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Parasin N, Amnuaylojaroen T, Saokaew S. Exposure to PM 10, PM 2.5, and NO 2 and gross motor function in children: a systematic review and meta-analysis. Eur J Pediatr 2023; 182:1495-1504. [PMID: 36754867 DOI: 10.1007/s00431-023-04834-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/10/2023]
Abstract
Air pollution exposure has been related to negative gross motor development in children. However, there is currently a lack of conclusive evidence for such a relationship. We carried out a systematic review and meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria to examine whether exposure to air pollution has an impact on children's gross motor development. Of the 9746 papers found, 7 studies examined the impact of air pollutant characteristics, such as PM2.5, PM10, and NO2, on children's gross motor development. The results of the study reveal a significant association between air pollutants and an increased likelihood of negative gross motor development. PM10 was discovered to be considerably riskier for children's gross motor development (effect: - 1.83, 95% CI: - 3.04, - 0.62, p value = 0.002). Additionally, NO2 exhibited indications of a tendency to be connected to a detrimental impact on children's gross motor development (effect - 0.18, 95% CI: - 0.42, 0.07, p value = 0.097). Conclusion: Our study indicates that exposure to PM10, PM2.5, and NO2, especially PM2.5 and PM10, is negatively associated with children's gross motor development. However, further research is required to determine how exposure to prenatal air pollution affects children's gross motor development. What is Known - What is New: • In this study, we provide an overview of emerging data related to PM10, PM2.5, and NO2 exposure in child development, especially on the gross motor function that continues to emerge, and key findings are highlighted. • Additionally, we summarize the evidence on the underlying effect of air pollution on gross motor function from human studies.. • Overall, we emphasize that evidence from human studies is critical in suggesting detrimental child health outcomes of an action to promote preventive strategies that will effectively protect children's health..
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Affiliation(s)
- Nichapa Parasin
- School of Allied Health Science, University of Phayao, Phayao, Thailand, 56000
| | - Teerachai Amnuaylojaroen
- School of Energy and Environment, University of Phayao, Phayao, Thailand, 56000.
- Atmospheric Pollution and Climate Change Research Units, School of Energy and Environment, University of Phayao, Phayao, Thailand, 56000.
| | - Surasak Saokaew
- Division of Social and Administrative Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand, 56000
- Unit of Excellence On Clinical Outcomes Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand, 56000
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand, 56000
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Lee EY, Bains A, Hunter S, Ament A, Brazo-Sayavera J, Carson V, Hakimi S, Huang WY, Janssen I, Lee M, Lim H, Silva DAS, Tremblay MS. Systematic review of the correlates of outdoor play and time among children aged 3-12 years. Int J Behav Nutr Phys Act 2021; 18:41. [PMID: 33736668 PMCID: PMC7972019 DOI: 10.1186/s12966-021-01097-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Due to the myriad of benefits of children's outdoor play and time, there is increasing concern over its decline. This systematic review synthesized evidence on the correlates of outdoor play and outdoor time among children aged 3-12 years. METHODS A total of 12 electronic databases in five different languages (Chinese, English, Korean, Spanish, Portuguese) were searched between October 28, 2019 and July 27, 2020. Covidence software was used for screening and Microsoft Excel with a predesigned coding form was used for data extraction. Evidence was synthesized and correlates were categorized using the socioecological model framework. RESULTS Based on 107 studies representing 188,498 participants and 422 childcare centers from 29 countries, 85 studies examined potential correlates of outdoor play while 23 studies examined that of outdoor time (one examined both). The duration of outdoor play and outdoor time ranged between 60 and 165 min/d and 42-240 min/d, respectively. Out of 287 (outdoor play) and 61 (outdoor time) potential correlates examined, 111 correlates for outdoor play and 33 correlates for outdoor time were identified as significant correlates. Thirty-three variables were identified as key/common correlates of outdoor play/time, including eight correlates at the individual level (e.g., sex/gender, race/ethnicity, physical activity), 10 correlates at the parental level (e.g., parental attitude/support/behavior, parenting practice), nine at the microsystem level (e.g., proximal home/social environment such as residence type, peer influence), three at the macrosystem/community level (e.g., availability of space children can play), and three at the physical ecology/pressure for macrosystem change level (e.g., seasonality, rurality). No key correlates were found at the institutional level. CONCLUSIONS Individual, parental, and proximal physical (home) and social environments appear to play a role in children's outdoor play and time. Ecological factors (i.e., seasonality, rurality) also appear to be related to outdoor play/time. Evidence was either inconsistent or lacking at institutional and macrosystem/community levels. Standardizing terminology and measures of outdoor play/time is warranted. Future work should investigate the interactions and processes of multiple variables across different levels of socioecological modelling to better understand the mechanisms through which outdoor play/time opportunities can be optimized for children while paying special attention to varying conditions in which children are born, live, and play.
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Affiliation(s)
- Eun-Young Lee
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
- Department of Gender Studies, Queen’s University, Kingston, ON Canada
| | - Ajaypal Bains
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | - Stephen Hunter
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Alyssa Ament
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | | | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Shawn Hakimi
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | - Wendy Y. Huang
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
- Department of Health Sciences, Queen’s University, Kingston, Canada
| | - Mikyung Lee
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | - Heejun Lim
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | | | - Mark S. Tremblay
- Healthy Active Lifestyle and Obesity (HALO) research group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
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Yu M, Wu Y, Gordon SP, Cheng J, Chen P, Wang Y, Yu H. Objectively measured association between air pollution and physical activity, sedentary behavior in college students in Beijing. ENVIRONMENTAL RESEARCH 2021; 194:110492. [PMID: 33217438 DOI: 10.1016/j.envres.2020.110492] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 06/11/2023]
Abstract
The purpose of this study is to examine the association between hourly air pollution on hourly physical activity (PA) and sedentary behavior (SB) among college students in Beijing, China. The secondary aim was to examine such associations varied at specific time. A total of 340 participants were recruited from the Tsinghua University, in Beijing, China. Accelerometers provided PA measures, including moderate-to-vigorous physical activity (MVPA), walking steps, energy expenditure and sedentary time for 7 consecutive days. Corresponding air pollution data by the Beijing Municipal Ecological Environment Bureau in the closed site (Wan Liu site) in Tsinghua University were collected including average hourly air quality index (AQI) and PM2.5 (μg/m³). Associations were estimated using linear individual fixed-effect regressions. We also conducted an air pollution risk perception survey among 2307 freshmen (76.6% males) who were enrolled in Tsinghua in 2016, and the survey was done in May 22-26, 2017. A one level increase in hourly air quality index (AQI) was associated with a reduction in 1-h PA by 0.083 (95% confidence interval [CI] = -0.137, -0.029) minutes of MVPA, 8.8 (95% CI = -15.0, -2.6) walking steps, 0.65 (95% CI = -1.03, -0.27) kcals of energy expenditure. A 10 μg/m³ increase in air pollution concentration in hourly PM2.5 was associated with a reduction in 1-h PA by 0.021 (95% confidence interval [CI] = -0.033, -0.010) minutes of MVPA, 2.2 (95% CI = -3.5, -0.9) walking steps, 0.170 (95% CI = -0.250, -0.089) kcals of energy expenditure an increase in 1-h sedentary behavior 0.045 (0.005, 0.0845). At specific time, stronger negative associations of AQI and PM2.5 air pollution with PA at 8 a.m., 4 p.m., 5 p.m. and 7 p.m. Similarly, stronger positive associations of 1 h AQI and PM2.5 air pollution with SB at 8 a.m., 9 a.m., 11 a.m., and 7 p.m. A total of 94.9% participants (n = 2235) responded "yes" to air pollution change activities in the survey, which may partially explain PA change. Air pollution may discourage physical activity and increases sedentary behavior among freshman students living in Beijing, China. This is preliminary study. The impact of air pollution on physical activity and sedentary behavior at a specific time may be different.
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Affiliation(s)
- Miao Yu
- School of Information Rescource Management, Renmin University of China, Beijing, China.
| | - Yin Wu
- Department of Physical Education, Tsinghua University, Beijing, China.
| | | | - Jiali Cheng
- Department of Physical Education, Tsinghua University, Beijing, China.
| | - Panpan Chen
- Department of Physical Education, Tsinghua University, Beijing, China.
| | - Yangyang Wang
- Department of Sociology, Tsinghua University, China.
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, China.
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Chen C, Ahlqvist VH, Henriksson P, Magnusson C, Berglind D. Preschool environment and preschool teacher's physical activity and their association with children's activity levels at preschool. PLoS One 2020; 15:e0239838. [PMID: 33057340 PMCID: PMC7561096 DOI: 10.1371/journal.pone.0239838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 09/14/2020] [Indexed: 11/24/2022] Open
Abstract
Objective The aim of this study was to investigate the association between preschool playground size, formalized physical activity (PA) policies, time spent outdoors and preschool teacher’s levels of PA and children’s objectively assessed levels of PA and sedentary time (ST) during preschool hours. Methods In total, 369 children and 84 preschool teachers from 27 preschools in Södermalm municipally, Stockholm Sweden wore an Actigraph GT3X+ accelerometer during 7 consecutive days. Preschool environmental and structural characteristics were measured via the Environment and Policy Evaluation Self-Report (EPAO-SR) instrument and time in- and outdoors was recorded by preschool teachers during the PA measurements. Weight and height of children were measured via validated scales and parents filled out a questionnaire on demographical and descriptive variables. Linear mixed models, nested on preschool level, were used to assess the association between predictors and outcomes. Results The mean child age was 4.7 years (SD 0.8) and 45% were girls. We found that children were more active in preschools with a formalized PA policy, compared to preschools without such a policy, but not less sedentary. The association between policy and activity seemed to be more pronounced when accounting for other environmental factors. Similar associations were found in children spent most time outdoors (uppermost quartile) compared with children spent least time outdoors (Lowermost quartile). Preschool teachers’ light PA (LPA) (ß = 0.25, P = 0.004) and steps (ß = 0.52, P<0.001) were associated with children’s LPA and steps while the preschool playground size showed no association with PA in children, when accounting for other environmental factors. Conclusion The current study showed that preschool structural characteristics such as formalized PA policies and more time spent outdoors were positively associated with children’s PA. These findings suggest that formalized PA policies and time outdoors may be of importance for promoting children’s PA during preschool hours.
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Affiliation(s)
- Chu Chen
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- * E-mail:
| | - Viktor H. Ahlqvist
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Cecilia Magnusson
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Daniel Berglind
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
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Yu H, Cheng J, Gordon SP, An R, Yu M, Chen X, Yue Q, Qiu J. Impact of Air Pollution on Sedentary Behavior: A Cohort Study of Freshmen at a University in Beijing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122811. [PMID: 30544739 PMCID: PMC6313684 DOI: 10.3390/ijerph15122811] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/05/2018] [Accepted: 12/07/2018] [Indexed: 12/22/2022]
Abstract
Human populations worldwide have experienced substantial environmental issues in part due to air pollution, notably in China. Gaps in the scientific literature remain regarding the relationship between air pollution and sedentary behavior among young adults in China. The purpose of this study is to examine the effect of air pollution on sedentary behavior among college students living in Beijing, China. We conducted follow-up health surveys on 12,174 freshman students enrolled at Tsinghua University from 2013 to 2017. Sedentary behavior was measured using the short version of the International Physical Activity Questionnaire (IPAQ). Corresponding air pollution data measured by the Ministry of Environmental Protection of the People's Republic of China were collected to include the average hourly air quality index (AQI), PM2.5, PM10, and NO₂ (µg/m³). The data were analyzed using linear individual fixed-effect regressions. An increase in air pollution concentration of one standard deviation in AQI, PM2.5, PM10, and NO₂ was associated with an increase in weekly total hours of sedentary behavior by 7.35 (95% confidence interval (CI) = 5.89, 8.80), 6.24 (95% CI = 5.00, 7.49), 6.80 (95% CI = 5.46, 8.15), and 7.06 (95% CI = 5.65, 8.47), respectively. In the presence of air pollution, women students tended to increase their sedentary behavior more than men. Air pollution increases sedentary behavior among freshman students living in Beijing, China. Replication of this study is warranted among various populations within China.
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Affiliation(s)
- Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing 100084, China.
| | - Jiali Cheng
- Department of Physical Education, Tsinghua University, Beijing 100084, China.
| | - Shelby Paige Gordon
- Department of Interdisciplinary Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA.
| | - Ruopeng An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA.
| | - Miao Yu
- Renmin University of China Libraries, Beijing 100872, China.
| | - Xiaodan Chen
- Department of Martial Art, Guangzhou Sport University, Guangzhou, Guangdong 510500, China.
| | - Qingli Yue
- Department of Olympic Games, Beijing Sport University, Beijing 100084, China.
| | - Jun Qiu
- Department of Physical Education, Tsinghua University, Beijing 100084, China.
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Yang IV, Lozupone CA, Schwartz DA. The environment, epigenome, and asthma. J Allergy Clin Immunol 2017; 140:14-23. [PMID: 28673400 DOI: 10.1016/j.jaci.2017.05.011] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 05/10/2017] [Accepted: 05/12/2017] [Indexed: 12/21/2022]
Abstract
Asthma prevalence has been on the increase, especially in North America compared with other continents. However, the prevalence of asthma differs worldwide, and in many countries the prevalence is stable or decreasing. This highlights the influence of environmental exposures, such as allergens, air pollution, and the environmental microbiome, on disease etiology and pathogenesis. The epigenome might provide the unifying mechanism that translates the influence of environmental exposures to changes in gene expression, respiratory epithelial function, and immune cell skewing that are hallmarks of asthma. In this review we will introduce the concept of the environmental epigenome in asthmatic patients, summarize previous publications of relevance to this field, and discuss future directions.
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Affiliation(s)
- Ivana V Yang
- Department of Medicine, University of Colorado, School of Medicine, Aurora, Colo; National Jewish Health, Denver, Colo; Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo.
| | - Catherine A Lozupone
- Department of Medicine, University of Colorado, School of Medicine, Aurora, Colo
| | - David A Schwartz
- Department of Medicine, University of Colorado, School of Medicine, Aurora, Colo; National Jewish Health, Denver, Colo; Department of Immunology, University of Colorado, Denver, Colo
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An R, Zhang S, Ji M, Guan C. Impact of ambient air pollution on physical activity among adults: a systematic review and meta-analysis. Perspect Public Health 2017; 138:111-121. [PMID: 28829249 DOI: 10.1177/1757913917726567] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS This study systematically reviewed literature regarding the impact of ambient air pollution on physical activity among children and adults. METHODS Keyword and reference search was conducted in PubMed and Web of Science to systematically identify articles meeting all of the following criteria - study designs: interventions or experiments, retrospective or prospective cohort studies, cross-sectional studies, and case-control studies; subjects: adults; exposures: specific air pollutants and overall air quality; outcomes: physical activity and sedentary behaviour; article types: peer-reviewed publications; and language: articles written in English. Meta-analysis was performed to estimate the pooled effect size of ambient PM2.5 air pollution on physical inactivity. RESULTS Seven studies met the inclusion criteria. Among them, six were conducted in the United States, and one was conducted in the United Kingdom. Six adopted a cross-sectional study design, and one used a prospective cohort design. Six had a sample size larger than 10,000. Specific air pollutants assessed included PM2.5, PM10, O3, and NOx, whereas two studies focused on overall air quality. All studies found air pollution level to be negatively associated with physical activity and positively associated with leisure-time physical inactivity. Study participants, and particularly those with respiratory disease, self-reported a reduction in outdoor activities to mitigate the detrimental impact of air pollution. Meta-analysis revealed a one unit (μg/m3) increase in ambient PM2.5 concentration to be associated with an increase in the odds of physical inactivity by 1.1% (odds ratio = 1.011; 95% confidence interval = 1.001, 1.021; p-value < .001) among US adults. CONCLUSIONS Existing literature in general suggested that air pollution discouraged physical activity. Current literature predominantly adopted a cross-sectional design and focused on the United States. Future studies are warranted to implement a longitudinal study design and evaluate the impact of air pollution on physical activity in heavily polluted developing countries.
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Affiliation(s)
- Ruopeng An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Sheng Zhang
- School of Sports Journalism and Foreign Studies, Shanghai University of Sport, Shanghai, China
| | - Mengmeng Ji
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Calderón-Garcidueñas L, Mora-Tiscareño A, Melo-Sánchez G, Rodríguez-Díaz J, Torres-Jardón R, Styner M, Mukherjee PS, Lin W, Jewells V. A Critical Proton MR Spectroscopy Marker of Alzheimer's Disease Early Neurodegenerative Change: Low Hippocampal NAA/Cr Ratio Impacts APOE ɛ4 Mexico City Children and Their Parents. J Alzheimers Dis 2016; 48:1065-75. [PMID: 26402110 DOI: 10.3233/jad-150415] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Severe air pollution exposures produce systemic, respiratory, myocardial, and brain inflammation and Alzheimer's disease (AD) hallmarks in clinically healthy children. We tested whether hippocampal metabolite ratios are associated with contrasting levels of air pollution, APOE, and body mass index (BMI) in paired healthy children and one parent sharing the same APOE alleles. We used 1H-MRS to interrogate bilateral hippocampal single-voxel in 57 children (12.45 ± 3.4 years) and their 48 parents (37.5 ± 6.78 years) from a low pollution city versus Mexico City (MC). NAA/Cr, Cho/Cr, and mI/Cr metabolite ratios were analyzed. The right hippocampus NAA/Cr ratio was significantly different between cohorts (p = 0.007). The NAA/Cr ratio in right hippocampus in controls versus APOE ɛ4 MC children and in left hippocampus in MC APOE ɛ4 parents versus their children was significantly different after adjusting for age, gender, and BMI (p = 0.027 and 0.01, respectively). The NAA/Cr ratio is considered reflective of neuronal density/functional integrity/loss of synapses/higher pTau burden, thus a significant decrease in hippocampal NAA/Cr ratios may constitute a spectral marker of early neurodegeneration in young urbanites. Decreases in NAA/Cr correlate well with cognitive function, behavioral symptoms, and dementia severity; thus, since the progression of AD starts decades before clinical diagnosis, our findings support the hypothesis that under chronic exposures to fine particulate matter and ozone above the standards, neurodegenerative processes start in childhood and APOE ɛ4 carriers are at higher risk. Gene and environmental factors are critical in the development of AD and the identification and neuroprotection of young urbanites at high risk must become a public health priority.
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Affiliation(s)
- Lilian Calderón-Garcidueñas
- The Center for Structural and Functional Neurosciences, The University of Montana, Missoula, MT, USA.,Escuela de Ciencias de la Salud, Universidad del Valle de México, Campus Saltillo, Saltillo, Coahuila, México
| | | | - Gastón Melo-Sánchez
- Escuela de Ciencias de la Salud, Universidad del Valle de México, Campus Saltillo, Saltillo, Coahuila, México
| | | | - Ricardo Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Martin Styner
- Department of Psychiatry and Computer Science, University of North Carolina, Chapel Hill, NC, USA
| | | | - Weili Lin
- Neuroradiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Valerie Jewells
- Neuroradiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Calderón-Garcidueñas L, Reynoso-Robles R, Vargas-Martínez J, Gómez-Maqueo-Chew A, Pérez-Guillé B, Mukherjee PS, Torres-Jardón R, Perry G, Gónzalez-Maciel A. Prefrontal white matter pathology in air pollution exposed Mexico City young urbanites and their potential impact on neurovascular unit dysfunction and the development of Alzheimer's disease. ENVIRONMENTAL RESEARCH 2016; 146:404-17. [PMID: 26829765 DOI: 10.1016/j.envres.2015.12.031] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/30/2015] [Accepted: 12/27/2015] [Indexed: 05/20/2023]
Abstract
Millions of urban children are chronically exposed to high concentrations of air pollutants, i.e., fine particulate matter (PM2.5) and ozone, associated with increased risk for Alzheimer's disease. Compared with children living with clear air those in Mexico City (MC) exhibit systemic, brain and intrathecal inflammation, low CSF Aβ42, breakdown of the BBB, attention and short-term memory deficits, prefrontal white matter hyperintensities, damage to epithelial and endothelial barriers, tight junction and neural autoantibodies, and Alzheimer and Parkinson's hallmarks. The prefrontal white matter is a target of air pollution. We examined by light and electron microscopy the prefrontal white matter of MC dogs (n: 15, age 3.17±0.74 years), children and teens (n: 34, age: 12.64±4.2 years) versus controls. Major findings in MC residents included leaking capillaries and small arterioles with extravascular lipids and erythrocytes, lipofuscin in pericytes, smooth muscle and endothelial cells (EC), thickening of cerebrovascular basement membranes with small deposits of amyloid, patchy absence of the perivascular glial sheet, enlarged Virchow-Robin spaces and nanosize particles (20-48nm) in EC, basement membranes, axons and dendrites. Tight junctions, a key component of the neurovascular unit (NVU) were abnormal in MC versus control dogs (χ(2)<0.0001), and white matter perivascular damage was significantly worse in MC dogs (p=0.002). The integrity of the NVU, an interactive network of vascular, glial and neuronal cells is compromised in MC young residents. Characterizing the early NVU damage and identifying biomarkers of neurovascular dysfunction may provide a fresh insight into Alzheimer pathogenesis and open opportunities for pediatric neuroprotection.
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Affiliation(s)
- Lilian Calderón-Garcidueñas
- The University of Montana, Missoula, MT 59812, USA; Universidad del Valle de México, Mexico City 04850, México.
| | | | | | | | | | | | - Ricardo Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City 04310, México
| | - George Perry
- College of Sciences, University of Texas at San Antonio, San Antonio, TX, USA
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Brockmeyer S, D'Angiulli A. How air pollution alters brain development: the role of neuroinflammation. Transl Neurosci 2016; 7:24-30. [PMID: 28123818 PMCID: PMC5017593 DOI: 10.1515/tnsci-2016-0005] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 01/29/2016] [Indexed: 12/16/2022] Open
Abstract
The present review synthesizes lines of emerging evidence showing how several samples of children populations living in large cities around the world suffer to some degree neural, behavioral and cognitive changes associated with air pollution exposure. The breakdown of natural barriers warding against the entry of toxic particles, including the nasal, gut and lung epithelial barriers, as well as widespread breakdown of the blood-brain barrier facilitatethe passage of airborne pollutants into the body of young urban residents. Extensive neuroinflammation contributes to cell loss within the central nervous system, and likely is a crucial mechanism by which cognitive deficits may arise. Although subtle, neurocognitive effects of air pollution are substantial, apparent across all populations, and potentially clinically relevant as early evidence of evolving neurodegenerative changes. The diffuse nature of the neuroinflammation risk suggests an integrated neuroscientific approach incorporating current clinical, cognitive, neurophysiological, radiological and epidemiologic research. Neuropediatric air pollution research requires extensive multidisciplinary collaborations to accomplish the goal of protecting exposed children through multidimensional interventions having both broad impact and reach. While intervening by improving environmental quality at a global scale is imperative, we also need to devise efficient strategies on how the neurocognitive effects on local pediatric populations should be monitored.
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Affiliation(s)
- Sam Brockmeyer
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; Institute of Interdisciplinary Studies (Child Studies), 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada
| | - Amedeo D'Angiulli
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; Institute of Interdisciplinary Studies (Child Studies), 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada
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Transcultural Applications to Lifestyle Medicine. LIFESTYLE MEDICINE 2016. [DOI: 10.1007/978-3-319-24687-1_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Calderón-Garcidueñas L, Franco-Lira M, D'Angiulli A, Rodríguez-Díaz J, Blaurock-Busch E, Busch Y, Chao CK, Thompson C, Mukherjee PS, Torres-Jardón R, Perry G. Mexico City normal weight children exposed to high concentrations of ambient PM2.5 show high blood leptin and endothelin-1, vitamin D deficiency, and food reward hormone dysregulation versus low pollution controls. Relevance for obesity and Alzheimer disease. ENVIRONMENTAL RESEARCH 2015; 140:579-592. [PMID: 26037109 DOI: 10.1016/j.envres.2015.05.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/07/2015] [Accepted: 05/12/2015] [Indexed: 06/04/2023]
Abstract
Millions of Mexico, US and across the world children are overweight and obese. Exposure to fossil-fuel combustion sources increases the risk for obesity and diabetes, while long-term exposure to fine particulate matter (PM2.5) and ozone (O3) above US EPA standards is associated with increased risk of Alzheimer's disease (AD). Mexico City Metropolitan Area children are chronically exposed to PM2.5 and O3 concentrations above the standards and exhibit systemic, brain and intrathecal inflammation, cognitive deficits, and Alzheimer disease neuropathology. We investigated adipokines, food reward hormones, endothelial dysfunction, vitamin D and apolipoprotein E (APOE) relationships in 80 healthy, normal weight 11.1±3.2 year olds matched by age, gender, BMI and SES, low (n: 26) versus high (n:54) PM2.5 exposures. Mexico City children had higher leptin and endothelin-1 (p<0.01 and p<0.000), and decreases in glucagon-like peptide-1 (GLP 1), ghrelin, and glucagon (<0.02) versus controls. BMI and leptin relationships were significantly different in low versus high PM2.5 exposed children. Mexico City APOE 4 versus 3 children had higher glucose (p=0.009). Serum 25-hydroxyvitamin D<30 ng/mL was documented in 87% of Mexico City children. Leptin is strongly positively associated to PM 2.5 cumulative exposures. Residing in a high PM2.5 and O3 environment is associated with 12h fasting hyperleptinemia, altered appetite-regulating peptides, vitamin D deficiency, and increases in ET-1 in clinically healthy children. These changes could signal the future trajectory of urban children towards the development of insulin resistance, obesity, type II diabetes, premature cardiovascular disease, addiction-like behavior, cognitive impairment and Alzheimer's disease. Increased efforts should be made to decrease pediatric PM2.5 exposures, to deliver health interventions prior to the development of obesity and to identify and mitigate environmental factors influencing obesity and Alzheimer disease.
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Affiliation(s)
- Lilian Calderón-Garcidueñas
- The Center for Structural and Functional Neurosciences, The University of Montana, Missoula, MT 59812, USA; Hospital Central Militar, Mexico City 11649, Mexico.
| | | | - Amedeo D'Angiulli
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada K1S 5B6
| | - Joel Rodríguez-Díaz
- Escuela de Ciencias de la Salud, Universidad del Valle de México, Saltillo, Coahuila 25204, Mexico
| | | | - Yvette Busch
- Clinical and Environmental Laboratory Micro Trace Minerals (MTM), 91217 Hersbruck, Germany
| | - Chih-kai Chao
- The Center for Structural and Functional Neurosciences, The University of Montana, Missoula, MT 59812, USA
| | - Charles Thompson
- The Center for Structural and Functional Neurosciences, The University of Montana, Missoula, MT 59812, USA
| | | | - Ricardo Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, 04510, Mexico
| | - George Perry
- College of Sciences, University of Texas at San Antonio, San Antonio, TX, USA
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Calderón-Garcidueñas L, Torres-Jardón R, Kulesza RJ, Park SB, D'Angiulli A. Air pollution and detrimental effects on children's brain. The need for a multidisciplinary approach to the issue complexity and challenges. Front Hum Neurosci 2014; 8:613. [PMID: 25161617 PMCID: PMC4129915 DOI: 10.3389/fnhum.2014.00613] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 07/22/2014] [Indexed: 12/16/2022] Open
Abstract
Millions of children in polluted cities are showing brain detrimental effects. Urban children exhibit brain structural and volumetric abnormalities, systemic inflammation, olfactory, auditory, vestibular and cognitive deficits v low-pollution controls. Neuroinflammation and blood-brain-barrier (BBB) breakdown target the olfactory bulb, prefrontal cortex and brainstem, but are diffusely present throughout the brain. Urban adolescent Apolipoprotein E4 carriers significantly accelerate Alzheimer pathology. Neurocognitive effects of air pollution are substantial, apparent across all populations, and potentially clinically relevant as early evidence of evolving neurodegenerative changes. The diffuse nature of the neuroinflammation and neurodegeneration forces to employ a weight of evidence approach incorporating current clinical, cognitive, neurophysiological, radiological and epidemiological research. Pediatric air pollution research requires extensive multidisciplinary collaborations to accomplish a critical goal: to protect exposed children through multidimensional interventions having both broad impact and reach. Protecting children and teens from neural effects of air pollution should be of pressing importance for public health.
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Affiliation(s)
- Lilian Calderón-Garcidueñas
- Department of Biomedical Sciences, The Center for Structural and Functional Neurosciences, University of Montana Missoula, MT, USA
| | - Ricardo Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autonoma de Mexico Mexico City, Mexico
| | - Randy J Kulesza
- Auditory Research Center, Lake Erie College of Osteopathic Medicine Erie, PA, USA
| | - Su-Bin Park
- Neuroscience, NICER Lab (Neuroscience of Imagery Cognition and Emotion Research Lab), Carleton University Ottawa, ON, Canada
| | - Amedeo D'Angiulli
- Neuroscience, NICER Lab (Neuroscience of Imagery Cognition and Emotion Research Lab), Carleton University Ottawa, ON, Canada
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Calderón-Garcidueñas L, Mora-Tiscareño A, Franco-Lira M, Cross JV, Engle R, Aragón-Flores M, Gómez-Garza G, Jewells V, Medina-Cortina H, Solorio E, Chao CK, Zhu H, Mukherjee PS, Ferreira-Azevedo L, Torres-Jardón R, D'Angiulli A. Flavonol-rich dark cocoa significantly decreases plasma endothelin-1 and improves cognition in urban children. Front Pharmacol 2013; 4:104. [PMID: 23986703 PMCID: PMC3749371 DOI: 10.3389/fphar.2013.00104] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 08/02/2013] [Indexed: 01/17/2023] Open
Abstract
Air pollution exposures are linked to systemic inflammation, cardiovascular and respiratory morbidity and mortality, neuroinflammation and neuropathology in young urbanites. In particular, most Mexico City Metropolitan Area (MCMA) children exhibit subtle cognitive deficits, and neuropathology studies show 40% of them exhibiting frontal tau hyperphosphorylation and 51% amyloid-β diffuse plaques (compared to 0% in low pollution control children). We assessed whether a short cocoa intervention can be effective in decreasing plasma endothelin 1 (ET-1) and/or inflammatory mediators in MCMA children. Thirty gram of dark cocoa with 680 mg of total flavonols were given daily for 10.11 ± 3.4 days (range 9–24 days) to 18 children (10.55 years, SD = 1.45; 11F/7M). Key metabolite ratios in frontal white matter and in hippocampus pre and during cocoa intervention were quantified by magnetic resonance spectroscopy. ET-1 significantly decreased after cocoa treatment (p = 0.0002). Fifteen children (83%) showed a marginally significant individual improvement in one or both of the applied simple short memory tasks. Endothelial dysfunction is a key feature of exposure to particulate matter (PM) and decreased endothelin-1 bioavailability is likely useful for brain function in the context of air pollution. Our findings suggest that cocoa interventions may be critical for early implementation of neuroprotection of highly exposed urban children. Multi-domain nutraceutical interventions could limit the risk for endothelial dysfunction, cerebral hypoperfusion, neuroinflammation, cognitive deficits, structural volumetric detrimental brain effects, and the early development of the neuropathological hallmarks of Alzheimer's and Parkinson's diseases.
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Affiliation(s)
- Lilian Calderón-Garcidueñas
- Biomedical Sciences, The Center for Structural and Functional Neurosciences, The University of Montana Missoula, MT, USA ; Hospital Central Militar, Secretaría de la Defensa Nacional Mexico City, Mexico
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Calderón-Garcidueñas L, Serrano-Sierra A, Torres-Jardón R, Zhu H, Yuan Y, Smith D, Delgado-Chávez R, Cross JV, Medina-Cortina H, Kavanaugh M, Guilarte TR. The impact of environmental metals in young urbanites' brains. EXPERIMENTAL AND TOXICOLOGIC PATHOLOGY : OFFICIAL JOURNAL OF THE GESELLSCHAFT FUR TOXIKOLOGISCHE PATHOLOGIE 2013; 65:503-11. [PMID: 22436577 PMCID: PMC3383886 DOI: 10.1016/j.etp.2012.02.006] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 01/16/2012] [Accepted: 02/21/2012] [Indexed: 01/22/2023]
Abstract
Air pollution exposures are linked to cognitive and olfaction deficits, oxidative stress, neuroinflammation and neurodegeneration including frontal hyperphosphorylated tau and diffuse amyloid plaques in Mexico City children and young adults. Mexico City residents are chronically exposed to fine particulate matter (PM(2.5)) concentrations (containing toxic combustion and industrial metals) above the annual standard (15 μg/m(3)) and to contaminated water and soil. Here, we sought to address the brain-region-specific effects of metals and key neuroinflammatory and DNA repair responses in two air pollution targets: frontal lobe and olfactory bulb from 12 controls vs. 47 Mexico City children and young adults average age 33.06±4.8 SE years. Inductively coupled plasma mass spectrometry (metal analysis) and real time PCR (for COX2, IL1β and DNA repair genes) in target tissues. Mexico City residents had higher concentrations of metals associated with PM: manganese (p=0.003), nickel and chromium (p=0.02) along with higher frontal COX2 mRNA (p=0.008) and IL1β (p=0.0002) and COX2 (p=0.005) olfactory bulb indicating neuroinflammation. Frontal metals correlated with olfactory bulb DNA repair genes and with frontal and hippocampal inflammatory genes. Frontal manganese, cobalt and selenium increased with age in exposed subjects. Together, these findings suggest PM-metal neurotoxicity causes brain damage in young urbanites, the olfactory bulb is a target of air pollution and participates in the neuroinflammatory response and since metal concentrations vary significantly in Mexico City urban sub-areas, place of residency has to be integrated with the risk for CNS detrimental effects particularly in children.
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Eyler A, Nanney MS, Brownson RC, Lohman D, Haire-Joshu D. Correlates of After-School Activity Preference in Children Ages 5–12. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2006.10598882] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Amy Eyler
- a School of Public Health , Saint Louis University , 3545 Lafayette Ave., St. Louis , MO , 63104-1399
| | - Marilyn S. Nanney
- b School of Public Health , Saint Louis University , 3454 Lafayette Ave., St. Louis , MO , 63104
| | - Ross C. Brownson
- c School of Public Health , Saint Louis University , 3545 Lafayette Avenue, St. Louis , MO , 63104
| | - Debra Lohman
- d School of Nursing , Saint Louis University , 3225 Caroline Mall, St. Louis , MO , 63104
| | - Debra Haire-Joshu
- e School of Public Health , Saint Louis University , 3545 Lafayette Avenue, St. Louis , MO , 63104
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Conrad A, Seiwert M, Hünken A, Quarcoo D, Schlaud M, Groneberg D. The German Environmental Survey for Children (GerES IV): reference values and distributions for time-location patterns of German children. Int J Hyg Environ Health 2012; 216:25-34. [PMID: 22410199 DOI: 10.1016/j.ijheh.2012.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Revised: 01/30/2012] [Accepted: 02/11/2012] [Indexed: 10/28/2022]
Abstract
Children's time-location patterns are important determinants of environmental exposure and other health-relevant factors. Building on data of the German Environmental Survey for Children (GerES IV), our study aimed at deriving reference values and distributions for time-location patterns of 3-14-year-old German children. We also investigated if GerES IV data are appropriate for evaluating associations with children's health determinants by linking them to data of the National Health Interview and Examination Survey for Children and Adolescents (KiGGS). Parents reported on the time their children usually spend at home, in other indoor environments, and outdoors. This information was characterized by statistical parameters, which were also calculated for different strata concerning socio-demography and the residential environment. Consequently, group differences were evaluated by t-tests and univariate ANOVA. Reference distributions were fitted to the time-location data by a Maximum Likelihood approach to make them also useable in probabilistic exposure modeling. Finally, associations between data on the children's physical activity as well as body weight and their outdoor time were investigated by bivariate correlation analysis and cross tabulation. On daily average, German children spend 15 h and 31 min at home, 4 h and 46 min in other indoor environments, and 3 h and 43 min outdoors. Time spent at home and outdoors decreases with age while time spent in other indoor environments increases. Differences in time-location patterns were also observed for the socio-economic status (SES) and immigration status. E.g., children with a high SES spend 24 min less outdoors than low SES children. Immigrants spend on daily average 20 min more at home and 15 min less outdoors than non-immigrant children. Outdoor time was associated with parameters of the residential environment like the building development. Children living in 1- or 2-family houses spend more time outdoors than children living in building blocks (3 h 48 min vs. 3 h 29 min). Physical activity correlates with outdoor time. For children with diminished age-specific outdoor time, a higher prevalence of obesity was observed (odds ratio: 3.2, 95% CI: 1.5-7.1). GerES IV provides a compilation of current time-location reference values and distributions on German children. This data hint to substantial differences in time-location patterns within the population to be considered in environmental health risk assessment.
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Affiliation(s)
- André Conrad
- Charité--University Medicine Berlin, Institute of Occupational Medicine, Germany.
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Calderón-Garcidueñas L, Engle R, Mora-Tiscareño A, Styner M, Gómez-Garza G, Zhu H, Jewells V, Torres-Jardón R, Romero L, Monroy-Acosta ME, Bryant C, González-González LO, Medina-Cortina H, D'Angiulli A. Exposure to severe urban air pollution influences cognitive outcomes, brain volume and systemic inflammation in clinically healthy children. Brain Cogn 2011; 77:345-55. [PMID: 22032805 DOI: 10.1016/j.bandc.2011.09.006] [Citation(s) in RCA: 169] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 09/22/2011] [Accepted: 09/26/2011] [Indexed: 12/31/2022]
Abstract
Exposure to severe air pollution produces neuroinflammation and structural brain alterations in children. We tested whether patterns of brain growth, cognitive deficits and white matter hyperintensities (WMH) are associated with exposures to severe air pollution. Baseline and 1 year follow-up measurements of global and regional brain MRI volumes, cognitive abilities (Wechsler Intelligence Scale for Children-Revised, WISC-R), and serum inflammatory mediators were collected in 20 Mexico City (MC) children (10 with white matter hyperintensities, WMH(+), and 10 without, WMH(-)) and 10 matched controls (CTL) from a low polluted city. There were significant differences in white matter volumes between CTL and MC children - both WMH(+) and WMH(-) - in right parietal and bilateral temporal areas. Both WMH(-) and WMH(+) MC children showed progressive deficits, compared to CTL children, on the WISC-R Vocabulary and Digit Span subtests. The cognitive deficits in highly exposed children match the localization of the volumetric differences detected over the 1 year follow-up, since the deficits observed are consistent with impairment of parietal and temporal lobe functions. Regardless of the presence of prefrontal WMH, Mexico City children performed more poorly across a variety of cognitive tests, compared to CTL children, thus WMH(+) is likely only partially identifying underlying white matter pathology. Together these findings reveal that exposure to air pollution may perturb the trajectory of cerebral development and result in cognitive deficits during childhood.
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Braniš M, Safránek J, Hytychová A. Indoor and outdoor sources of size-resolved mass concentration of particulate matter in a school gym-implications for exposure of exercising children. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2011; 18:598-609. [PMID: 20972889 DOI: 10.1007/s11356-010-0405-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 10/12/2010] [Indexed: 05/30/2023]
Abstract
INTRODUCTION It has been noticed many times that schools are buildings with high levels of particulate matter concentrations. Several authors documented that concentrations of particulate matter in indoor school microenvironments exceed limits recommended by WHO namely when school buildings are situated near major roads with high traffic densities. In addition, exercise under conditions of high particulate concentrations may increase the adverse health effects, as the total particle deposition increases in proportion to minute ventilation, and the deposition fraction nearly doubles from rest to intense exercise. SITE AND METHODS Mass concentrations of size-segregated aerosol were measured simultaneously in an elementary school gym and an adjacent outdoor site in the central part of Prague by two pairs of collocated aerosol monitors-a fast responding photometer DusTrak and a five stage cascade impactor. To encompass seasonal and annual differences, 89 days of measurements were performed during ten campaigns between 2005 and 2009. RESULTS AND DISCUSSION The average (all campaigns) outdoor concentration of PM(2.5) (28.3 μg m(-3)) measured by the cascade impactors was higher than the indoor value (22.3 μg m(-3)) and the corresponding average from the nearest fixed site monitor (23.6 μg m(-3)). Indoor and outdoor PM(2.5) concentrations exceeded the WHO recommended 24-h limit in 42% and 49% of the days measured, respectively. The correlation coefficient (r) between corresponding outdoor and indoor aerosol sizes increased with decreasing aerodynamic diameter of the collected particles (r = 0.32-0.87), suggesting a higher infiltration rate of fine and quasi-ultrafine particles. Principal component analysis revealed five factors explaining more than 82% of the data variability. The first two factors reflected a close association between outdoor and indoor fine and quasi-ultrafine particles confirming the hypothesis of high infiltration rate of particles from outdoors. The third factor indicated that human activity is the main source of indoor emission of coarse particles. The fourth factor involved only outdoor variables showing the resuspension of coarse ambient aerosol on dry and warm days without its seeming effect on the indoor coarse PM levels. Having in mind that high concentrations of both fine and coarse aerosol were frequently observed in the studied space, our results suggest that indoor exercise in polluted urbanized areas may increase the overall exposure and thus represent a potential health risk to young individuals during physical education at schools.
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Affiliation(s)
- Martin Braniš
- Faculty of Science, Institute for Environmental Studies, Charles University in Prague, Albertov 6, 128 43, Prague 2, Czech Republic.
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Calderón-Garcidueñas L, Macías-Parra M, Hoffmann HJ, Valencia-Salazar G, Henríquez-Roldán C, Osnaya N, Monte OCD, Barragán-Mejía G, Villarreal-Calderon R, Romero L, Granada-Macías M, Torres-Jardón R, Medina-Cortina H, Maronpot RR. Immunotoxicity and Environment: Immunodysregulation and Systemic Inflammation in Children. Toxicol Pathol 2009; 37:161-9. [DOI: 10.1177/0192623308329340] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Environmental pollutants, chemicals, and drugs have an impact on children’s immune system development. Mexico City (MC) children exposed to significant concentrations of air pollutants exhibit chronic respiratory inflammation, systemic inflammation, neuroinflammation, and cognitive deficits. We tested the hypothesis that exposure to severe air pollution plays a role in the immune responses of asymptomatic, apparently healthy children. Blood measurements for markers of immune function, inflammatory mediators, and molecules interacting with the lipopolysaccharide recognition complex were obtained from two cohorts of matched children (aged 9.7 ± 1.2 years) from southwest Mexico City (SWMC) (n = 66) and from a control city (n = 93) with criteria pollutant levels below current standards. MC children exhibited significant decreases in the numbers of natural killer cells ( p = .003) and increased numbers of mCD14+ monocytes ( p < .001) and CD8+ cells ( p = .02). Lower concentrations of interferon γ ( p = .009) and granulocyte–macrophage colony-stimulating factor ( p < .001), an endotoxin tolerance-like state, systemic inflammation, and an anti-inflammatory response were also present in the highly exposed children. C-reactive protein and the prostaglandin E metabolite levels were positively correlated with twenty-four- and forty-eight-hour cumulative concentrations of PM2.5. Exposure to urban air pollution is associated with immunodysregulation and systemic inflammation in children and is a major health threat.
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Affiliation(s)
- Lilian Calderón-Garcidueñas
- Instituto Nacional de Pediatría, Mexico City, Mexico
- Department of Biomedical and Pharmaceutical Sciences, College of Health Professions and Biomedical Sciences, The University of Montana, Missoula, Montana, USA
| | | | - Hans J. Hoffmann
- Department of Respiratory Diseases, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Norma Osnaya
- Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | | | - Rodolfo Villarreal-Calderon
- Department of Biomedical and Pharmaceutical Sciences, College of Health Professions and Biomedical Sciences, The University of Montana, Missoula, Montana, USA
| | - Lina Romero
- Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Margarita Granada-Macías
- Postgrado en Ciencias Biológicas, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ricardo Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Robert R. Maronpot
- Experimental Pathology Laboratories, Inc., Research Triangle Park, North Carolina, USA
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Air pollution, cognitive deficits and brain abnormalities: A pilot study with children and dogs. Brain Cogn 2008; 68:117-27. [DOI: 10.1016/j.bandc.2008.04.008] [Citation(s) in RCA: 360] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2007] [Revised: 04/11/2008] [Accepted: 04/14/2008] [Indexed: 11/17/2022]
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Calderón-Garcidueñas L, Villarreal-Calderon R, Valencia-Salazar G, Henríquez-Roldán C, Gutiérrez-Castrellón P, Torres-Jardón R, Osnaya-Brizuela N, Romero L, Torres-Jardón R, Solt A, Reed W. Systemic Inflammation, Endothelial Dysfunction, and Activation in Clinically Healthy Children Exposed to Air Pollutants. Inhal Toxicol 2008; 20:499-506. [DOI: 10.1080/08958370701864797] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
OBJECTIVE To test the contribution of maternal depression during late infancy to physical activity in children 5 years later. METHOD Children (n = 168) from very low-income households in semiurban Mexico were assessed as toddlers (15 months, Time 1) and at pre-school age (4-6 years, Time 2). Child low activity level (<20 minutes of activity daily for <7 d/wk) at Time 2 was the primary outcome measure and maternal depressive symptoms (Center for Epidemiologic Studies-Depression Scale) by self-report at Time 1 was the primary independent variable. Covariates tested included child age, sex, BMI percentile, television viewing and behavior (Behavior Problem Index subscales), current maternal depressive symptoms, age, BMI and physical activity level, and family socioeconomic status; all covariates were assessed at Time 2 except for socioeconomic status. RESULTS At 4 to 6 years old, 27.5% of children were categorized with low activity level. Exposure to high maternal depressive symptoms at child age 15 months was associated with an increased risk of having a low activity level at age 4 to 6 years (OR, 2.38; 95% CI, 1.05-5.40); results were unchanged with the inclusion of current maternal depressive symptoms. High child TV viewing was significantly associated with low activity level (OR, 5.44; 95% CI, 2.06-14.3), but did not change the effect of maternal depressive symptoms in early childhood. Tests of mediation revealed that current child internalizing behavior, but not externalizing behavior, significantly attenuated the association between early high maternal depressive symptoms and later childhood activity level. CONCLUSION Exposure to maternal depressive symptoms in late infancy is a risk factor for low activity level in later childhood and the association may be mediated by child internalizing factors.
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Calderón-Garcidueñas L, Solt AC, Henríquez-Roldán C, Torres-Jardón R, Nuse B, Herritt L, Villarreal-Calderón R, Osnaya N, Stone I, García R, Brooks DM, González-Maciel A, Reynoso-Robles R, Delgado-Chávez R, Reed W. Long-term air pollution exposure is associated with neuroinflammation, an altered innate immune response, disruption of the blood-brain barrier, ultrafine particulate deposition, and accumulation of amyloid beta-42 and alpha-synuclein in children and young adults. Toxicol Pathol 2008; 36:289-310. [PMID: 18349428 DOI: 10.1177/0192623307313011] [Citation(s) in RCA: 613] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Air pollution is a serious environmental problem. We investigated whether residency in cities with high air pollution is associated with neuroinflammation/neurodegeneration in healthy children and young adults who died suddenly. We measured mRNA cyclooxygenase-2, interleukin-1beta, and CD14 in target brain regions from low (n = 12) or highly exposed residents (n = 35) aged 25.1 +/- 1.5 years. Upregulation of cyclooxygenase-2, interleukin-1beta, and CD14 in olfactory bulb, frontal cortex, substantia nigrae and vagus nerves; disruption of the blood-brain barrier; endothelial activation, oxidative stress, and inflammatory cell trafficking were seen in highly exposed subjects. Amyloid beta42 (Abeta42) immunoreactivity was observed in 58.8% of apolipoprotein E (APOE) 3/3 < 25 y, and 100% of the APOE 4 subjects, whereas alpha-synuclein was seen in 23.5% of < 25 y subjects. Particulate material (PM) was seen in olfactory bulb neurons, and PM < 100 nm were observed in intraluminal erythrocytes from lung, frontal, and trigeminal ganglia capillaries. Exposure to air pollution causes neuroinflammation, an altered brain innate immune response, and accumulation of Abeta42 and alpha-synuclein starting in childhood. Exposure to air pollution should be considered a risk factor for Alzheimer's and Parkinson's diseases, and carriers of the APOE 4 allele could have a higher risk of developing Alzheimer's disease if they reside in a polluted environment.
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Rodriguez C, Tonkin R, Heyworth J, Kusel M, De Klerk N, Sly PD, Franklin P, Runnion T, Blockley A, Landau L, Hinwood AL. The relationship between outdoor air quality and respiratory symptoms in young children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2007; 17:351-360. [PMID: 17924263 DOI: 10.1080/09603120701628669] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The aim of this study was to investigate the relationship between air pollution and respiratory symptoms in young children. A total of 263 children at high risk of developing asthma or atopy were recruited antenatally and all respiratory symptoms experienced by the children were recorded by their parents for five years. Daily pollutant concentrations and meteorological data (ambient temperature and humidity) were collected from network monitoring sites. Logistic regression models investigating relationships between individual air pollutants and respiratory symptoms showed significant associations between Ozone (O3) (1 h and 8 h) concentrations and raised body temperature (lag 0); Carbon monoxide (CO) (8 h) and wheeze/rattle and runny/blocked nose (lag 5 and additive exposure over 5 days); Nitrogen dioxide (NO2) (24 h) concentrations and cough (lag 0 and additive exposure over 5 days) and PM2.5 and visibility (BSP) (1 h) with cough (lag 0). These associations were observed even though air pollutant concentrations were below national standards throughout the study period.
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Affiliation(s)
- Clemencia Rodriguez
- Centre for Ecosystem Management, Edith Cowan University, Joondalup, Australia
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Calderón-Garcidueñas L, Vincent R, Mora-Tiscareño A, Franco-Lira M, Henríquez-Roldán C, Barragán-Mejía G, Garrido-García L, Camacho-Reyes L, Valencia-Salazar G, Paredes R, Romero L, Osnaya H, Villarreal-Calderón R, Torres-Jardón R, Hazucha MJ, Reed W. Elevated plasma endothelin-1 and pulmonary arterial pressure in children exposed to air pollution. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:1248-53. [PMID: 17687455 PMCID: PMC1940106 DOI: 10.1289/ehp.9641] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Accepted: 04/27/2007] [Indexed: 05/16/2023]
Abstract
BACKGROUND Controlled exposures of animals and humans to particulate matter (PM) or ozone air pollution cause an increase in plasma levels of endothelin-1, a potent vasoconstrictor that regulates pulmonary arterial pressure. OBJECTIVES The primary objective of this field study was to determine whether Mexico City children, who are chronically exposed to levels of PM and O(3) that exceed the United States air quality standards, have elevated plasma endothelin-1 levels and pulmonary arterial pressures. METHODS We conducted a study of 81 children, 7.9 +/- 1.3 years of age, lifelong residents of either northeast (n = 19) or southwest (n = 40) Mexico City or Polotitlán (n = 22), a control city with PM and O(3) levels below the U.S. air quality standards. Clinical histories, physical examinations, and complete blood counts were done. Plasma endothelin-1 concentrations were determined by immunoassay, and pulmonary arterial pressures were measured by Doppler echocardiography. RESULTS Mexico City children had higher plasma endothelin-1 concentrations compared with controls (p < 0.001). Mean pulmonary arterial pressure was elevated in children from both northeast (p < 0.001) and southwest (p < 0.05) Mexico City compared with controls. Endothelin-1 levels in Mexico City children were positively correlated with daily outdoor hours (p = 0.012), and 7-day cumulative levels of PM air pollution < 2.5 mum in aerodynamic diameter (PM(2.5)) before endothelin-1 measurement (p = 0.03). CONCLUSIONS Chronic exposure of children to PM(2.5) is associated with increased levels of circulating endothelin-1 and elevated mean pulmonary arterial pressure.
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Affiliation(s)
- Lilian Calderón-Garcidueñas
- Instituto Nacional de Pediatría, Mexico City, Mexico
- The Center for Structural and Functional Neurosciences, University of Montana, Missoula, Montanta, USA
| | - Renaud Vincent
- Inhalation Toxicology and Aerobiology Section, Safe Environments Programme, Health Canada, Ottawa, Ontario, Canada
| | | | | | | | | | | | | | | | | | - Lina Romero
- Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Hector Osnaya
- Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | - Ricardo Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Milan J. Hazucha
- Department of Medicine
- Center for Environmental Medicine, Asthma and Lung Biology and
| | - William Reed
- Center for Environmental Medicine, Asthma and Lung Biology and
- Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA
- Address correspondence to W. Reed, CB# 7310, 104 Mason Farm Rd., Chapel Hill, NC 27599-7310 USA. Telephone: (919) 966-0669. Fax: (919) 966-9863. E-mail:
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Turnovska TH, Mandadzhieva SK, Marinov BI, Kostianev SS. Respiratory and cardiovascular functions among smoking and nonsmoking girls from two regions with different air pollution degree. Int J Hyg Environ Health 2007; 210:61-8. [PMID: 16996799 DOI: 10.1016/j.ijheh.2006.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2005] [Revised: 07/17/2006] [Accepted: 08/02/2006] [Indexed: 10/24/2022]
Abstract
AIM The aim of the present study was to analyze the respiratory and cardiovascular functions among smoking and nonsmoking girls attending two schools situated in regions with different levels of air pollution. The characteristic of air pollution is based on the data gathered by stations 1 and 2 belonging to the Uniform National System for Monitoring the Air Pollution in Bulgaria. The participants (n=108, 16.07+/-0.80 years) were separated in two groups: smokers (S1 - from school 1, S2 - from school 2) and nonsmokers (NS1 - from school 1, NS2 - from school 2). All of them performed pulmonary function testing and .cardiopulmonary exercise testing on a treadmill using our modification of the Balke protocol (Marinov et al., 2000). Reference values for European children, previously validated for the Bulgarian population, were used. RESULTS There are no significant differences in mean levels of VC, IC, FEV1, MEF50 and MEF25 (as a percentage from the predicted value as well). The average level of the Tiffneau index is noticeably higher among nonsmokers from the two regions and is the lowest among smokers from the more polluted area, but a significant difference exists between S2 (88.7+/-5.9) and NS2 (92.6+/-4.7), p=0.047; T(L,CO)%pred: S1 (85.4+/-7.2) vs. S2 (86.7+/-8.2), p=0.048 and NS1 (88.3+/-8.2) vs. NS2 (92.8+/-14.5), p=0.037; V(E)%pred: S1 (127.5+/-9.6) vs. S2 (123.7+/-6.1), p=0.035; higher levels of total lung capacity (TLC%pred), S1 (107.3+/-9.2) vs. NS2 (104.3+/-9.1), p=0.009 and alveolar ventilation (VA), S1 (5.0+/-0.6) vs. NS2 (4.6+/-0.5), p=0.008. CONCLUSIONS 1. The negative effects of the combined influence of tobacco smoking and air pollution on some respiratory and cardiovascular functions of adolescent girls are more pronounced than each influence alone. 2. The cardiopulmonary exercise test gives adequate information about the combined effect of air pollution and smoking and using it for preventive purposes is an advisable method.
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Affiliation(s)
- Tanya H Turnovska
- Department of Hygiene and Ecomedicine, Medical University, Vassil Aprilov Blvd., 15 A, Plovdiv, Bulgaria.
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Calderón-Garcidueñas L, Mora-Tiscareño A, Fordham LA, Chung CJ, Valencia-Salazar G, Flores-Gómez S, Solt AC, Campo AGD, Jardón-Torres R, Henríquez-Roldán C, Hazucha MJ, Reed W. Lung radiology and pulmonary function of children chronically exposed to air pollution. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:1432-7. [PMID: 16966101 PMCID: PMC1570091 DOI: 10.1289/ehp.8377] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
We analyzed the chest radiographs (CXRs) of 249 clinically healthy children, 230 from southwest Mexico City and 19 from Tlaxcala. In contrast to children from Tlaxcala, children from southwest Mexico City were chronically exposed to ozone levels exceeding the U.S. National Ambient Air Quality Standards for an average of 4.7 hr/day and to concentrations of particulate matter (PM) with aerodynamic diameters </= 2.5 microm (PM2.5) above the annual standard. CXRs of Mexico City children demonstrated bilateral hyperinflation (151 of 230) and increased linear markings (121 of 230) . Hyperinflation and interstitial markings were significantly more common in Mexico City children (p < 0.0002 and 0.00006 respectively) . Mexico City boys had a higher probability of developing interstitial markings with age (p = 0.004) . Computed tomography (CT) scans were obtained in 25 selected Mexico City children with abnormal CXRs. Mild bronchial wall thickening was seen in 10 of 25, prominent central airways in 4 of 25, air trapping in 8 of 21, and pulmonary nodules in 2 of 21. Only 7.8% of Mexico City children had abnormal lung function tests based on predicted values. These findings are consistent with bronchiolar, peribronchiolar, and/or alveolar duct inflammation, possibly caused by ozone, PM, and lipopolysaccharide exposure. The epidemiologic implications of these findings are important for children residing in polluted environments, because bronchiolar disease could lead to chronic pulmonary disease later in life.
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Affiliation(s)
- Lilian Calderón-Garcidueñas
- Instituto Nacional de Pediatría, Mexico City, Mexico
- College of Health Professions and Biomedical Sciences, University of Montana, Missoula, Montana, USA
| | | | - Lynn A. Fordham
- Pediatric Imaging Section, Department of Radiology, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, USA
| | - Charles J. Chung
- Western New York Radiology, Buffalo General Hospital, Buffalo, New York, USA
| | | | | | - Anna C. Solt
- Instituto Nacional de Pediatría, Mexico City, Mexico
- Harvard South Shore Psychiatry Program, Brockton, Massachusetts, USA
| | | | - Ricardo Jardón-Torres
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Milan J. Hazucha
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, USA
| | - William Reed
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, USA
- Address correspondence to W. Reed, Department of Pediatrics and Center for Environmental Medicine, Asthma and Lung Biology, CB#7310, 104 Mason Farm Rd., Chapel Hill, NC 27599-7310, USA. Telephone: (919) 966-0669. Fax: (919) 966-9863. E-mail:
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Hudson R, Arriola A, Martínez-Gómez M, Distel H. Effect of Air Pollution on Olfactory Function in Residents of Mexico City. Chem Senses 2005; 31:79-85. [PMID: 16354742 DOI: 10.1093/chemse/bjj019] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To our knowledge there has been no study of the effect of everyday air pollution on olfactory function. It was therefore the aim of this study to compare the olfactory performance of long-term residents of Mexico City, an environment with high air pollution, with the olfactory performance of residents of the Mexican state of Tlaxcala, a region geographically similar to Mexico City but with low air pollution. Healthy volunteers [82 Mexico City subjects (MEX), 86 Tlaxcala subjects (TLX)] 20-63 years of age and balanced for age and gender between the two localities were tested for the perception of the odors of everyday beverages presented in squeeze bottles. When tested with ascending concentrations of stimuli in a three-way oddball paradigm, residents of Tlaxcala detected the odors of instant coffee and of an orange drink at significantly lower concentrations than residents of Mexico City. They also performed significantly better in discriminating between the two similar-smelling Mexican beverages horchata and atole in an oddball test. Significant differences between the two populations in overall olfactory performance were apparent in three of the four age classes (20- to 29-, 30- to 39-, and 40- to 49-year-old subjects) but not in the 50-63 years age class. About 10% of MEX subjects compared to about 2% of TLX subjects were judged to have poor olfactory function; all were from the older age classes (mean age: 48.6 years). Thus, air pollution in Mexico City appears to have a substantial impact on olfactory function even in young and middle-aged residents.
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Affiliation(s)
- Robyn Hudson
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Apartado Postal 70228, CP 04510 México DF, Mexico.
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Calderón-Garcidueñas L, Mora-Tiscareño A, Fordham LA, Valencia-Salazar G, Chung CJ, Rodriguez-Alcaraz A, Paredes R, Variakojis D, Villarreal-Calderón A, Flores-Camacho L, Antunez-Solis A, Henríquez-Roldán C, Hazucha MJ. Respiratory damage in children exposed to urban pollution. Pediatr Pulmonol 2003; 36:148-61. [PMID: 12833495 DOI: 10.1002/ppul.10338] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Southwest Metropolitan Mexico City (SWMMC) children are chronically exposed to complex mixtures of air pollutants. In a cross-sectional arm of our study, we investigated the association between exposure to SWMMC atmosphere and nasal abnormalities, hyperinflation, and interstitial markings assessed by chest X-rays, lung function changes, several serum cytokines, and endothelin-1 in 174 children aged 5-17 years vs. 27 control children residents in low-polluted areas. Control children had no nasal lesions, and only one child showed an abnormal chest X-ray. SWMMC children exhibited nasal abnormalities (22%), hyperinflation (67%), interstitial markings (49%), and a mild restrictive pattern by spirometry (10%). Interstitial markings were associated with a decrease in predicted values of FEF(25-75), FEF(75), and the FEV(1)/FVC ratio. Boys had a higher probability of developing interstitial markings with age (P = 0.004). Blood smear findings included toxic granulations in neutrophils and schistocytes. SWMMC children had more serum IL10 and IL6 and less IL8 than controls. In a longitudinal arm of our study, we found a significant seasonal drop in FVC and FEV(1) associated with a 6-month period of high ozone and PM(10) levels. Our data strongly suggest that a lifelong exposure to urban air pollution causes respiratory damage in children. Moreover, a cytokine network becomes imbalanced, with a shift towards upregulation of anti-inflammatory cytokines. Consequently, these children are potentially at risk for developing chronic lung disease and other systemic effects later in life.
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