Short-term air pollution, cognitive performance and nonsteroidal anti-inflammatory drug use in the Veterans Affairs Normative Aging Study

Impact of fine particulate matter on latent tuberculosis infection and active tuberculosis in older adults: a population-based multicentre cohort study

Evidence showed that air pollution was associated with an increased risk of tuberculosis (TB). This study aimed to study the impact of long-term exposure to ambient particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) on the acquisition of LTBI and on the risk of subsequent active disease development among rural older adults from a multicentre cohort, which have not yet been investigated to date. A total of 4790 older adults were included in a population-based, multicentre, prospective cohort study (LATENTTB-NSTM) from 2013 to 2018. The level of long-term exposure to PM2.5 for each participant was assessed by aggregating satellite-based estimates. Logistic regression and time-varying Cox proportional hazards models with province-level random intercepts were employed to assess associations of long-term exposures to PM2.5 with the risk of LTBI and subsequent development of active TB, respectively. Out of 4790 participants, 3284 were LTBI-free at baseline, among whom 2806 completed the one-year follow-up and 127 developed newly identified LTBI. No significant associations were identified between PM2.5 and the risk of LTBI. And among 1506 participants with LTBI at baseline, 30 active TB cases were recorded during the 5-year follow-up. Particularly, an increment of 5 μg/m3 in 2-year moving averaged PM2.5 was associated with a 50.6% increased risk of active TB (HR = 1.506, 95% CI: 1.161-1.955). Long-term air pollution might be a neglected risk factor for active TB development from LTBI, especially for those living in developing or less-developed areas where the air quality is poor.

Short-Term PM2.5 Exposure and DNA Methylation Changes of Circadian Rhythm Genes: Evidence from Two Experimental Studies

The circadian rhythm regulates many crucial physiological processes, impacting human aging and aging-related outcomes. Observational evidence links circadian rhythm disturbance to PM2.5 exposure, yet the underlying DNA methylation mechanisms remain unclear due to limited PM2.5-dominated experimental settings. Therefore, we investigated the associations between short-term PM2.5 exposure and DNA methylation changes of 1188 CpG candidates across circadian genes among 32 young adults in the FDU study, with the validation in 26 individuals from the PKU study. Further mediation analyses tested whether DNA methylation of circadian genes could mediate the influence of PM2.5 on aging measured by three epigenetic ages: DNAmGrimAge, DunedinPoAm, and the mortality risk score. We identified three CpG sites associated with personal PM2.5 exposure: cg01248361 (CSNK2A2), cg17728065 (RORA), and cg22513396 (PRKAG2). Acute effects of PM2.5 on the three loci could be mediated by several circulating biomarkers, including MDA and EGF, with up to ∼30% of mediated proportions. Three loci further showed varying potentials in mediating the aging acceleration effect of PM2.5. Locus cg17728065 is the key site exhibiting a robust mediating effect (7.54-12.52%) on PM2.5-induced aging acceleration. Our findings demonstrated that PM2.5, even short-term peaks, could leave imprints on human aging via inducing aberrant temporal fluctuation in circadian homeostasis captured by DNA methylation profiles.

Particulate matter pollution, polygenic risk score and mosaic loss of chromosome Y in middle-aged and older men from the Dongfeng-Tongji cohort study

Mosaic loss of chromosome Y (mLOY) is the most common somatic alteration as men aging and may reflect genome instability. PM exposure is a major health concern worldwide, but its effects with genetic factors on mLOY has never been investigated. Here we explored the associations of PM2.5 and PM10 exposure with mLOY of 10,158 males measured via signal intensity of 2186 probes in male-specific chromosome-Y region from Illumina array data. The interactive and joint effects of PM2.5 and PM10 with genetic factors and smoking on mLOY were further evaluated. Compared with the lowest tertiles of PM2.5 levels in each exposure window, the highest tertiles in the same day, 7-, 14-, 21-, and 28-day showed a 0.005, 0.006, 0.007, 0.007, and 0.006 decrease in mLRR-Y, respectively (all P < 0.05), with adjustment for age, BMI, smoking pack-years, alcohol drinking status, physical activity, education levels, season of blood draw, and experimental batch. Such adverse effects were also observed in PM10-mLOY associations. Moreover, the unweighted and weighted PRS presented significant negative associations with mLRR-Y (both P < 0.001). Participants with high PRS and high PM2.5 or PM10 exposure in the 28-day separately showed a 0.018 or 0.019 lower mLRR-Y level [β (95 %CI) = -0.018 (-0.023, -0.012) and - 0.019 (-0.025, -0.014), respectively, both P < 0.001], when compared to those with low PRS and low PM2.5 or PM10 exposure. We also observed joint effects of PM with smoking on exacerbated mLOY. This large study is the first to elucidate the impacts of PM2.5 exposure on mLOY, and provides key evidence regarding the interactive and joint effects of PM with genetic factors on mLOY, which may promote understanding of mLOY development, further modifying and increasing healthy aging in males.

Characterizing Neighborhood Vulnerabilities in Mild Cognitive Impairment using the Environmental Justice Index

Background

There is a need for integration and comprehensive characterization of environmental determinants of Alzheimer's disease. The Environmental Justice Index (EJI) is a new measure that consolidates multiple environmental health hazards.

Objective

This analysis aims to explore how environmental vulnerabilities vary by race/ethnicity and whether they predict cognitive outcomes in a clinical trial of mild cognitive impairment (MCI).

Methods

We used data from a clinical trial of 107 MCI participants (28% minorities). Using the EJI, we extracted 40 measures of neighborhood environmental and social vulnerability including air and water pollution, access to recreational spaces, exposure to coal and lead mines, and area poverty. We also examined the relationship of the EJI to the Area Deprivation Index (ADI). Data was analyzed using regressions, correlations, and t-tests.

Results

Environmental Burden Rank (EBR) across the sample (0.53±0.32) was near the 50th percentile nationally. When divided by race/ethnicity, environmental (p = 0.025) and social (p < 0.0001) vulnerabilities were significantly elevated for minorities, specifically for exposure to ozone, diesel particulate matter, carcinogenic air toxins, and proximity to treatment storage and disposal sites. ADI state decile was not correlated with the EBR. Neither EBR nor ADI were a significant predictor of cognitive decline.

Conclusions

To our knowledge, this is the first study to link the EJI to an MCI trial. Despite limitations of a relatively small sample size, the study illustrates the potential of the EJI to provide deeper phenotyping of the exposome and diversity in clinical trial subjects.

Reducing Indoor Particulate Air Pollution Improves Student Test Scores: A Randomized Double-Blind Crossover Study

Short-term exposure to air pollution is associated with a decline in cognitive function. Standardized test scores have been employed to evaluate the effects of air pollution exposure on cognitive performance. Few studies aimed to prove whether air pollution is responsible for reduced test scores; none have implemented a "gold-standard" method for assessing the association such as a randomized, double-blind intervention. This study used a "gold-standard" method─randomized, double-blind crossover─to assess whether reducing short-term indoor particle concentrations results in improved test scores in college students in Tianjin, China. Participants (n = 162) were randomly assigned to one of two similar classrooms and completed a standardized English test on two consecutive weekends. Air purifiers with active or sham (i.e., filter removed) particle filtration were placed in each classroom. The filtration mode was switched between the two test days. Linear mixed-effect models were used to evaluate the effect of the intervention mode on the test scores. The results show that air purification (i.e., reducing PM) was significantly associated with increases in the z score for combined (0.11 [95%CI: 0.02, 0.21]) and reading (0.11 [95%CI: 0.00, 0.22]) components. In conclusion, a short-term reduction in indoor particle concentration led to improved test scores in students, suggesting an improvement in cognitive function.

Environmental PM2.5-triggered stress responses in digestive diseases

Airborne particulate matter in fine and ultrafine ranges (aerodynamic diameter less than 2.5 μm, PM2.5) is a primary air pollutant that poses a serious threat to public health. Accumulating evidence has pointed to a close association between inhalation exposure to PM2.5 and increased morbidity and mortality associated with modern human complex diseases. The adverse health effect of inhalation exposure to PM2.5 pollutants is systemic, involving multiple organs, different cell types and various molecular mediators. Organelle damages and oxidative stress appear to play a major role in the cytotoxic effects of PM2.5 by mediating stress response pathways related to inflammation, metabolic alteration and cell death programmes. The organs or tissues in the digestive tract, such as the liver, pancreas and small intestines, are susceptible to PM2.5 exposure. This review underscores PM2.5-induced inflammatory stress responses and their involvement in digestive diseases caused by PM2.5 exposure.

Cohort Network: A Knowledge Graph toward Data Dissemination and Knowledge-Driven Discovery for Cohort Studies

Contemporary environmental health sciences draw on large-scale longitudinal studies to understand the impact of environmental exposures and behavior factors on the risk of disease and identify potential underlying mechanisms. In such studies, cohorts of individuals are assembled and followed up over time. Each cohort generates hundreds of publications, which are typically neither coherently organized nor summarized, hence limiting knowledge-driven dissemination. Hence, we propose a Cohort Network, a multilayer knowledge graph approach to extract exposures, outcomes, and their connections. We applied the Cohort Network on 121 peer-reviewed papers published over the past 10 years from the Veterans Affairs (VA) Normative Aging Study (NAS). The Cohort Network visualized connections between exposures and outcomes across different publications and identified key exposures and outcomes, such as air pollution, DNA methylation, and lung function. We demonstrated the utility of the Cohort Network for new hypothesis generation, e.g., identification of potential mediators of exposure-outcome associations. The Cohort Network can be used by investigators to summarize the cohort's research and facilitate knowledge-driven discovery and dissemination.

The impact of COVID-19 public health restrictions on particulate matter pollution measured by a validated low-cost sensor network in Oxford, UK

Emergency responses to the COVID-19 pandemic led to major changes in travel behaviours and economic activities with arising impacts upon urban air quality. To date, these air quality changes associated with lockdown measures have typically been assessed using limited city-level regulatory monitoring data, however, low-cost air quality sensors provide capabilities to assess changes across multiple locations at higher spatial-temporal resolution, thereby generating insights relevant for future air quality interventions. The aim of this study was to utilise high-spatial resolution air quality information utilising data arising from a validated (using a random forest field calibration) network of 15 low-cost air quality sensors within Oxford, UK to monitor the impacts of multiple COVID-19 public heath restrictions upon particulate matter concentrations (PM₁₀, PM_2.5) from January 2020 to September 2021. Measurements of PM₁₀ and PM_2.5 particle size fractions both within and between site locations are compared to a pre-pandemic related public health restrictions baseline. While average peak concentrations of PM₁₀ and PM_2.5 were reduced by 9-10 μg/m³ below typical peak levels experienced in recent years, mean daily PM₁₀ and PM_2.5 concentrations were only ∼1 μg/m³ lower and there was marked temporal (as restrictions were added and removed) and spatial variability (across the 15-sensor network) in these observations. Across the 15-sensor network we observed a small local impact from traffic related emission sources upon particle concentrations near traffic-oriented sensors with higher average and peak concentrations as well as greater dynamic range, compared to more intermediate and background orientated sensor locations. The greater dynamic range in concentrations is indicative of exposure to more variable emission sources, such as road transport emissions. Our findings highlight the great potential for low-cost sensor technology to identify highly localised changes in pollutant concentrations as a consequence of changes in behaviour (in this case influenced by COVID-19 restrictions), generating insights into non-traffic contributions to PM emissions in this setting. It is evident that additional non-traffic related measures would be required in Oxford to reduce the PM₁₀ and PM_2.5 levels to within WHO health-based guidelines and to achieve compliance with PM_2.5 targets developed under the Environment Act 2021.

Linking Air Pollution Exposure to Blood-Based Metabolic Features in a Community-Based Aging Cohort with and without Dementia

BACKGROUND

Long-term exposure to air pollution has been associated with changes in levels of metabolites measured in the peripheral blood. However, most research has been conducted in ethnically homogenous, young or middle-aged populations.

OBJECTIVE

To study the relationship between the plasma metabolome and long-term exposure to three air pollutants: particulate matter (PM) less than 2.5μm in aerodynamic diameter (PM2.5), PM less than 10μm in aerodynamic diameter (PM10), and nitrogen dioxide (NO2) in an ethnically diverse, older population.

METHODS

Plasma metabolomic profiles of 107 participants of the Washington Heights and Inwood Community Aging Project in New York City, collected from 1995-2015, including non-Hispanic white, Caribbean Hispanic, and non-Hispanic Black older adults were used. We estimated the association between each metabolic feature and predicted annual mean exposure to the air pollutants using three approaches: 1) A metabolome wide association study framework; 2) Feature selection using elastic net regression; and 3) A multivariate approach using partial-least squares discriminant analysis.

RESULTS

79 features associated with exposure to PM2.5 but none associated with PM10 or NO2. PM2.5 exposure was associated with altered amino acid metabolism, energy production, and oxidative stress response, pathways also associated with Alzheimer's disease. Three metabolites were associated with PM2.5 exposure through all three approaches: cysteinylglycine disulfide, a diglyceride, and a dicarboxylic acid. The relationship between several features and PM2.5 exposure was modified by diet and metabolic diseases.

CONCLUSIONS

These relationships uncover the mechanisms through which PM2.5 exposure can lead to altered metabolic outcomes in an older population.

Long-Term Air Pollution, Genetic Susceptibility, and the Risk of Depression and Anxiety: A Prospective Study in the UK Biobank Cohort

BACKGROUND

Depression and anxiety are two mental disorders that are often comorbid. However, the associations of long-term air pollution exposure with depression and anxiety remain inconclusive.

OBJECTIVE

We conducted a cross-sectional and prospective study to examine the associations of ambient exposure to particulate matter (PM) with a diameter of ≤2.5μm (PM2.5), ≤10μm (PM10), and 2.5-10μm (PMcoarse), nitrogen oxides (NOx), and nitrogen dioxide (NO2) with the risk of depression and anxiety in the UK Biobank.

METHODS

This study included 398,241 participants from the UK Biobank, 128,456 of whom participated the 7-y online mental health survey. A total of 345,876 individuals were free of depression and anxiety at baseline; of those, 16,185 developed incident mental disorders during a median of 8.7 y of follow-up. Depression and anxiety were assessed using hospital admission records and mental health questionnaires. Associations of air pollution with prevalent and incident mental disorders were examined using logistic regression and Cox regression models, respectively.

RESULTS

Elevated levels of the five air pollutants were associated with higher odds of mental disorders at baseline. Levels of four pollutants but not PMcoarse were also associated with higher odds and risks of mental disorders during follow-up; specifically, hazard ratios [HR, 95% confidence interval (CI)] of an interquartile range increase in PM2.5, PM10, NOx, and NO2 for incident mental disorders were 1.03 (95% CI: 1.01, 1.05), 1.06 (95% CI: 1.04, 1.08), 1.03 (95% CI: 1.01, 1.05), and 1.06 (95% CI: 1.04, 1.09), respectively. An air pollution index reflecting combined effects of pollutants also demonstrated a positive association with the risk of mental disorders. HR (95% CI) of incident mental disorders were 1.11 (95% CI: 1.05, 1.18) in the highest quintile group in comparison with the lowest quintile of the air pollution index. We further observed that the associations between air pollution and mental disorders differed by a genetic risk score based on single nucleotide polymorphisms previously associated with genetic susceptibility to mental disorders in the UK Biobank cohort.

DISCUSSION

To our knowledge, this research is one of the largest cohort studies that demonstrates an association between mental health disorders and exposure to long-term air pollution, which could be further enhanced by genetic predisposition. https://doi.org/10.1289/EHP10391.

Short-term PM2.5 exposure and cognitive function: Association and neurophysiological mechanisms

BACKGROUND

Although converging evidence has demonstrated that exposure to fine particulate matter (PM_2.5) caused adverse effects on brain structure and cognitive function, the association between the short-term exposure to PM_2.5 and cognition dysfunction remained underexplored, especially possible neurophysiological mechanisms.

METHODS

We conducted a longitudinal observational study with four repeated measurement sessions among 90 young adults from September 2020 to June 2021. During each measurement session, we measured participants' personal-level air pollution exposure for one week with portable monitors, followed by executive function assessment and electrophysiological signal recording at an assessment center. Standard Stroop color-word test was used accompanied with electroencephalogram (EEG) recording to assess performance on executive function. We used linear mixed-effect model with lagged values of PM_2.5 levels to analyze the association between PM_2.5 exposure and changes in executive function, and mediation analysis to investigate mediation effect by EEG signal.

RESULTS

Adjusted mixed-effect models demonstrated that elevated PM_2.5 exposure three days prior to cognitive assessment (lag-3) was associated with (1) declined performance in both congruent and incongruent tasks in Stroop test, (2) reduced lower and upper alpha event-related desynchronization (ERD) during 500-1000 ms after stimuli, both indicating impaired executive control. Lower and upper alpha ERD also mediated observed associations between short-term PM_2.5 exposure and executive function. No significant associations were found between short-term PM_2.5 exposure or aperiodic exponents in tonic and phasic states, or periodic alpha oscillations in tonic state.

CONCLUSION

Our results provided evidence that short-term PM_2.5 exposure was associated with executive dysfunction. Reduced alpha ERD was likely to be the underlying pathway through which PM_2.5 induced adverse effects on neuron activities during cognitive tasks.

Short-Term Exposure of PM2.5 and Epigenetic Aging: A Quasi-Experimental Study

Epigenetic age (EA) is an emerging DNA methylation-based biomarker of biological aging, but whether EA is causally associated with short-term PM_2.5 exposure remains unknown. We conducted a quasi-experimental study of 26 healthy adults to test whether short-term PM_2.5 exposure accelerates seven EAs with three health examinations performed before, during, and after multiple PM_2.5 pollution waves. Seven EAs were derived from the DNA methylation profiles of the Illumina HumanMethylationEPIC BeadChip from CD4+ T-helper cells. We found that an increase of 10 μg/m³ in the 0-24 h personal PM_2.5 exposure prior to health examinations was associated with a 0.035, 0.035, 0.050, 0.055, 0.052, and 0.037-unit increase in the changes of z-scored DNA methylation age acceleration (AA,Horvath), AA (Hannum), AA (GrimAge), DunedinPoAm, mortality risk score (MS), and epiTOC, respectively (p-values < 0.05). The same increase in the 24-48 h average personal PM_2.5 exposure yielded smaller effects but was still robustly associated with the changes in AA (GrimAge), DunedinPoAm, and MS. Such acute aging effects of PM_2.5 were mediated by the changes in several circulating biomarkers, including EC-SOD and sCD40L, with up to ∼28% mediated proportions. Our findings demonstrated that short-term PM_2.5 exposure could accelerate aging reflected by DNA methylation profiles via blood coagulation, oxidative stress, and systematic inflammation.

Effect of Short- to Long-Term Exposure to Ambient Particulate Matter on Cognitive Function in a Cohort of Middle-Aged and Older Adults: KoGES

Exposure to ambient air pollution and its threat to human health is a global concern, especially in the elderly population. Therefore, more in-depth studies are required to understand the extent of the harmful effects of particulate matter (PM) based on duration and levels of exposure. An investigation was conducted to determine the association between short- (1-14 days), medium- (1, 3, and 6 months), and long-term (1, 2, and 3 years) exposure to air pollutants (PM_2.5 and PM₁₀) and cognitive function among Koreans (4175 participants, mean age 67.8 years, 55.2% women) aged over 50 years. Higher levels of PM_2.5 exposure for short to long term and PM₁₀ exposure for medium to long term were found to be associated with decreased cognitive function, as indicated by lower scores of the Mini-Mental State Examination adopted in Korean (K-MMSE). There were significant effect modifications by sex, age group, alcohol consumption, physical activity, and smoking status in the association between long-term PM_2.5 and PM₁₀ exposure and cognitive function. These findings, which underscore the importance of the efforts to reduce the exposure levels and durations of air pollutants, especially in the vulnerable elderly population, provide evidence for establishing more stringent policies for air pollution regulations.

The links of fine airborne particulate matter exposure to occurrence of cardiovascular and metabolic diseases in Michigan, USA

Air pollutants, particularly airborne particulate matter with aerodynamic diameter < 2.5μm (PM2.5), have been linked to the increase in mortality and morbidity associated with cardiovascular and metabolic diseases. In this study, we investigated the dose-risk relationships between PM2.5 concentrations and occurrences of cardiovascular and metabolic diseases as well as the confounding socioeconomic factors in Michigan, USA, where PM2.5 levels are generally considered acceptable. Multivariate linear regression analyses were performed to investigate the relationship between health outcome and annual ground-level PM2.5 concentrations of 82 counties in Michigan. The analyses revelated significant linear dose-response associations between PM2.5 concentrations and cardiovascular disease (CVD) hospitalization. A 10 μg/m3 increase in PM2.5 exposure was found to be associated with a 3.0% increase in total CVD, 0.45% increase in Stroke, and a 0.3% increase in Hypertension hospitalization rates in Medicare beneficiaries. While the hospitalization rates of Total Stroke, Hemorrhagic Stroke, and Hypertension in urbanized counties were significantly higher than those of rural counties, the death rates of coronary heart disease and ischemic stroke in urbanized counties were significantly lower than those of rural counties. These results were correlated with the facts that PM2.5 levels in urbanized counties were significantly higher than that in rural counties and that the percentage of the population with health insurance and the median household income in rural counties were significantly lower. While obesity prevalence showed evidence of a weak positive correlation (ρ = 0.20, p-value = 0.078) with PM2.5 levels, there was no significant dose-response association between county diabetes prevalence rates and PM2.5 exposure in Michigan. In summary, this study revealed strong dose-response associations between PM2.5 concentrations and CVD incidence in Michigan, USA. The socioeconomic factors, such as access to healthcare resources and median household income, represent important confounding factors that could override the impact of PM2.5 exposure on CVD mortality.

Association of DNA methylation in circulating CD4+T cells with short-term PM2.5 pollution waves: A quasi-experimental study of healthy young adults

BACKGROUND

Fine particulate matter (PM2.5) is a modifiable environmental risk factor with established adverse effects on human health. However, associations between acute PM2.5 fluctuation and DNA methylation remain unknown.

METHODS

A quasi-experimental study utilizing naturally occurring PM2.5 pollution waves (PPWs) was conducted on 32 healthy young adults. Repeated follow-up measurements were performed and participants served as their own controls before, during, and after PPWs. Exposure measurements including indoor and ambient PM2.5 levels, and equivalent personal PM2.5 exposure were further estimated based on the time-location information. DNA methylation profiles of circulating CD4+T cells were obtained using Illumina HumanMethylationEPIC BeadChip. Linear mixed-effect models were applied to estimate the associations between two scenarios (during-PPWs vs. pre-PPWs periods and during-PPWs vs. post-PPWs periods) and methylation level of each CpG site. We further validated their associations with the personal PM2.5 exposure, and GO and KEGG analyses and mediation analysis were conducted accordingly.

RESULTS

Data from 26 participants were included in final analysis after quality control. Short-term high PM2.5 exposure was associated with DNA methylation changes of participants. Nine differently methylated CpG sites were not only significantly associated with PPWs periods but also with personal PM2.5 exposure in 24-h prior to the health examinations (p < 0.01). Gene ontology analysis found that five sites were associated with two pathways relating to membrane protein synthesis. PM2.5-related changes in CpG sites were mediated by sP-selectin, 8-isoPGF2α, EGF, GRO, IL-15, and IFN-α2, with mediated proportions ranging from 9.65% to 23.40%.

CONCLUSIONS

This is the first quasi-experimental study showing that short-term high PM2.5 exposure could alter the DNA methylation of CD4+T cells, which provided valuable information for further exploring underlying biological mechanisms and epigenetic biomarkers for PM2.5-related acute health effects.

Short-Term Exposure to Wildfire Smoke and PM2.5 and Cognitive Performance in a Brain-Training Game: A Longitudinal Study of U.S. Adults

BACKGROUND

There is increasing evidence that long-term exposure to fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)] may adversely impact cognitive performance. Wildfire smoke is one of the biggest sources of PM2.5 and concentrations are likely to increase under climate change. However, little is known about how short-term exposure impacts cognitive function.

OBJECTIVES

We aimed to evaluate the associations between daily and subdaily (hourly) PM2.5 and wildfire smoke exposure and cognitive performance in adults.

METHODS

Scores from 20 plays of an attention-oriented brain-training game were obtained for 10,228 adults in the United States (U.S.). We estimated daily and hourly PM2.5 exposure through a data fusion of observations from multiple monitoring networks. Daily smoke exposure in the western U.S. was obtained from satellite-derived estimates of smoke plume density. We used a longitudinal repeated measures design with linear mixed effects models to test for associations between short-term exposure and attention score. Results were also stratified by age, gender, user behavior, and region.

RESULTS

Daily and subdaily PM2.5 were negatively associated with attention score. A 10 μg/m3 increase in PM2.5 in the 3 h prior to gameplay was associated with a 21.0 [95% confidence interval (CI): 3.3, 38.7]-point decrease in score. PM2.5 exposure over 20 plays accounted for an estimated average 3.7% (95% CI: 0.7%, 6.7%) reduction in final score. Associations were more pronounced in the wildfire-impacted western U.S. Medium and heavy smoke density were also negatively associated with score. Heavy smoke density the day prior to gameplay was associated with a 117.0 (95% CI: 1.7, 232.3)-point decrease in score relative to no smoke. Although differences between subgroups were not statistically significant, associations were most pronounced for younger (18-29 y), older (≥70y), habitual, and male users.

DISCUSSION

Our results indicate that PM2.5 and wildfire smoke were associated with reduced attention in adults within hours and days of exposure, but further research is needed to elucidate these relationships. https://doi.org/10.1289/EHP10498.

Short-term NO2 exposure and cognitive and mental health: A panel study based on a citizen science project in Barcelona, Spain

BACKGROUND

The association between short-term exposure to air pollution and cognitive and mental health has not been thoroughly investigated so far.

OBJECTIVES

We conducted a panel study co-designed with citizens to assess whether air pollution can affect attention, perceived stress, mood and sleep quality.

METHODS

From September 2020 to March 2021, we followed 288 adults (mean age = 37.9 years; standard deviation = 12.1 years) for 14 days in Barcelona, Spain. Two tasks were self-administered daily through a mobile application: the Stroop color-word test to assess attention performance and a set of 0-to-10 rating scale questions to evaluate perceived stress, well-being, energy and sleep quality. From the Stroop test, three outcomes related to selective attention were calculated and z-score-transformed: response time, cognitive throughput and inhibitory control. Air pollution was assessed using the mean nitrogen dioxide (NO₂) concentrations (mean of all Barcelona monitoring stations or using location data) 12 and 24 h before the tasks were completed. We applied linear regression with random effects by participant to estimate intra-individual associations, controlling for day of the week and time-varying factors such as alcohol consumption and physical activity.

RESULTS

Based on 2,457 repeated attention test performances, an increase of 30 μg/m³ exposure to NO₂ 12 h was associated with lower cognitive throughput (beta = -0.08, 95% CI: -0.15, -0.01) and higher response time (beta = 0.07, 95% CI: 0.01, 0.14) (increase inattentiveness). Moreover, an increase of 30 μg/m³ exposure to NO₂ 12 h was associated with higher self-perceived stress (beta = 0.44, 95% CI: 0.13, 0.77). We did not find statistically significant associations with inhibitory control and subjective well-being.

CONCLUSIONS

Our findings suggest that short-term exposure to air pollution could have adverse effects on attention performance and perceived stress in adults.

Role of sleep quality in the acceleration of biological aging and its potential for preventive interaction on air pollution insults: Findings from the UK Biobank cohort

Sleep has been associated with aging and relevant health outcomes, but the causal relationship remains inconclusive. In this study, we investigated the associations of sleep behaviors with biological ages (BAs) among 363,886 middle and elderly adults from UK Biobank. Sleep index (0 [worst]-6 [best]) of each participant was retrieved from the following six sleep behaviors: snoring, chronotype, daytime sleepiness, sleep duration, insomnia, and difficulties in getting up. Two BAs, the KDM-biological age and PhenoAge, were estimated by corresponding algorithms based on clinical traits, and their residual discrepancies with chronological age were defined as the age accelerations (AAs). We first observed negative associations between the sleep index and the two AAs, and demonstrated that the change of AAs could be the consequence of sleep quality using Mendelian randomization with genetic risk scores of sleep index and BAs. Particularly, a one-unit increase in sleep index was associated with 0.104- and 0.119-year decreases in KDM-biological AA and PhenoAge acceleration, respectively. Air pollution is another key driver of aging. We further observed significant independent and joint effects of sleep and air pollution (PM_2.5 and NO₂ ) on AAs. Sleep quality also showed a modifying effect on the associations of elevated PM_2.5 and NO₂  levels with accelerated AAs. For instance, an interquartile range increase in PM_2.5  level was associated with 0.009-, 0.044-, and 0.074-year increase in PhenoAge acceleration among people with high (5-6), medium (3-4), and low (0-2) sleep index, respectively. Our findings elucidate that better sleep quality could lessen accelerated biological aging resulting from air pollution.

Outdoor air pollution exposure and cognitive performance: findings from the enrolment phase of the CONSTANCES cohort

BACKGROUND

Air pollution exposure is one of the modifiable risk factors of cognitive decline. We aimed to test the association between exposure to several outdoor air pollutants and domain-specific cognitive performance.

METHODS

In this cross-sectional study, we used data from the enrolment phase of the French CONSTANCES cohort. From the 220 000 people (aged 18-69 years) randomly recruited in the French CONSTANCES cohort, participants aged 45 years old or older (104 733 people) underwent a comprehensive cognitive assessment (verbal episodic memory, language skills, and executive functions). After exclusion of those who were not suitable for our analysis, 61 462 participants with available data were included in the analyses. We used annual mean concentrations at residential addresses, derived from land-use regression models, to assign exposure to particulate matter with aerodynamic diameters less than 2·5 μm (PM_2·5), nitrogen dioxide (NO₂), and black carbon. We used multiple linear regression models with different covariate adjustments to test the associations between each pollutant and cognitive outcomes. We did several sensitivity analyses, including multilevel modelling, meta-analysis by centre of recruitment, and exclusion of specific population groups.

FINDINGS

We found significantly poorer cognitive function, especially on semantic fluency and domains of executive functions, with an increase in exposure to black carbon and NO₂. Exposure to PM_2·5 was mainly significant for the semantic fluency test. We found that decrease in cognitive performance with an increase of one interquartile range of exposure ranged from 1% to nearly 5%. The largest effect size (percentage decrease) for both PM_2.5 and NO₂ was found for the semantic fluency test (PM_2.5 4·6%, 95% CI 2·1-6·9 and NO₂ 3·8%, 1·9-5·7), whereas for black carbon, the largest effect size was found for the digit symbol substitution test of the domains of executive functions (4·5%, 2·7-6·3). Monotonic and linear exposure-response associations were found between air pollution exposure and cognitive performance, starting from a low level of exposures.

INTERPRETATION

Significantly poorer cognitive performance was associated with exposure to outdoor air pollution even at low levels of exposure. This highlights the importance of further efforts to reduce exposure to air pollution.

FUNDING

The Caisse Nationale d'Assurance Maladie, and partly funded by Merck Sharp & Dohme and L'Oréal, the French National Research Agency, and Fondation de France.

TRANSLATION

For the French translation of the abstract see Supplementary Materials section.

Integrating Environment and Aging Research: Opportunities for Synergy and Acceleration

Despite significant overlaps in mission, the fields of environmental health sciences and aging biology are just beginning to intersect. It is increasingly clear that genetics alone does not predict an individual’s neurological aging and sensitivity to disease. Accordingly, aging neuroscience is a growing area of mutual interest within environmental health sciences. The impetus for this review came from a workshop hosted by the National Academies of Sciences, Engineering, and Medicine in June of 2020, which focused on integrating the science of aging and environmental health research. It is critical to bridge disciplines with multidisciplinary collaborations across toxicology, comparative biology, epidemiology to understand the impacts of environmental toxicant exposures and age-related outcomes. This scoping review aims to highlight overlaps and gaps in existing knowledge and identify essential research initiatives. It begins with an overview of aging biology and biomarkers, followed by examples of synergy with environmental health sciences. New areas for synergistic research and policy development are also discussed. Technological advances including next-generation sequencing and other-omics tools now offer new opportunities, including exposomic research, to integrate aging biomarkers into environmental health assessments and bridge disciplinary gaps. This is necessary to advance a more complete mechanistic understanding of how life-time exposures to toxicants and other physical and social stressors alter biological aging. New cumulative risk frameworks in environmental health sciences acknowledge that exposures and other external stressors can accumulate across the life course and the advancement of new biomarkers of exposure and response grounded in aging biology can support increased understanding of population vulnerability. Identifying the role of environmental stressors, broadly defined, on aging biology and neuroscience can similarly advance opportunities for intervention and translational research. Several areas of growing research interest include expanding exposomics and use of multi-omics, the microbiome as a mediator of environmental stressors, toxicant mixtures and neurobiology, and the role of structural and historical marginalization and racism in shaping persistent disparities in population aging and outcomes. Integrated foundational and translational aging biology research in environmental health sciences is needed to improve policy, reduce disparities, and enhance the quality of life for older individuals.

The effect of China's Clean Air Act on cognitive function in older adults: a population-based, quasi-experimental study

BACKGROUND

Air pollution might accelerate cognitive ageing; it is unclear whether large-scale interventions, such as China's Clean Air Act (CCAA), can mitigate cognitive deterioration. We aimed to evaluate the effect of CCAA on changes in cognitive function in older adults.

METHODS

In this population-based, quasi-experimental study, we did a difference-in-differences analysis of the data collected during the 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The study design used a counterfactual analysis feature by dividing CLHLS participants into two groups. The intervention group included participants who lived in areas where the provincial government set a target of reducing particulate matter (PM) by at least 5% annually from 2014 onward, whereas the control group consisted of individuals who lived in areas without a PM reduction target. Global cognitive function was measured using the Mini-Mental State Examination (MMSE). We used fixed-effects models to examine the between-group differences in MMSE score changes before and after CCAA implementation. We associated longitudinal changes in MMSE scores with changes in concentrations of PM with a diameter of less than 2·5 μm (PM_2·5) concentration and other regulated pollutants. We used alternative models and sensitivity analyses to evaluate the robustness of the results from the main models.

FINDINGS

2812 individuals participated in the 2014 and 2018 surveys (mean age 81·0 years [SD 9·3] in 2014; 1408 [50·1%] female and 1404 [49·9%] male). 2251 (80·0%) were included in the intervention group and 561 (20·0%) in the control group. After controlling for potential confounders, the intervention group had a significantly smaller decline in MMSE scores from 2014 to 2018 compared with the control group: the mean between-group difference was 2·45 points (95% CI 1·32-3·57). Interquartile increases in PM_2·5 were associated with a significant MMSE score decline of 0·83 points (95% CI 0·24-1·42); similarly, increases in SO₂ were also associated with a significant MMSE score decline of 0·80 points (0·32-1·29).

INTERPRETATION

Implementing stringent clean air policies might mitigate the risk of air pollutant-associated cognitive ageing in older people.

FUNDING

National Natural Sciences Foundation of China, National Key R&D Program of China, China Postdoctoral Science Foundation funded project, the Duke/Duke-National University of Singapore Collaboration Pilot Project, the National Institute on Aging and Peking University-Baidu Fund, Energy Foundation, and the Fundamental Research Funds for the Central Universities.

Long-term ozone exposure and cognitive impairment among Chinese older adults: A cohort study

Ambient particulate matter pollution has been linked to impaired cognitive performance, but the effect of ambient ozone exposure on cognitive function remains largely unknown. We examined the association of long-term ozone exposure with the risk of cognitive impairment among a national representative cohort of 9,544 Chinese older adults (aged 65 years and over) with baseline normal cognition from the Chinese Longitudinal Healthy Longevity Survey (2005-2018). The ozone exposure of each participant was measured by annual mean ozone concentrations for the county of residence. Cognitive function was assessed by the Chinese version of the Mini-Mental State Examination (MMSE). We defined cognitive impairment as an MMSE score below 18 points accompanied by an MMSE score that declined ≥ 4 points from baseline. Cox proportional hazards models were applied to explore the association of ozone exposure with cognitive impairment. During the mean follow-up time of 6.5 years, 2,601 older adults developed cognitive impairment. Each 10-μg/m³ increase in annual mean ozone exposure was associated with a 10.4% increased risk of cognitive impairment. The exposure-response relationship between ozone exposure and risk of cognitive impairment showed a linear trend. Sensitivity analyses revealed the association to be robust. We found that older adults from Eastern, Central, and Southern China were particularly susceptible. Our results show that ozone is a risk factor for late-life cognitive decline. Reducing ambient ozone pollution may help delay the onset of cognitive impairment among older adults.

DunedinPACE, a DNA methylation biomarker of the pace of aging

Background

Measures to quantify changes in the pace of biological aging in response to intervention are needed to evaluate geroprotective interventions for humans. Previously, we showed that quantification of the pace of biological aging from a DNA-methylation blood test was possible (Belsky et al., 2020). Here, we report a next-generation DNA-methylation biomarker of Pace of Aging, DunedinPACE (for Pace of Aging Calculated from the Epigenome).

Methods

We used data from the Dunedin Study 1972-1973 birth cohort tracking within-individual decline in 19 indicators of organ-system integrity across four time points spanning two decades to model Pace of Aging. We distilled this two-decade Pace of Aging into a single-time-point DNA-methylation blood-test using elastic-net regression and a DNA-methylation dataset restricted to exclude probes with low test-retest reliability. We evaluated the resulting measure, named DunedinPACE, in five additional datasets.

Results

DunedinPACE showed high test-retest reliability, was associated with morbidity, disability, and mortality, and indicated faster aging in young adults with childhood adversity. DunedinPACE effect-sizes were similar to GrimAge Clock effect-sizes. In analysis of incident morbidity, disability, and mortality, DunedinPACE and added incremental prediction beyond GrimAge.

Conclusions

DunedinPACE is a novel blood biomarker of the pace of aging for gerontology and geroscience.

Funding

This research was supported by US-National Institute on Aging grants AG032282, AG061378, AG066887, and UK Medical Research Council grant MR/P005918/1.

Short-term exposure to PM2.5 components and renal health: Findings from the Veterans Affairs Normative Aging Study

There is little evidence on the short-term impact of fine particulate matter (PM_2.5) on renal health, and the potential interactions and various influences of PM_2.5 components on renal health have not been examined. We investigated whether short-term (≤28 days) ambient PM_2.5 and 15 PM_2.5 components were associated with serum uric acid (SUA), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), and odds of incident chronic kidney disease (CKD) using both mixed-effect and Bayesian kernel machine regression (BKMR) models in the Normative Aging Study. This analysis included 2466 study visits from 808 older males enrolled during 1998-2016 with available data. BKMR showed positive relationships of PM_2.5 mixture with SUA and odds of CKD, and an inverse relationship with eGFR. In the 28-day exposure window, an interquartile range (IQR) increase in vanadium was associated with a 0.244-mg/dL higher SUA. IQR increases in sulfur and lead were associated with a 1.281- and 1.008-mL/min/1.73 m² decrease in eGFR, respectively. The same change in sulfur was also associated with a 39% higher odds of CKD. Our findings provide solid evidence supporting short-term adverse effects of PM_2.5 on renal health and further highlight that components from oil combustion and regional pollution may be major contributors.

Associations between Acute Exposures to PM2.5 and Carbon Dioxide Indoors and Cognitive Function in Office Workers: A Multicountry Longitudinal Prospective Observational Study

Despite evidence of the air pollution effects on cognitive function, little is known about the acute impact of indoor air pollution on cognitive function among the working-age population. We aimed to understand whether cognitive function was associated with real-time indoor concentrations of particulate matter (PM2.5) and carbon dioxide (CO2). We conducted a prospective observational longitudinal study among 302 office workers in urban commercial buildings located in six countries (China, India, Mexico, Thailand, the United States of America, and the United Kingdom). For 12 months, assessed cognitive function using the Stroop color-word test and Addition-Subtraction test (ADD) via a mobile research app. We found that higher PM2.5 and lower ventilation rates, as assessed by CO2 concentration, were associated with slower response times and reduced accuracy (fewer correct responses per minute) on the Stroop and ADD for 8 out 10 test metrics. Each interquartile (IQR) increase in PM2.5 (IQR=8.8 µg/m3) was associated with a 0.82% (95%CI: 0.42, 1.21) increase in Stroop response time, a 6.18% (95% CI: 2.08, 10.3) increase in Stroop interference time, a 0.7% (95% CI: -1.38, -0.01) decrease in Stroop throughput, and a 1.51% (95% CI: -2.65, -0.37) decrease in ADD throughput. For CO2, an IQR increase (IQR=315ppm) was associated with a 0.85% (95% CI: 0.32, 1.39) increase in Stroop response time, a 7.88% (95% CI: 2.08, 13.86) increase in Stroop interference time, a 1.32% (95% CI: -2.3, -0.38) decrease in Stroop throughput, and a 1.13% (95% CI: 0.18, 2.11) increase in ADD response time. A sensitivity analysis showed significant association between PM2.5 in four out of five cognitive test performance metrics only at levels above 12 µg/m3. Enhanced filtration and higher ventilation rates that exceed current minimum targets are essential public health strategies that may improve employee productivity.