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Zhao Y, Peng Y, Wang M, Zhao Y, He Y, Zhang L, Liu J, Zheng S. Exposure to PM 2.5 and its constituents is associated with metabolic dysfunction-associated fatty liver disease: a cohort study in Northwest of China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:304. [PMID: 39002087 DOI: 10.1007/s10653-024-02071-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 06/06/2024] [Indexed: 07/15/2024]
Abstract
Accumulating animal studies have demonstrated associations between ambient air pollution (AP) and metabolic dysfunction-associated fatty liver disease (MAFLD), but relevant epidemiological evidence is limited. We evaluated the association of long-term exposure to AP with the risk of incident MAFLD in Northwest China. The average AP concentration between baseline and follow-up was used to assess individual exposure levels. Cox proportional hazard models and restricted cubic spline functions (RCS) were used to estimate the association of PM2.5 and its constituents with the risk of MAFLD and the dose-response relationship. Quantile g-computation was used to assess the joint effects of mixed exposure to air pollutants on MAFLD and the weights of the various pollutants. We observed 1516 cases of new-onset MAFLD, with an incidence of 10.89%. Increased exposure to pollutants was significantly associated with increased odds of MAFLD, with hazard ratios (HRs) of 2.93 (95% CI: 1.22, 7.00), 2.86 (1.44, 5.66), 7.55 (3.39, 16.84), 4.83 (1.89, 12.38), 3.35 (1.35, 8.34), 1.89 (1.02, 1.62) for each interquartile range increase in PM2.5, SO42-, NO3-, NH4+, OM, and BC, respectively. Stratified analyses suggested that females, frequent exercisers and never-drinkers were more susceptible to MAFLD associated with ambient PM2.5 and its constituents. Mixed exposure to SO42-, NO3-, NH4+, OM and BC was associated with an increased risk of MAFLD, and the weight of BC had the strongest effect on MAFLD. Exposure to ambient PM2.5 and its constituents increased the risk of MAFLD.
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Affiliation(s)
- Yamin Zhao
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yindi Peng
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Minzhen Wang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
| | - Yanan Zhao
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yingqian He
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Lulu Zhang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jing Liu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Shan Zheng
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
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Wu P, Guo Q, Zhao Y, Bian M, Cao S, Zhang J(J, Duan X. Emerging concern on air pollution and health: Trade-off between air pollution exposure and physical activity. ECO-ENVIRONMENT & HEALTH 2024; 3:202-207. [PMID: 38655004 PMCID: PMC11035044 DOI: 10.1016/j.eehl.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/31/2023] [Accepted: 01/25/2024] [Indexed: 04/26/2024]
Abstract
Air pollution is a major contributor to the global disease burden, especially affecting respiratory and cardiovascular health. However, physical activity is associated with improved lung function, a slower decline in lung function, and lower mortality. The public is more likely to be exposed to air pollution during outdoor physical activity. However, studies on how long-term and short-term exposure to air pollution interacts with physical activity yield inconsistent results, and the thresholds for air pollution and physical activity remain unclear. Thus, more studies are needed to provide sufficient evidence to guide the public to safely engage in outdoor physical activity when exposed to air pollution.
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Affiliation(s)
- Pengpeng Wu
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Qian Guo
- China North Artificial Intelligence & Innovation Research Institute, Beiing 100072, China
- Collective Intelligence & Collaboration Laboratory, Beijing 100072, China
| | - Yuchen Zhao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Mengyao Bian
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Junfeng (Jim) Zhang
- Nicholas School of the Environment and Global Health Institute, Duke University, Durham, NC 27708, USA
- Duke Kunshan University, Kunshan 215316, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
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Zhang X, Zhang T, Chen X, Ni J, Xu S, Peng Y, Wang G, Sun W, Liu X, Pan F. The impact of short-term exposure to meteorological factors on the risk of death from hypertension and its major complications: a time series analysis based on Hefei, China. Int Arch Occup Environ Health 2024; 97:313-329. [PMID: 38403848 DOI: 10.1007/s00420-024-02046-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/16/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study aimed to reveal the short-term impact of meteorological factors on the mortality risk in hypertensive patients, providing a scientific foundation for formulating pertinent prevention and control policies. METHODS In this research, meteorological factor data and daily death data of hypertensive patients in Hefei City from 2015 to 2018 were integrated. Time series analysis was performed using distributed lag nonlinear model (DLNM) and generalized additive model (GAM). Furthermore, we conducted stratified analysis based on gender and age. Relative risk (RR) combined with 95% confidence interval (95% CI) was used to represent the mortality risk of single day and cumulative day in hypertensive patients. RESULTS Single-day lag results indicated that high daily mean temperature (T mean) (75th percentile, 24.9 °C) and low diurnal temperature range (DTR) (25th percentile, 4.20 °C) levels were identified as risk factors for death in hypertensive patients (maximum effective RR values were 1.144 and 1.122, respectively). Extremely high levels of relative humidity (RH) (95th percentile, 94.29%) reduced the risk of death (RR value was 0.893). The stratified results showed that the elderly and female populations are more susceptible to low DTR levels, whereas extremely high levels of RH have a more significant protective effect on both populations. CONCLUSION Overall, we found that exposure to low DTR and high T mean environments increases the risk of death for hypertensive patients, while exposure to extremely high RH environments significantly reduces the risk of death for hypertensive patients. These findings contribute valuable insights for shaping targeted prevention and control strategies.
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Affiliation(s)
- Xu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xuyang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Jianping Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Siwen Xu
- School of Medicine, Tongji University, 500 Zhennan Road, Shanghai, 200333, China
| | - Yongzhen Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Guosheng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Wanqi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Xuxiang Liu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, 230032, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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Zeng YQ, Chong KC, Chang LY, Liang X, Guo LH, Dong G, Tam T, Lao XQ. Exposure to Neighborhood Greenness and Hypertension Incidence in Adults: A Longitudinal Cohort Study in Taiwan. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:37001. [PMID: 38427031 PMCID: PMC10906659 DOI: 10.1289/ehp13071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 01/11/2024] [Accepted: 02/01/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND There are few studies on the health effects of long-term exposure to neighborhood greenness in a longitudinal setting, especially in Asian countries with high population densities. OBJECTIVES This study investigates the association between long-term exposure to neighborhood greenness and hypertension among adults in Taiwan. METHODS We selected 125,537 participants (≥ 18 years of age) without hypertension from Taiwan who had joined the standard medical examination program between 2001 and 2016. Neighborhood greenness was estimated using the normalized difference vegetation index (NDVI), derived from satellite images at a resolution of 250 m 2 . The 2-y average NDVI value within a 500 -m circular buffer around participants' residences was calculated. A time-varying Cox regression model was used to investigate the association between neighborhood greenness and incident hypertension. Mediation analyses were performed to examine whether the association was explained by air pollution, leisure-time physical exercise, or body mass index (BMI). RESULTS Compared with living in areas within the first quartile of neighborhood greenness, living in areas within the second, third, and fourth quartiles of neighborhood greenness was found to be associated with a lower risk of hypertension, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 0.95 (95% CI: 0.91, 1.00), 0.95 (95% CI: 0.90, 0.99), and 0.93 (95% CI: 0.88, 0.97), respectively. Each 0.1-unit increase in the NDVI was associated with a 24% lower risk of developing hypertension (HR = 0.76; 95% CI: 0.66, 0.87), with this associations being stronger among males and those with higher education levels. This association was slightly mediated by BMI but not by air pollution or leisure-time physical exercise. DISCUSSION Our findings suggest the protective effects of neighborhood greenness on hypertension development, especially in males and well-educated individuals. Our results reinforced the importance of neighborhood greenness for supporting health. https://doi.org/10.1289/EHP13071.
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Affiliation(s)
- Yi Qian Zeng
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ka Chun Chong
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Xue Liang
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li-Hao Guo
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guanghui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiang Qian Lao
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong SAR, China
- School of Public Health, Zhengzhou University, Zhengzhou, China
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Griggs S, Pignatiello G, Motairek I, Rieke J, Howard Q, Crawford SL, Rajagopalan S, Al-Kindi S, Hickman RL. Environmental exposures and blood pressure in adolescents and adults in the T1D exchange clinic registry. J Diabetes Complications 2023; 37:108594. [PMID: 37660429 PMCID: PMC10592032 DOI: 10.1016/j.jdiacomp.2023.108594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 09/05/2023]
Abstract
AIMS To examine the associations between environmental determinants of health and blood pressure and whether age, sex, or race moderated the associations among 18,754 adolescents and adults from the type 1 diabetes (T1D) Exchange Clinic Registry. METHODS We used multivariable linear regression. Environmental determinants included exposure to ambient fine particulate matter (PM2.5, obtained from an integrated model), nitrogen dioxide (NO2), noise and light pollution, and the normalized difference vegetation index (NDVI, a marker of green space) at the ZIP code level of residence. RESULTS Higher exposure to PM2.5 and NO2, and lower NDVI, was associated with higher systolic and diastolic blood pressure, and higher light pollution exposure were similarly associated with higher diastolic blood pressure. These associations between environmental exposures and blood pressure remained significant after accounting for other covariates (age, sex, race/ethnicity, BMI, and T1D duration). With aging, the negative association between NDVI and blood pressure weakened. CONCLUSIONS These findings emphasize the significance of minimizing exposure to environmental pollutants, including PM2.5 and NO2, as well as ensuring access to areas with higher NDVI, to promote cardiovascular health in individuals with T1D.
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Affiliation(s)
- Stephanie Griggs
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America.
| | - Grant Pignatiello
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America; Case Western Reserve University, Frances Payne Bolton School of Nursing, United States of America.
| | - Issam Motairek
- Cardiovascular Phenomics Core, School of Medicine, Case Western Reserve University, United States of America.
| | - Jorden Rieke
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America; Case Western Reserve University, Frances Payne Bolton School of Nursing, United States of America.
| | - Quiana Howard
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America.
| | - Sybil L Crawford
- University of Massachusetts Chan Medical School, Tan Chingfen Graduate School of Nursing, Worcester, MA 01655, United States of America.
| | - Sanjay Rajagopalan
- Cardiovascular Research Institute, Case Western Reserve University, School of Medicine, United States of America.
| | - Sadeer Al-Kindi
- Center for Vascular Metabolic Disease, School of Medicine, United States of America.
| | - Ronald L Hickman
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America.
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Cao M, Zheng C, Zhou H, Wang X, Chen Z, Zhang L, Cao X, Tian Y, Han X, Liu H, Liu Y, Xue T, Wang Z, Guan T. Air pollution attenuated the benefits of physical activity on blood pressure: Evidence from a nationwide cross-sectional study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115345. [PMID: 37572623 DOI: 10.1016/j.ecoenv.2023.115345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/14/2023]
Abstract
INTRODUCTION Although physical activity (PA) has multiple health benefits, the inhaled dose of fine particulate matter (PM2.5) during PA may increase. The trade-off between harmful effects of PM2.5 exposure and protective effects of PA remain unclear. Our study aims to examine the joint effects of PA and PM2.5 exposure on blood pressure (BP) in Chinese adults. METHODS A total of 203,108 adults aged ≥ 18 years from the China Hypertension Survey study (2012-2015) were included. Individual-level PA was assessed as minutes of metabolic equivalent tasks per week (MET-min/week). The average weekly PM2.5 exposures were estimated by using a spatial resolution of 10 km, integrating multiple data sources, including monitoring values, satellite measurements and model simulations. BP was measured with a professional portable BP monitor. Generalized linear regressions were used to estimate joint associations and to further explore two-dimensional nonlinear associations. RESULTS The median PA and 4-week PM2.5 average exposures were 3213.0 MET-min/week and 47.8 μg/m3, respectively. PA was negatively associated with BP, while PM2.5 exposure was positively with BP. The associations between PA and systolic BP were significantly modified by PM2.5 exposure (Pinteraction < 0.001). Compared with inactive participants under low PM2.5 exposure, those with highest level of PA under low PM2.5 exposure had a 0.90 (95 % CI: 0.53, 1.26) mmHg decrease in systolic BP, whereas they had a 0.48 (95 % CI: 0.07, 0.89) mmHg increase under high PM2.5 exposure. When PM2.5 exposure was approximately > 25 μg/m3, the joint exposure to total PA and PM2.5 was associated with an increase in systolic BP. CONCLUSIONS The benefits of PA on BP were counteracted by high PM2.5 levels.
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Affiliation(s)
- Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Haoqi Zhou
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xue Cao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yixin Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xueyan Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hengyi Liu
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tao Xue
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Zhao Y, Guo Q, Zhao J, Bian M, Qian L, Shao J, Wang Q, Duan X. Long-term exposure to fine particulate matter modifies the association between physical activity and the risk of hypertension. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:43690-43701. [PMID: 36658317 DOI: 10.1007/s11356-023-25256-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
The trade-off between the potentially detrimental effects of fine particulate matter (PM2.5) and the benefits of physical activity (PA) is unclear. We aimed to explore the independent and interaction effects between long-term PM2.5 exposure and PA on blood pressure (BP) and hypertension. A total of 8704 adults (≥45 years) without hypertension at baseline in a nationwide cohort of the China Health and Retirement Longitudinal Study (CHARLS) were followed from 2011 to 2015. The participants were selected using a four-stage, stratified, and cluster sampling procedure. The annual PM2.5 concentrations at the residential address were estimated from a two-stage machine learning model with a 10 km × 10 km resolution. A standard questionnaire collected information on PA and potential confounders, and metabolic equivalents (MET·h/wk), which combined frequency, intensity, and duration information, were used to assess PA levels. We adopted mixed-effects regression models to explore the independent and interaction effects between long-term PM2.5 exposure and PA on BP and risk of hypertension. Systolic blood pressure (SBP) decreased by -0.84 mmHg (95% CI: -1.34, -0.34) per an IQR (interquartile range, 175.5 MET·h/wk) increase in PA, and diastolic blood pressure (DBP) decreased by -0.42 mmHg (95% CI: -0.76, -0.07). Each IQR (36.1 μg/m3) increment in PM2.5 was associated with 0.48 mmHg (95% CI: -0.24, 1.20) in SBP and -0.02 mmHg (95% CI: -0.44, 0.39) in DBP. PM2.5 showed an elevated effect with risks of hypertension (odds ratio, OR = 1.01; 95% CI: 1.00, 1.03), while PA showed the inverse result (OR = 0.98; 95% CI: 0.97, 0.99). Interaction analyses indicated PA maintained the beneficial effects on BP, but the negative association was attenuated, accompanied by the increase of PM2.5. PA decreased the BP and hypertension risks, while PM2.5 showed the opposite results. PM2.5 attenuated the beneficial effects of PA on BP and modified the association between PA and the risk of hypertension.
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Affiliation(s)
- Yuchen Zhao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Qian Guo
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Jiahao Zhao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Mengyao Bian
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Liqianxin Qian
- School of Civil and Resource Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Jing Shao
- National Institute of Sports Medicine, General Administration of Sport of China, Beijing, 100029, China
| | - Qirong Wang
- National Institute of Sports Medicine, General Administration of Sport of China, Beijing, 100029, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
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Bo Y, Yu T, Guo C, Chang LY, Huang J, Wong MCS, Tam T, Lao XQ. Isolated systolic or diastolic hypertension and mortality risk in young adults using the 2017 American College of Cardiology/American Heart Association blood pressure guideline: a longitudinal cohort study. J Hypertens 2023; 41:271-279. [PMID: 36583352 DOI: 10.1097/hjh.0000000000003325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Little is known regarding the health effects of different hypertension phenotypes including isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH) defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline among young adults. We conducted this longitudinal study using time-varying analyses to evaluate the relationship between cardiovascular/all-natural mortality risk and different hypertension phenotypes in young adults. METHODS A total of 284 597 young adults (aged 18-39 years) were recruited between 1996 and 2016. Participants were classified into eight mutually exclusive BP groups: normal blood pressure (BP), elevated BP, stage 1 IDH, stage 1 ISH, stage 1 SDH, stage 2 IDH, stage 2 ISH, and stage 2 SDH. The outcomes were cardiovascular and all-natural mortality. RESULTS After a median follow-up of 15.8 years, 2341 all-natural deaths with 442 cardiovascular deaths were observed. When compared with individuals with normal BP, the multivariable adjusted hazard ratios (95% confidence interval) of cardiovascular mortality was 1.39 (1.01-1.93) for elevated BP, 2.00 (1.45-2.77) for stage 1 IDH, 1.66 (1.08-2.56) for stage 1 ISH, 3.08 (2.13-4.45) for stage 1 SDH, 2.85 (1.76-4.62) for stage 2 IDH, 4.30 (2.96-6.25) for stage 2 ISH, and 6.93 (4.99-9.61) for stage 2 SDH, respectively. In consideration to all-natural mortality, similar results were observed for stage 1 SDH, stage 2 ISH, and stage 2 SDH; but not for elevated BP, stage 1 IDH, stage 1 ISH, and stage 2 IDH. CONCLUSION Young adults with stage 1 or stage 2 ISH, IDH, and SDH are at increased risk of cardiovascular death than those with normal BP. Regardless of BP stage, SDH was associated with a higher cardiovascular mortality risk than IDH and ISH.
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Affiliation(s)
- Yacong Bo
- School of Public Health, Zhengzhou University, Henan, China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Taiwan
| | - Cui Guo
- Department of Urban Planning and Design, University of Hong Kong, Hong Kong
| | | | - Junjie Huang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong
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Bo YC, Yu T, Guo C, Lin CC, Yang HT, Chang LYY, Thomas GN, Tam T, Lau AKH, Lao XQ. Cardiovascular Mortality, Habitual Exercise, and Particulate Matter 2.5 Exposure: A Longitudinal Cohort Study. Am J Prev Med 2023; 64:250-258. [PMID: 36272861 DOI: 10.1016/j.amepre.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Habitual exercise may amplify the respiratory uptake of air pollutants in the lung, exacerbating the adverse effects of air pollution. However, it is unclear whether this can reduce the health benefits of habitual exercise (referred to as leisure-time exercise). Thus, the combined effects of habitual exercise and chronic exposure to ambient fine particulate matter 2.5 on cardiovascular mortality were examined among adults in Taiwan. METHODS A total of 384,128 adults were recruited between 2001 and 2016 and followed up to May 31, 2019. Participants' vital status was obtained by matching their unique identification numbers with records of cardiovascular death in the National Death Registry of Taiwan. A time-varying Cox regression model was used to analyze the data. Analyses were conducted in 2021. RESULTS Cardiovascular death risks were inversely associated with habitual exercise and positively associated with chronic exposure to particulate matter 2.5. The beneficial effects of habitual exercise on cardiovascular mortality were not modified by chronic exposure to particulate matter 2.5. Inactive participants with high particulate matter 2.5 exposure exhibited a 123% higher risk of cardiovascular death than high-exercise-group participants exposed to low levels of particulate matter 2.5 (95% CI=89, 163). CONCLUSIONS High level of habitual exercise combined with low exposure level of ambient particulate matter 2.5 is associated with the lowest risk of cardiovascular death. A higher level of habitual exercise is associated with a lower risk of cardiovascular death at all levels of particulate matter 2.5 exposure studied. The results indicate that habitual exercise is a safe health promotion strategy even for people residing in relatively polluted regions.
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Affiliation(s)
- Yacong C Bo
- School of Public Health, Zhengzhou University, Zhenghzou, China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Cui Guo
- Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Changqing C Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Hsiao Ting Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Ave, Hong Kong
| | | | - G N Thomas
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Central Ave, Hong Kong
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Ave, Hong Kong; Department of Biomedical Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong.
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10
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Wu M, Pang Y, Chen M, Li L, Yan L, Ning J, Liu Q, Zhang Y, Jiang T, Kang A, Huang X, Hu W, Hu H, Geng Z, He L, Wang H, Wang M, Yang P, Chen J, Wu R, Shi B, Niu Y, Zhang R. Moderate physical activity against effects of short-term PM 2.5 exposure on BP via myokines-induced inflammation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 854:158598. [PMID: 36108849 DOI: 10.1016/j.scitotenv.2022.158598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/24/2022] [Accepted: 09/04/2022] [Indexed: 06/15/2023]
Abstract
Exposure to PM2.5 increases blood pressure (BP) and cardiovascular morbidity and mortality. We conducted a randomized controlled panel study in Shijiazhuang, China among 55 healthy college students randomly assigned to either the control (CON) or SPORTS group with intervention of 2000 m jogging in 20 min for 3 times in 4 days, and 3-round health examinations from November 15, 2020 to December 6, 2020. We aimed to evaluate whether moderate physical activity (PA) protected BP health against PM2.5 exposure and explore potential mechanisms through myokines and inflammation. Individual PM2.5 exposure was calculated based on outdoor and indoor PM2.5 concentration monitoring data as well as time-activity diary of each subject. In the CON group, the exposure-response curve for SBP was linear with a threshold concentration of approximately 31 μg/m3, while an increment of SBP level was 4.38 mm Hg (95%CI: 0.17 mm Hg, 8.59 mm Hg) at lag03 for each 10-μg/m3 increase in PM2.5, using linear mixed-effect models. For inflammatory indicators, PM2.5 exposure was associated with significant increases in eosinophil counts and proportion in CON group, but decreases in MCP-1 and TNF-α in SPORTS group. Meanwhile, higher myokines including CLU and IL-6 were observed in SPORTS group compared to the CON group. Further mediation analyses revealed that eosinophil counts mediated the elevated BP in CON group, whereas MCP-1 and TNF-α were also crucial mediating cytokines for the SPORTS group, as well as CLU and IL-6 acted as mediators on BP and inflammation indicators in SPORTS group. This study suggests that moderate PA could counteract the elevated BP induced by PM2.5 exposure via myokines-suppressed inflammation pathways.
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Affiliation(s)
- Mengqi Wu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Yaxian Pang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Meiyu Chen
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Lipeng Li
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China; Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Lina Yan
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Jie Ning
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Qingping Liu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Yaling Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Tao Jiang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Aijuan Kang
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Xiaoyan Huang
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Wentao Hu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Huaifang Hu
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Zihan Geng
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Liyi He
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Hui Wang
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Mengruo Wang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Peihao Yang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Jiawei Chen
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Ruiting Wu
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Beibei Shi
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Yujie Niu
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China; Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China
| | - Rong Zhang
- Department of Toxicology, Hebei Medical University, Shijiazhuang 050017, Hebei, China; Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang 050017, Hebei, China.
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11
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Guo C, Chang LY, Bo Y, Lin C, Lau AKH, Tam T, Lao XQ. Life-course exposure to ambient fine particulate matter and hypertension in adulthood: a longitudinal cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:788-797. [PMID: 35904742 DOI: 10.1007/s11356-022-22272-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
PM2.5-hypertension association were well documented in adults, while the effects of life-course exposure to PM2.5 on adulthood hypertension remained unclear. This study aimed to investigate the associations between life-course exposure to ambient PM2.5 and incident hypertension in adulthood in Asia. We included 4272 participants with 17,814 medical visits from two open cohorts in Taiwan and Hong Kong between 2000 and 2018. We used a satellite-based model to assess 2-year average PM2.5 exposure at a resolution of 1 km2. A linear mixed model was used to examine the association with blood pressure. A Cox regression model with time-dependent covariates was used to examine the overall association with the development of hypertension in adulthood. Life-course mixed models were used to examine the effects of PM2.5 exposure at different life stages on blood pressure and hypertension. For every 10 μg/m3 increase in PM2.5, the overall risk of adulthood hypertension increased by 40% (95% confidence interval [CI] 8-80%). The health effects of PM2.5 exposure at different life-stages on incident hypertension were generally independent of each other. In critical model, the risk of developing hypertension increased 23%, 27%, and 55% for each 10 μg/m3 increase in PM2.5 exposure during school age, adolescence, and adulthood, respectively. Similar associations were found between life-course PM2.5 exposure and blood pressure. Association between PM2.5 and adulthood hypertension can be traced back to childhood. Our study suggests that life-course control of air pollution exposure should be implemented to alleviate the huge burden of adulthood hypertension.
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Affiliation(s)
- Cui Guo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
- Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China.
- Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China.
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12
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Guo Q, Zhao Y, Zhao J, Bian M, Qian L, Xue T, Zhang JJ, Duan X. Physical activity attenuated the associations between ambient air pollutants and metabolic syndrome (MetS): A nationwide study across 28 provinces. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 315:120348. [PMID: 36202264 DOI: 10.1016/j.envpol.2022.120348] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/14/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
The independent associations of air pollution and Physical activity (PA) with metabolic syndrome (MetS) were inconsistent, while the joint associations between PA and air pollution with MetS were still unknown. We aimed to (1) further confirm the independent associations of PA and air pollution; (2) examine whether PA would attenuate the positive associations of air pollutants with MetS. We included 13,418 adults above 45 years old in this study. We defined MetS according to the Joint Interim Societies. The concentration of air pollutants (including fine particulate matter (PM2.5), inhalable particles (PM10), ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO)) were estimated by ground-based measurements and satellite remote sensing products. We assessed the level of PA by metabolic equivalent (MET)-hour/week by summing the MET of all activities. We applied logistic regression models with sampling weight to explore the independent and joint associations of PA and air pollutants on MetS. Interaction plots were conducted to exhibit estimates of air pollutants on MetS as a function of PA. We found that all air pollutants were positively associated with the odds of MetS, while PA showed beneficial associations with MetS. The associations of air pollution on MetS decreased accompanied the increase of PA, while the detrimental effects between air pollutants and MetS did not be reversed by PA. In conclusion, PA may attenuate the associations of air pollutants with MetS, although in polluted areas, suggesting that keeping PA might be an effective way to reduce the adverse effects of air pollution with MetS.
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Affiliation(s)
- Qian Guo
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Yuchen Zhao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Jiahao Zhao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Mengyao Bian
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Liqianxin Qian
- School of Civil and Resource Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Tao Xue
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100083, China
| | - Junfeng Jim Zhang
- Nicholas School of the Environment and Global Health Institute, Duke University, Durham, NC, USA; Duke Kunshan University, Kunshan, Jiangsu Province, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
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13
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Chen G, Wu Y, Qian ZM, Wang X, Howard SW, McMillin SE, Lin H, Ruan Z, Zhang Z. Associations between conjunctivitis and ambient PM 2.5 and physical activity: A nationwide prospective cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:157979. [PMID: 35981585 DOI: 10.1016/j.scitotenv.2022.157979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/26/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Currently, there is no evidence of fine particulate matter pollution (PM2.5) altering the relationship between physical activity (PA) and the risk of conjunctivitis. METHODS Based on the UK Biobank study, we included 308,507 participants aged 40-69 years at baseline (2006 to 2010) and prospectively followed up for conjunctivitis diagnosis till 2020. Annual concentrations of PM2.5 in 2010 were estimated for each participant using Land Use Regression models. PA levels during work and leisure time were reported via the International Physical Activity Questionnaire at baseline. We used Cox proportional hazards models to examine the associations of PM2.5 and PA with incident conjunctivitis, as well as their interaction at both multiplicative and additive scales. RESULTS During the 11.6 years of follow up, we identified 4002 incident conjunctivitis cases. High-PA (≥3000 metabolic equivalent of task [MET]-mins/week) was associated with lower risk of conjunctivitis (hazard ratio [HR]: 0.79, 95% confidence interval [CI]: 0.73-0.86) compared to low-PA (0 to <600 MET-mins/week), while every 1 μg/m3 increment in PM2.5 was associated with a 16% higher risk of conjunctivitis (HR = 1.16, 95% CI: 1.09-1.23). We did not observe statistically significant interactions between PM2.5 and PA on their associations with conjunctivitis. CONCLUSION Habitual PA and PM2.5 exposure were oppositely related to incident conjunctivitis. The benefits of PA remain in people irrespective of exposure to air pollution.
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Affiliation(s)
- Ge Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Yinglin Wu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63104, United States of America
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Steven W Howard
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63104, United States of America
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63104, United States of America
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Zengliang Ruan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China; Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu 210096, PR China.
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
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Chen X, Giles J, Yao Y, Yip W, Meng Q, Berkman L, Chen H, Chen X, Feng J, Feng Z, Glinskaya E, Gong J, Hu P, Kan H, Lei X, Liu X, Steptoe A, Wang G, Wang H, Wang H, Wang X, Wang Y, Yang L, Zhang L, Zhang Q, Wu J, Wu Z, Strauss J, Smith J, Zhao Y. The path to healthy ageing in China: a Peking University-Lancet Commission. Lancet 2022; 400:1967-2006. [PMID: 36423650 PMCID: PMC9801271 DOI: 10.1016/s0140-6736(22)01546-x] [Citation(s) in RCA: 169] [Impact Index Per Article: 84.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 11/22/2022]
Abstract
Around the world, populations are ageing at a faster pace than in the past and this demographic transition will have impacts on all aspects of societies. In May 2020, the UN General Assembly declared 2021–2030 the Decade of Healthy Ageing, highlighting the importance for policymakers across the world to focus policy on improving the lives of older people, both today and in the future. While rapid population ageing poses challenges, China’s rapid economic growth over the last forty years has created space for policy to assist older persons and families in their efforts to improve health and well-being at older ages. As China is home to 1/5 of the world’s older people, China is often held up as an example for other middle-income countries. This Commission Report aims to help readers to understand the process of healthy ageing in China as a means of drawing lessons from the China experience. In addition, with the purpose of informing the ongoing policy dialogue within China, the Commission Report highlights the policy challenges on the horizon and draws lessons from international experience.
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Affiliation(s)
- Xinxin Chen
- Institute of Social Science Survey, Peking University, Beijing, China
| | | | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Winnie Yip
- Department of Global Health and Population, Harvard University, Boston, MA, USA
| | - Qinqin Meng
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, Boston, MA, USA; Division of Geriatric Medicine, UCLA, Los Angeles, CA, USA
| | - He Chen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Xi Chen
- Department of Health Policy and Management, Department of Economics, Yale School of Public Health, New Haven, CT, USA
| | - Jin Feng
- School of Economics, Fudan University, Shanghai, China
| | | | | | - Jinquan Gong
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Perry Hu
- Division of Geriatric Medicine, UCLA, Los Angeles, CA, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Xiaoyan Lei
- National School of Development, Peking University, Beijing, China
| | - Xiao Liu
- School of Labor Economics, Capital University of Economics and Business, Beijing, China
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Gewei Wang
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Harold Wang
- Program in Bioinformatics, UCLA, Los Angeles, CA, USA
| | - Huali Wang
- Dementia Care & Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xiaoyu Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing, China
| | - Yafeng Wang
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Li Yang
- Department of Health Policy and Management, Peking University, Beijing, China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital and National Institute of Health Data Science, Peking University, Beijing, China
| | - Quan Zhang
- National School of Development, Peking University, Beijing, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - John Strauss
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | | | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China.
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Guo C, Yu T, Chen J, Chang LY, Lin C, Yu Z, Chan SHT, Dong G, Tam T, Huang B, Lau AK, Lao XQ. Associations between long-term exposure to multiple air pollutants and age at menopause: a longitudinal cohort study. Ann Epidemiol 2022; 76:68-76. [DOI: 10.1016/j.annepidem.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/15/2022]
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16
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Li ZH, Zhong WF, Zhang XR, Chung VC, Song WQ, Chen Q, Wang XM, Huang QM, Shen D, Zhang PD, Liu D, Zhang YJ, Chen PL, Cheng X, Yang HL, Cai MC, Gao X, Kraus VB, Mao C. Association of physical activity and air pollution exposure with the risk of type 2 diabetes: a large population-based prospective cohort study. Environ Health 2022; 21:106. [PMID: 36336676 PMCID: PMC9639290 DOI: 10.1186/s12940-022-00922-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The interplay between physical activity (PA) and air pollution in relation to type 2 diabetes (T2D) remains largely unknown. Based on a large population-based cohort study, this study aimed to examine whether the benefits of PA with respect to the risk of T2D are moderated by exposure to air pollution. METHODS UK Biobank participants (n = 359,153) without diabetes at baseline were included. Information on PA was obtained using the International Physical Activity Questionnaire short form. Exposure to air pollution, including PM2.5, PMcoarse (PM2.5-10), PM10, and NO2, was estimated from land use regression models. Cox regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS During a median of 8.9 years of follow-up, 13,706 T2D events were recorded. Compared with a low PA level, the HRs for the risk of T2D among individuals with moderate and high PA were 0.82 (95% CI, 0.79-0.86) and 0.73 (95% CI, 0.70-0.77), respectively. Compared with low levels of air pollution, the HRs for risk of T2D for high levels of air pollution (PM2.5, PMcoarse, PM10, and NO2) were 1.19 (1.14-1.24), 1.06 (1.02-1.11), 1.13 (1.08-1.18), and 1.19 (1.14-1.24), respectively. There was no effect modification of the associations between PA and T2D by air pollution (all P-interactions > 0.05). The inverse associations between PA and T2D in each air pollution stratum were generally consistent (all P for trend < 0.05). CONCLUSION A higher PA and lower air pollution level were independently associated with a lower risk of T2D. The beneficial effects of PA on T2D generally remained stable among participants exposed to different levels of air pollution. Further studies are needed to replicate our findings in moderately and severely polluted areas.
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Affiliation(s)
- Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Xi-Ru Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Vincent Ch Chung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Xiao-Meng Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Qing-Mei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Dong Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Pei-Dong Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Dan Liu
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Yu-Jie Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Xin Cheng
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Hai-Lian Yang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Miao-Chun Cai
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, University Park, USA
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute, Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China.
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Liu Q, Huang K, Liang F, Yang X, Li J, Chen J, Liu X, Cao J, Shen C, Yu L, Zhao Y, Deng Y, Li Y, Hu D, Lu X, Liu Y, Gu D, Liu F, Huang J. Long-term exposure to fine particulate matter modifies the association between physical activity and hypertension incidence. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:708-715. [PMID: 35065296 PMCID: PMC9729921 DOI: 10.1016/j.jshs.2022.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/25/2021] [Accepted: 12/17/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND The trade-off between the benefits of regular physical activity (PA) and the potentially detrimental effects of augmented exposure to air pollution in highly polluted regions remains unclear. This study aimed to examine whether ambient fine particulate matter (PM2.5) exposure modified the impacts of PA volume and intensity on hypertension risk. METHODS We included 54,797 participants without hypertension at baseline in a nationwide cohort of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. PA volume and intensity were assessed by questionnaire, and high-resolution (1 km ×1 km) PM2.5 estimates were generated using a satellite-based model. RESULTS During 413,516 person-years of follow-up, 12,100 incident hypertension cases were identified. PM2.5 significantly modified the relationship between PA and hypertension incidence (pinteraction < 0.001). Increased PA volume was negatively associated with incident hypertension in the low PM2.5 stratum (<59.8 μg/m3, ptrend < 0.001), with a hazard ratio of 0.81 (95% confidence interval (95%CI): 0.74-0.88) when comparing the fourth with the first quartile of PA volume. However, the health benefits were not observed in the high PM2.5 stratum (≥59.8 μg/m3, ptrend = 0.370). Moreover, compared with light PA intensity, vigorous intensity was related to a 20% (95%CI: 9%-29%) decreased risk of hypertension for participants exposed to low PM2.5, but a 17% (95%CI: 4%-33%) increased risk for those with high PM2.5 levels. CONCLUSION PA was associated with a reduced risk of hypertension only among participants with low PM2.5 exposure. Our findings recommended regular PA to prevent hypertension in less polluted regions and reinforced the importance of air quality improvement.
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Affiliation(s)
- Qiong Liu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Keyong Huang
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Fengchao Liang
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Jianxin Li
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jichun Chen
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China
| | - Jie Cao
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China
| | - Ying Deng
- Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Ying Li
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China
| | - Xiangfeng Lu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Dongfeng Gu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China
| | - Fangchao Liu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
| | - Jianfeng Huang
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
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Chen Z, Liu P, Xia X, Wang L, Li X. The underlying mechanism of PM2.5-induced ischemic stroke. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 310:119827. [PMID: 35917837 DOI: 10.1016/j.envpol.2022.119827] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/04/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
Under the background of global industrialization, PM2.5 has become the fourth-leading risk factor for ischemic stroke worldwide, according to the 2019 GBD estimates. This highlights the hazards of PM2.5 for ischemic stroke, but unfortunately, PM2.5 has not received the attention that matches its harmfulness. This article is the first to systematically describe the molecular biological mechanism of PM2.5-induced ischemic stroke, and also propose potential therapeutic and intervention strategies. We highlight the effect of PM2.5 on traditional cerebrovascular risk factors (hypertension, hyperglycemia, dyslipidemia, atrial fibrillation), which were easily overlooked in previous studies. Additionally, the effects of PM2.5 on platelet parameters, megakaryocytes activation, platelet methylation, and PM2.5-induced oxidative stress, local RAS activation, and miRNA alterations in endothelial cells have also been described. Finally, PM2.5-induced ischemic brain pathological injury and microglia-dominated neuroinflammation are discussed. Our ultimate goal is to raise the public awareness of the harm of PM2.5 to ischemic stroke, and to provide a certain level of health guidance for stroke-susceptible populations, as well as point out some interesting ideas and directions for future clinical and basic research.
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Affiliation(s)
- Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China.
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Guo C, Yu T, Lin C, Chang LY, Bo Y, Wong MCS, Tam T, Lau AKH, Lao XQ. Habitual Exercise, Air Pollution, and Pneumonia Mortality: A Longitudinal Cohort Study of Approximately 0.4 Million Adults. Am J Epidemiol 2022; 191:1732-1741. [PMID: 35773998 DOI: 10.1093/aje/kwac113] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 01/29/2023] Open
Abstract
In this study, we aimed to examine the combined associations of particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) and habitual exercise with pneumonia mortality. We included 384,130 persons aged ≥18 years from Taiwan, Republic of China, during 2001-2016. We followed participants until May 31, 2019, to obtain information on vital status. A time-dependent Cox regression model was used for statistical analysis. We found that risks of pneumonia mortality were reduced by 55% (hazard ratio (HR) = 0.45, 95% confidence interval (CI): 0.36, 0.55) and 36% (HR = 0.64, 95% CI: 0.52, 0.80) in participants who engaged in high and moderate levels of exercise, respectively, as compared with inactive persons. By contrast, each 10-μg/m3 increase in chronic PM2.5 exposure was associated with a 30% (HR = 1.30, 95% CI: 1.17, 1.45) higher risk of pneumonia mortality. Risk of pneumonia death was 72% lower (HR = 0.28, 95% CI: 0.20, 0.41) for persons with a high exercise level and a low PM2.5 level. Lower risk of pneumonia mortality was associated with both higher exercise and lower PM2.5 air pollution levels. For adults exposed to different levels of PM2.5, exercise benefits remained. Our findings suggest that engaging in exercise is a safe and effective strategy for alleviating the burden of pneumonia mortality, even for people who reside in a moderately polluted area.
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Raichlen DA, Furlong M, Klimentidis YC, Sayre MK, Parra KL, Bharadwaj PK, Wilcox RR, Alexander GE. Association of Physical Activity with Incidence of Dementia Is Attenuated by Air Pollution. Med Sci Sports Exerc 2022; 54:1131-1138. [PMID: 35704438 PMCID: PMC9204780 DOI: 10.1249/mss.0000000000002888] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Physical activity (PA) is recognized as one of the key lifestyle behaviors that reduces risk of developing dementia late in life. However, PA also leads to increased respiration, and in areas with high levels of air pollution, PA may increase exposure to pollutants linked with higher risk of developing dementia. Here, we investigate whether air pollution attenuates the association between PA and dementia risk. METHODS This prospective cohort study included 35,562 adults 60 yrs and older from the UK Biobank. Average acceleration magnitude (ACCave) from wrist-worn accelerometers was used to assess PA levels. Air pollution levels (NO, NO2, PM10, PM2.5, PM2.5-10, and PM2.5 absorbance) were estimated with land use regression methods. Incident all-cause dementia was derived from inpatient hospital records and death registry data. RESULTS In adjusted models, ACCave was associated with reduced risk of developing dementia (HR = 0.71, 95% confidence interval [CI] = 0.60-0.83), whereas air pollution variables were not associated with dementia risk. There were significant interactions between ACCave and PM2.5 (HRinteraction = 1.33, 95% CI = 1.13-1.57) and PM2.5 absorbance (HRinteraction = 1.24, 95% CI = 1.07-1.45) on incident dementia. At the lowest tertiles of pollution, ACCave was associated with reduced risk of incident dementia (HRPM 2.5 = 0.66, 95% CI = 0.49-0.91; HRPM 2.5 absorbance = 0.60, 95% CI = 0.44-0.81). At the highest tertiles of these pollutants, there was no significant association of ACCave with incident dementia (HRPM 2.5 = 0.88, 95% CI = 0.68-1.14; HRPM 2.5 absorbance = 0.79, 95% CI = 0.60-1.04). CONCLUSIONS PA is associated with reduced risk of developing all-cause dementia. However, exposure to even moderate levels of air pollution attenuates the benefits of PA on risk of dementia.
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Affiliation(s)
- David A Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, CA
| | - Melissa Furlong
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | | | - M Katherine Sayre
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, CA
| | - Kimberly L Parra
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | | | - Rand R Wilcox
- Department of Psychology, University of Southern California, CA
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21
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Zeng YQ, Chan SHT, Guo C, Chang LY, Bo Y, Lin C, Yu Z, Lau AKH, Tam T, Lao XQ. Habitual exercise, chronic exposure to fine particulate matter and high-sensitivity C reactive protein in Asian adults. Occup Environ Med 2022; 79:557-565. [PMID: 35738890 DOI: 10.1136/oemed-2022-108328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/06/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Exercise may increase the inhaled amount of air pollutants and exacerbate the adverse health effects. We investigated the combined effects of chronic exposure to fine particulate matter with an aerodynamic diameter less than 2.5 µm (PM2.5) and habitual exercise on C reactive protein (CRP), a sensitive marker of inflammation. METHODS We selected 40 209 Taiwanese adults who joined a standard medical screening programme between 2001 and 2016. The PM2.5 exposure was estimated at each participant's address using a satellite-based spatiotemporal model. Information on habitual exercise was collected using a standard self-administered questionnaire. Mixed-effects linear regression models were used to investigate the associations of CRP with PM2.5 and exercise. An interaction term of PM2.5 and exercise was introduced in the models to test the modifying effects. RESULTS A greater amount of habitual exercise was associated with a decreased level of CRP, while a higher concentration of PM2.5 exposure was associated with an increased level of CRP. The inverse associations of habitual exercise with CRP were not modified by chronic exposure to PM2.5. The participants in the group with a low level of exercise and a high level of PM2.5 exposure exhibited a 19.1% higher level of CRP than those in the group with a high level of exercise and a low level of PM2.5 exposure (95% CI: 13.7% to 24.8%; p<0.001). The longitudinal and sensitivity analyses yielded similar results. CONCLUSIONS Increased levels of exercise and reduced exposure levels of PM2.5 are associated with a lower CRP level. Habitual exercise reduces CRP level regardless of the levels of chronic PM2.5 exposure. Our results support that habitual exercise is a safe approach for reducing systemic inflammation to improve cardiovascular health even for people residing in relatively polluted areas.
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Affiliation(s)
- Yi Qian Zeng
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shin Heng Teresa Chan
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cui Guo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changqing Lin
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Zengli Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong SAR, China.,Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China .,Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, Guangdong, China
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Ao L, Zhou J, Han M, Li H, Li Y, Pan Y, Chen J, Xie X, Jiang Y, Wei J, Chen G, Li S, Guo Y, Hong F, Li Z, Xiao X, Zhao X. The joint effects of physical activity and air pollution on type 2 diabetes in older adults. BMC Geriatr 2022; 22:472. [PMID: 35650529 PMCID: PMC9158242 DOI: 10.1186/s12877-022-03139-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/12/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Older adults with type 2 diabetes are at higher risk of developing common geriatric syndromes and have a lower quality of life. To prevent type 2 diabetes in older adults, it's unclear whether the health benefits of physical activity (PA) will be influenced by the harms caused by increased exposure to air pollution during PA, especially in developing countries with severe air pollution problem. We aimed to investigate the joint effects of PA and long-term exposure to air pollution on the type 2 diabetes in older adults from China. METHODS This cross-sectional study was based on the China Multi-Ethnic cohort (CMEC) study. The metabolic equivalent of PA was calculated according to the PA scale during the CMEC baseline survey. High resolution air pollution datasets (PM10, PM2.5 and PM1) were collected from open products. The joint effects were assessed by the marginal structural mean model with generalized propensity score. RESULTS A total of 36,562 participants aged 50 to 79 years were included in the study. The prevalence of type 2 diabetes was 10.88%. The mean (SD) level of PA was 24.93 (18.60) MET-h/d, and the mean (SD) level of PM10, PM2.5, and PM1 were 70.00 (23.32) µg/m3, 40.45 (15.66) µg/m3 and 27.62 (6.51) µg/m3, respectively. With PM10 < 92 µg/m3, PM2.5 < 61 µg/m3, and PM1 < 36 µg/m3, the benefit effects of PA on type 2 diabetes was significantly greater than the harms due to PMs when PA levels were roughly below 80 MET-h/d. With PM10 ≥ 92 µg/m3, PM2.5 ≥ 61 µg/m3, and PM1 ≥ 36 µg/m3, the odds ratio (OR) first decreased and then rose rapidly with confidence intervals progressively greater than 1 and break-even points close to or even below 40 MET-h/d. CONCLUSIONS Our findings implied that for the prevention of type 2 diabetes in older adults, the PA health benefits outweighed the harms of air pollution except in extreme air pollution situations, and suggested that when the air quality of residence is severe, the PA levels should ideally not exceed 40 MET-h/d.
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Affiliation(s)
- Linjun Ao
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Junmin Zhou
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Mingming Han
- grid.507966.bChengdu Center for Disease Control and Prevention, Sichuan, China
| | - Hong Li
- grid.508395.20000 0004 9404 8936Yunnan Center for Disease Control and Prevention, Yunnan, China
| | - Yajie Li
- Tibet Center for Disease Control and Prevention CN, Tibet, China
| | - Yongyue Pan
- grid.440680.e0000 0004 1808 3254Tibet University, Tibet, China
| | - Jiayi Chen
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Xiaofen Xie
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Ye Jiang
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Jing Wei
- grid.164295.d0000 0001 0941 7177Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD USA
| | - Gongbo Chen
- grid.12981.330000 0001 2360 039XGuangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Shanshan Li
- grid.1002.30000 0004 1936 7857Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- grid.1002.30000 0004 1936 7857Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Feng Hong
- grid.413458.f0000 0000 9330 9891School of Public Health, the key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Zhifeng Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xiong Xiao
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
| | - Xing Zhao
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu Sichuan, China
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Guo C, Yu T, Bo Y, Lin C, Chang LY, Wong MCS, Yu Z, Lau AKH, Tam T, Lao XQ. Long-term Exposure to Fine Particulate Matter and Mortality A Longitudinal Cohort Study of 400,459 Adults. Epidemiology 2022; 33:309-317. [PMID: 35067568 DOI: 10.1097/ede.0000000000001464] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cohort studies on the association between long-term exposure to fine particulate matter (PM2.5) and mortality have been well established for America and Europe, but limited and inconsistent in Asia with much higher air pollution. This study aims to investigate the associations between ambient PM2.5 and all-cause and cause-specific mortality over a period of rising and then declining PM2.5. METHODS We enrolled a total of 400,459 adults from an open cohort between 2001 and 2016, and followed them up until 31 May 2019. We obtained mortality data from the National Death Registry maintained by the Ministry of Health and Welfare in Taiwan. We estimated ambient PM2.5 exposures using a satellite-based spatiotemporal model. We performed a Cox regression model with time-dependent covariates to investigate the associations of PM2.5 with deaths from all causes and specific causes. RESULTS This study identified 14,627 deaths and had a total of 5 million person-years of follow-up. Each 10 µg/m3 increase in PM2.5 was associated with an increased hazard risk of 29% (95% confidence interval: 24%-35%) in all-cause mortality. Risk of death increased by 30% for natural causes, 20% for cancer, 42% for cardiovascular disease (CVD) causes, and 53% for influenza and pneumonia causes, for each 10 µg/m3 increase in PM2.5. Sensitivity analyses generally yielded similar results. CONCLUSION Long-term exposure to ambient PM2.5 was associated with increased risks of all-cause mortality and deaths from cancers, natural causes, CVD, and influenza and pneumonia. Longitudinal study design should be encouraged for air pollution epidemiologic investigation.
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Affiliation(s)
- Cui Guo
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tsung Yu
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan
| | - Yacong Bo
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | | | - Martin C S Wong
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- The School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical Colleges, Beijing, China
- The School of Public Health, The Peking University, Beijing, China
| | - Zengli Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, Henan, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
- Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong
| | - Xiang Qian Lao
- From the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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Sun S, Yang Q, Zhou Q, Cao W, Yu S, Zhan S, Sun F. Long-term exposure to air pollution, habitual physical activity and risk of non-alcoholic fatty liver disease: A prospective cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 235:113440. [PMID: 35344898 DOI: 10.1016/j.ecoenv.2022.113440] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 05/21/2023]
Abstract
BACKGROUND Emerging studies suggest a positive association between air pollution exposure and risk of non-alcoholic fatty liver disease (NAFLD), however, the combined effects of long-term exposure to air pollution, physical activity (PA), and risk of NAFLD is unclear. METHODS We included 58,026 Taiwan residents who received a standard medical screening program between 2001 and 2016. Levels of fine particulate matter (PM2.5) at each participant's residential address were estimated using multiple satellite-based aerosol optical depth data combined with a chemical transport model. PA volume was calculated as hours of metabolic equivalent tasks per week (MET-h/week) based on a standard self-administered questionnaire. Incident NAFLD was defined as the first occurrence of a fatty liver index (FLI) value > 30 or a hepatic steatosis index (HSI) value > 36 in participants without NAFLD at the baseline. Time-varying Cox regression was used to evaluate the combined effects of PA and PM2.5. RESULTS Exposure to PM2.5 was positively associated with NAFLD. A 1 μg/m3 increase in PM2.5 above 23.5 μg/m3 was associated with a hazard ratio (HR) of 1.06 (95% CI: 1.04, 1.09) and 1.05 (95% CI: 1.03, 1.07) for NAFLD identified by FLI and HSI, respectively. Performing PA was inversely associated with NAFLD. Compared with participants in high PM2.5 [≥ 27.5 μg/m3]-very low PA [< 3.75 MET-h/week] group, low PM2.5 [< 23.5 μg/m3]-very high PA [≥ 25.50 MET-h/week] group had a 57% (95% CI: 50%, 63%) and 42% (95% CI: 33%, 50%) lower risk of NAFLD defined by FLI and HSI, respectively. We found no evidence of any additive or multiplicative interaction between PA and PM2.5. CONCLUSION Long-term PM2.5 exposure was positively associated with NAFLD, whereas performing PA was inversely associated with NAFLD. The benefits of PA on NAFLD remained stable in participants exposed to various PM2.5 levels.
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Affiliation(s)
- Shengzhi Sun
- School of Public Health, Peking University Health Science Centre, Beijing 100191, China; School of Public Health, Capital Medical University, Beijing 100069, China
| | - Qingqing Yang
- School of Public Health, Peking University Health Science Centre, Beijing 100191, China
| | - Qingxin Zhou
- School of Public Health, Peking University Health Science Centre, Beijing 100191, China
| | - Wangnan Cao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 1000191, China
| | - Siwang Yu
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Molecular and Cellular Pharmacology, Peking University School of Pharmaceutical Sciences, Beijing 100191, China
| | - Siyan Zhan
- School of Public Health, Peking University Health Science Centre, Beijing 100191, China
| | - Feng Sun
- School of Public Health, Peking University Health Science Centre, Beijing 100191, China.
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Chan SHT, Yu T, Zhang Z, Chang LY, Guo C, Bo Y, Tam T, Lau AKH, Lao XQ. Total and differential white blood cell count and cause-specific mortality in 436 750 Taiwanese adults. Nutr Metab Cardiovasc Dis 2022; 32:937-947. [PMID: 35078679 DOI: 10.1016/j.numecd.2021.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/04/2021] [Accepted: 11/06/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS White blood cell (WBC) count is an easily obtainable biomarker of systematic inflammation. Our study aimed to investigate the associations of differential WBC count with all-cause and cause-specific mortality in a general Asian population. METHODS AND RESULTS Cox proportional hazards model was used to evaluate the associations of WBC count with mortality separately for men and women, with adjustment for multiple variables including age, smoking, and other lifestyle factors. Stratified analyses by age, smoking, diabetes, and hypertension were conducted to explore potential effect modification. Elevated WBC count was significantly associated with increased mortality risk. The adjusted hazard ratios of total WBC (10th decile compared to decile of lowest risk) for all-cause mortality were 1.42 (95% CI: 1.33, 1.53) for men and 1.54 (95% CI: 1.42, 1.68) for women. Similar risks were observed for neutrophils, monocytes, and neutrophil/lymphocyte (NL) ratio. The highest deciles of neutrophils, monocytes, and NL ratio were also positively associated with risk of cardiovascular/cerebrovascular, cancer, and respiratory mortality after adjusting for covariates. Results for all-cause mortality remained statistically significant for participants who were <60 years old, non-smokers, non-diabetic, and non-hypertensive. CONCLUSIONS Total and differential WBC counts (neutrophils, monocytes, and NL ratios) are positively associated with increased risk of all-cause mortality, cardiovascular and cerebrovascular, cancer, and respiratory mortality among Taiwanese adults.
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Affiliation(s)
- Shin Heng Teresa Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tsung Yu
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan
| | - Zilong Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Cui Guo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China.
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Health Effects of Long-Term Exposure to Ambient PM 2.5 in Asia-Pacific: a Systematic Review of Cohort Studies. Curr Environ Health Rep 2022; 9:130-151. [PMID: 35292927 PMCID: PMC9090712 DOI: 10.1007/s40572-022-00344-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 12/21/2022]
Abstract
Abstract Purpose of Review Health effects of long-term exposure to ambient PM2.5 vary with regions, and 75% of the deaths attributable to PM2.5 were estimated in Asia-Pacific in 2017. This systematic review aims to summarize the existing evidence from cohort studies on health effects of long-term exposure to ambient PM2.5 in Asia-Pacific. Recent Findings In Asia-Pacific, 60 cohort studies were conducted in Australia, Mainland China, Hong Kong, Taiwan, and South Korea. They consistently supported associations of long-term exposure to PM2.5 with increased all-cause/non-accidental and cardiovascular mortality as well as with incidence of cardiovascular diseases, type 2 diabetes mellitus, kidney diseases, and chronic obstructive pulmonary disease. Evidence for other health effects was limited. Inequalities were identified in PM2.5-health associations. Summary To optimize air pollution control and public health prevention, further studies need to assess the health effects of long-term PM2.5 exposure in understudied regions, the health effects of long-term PM2.5 exposure on mortality and risk of type 2 diabetes mellitus, renal diseases, dementia and lung cancer, and inequalities in PM2.5-health associations. Study design, especially exposure assessment methods, should be improved. Supplementary Information The online version contains supplementary material available at 10.1007/s40572-022-00344-w.
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Zhu Y, Liu M, Fu W, Bo Y. Association Between Serum Aldehydes and Hypertension in Adults: A Cross-Sectional Analysis of the National Health and Nutrition Examination Survey. Front Cardiovasc Med 2022; 9:813244. [PMID: 35321099 PMCID: PMC8934859 DOI: 10.3389/fcvm.2022.813244] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background Exposure to ambient pollutants and chemicals were found to be associated with increased risk of hypertension. However, the relationship between the increased aldehyde exposure and hypertension are still unclear. This study aimed to investigate the potential associations of serum aldehydes levels with prevalent hypertension. Methods A total of 1,733 U.S. adults with data on hypertension outcome and serum aldehydes measurement from the National Health and Nutrition Examination Survey 2013–2014 were included. The serum levels of aldehydes were measured via an automated analytical method using solid phase microextraction gas chromatography and high-resolution mass spectrometry. Multivariate logistic regression models were adopted to assess the associations between six selected aldehydes exposure (benzaldehyde, butyraldehyde, heptanaldehyde, hexanaldehyde, isopentanaldehyde, and propanaldehyde) and prevalence of hypertension. Results The mean age was 48.0 ± 16.7 years and an approximately equivalent of sex distribution was observed (female 49.9%). There seems to be a numerically higher level of hexanaldehyde in participants with hypertension when compared to participants without hypertension (2.6 ± 3.9 ng/mL vs. 2.3 ± 1.1 ng/mL). After adjusting for potential confounders, the odds ratio (OR) for hypertension was 2.15 [95% confidence interval (CI): 1.33–3.51] in participants from the highest quartile of serum hexanaldehyde concentration in comparison to those from the lowest quartile. Subgroup analyses and sensitivity analyses showed generally similar results. Conclusion In summary, current evidence suggested that increased serum hexanaldehyde level was positively associated with prevalent hypertension in U.S. adults.
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Affiliation(s)
- Yongjian Zhu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Yongjian Zhu
| | - Mingjing Liu
- Department of Clinical Medicine, Sanquan College of Xinxiang Medical University, Xinxiang, China
| | - Wanrong Fu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yacong Bo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Zhao M, Xu Z, Guo Q, Gan Y, Wang Q, Liu JA. Association between long-term exposure to PM 2.5 and hypertension: A systematic review and meta-analysis of observational studies. ENVIRONMENTAL RESEARCH 2022; 204:112352. [PMID: 34762927 DOI: 10.1016/j.envres.2021.112352] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Numerous studies have examined the association between long-term exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) and hypertension. However, the results are inconsistent. OBJECTIVES Considering the limitations of previous meta-analyses and the publication of many new studies in recent years, we conducted this meta-analysis to assess the relationship between long-term PM2.5 exposure and the incidence and prevalence of hypertension in a healthy population. METHODS We searched PubMed, Web of Science, Embase, and Scopus for relevant studies published until April 2, 2021 and reviewed the reference lists of previous reviews. A total of 28 observational studies reporting RR or OR with 95% CI for the association between long-term PM2.5 exposure and the risk of hypertension were included. RESULTS After the sensitivity analysis, we excluded one study with a high degree of heterogeneity, resulting in 27 studies and 28 independent reports. Approximately 42 million participants were involved, and the cases of hypertension in cohort and cross-sectional studies were 508,749 and 1,793,003, respectively. The meta-analysis showed that each 10 μg/m3 increment in PM2.5 was significantly associated with the risks of hypertension incidence (RR = 1.21, 95% CI: 1.07, 1.35) and prevalence (OR = 1.06, 95% CI: 1.03, 1.09). Subgroup analyses showed that occupational exposure had a significant effect on the association of PM2.5 and hypertension incidence (p for interaction = 0.042) and that the PM2.5 concentration level and physical activity had a noticeable effect on the association of PM2.5 and hypertension prevalence (p for interaction = 0.005; p for interaction = 0.022). CONCLUSIONS A significantly positive correlation was observed between long-term PM2.5 exposure and risks of hypertension incidence and prevalence, and a high PM2.5 concentration resulted in an increased risk of hypertension.
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Affiliation(s)
- Mingqing Zhao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ziyuan Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qianqian Guo
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun-An Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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You Y, Wang D, Liu J, Chen Y, Ma X, Li W. Physical Exercise in the Context of Air Pollution: An Emerging Research Topic. Front Physiol 2022; 13:784705. [PMID: 35295574 PMCID: PMC8918627 DOI: 10.3389/fphys.2022.784705] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/18/2022] [Indexed: 12/12/2022] Open
Abstract
Physical exercise (PE) brings physiological benefits to human health; paradoxically, exposure to air pollution (AP) is harmful. Hence, the combined effects of AP and PE are interesting issues worth exploring. The objective of this study is to review literature involved in AP-PE fields to perform a knowledge-map analysis and explore the collaborations, current hotspots, physiological applications, and future perspectives. Herein, cluster, co-citation, and co-occurrence analysis were applied using CiteSpace and VOSviewer software. The results demonstrated that AP-PE domains have been springing up and in rapid growth since the 21st century. Subsequently, active countries and institutions were identified, and the productive institutions were mainly located in USA, China, UK, Spain, and Canada. Developed countries seemed to be the major promoters. Additionally, subject analysis found that environmental science, public health, and sports medicine were the core subjects, and multidimensional communications were forming. Thereafter, a holistic presentation of reference co-citation clusters was conducted to discover the research topics and trace the development focuses. Youth, elite athletes, and rural population were regarded as the noteworthy subjects. Commuter exposure and moderate aerobic exercise represented the common research context and exercise strategy, respectively. Simultaneously, the research hotspots and application fields were elaborated by keyword co-occurrence distribution. It was noted that physiological adaptations including respiratory, cardiovascular, metabolic, and mental health were the major themes; oxidative stress and inflammatory response were the mostly referred mechanisms. Finally, several challenges were proposed, which are beneficial to promote the development of the research field. Molecular mechanisms and specific pathways are still unknown and the equilibrium points and dose-effect relationships remain to be further explored. We are highly confident that this study provides a unique perspective to systematically and comprehensively review the pieces of AP-PE research and its related physiological mechanisms for future investigations.
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Affiliation(s)
- Yanwei You
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Dizhi Wang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Jianxiu Liu
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xindong Ma
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
- *Correspondence: Xindong Ma
| | - Wenkai Li
- China Table Tennis College, Shanghai University of Sport, Shanghai, China
- Wenkai Li
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Chronic fine particulate matter exposure, habitual exercise, and dyslipidemia: A longitudinal cohort study. Environ Epidemiol 2022; 6:e190. [PMID: 35169668 PMCID: PMC8835602 DOI: 10.1097/ee9.0000000000000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Physical activity may increase the intake of air pollutants due to a higher ventilation rate, which may exacerbate the adverse health effects. This study investigated the combined effects of habitual exercise and long-term exposure to fine particulate matter (PM2.5) on the incidence of dyslipidemia in a large longitudinal cohort in Taiwan. Methods: A total of 121,948 adults (≥18 years) who received at least two medical examinations from 2001 to 2016 were recruited, yielding 407,821 medical examination records. A satellite-based spatiotemporal model was used to estimate the 2-year average PM2.5 concentration (i.e., the year of and the year before the medical examination) at each participant’s address. Information on habitual exercise within 1 month before the medical examination was collected using a standard self-administered questionnaire. A Cox regression model with time-dependent covariates was used to investigate the combined effects. Results: Compared with inactivity, moderate and high levels of exercise were associated with a lower incidence of dyslipidemia, with hazard ratios (HRs) (95% confidence intervals [CIs]) of 0.91 (0.88, 0.94) and 0.73 (0.71, 0.75), respectively. Participants with a moderate (22.37–25.96 μg/m3) or high (>25.96 μg/m3) level of PM2.5 exposure had a higher incidence of dyslipidemia than those with a low level of PM2.5 exposure (≤22.37 μg/m3), with HRs (95% CIs) of 1.36 (1.32, 1.40), and 1.90 (1.81, 1.99), respectively. We observed a statistically significant, but minor, interaction effect of PM2.5 exposure and exercise on the development of dyslipidemia, with an overall hazard ratios (95% CI) of 1.08 (1.05, 1.10), indicating that an incremental increase in the level of exercise was associated with an 8% increase in the risk of dyslipidemia associated with every 10 μg/m3 increase in PM2.5 exposure. However, the negative association between habitual exercise and dyslipidemia remained, regardless of the level of PM2.5 exposure, suggesting that the benefits of increased habitual exercise outweighed the adverse effects of the increase in PM2.5 intake during exercise. Conclusions: Increased levels of exercise and reduced levels of PM2.5 exposures were associated with a lower incidence of dyslipidemia. Although an increase in habitual exercise slightly increased the risk of dyslipidemia associated with PM2.5 exposure, the benefits of the increased habitual exercise outweighed the risks. Our findings suggest that habitual exercise is an effective approach for dyslipidemia prevention, even for people residing in relatively polluted areas.
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Association between Exercise and Blood Pressure in Hypertensive Residents: A Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2453805. [PMID: 35069755 PMCID: PMC8767394 DOI: 10.1155/2022/2453805] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/02/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Exercise is recommended as an effective lifestyle behaviour for adults to prevent and treat hypertension. In this study, a randomized-effect meta-analysis was used to analyse the influence of exercise interventions on blood pressure in patients with hypertension. METHODS Candidate papers were retrieved from PubMed, Web of Science, Embase, and Cochrane Library electronic databases, and 46 studies were finally included and analysed. RESULTS It was shown that preplanned walking (systolic blood pressure (SBP): WMD (weighted mean difference) = -5.94, 95% CI: -8.57, -3.30; diastolic blood pressure (DBP): WMD = -2.66, 95% CI: -3.66, -1.67), yoga (SBP: WMD = -5.09, 95% CI: -9.28, -0.89; DBP: WMD = -3.06, 95% CI: -5.16, -0.96), aquatic sports (SBP WMD = -7.53, 95% CI: -11.40, -3.65; DBP: WMD = -5.35, 95% CI: -9.00, -1.69), and football (SBP: WMD = -6.06, 95% CI: -9.30, -2.82; DBP: WMD = -5.55, 95% CI: -8.98, -2.13) had significant effects on blood pressure reduction. However, Tai Chi (SBP: WMD = -8.31, 95% CI: -20.39, 3.77; DBP: WMD = -3.05, 95% CI: -6.96, 0.87) and Qigong (SBP: WMD = -4.34, 95% CI: -13.5, 4.82; DBP: WMD = -3.44, 95% CI: -7.89, 1.01) did not significantly reduce blood pressure. The heterogeneity of the meta-analysis was high. CONCLUSION Walking, yoga, aquatic sports, and football were feasible and independent lifestyle interventions, and they were effective options for treating hypertension. More scientifically designed randomized controlled trials are needed in the future to further compare different forms of exercise for the treatment of hypertension.
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Ong GX, Ji JS. Is outdoor exercise in air polluted cities a major threat to global health? ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 230:113146. [PMID: 34974363 DOI: 10.1016/j.ecoenv.2021.113146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Gui Xian Ong
- Environmental Research Center, Duke Kunshan University, China.
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, China.
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Hu HB, Hou ZH, Huang CH, LaMonte MJ, Wang M, Lu B. Associations of exposure to residential green space and neighborhood walkability with coronary atherosclerosis in Chinese adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118347. [PMID: 34637822 PMCID: PMC8616833 DOI: 10.1016/j.envpol.2021.118347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 05/31/2023]
Abstract
Residential green space and neighborhood walkability are important foundations of a healthy and sustainable city. Yet, their associations with atherosclerosis, the disease underlying clinical coronary heart disease (CHD), is unknown, especially in susceptible populations. We aim to explore the associations of exposure to residential green space and neighborhood walkability with coronary atherosclerosis. In this study of 2021 adults with suspected CHD, we evaluated the associations of exposure to green space (using Normalized Difference Vegetation Index [NDVI] and enhanced vegetation index [EVI] surrounding each participant's home) and neighborhood walkability (using walkability index and number of parks near home) with atherosclerosis (using coronary artery calcium score, CAC) using linear regression model adjusted for individual-level characteristics. Mediation analysis was further applied to explore potential mechanisms through the pathways of physical activity, air pollution, and psychological stress. In the primary model, an interquartile increase in annual mean NDVI and EVI within the 1-km area was associated with -15.8% (95%CI: 28.7%, -0.7%), and -18.6% (95%Cl: 31.3%, -3.6%) lower CAC score, respectively. However, an interquartile increase in the walkability index near home was associated with a 7.4% (95% CI: 0.1%, 15.2%) higher CAC score. The combined exposure to a green space area in a 1-km area and the walkability index were inversely associated with atherosclerosis, albeit with a smaller magnitude than a single-exposure model. The findings from a mediation analysis suggested that increased physical exercise and ameliorated particulate matter <2.5 μm (PM2.5) may partially contribute to the relationship between green space and atherosclerosis, and for walkability index, partially explained by increased PM2.5 exposure. Our study suggested a beneficial association between green space and atherosclerosis, but an adverse association between neighborhood walkability and atherosclerosis. Therefore, urban development that aims to improve neighborhood walkability should jointly account for enhancing green space properties from a public health perspective.
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Affiliation(s)
- Hai-Bo Hu
- School of Physical Education, Yantai University, Shandong, China
| | - Zhi-Hui Hou
- Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Cong-Hong Huang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA; RENEW Institute, University at Buffalo, Buffalo, NY, USA; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Bin Lu
- Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
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Xu J, Zhou J, Luo P, Mao D, Xu W, Nima Q, Cui C, Yang S, Ao L, Wu J, Wei J, Chen G, Li S, Guo Y, Zhang J, Liu Z, Zhao X. Associations of long-term exposure to ambient air pollution and physical activity with insomnia in Chinese adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 792:148197. [PMID: 34144234 DOI: 10.1016/j.scitotenv.2021.148197] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Air pollution is a potential environmental risk for sleep disturbance. However, the evidence is very limited in China. On the other hand, physical activity (PA) is a preventive behavior that can improve insomnia, but whether PA mitigates the negative impact of air pollution on insomnia is unknown. METHODS We obtained data from the baseline of China Multi-Ethnic Cohort (CMEC) survey, and examined the association between air pollution and insomnia, as well as PA's modification effect of on this association. We included 70,668 respondents and assessed insomnia by self-reported symptoms collected using electronic questionnaires. Using satellite data, we estimated the residence-specified, three-year average PM1, PM2.5, PM10 (particulate matter with aerodynamic diameters of ≤1 μm, ≤2.5 μm and 10 μm, respectively), O3 (ozone), and NO2 (nitrogen dioxide) concentrations. We established the associations between air pollutants and insomnia through logistic regression. We evaluated the modification impact of total and domain-specific PA (leisure, occupation, housework, transportation) by introducing an interaction term. RESULTS Positive associations were observed between long-term exposure to PM1, PM2.5, PM10, and O3 and insomnia symptoms, with ORs (95% CI) of 1.09 (1.03-1.16), 1.11 (1.07-1.15), 1.07 (1.05-1.10) and 1.15 (1.11-1.20), respectively. As total PA increased, the ORs of air pollution for insomnia tended to decrease and then rise. We observed varying modification effects of domain-specific PA. With an increase in leisure PA, the ORs for PM2.5 and PM10 significantly declined. However, increased ORs of air pollutants were related to insomnia among participants with higher levels of occupational and housework PA. CONCLUSION Long-term exposure to higher concentrations of PM1, PM2.5, PM10, and O3 increases the risk of insomnia symptoms. Moderate to high levels of leisure PA alleviate the harmful effects of air pollution on insomnia, while high levels of occupation and housework PA intensify such effects.
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Affiliation(s)
- Jiayue Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Peng Luo
- School of Public Health, the key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China.
| | - Deqiang Mao
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400042, China
| | - Wen Xu
- Yunnan Center for Disease Control and Prevention, Kunming 650022, China
| | - Qucuo Nima
- Tibet Center for Disease Control and Prevention CN, Lhasa 850000, China
| | | | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Linjun Ao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China.
| | - Jialong Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Jing Wei
- Department of Chemical and Biochemical Engineering, Iowa Technology Institute, Center for Global and Regional Environmental Research, University of Iowa, Iowa City, IA, USA
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment; Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Juying Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China.
| | - Zhu Liu
- Chengdu Center for Disease Control and Prevention, Chengdu 610041, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China.
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Bo Y, Yu T, Chang LY, Guo C, Lin C, Zeng Y, Huang B, Tam T, Lau AKH, Wong SYS, Lao XQ. Combined effects of chronic PM2.5 exposure and habitual exercise on cancer mortality: a longitudinal cohort study. Int J Epidemiol 2021; 51:225-236. [PMID: 34632511 DOI: 10.1093/ije/dyab209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 09/20/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Exercise may increase the inhalation and deposition of air pollutants, which may counteract its beneficial effects. We thus examined the combined effects of chronic exposure to fine particulate matter (PM2.5) and habitual exercise on the risk of death from cancer in Taiwan. PATIENTS AND METHODS A total of 384 128 adults (≥18 years of age) were recruited for a medical screening programme between 2001 and 2016, yielding 842 384 medical-examination records. All participants were followed up until 31 May 2019. Vital data were obtained from the National Death Registry of Taiwan and the ambient PM2.5 exposure was estimated using a satellite-based spatiotemporal model. Information on habitual exercise was collected using a standard self-administered questionnaire. The time-dependent Cox-regression model was used to evaluate the combined effects. RESULTS A greater amount of habitual exercise was associated with lower risk of death from cancer, whilst a higher level of PM2.5 exposure was associated with a higher risk of death from cancer. The inverse associations of habitual exercise with death from cancer were not modified by chronic exposure to PM2.5. The participants in the group with a high level of exercise and a low level of PM2.5 exposure exhibited a 35% lower risk of death from cancer than those in the group with a low level of exercise and a high level of PM2.5 exposure (95% confidence interval: 28%, 42%). CONCLUSIONS Increased levels of exercise and reduced exposure levels of PM2.5 are associated with a lower risk of death from cancer. Habitual exercise reduces the risk of death from cancer regardless of the levels of chronic PM2.5 exposure. Our results indicate that habitual exercise is a suitable health-promotion strategy even for people who reside in moderately polluted regions.
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Affiliation(s)
- Yacong Bo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.,Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Taiwan
| | | | - Cui Guo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Changqing Lin
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, China
| | - Yiqian Zeng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Bo Huang
- Department of Geography and Resource Management, the Chinese University of Hong Kong, Hong Kong, China
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, China.,Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong, China
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.,Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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Zhang Z, Wang J, Kwong JC, Burnett RT, van Donkelaar A, Hystad P, Martin RV, Bai L, McLaughlin J, Chen H. Long-term exposure to air pollution and mortality in a prospective cohort: The Ontario Health Study. ENVIRONMENT INTERNATIONAL 2021; 154:106570. [PMID: 33892223 DOI: 10.1016/j.envint.2021.106570] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/31/2021] [Accepted: 04/08/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Air pollution has been associated with increased mortality. However, updated evidence from cohort studies with detailed information on various risk factors is needed, especially in regions with low air pollution levels. We investigated the associations between long-term exposure to air pollution and mortality in a prospective cohort. METHODS We studied 88,615 participants aged ≥30 years from an ongoing cohort study in Ontario, Canada from 2009 to 2017. Exposure to ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2) was estimated at participants' residence. Cox proportional hazard models were used to investigate the associations between air pollution and non-accidental, cardiovascular, and respiratory mortality, adjusted for a wide array of individual-level and contextual covariates. Potential effect modification by socio-demographic and behavioral factors was also examined in exploratory stratified analyses. RESULTS The fully adjusted hazard ratios (HRs) per 1 µg/m3 increment in PM2.5 were 1.037 [95% confidence interval (CI): 1.018, 1.057]¸ 1.083 (95% CI: 1.040, 1.128) and 1.109 (95% CI: 1.035, 1.187) for non-accidental, cardiovascular, and respiratory mortality, respectively. Positive associations were also found for NO2; the corresponding HRs per 1 ppb increment were 1.027 (95% CI: 1.021, 1.034), 1.032 (95% CI: 1.019, 1.046) and 1.044 (95% CI: 1.020, 1.068). We found suggestive evidence of stronger associations in physically active participants, smokers, and those with lower household income. CONCLUSIONS Long-term exposure to PM2.5 and NO2 was associated with increased risks for non-accidental, cardiovascular, and respiratory mortality, suggesting potential benefits of further improvement in air quality even in low-exposure environments.
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Affiliation(s)
- Zilong Zhang
- Public Health Ontario, Toronto, ON, Canada; ICES, Toronto, ON, Canada; Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - John Wang
- Public Health Ontario, Toronto, ON, Canada; ICES, Toronto, ON, Canada
| | - Jeffrey C Kwong
- Public Health Ontario, Toronto, ON, Canada; ICES, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Richard T Burnett
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada; Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Perry Hystad
- College of Public Health and Human Studies, Oregon State University, Corvallis, OR, USA
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada; Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA; Harvard-Smithsonian Centre for Astrophysics, Cambridge, MA, USA
| | - Li Bai
- ICES, Toronto, ON, Canada
| | - John McLaughlin
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Hong Chen
- Public Health Ontario, Toronto, ON, Canada; ICES, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
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Lin Y, Yang X, Liang F, Huang K, Liu F, Li J, Xiao Q, Chen J, Liu X, Cao J, Chen S, Shen C, Yu L, Lu F, Wu X, Zhao L, Wu X, Li Y, Hu D, Huang J, Lu X, Liu Y, Gu D. Benefits of active commuting on cardiovascular health modified by ambient fine particulate matter in China: A prospective cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 224:112641. [PMID: 34461320 PMCID: PMC9188394 DOI: 10.1016/j.ecoenv.2021.112641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Active commuting as a contributor to daily physical activity is beneficial for cardiovascular health, but leads to more chances of exposure to ambient air pollution. This study aimed to investigate associations between active commuting to work with cardiovascular disease (CVD), mortality and life expectancy among general Chinese adults, and to further evaluate the modification effect of fine particulate matter (PM2.5) exposure on these associations. METHODS We included 76,176 Chinese adults without CVD from three large cohorts of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project. Information about commuting mode and physical activity were collected by unified questionnaire. Satellite-based PM2.5 concentrations at 1-km spatial resolution was used for estimating PM2.5 exposure of participants. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD incidence, mortality and all-cause mortality were estimated using Cox proportional hazards regression models. Multiplicative interaction term of commuting mode and PM2.5 level was tested to investigate potential effect modification. RESULTS During 448,499 person-years of follow-up, 2230 CVD events and 2777 all-cause deaths were recorded. Compared with the non-active commuters, the multivariable-adjusted HRs (95% CIs) of CVD incidence and all-cause mortality were 0.95(0.85-1.05) and 0.79(0.72-0.87) for walking commuters, respectively. Corresponding HRs (95% CIs) for cycling commuters were 0.71(0.62-0.82) and 0.67(0.59-0.76). Active commuters over 45 years old were estimated to have more CVD-free years and life expectancy than non-active commuters under lower PM2.5 concentration. However, these beneficial effects of active commuting were alleviated or counteracted by long-term exposure to high PM2.5 concentration. Significant multiplicative interaction of commuting mode and PM2.5 level was showed in all-cause mortality, with the lowest risk observed in cycling participants exposed to lower level of PM2.5. CONCLUSIONS Active commuting was associated with lower risk of CVD, all-cause mortality, and longer life expectancy among Chinese adults under ambient settings with lower PM2.5 level. It will be valuable to encourage active commuting among adults and develop stringent strategies on ambient PM2.5 pollution control for prevention of CVD and prolongation of life expectancy.
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Affiliation(s)
- Yuan Lin
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Keyong Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qingyang Xiao
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Jichun Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Shufeng Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China
| | - Xianping Wu
- Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Liancheng Zhao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xigui Wu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China.
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Guo C, Yu T, Chang LY, Lin C, Yang HT, Bo Y, Zeng Y, Tam T, Lau AKH, Lao XQ. Effects of air pollution and habitual exercise on the risk of death: a longitudinal cohort study. CMAJ 2021; 193:E1240-E1249. [PMID: 34400482 PMCID: PMC8386491 DOI: 10.1503/cmaj.202729] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 01/15/2023] Open
Abstract
Background: Exercise may exacerbate the adverse health effects of air pollution by increasing the inhalation of air pollutants. We investigated the combined effects of long-term exposure to fine particle matter (PM2.5) and habitual exercise on deaths from natural causes in Taiwan. Methods: We recruited 384 130 adults (aged ≥ 18 yr) with 842 394 medical examination records between 2001 and 2016, and followed all participants until May 31, 2019. We obtained vital data from the National Death Registry of Taiwan. We estimated PM2.5 exposure using a satellite-based spatiotemporal model, and collected information on exercise habits using a standard self-administered questionnaire. We analyzed the data using a Cox regression model with time-dependent covariates. Results: A higher level of habitual exercise was associated with a lower risk of death from natural causes, compared with inactivity (hazard ratio [HR] 0.84, 95% confidence interval [CI] 0.80–0.88 for the moderate exercise group; HR 0.65, 95% CI 0.62–0.68 for the high exercise groups), whereas a higher PM2.5 exposure was associated with a higher risk of death from natural causes compared with lower exposure (HR 1.02, 95% CI 0.98–1.07, and HR 1.15, 95% CI 1.10–1.20, for the moderate and high PM2.5 exposure groups, respectively). Compared with inactive adults with high PM2.5 exposure, adults with high levels of habitual exercise and low PM2.5 exposure had a substantially lower risk of death from natural causes. We found a minor, but statistically significant, interaction effect between exercise and PM2.5 exposure on risk of death (HR 1.03 95% CI 1.01–1.06). Subgroup analyses, stratified by PM2.5 categories, suggested that moderate and high levels of exercise were associated with a lower risk of death in each PM2.5 stratum, compared with inactivity. Interpretation: Increased levels of exercise and reduced PM2.5 exposure are associated with a lower risk of death from natural causes. Habitual exercise can reduce risk regardless of the levels of PM2.5 exposure. Our results suggest that exercise is a safe health improvement strategy, even for people residing in relatively polluted regions.
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Affiliation(s)
- Cui Guo
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Tsung Yu
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Ly-Yun Chang
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Changqing Lin
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Hsiao Ting Yang
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Yiqian Zeng
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Tony Tam
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Alexis K H Lau
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China.
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Mobility speed predicts new-onset hypertension: a longitudinal study. Blood Press Monit 2021; 27:22-26. [PMID: 34267074 PMCID: PMC8734633 DOI: 10.1097/mbp.0000000000000562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate whether declining mobility and muscle strength predict new-onset hypertension in suburban-dwelling elderly individuals.
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Zeng Y, Lin C, Guo C, Bo Y, Chang LY, Lau AKH, Tam T, Yu Z, Lao XQ. Combined effects of chronic PM 2.5 exposure and habitual exercise on renal function and chronic kidney disease: A longitudinal cohort study. Int J Hyg Environ Health 2021; 236:113791. [PMID: 34147785 DOI: 10.1016/j.ijheh.2021.113791] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/19/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND We investigated the combined effects of chronic PM2.5 exposure and habitual exercise on the decline of renal function and the incidence of chronic kidney disease (CKD) in a large cohort in Taiwan. METHODS The present data analysis included a total of 108,615 participants aged 18 years or above who were recruited between 2001 and 2016. All participants underwent at least two medical examinations. Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. The incident of eGFR decline ≥30% was defined as a decline in eGFR of ≥30% during the study period, while the incident CKD was defined as an eGFR <60 mL/min/1.73 m2 or a newly self-reported physician-diagnosed CKD in the subsequent visits. The satellite-based spatiotemporal model was used to estimate PM2.5 exposure at each participant's address. Information on habitual exercise was collected using a standard self-administered questionnaire. The Cox regression model with time-dependent covariates was used for data analyses. RESULTS Higher habitual exercise was associated with lower risks of renal function decline and CKD development, whereas higher PM2.5 exposure was associated with higher risks of renal function decline and CKD development. We found no significant interaction effect between PM2.5 and habitual exercise, with an HR (95% CI) of 1.02 (0.97, 1.07) for incident eGFR decline ≥30% and 1.00 (0.95, 1.05) for CKD development. Compared to participants with inactive-exercise and high-PM2.5, participants with high-exercise and low-PM2.5 had 74% and 61% lower risks of renal function decline and CKD development, respectively. CONCLUSION Increased habitual exercise and reduced PM2.5 exposures are associated with lower risks of renal function decline and CKD development. Habitual exercise reduces risks of renal function decline and CKD development regardless of the levels of chronic PM2.5 exposure. Our study suggests that habitual exercise is a safe approach for kidney health improvement even for people residing in relatively polluted areas and should be promoted.
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Affiliation(s)
- Yiqian Zeng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Cui Guo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zengli Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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Guo C, Yang HT, Chang LY, Bo Y, Lin C, Zeng Y, Tam T, Lau AKH, Hoek G, Lao XQ. Habitual exercise is associated with reduced risk of diabetes regardless of air pollution: a longitudinal cohort study. Diabetologia 2021; 64:1298-1308. [PMID: 33660006 DOI: 10.1007/s00125-021-05408-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS Physical activity may increase a person's inhalation of air pollutants and exacerbate the adverse health effects. This study aimed to investigate the combined associations of chronic exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and habitual physical activity with the incidence of type 2 diabetes in Taiwan. METHODS We selected 156,314 non-diabetic adults (≥18 years old) who joined an ongoing longitudinal cohort between 2001 and 2016. Incident type 2 diabetes was identified at the follow-up medical examinations. Two-year mean PM2.5 exposure was estimated at each participant's address using a satellite-based spatiotemporal model. Information on physical activity and a wide range of covariates was collected using a standard self-administered questionnaire. We analysed the data using a Cox regression model with time-varying covariates. An interaction term between PM2.5 and physical activity was included to examine the overall interaction effects. RESULTS Compared with high physical activity, moderate and inactive/low physical activity were associated with a higher risk of diabetes (HR [95% CI] 1.31 [1.22, 1.41] and 1.56 [1.46, 1.68], respectively). Participants with moderate/high PM2.5 had a higher risk of type 2 diabetes than the participants exposed to low PM2.5 (HR 1.31 [1.22, 1.40] and 1.94 [1.76, 2.14], respectively). The participants with high physical activity and low PM2.5 had a 64% lower risk of type 2 diabetes than those with inactive/low physical activity and high PM2.5. CONCLUSIONS/INTERPRETATION Higher physical activity and lower PM2.5 exposure are associated with lower risk of type 2 diabetes. Habitual physical activity can reduce the risk of diabetes regardless of the levels of PM2.5 exposure. Our results indicate that habitual physical activity is a safe diabetes prevention strategy for people residing in relatively polluted regions.
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Affiliation(s)
- Cui Guo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Hsiao Ting Yang
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, SAR, China
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Changqing Lin
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, SAR, China
- Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong, SAR, China
| | - Yiqian Zeng
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, SAR, China
- Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong, SAR, China
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, SAR, China.
- Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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