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Thorsen EHK, Dalbøge A, Hovgaard N, Andersen JH, Jahn A. Occupational mechanical exposures as risk factor for shoulder osteoarthritis: a systematic review. Ann Work Expo Health 2024:wxae063. [PMID: 39231439 DOI: 10.1093/annweh/wxae063] [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: 04/15/2024] [Accepted: 07/09/2024] [Indexed: 09/06/2024] Open
Abstract
OBJECTIVES The aim of this systematic review was to study the association between occupational mechanical exposures and shoulder osteoarthritis (OA). METHODS A protocol was registered in PROSPERO. Four databases were systematically searched based on PECOS criteria. Outcome was defined as shoulder OA (acromioclavicular (AC) and/or glenohumeral OA) and exposure as occupational mechanical exposures (vibration, upper arm elevation, force, lifting, repetition, and combined mechanical exposures). We included epidemiological studies estimating the prevalence of shoulder OA or the association between occupational mechanical exposures and shoulder OA. Two researchers independently screened articles, performed data extraction, and assessed the risk of bias and level of evidence using GRADE. RESULTS A total of 1642 articles were screened, of which 7 met the inclusion criteria. Four studies were assessed as having a high risk of bias, 1 with a moderate risk, and 2 with a low risk. Based on job titles, higher prevalence estimates (2.9% to 61.8%) were found in exposed job groups. For all occupational mechanical exposures, exposure-response relations were found in relation to AC OA. For vibration, the odds ratio (OR) ranged between 1.7 and 3.1 in the highest exposure groups, while the ORs for upper arm-elevation, force, lifting, repetition, and combined mechanical exposures ranged between 0.5 to 2.2, 1.3 to 1.8, 7.3 to 10.3, 2.4, and 2.2 to 2.9. Low or very low level of evidence was found for all exposures. CONCLUSIONS This systematic review found an indication of an association between occupational mechanical exposures and shoulder OA, especially AC OA. However, the level of evidence varied between low and very low. High-quality studies assessing the association and differentiating between the specific shoulder joints are highly warranted.
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Affiliation(s)
- Ea Helene Korsgaard Thorsen
- Danish Ramazzini Centre, Department of Occupational Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Annett Dalbøge
- Danish Ramazzini Centre, Department of Occupational Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University Hospital, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Nicholas Hovgaard
- Danish Ramazzini Centre, Department of Occupational Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Johan Hviid Andersen
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
- Danish Ramazzini Centre, Department of Occupational Medicine-University Research Clinic, Hospitalsparken 15, Goedstrup Hospital, 7400 Herning, Denmark
| | - Alexander Jahn
- Danish Ramazzini Centre, Department of Occupational Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University Hospital, 8200 Aarhus, Denmark
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Zhou X, Wei C, Chen Z, Xia X, Wang L, Li X. Potential mechanisms of ischemic stroke induced by heat exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 952:175815. [PMID: 39197783 DOI: 10.1016/j.scitotenv.2024.175815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 08/04/2024] [Accepted: 08/24/2024] [Indexed: 09/01/2024]
Abstract
Recent decades of epidemiological and clinical research have suggested that heat exposure could be a potential risk factor for ischemic stroke. Despite climate factors having a minor impact on individuals compared with established risk factors such as smoking, their widespread and persistent effects significantly affect public health. The mechanisms by which heat exposure triggers ischemic stroke are currently unclear. However, several potential mechanisms, such as the impact of temperature variability on stroke risk factors, inflammation, oxidative stress, and coagulation system changes, have been proposed. This article details the potential mechanisms by which heat exposure may induce ischemic stroke, aiming to guide the prevention and treatment of high-risk groups in hot climates and support public health policy development.
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Affiliation(s)
- Xiao Zhou
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Chanjuan Wei
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhuangzhuang Chen
- 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
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China.
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Symeonides C, Aromataris E, Mulders Y, Dizon J, Stern C, Barker TH, Whitehorn A, Pollock D, Marin T, Dunlop S. An Umbrella Review of Meta-Analyses Evaluating Associations between Human Health and Exposure to Major Classes of Plastic-Associated Chemicals. Ann Glob Health 2024; 90:52. [PMID: 39183960 PMCID: PMC11342836 DOI: 10.5334/aogh.4459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/07/2024] [Indexed: 08/27/2024] Open
Abstract
Background: Epidemiological research investigating the impact of exposure to plastics, and plastic-associated chemicals, on human health is critical, especially given exponentially increasing plastic production. In parallel with increasing production, academic research has also increased exponentially both in terms of the primary literature and ensuing systematic reviews with meta-analysis. However, there are few overviews that capture a broad range of chemical classes to present a state of play regarding impacts on human health. Methods: We undertook an umbrella review to review the systematic reviews with meta-analyses. Given the complex composition of plastic and the large number of identified plastic-associated chemicals, it was not possible to capture all chemicals that may be present in, and migrate from, plastic materials. We therefore focussed on a defined set of key exposures related to plastics. These were microplastics, due to their ubiquity and potential for human exposure, and the polymers that form the matrix of consumer plastics. We also included plasticisers and flame retardants as the two classes of functional additive with the highest concentration ranges in plastic. In addition, we included bisphenols and per- and polyfluoroalkyl substances (PFAS) as two other major plastic-associated chemicals with significant known exposure through food contact materials. Epistemonikos and PubMed were searched for systematic reviews with meta-analyses, meta-analyses, and pooled analyses evaluating the association of plastic polymers, particles (microplastics) or any of the selected groups of high-volume plastic-associated chemicals above, measured directly in human biospecimens, with human health outcomes. Results: Fifty-two systematic reviews were included, with data contributing 759 meta-analyses. Most meta-analyses (78%) were from reviews of moderate methodological quality. Across all the publications retrieved, only a limited number of plastic-associated chemicals within each of the groups searched had been evaluated in relevant meta-analyses, and there were no meta-analyses evaluating polymers, nor microplastics. Synthesised estimates of the effects of plastic-associated chemical exposure were identified for the following health outcome categories in humans: birth, child and adult reproductive, endocrine, child neurodevelopment, nutritional, circulatory, respiratory, skin-related and cancers. Bisphenol A (BPA) is associated with decreased anoclitoral distance in infants, type 2 diabetes (T2D) in adults, insulin resistance in children and adults, polycystic ovary syndrome, obesity and hypertension in children and adults and cardiovascular disease (CVD); other bisphenols have not been evaluated. Phthalates, the only plasticisers identified, are associated with spontaneous pregnancy loss, decreased anogenital distance in boys, insulin resistance in children and adults, with additional associations between certain phthalates and decreased birth weight, T2D in adults, precocious puberty in girls, reduced sperm quality, endometriosis, adverse cognitive development and intelligence quotient (IQ) loss, adverse fine motor and psychomotor development and elevated blood pressure in children and asthma in children and adults. Polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) but not other flame retardants, and some PFAS were identified and are all associated with decreased birth weight. In general populations, PCBs are associated with T2D in adults and endometriosis, bronchitis in infants, CVD, non-Hodgkin's lymphoma (NHL) and breast cancer. In PCB-poisoned populations, exposure is associated with overall mortality, mortality from hepatic disease (men), CVD (men and women) and several cancers. PBDEs are adversely associated with children's cognitive development and IQ loss. PBDEs and certain PFAS are associated with changes in thyroid function. PFAS exposure is associated with increased body mass index (BMI) and overweight in children, attention deficit hyperactive disorder (ADHD) in girls and allergic rhinitis. Potential protective associations were found, namely abnormal pubertal timing in boys being less common with higher phthalate exposure, increased high-density lipoprotein (HDL) with exposure to mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) and reduced incidence of chronic lymphocytic lymphoma (a subtype of NHL) with PCB exposure. Conclusions: Exposure to plastic-associated chemicals is associated with adverse outcomes across a wide range of human health domains, and every plastic-associated chemical group is associated with at least one adverse health outcome. Large gaps remain for many plastic-associated chemicals. Recommendations: For research, we recommend that efforts are harmonised globally to pool resources and extend beyond the chemicals included in this umbrella review. Priorities for primary research, with ensuing systematic reviews, could include micro- and nanoplastics as well as emerging plastic-associated chemicals of concern such as bisphenol analogues and replacement plasticisers and flame retardants. With respect to chemical regulation, we propose that safety for plastic-associated chemicals in humans cannot be assumed at market entry. We therefore recommend that improved independent, systematic hazard testing for all plastic-associated chemicals is undertaken before market release of products. In addition because of the limitations of laboratory-based testing for predicting harm from plastic in humans, independent and systematic post-market bio-monitoring and epidemiological studies are essential to detect potential unforeseen harms.
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Affiliation(s)
- Christos Symeonides
- Minderoo Foundation, Perth, Western Australia, Australia
- Centre for Community Child Health, Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Edoardo Aromataris
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Janine Dizon
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Cindy Stern
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Timothy Hugh Barker
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ashley Whitehorn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Danielle Pollock
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tania Marin
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sarah Dunlop
- Minderoo Foundation, Perth, Western Australia, Australia
- School of Biological Sciences, The University of Western Australia, Perth, Australia
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Miotto E, Tartaglione AM, Iavarone I, Ricceri L, Zona A, Ceccarini A, Rossi S, Fazzo L. Neurodevelopmental outcomes in children living near hazardous waste sites: a systematic review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-14. [PMID: 39110000 DOI: 10.1080/09603123.2024.2384963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 07/22/2024] [Indexed: 09/12/2024]
Abstract
Mismanagement of hazardous waste (HW) causes severe threats to ecosystems and human health. We conducted a systematic literature review and evaluated the evidence regarding the association between residential exposure to HW and childhood neurobehavioral effects. We consulted international agencies websites and conducted a search on MEDLINE and EMBASE databases by applying a "Population-Exposure-Comparator-Outcome" question. The evidence evaluation, based on the quality of the studies and their concordance, was graded in sufficient/limited/inadequate. Documents from international agencies were not found. Of the seventy-five studies screened, nine met the eligibility criteria. Studies agree on the association between residential exposure to HW sites and negative neurodevelopmental effects. The evidence of the association was attributed limited to cognitive and behavioral outcomes, and inadequate to Autism Spectrum Disorder. The evidence was evaluated sufficient for HW sites releasing lead and cognitive disorders. Residential exposure to unsafe HW sites may contribute to childhood neurobehavioral alterations. It is urgent to implement environmental remediation of contaminated sites and counteracting illegal and unsafe HW management practices.
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Affiliation(s)
- Edoardo Miotto
- Department of Medicine, University of Udine, Udine, Italy
| | - Anna Maria Tartaglione
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Roma, Italy
| | - Ivano Iavarone
- Department Environment and Health, Istituto Superiore di Sanità, Roma, Italy
- World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites
| | - Laura Ricceri
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Roma, Italy
| | - Amerigo Zona
- Department Environment and Health, Istituto Superiore di Sanità, Roma, Italy
- World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites
| | | | - Sabrina Rossi
- Department Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Lucia Fazzo
- Department Environment and Health, Istituto Superiore di Sanità, Roma, Italy
- World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites
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Ricolfi L, Vendl C, Bräunig J, Taylor MD, Hesselson D, Gregory Neely G, Lagisz M, Nakagawa S. A research synthesis of humans, animals, and environmental compartments exposed to PFAS: A systematic evidence map and bibliometric analysis of secondary literature. ENVIRONMENT INTERNATIONAL 2024; 190:108860. [PMID: 38968830 DOI: 10.1016/j.envint.2024.108860] [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: 10/20/2023] [Revised: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are a class of widely used anthropogenic chemicals. Concerns regarding their persistence and potential adverse effects have led to multiple secondary research publications. Here, we aim to assess the resulting evidence base in the systematic secondary literature by examining research gaps, evaluating the quality of reviews, and exploring interdisciplinary connections. METHODS This study employed a systematic evidence-mapping approach to assess the secondary literature on the biological, environmental, and medical aspects of exposure to 35 fluorinated compounds. The inclusion criteria encompassed systematic reviews published in peer-reviewed journals, pre-prints, and theses. Comprehensive searches across electronic databases and grey literature identified relevant reviews. Data extraction and synthesis involved mapping literature content and narrative descriptions. We employed a modified version of the AMSTAR2 checklist to evaluate the methodological rigour of the reviews. A bibliometric data analysis uncovered patterns and trends in the academic literature. A research protocol for this study was previously pre-registered (osf.io/2tpn8) and published (Vendl et al., Environment International 158 (2022) 106973). The database is freely accessible through the interactive and user-friendly web application of this systematic evidence map at https://hi-this-is-lorenzo.shinyapps.io/PFAS_SEM_Shiny_App/. RESULTS Our map includes a total of 175 systematic reviews. Over the years, there has been a steady increase in the annual number of publications, with a notable surge in 2021. Most reviews focused on human exposure, whereas environmental and animal-related reviews were fewer and often lacked a rigorous systematic approach to literature search and screening. Review outcomes were predominantly associated with human health, particularly with reproductive and children's developmental health. Animal reviews primarily focused on studies conducted in controlled laboratory settings, and wildlife reviews were characterised by an over-representation of birds and fish species. Recent reviews increasingly incorporated quantitative synthesis methodologies. The methodological strengths of the reviews included detailed descriptions of study selection processes and disclosure of potential conflicts of interest. However, weaknesses were observed in the critical lack of detail in reporting methods. A bibliometric analysis revealed that the most productive authors collaborate within their own country, leading to limited and clustered international collaborations. CONCLUSIONS In this overview of the available systematic secondary literature, we map literature content, assess reviews' methodological quality, highlight data gaps, and draw research network clusters. We aim to facilitate literature reviews, guide future research initiatives, and enhance opportunities for cross-country collaboration. Furthermore, we discuss how this systematic evidence map and its publicly available database benefit scientists, regulatory agencies, and other stakeholders by providing access to current systematic secondary literature on PFAS exposure.
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Affiliation(s)
- Lorenzo Ricolfi
- Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales Sydney, Sydney, Australia.
| | - Catharina Vendl
- Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales Sydney, Sydney, Australia; Dauphin Island Sea Lab, Dauphin Island, Al, USA.
| | - Jennifer Bräunig
- Queensland Alliance for Environmental Health Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia; NSW Department of Climate Change, Energy, the Environment and Water, Environment Protection Science Branch, Sydney, Australia.
| | - Matthew D Taylor
- Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales Sydney, Sydney, Australia; Queensland Alliance for Environmental Health Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia; Port Stephens Fisheries Institute, New South Wales Department of Primary Industries, Nelson Bay, Australia.
| | - Daniel Hesselson
- Centenary Institute and Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - G Gregory Neely
- Dr. John and Anne Chong Lab for Functional Genomics, Charles Perkins Centre, School of Life and Environmental Sciences, University of Sydney, Sydney, Australia.
| | - Malgorzata Lagisz
- Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales Sydney, Sydney, Australia; Theoretical Sciences Visiting Program, Okinawa Institute of Science and Technology Graduate University, Onna, Japan.
| | - Shinichi Nakagawa
- Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales Sydney, Sydney, Australia; Theoretical Sciences Visiting Program, Okinawa Institute of Science and Technology Graduate University, Onna, Japan.
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Bonafede M, d'Errico A, Rugarli S, Mensi C, Miligi L, Calisti R, della Gatta R, Piro S, Melis P, Vasselli D, Binazzi A. The psychological impact of diagnosis of sinonasal, nasopharyngeal, and laryngeal cancers: a systematic review. Front Psychol 2024; 15:1355186. [PMID: 39077217 PMCID: PMC11285066 DOI: 10.3389/fpsyg.2024.1355186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 06/19/2024] [Indexed: 07/31/2024] Open
Abstract
Objective High risk of degraded quality of life and psychological distress is observed in patients diagnosed with sinonasal, nasopharyngeal, and laryngeal cancers, which could be caused by exposure to carcinogens in workplaces. This review aimed to investigate the psychological impact of diagnosis associated with the possible occupational etiology of such neoplasms and to explore the instruments that evaluate the quality of life (QoL), anxiety, and depression in these patients. Methods Studies were considered for the review only if they described aspects of the psychological impact of the diagnosis of sinonasal, nasopharyngeal, and laryngeal cancers and reported results distinguished by the tumor site. The psychological impact was assessed in terms of health-related QoL, anxiety, and depression using reliable psychometric questionnaires administered at the time of diagnosis and 1 year later. Results In more than 5,900 records identified, 442 studies fulfilled the eligibility criteria and 436 were excluded after full-text screening, resulting in six studies to be finally included in the review. The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30), EORTC QLQ-H&N35, and Functional Assessment of Cancer Therapy (FACT) were used to evaluate the QoL, whereas the Hospital Anxiety and Depression Scale (HADS) and Center for Epidemiologic Studies Depression Scale (CES-D) questionnaires were employed to assess anxiety and depression. QoL scores were similar to those of the general population at the time of diagnosis and remained unchanged or slightly improved at 1 year since diagnosis. In contrast, a higher prevalence of anxiety and depression was observed compared with the general population, although the results were inconsistent across the very few studies identified. No study investigating the association between the potential occupational etiology and QoL or distress was found. Conclusion Exploring the existing scientific literature on emotional distress in sinonasal, nasopharyngeal, and laryngeal cancer patients was prompted by concerns over the disfiguring nature of treatment and the additional emotional burden resulting from their occupational etiology. Unfortunately, neither a crucial element nor other risk factors (lifestyle, smoking, drinking, etc.) were examined in any study. Patients' employment history should be considered in order to assess the possible impact of believing they are affected by an occupational exposure disease in the evaluation of their psychological distress. This history would support evidence-based recommendations about dedicated psychological interventions.
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Affiliation(s)
- Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Angelo d'Errico
- Epidemiology, Local Health Unit ASL TO3, Piedmont Region, Grugliasco, Italy
| | - Sabrina Rugarli
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Lucia Miligi
- Sinonasal Cancer Registry of Tuscany, Occupational and Environmental Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Firenze, Italy
| | - Roberto Calisti
- Sinonasal Cancer Registry of Marche, Department of Prevention, Unit of Workplace Prevention and Safety and of Occupational Epidemiology (SPreSAL Epi Occ), Macerata Health Authority, Civitanova Marche, Italy
| | - Rosa della Gatta
- Sinonasal Cancer Registry of Marche, Department of Prevention, Unit of Workplace Prevention and Safety and of Occupational Epidemiology (SPreSAL Epi Occ), Macerata Health Authority, Civitanova Marche, Italy
| | - Sara Piro
- Sinonasal Cancer Registry of Tuscany, Occupational and Environmental Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Firenze, Italy
| | - Paola Melis
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Donatella Vasselli
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
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7
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Svendsen C, Mathisen GH, Vist GE, Husøy T, Ames HM, Beronius A, Di Consiglio E, Druwe I, Hartung T, Hoffmann S, Hooijmans CR, Machera K, Robinson JF, Roggen E, Rooney AA, Roth N, Spilioti E, Spyropoulou A, Tcheremenskaia O, Testai E, Vinken M, Whaley P. Cross-mapping of terms used in chemical risk assessment with those used in systematic review: research protocol. EVIDENCE-BASED TOXICOLOGY 2024; 2:2371285. [PMID: 39239089 PMCID: PMC11376327 DOI: 10.1080/2833373x.2024.2371285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/18/2024] [Indexed: 09/07/2024]
Abstract
The focus on implementation of systematic review (SR) principles in chemical risk assessments (CRAs) is growing as it has the potential to advance the rigour and transparency of the CRAs. However, the SR and CRA communities use their own specific terminologies. Understanding the meaning of core SR and CRA terms and where they overlap is critical for application of SR methods and principles in CRAs. Moreover, it will increase the possibility for cross-sectorial collaboration, avoid misunderstandings, and improve communication among risk assessors, researchers, and policy makers. We present a process for the cross-mapping of core CRA terms and core SR terms. Core terms for study appraisal, evidence synthesis and integration used in the SR and CRA communities will be included. The outcome will be an overview of how core SR terms map onto core CRA terms and vice versa, and a description of the relationship and conceptual overlap between the terms. The cross-mapping is divided in three phases, where in the first phase the core SR and CRA terms will be identified. In the second phase, existing SR and CRA definitions will be mapped. In the third phase, descriptions of the relationship and conceptual overlap between the terms will be derived. The third phase will include weekly one-hour online meetings for SR and CRA experts.
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Affiliation(s)
- Camilla Svendsen
- Norwegian Scientific Committee for Food and Environment, Norwegian Institute of Public Health, Oslo, Norway
- Department of Chemical Toxicology, Norwegian Institute of Public Health, Oslo, Norway
| | - Gro H Mathisen
- Norwegian Scientific Committee for Food and Environment, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunn E Vist
- Norwegian Scientific Committee for Food and Environment, Norwegian Institute of Public Health, Oslo, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Trine Husøy
- Norwegian Scientific Committee for Food and Environment, Norwegian Institute of Public Health, Oslo, Norway
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Heather M Ames
- Norwegian Scientific Committee for Food and Environment, Norwegian Institute of Public Health, Oslo, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Anna Beronius
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Emma Di Consiglio
- Environment & Health Department, Italian National Institute of Health (ISS), Rome, Italy
| | - Ingrid Druwe
- United States Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessments, Research Triangle Park, NC, USA
| | - Thomas Hartung
- Center for Alternatives to Animal Testing (CAAT), Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
- CAAT Europe, University of Konstanz, Konstanz, Germany
| | - Sebastian Hoffmann
- Evidence-based toxicology collaboration (EBTC), Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
- seh consulting + services, Paderborn, Germany
| | - Carlijn R Hooijmans
- Department of Anesthesiology, Pain and Palliative Care, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Kyriaki Machera
- Laboratory of Toxicological Control of Pesticides, Scientific Directorate of Pesticides' Control and Phytopharmacy, Benaki Phytopathological Institute, Kifissia, Greece
| | - Joshua F Robinson
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), USA
| | - Erwin Roggen
- 3Rs Management and Consulting ApS, Lyngby, Denmark
| | - Andrew A Rooney
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Nicolas Roth
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Basel, Switzerland
| | - Eliana Spilioti
- Laboratory of Toxicological Control of Pesticides, Scientific Directorate of Pesticides' Control and Phytopharmacy, Benaki Phytopathological Institute, Kifissia, Greece
| | - Anastasia Spyropoulou
- Laboratory of Toxicological Control of Pesticides, Scientific Directorate of Pesticides' Control and Phytopharmacy, Benaki Phytopathological Institute, Kifissia, Greece
| | - Olga Tcheremenskaia
- Environment & Health Department, Italian National Institute of Health (ISS), Rome, Italy
| | - Emanuela Testai
- Environment & Health Department, Italian National Institute of Health (ISS), Rome, Italy
| | - Mathieu Vinken
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel; Belgium
| | - Paul Whaley
- Norwegian Scientific Committee for Food and Environment, Norwegian Institute of Public Health, Oslo, Norway
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
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8
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Yang X, Xu X, Wang Y, Yang J, Wu X. Heat exposure impacts on urban health: A meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 947:174650. [PMID: 38986701 DOI: 10.1016/j.scitotenv.2024.174650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/27/2024] [Accepted: 07/07/2024] [Indexed: 07/12/2024]
Abstract
The escalating health risks posed by warm weather in urban areas have become a pressing global public health issue. This study undertakes a meta-analysis to evaluate the impact of warm weather on health in urban settings. We comprehensively searched PubMed, Embase, Scopus, and Web of Science for literature published before September 6, 2023, evaluating evidence quality using the Navigation Guide Criteria. We included original studies utilizing high temperatures or heatwaves as exposure metrics and employing observational designs. A meta-analysis was carried out to assess the relative risk (RR) of the association between high temperatures (or heatwaves) and disease outcomes. Out of 12,893 studies identified, 188 met the inclusion criteria for meta-analysis. Results demonstrate a statistically significant association between a 1 °C temperature increase and a 2.1 % elevation in disease-related mortality (RR 1.021 [95 % CI 1.018-1.023]), alongside a 1.1 % increase in morbidity (RR 1.011 [95 % CI 1.007-1.016]). Heatwaves also showed associations with increased total mortality (RR 1.224 [95 % CI 1.186-1.264]) and morbidity (RR 1.038 [95 % CI 1.010-1.066]). Subgroup analyses for diseases, sex, age, climatic zones, countries, and time periods consistently indicated heightened disease-related mortality and morbidity linked to high temperatures. Notably, China's urban population faced an elevated mortality risk (RR 1.027 [95 % CI 1.018-1.036]) compared to other countries (RR 1.021 [95 % CI 1.019-1.024]). Mortality associated with high temperatures after 2007 (RR 1.022 [95 % CI 1.015-1.029]) was higher than before 2007 (RR 1.017 [95 % CI 1.013-1.021]), reflecting increased health risks as the global warming accelerates. Our findings underscore the positive association between rising temperatures and/or heatwaves and adverse health outcomes in urban populations. The widespread exposure to high temperatures amplifies health risks across various diseases, demographics, climates, and countries, with potential exacerbation under ongoing global warming. Further research is imperative to delineate factors influencing altered heat exposure impacts.
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Affiliation(s)
- Xudong Yang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing 100084, China
| | - Xingyuan Xu
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
| | - Yize Wang
- Department of Radiology, Hefei Binhu Hospital, Anhui province, Hefei 230092, China
| | - Jun Yang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing 100084, China.
| | - Xingwang Wu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
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Jahn A, Andersen JH, Seidler A, Christiansen DH, Dalbøge A. Occupational psychosocial exposures and chronic low-back pain: a systematic review and meta-analysis. Scand J Work Environ Health 2024; 50:329-340. [PMID: 38739907 PMCID: PMC11214847 DOI: 10.5271/sjweh.4165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE This study aimed to explore the association between occupational psychosocial exposures and chronic low-back pain (LBP) by conducting a systematic review and meta-analysis. METHODS The research protocol was registered in PROSPERO. A systematic literature search was performed in six databases, identifying articles complying with predefined inclusion criteria. In our PECOS, we defined outcome as chronic LBP ≥3 months, exposures as occupational psychosocial exposures, and restricted study design to case-control and cohort studies. Two authors independently excluded articles, extracted data, assessed risk of bias, and graded evidence levels. Meta-analyses were performed using random-effects models. RESULTS The 20 included articles encompassed six different occupational psychosocial exposures (job control, demand, strain, support, stress, and satisfaction), only 1 had low risk of bias. For all occupational psychosocial exposures, odds ratios ranged from 0.8 to 1.1. Sensitivity analyses based on risk of bias was conducted for two outcomes ie, job control and job demand, finding no differences between high and low-to-moderate risk of bias studies. Using GRADE, we found a very low level of evidence of the association for all occupational psychosocial exposures. CONCLUSION In this study, we found no association between occupational psychosocial exposures and chronic LBP. However, it is important to underline that the level of evidence was very low. High quality studies are highly warranted.
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Affiliation(s)
- Alexander Jahn
- Danish Ramazzini Centre, Department of Occupational Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University Hospital, Aarhus N, Denmark.
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More S, Bampidis V, Benford D, Bragard C, Hernandez‐Jerez A, Bennekou SH, Koutsoumanis K, Lambré C, Machera K, Mennes W, Mullins E, Nielsen SS, Schlatter J, Schrenk D, Turck D, Younes M, Fletcher T, Greiner M, Ntzani E, Pearce N, Vinceti M, Vrijheid M, Georgiadis M, Gervelmeyer A, Halldorsson TI. Scientific Committee guidance on appraising and integrating evidence from epidemiological studies for use in EFSA's scientific assessments. EFSA J 2024; 22:e8866. [PMID: 38974922 PMCID: PMC11224774 DOI: 10.2903/j.efsa.2024.8866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
EFSA requested its Scientific Committee to prepare a guidance document on appraising and integrating evidence from epidemiological studies for use in EFSA's scientific assessments. The guidance document provides an introduction to epidemiological studies and illustrates the typical biases, which may be present in different epidemiological study designs. It then describes key epidemiological concepts relevant for evidence appraisal. This includes brief explanations for measures of association, exposure assessment, statistical inference, systematic error and effect modification. The guidance then describes the concept of external validity and the principles of appraising epidemiological studies. The customisation of the study appraisal process is explained including tailoring of tools for assessing the risk of bias (RoB). Several examples of appraising experimental and observational studies using a RoB tool are annexed to the document to illustrate the application of the approach. The latter part of this guidance focuses on different steps of evidence integration, first within and then across different streams of evidence. With respect to risk characterisation, the guidance considers how evidence from human epidemiological studies can be used in dose-response modelling with several different options being presented. Finally, the guidance addresses the application of uncertainty factors in risk characterisation when using evidence from human epidemiological studies.
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Geremew G, Cumming O, Haddis A, Freeman MC, Ambelu A. Rainfall and Temperature Influences on Childhood Diarrhea and the Effect Modification Role of Water and Sanitation Conditions: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:823. [PMID: 39063400 PMCID: PMC11276699 DOI: 10.3390/ijerph21070823] [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: 03/22/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 07/28/2024]
Abstract
The latest report from the Intergovernmental Panel on Climate Change (IPCC) highlighted the worsening impacts of climate change. Two climate factors-temperature and rainfall uncertainties-influence the risk of childhood diarrhea, which remains a significant cause of morbidity and mortality in low- and middle-income countries. They create a conducive environment for diarrhea-causing pathogens and overwhelm environmental prevention measures. This study aimed to produce comprehensive evidence on the association of temperature and rainfall variability with the risk of childhood diarrhea and the influence of water and sanitation conditions on those associations. We conducted a systematic review and meta-analysis using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) approach. Records published in English from 2006 to 2023 were searched on 8 January 2024 via PubMed, EMBASE, ScienceDirect, Scopus, the Cochrane Library, and Google/Google Scholar using comprehensive search terms. We assessed studies for any risk of bias using the Navigation Guide and rated the quality of the evidence using the GRADE approach. The heterogeneity among estimates was assessed using I-squared statistics (I2). The findings of the analysis were presented with forest plots using an incidence rate ratio (IRR). A meta-analysis was conducted on effect modifiers (water supply and sanitation conditions) using a random effects model with a 95% confidence interval (CI). The statistical analyses were conducted using R 4.3.2 software and Review Manager 5.3. A total of 2017 records were identified through searches, and only the 36 articles that met the inclusion criteria were included. The analysis suggests a small positive association between increased temperature and the occurrence of under-five diarrhea, with the pooled IRR = 1.04; 95% CI [1.03, 1.05], at I2 = 56% and p-value < 0.01, and increased rainfall and U5 diarrhea, with IRR = 1.14; 95% CI [1.03, 1.27], at I2 = 86% and p-value < 0.01. The meta-analysis indicated a positive association between unimproved latrine facilities and drinking water sources with a rainfall-modified effect on U5 diarrhea, with IRR = 1.21; 95% CI [0.95, 1.53], at I2 = 62% and p-value = 0.03. We found that an increase in mean temperature and rainfall was associated with an increased risk of childhood diarrhea. Where there were unimproved latrine facilities and drinking water sources, the increase in mean rainfall or temperature would increase the incidence of childhood diarrhea. The results of this review help in assessing the effectiveness of current intervention programs, making changes as needed, or creating new initiatives to lower the prevalence of childhood diarrhea.
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Affiliation(s)
- Gorfu Geremew
- Department of Environmental Health Science and Technology, Jimma University, Jimma P.O. Box 378, Ethiopia;
| | - Oliver Cumming
- Department of Disease Control, Faculty of Infectious Tropical Disease, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Alemayehu Haddis
- Department of Environmental Health Science and Technology, Jimma University, Jimma P.O. Box 378, Ethiopia;
| | - Matthew C. Freeman
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
| | - Argaw Ambelu
- Division of Water and Health, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa P.O. Box 1165, Ethiopia;
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Bu Y, Zhang X, Song S, Su H, Yu Z, Guo Y. Association of greenspace with hypertension in adult: a systematic review and meta-analysis of epidemiological studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2556-2577. [PMID: 37742118 DOI: 10.1080/09603123.2023.2259817] [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: 01/21/2023] [Accepted: 09/11/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Several studies have investigated the relationship of greenspace with blood pressure (BP) and hypertension, but the results were inconsistent. We aimed to assess the relationship of greenspace with BP/hypertension. METHODS We searched PubMed, Embase and Web of Science on greenspace and BP/hypertension published before 5 April 2023. The methodological quality and risk of bias were evaluated. RESULTS Twenty-seven articles were included. Our results suggested that higher normalized difference vegetation index (NDVI) was associated with lower odds of hypertension and levels of SBP [for every 10% increase of NDVI 500-m and NDVI 1000-m, the ORs were 0.95 (95% CI: 0.90-0.99) and 0.95 (95% CI: 0.90-0.99), the ꞵwas -1.32 (95% CI: -2.18, -0.45) and -1.41 (95% CI: -2.57, -0.25), respectively]. CONCLUSION This study indicated that higher exposure to greenspace might be associated with lower levels of BP and risk of hypertension. Increase green spaces should be regarded as an important public health intervention..
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Affiliation(s)
- Yongjun Bu
- College of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Xiaoyu Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shuaixing Song
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hexin Su
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zengli Yu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yuewei Guo
- School of Management, Xinxiang Medical University, Xinxiang, China
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Patwary MM, Bardhan M, Disha AS, Dzhambov AM, Parkinson C, Browning MHEM, Labib SM, Larson LR, Haque MZ, Rahman MA, Alam MA, Tareq MF, Shuvo FK. Nature exposure and mental health during the COVID-19 pandemic: A Navigation Guide systematic review with meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 356:124284. [PMID: 38821342 DOI: 10.1016/j.envpol.2024.124284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/02/2024]
Abstract
Prior reviews have highlighted that nature exposure was a valuable coping strategy enhancing mental health during the COVID-19 pandemic. However, no existing reviews have determined the quality of evidence and risk of bias of the empirical studies supporting this claim. To address this gap, we employed a Navigation Guide systematic review and meta-analysis approach to investigate associations between nature exposure and mental health during the pandemic. Searches in PubMed, Web of Science, Scopus, CINAHL, and PsycInfo retrieved relevant articles published between January 1, 2020, and March 4, 2024. We used the Navigation Guide methodology to assess the risk of bias and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessments to evaluate the overall quality of evidence. Our search retrieved 113 studies that met the inclusion criteria and reported diverse types of exposure, including nature availability, nature visit frequency, green space accessibility, and green space type, alongside associations with 12 mental health outcomes. Meta-analyses found access to gardens was associated with lower odds of depression [(Pooled odds ratio [OR] = 0.71, 95%CI = 0.61, 0.82), I2 = 0%, n = 3] and anxiety [(Pooled OR = 0.73, 95%CI = 0.63, 0.84), I2 = 0%, n = 3]. Increased time in green spaces was associated with lower level of stress [(Pooled Corr = -0.11, 95%CI = -0.17, -0.05), I2 = 0%, n = 2]. Higher frequency of visits to nature was associated with improved mental well-being [(Pooled standardized beta = 0.10, 95%CI = 0.07, 0.14), I2 = 0%, n = 2] and general mental health [(Pooled standardized beta = 0.11, 95%CI = 0.03-0.38), I2 = 82%, n = 2]. However, the number of pooled studies was small and the overall quality of evidence was "very low" for all outcomes, and high levels of bias were observed (26% of studies had high, 71% probably high). Nonetheless, given the trends in the results, nature-based solutions emphasizing exposure to gardens and green spaces near the home may have promoted psychological resilience during this public health crisis.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mondira Bardhan
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, USA
| | - Asma Safia Disha
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Department of Environmental Science and Management, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Angel M Dzhambov
- Research Group "Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Colby Parkinson
- Department of Recreation, Park, and Tourism Management, Pennsylvania State University, University Park, PA, USA
| | - Matthew H E M Browning
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, USA
| | - S M Labib
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Vening Meineszgebouw A, Princetonlaan 8a, 3584 CB, Utrecht, the Netherlands
| | - Lincoln R Larson
- Department of Parks, Recreation & Tourism Management, North Carolina State University, Raleigh, NC, USA
| | - Md Zahidul Haque
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Md Atiqur Rahman
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Md Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Md Faysal Tareq
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Institute of Environmental Sciences (CML), Leiden University, Netherlands
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Patwary MM, Sakhvidi MJZ, Ashraf S, Dadvand P, Browning MHEM, Alam MA, Bell ML, James P, Astell-Burt T. Impact of green space and built environment on metabolic syndrome: A systematic review with meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:170977. [PMID: 38360326 DOI: 10.1016/j.scitotenv.2024.170977] [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: 12/07/2023] [Revised: 02/03/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
Metabolic Syndrome presents a significant public health challenge associated with an increased risk of noncommunicable diseases such as cardiovascular conditions. Evidence shows that green spaces and the built environment may influence metabolic syndrome. We conducted a systematic review and meta-analysis of observational studies published through August 30, 2023, examining the association of green space and built environment with metabolic syndrome. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 18 studies that met the inclusion criteria and were included in our review. Most were from China (n = 5) and the USA (n = 5), and most used a cross-sectional study design (n = 8). Nine studies (50 %) reported only green space exposures, seven (39 %) reported only built environment exposures, and two (11 %) reported both built environment and green space exposures. Studies reported diverse definitions of green space and the built environment, such as availability, accessibility, and quality, particularly around participants' homes. The outcomes focused on metabolic syndrome; however, studies applied different definitions of metabolic syndrome. Meta-analysis results showed that an increase in normalized difference vegetation index (NDVI) within a 500-m buffer was associated with a lower risk of metabolic syndrome (odds ratio [OR] = 0.90, 95%CI = 0.87-0.93, I2 = 22.3 %, n = 4). A substantial number of studies detected bias for exposure classification and residual confounding. Overall, the extant literature shows a 'limited' strength of evidence for green space protecting against metabolic syndrome and an 'inadequate' strength of evidence for the built environment associated with metabolic syndrome. Studies with more robust study designs, better controlled confounding factors, and stronger exposure measures are needed to understand better what types of green spaces and built environment features influence metabolic syndrome.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sadia Ashraf
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Md Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Michelle L Bell
- Yale School of the Environment, Yale University, New Haven, CT, United States
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Harvard University, Boston, MA, USA
| | - Thomas Astell-Burt
- School of Architecture, Design, and Planning, University of Sydney, Australia
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Qiao JC, Sun LJ, Zhang MY, Gui SY, Wang XC, Hu CY. Association between ambient particulate matter exposure and mitochondrial DNA copy number: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:171423. [PMID: 38442762 DOI: 10.1016/j.scitotenv.2024.171423] [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: 10/27/2023] [Revised: 02/24/2024] [Accepted: 02/29/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Ambient particulate matter (PM) has been recognized as inducing oxidative stress, which could contribute to mitochondrial damage and dysfunction. However, studies investigating the association between ambient PM and mitochondria, particularly mitochondrial DNA copy number (mtDNA-CN), have yielded inconsistent results. METHODS We conducted comprehensive literature searches to identify observational studies published before July 17, 2023, examining the association between ambient PM exposure and mtDNA-CN. Meta-analysis using random effects model was employed to calculate the pooled effect estimates for general individual exposures, as well as for prenatal exposure with specific trimester. Additionally, the quality and level of evidence for each exposure-outcome pair was evaluated. RESULTS A total of 10 studies were included in the systematic review and meta-analysis. The results indicated that general individual exposure to PM2.5 (β = -0.084, 95 % CI: -0.521, 0.353; I2 = 93 %) and PM10 (β = 0.035, 95 % CI: -0.129, 0.199; I2 = 95 %) did not significantly affect mtDNA-CN. Prenatal exposure to PM2.5 (β = 0.023, 95 % CI: -0.087, 0.133; I2 = 0 %) and PM10 (β = 0.006, 95 % CI: -0.135; 0.147; I2 = 51 %) were also not significantly associated with mtDNA-CN in offspring. The level of evidence for each tested exposure-outcome pair was assessed as "inadequate." CONCLUSIONS The findings of this systematic review and meta-analysis indicate that there is an "inadequate" strength of evidence for the association between general individual or prenatal exposure to ambient PM and mtDNA-CN. Future research necessitates studies with more rigorous design, enhanced control of confounding factors, and improved measures of exposure to substantiate our findings.
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Affiliation(s)
- Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Liang-Jie Sun
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Meng-Yue Zhang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China
| | - Xin-Chen Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
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16
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Jahn A, Andersen JH, Seidler A, Christiansen DH, Dalbøge A. Hip osteoarthritis and occupational mechanical exposures: a systematic review and meta-analysis. Scand J Work Environ Health 2024; 50:244-256. [PMID: 38483209 PMCID: PMC11129821 DOI: 10.5271/sjweh.4152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Indexed: 04/30/2024] Open
Abstract
OBJECTIVES The aim was to conduct a systematic review and meta-analysis investigating the association between occupational mechanical exposures and hip osteoarthritis. METHODS The study was registered in PROSPERO. A systematic literature search was conducted in six databases to identify relevant articles. Two authors independently excluded articles, extracted data, assessed the risk of bias of each included article, and graded the level of evidence. We conducted a meta-analysis using random-effects model and performed a sensitivity analysis stratifying articles based on the risk of bias assessment, study design, and the outcome measurement. RESULTS Twenty-four articles were eligible for inclusion. The highest pooled odds ratio (OR) was found for combined mechanical exposures [OR 1.7, 95% confidence interval (CI) 1.4-2.0], non-neutral postures (OR 1.7, 95% CI 1.4-2.1), lifting/carrying loads (OR 1.6, 95% CI 1.3-1.9), and climbing stairs (OR 1.6, 95% CI 1.1-2.2). The range of pooled OR for the remaining mechanical exposures (eg, standing, walking, kneeling, squatting, and sitting) was 0.6-1.6. Grading the quality of evidence, a moderate level of evidence was found for the combined mechanical exposures and for lifting/carrying loads. The remaining exposure categories were graded as having either low or very low levels of evidence. CONCLUSIONS Considerable heterogeneity was observed across the included studies, and high-quality literature using objective exposure measurements is warranted. Despite various limitations affecting the comparability, occupational mechanical exposures seem to influence the likelihood of developing hip osteoarthritis.
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Affiliation(s)
- Alexander Jahn
- Danish Ramazzini Centre, Department of Occupational Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University Hospital, Aarhus N, Denmark.
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Bline AP, Ellis LB, Pelch KE, Lam J, Sen S, Zlatnik M, Varshavsky J. The effect of per and polyfluoroalkyl substance (PFAS) exposure on gestational diabetes mellitus and its subclinical risk factors: A systematic review and meta-analysis protocol. ENVIRONMENT INTERNATIONAL 2024; 188:108711. [PMID: 38754246 DOI: 10.1016/j.envint.2024.108711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/30/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Multiple lines of evidence suggest that exposure to per- and polyfluoroalkyl substances (PFAS) may alter glucose homeostasis, particularly during pregnancy, and may affect risk for developing gestational diabetes mellitus (GDM). While previous systematic reviews have been conducted on this topic, they did not assess internal validity of the included studies and their search strategies were narrowly focused. OBJECTIVE The objective of this study is to assess the effect of higher PFAS exposure (defined by individual compounds or mixtures measured before or during pregnancy) on GDM and subclinical measures of impaired glucose homeostasis (measured during pregnancy) compared to lower PFAS exposure in pregnant. METHODS We developed our systematic review protocol in accordance with the Navigation Guide. Peer-reviewed journal and grey literature searches were piloted in to identify relevant studies and refine our search terms and strategy. We also piloted the study screening criteria and data extraction form in DistillerSR, and refined our protocol accordingly. The risk of bias assessment protocol was adapted from Navigation Guide guidance and will be piloted and performed in DistillerSR. Pending the identification of comparable studies, quantitative meta-analyses will be performed where possible. Study results that cannot be quantitatively synthesized will be included in a narrative synthesis. The quality and strength of the body of evidence will be evaluated using Navigation Guide methodology, which is informed by guidance from the Cochrane Collaboration and Grading of Recommendations Assessment, Development and Evaluation (GRADE). We also made refinements to the quality of evidence considerations based on guidance from the National Institute of Environmental Health Sciences (NIEHS) Office of Health Assessment and Translation (OHAT). FUNDING This work was supported by the Systematizing Data on Per- and Polyfluoroalkyl Substances and Health Northeastern University TIER 1 Award.
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Affiliation(s)
- Abigail P Bline
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, United States; Silent Spring Institute, Newton, MA, United States.
| | - Lauren B Ellis
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, United States; Department of Health Sciences, Northeastern University, Boston, MA, United States.
| | - Katherine E Pelch
- Natural Resources Defense Council, San Francisco, CA, United States.
| | - Juleen Lam
- Department of Public Health, California State University, East Bay, Hayward, CA, United States.
| | - Saunak Sen
- College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States.
| | - Marya Zlatnik
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, United States.
| | - Julia Varshavsky
- Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, United States; Department of Health Sciences, Northeastern University, Boston, MA, United States; Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, United States.
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Rattner BA, Bean TG, Beasley VR, Berny P, Eisenreich KM, Elliott JE, Eng ML, Fuchsman PC, King MD, Mateo R, Meyer CB, O'Brien JM, Salice CJ. Wildlife ecological risk assessment in the 21st century: Promising technologies to assess toxicological effects. INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT 2024; 20:725-748. [PMID: 37417421 DOI: 10.1002/ieam.4806] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
Despite advances in toxicity testing and the development of new approach methodologies (NAMs) for hazard assessment, the ecological risk assessment (ERA) framework for terrestrial wildlife (i.e., air-breathing amphibians, reptiles, birds, and mammals) has remained unchanged for decades. While survival, growth, and reproductive endpoints derived from whole-animal toxicity tests are central to hazard assessment, nonstandard measures of biological effects at multiple levels of biological organization (e.g., molecular, cellular, tissue, organ, organism, population, community, ecosystem) have the potential to enhance the relevance of prospective and retrospective wildlife ERAs. Other factors (e.g., indirect effects of contaminants on food supplies and infectious disease processes) are influenced by toxicants at individual, population, and community levels, and need to be factored into chemically based risk assessments to enhance the "eco" component of ERAs. Regulatory and logistical challenges often relegate such nonstandard endpoints and indirect effects to postregistration evaluations of pesticides and industrial chemicals and contaminated site evaluations. While NAMs are being developed, to date, their applications in ERAs focused on wildlife have been limited. No single magic tool or model will address all uncertainties in hazard assessment. Modernizing wildlife ERAs will likely entail combinations of laboratory- and field-derived data at multiple levels of biological organization, knowledge collection solutions (e.g., systematic review, adverse outcome pathway frameworks), and inferential methods that facilitate integrations and risk estimations focused on species, populations, interspecific extrapolations, and ecosystem services modeling, with less dependence on whole-animal data and simple hazard ratios. Integr Environ Assess Manag 2024;20:725-748. © 2023 His Majesty the King in Right of Canada and The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC). Reproduced with the permission of the Minister of Environment and Climate Change Canada. This article has been contributed to by US Government employees and their work is in the public domain in the USA.
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Affiliation(s)
- Barnett A Rattner
- US Geological Survey, Eastern Ecological Science Center, Laurel, Maryland, USA
| | | | - Val R Beasley
- College of Veterinary Medicine, University of Illinois at Urbana, Champaign, Illinois, USA
| | | | - Karen M Eisenreich
- US Environmental Protection Agency, Washington, District of Columbia, USA
| | - John E Elliott
- Environment and Climate Change Canada, Delta, British Columbia, Canada
| | - Margaret L Eng
- Environment and Climate Change Canada, Dartmouth, Nova Scotia, Canada
| | | | - Mason D King
- Simon Fraser University, Burnaby, British Columbia, Canada
| | | | | | - Jason M O'Brien
- Environment and Climate Change Canada, Ottawa, Ontario, Canada
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Higgins JPT, Morgan RL, Rooney AA, Taylor KW, Thayer KA, Silva RA, Lemeris C, Akl EA, Bateson TF, Berkman ND, Glenn BS, Hróbjartsson A, LaKind JS, McAleenan A, Meerpohl JJ, Nachman RM, Obbagy JE, O'Connor A, Radke EG, Savović J, Schünemann HJ, Shea B, Tilling K, Verbeek J, Viswanathan M, Sterne JAC. A tool to assess risk of bias in non-randomized follow-up studies of exposure effects (ROBINS-E). ENVIRONMENT INTERNATIONAL 2024; 186:108602. [PMID: 38555664 PMCID: PMC11098530 DOI: 10.1016/j.envint.2024.108602] [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: 06/27/2023] [Revised: 02/26/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Observational epidemiologic studies provide critical data for the evaluation of the potential effects of environmental, occupational and behavioural exposures on human health. Systematic reviews of these studies play a key role in informing policy and practice. Systematic reviews should incorporate assessments of the risk of bias in results of the included studies. OBJECTIVE To develop a new tool, Risk Of Bias In Non-randomized Studies - of Exposures (ROBINS-E) to assess risk of bias in estimates from cohort studies of the causal effect of an exposure on an outcome. METHODS AND RESULTS ROBINS-E was developed by a large group of researchers from diverse research and public health disciplines through a series of working groups, in-person meetings and pilot testing phases. The tool aims to assess the risk of bias in a specific result (exposure effect estimate) from an individual observational study that examines the effect of an exposure on an outcome. A series of preliminary considerations informs the core ROBINS-E assessment, including details of the result being assessed and the causal effect being estimated. The assessment addresses bias within seven domains, through a series of 'signalling questions'. Domain-level judgements about risk of bias are derived from the answers to these questions, then combined to produce an overall risk of bias judgement for the result, together with judgements about the direction of bias. CONCLUSION ROBINS-E provides a standardized framework for examining potential biases in results from cohort studies. Future work will produce variants of the tool for other epidemiologic study designs (e.g. case-control studies). We believe that ROBINS-E represents an important development in the integration of exposure assessment, evidence synthesis and causal inference.
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Affiliation(s)
- Julian P T Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Bristol Evidence Synthesis Group, University of Bristol, Bristol, UK; NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Andrew A Rooney
- National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Kyla W Taylor
- National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Kristina A Thayer
- Center for Public Health and Environmental Assessment, Chemical & Pollutant Assessment Division, US Environmental Protection Agency, Research Triangle Park, NC, USA
| | | | | | - Elie A Akl
- Faculty of Medicine, American University of Beirut, Riad El-Solh, Lebanon
| | - Thomas F Bateson
- Center for Public Health and Environmental Assessment, Chemical and Pollutant Assessment Division, US Environmental Protection Agency, Washington, DC, USA
| | | | - Barbara S Glenn
- Center for Public Health and Environmental Assessment, Chemical and Pollutant Assessment Division, US Environmental Protection Agency, Washington, DC, USA
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, University of Southern Denmark, Odense, Denmark
| | | | - Alexandra McAleenan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Germany; Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Rebecca M Nachman
- Center for Public Health and Environmental Assessment, Chemical and Pollutant Assessment Division, US Environmental Protection Agency, Washington, DC, USA
| | - Julie E Obbagy
- Nutrition Evidence Systematic Review Branch, Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA, USA
| | - Annette O'Connor
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Elizabeth G Radke
- Center for Public Health and Environmental Assessment, Chemical and Pollutant Assessment Division, US Environmental Protection Agency, Washington, DC, USA
| | - Jelena Savović
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Bristol Evidence Synthesis Group, University of Bristol, Bristol, UK; NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Holger J Schünemann
- Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada
| | - Beverley Shea
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kate Tilling
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Jos Verbeek
- Cochrane Work, Department of Public and Occupational Health, Academic Medical Centers Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Jonathan A C Sterne
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Health Data Research UK South-West, Bristol, UK
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Michel SKF, Atmakuri A, von Ehrenstein OS. Systems for rating bodies of evidence used in systematic reviews of air pollution exposure and reproductive and children's health: a methodological survey. Environ Health 2024; 23:32. [PMID: 38539160 PMCID: PMC10976715 DOI: 10.1186/s12940-024-01069-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/05/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Translating findings from systematic reviews assessing associations between environmental exposures and reproductive and children's health into policy recommendations requires valid and transparent evidence grading. METHODS We aimed to evaluate systems for grading bodies of evidence used in systematic reviews of environmental exposures and reproductive/ children's health outcomes, by conducting a methodological survey of air pollution research, comprising a comprehensive search for and assessment of all relevant systematic reviews. To evaluate the frameworks used for rating the internal validity of primary studies and for grading bodies of evidence (multiple studies), we considered whether and how specific criteria or domains were operationalized to address reproductive/children's environmental health, e.g., whether the timing of exposure assessment was evaluated with regard to vulnerable developmental stages. RESULTS Eighteen out of 177 (9.8%) systematic reviews used formal systems for rating the body of evidence; 15 distinct internal validity assessment tools for primary studies, and nine different grading systems for bodies of evidence were used, with multiple modifications applied to the cited approaches. The Newcastle Ottawa Scale (NOS) and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, neither developed specifically for this field, were the most commonly used approaches for rating individual studies and bodies of evidence, respectively. Overall, the identified approaches were highly heterogeneous in both their comprehensiveness and their applicability to reproductive/children's environmental health research. CONCLUSION Establishing the wider use of more appropriate evidence grading methods is instrumental both for strengthening systematic review methodologies, and for the effective development and implementation of environmental public health policies, particularly for protecting pregnant persons and children.
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Affiliation(s)
- Sophie K F Michel
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
| | - Aishwarya Atmakuri
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Ondine S von Ehrenstein
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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Nyadanu SD, Dunne J, Tessema GA, Mullins B, Kumi-Boateng B, Bell ML, Duko B, Pereira G. Maternal exposure to ambient air temperature and adverse birth outcomes: An umbrella review of systematic reviews and meta-analyses. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 917:170236. [PMID: 38272077 DOI: 10.1016/j.scitotenv.2024.170236] [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: 07/27/2023] [Revised: 12/28/2023] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Multiple systematic reviews on prenatal ambient temperature and adverse birth outcomes exist, but the overall epidemiological evidence and the appropriate metric for thermal stress remain unclear. An umbrella review was performed to summarise and appraise the evidence with recommendations. METHODS Systematic reviews and meta-analyses on the associations between ambient temperature and adverse birth outcomes (preterm birth, stillbirth, birth weight, low birth weight, and small for gestational age) up to December 20, 2023, were synthesised according to a published protocol. Databases PubMed, CINAHL, Scopus, MEDLINE/Ovid, EMBASE/Ovid, Web of Science Core Collection, systematic reviews repositories, electronic grey literature, and references were searched. Risk of bias was assessed using Joanna Briggs Institute's critical appraisal tool. RESULTS Eleven systematic reviews, including two meta-analyses, were included. This comprised 90 distinct observational studies that employed multiple temperature assessment metrics with a very high overlap of primary studies. Primary studies were mostly from the United States while both Africa and South Asia contributed only three studies. A majority (7 out of 11) of the systematic reviews were rated as moderate risk of bias. All systematic reviews indicated that maternal exposures to both extremely high and low temperatures, particularly during late gestation are associated with increased risks of preterm birth, stillbirth, and reduced fetal growth. However, due to great differences in the exposure assessments, high heterogeneity, imprecision, and methodological limitations of the included systematic reviews, the overall epidemiological evidence was classified as probable evidence of causation. No study assessed biothermal metrics for thermal stress. CONCLUSIONS Despite the notable methodological differences, prenatal exposure to extreme ambient temperatures, particularly during late pregnancy, was associated with adverse birth outcomes. Adhering to the appropriate systematic review guidelines for environmental health research, incorporating biothermal metrics into exposure assessment, evidence from broader geodemographic settings, and interventions are recommended in future studies.
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Affiliation(s)
- Sylvester Dodzi Nyadanu
- Curtin School of Population Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia; Education, Culture, and Health Opportunities (ECHO) Ghana, ECHO Research Group International, P. O. Box 424, Aflao, Ghana.
| | - Jennifer Dunne
- Curtin School of Population Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia
| | - Gizachew A Tessema
- Curtin School of Population Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia; School of Public Health, University of Adelaide, Adelaide, South Australia 5000, Australia
| | - Ben Mullins
- Curtin School of Population Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia
| | - Bernard Kumi-Boateng
- Department of Geomatic Engineering, University of Mines and Technology, P. O. Box 237, Tarkwa, Ghana
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT 06511, USA
| | - Bereket Duko
- Curtin School of Population Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia; enAble Institute, Curtin University, Perth, Kent Street, Bentley, Western Australia 6102, Australia; WHO Collaborating Centre for Climate Change and Health Impact Assessment, Faculty of Health Science, Curtin University, WA, Australia
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22
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Luque-García L, Muxika-Legorburu J, Mendia-Berasategui O, Lertxundi A, García-Baquero G, Ibarluzea J. Green and blue space exposure and non-communicable disease related hospitalizations: A systematic review. ENVIRONMENTAL RESEARCH 2024; 245:118059. [PMID: 38157973 DOI: 10.1016/j.envres.2023.118059] [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: 07/17/2023] [Revised: 12/05/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
The global increase in non-communicable diseases (NCDs) presents a critical public health concern. Emerging evidence suggests that exposure to natural environments may reduce the risk of developing NCDs through multiple pathways. The present systematic review aims to synthesize and evaluate the observational evidence regarding associations between exposure to green and blue spaces and hospital admissions related to NCDs. A comprehensive literature search strategy was conducted in Embase (Ovid), PubMed, and Web of Science. The risk of bias and quality of the evidence were assessed using The Navigation Guide methodology, an approach specifically designed for environmental health research. Of 3060 search results, 17 articles were included. Notably, the majority of the studies (n = 14; 82.4%) were published from 2020 onwards. Most studies were conducted in the United States (n = 6; 35.3%) and China (n = 4; 23.5%). Exposure to green spaces was assessed through all studies, while only three included blue spaces. In terms of study design, cohort design was employed in nearly half of the studies (n = 8; 47.1%), followed by case-crossover design (n = 3, 17.6%). Over 75% of the included studies (n = 13) had a high or probably high rating in the risk of bias assessment. The studies encompassed diverse NCD outcome domains; cardiovascular diseases (CVDs) (n = 10), respiratory diseases (RSDs) (n = 2), heat-related diseases (n = 1), metabolic diseases (n = 2), cancer (n = 1), neurodegenerative diseases (NDDs) (n = 2), and mental health disorders (n = 2). The present review suggests that a clear link between blue space exposure and NCD hospital admissions is not evident. However, exposure to green spaces appears to predominantly have a protective effect, although the direction of the association varies across different outcome domains. The heterogeneity among the outcome domains together with the limited number of studies, emphasizes the need for more robust evidence.
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Affiliation(s)
- L Luque-García
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain.
| | - J Muxika-Legorburu
- Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain
| | - O Mendia-Berasategui
- Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain
| | - A Lertxundi
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain
| | - G García-Baquero
- Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Faculty of Biology, University of Salamanca, Avda Licenciado Méndez Nieto S/n, 37007, Salamanca, Spain
| | - J Ibarluzea
- Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastián, Spain; Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain
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Woodruff TJ. Health Effects of Fossil Fuel-Derived Endocrine Disruptors. N Engl J Med 2024; 390:922-933. [PMID: 38446677 DOI: 10.1056/nejmra2300476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Affiliation(s)
- Tracey J Woodruff
- From the Program on Reproductive Health and the Environment, Environmental Research and Translation for Health Center, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco
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Stacy C, Amélie C, Blanche W, Audrey R, Margaux S, Simon P, Julien J, Matteo R, Andreas K, Christophe R, Martine V, Mark N, Rémy S, Karine A. A plausibility database summarizing the level of evidence regarding the hazards induced by the exposome on children health. Int J Hyg Environ Health 2024; 256:114311. [PMID: 38271818 DOI: 10.1016/j.ijheh.2023.114311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 11/25/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024]
Abstract
Childhood diseases correspond to major public health issues. A large number of studies using different approaches provide evidence regarding effects of environmental exposures, encompassed in the exposome, on children's health. We aimed to summarize the overall level of evidence (LoE) from all streams of evidence regarding exposome effects on child health. For 88 selected chemical and urban factors, we retrieved the conclusions of agency reports or literature reviews published between 2015 and 2021 regarding effects on child health, including cardiovascular, metabolic, neurodevelopmental, respiratory and other health outcomes. Adapted versions of PRISMA flowchart and AMSTAR-2 tool were used to select and assess the quality of the systematic reviews retrieved from PubMed and SCOPUS databases. For each factor-outcome pair, conclusions in three streams of evidence (epidemiological, toxicological and mechanistic, the latter corresponding to in vitro and in silico approaches) were translated into stream-specific LoEs and then combined into an overall LoE ranging from "very unlikely" to "very likely". The 88 environmental factors were implied in 611 factor-outcome pairs. Forty-four pairs (7%), corresponding to 16 factors, had a very likely overall LoE (≥80%); 127 pairs (21%), corresponding to 49 factors, had a likely or more overall LoE (≥60%). For 81 pairs (13%), no evidence was available in agency reports or published reviews, while for 275 pairs (45%), corresponding to 68 factors, the overall LoE was very unlikely (<20%). Exposure factors with the greatest number of associated health outcomes with a high overall LoE were HCB, PCBs, temperature (8 outcomes), PFOA (7 outcomes), PFOS, cotinine (6 outcomes), arsenic, lead (5 outcomes), bisphenols A and S, PFNA and PM2.5 (4 outcomes), DDT, DDE and DDD, PFHxA, PFDA, green space, UV radiation (3 outcomes). We developed an approach to extract and summarize the existing evidence about effects of environmental factors on health. The plausibility database built for children's health can be used to identify research gaps, conduct quantitative risk assessment studies. It could be expanded to consider a larger fraction of the exposome and other age groups and should be updated on a regular basis.
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Affiliation(s)
- Colzin Stacy
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Chemicals Assessment Unit, Maisons-Alfort, France
| | - Crépet Amélie
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Methodology and Studies Unit, Maisons-Alfort, France
| | | | - Rocabois Audrey
- French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Sanchez Margaux
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Air Risk Assessment Unit, Maisons-Alfort, France
| | - Perreau Simon
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Chemicals Assessment Unit, Maisons-Alfort, France
| | - Jean Julien
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Food Risk Assessment Unit, Maisons-Alfort, France
| | - Redaelli Matteo
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Air Risk Assessment Unit, Maisons-Alfort, France
| | - Kortenkamp Andreas
- Centre for Pollution Research and Policy, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Rousselle Christophe
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Chemicals Assessment Unit, Maisons-Alfort, France
| | - Vrijheid Martine
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Nieuwenhuijsen Mark
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Slama Rémy
- French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France.
| | - Angeli Karine
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Chemicals Assessment Unit, Maisons-Alfort, France
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Chartres N, Joglekar R. Invited Perspective: Why Systematic Reviews, Scoping Reviews, and Evidence-to-Decision Frameworks Are Critical for Transparent, Consistent, Equitable, and Science-Based Decision-Making in Environmental Health. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:31304. [PMID: 38477608 PMCID: PMC10936216 DOI: 10.1289/ehp14346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Nicholas Chartres
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Rashmi Joglekar
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
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26
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Jahn A, Nielsen ML, Kyndi M, Dalbøge A. Association between night work and prostate cancer: a systematic review and meta-analysis. Int Arch Occup Environ Health 2024; 97:207-215. [PMID: 38175230 DOI: 10.1007/s00420-023-02037-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE The aim was to conduct a systematic review and meta-analysis to study the association between night work and the development of prostate cancer. METHODS A systematic literature search was conducted in CINAHL, Embase, MEDLINE, and Web of Science. Studies were included based on a PECOS; the population included men in/above the working age, exposure defined as night work, outcome defined as prostate cancer, and study design restricted to cohort studies. The exclusion of articles, risk-of-bias assessment, and data extraction were performed by two reviewers. A meta-analysis was conducted using a random-effects model, including a sensitivity analysis stratified based on the risk-of-bias assessment. We evaluated publication bias using a funnel plot and Egger´s test, and the level of evidence was assessed using GRADE. RESULTS A total of 528 articles were identified, and eight cohort studies were included. Three studies had a moderate risk of bias, while five studies had a high risk of bias. The meta-analysis showed a pooled hazard ratio (HR) of 1.0 (95% CI 0.6-1.7). In the sensitivity analysis, moderate vs. high risk-of-bias studies showed a pooled HR of 1.2 (95% CI 0.3-4.1) and 0.9 (95% CI 0.6-1.3), respectively. Based on GRADE, the level of evidence was rated low. CONCLUSION We found no association between night work and the development of prostate cancer. The evidence was assessed as limited and inconsistent. Future studies encompassing consistent definitions of night work, including objective exposure data, are highly warranted.
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Affiliation(s)
- Alexander Jahn
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark.
| | - Mathilde Lumbye Nielsen
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark
| | - Marianne Kyndi
- Danish Ramazzini Centre, Department of Occupational Medicine-University Research Clinic, Regional Hospital Goedstrup, Herning, Denmark
| | - Annett Dalbøge
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Zhang Y, Tingting Y, Huang W, Yu P, Chen G, Xu R, Song J, Guo Y, Li S. Health Impacts of Wildfire Smoke on Children and Adolescents: A Systematic Review and Meta-analysis. Curr Environ Health Rep 2024; 11:46-60. [PMID: 38038861 DOI: 10.1007/s40572-023-00420-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE OF REVIEW Wildfire smoke is associated with human health, becoming an increasing public health concern. However, a comprehensive synthesis of the current evidence on the health impacts of ambient wildfire smoke on children and adolescents, an exceptionally vulnerable population, is lacking. We conduct a systematic review of peer-reviewed epidemiological studies on the association between wildfire smoke and health of children and adolescents. RECENT FINDINGS We searched for studies available in MEDLINE, EMBASE, and Scopus from database inception up to October 11, 2022. Of 4926 studies initially identified, 59 studies from 14 countries were ultimately eligible. Over 33.3% of the studies were conducted in the USA, and two focused on multi-countries. The exposure assessment of wildfire smoke was heterogenous, with wildfire-specific particulate matters with diameters ≤ 2.5 µm (PM2.5, 22.0%) and all-source (22.0%) PM2.5 during wildfire period most frequently used. Over half of studies (50.6%) focused on respiratory-related morbidities/mortalities. Wildfire smoke exposure was consistently associated with enhanced risks of adverse health outcomes in children/adolescents. Meta-analysis results presented a pooled relative risk (RR) of 1.04 (95% confidence interval [CI], 0.96-1.12) for all-cause respiratory morbidity, 1.11 (95% Ci: 0.93-1.32) for asthma, 0.93 (95% CI, 0.85-1.03) for bronchitis, and 1.13 (95% CI, 1.05-1.23) for upper respiratory infection, whilst - 21.71 g for birth weight (95% CI, - 32.92 to - 10.50) per 10 µg/m3 increment in wildfire-specific PM2.5/all-source PM2.5 during wildfire event. The majority of studies found that wildfire smoke was associated with multiple adverse health outcomes among children and adolescents, with respiratory morbidities of significant concern. In-utero exposure to wildfire smoke may increase the risk of adverse birth outcomes and have long-term impacts on height. Higher maternal baseline exposure to wildfire smoke and poor family-level baseline birthweight respectively elevated risks in preterm birth and low birth weight associated with wildfire smoke. More studies in low- and middle-income countries and focusing on extremely young children are needed. Despite technological progress, wildfire smoke exposure measurements remain uncertain, demanding improved methodologies to have more precise assessment of wildfire smoke levels and thus quantify the corresponding health impacts and guide public mitigation actions.
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Affiliation(s)
- Yiwen Zhang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia
| | - Ye Tingting
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia
| | - Jiangning Song
- Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University, Melbourne, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia.
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Bui TT, Aasa J, Abass K, Ågerstrand M, Beronius A, Castro M, Escrivá L, Galizia A, Gliga A, Karlsson O, Whaley P, Yost E, Rudén C. Applying a modified systematic review and integrated assessment framework (SYRINA) - a case study on triphenyl phosphate. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2024; 26:380-399. [PMID: 38205707 PMCID: PMC10879963 DOI: 10.1039/d3em00353a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
This work presents a case study in applying a systematic review framework (SYRINA) to the identification of chemicals as endocrine disruptors. The suitability and performance of the framework is tested with regard to the widely accepted World Health Organization definition of an endocrine disruptor (ED). The endocrine disrupting potential of triphenyl phosphate (TPP), a well-studied flame retardant reported to exhibit various endocrine related effects was assessed. We followed the 7 steps of the SYRINA framework, articulating the research objective via Populations, Exposures, Comparators, Outcomes (PECO) statements, performed literature search and screening, conducted study evaluation, performed data extraction and summarized and integrated the evidence. Overall, 66 studies, consisting of in vivo, in vitro and epidemiological data, were included. We concluded that triphenyl phosphate could be identified as an ED based on metabolic disruption and reproductive function. We found that the tools used in this case study and the optimizations performed on the framework were suitable to assess properties of EDs. A number of challenges and areas for methodological development in systematic appraisal of evidence relating to endocrine disrupting potential were identified; significant time and effort were needed for the analysis of in vitro mechanistic data in this case study, thus increasing the workload and time needed to perform the systematic review process. Further research and development of this framework with regards to grey literature (non-peer-reviewed literature) search, harmonization of study evaluation methods, more consistent evidence integration approaches and a pre-defined method to assess links between adverse effect and endocrine activity are recommended. It would also be advantageous to conduct more case studies for a chemical with less data than TPP.
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Affiliation(s)
- Thuy T Bui
- Department of Environmental Science, Stockholm University, Sweden.
| | | | - Khaled Abass
- Department of Environmental Health Sciences, College of Health Sciences, University of Sharjah, United Arab Emirates
- Sharjah Institute for Medical Research (SIMR), University of Sharjah, United Arab Emirates
- Research Unit of Biomedicine and Internal Medicine, Faculty of Medicine, University of Oulu, Finland
| | | | | | - Mafalda Castro
- Section for Environmental Chemistry and Physics, University of Copenhagen, Denmark
| | - Laura Escrivá
- Laboratory of Food Chemistry and Toxicology, Faculty of Pharmacy, University of Valencia, Spain
| | - Audrey Galizia
- United States Environmental Protection Agency, Center for Public Health and Environmental Assessment, USA
| | - Anda Gliga
- Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Oskar Karlsson
- Science for Life Laboratory, Department of Environmental Science, Stockholm University, Sweden
| | - Paul Whaley
- Lancaster Environment Centre, Lancaster University, UK
| | - Erin Yost
- United States Environmental Protection Agency, Center for Public Health and Environmental Assessment, USA
| | - Christina Rudén
- Department of Environmental Science, Stockholm University, Sweden.
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Freeman B, Peters MJ, Bittoun R, Brightwell R, English DR, Thomas DP, Otlowski MF, Zwar NA, Chamberlain C. National Health and Medical Research Council statement on electronic cigarettes: 2022 update. Med J Aust 2024; 220:100-106. [PMID: 37949610 DOI: 10.5694/mja2.52163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/19/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Electronic cigarette (e-cigarette) use in Australia has rapidly increased since the 2017 National Health and Medical Research Council (NHMRC) Chief Executive Officer (CEO) statement on e-cigarettes. The type of products available and the demographic characteristics of people using these products have changed. New evidence has been published and there is growing concern among public health professionals about the increased use, particularly among young people who do not currently smoke combustible cigarettes. The combination of these issues led NHMRC to review the current evidence and provide an updated statement on e-cigarettes. In this article, we describe the comprehensive process used to review the evidence and develop the 2022 NHMRC CEO statement on electronic cigarettes. MAIN RECOMMENDATIONS E-cigarettes can be harmful; all e-cigarette users are exposed to chemicals and toxins that have the potential to cause adverse health effects. There are no health benefits of using e-cigarettes if you do not currently smoke tobacco cigarettes. Adolescents are more likely to try e-cigarettes if they are exposed to e-cigarettes on social media. Short term e-cigarette use may help some smokers to quit who have been previously unsuccessful with other smoking cessation aids. There are other proven safe and effective options available to help smokers to quit. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT The evidence base for the harms of e-cigarette use has strengthened since the previous NHMRC statement. Significant gaps in the evidence base remain, especially about the longer term health harms of using e-cigarettes and the toxicity of many chemicals in e-cigarettes inhaled as an aerosol.
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Affiliation(s)
| | - Matthew J Peters
- Macquarie University, Sydney, NSW
- Concord Repatriation General Hospital, Sydney, NSW
| | - Renee Bittoun
- Avondale University, Cooranbong, NSW
- University of Notre Dame Australia, Sydney, NSW
| | | | - Dallas R English
- Centre for MEGA Epidemiology, University of Melbourne, Melbourne, VIC
| | - David P Thomas
- Menzies School of Health Research, Charles Darwin University, Darwin, NT
| | | | | | - Catherine Chamberlain
- University of Melbourne, Melbourne, VIC
- Judith Lumley Centre, La Trobe University, Melbourne, VIC
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Sprague NL, Uong SP, Zonnevylle H, Chatterjee T, Hernández D, Rundle AG, Ekenga CC. The CHANGE (Climate Health ANalysis Grading Evaluation) tool for weight of evidence reviews on climate change and health research. Environ Health 2024; 23:7. [PMID: 38243236 PMCID: PMC10797793 DOI: 10.1186/s12940-023-01040-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/12/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Climate change has been identified as one of the biggest threats to human health. Despite this claim, there are no standardized tools that assess the rigor of published literature for use in weight of evidence (WOE) reviews. Standardized assessment tools are essential for creating clear and comparable WOE reviews. As such, we developed a standardized tool for evaluating the quality of climate change and health studies focused on evaluating studies that quantify exposure-response relationships and studies that implement and/or evaluate adaptation interventions. METHODS The authors explored systematic-review methodology to enhance transparency and increase efficiency in summarizing and synthesizing findings from studies on climate change and health research. The authors adapted and extended existing WOE methods to develop the CHANGE (Climate Health ANalysis Grading Evaluation) tool. The resulting assessment tool has been refined through application and subsequent team input. RESULTS The CHANGE tool is a two-step standardized tool for systematic review of climate change and health studies of exposure-response relationships and adaptation intervention studies. Step one of the CHANGE tool aims to classify studies included in weight-of-evidence reviews and step two assesses the quality and presence of bias in the climate change and health studies. CONCLUSION The application of the CHANGE tool in WOE reviews of climate change and health will lead to increased comparability, objectivity, and transparency within this research area.
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Affiliation(s)
- Nadav L Sprague
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Stephen P Uong
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Hannah Zonnevylle
- Soil and Crop Sciences, School of Integrative Plant Science, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Trinish Chatterjee
- Department of Earth and Environmental Sciences, Columbia University, New York, NY, USA
| | - Diana Hernández
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA
| | - Christine C Ekenga
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Pfleger E, Lutz R, Drexler H. [Environmental risks and health literacy: a systematic review]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:85-98. [PMID: 37823907 PMCID: PMC10776732 DOI: 10.1007/s00103-023-03782-5] [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: 03/13/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Environmental factors can play an important role in pathogenesis. However, the understanding of the relationship between environmental risks and health in the general population appears to be poor. The aim of this systematic review is to describe the state of research on the relationship between health literacy (HL) or environmental health literacy (EHL) and environmental risks differentiated by the researched environmental risks, the affected population, the measurement and level of HL or EHL, and their interaction with other variables. METHODS A systematic literature search was conducted using the Pubmed, Scopus, and LIVIVO databases. Original studies in German or English that investigated HL or EHL in the context of an environmental risk or pollutant in a population were included. The Navigation Guide was used to assess the methodological quality of the studies. RESULTS Twenty-four studies were included in the qualitative analysis. The operationalization of HL or EHL was heterogeneous in 22 studies. Nine studies referred to environmental issues in general, and 15 studies analyzed individual environmental risks. Eleven studies referred to the general population, 12 to specified target groups, and 1 study examined both. The level of HL or EHL proved to be in need of improvement in all populations. Interventions such as trainings were able to increase HL or EHL. DISCUSSION The heterogeneous operationalizations impede the comparability of the studies. Future work should target the standardization of methodological aspects. Overall, it appears that interventions such as trainings were conducive to improving HL or EHL. In practice, this should therefore be given greater focus in order to increase HL or EHL.
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Affiliation(s)
- Elisabeth Pfleger
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestraße 9-11, 91054, Erlangen, Deutschland.
| | - Regina Lutz
- FOM Hochschule für Oekonomie & Management, Essen, Deutschland
| | - Hans Drexler
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestraße 9-11, 91054, Erlangen, Deutschland
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Goodman CV, Green R, DaCosta A, Flora D, Lanphear B, Till C. Sex difference of pre- and post-natal exposure to six developmental neurotoxicants on intellectual abilities: a systematic review and meta-analysis of human studies. Environ Health 2023; 22:80. [PMID: 37978510 PMCID: PMC10655280 DOI: 10.1186/s12940-023-01029-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Early life exposure to lead, mercury, polychlorinated biphenyls (PCBs), polybromide diphenyl ethers (PBDEs), organophosphate pesticides (OPPs), and phthalates have been associated with lowered IQ in children. In some studies, these neurotoxicants impact males and females differently. We aimed to examine the sex-specific effects of exposure to developmental neurotoxicants on intelligence (IQ) in a systematic review and meta-analysis. METHOD We screened abstracts published in PsychINFO and PubMed before December 31st, 2021, for empirical studies of six neurotoxicants (lead, mercury, PCBs, PBDEs, OPPs, and phthalates) that (1) used an individualized biomarker; (2) measured exposure during the prenatal period or before age six; and (3) provided effect estimates on general, nonverbal, and/or verbal IQ by sex. We assessed each study for risk of bias and evaluated the certainty of the evidence using Navigation Guide. We performed separate random effect meta-analyses by sex and timing of exposure with subgroup analyses by neurotoxicant. RESULTS Fifty-one studies were included in the systematic review and 20 in the meta-analysis. Prenatal exposure to developmental neurotoxicants was associated with decreased general and nonverbal IQ in males, especially for lead. No significant effects were found for verbal IQ, or postnatal lead exposure and general IQ. Due to the limited number of studies, we were unable to analyze postnatal effects of any of the other neurotoxicants. CONCLUSION During fetal development, males may be more vulnerable than females to general and nonverbal intellectual deficits from neurotoxic exposures, especially from lead. More research is needed to examine the nuanced sex-specific effects found for postnatal exposure to toxic chemicals.
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Affiliation(s)
- Carly V Goodman
- Faculty of Health, York University, Toronto, M3J 1P3, ON, Canada.
| | - Rivka Green
- Faculty of Health, York University, Toronto, M3J 1P3, ON, Canada
| | - Allya DaCosta
- Faculty of Health, York University, Toronto, M3J 1P3, ON, Canada
| | - David Flora
- Faculty of Health, York University, Toronto, M3J 1P3, ON, Canada
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Christine Till
- Faculty of Health, York University, Toronto, M3J 1P3, ON, Canada
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Boogaard H, Atkinson RW, Brook JR, Chang HH, Hoek G, Hoffmann B, Sagiv SK, Samoli E, Smargiassi A, Szpiro AA, Vienneau D, Weuve J, Lurmann FW, Forastiere F. Evidence Synthesis of Observational Studies in Environmental Health: Lessons Learned from a Systematic Review on Traffic-Related Air Pollution. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:115002. [PMID: 37991444 PMCID: PMC10664749 DOI: 10.1289/ehp11532] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/12/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND There is a long tradition in environmental health of using frameworks for evidence synthesis, such as those of the U.S. Environmental Protection Agency for its Integrated Science Assessments and the International Agency for Research on Cancer Monographs. The framework, Grading of Recommendations Assessment, Development, and Evaluation (GRADE), was developed for evidence synthesis in clinical medicine. The U.S. Office of Health Assessment and Translation (OHAT) elaborated an approach for evidence synthesis in environmental health building on GRADE. METHODS We applied a modified OHAT approach and a broader "narrative" assessment to assess the level of confidence in a large systematic review on traffic-related air pollution and health outcomes. DISCUSSION We discuss several challenges with the OHAT approach and its implementation and suggest improvements for synthesizing evidence from observational studies in environmental health. We consider the determination of confidence using a formal rating scheme of up- and downgrading of certain factors, the treatment of every factor as equally important, and the lower initial confidence rating of observational studies to be fundamental issues in the OHAT approach. We argue that some observational studies can offer high-confidence evidence in environmental health. We note that heterogeneity in magnitude of effect estimates should generally not weaken the confidence in the evidence, and consistency of associations across study designs, populations, and exposure assessment methods may strengthen confidence in the evidence. We mention that publication bias should be explored beyond statistical methods and is likely limited when large and collaborative studies comprise most of the evidence and when accrued over several decades. We propose to identify possible key biases, their most likely direction, and their potential impacts on the results. We think that the OHAT approach and other GRADE-type frameworks require substantial modification to align better with features of environmental health questions and the studies that address them. We emphasize that a broader, "narrative" evidence assessment based on the systematic review may complement a formal GRADE-type evaluation. https://doi.org/10.1289/EHP11532.
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Affiliation(s)
| | - Richard W. Atkinson
- Population Health Research Institute, St. George’s University of London, London, United Kingdom
| | - Jeffrey R. Brook
- Occupational and Environmental Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Sharon K. Sagiv
- Center for Environmental Research and Children’s Health, Division of Epidemiology, University of California Berkeley School of Public Health, Berkeley, California, USA
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Audrey Smargiassi
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Adam A. Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Francesco Forastiere
- Environmental Research Group, School of Public Health, Imperial College London, London, United Kingdom
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Ellis LB, Molina K, Robbins CR, Freisthler M, Sgargi D, Mandrioli D, Perry MJ. Adult Organophosphate and Carbamate Insecticide Exposure and Sperm Concentration: A Systematic Review and Meta-Analysis of the Epidemiological Evidence. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:116001. [PMID: 37966213 PMCID: PMC10648769 DOI: 10.1289/ehp12678] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Evidence of the negative impacts of contemporary use insecticides on sperm concentration has increased over the last few decades; however, meta-analyses on this topic are rare. OBJECTIVES This investigation assessed the qualitative and quantitative strength of epidemiological evidence regarding adult exposure to two classes of contemporary use insecticides-organophosphates (OPs) and N -methyl carbamates (NMCs)-and sperm concentration using robust and reproducible systematic review and meta-analysis methods. METHODS Three scientific databases (PubMed, Scopus, and Web of Science), two U.S. government databases (NIOSHTIC-2 and Science.gov), and five nongovernmental organization websites were searched for relevant primary epidemiological studies published in any language through 11 August 2022. Risk of bias and strength of evidence were evaluated according to Navigation Guide systematic review methodology. Bias-adjusted standardized mean difference effect sizes were calculated and pooled using a three-level, multivariate random-effect meta-analysis model with cluster-robust variance estimation. RESULTS Across 20 studies, 21 study populations, 42 effect sizes, and 1,774 adult men, the pooled bias-adjusted standardized mean difference in sperm concentration between adult men more- and less-exposed to OP and NMC insecticides was - 0.30 (95% CI: - 0.49 , - 0.10 ; P Satt < 0.01 ). Sensitivity and subgroup analyses explored statistical heterogeneity and validated the model robustness. Although the pooled effect estimate was modified by risk of bias, insecticide class, exposure setting, and recruitment setting, it remained negative in direction across all meta-analyses. The body of evidence was rated to be of moderate quality, with sufficient evidence of an association between higher adult OP and NMC insecticide exposure and lower sperm concentration. DISCUSSION This comprehensive investigation found sufficient evidence of an association between higher OP and NMC insecticide exposure and lower sperm concentration in adults. Although additional cohort studies can be beneficial to fill data gaps, the strength of evidence warrants reducing exposure to OP and NMC insecticides now to prevent continued male reproductive harm. https://doi.org/10.1289/EHP12678.
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Affiliation(s)
- Lauren B. Ellis
- Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Karen Molina
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - C. Rebecca Robbins
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Marlaina Freisthler
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Melissa J. Perry
- College of Public Health, George Mason University, Fairfax, Virginia, USA
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Huang J. Invited Perspective: Risk of Bias Assessments, Target Trials, and the Strengths of Environmental Epidemiology. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:111302. [PMID: 37966214 PMCID: PMC10648748 DOI: 10.1289/ehp13824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023]
Affiliation(s)
- Jonathan Huang
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai’i at Manoa, Honolulu, Hawaii, USA
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
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Sapari H, Selamat MI, Isa MR, Ismail R, Wan Mahiyuddin WR. The Impact of Heat Waves on Health Care Services in Low- or Middle-Income Countries: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e44702. [PMID: 37843898 PMCID: PMC10616749 DOI: 10.2196/44702] [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: 12/04/2022] [Revised: 06/02/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Heat waves significantly impact ecosystems and human health, especially that of vulnerable populations, and are associated with increased morbidity and mortality. Besides being directly related to climate-sensitive health outcomes, heat waves have indirectly increased the burden on our health care systems. Although the existing literature examines the impact of heat waves and morbidity, past research has mostly been conducted in high-income countries (HICs), and studies on the impact of heat waves on morbidity in low- or middle-income countries (LMICs) are still scarce. OBJECTIVE This paper presents the protocol for a systematic review that aims to provide evidence of the impact of heat waves on health care services in LMICs. METHODS We will identify peer-reviewed studies from 3 online databases, including the Web of Science, PubMed, and SCOPUS, published from January 2002 to April 2023, using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment will be conducted using the Navigation Guide checklist. Key search terms include heatwaves, extreme heat, hospitalization, outpatient visit, burden, health services, and morbidity. RESULTS This systematic review will provide insight into the impact of heat waves on health care services in LMICs, especially on emergency department visits, ambulance call-outs, hospital admissions, outpatient department visits, in-hospital mortality, and health care operational costs. CONCLUSIONS The results of this review are anticipated to help policymakers and key stakeholders obtain a better understanding of the impact of heat waves on health care services and prioritize investments to mitigate the effects of heat waves in LMICs. This entails creating a comprehensive heat wave plan and ensuring that adequate infrastructure, capacity, and human resources are allocated in the health care sector. These measures will undoubtedly contribute to the development of resilience in health care systems and hence protect the health and well-being of individuals and communities. TRIAL REGISTRATION PROSPERO CRD42022365471; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=365471. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44702.
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Affiliation(s)
- Hadita Sapari
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Mohamad Ikhsan Selamat
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Mohamad Rodi Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selangor, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Wan Rozita Wan Mahiyuddin
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
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Rugulies R, Aust B, Greiner BA, Arensman E, Kawakami N, LaMontagne AD, Madsen IEH. Work-related causes of mental health conditions and interventions for their improvement in workplaces. Lancet 2023; 402:1368-1381. [PMID: 37838442 DOI: 10.1016/s0140-6736(23)00869-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 02/11/2023] [Accepted: 04/27/2023] [Indexed: 10/16/2023]
Abstract
Mental health problems and disorders are common among working people and are costly for the affected individuals, employers, and whole of society. This discussion paper provides an overview of the current state of knowledge on the relationship between work and mental health to inform research, policy, and practice. We synthesise available evidence, examining both the role of working conditions in the development of mental disorders, and what can be done to protect and promote mental health in the workplace. We show that exposure to some working conditions is associated with an increased risk of the onset of depressive disorders, the most studied mental disorders. The causality of the association, however, is still debated. Causal inference should be supported by more research with stronger linkage to theory, better exposure assessment, better understanding of biopsychosocial mechanisms, use of innovative analytical methods, a life-course perspective, and better understanding of the role of context, including the role of societal structures in the development of mental disorders. There is growing evidence for the effectiveness of interventions to protect and promote mental health and wellbeing in the workplace; however, there is a disproportionate focus on interventions directed towards individual workers and illnesses, compared with interventions for improving working conditions and enhancing mental health. Moreover, research on work and mental health is mainly done in high-income countries, and often does not address workers in lower socioeconomic positions. Flexible and innovative approaches tailored to local conditions are needed in implementation research on workplace mental health to complement experimental studies. Improvements in translating workplace mental health research to policy and practice, such as through workplace-oriented concrete guidance for interventions, and by national policies and programmes focusing on the people most in need, could capitalise on the growing interest in workplace mental health, possibly yielding important mental health gains in working populations.
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Affiliation(s)
- Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland; National Suicide Research Foundation, University College Cork, Cork, Ireland; Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Junpukai Foundation, Okayama, Japan
| | - Anthony D LaMontagne
- School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Jahn A, Andersen JH, Christiansen DH, Seidler A, Dalbøge A. Occupational mechanical exposures as risk factor for chronic low-back pain: a systematic review and meta-analysis. Scand J Work Environ Health 2023; 49:453-465. [PMID: 37581384 PMCID: PMC10838064 DOI: 10.5271/sjweh.4114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Indexed: 08/16/2023] Open
Abstract
OBJECTIVES The association between occupational mechanical exposures and low-back pain (LBP) has been studied in several systematic reviews. However, no systematic review addressing chronic LBP exists. The aim of this systematic review and meta-analysis was to examine the association between occupational mechanical exposures and chronic LBP. METHODS The study was registered in PROSPERO. We used an existing systematic review to identify articles published before January 2014. For studies published between January 2014 and September 2022, a systematic literature search was conducted in six databases. Two authors independently excluded articles, extracted data, and assessed risk of bias and level of evidence (GRADE). Meta-analyses were conducted using random-effects models comparing highest versus lowest exposure group with sensitivity analyses based on study quality (low/moderate versus high risk of bias), study design (cohort versus case-control), and outcome definition (non-specific LBP versus specific chronic LBP). RESULTS Twenty-six articles were included. Highest pooled odd ratios (OR) were found for combined mechanical exposures [OR 2.2, 95% confidence interval (CI) 1.4-3.6], lifting/carrying loads (OR 1.7, 95% CI 1.4-2.2), and non-neutral postures (OR 1.5, 95% CI 1.2-1.9). For the remaining mechanical exposures (ie, whole-body vibrations, standing/walking, and sitting), OR ranged between 1.0 and 1.4. In the sensitivity analyses, generally, higher pooled OR were found in low/moderate risk of bias studies, case-control studies, and studies of specific chronic LBP. CONCLUSIONS Moderate evidence of an association was found for lifting/carrying loads, non-neutral postures, and combined mechanical exposures. Low or very low evidence was found for whole-body vibrations, standing/walking, and sitting. Studies using standardized exposure definition, metric, and technical measurements are highly warranted.
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Affiliation(s)
- Alexander Jahn
- Danish Ramazzini Centre, Department of Occupational Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University Hospital, Aarhus N, Denmark.
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More S, Bampidis V, Benford D, Bragard C, Hernández‐Jerez A, Bennekou SH, Koutsoumanis KP, Lambré C, Machera K, Mullins E, Nielsen SS, Schlatter J, Schrenk D, Turck D, Younes M, Kraft A, Naegeli H, Tsaioun K, Aiassa E, Arcella D, Barizzone F, Cushen M, Georgiadis M, Gervelmeyer A, Lanzoni A, Lenzi P, Lodi F, Martino L, Messens W, Ramos Bordajandi L, Rizzi V, Stancanelli G, Supej Š, Halldorsson TI. Guidance on protocol development for EFSA generic scientific assessments. EFSA J 2023; 21:e08312. [PMID: 37908452 PMCID: PMC10613941 DOI: 10.2903/j.efsa.2023.8312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
EFSA Strategy 2027 outlines the need for fit-for-purpose protocols for EFSA generic scientific assessments to aid in delivering trustworthy scientific advice. This EFSA Scientific Committee guidance document helps address this need by providing a harmonised and flexible framework for developing protocols for EFSA generic assessments. The guidance replaces the 'Draft framework for protocol development for EFSA's scientific assessments' published in 2020. The two main steps in protocol development are described. The first is problem formulation, which illustrates the objectives of the assessment. Here a new approach to translating the mandated Terms of Reference into scientifically answerable assessment questions and sub-questions is proposed: the 'APRIO' paradigm (Agent, Pathway, Receptor, Intervention and Output). Owing to its cross-cutting nature, this paradigm is considered adaptable and broadly applicable within and across the various EFSA domains and, if applied using the definitions given in this guidance, is expected to help harmonise the problem formulation process and outputs and foster consistency in protocol development. APRIO may also overcome the difficulty of implementing some existing frameworks across the multiple EFSA disciplines, e.g. the PICO/PECO approach (Population, Intervention/Exposure, Comparator, Outcome). Therefore, although not mandatory, APRIO is recommended. The second step in protocol development is the specification of the evidence needs and the methods that will be applied for answering the assessment questions and sub-questions, including uncertainty analysis. Five possible approaches to answering individual (sub-)questions are outlined: using evidence from scientific literature and study reports; using data from databases other than bibliographic; using expert judgement informally collected or elicited via semi-formal or formal expert knowledge elicitation processes; using mathematical/statistical models; and - not covered in this guidance - generating empirical evidence ex novo. The guidance is complemented by a standalone 'template' for EFSA protocols that guides the users step by step through the process of planning an EFSA scientific assessment.
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Schlünssen V, Ádám B, Momen NC, Nemery B, Pega F. Response to Letter to the Editor regarding "The prevalences and levels of occupational exposure to dusts and/or fibres (silica, asbestos and coal): A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury". ENVIRONMENT INTERNATIONAL 2023; 179:108165. [PMID: 37669593 DOI: 10.1016/j.envint.2023.108165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/07/2023]
Affiliation(s)
- Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark.
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Ben Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
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Hu CY, Qiao JC, Gui SY, Xu KX, Dzhambov AM, Zhang XJ. Perfluoroalkyl and polyfluoroalkyl substances and hypertensive disorders of pregnancy: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2023; 231:116064. [PMID: 37178750 DOI: 10.1016/j.envres.2023.116064] [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: 02/22/2023] [Revised: 04/22/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
Hypertensive disorders of pregnancy (HDP), including gestational hypertension (GH) and preeclampsia (PE), cause significant morbidity and mortality among pregnant women. Several environmental toxins, particularly those that affect the normal function of the placenta and the endothelium, are emerging as potential risk factors for HDP. Among them, per- and polyfluoroalkyl substances (PFAS), widely used in a variety of commercial products, have been related to a variety of adverse health effects including HDP. This study was conducted by searching three databases for observational studies reporting associations between PFAS and HDP, all of which were published before December 2022. We used random-effects meta-analysis to calculate pooled risk estimates, and assessing each combination of exposure and outcome for quality and level of evidence. In total, 15 studies were included in the systematic review and meta-analysis. The results from meta-analyses showed that risk of PE was increased with exposure to PFOA (perfluorooctanoic acid) (RR = 1.39, 95% CI = 1.05, 1.85; N = 6 studies; exposure = 1 ln-unit increment; low certainty), PFOS (perfluorooctane sulfonate) (RR = 1.51, 95% CI = 1.23, 1.86; N = 6 studies; exposure = 1 ln-unit increment; moderate certainty), and PFHxS (perfluorohexane sulfonate) (RR = 1.39, 95% CI = 1.10, 1.76; N = 6 studies; exposure = 1 ln-unit increment; low certainty). PFOS was also associated with an increased risk of HDP (RR = 1.39, 95% CI = 1.10, 1.76; exposure = 1 ln-unit increment; low certainty). Exposure to legacy PFAS (PFOA, PFOS, PFHxS) is associated with an increased risk of PE, and PFOS is further associated with HDP. In view of the limitations of meta-analysis and quality of evidence, these findings should be interpreted with caution. Further research is required that assesses exposure to multiple PFAS in diverse and well-powered cohorts.
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Affiliation(s)
- Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Ke-Xin Xu
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria, 15A Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria; Research group "Health and Quality of Life in a Green and Sustainable Environment", SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Huang W, Gao Y, Xu R, Yang Z, Yu P, Ye T, Ritchie EA, Li S, Guo Y. Health Effects of Cyclones: A Systematic Review and Meta-Analysis of Epidemiological Studies. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:86001. [PMID: 37639476 PMCID: PMC10461789 DOI: 10.1289/ehp12158] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND More intense cyclones are expected in the future as a result of climate change. A comprehensive review is urgently needed to summarize and update the evidence on the health effects of cyclones. OBJECTIVES We aimed to provide a systematic review with meta-analysis of current evidence on the risks of all reported health outcomes related to cyclones and to identify research gaps and make recommendations for further research. METHODS We systematically searched five electronic databases (MEDLINE, Embase, PubMed, Scopus, and Web of Science) for relevant studies in English published before 21 December 2022. Following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, we developed inclusion criteria, screened the literature, and included epidemiological studies with a quantitative risk assessment of any mortality or morbidity-related outcomes associated with cyclone exposures. We extracted key data and assessed study quality for these studies and applied meta-analyses to quantify the overall effect estimate and the heterogeneity of comparable studies. RESULTS In total, 71 studies from eight countries (the United States, China, India, Japan, the Philippines, South Korea, Australia, Brazil), mostly the United States, were included in the review. These studies investigated the all-cause and cause-specific mortality, as well as morbidity related to injury, cardiovascular diseases (CVDs), respiratory diseases, infectious diseases, mental disorders, adverse birth outcomes, cancer, diabetes, and other outcomes (e.g., suicide rates, gender-based violence). Studies mostly included only one high-amplitude cyclone (cyclones with a Saffir-Simpson category of 4 or 5, i.e., Hurricanes Katrina or Sandy) and focused on mental disorders morbidity and all-cause mortality and hospitalizations. Consistently elevated risks of overall mental health morbidity, post-traumatic stress disorder (PTSD), as well as all-cause mortality or hospitalizations, were found to be associated with cyclones. However, the results for other outcomes were generally mixed or limited. A statistically significant overall relative risk of 1.09 [95% confidence interval (CI): 1.04, 1.13], 1.18 (95% CI: 1.12, 1.25), 1.15 (95% CI: 1.13, 1.18), 1.26 (95% CI: 1.05, 1.50) was observed for all-cause mortality, all-cause hospitalizations, respiratory disease, and chronic obstructive pulmonary disease hospitalizations, respectively, after cyclone exposures, whereas no statistically significant risks were identified for diabetes mortality, heart disease mortality, and preterm birth. High between-study heterogeneity was observed. CONCLUSIONS There is generally consistent evidence supporting the notion that high-amplitude cyclones could significantly increase risks of mental disorders, especially for PTSD, as well as mortality and hospitalizations, but the evidence for other health outcomes, such as chronic diseases (e.g., CVDs, cancer, diabetes), and adverse birth outcomes remains limited or inconsistent. More studies with rigorous exposure assessment, of larger spatial and temporal scales, and using advanced modeling strategy are warranted in the future, especially for those small cyclone-prone countries or regions with low and middle incomes. https://doi.org/10.1289/EHP12158.
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Affiliation(s)
- Wenzhong Huang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuan Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Zhengyu Yang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tingting Ye
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Elizabeth A. Ritchie
- School of Earth Atmosphere and Environment, Monash University, Melbourne, Victoria, Australia
- Department of Civil Engineering, Monash University, Melbourne, Victoria, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Michel S, Atmakuri A, von Ehrenstein OS. Prenatal exposure to ambient air pollutants and congenital heart defects: An umbrella review. ENVIRONMENT INTERNATIONAL 2023; 178:108076. [PMID: 37454629 DOI: 10.1016/j.envint.2023.108076] [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: 09/30/2022] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Prenatal exposure to ambient air pollutants has been linked to congenital heart defects (CHD), but findings of existing systematic reviews have been mixed. OBJECTIVE To assess the epidemiological evidence on associations between prenatal exposure to ambient air pollutants and CHD subtypes, based on a systematic overview of reviews ("umbrella review"). METHODS We conducted a systematic search for reviews assessing associations between prenatal exposure to criteria air pollutants and CHD. The risk of bias was evaluated using the Risk of Bias in Systematic Reviews (ROBIS) tool. The certainty of the systematic review findings was graded using the Navigation Guide methodology. RESULTS We identified eleven systematic reviews, including eight with meta-analyses, assessing in total 35 primary studies of prenatal exposure to criteria air pollutants and various CHD subtypes. The certainty of the findings of four meta-analyses indicating an increased risk for coarctation of the aorta associated with nitrogen dioxide exposure was rated as moderate. The certainty of findings indicating positive, inverse, or null associations for other pollutant-subtype combinations was rated as very low to low, based on low precision and high statistical heterogeneity of summary odds ratios (SOR), substantial inconsistencies between review findings, and methodological limitations of the systematic reviews. DISCUSSION The inconsistent findings and high statistical heterogeneity of many SOR of the included systematic reviews may partly be traced to differences in methodological approaches, and the risk of bias across included reviews (e.g., inclusion criteria, systematic search strategies, synthesis methods) and primary studies (e.g., exposure assessment, diagnostic criteria). Adherence to appropriate systematic review guidelines for environmental health research, as well as rigorous evaluation of risk of bias in primary studies, are essential for future risk assessments and policy-making. Still, our findings suggest that prenatal exposure to ambient air pollutants may increase risks for at least some CHD subtypes.
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Affiliation(s)
- Sophie Michel
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
| | - Aishwarya Atmakuri
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, Los Angeles, California, USA
| | - Ondine S von Ehrenstein
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA; Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
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Sherif M, Makame KR, Östlundh L, Paulo MS, Nemmar A, Ali BR, Al-Rifai RH, Nagy K, Ádám B. Genotoxicity of Occupational Pesticide Exposures among Agricultural Workers in Arab Countries: A Systematic Review and Meta-Analysis. TOXICS 2023; 11:663. [PMID: 37624167 PMCID: PMC10458041 DOI: 10.3390/toxics11080663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/17/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023]
Abstract
Exposure to pesticides in Arab countries is a significant public health concern due to extensive agricultural activity and pesticide use. This systematic review aimed to evaluate the genotoxic effects of agricultural pesticide exposure in the region, identify research gaps, and assess methodological limitations. Following the PRISMA guidelines, a comprehensive search yielded five relevant studies conducted in Egypt, Syria, and Jordan. Various genotoxicity assays were employed, revealing a higher level of DNA damage in exposed compared to non-exposed individuals. Farmers exposed to pesticides exhibited a significantly higher occurrence of chromosomal translocation (t(14;18)), micronuclei, and chromosomal aberrations. However, only two studies assessed cytotoxicity indirectly. The studies predominantly focused on male participants, with variations in sample size and pesticide types. The lack of detailed exposure data necessitates cautious interpretation. This review underscores the need for further research on the genotoxicity of occupational pesticide exposure in the Middle East. Future studies should adopt robust study designs, collect biological and environmental samples, conduct repeated sampling, analyze seasonal variations, and encompass diverse study sites associated with specific crop groups.
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Affiliation(s)
- Moustafa Sherif
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.S.); (R.H.A.-R.)
| | - Khadija Ramadhan Makame
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Linda Östlundh
- University Library, Örebro University, SE-702 81 Örebro, Sweden;
| | - Marilia Silva Paulo
- IPH, CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal;
| | - Abderrahim Nemmar
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates;
| | - Bassam R. Ali
- Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates;
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.S.); (R.H.A.-R.)
| | - Károly Nagy
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.S.); (R.H.A.-R.)
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Mustieles V, Rolland M, Pin I, Thomsen C, Sakhi AK, Sabaredzovic A, Muckle G, Guichardet K, Slama R, Philippat C. Early-Life Exposure to a Mixture of Phenols and Phthalates in Relation to Child Social Behavior: Applying an Evidence-Based Prioritization to a Cohort with Improved Exposure Assessment. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87006. [PMID: 37556305 PMCID: PMC10411634 DOI: 10.1289/ehp11798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 05/10/2023] [Accepted: 06/26/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Previous studies aiming at relating exposure to phenols and phthalates with child social behavior characterized exposure using one or a few spot urine samples, resulting in substantial exposure misclassification. Moreover, early infancy exposure was rarely studied. OBJECTIVES We aimed to examine the associations of phthalates and phenols with child social behavior in a cohort with improved exposure assessment and to a priori identify the chemicals supported by a higher weight of evidence. METHODS Among 406 mother-child pairs from the French Assessment of Air Pollution exposure during Pregnancy and Effect on Health (SEPAGES) cohort, 25 phenols/phthalate metabolites were measured in within-subject pools of repeated urine samples collected at the second and third pregnancy trimesters (∼ 21 samples/trimester) and at 2 months and 1-year of age (∼ 7 samples/period). Social behavior was parent-reported at 3 years of age of the child using the Social Responsiveness Scale (SRS). A structured literature review of the animal and human evidence was performed to prioritize the measured phthalates/phenols based on their likelihood to affect social behavior. Both adjusted linear regression and Bayesian Weighted Quantile Sum (BWQS) regression models were fitted. False discovery rate (FDR) correction was applied only to nonprioritized chemicals. RESULTS Prioritized compounds included bisphenol A, bisphenol S, triclosan (TCS), diethyl-hexyl phthalate (Σ DEHP ), mono-ethyl phthalate (MEP), mono-n -butyl phthalate (MnBP), and mono-benzyl phthalate (MBzP). With the exception of bisphenols, which showed a mixed pattern of positive and negative associations in pregnant mothers and neonates, few prenatal associations were observed. Most associations were observed with prioritized chemicals measured in 1-y-old infants: Each doubling in urinary TCS (β = 0.78 ; 95% CI: 0.00, 1.55) and MEP (β = 0.92 ; 95% CI: - 0.11 , 1.96) concentrations were associated with worse total SRS scores, whereas MnBP and Σ DEHP were associated with worse Social Awareness (β = 0.25 ; 95% CI: 0.01, 0.50) and Social Communication (β = 0.43 ; 95% CI: - 0.02 , 0.89) scores, respectively. BWQS also suggested worse total SRS [Beta 1 = 1.38 ; 95% credible interval (CrI): - 0.18 , 2.97], Social Awareness (Beta 1 = 0.37 ; 95% CrI: 0.06, 0.70), and Social Communication (Beta 1 = 0.91 ; 95% CrI: 0.31, 1.53) scores per quartile increase in the mixture of prioritized compounds assessed in 1-y-old infants. The few associations observed with nonprioritized chemicals did not remain after FDR correction, with the exception of benzophenone-3 exposure in 1-y-old infants, which was suggestively associated with worse Social Communication scores (corrected p = 0.07 ). DISCUSSION The literature search allowed us to adapt our statistical analysis according to the weight of evidence and create a corpus of experimental and epidemiological knowledge to better interpret our findings. Early infancy appears to be a sensitive exposure window that should be further investigated. https://doi.org/10.1289/EHP11798.
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Affiliation(s)
- Vicente Mustieles
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Matthieu Rolland
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Isabelle Pin
- Pediatric Department, Grenoble Alpes University Hospital, La Tronche, France
| | | | | | | | - Gina Muckle
- Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, Canada
| | - Karine Guichardet
- Pediatric Department, Grenoble Alpes University Hospital, La Tronche, France
| | - Rémy Slama
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Claire Philippat
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
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Eaves LA, Choi G, Hall E, Sillé FC, Fry RC, Buckley JP, Keil AP. Prenatal Exposure to Toxic Metals and Neural Tube Defects: A Systematic Review of the Epidemiologic Evidence. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:86002. [PMID: 37647124 PMCID: PMC10467818 DOI: 10.1289/ehp11872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 05/31/2023] [Accepted: 07/25/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Neural tube defects (NTDs) affect > 300,000 pregnancies worldwide annually. Few nongenetic factors, other than folate deficiency, have been identified that may provide intervenable solutions to reduce the burden of NTDs. Prenatal exposure to toxic metals [arsenic (As), cadmium (Cd), mercury (Hg), manganese (Mn) and lead (Pb)] may increase the risk of NTDs. Although a growing epidemiologic literature has examined associations, to our knowledge no systematic review has been conducted to date. OBJECTIVE Through adaptation of the Navigation Guide systematic review methodology, we aimed to answer the question "does exposure to As, Cd, Hg, Mn, or Pb during gestation increase the risk of NTDs?" and to assess challenges to evaluating this question given the current evidence. METHODS We selected available evidence on prenatal As, Cd, Hg, Mn, or Pb exposure and risk of specific NTDs (e.g., spina bifida, anencephaly) or all NTDs via a comprehensive search across MEDLINE, Embase, Web of Science, and TOXLINE databases and applied inclusion/exclusion criteria. We rated the quality and strength of the evidence for each metal. We applied a customized risk of bias protocol and evaluated the sufficiency of evidence of an effect of each metal on NTDs. RESULTS We identified 30 studies that met our criteria. Risk of bias for confounding and selection was high in most studies, but low for missing data. We determined that, although the evidence was limited, the literature supported an association between prenatal exposure to Hg or Mn and increased risk of NTDs. For the remaining metals, the evidence was inadequate to establish or rule out an effect. CONCLUSION The role of gestational As, Cd, or Pb exposure in the etiology of NTDs remains unclear and warrants further investigation in high-quality studies, with a particular focus on controlling confounding, mitigating selection bias, and improving exposure assessment. https://doi.org/10.1289/EHP11872.
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Affiliation(s)
- Lauren A. Eaves
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-Chapel Hill), Chapel Hill, North Carolina, USA
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Giehae Choi
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emily Hall
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fenna C.M. Sillé
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-Chapel Hill), Chapel Hill, North Carolina, USA
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessie P. Buckley
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alexander P. Keil
- Department of Epidemiology, Gillings School of Global Public Health, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
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Jia Y, Lin Z, He Z, Li C, Zhang Y, Wang J, Liu F, Li J, Huang K, Cao J, Gong X, Lu X, Chen S. Effect of Air Pollution on Heart Failure: Systematic Review and Meta-Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:76001. [PMID: 37399145 PMCID: PMC10317211 DOI: 10.1289/ehp11506] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 02/15/2023] [Accepted: 06/06/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent. OBJECTIVES We aimed to conduct a systematic review of the literature and meta-analysis to provide a more comprehensive and multiperspective assessment of the associations between short- and long-term air pollution exposure and HF from epidemiological evidences. METHODS Three databases were searched up to 31 August 2022 for studies investigating the association between air pollutants (PM 2.5 , PM 10 , NO 2 , SO 2 , CO, O 3 ) and HF hospitalization, incidence, or mortality. A random effects model was used to derive the risk estimations. Subgroup analysis was conducted by geographical location, age of participants, outcome, study design, covered area, the methods of exposure assessment, and the length of exposure window. Sensitivity analysis and adjustment for publication bias were performed to test the robustness of the results. RESULTS Of 100 studies covering 20 countries worldwide, 81 were for short-term and 19 were for long-term exposure. Almost all air pollutants were adversely associated with the risk of HF in both short- and long-term exposure studies. For short-term exposures, we found the risk of HF increased by 1.8% [relative risk ( RR ) = 1.018 , 95% confidence interval (CI): 1.011, 1.025] and 1.6% (RR = 1.016 , 95% CI: 1.011, 1.020) per 10 - μ g / m 3 increment of PM 2.5 and PM 10 , respectively. HF was also significantly associated with NO 2 , SO 2 , and CO, but not O 3 . Positive associations were stronger when exposure was considered over the previous 2 d (lag 0-1) rather than on the day of exposure only (lag 0). For long-term exposures, there were significant associations between several air pollutants and HF with RR (95% CI) of 1.748 (1.112, 2.747) per 10 - μ g / m 3 increment in PM 2.5 , 1.212 (1.010, 1.454) per 10 - μ g / m 3 increment in PM 10 , and 1.204 (1.069, 1.356) per 10 -ppb increment in NO 2 , respectively. The adverse associations of most pollutants with HF were greater in low- and middle-income countries than in high-income countries. Sensitivity analysis demonstrated the robustness of our results. DISCUSSION Available evidence highlighted adverse associations between air pollution and HF regardless of short- and long-term exposure. Air pollution is still a prevalent public health issue globally and sustained policies and actions are called for to reduce the burden of HF. https://doi.org/10.1289/EHP11506.
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Affiliation(s)
- Yanhui Jia
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Zhennan Lin
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Zhi He
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Chenyang Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Youjing Zhang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jingyu Wang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Fangchao Liu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jianxin Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Keyong Huang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jie Cao
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Xinyuan Gong
- Department of Science and Education, Tianjin First Central Hospital, Tianjin, China
| | - Xiangfeng Lu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Shufeng Chen
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
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Song X, Ma Y, Tang J, Peng J, Hu Y, Han Y, Fu X, Luo X, Li X, Ge L, Yang K, Chen Y. Use of GRADE in systematic reviews of health effects on pollutants and extreme temperatures: A cross-sectional survey. J Clin Epidemiol 2023; 159:206-213. [PMID: 37253394 DOI: 10.1016/j.jclinepi.2023.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/18/2023] [Accepted: 05/23/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVES (i) To analyze trends and gaps in evidence of health effects on pollutants and extreme temperatures by evidence mapping; (ii) to conduct a cross-sectional survey on the use of the Grades of Recommendations Assessment Development and Evaluation (GRADE) in systematic reviews or meta-analyses (SR/MAs) of health effects on pollutants and extreme temperatures. STUDY DESIGN AND SETTING PubMed, Embase, the Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched until July 7, 2022. SR/MAs investigated health effects of pollutants and extreme temperatures were included. RESULTS Out of 22,658 studies, 312 SR/MAs were included in evidence mapping, and the effects of pollutants on cancer and congenital malformations were new research hotspots. Among 16 SR/MAs involving 108 outcomes that were rated using GRADE, the certainty of evidence was mostly downgraded for inconsistency (50, 42.7%), imprecision (33, 28.2%), and risk of bias (24, 20.5%). In contrast, concentration-response gradient (26, 65.0%) was the main upgrade factor. CONCLUSION GRADE is not widely used in SR/MAs of health effects on pollutants and extreme temperatures. The certainty of evidence is generally low, mainly because of the serious inconsistency or imprecision. Use of the GRADE in SR/MAs of health effects on pollutants and extreme temperatures should strengthen.
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Affiliation(s)
- Xuping Song
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China; Institute of Health Data Science, Lanzhou University, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China; McMaster Health Forum, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton L8S4L8, Canada
| | - Yan Ma
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jing Tang
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jiali Peng
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yue Hu
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yunze Han
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xinyu Fu
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
| | - Xufei Luo
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiuxia Li
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China
| | - Long Ge
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China; Institute of Health Data Science, Lanzhou University, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Kehu Yang
- Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China; Institute of Health Data Science, Lanzhou University, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Yaolong Chen
- Department of Social Medicine and Health Management, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China; Institute of Health Data Science, Lanzhou University, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.
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Cipriani A, Seedat S, Milligan L, Salanti G, Macleod M, Hastings J, Thomas J, Michie S, Furukawa TA, Gilbert D, Soares-Weiser K, Moreno C, Leucht S, Egger M, Mansoori P, Barker JM, Siafis S, Ostinelli EG, McCutcheon R, Wright S, Simpson M, Elugbadebo O, Chiocchia V, Tonia T, Elgarf R, Kurtulmus A, Sena E, Simple O, Boyce N, Chung S, Sharma A, Wolpert M, Potts J, Elliott JH. New living evidence resource of human and non-human studies for early intervention and research prioritisation in anxiety, depression and psychosis. BMJ MENTAL HEALTH 2023; 26:e300759. [PMID: 37290906 PMCID: PMC10255027 DOI: 10.1136/bmjment-2023-300759] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 06/10/2023]
Abstract
In anxiety, depression and psychosis, there has been frustratingly slow progress in developing novel therapies that make a substantial difference in practice, as well as in predicting which treatments will work for whom and in what contexts. To intervene early in the process and deliver optimal care to patients, we need to understand the underlying mechanisms of mental health conditions, develop safe and effective interventions that target these mechanisms, and improve our capabilities in timely diagnosis and reliable prediction of symptom trajectories. Better synthesis of existing evidence is one way to reduce waste and improve efficiency in research towards these ends. Living systematic reviews produce rigorous, up-to-date and informative evidence summaries that are particularly important where research is emerging rapidly, current evidence is uncertain and new findings might change policy or practice. Global Alliance for Living Evidence on aNxiety, depressiOn and pSychosis (GALENOS) aims to tackle the challenges of mental health science research by cataloguing and evaluating the full spectrum of relevant scientific research including both human and preclinical studies. GALENOS will also allow the mental health community-including patients, carers, clinicians, researchers and funders-to better identify the research questions that most urgently need to be answered. By creating open-access datasets and outputs in a state-of-the-art online resource, GALENOS will help identify promising signals early in the research process. This will accelerate translation from discovery science into effective new interventions for anxiety, depression and psychosis, ready to be translated in clinical practice across the world.
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Affiliation(s)
- Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Soraya Seedat
- South African Medical Research Council/Stellenbosch University Extramural Genomics of Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Georgia Salanti
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Malcolm Macleod
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Janna Hastings
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
| | - James Thomas
- EPPI Centre, Social Research Institute, University College London, London, UK
| | - Susan Michie
- UCL Centre for Behaviour Change, University College London, London, UK
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
| | - David Gilbert
- Chair, GALENOS Global Experiential Advisory Board, InHealth Associates, London, UK
| | | | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology and Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Spyridon Siafis
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Edoardo Giuseppe Ostinelli
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | - Robert McCutcheon
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Simonne Wright
- South African Medical Research Council/Stellenbosch University Extramural Genomics of Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Olufisayo Elugbadebo
- South African Medical Research Council/Stellenbosch University Extramural Genomics of Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Virginia Chiocchia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Rania Elgarf
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | - Ayse Kurtulmus
- Department of Psychiatry, Istanbul Medeniyet University, Turkey, Turkey
| | - Emily Sena
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ouma Simple
- South African Medical Research Council/Stellenbosch University Extramural Genomics of Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | | | | | | | - Jennifer Potts
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | - Julian H Elliott
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Future Evidence Foundation, Melbourne, Victoria, Australia
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Arsad FS, Hod R, Ahmad N, Baharom M, Ja'afar MH. Assessment of indoor thermal comfort temperature and related behavioural adaptations: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27089-9. [PMID: 37211568 DOI: 10.1007/s11356-023-27089-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/13/2023] [Indexed: 05/23/2023]
Abstract
Thermal comfort is linked to our health, well-being, and productivity. The thermal environment is one of the main factors that influence thermal comfort and, consequently, the productivity of occupants inside buildings. Meanwhile, behavioural adaptation is well known to be the most critical contributor to the adaptive thermal comfort model. This systematic review aims to provide evidence regarding indoor thermal comfort temperature and related behavioural adaptation. Studies published between 2010 and 2022 examining indoor thermal comfort temperature and behavioural adaptations were considered. In this review, the indoor thermal comfort temperature ranges from 15.0 to 33.8 °C. The thermal comfort temperature range varied depending on several factors, such as climatic features, ventilation mode, type of buildings, and age of the study population. Elderly and younger children have distinctive thermal acceptability. Clothing adjustment, fan usage, AC usage, and open window were the most common adaptive behaviour performed. Evidence shows that behavioural adaptations were also influenced by climatic features, ventilation mode, type of buildings, and age of the study population. Building designs should incorporate all factors that affect the thermal comfort of the occupants. Awareness of practical behavioural adaptations is crucial to ensure occupants' optimal thermal comfort.
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Affiliation(s)
- Fadly Syah Arsad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Bandar Tun Razak, Kuala Lumpur, Malaysia.
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Mazni Baharom
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Mohd Hasni Ja'afar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Bandar Tun Razak, Kuala Lumpur, Malaysia
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