with an increase in cognitive score by 0.576 (0.270) points (PA frequency: 95% CI = 0.544, 0.608, PA time: 95% CI = 0.248, 0.293). PA frequency (β = -0.005, 95% CI = -0.006, -0.003) and PA time (β = -0.002, 95% CI = -0.003, -0.001) exhibited interactive effects with PM2.5. Increased PA frequency and time were more beneficial to cognitive function in the low PM2.5 exposure group compared to those exposed to high PM2.5 levels. Moreover, relative to lower PM2.5 exposure, the cognitive benefits of physically active individuals with higher PM2.5 exposure were attenuated but still improved cognition when compared to those with no PA.

CONCLUSION

Engaging in leisure-time PA provides cognitive benefits even under PM2.5 exposure, although PM2.5 exposure attenuates these benefits. Among all PM2.5 components, BC demonstrated the most significant cognitive hazard and interaction with leisure-time PA. Promoting PA as a preventive measure may offer a cost-effective and convenient strategy to mitigate the negative impact of PM2.5 exposure on cognition. There is no excuse to avoid PA under PM2.5 exposure, as its cognitive benefits persist even in polluted environments.