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Zhang X, Blackwell CK, Moore J, Liu SH, Liu C, Forrest CB, Ganiban J, Stroustrup A, Aschner JL, Trasande L, Deoni SCL, Elliott AJ, Angal J, Karr CJ, Lester BM, McEvoy CT, O'Shea TM, Fry RC, Shipp GM, Gern JE, Herbstman J, Carroll KN, Teitelbaum SL, Wright RO, Wright RJ. Associations between neighborhood characteristics and child well-being before and during the COVID-19 pandemic: A repeated cross-sectional study in the Environmental influences on Child Health Outcomes (ECHO) program. ENVIRONMENTAL RESEARCH 2024; 252:118765. [PMID: 38548252 DOI: 10.1016/j.envres.2024.118765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
The corona virus disease (COVID-19) pandemic disrupted daily life worldwide, and its impact on child well-being remains a major concern. Neighborhood characteristics affect child well-being, but how these associations were affected by the pandemic is not well understood. We analyzed data from 1039 children enrolled in the Environmental influences on Child Health Outcomes Program whose well-being was assessed using the Patient-Reported Outcomes Measurement Information System Global Health questionnaire and linked these data to American Community Survey (ACS) data to evaluate the impacts of neighborhood characteristics on child well-being before and during the pandemic. We estimated the associations between more than 400 ACS variables and child well-being t-scores stratified by race/ethnicity (non-Hispanic white vs. all other races and ethnicities) and the timing of outcome data assessment (pre-vs. during the pandemic). Network graphs were used to visualize the associations between ACS variables and child well-being t-scores. The number of ACS variables associated with well-being t-scores decreased during the pandemic period. Comparing non-Hispanic white with other racial/ethnic groups during the pandemic, different ACS variables were associated with child well-being. Multiple ACS variables representing census tract-level housing conditions and neighborhood racial composition were associated with lower well-being t-scores among non-Hispanic white children during the pandemic, while higher percentage of Hispanic residents and higher percentage of adults working as essential workers in census tracts were associated with lower well-being t-scores among non-white children during the same study period. Our study provides insights into the associations between neighborhood characteristics and child well-being, and how the COVID-19 pandemic affected this relationship.
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Affiliation(s)
- Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | | | | | - Shelley H Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chang Liu
- Department of Psychology, Washington State University, WA, USA
| | | | - Jody Ganiban
- Department of Psychological and Brain Sciences, George Washington University, Washington D.C, USA
| | - Annemarie Stroustrup
- Departments of Pediatrics and Occupational Medicine, Epidemiology & Prevention, Zucker School of Medicine at Hofstra / Northwell and Cohen Children's Hospital, New Hyde Park, NY, USA
| | - Judy L Aschner
- Departments of Pediatrics, Hackensack Meridian School of Medicine, Nutley NJ and Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Sean C L Deoni
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Amy J Elliott
- Avera Research Institute and University of South Dakota School of Medicine, Sioux Falls, SD, USA
| | - Jyoti Angal
- Avera Research Institute and University of South Dakota School of Medicine, Sioux Falls, SD, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, University of Washington, WA, USA
| | - Barry M Lester
- Department of Psychiatry and Human Behavior/ Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
| | - Cindy T McEvoy
- Department of Pediatrics and Papé Pediatric Research Institute, Oregon Health & Science University, Portland, OR, USA
| | - T Michael O'Shea
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, NC, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, NC, USA
| | - Gayle M Shipp
- Chareles Stewart Mott Department of Public Health, Michigan State University, MI, USA
| | - James E Gern
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
| | - Julie Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, NY, USA
| | - Kecia N Carroll
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Susan L Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Labib SM. Greenness, air pollution, and temperature exposure effects in predicting premature mortality and morbidity: A small-area study using spatial random forest model. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 928:172387. [PMID: 38608883 DOI: 10.1016/j.scitotenv.2024.172387] [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: 01/03/2024] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Although studies have provided negative impacts of air pollution, heat or cold exposure on mortality and morbidity, and positive effects of increased greenness on reducing them, a few studies have focused on exploring combined and synergetic effects of these exposures in predicting these health outcomes, and most had ignored the spatial autocorrelation in analyzing their health effects. This study aims to investigate the health effects of air pollution, greenness, and temperature exposure on premature mortality and morbidity within a spatial machine-learning modeling framework. METHODS Years of potential life lost reflecting premature mortality and comparative illness and disability ratio reflecting chronic morbidity from 1673 small areas covering Greater Manchester for the year 2008-2013 obtained. Average annual levels of NO2 concentration, normalized difference vegetation index (NDVI) representing greenness, and annual average air temperature were utilized to assess exposure in each area. These exposures were linked to health outcomes using non-spatial and spatial random forest (RF) models while accounting for spatial autocorrelation. RESULTS Spatial-RF models provided the best predictive accuracy when accounted for spatial autocorrelation. Among the exposures considered, air pollution emerged as the most influential in predicting mortality and morbidity, followed by NDVI and temperature exposure. Nonlinear exposure-response relations were observed, and interactions between exposures illustrated specific ranges or sweet and sour spots of exposure thresholds where combined effects either exacerbate or moderate health conditions. CONCLUSION Air pollution exposure had a greater negative impact on health compared to greenness and temperature exposure. Combined exposure effects may indicate the highest influence of premature mortality and morbidity burden.
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Affiliation(s)
- S M Labib
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, the Netherlands.
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Chen L, Qin Y, Zhang Y, Song X, Wang R, Jiang J, Liu J, Guo T, Yuan W, Song Z, Dong Y, Song Y, Ma J. Association of the external environmental exposome and obesity: A comprehensive nationwide study in 2019 among Chinese children and adolescents. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 927:172233. [PMID: 38615759 DOI: 10.1016/j.scitotenv.2024.172233] [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: 01/02/2024] [Revised: 03/15/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Children and adolescents are particularly vulnerable to the effects of various environmental factors, which could disrupt growth processes and potentially lead to obesity. Currently, comprehensive and systematic assessments of these environmental exposures during developmental periods are lacking. Therefore, this study aims to evaluate the association between external environmental exposures and the incidence of obesity in children and adolescents. METHODS Data was collected from the 2019 Chinese National Survey on Students' Constitution and Health, including 214,659 Han children aged 7 to 19. Body Mass Index (BMI) and BMI-for-age z-score (zBMI) were the metrics used to assess overweight and obesity prevalence. The study assessed 18 environmental factors, including air pollutants, natural space, land cover, meteorological conditions, built environment, road conditions, and artificial light at night. Exposome-wide association study (ExWAS) to analyze individual exposures' associations with health outcomes, and Weighted Quantile Sum (WQS) to assess cumulative exposure effects. RESULTS Among the children and adolescents, there were 24.2 % participants classified as overweight or obesity. Notably, 17 out of 18 environmental factors exhibited significant associations with zBMI and overweight/obesity. Seven air pollutants, road conditions, and built density were positively correlated with higher zBMI and obesity risk, while NDVI, forests, and meteorological factors showed negative correlations. Co-exposure analysis highlighted that SO2, ALAN, PM10, and trunk road density significantly increased zBMI, whereas rainfall, grassland, and forest exposure reduced it. Theoretically reduction in the number and prevalence of cases was calculated, indicating potential reductions in prevalence of up to 4.51 % for positive exposures and 5.09 % for negative exposures. Notably, substantial reductions were observed in regions with high pollution levels. CONCLUSION This large-scale investigation, encompassing various environmental exposures in schools, highlights the significant impact of air pollution, road characteristics, rainfall, and forest coverage on childhood obesity.
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Affiliation(s)
- Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yang Qin
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Xinli Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - RuoLin Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jianuo Jiang
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Tongjun Guo
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Wen Yuan
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Zhiying Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
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Cadman T, Elhakeem A, Vinther JL, Avraam D, Carrasco P, Calas L, Cardol M, Charles MA, Corpeleijn E, Crozier S, de Castro M, Estarlich M, Fernandes A, Fossatti S, Gruszfeld D, Guerlich K, Grote V, Haakma S, Harris JR, Heude B, Huang RC, Ibarluzea J, Inskip H, Jaddoe V, Koletzko B, Lioret S, Luque V, Manios Y, Moirano G, Moschonis G, Nader J, Nieuwenhuijsen M, Andersen AMN, McEachen R, de Moira AP, Popovic M, Roumeliotaki T, Salika T, Santa Marina L, Santos S, Serbert S, Tzorovili E, Vafeiadi M, Verduci E, Vrijheid M, Vrijkotte TGM, Welten M, Wright J, Yang TC, Zugna D, Lawlor D. Associations of Maternal Educational Level, Proximity to Green Space During Pregnancy, and Gestational Diabetes With Body Mass Index From Infancy to Early Adulthood: A Proof-of-Concept Federated Analysis in 18 Birth Cohorts. Am J Epidemiol 2024; 193:753-763. [PMID: 37856700 DOI: 10.1093/aje/kwad206] [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: 08/01/2022] [Revised: 04/06/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Abstract
International sharing of cohort data for research is important and challenging. We explored the feasibility of multicohort federated analyses by examining associations between 3 pregnancy exposures (maternal education, exposure to green vegetation, and gestational diabetes) and offspring body mass index (BMI) from infancy to age 17 years. We used data from 18 cohorts (n = 206,180 mother-child pairs) from the EU Child Cohort Network and derived BMI at ages 0-1, 2-3, 4-7, 8-13, and 14-17 years. Associations were estimated using linear regression via 1-stage individual participant data meta-analysis using DataSHIELD. Associations between lower maternal education and higher child BMI emerged from age 4 and increased with age (difference in BMI z score comparing low with high education, at age 2-3 years = 0.03 (95% confidence interval (CI): 0.00, 0.05), at 4-7 years = 0.16 (95% CI: 0.14, 0.17), and at 8-13 years = 0.24 (95% CI: 0.22, 0.26)). Gestational diabetes was positively associated with BMI from age 8 years (BMI z score difference = 0.18, 95% CI: 0.12, 0.25) but not at younger ages; however, associations attenuated towards the null when restricted to cohorts that measured gestational diabetes via universal screening. Exposure to green vegetation was weakly associated with higher BMI up to age 1 year but not at older ages. Opportunities of cross-cohort federated analyses are discussed.
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Aguilar-Lacasaña S, Fontes Marques I, de Castro M, Dadvand P, Escribà X, Fossati S, González JR, Nieuwenhuijsen M, Alfano R, Annesi-Maesano I, Brescianini S, Burrows K, Calas L, Elhakeem A, Heude B, Hough A, Isaevska E, W V Jaddoe V, Lawlor DA, Monaghan G, Nawrot T, Plusquin M, Richiardi L, Watmuff A, Yang TC, Vrijheid M, F Felix J, Bustamante M. Green space exposure and blood DNA methylation at birth and in childhood - A multi-cohort study. ENVIRONMENT INTERNATIONAL 2024; 188:108684. [PMID: 38776651 DOI: 10.1016/j.envint.2024.108684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/21/2024] [Accepted: 04/21/2024] [Indexed: 05/25/2024]
Abstract
Green space exposure has been associated with improved mental, physical and general health. However, the underlying biological mechanisms remain largely unknown. The aim of this study was to investigate the association between green space exposure and cord and child blood DNA methylation. Data from eight European birth cohorts with a total of 2,988 newborns and 1,849 children were used. Two indicators of residential green space exposure were assessed: (i) surrounding greenness (satellite-based Normalized Difference Vegetation Index (NDVI) in buffers of 100 m and 300 m) and (ii) proximity to green space (having a green space ≥ 5,000 m2 within a distance of 300 m). For these indicators we assessed two exposure windows: (i) pregnancy, and (ii) the period from pregnancy to child blood DNA methylation assessment, named as cumulative exposure. DNA methylation was measured with the Illumina 450K or EPIC arrays. To identify differentially methylated positions (DMPs) we fitted robust linear regression models between pregnancy green space exposure and cord blood DNA methylation and between cumulative green space exposure and child blood DNA methylation. Two sensitivity analyses were conducted: (i) without adjusting for cellular composition, and (ii) adjusting for air pollution. Cohort results were combined through fixed-effect inverse variance weighted meta-analyses. Differentially methylated regions (DMRs) were identified from meta-analysed results using the Enmix-combp and DMRcate methods. There was no statistical evidence of pregnancy or cumulative exposures associating with any DMP (False Discovery Rate, FDR, p-value < 0.05). However, surrounding greenness exposure was inversely associated with four DMRs (three in cord blood and one in child blood) annotated to ADAMTS2, KCNQ1DN, SLC6A12 and SDK1 genes. Results did not change substantially in the sensitivity analyses. Overall, we found little evidence of the association between green space exposure and blood DNA methylation. Although we identified associations between surrounding greenness exposure with four DMRs, these findings require replication.
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Affiliation(s)
- Sofia Aguilar-Lacasaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain; Universitat de Barcelona, Barcelona, Spain.
| | - Irene Fontes Marques
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Xavier Escribà
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Juan R González
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Rossella Alfano
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium
| | - Isabella Annesi-Maesano
- Desbrest Institute of Epidemiology and Public Health (IDESP), Montpellier University and Inserm, Montpellier, Service des Maladies Allergiques et Respiratoires, CHU, Montpellier, France
| | - Sonia Brescianini
- Centre for Behavioural Science and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Kimberley Burrows
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lucinda Calas
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Ahmed Elhakeem
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Amy Hough
- Born in Bradford, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Elena Isaevska
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy
| | - Vincent W V Jaddoe
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Deborah A Lawlor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Genevieve Monaghan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium; Department of Public Health, Leuven University (KU Leuven), Leuven, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium
| | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy
| | - Aidan Watmuff
- Born in Bradford, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Tiffany C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, UK
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Janine F Felix
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mariona Bustamante
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain
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Wang S, Wang Y, Wan Y, Su P, Tao F, Sun Y. Modifiable factors associated with cognitive performance in Chinese adolescents: a national environment-wide association study. Eur Child Adolesc Psychiatry 2024; 33:1047-1056. [PMID: 37204501 DOI: 10.1007/s00787-023-02229-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 05/11/2023] [Indexed: 05/20/2023]
Abstract
Growing evidence exists about the candidate factors of childhood cognitive performance, but mainly limited to single-exposure studies. We sought to systematically and simultaneously identify and validate a wide range of potential modifiable factors for childhood cognitive performance. We used data from five waves of data from the China Family Panel Studies (CFPS-2010, 2012, 2014, 2016 and 2018). Our analytical sample was restricted to those children aged 2-5 at baseline with valid exposure information. A total of 80 modifiable factors were identified. Childhood cognitive performance was assessed using vocabulary and mathematics test at wave 5. We used an environment-wide association study (EnWAS) to screen all exposure-outcome associations independently and used the least absolute shrinkage and selection operator (LASSO) variable selection algorithm to identify factors associated with cognitive performance. Multivariable linear model was then used to evaluate causal relationships between identified factors and cognitive performance. Of the 1305 participants included in the study (mean ± SD, 3.5 ± 1.1 years age at baseline, 45.1% girls). Eight factors were retained in the LASSO regression analysis. Six factors across community characteristics (percentage of poverty in the community; percentage of children in the community), household characteristics (family size), child health and behaviors (mobile internet access), parenting behaviors and cognitive enrichment (parental involvement in child' s education), and parental wellbeing (paternal happiness) domains were significantly associated with childhood cognition. Using a three-stage approach, this study validates several actionable targets for improving childhood cognitive performance.
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Affiliation(s)
- Shanshan Wang
- Department of Maternal, Child and Adolescent Health, Anhui Medical University School of Public Health, 81 Meishan Road, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
| | - Ya Wang
- Section of Child Health, Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, Anhui Medical University School of Public Health, 81 Meishan Road, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Puyu Su
- Department of Maternal, Child and Adolescent Health, Anhui Medical University School of Public Health, 81 Meishan Road, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, Anhui Medical University School of Public Health, 81 Meishan Road, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, Anhui Medical University School of Public Health, 81 Meishan Road, Hefei, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China.
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7
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Binter AC, Granés L, Bannier E, de Castro M, Petricola S, Fossati S, Vrijheid M, Chevrier C, El Marroun H, Nieuwenhuijsen M, Saint-Amour D, Tiemeier H, Guxens M. Urban environment during pregnancy and childhood and white matter microstructure in preadolescence in two European birth cohorts. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 346:123612. [PMID: 38387546 DOI: 10.1016/j.envpol.2024.123612] [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: 08/17/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024]
Abstract
Growing evidence suggests that urban environment may influence cognition and behavior in children, but the underlying pollutant and neurobiological mechanisms are unclear. We evaluated the association of built environment and urban natural space indicators during pregnancy and childhood with brain white matter microstructure in preadolescents, and examined the potential mediating role of air pollution and road-traffic noise. We used data of the Generation R Study, a population-based birth cohort in Rotterdam, the Netherlands (n = 2725; 2002-2006) for the primary analyses. Replication of the main findings was attempted on an independent neuroimaging dataset from the PELAGIE birth cohort, France (n = 95; 2002-2006). We assessed exposures to 12 built environment and 4 urban natural spaces indicators from conception up to 9 years of age. We computed 2 white matter microstructure outcomes (i.e., average of fractional anisotropy (FA) and mean diffusivity (MD) from 12 white matte tracts) from diffusion tensor imaging data. Greater distance to the nearest major green space during pregnancy was associated with higher whole-brain FA (0.001 (95%CI 0.000; 0.002) per 7 m increase), and higher land use diversity during childhood was associated with lower whole-brain MD (-0.001 (95%CI -0.002; -0.000) per 0.12-point increase), with no evidence of mediation by air pollution nor road-traffic noise. Higher percentage of transport and lower surrounding greenness during pregnancy were associated with lower whole-brain FA, and road-traffic noise mediated 19% and 52% of these associations, respectively. We found estimates in the same direction in the PELAGIE cohort, although confidence intervals were larger and included the null. This study suggests an association between urban environment and white matter microstructure, mainly through road-traffic noise, indicating that greater access to green space nearby might promote white matter development.
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Affiliation(s)
- Anne-Claire Binter
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Laura Granés
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
| | - Elise Bannier
- Inria, CRNS, Inserm, IRISA UMR 6074, Empenn U1228, Univ Rennes, Rennes, France; CHU Rennes, Department of Radiology, Rennes, France
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Sami Petricola
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Cécile Chevrier
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Rotterdam, the Netherlands
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Dave Saint-Amour
- Département de Psychologie, Université du Québec à Montréal, Montréal, Québec, Canada; Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
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8
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Ye T, Xu R, Abramson MJ, Guo Y, Zhang Y, Saldiva PHN, Coelho MSZS, Li S. Maternal greenness exposure and preterm birth in Brazil: A nationwide birth cohort study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123156. [PMID: 38142032 DOI: 10.1016/j.envpol.2023.123156] [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: 09/07/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023]
Abstract
In the dynamic landscape of maternal and child health, understanding the intricate interplay between environmental factors and pregnancy outcomes is of paramount importance. This study investigates the relationship between maternal greenness exposure and preterm births in Brazil using data spanning from 2010 to 2019. Satellite-derived indices, including the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), were employed to assess greenness exposure during whole pregnancy in maternal residential area. Employing Cox proportional hazard models, we calculated the hazard ratios (HRs) with 95% confidence intervals (CIs) for changes in NDVI, while adjusting for individual and area-level covariates. In total, 24,010,250 live births were included. Prevalence of preterm birth was 11.5%, with a modest but statistically significant decreasing trend (p = 0.013) observed across the nation over the study period. The findings reveal a significant association between greenness exposure and a reduced risk of preterm birth. Specifically, for every 0.1 increase in NDVI, there was a 2.0% decrease in the risk of preterm birth (95%CI: 1.9%-2.2%). Stratified analyses based on maternal education and ethnicity indicated potential effect modifications, with stronger protective effects observed among younger mothers and those with less years of education. Sensitivity analyses using EVI yielded consistent results. In conclusion, this study suggests that higher maternal greenness exposure is linked to a decreased risk of preterm birth in Brazil. These findings imply that enhancing residential greenspaces could be a valuable public health strategy to promote maternal and child health in Brazil.
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Affiliation(s)
- Tingting Ye
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Michael J Abramson
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yiwen Zhang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Paulo H N Saldiva
- Urban Health Laboratory University of São Paulo, Faculty of Medicine/INSPER, São Paulo, 01246-903, Brazil
| | - Micheline S Z S Coelho
- Urban Health Laboratory University of São Paulo, Faculty of Medicine/INSPER, São Paulo, 01246-903, Brazil
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
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9
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McEachan RRC, Santorelli G, Watmuff A, Mason D, Barber SE, Bingham DD, Bird PK, Lennon L, Lewer D, Mon-Williams M, Shire KA, Waiblinger D, West J, Yang TC, Lawlor DA, Pickett KE, Wright J. Cohort Profile Update: Born in Bradford. Int J Epidemiol 2024; 53:dyae037. [PMID: 38552669 PMCID: PMC11065350 DOI: 10.1093/ije/dyae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/27/2024] [Indexed: 05/04/2024] Open
Affiliation(s)
- Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Gillian Santorelli
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Aidan Watmuff
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Daniel D Bingham
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, UK
| | - Philippa K Bird
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Laura Lennon
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Dan Lewer
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Mark Mon-Williams
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
| | - Katy A Shire
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Dagmar Waiblinger
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Jane West
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Tiffany C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Clifton, Bristol, UK
- Bristol Medical School, University of Bristol, Clifton, Bristol, UK
| | - Kate E Pickett
- Department of Health Sciences, University of York, York, West Yorkshire, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, West Yorkshire, UK
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10
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YOU L, SUN G, YU D, LIU X, XU G. [New advances in exposomics-analysis methods and research paradigms based on chromatography-mass spectrometry]. Se Pu 2024; 42:109-119. [PMID: 38374591 PMCID: PMC10877474 DOI: 10.3724/sp.j.1123.2023.12001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Indexed: 02/21/2024] Open
Abstract
The occurrence and development of human diseases are influenced by both genetic and environmental factors. Research models that describe disease occurrence only from the perspective of genetics present certain limitations. In recent years, effects of environment factors on the occurrence and development of diseases have attracted extensive attentions. Exposomics focuses on the measurement of all exposure factors in an individual's life and how these factors are related to disease development. Exposomics provides new ideas to promote studies on the relationship between human health and environmental factors. Environmental exposures are characterized with different physical and chemical properties, as well as very low concentrations in vivo, which contribute great challenges in the comprehensive measurement of chemical residues in the human body. Chromatography-mass spectrometry-based technologies combine the high-efficiency separation ability of chromatography with the high resolution and sensitive detection characteristics of mass spectrometry; the combination of these techniques can achieve the high-coverage, high-throughput, and sensitive detection of environmental exposures, thus providing a powerful tool for measuring chemical exposures. Exposomics-analysis methods based on chromatography-mass spectrometry mainly include targeted quantitative analysis, suspect screening, and non-targeted screening. To explore the relationship between environmental exposure and the occurrence and development of diseases, researchers have developed research paradigms, including exposome wide association study, mixed-exposure study, exposomics and multi-omics (genome, transcriptome, proteome, metabolome)-association study, and so on. The emergence of these methods has brought about unprecedented developments in exposomics studies. In this manuscript, analytical methods based on chromatography-mass spectrometry, exposomics research paradigms, and their relevant prospects are reviewed.
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11
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Ahmer Z, Atif M, Zaheer S, Adil O, Shaikh S, Shafique K. Association between residential green spaces and pregnancy outcomes: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-18. [PMID: 38185100 DOI: 10.1080/09603123.2023.2299242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Abstract
Residential exposure to greenness has shown positive influences on pregnancy outcomes like birth weight, preterm births, and small to gestational age (SGA) deliveries. We aimed to comprehensively review and investigate these associations by conducting a systematic review with meta-analysis. Relevant studies were retrieved from PubMed, EMBASE, ScienceDirect, and Google Scholar databases before June 2023. Summary effect estimates included birth weight, low birth weight (LBW), preterm births, and SGA which were calculated for 0.1 unit increase in residential greenness exposure. Overall quality of the evidence was examined through Joanna Briggs Institute (JBI) critical appraisal tool. The review included 31 articles and found a statistically significant increase in birth weight measured at 250 m buffer distance (β = 8.95, 95% CI = 1.63-16.27). Green spaces were also associated with lower odds of LBW (OR = 0.97, 95% CI = 0.96-0.98). Residential greenness had positive impacts on pregnancy outcomes that calls for emphasis on urban planning, especially in developing countries.
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Affiliation(s)
- Zaeema Ahmer
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Maria Atif
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Sidra Zaheer
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Omair Adil
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Shiraz Shaikh
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | - Kashif Shafique
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
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12
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Persson Waye K, Löve J, Lercher P, Dzhambov AM, Klatte M, Schreckenberg D, Belke C, Leist L, Ristovska G, Jeram S, Kanninen KM, Selander J, Arat A, Lachmann T, Clark C, Botteldooren D, White K, Julvez J, Foraster M, Kaprio J, Bolte G, Psyllidis A, Gulliver J, Boshuizen H, Bozzon A, Fels J, Hornikx M, van den Hazel P, Weber M, Brambilla M, Braat-Eggen E, Van Kamp I, Vincens N. Adopting a child perspective for exposome research on mental health and cognitive development - Conceptualisation and opportunities. ENVIRONMENTAL RESEARCH 2023; 239:117279. [PMID: 37778607 DOI: 10.1016/j.envres.2023.117279] [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: 07/09/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/03/2023]
Abstract
Mental disorders among children and adolescents pose a significant global challenge. The exposome framework covering the totality of internal, social and physical exposures over a lifetime provides opportunities to better understand the causes of and processes related to mental health, and cognitive functioning. The paper presents a conceptual framework on exposome, mental health, and cognitive development in children and adolescents, with potential mediating pathways, providing a possibility for interventions along the life course. The paper underscores the significance of adopting a child perspective to the exposome, acknowledging children's specific vulnerability, including differential exposures, susceptibility of effects and capacity to respond; their susceptibility during development and growth, highlighting neurodevelopmental processes from conception to young adulthood that are highly sensitive to external exposures. Further, critical periods when exposures may have significant effects on a child's development and future health are addressed. The paper stresses that children's behaviour, physiology, activity pattern and place for activities make them differently vulnerable to environmental pollutants, and calls for child-specific assessment methods, currently lacking within today's health frameworks. The importance of understanding the interplay between structure and agency is emphasized, where agency is guided by social structures and practices and vice-versa. An intersectional approach that acknowledges the interplay of social and physical exposures as well as a global and rural perspective on exposome is further pointed out. To advance the exposome field, interdisciplinary efforts that involve multiple scientific disciplines are crucial. By adopting a child perspective and incorporating an exposome approach, we can gain a comprehensive understanding of how exposures impact children's mental health and cognitive development leading to better outcomes.
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Affiliation(s)
- Kerstin Persson Waye
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Jesper Löve
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Peter Lercher
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Angel M Dzhambov
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria; Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Research Group "Health and Quality of Life in a Green and Sustainable Environment", SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Bulgaria
| | - Maria Klatte
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Dirk Schreckenberg
- Centre for Applied Psychology, Environmental and Social Research (Zeus GmbH), Hagen, Germany
| | - Christin Belke
- Centre for Applied Psychology, Environmental and Social Research (Zeus GmbH), Hagen, Germany
| | - Larisa Leist
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Gordana Ristovska
- Institute of Public Health of the Republic of North Macedonia, Skopje, Macedonia
| | - Sonja Jeram
- National Institute of Public Health, Ljubljana, Slovenia
| | - Katja M Kanninen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jenny Selander
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Arzu Arat
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Lachmann
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany; Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, Madrid, Spain
| | - Charlotte Clark
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Dick Botteldooren
- Department of Information Technology, Faculty of Engineering and Architecture, Ghent University, Ghent, Belgium
| | - Kim White
- National Institute for Public Health and the Environment, Netherlands
| | - Jordi Julvez
- Institut D'Investigació Sanitària Pere Virgili (IISPV), Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Reus, Spain
| | | | - Jaakko Kaprio
- Institute for Molecular Medicine Finland and Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Gabriele Bolte
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Achilleas Psyllidis
- Department of Sustainable Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - John Gulliver
- Population Health Research Institute, St George's, University of London, London, United Kingdom; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom
| | - Hendriek Boshuizen
- Department for Statistics, Datascience and Mathematical Modelling, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Alessandro Bozzon
- Department of Sustainable Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - Janina Fels
- Institute for Hearing Technology and Acoustics, RWTH Aachen University, Aachen, Germany
| | - Maarten Hornikx
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Peter van den Hazel
- International Network on Children's Health, Environment and Safety, Ellecom, the Netherlands
| | | | - Marco Brambilla
- Data Science Laboratory, Politecnico di Milano, Milan, Italy
| | | | - Irene Van Kamp
- National Institute for Public Health and the Environment, Netherlands
| | - Natalia Vincens
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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13
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Liu N, Deng Q, Hu P, Chang J, Li Y, Zhang Y, Su Y, Liu J, Long Y. Associations between urban exposome and recurrence risk among survivors of acute myocardial infarction in Beijing, China. ENVIRONMENTAL RESEARCH 2023; 238:117267. [PMID: 37776939 PMCID: PMC7615203 DOI: 10.1016/j.envres.2023.117267] [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: 05/22/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023]
Abstract
Few previous studies have investigated the impacts of coexposure to multiple urban environmental factors on the prognosis of acute myocardial infarction (AMI) events. This study aimed to evaluate the associations between the urban exposome and AMI recurrence. We used data from 88,509 AMI patients from a large cohort obtained from the Beijing Cardiovascular Disease Surveillance System between 2013 and 2019. Twenty-six types of urban exposures were assessed within 300-m, 500-m, and 1000-m buffers of patients' home addresses in the baseline and cumulative average levels. We used the Cox proportional hazard model along with the Elastic Net (ENET) algorithm to estimate the hazard ratios (HRs) of recurrent AMI per interquartile range increase in each selected urban exposure. The increased risk of AMI recurrence was significantly associated with lower urban function diversity in the 500-m buffer, longer distance to subway stations and higher PM2.5 for both baseline and cumulative average exposure. The cumulative averages of two urban factors, including the distance to parks, and the density of fruit and vegetable shops in the 1000-m buffer, were also identified as significant factors affecting the risk of AMI recurrence. These findings can help improve the urban design for promoting human cardiovascular health.
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Affiliation(s)
- Ningrui Liu
- School of Architecture, Tsinghua University, Beijing, China
| | - Qiuju Deng
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China
| | - Piaopiao Hu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China
| | - Jie Chang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China
| | - Yan Li
- School of Architecture, Tsinghua University, Beijing, China
| | - Yuyang Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Yuwei Su
- School of Architecture, Tsinghua University, Beijing, China; School of Urban Design, Wuhan University, Wuhan, China
| | - Jing Liu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China.
| | - Ying Long
- School of Architecture, Tsinghua University, Beijing, China; Hang Lung Center for Real Estate, Key Laboratory of Eco Planning & Green Building, Ministry of Education, Tsinghua University, Beijing, China.
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14
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Anguita-Ruiz A, Amine I, Stratakis N, Maitre L, Julvez J, Urquiza J, Luo C, Nieuwenhuijsen M, Thomsen C, Grazuleviciene R, Heude B, McEachan R, Vafeiadi M, Chatzi L, Wright J, Yang TC, Slama R, Siroux V, Vrijheid M, Basagaña X. Beyond the single-outcome approach: A comparison of outcome-wide analysis methods for exposome research. ENVIRONMENT INTERNATIONAL 2023; 182:108344. [PMID: 38016387 DOI: 10.1016/j.envint.2023.108344] [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: 07/28/2023] [Revised: 10/16/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023]
Abstract
Outcome-wide analysis can offer several benefits, including increased power to detect weak signals and the ability to identify exposures with multiple effects on health, which may be good targets for preventive measures. Recently, advanced statistical multivariate techniques for outcome-wide analysis have been developed, but they have been rarely applied to exposome analysis. In this work, we provide an overview of a selection of methods that are well-suited for outcome-wide exposome analysis and are implemented in the R statistical software. Our work brings together six different methods presenting innovative solutions for typical problems arising from outcome-wide approaches in the context of the exposome, including dependencies among outcomes, high dimensionality, mixed-type outcomes, missing data records, and confounding effects. The identified methods can be grouped into four main categories: regularized multivariate regression techniques, multi-task learning approaches, dimensionality reduction approaches, and bayesian extensions of the multivariate regression framework. Here, we compare each technique presenting its main rationale, strengths, and limitations, and provide codes and guidelines for their application to exposome data. Additionally, we apply all selected methods to a real exposome dataset from the Human Early-Life Exposome (HELIX) project, demonstrating their suitability for exposome research. Although the choice of the best method will always depend on the challenges to be faced in each application, for an exposome-like analysis we find dimensionality reduction and bayesian methods such as reduced rank regression (RRR) or multivariate bayesian shrinkage priors (MBSP) particularly useful, given their ability to deal with critical issues such as collinearity, high-dimensionality, missing data or quantification of uncertainty.
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Affiliation(s)
- Augusto Anguita-Ruiz
- ISGlobal, 08003 Barcelona, Spain; CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ines Amine
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to the Development and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France
| | | | - Lea Maitre
- ISGlobal, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Jordi Julvez
- ISGlobal, 08003 Barcelona, Spain; CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020 Valencia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Clinical and Epidemiological Neuroscience Group (NeuroÈpia), 43204 Reus (Tarragona), Catalonia, Spain
| | | | - Chongliang Luo
- Division of Public Health Sciences, Washington University School of Medicine in St. Louis, 600 S Taylor Ave, St. Louis, MO 63110, USA
| | - Mark Nieuwenhuijsen
- ISGlobal, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Cathrine Thomsen
- Department of Food Safety, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Regina Grazuleviciene
- Department of Environmental Science, Vytautas Magnus University, 44248 Kaunas, Lithuania
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Leda Chatzi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Tiffany C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Rémy Slama
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to the Development and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Valérie Siroux
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to the Development and Respiratory Health, Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Martine Vrijheid
- ISGlobal, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Xavier Basagaña
- ISGlobal, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
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15
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Marques I, Santos S, Monasso GS, Fossati S, Vrijheid M, Nieuwenhuijsen M, Jaddoe VWV, Felix JF. Associations of green and blue space exposure in pregnancy with epigenetic gestational age acceleration. Epigenetics 2023; 18:2165321. [PMID: 36628941 PMCID: PMC9980449 DOI: 10.1080/15592294.2023.2165321] [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] [Indexed: 01/12/2023] Open
Abstract
Early life is seen as a particularly sensitive period for environmental exposures. Natural space exposure during pregnancy has been associated with offspring health. Epigenetic gestational age acceleration, a discrepancy between clinical and DNA methylation-based gestational age, may underlie these associations. In 1359 mother-newborn pairs from the population-based Generation R Study, we examined the associations of natural space exposure, defined as surrounding greenness, distance to major green and blue (water) space, and size of the blue space during pregnancy with offspring epigenetic gestational age acceleration. Natural space exposure was based on participants' geocoded addresses, and epigenetic gestational age acceleration was calculated from cord blood DNA methylation using Bohlin's and Knight's epigenetic clocks. Sensitivity analyses were conducted in a subgroup of newborns with optimal pregnancy dating, based on last menstrual period. Surrounding greenness, measured in normalized difference vegetation index values, was intermediate (median 0.4, IQR 0.2), and 84% and 56% of the participants had a major green or blue space near their home address, respectively. We did not observe associations of natural space availability during pregnancy with offspring epigenetic gestational age acceleration. This could imply that epigenetic gestational age acceleration in cord blood does not underlie the effects of residential natural space availability in pregnancy on offspring health. Future studies could investigate whether residential natural space availability during pregnancy is associated with offspring differential DNA methylation at other CpGs than those included in the epigenetic gestational clocks.
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Affiliation(s)
- Irene Marques
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Susana Santos
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
| | - Giulietta S Monasso
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Serena Fossati
- ISGlobal, Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBER), Madrid, Spain
| | - Martine Vrijheid
- ISGlobal, Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBER), Madrid, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBER), Madrid, Spain
| | - Vincent W V Jaddoe
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Janine F Felix
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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16
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Luo S, Wang Y, Mayvaneh F, Relvas H, Baaghideh M, Wang K, Yuan Y, Yin Z, Zhang Y. Surrounding greenness is associated with lower risk and burden of low birth weight in Iran. Nat Commun 2023; 14:7595. [PMID: 37989742 PMCID: PMC10663448 DOI: 10.1038/s41467-023-43425-6] [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: 03/02/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023] Open
Abstract
The nexus between prenatal greenspace exposure and low birth weight (LBW) remains largely unstudied in low- and middle-income countries (LMICs). We investigated a nationwide retrospective cohort of 4,021,741 live births (263,728 LBW births) across 31 provinces in Iran during 2013-2018. Greenness exposure during pregnancy was assessed using satellite-based normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). We estimated greenness-LBW associations using multiple logistic models, and quantified avoidable LBW cases under scenarios of improved greenspace through counterfactual analyses. Association analyses provide consistent evidence for approximately L-shaped exposure-response functions, linking 7.0-11.5% declines in the odds of LBW to each 0.1-unit rise in NDVI/EVI with multiple buffers. Assuming causality, 3931-5099 LBW births can be avoided by achieving greenness targets of mean NDVI/EVI, amounting to 4.4-5.6% of total LBW births in 2015. Our findings suggest potential health benefits of improved greenspace in lowering LBW risk and burden in LMICs.
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Affiliation(s)
- Siqi Luo
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Institute of Social Development and Health Management, Wuhan University of Science and Technology, 430065, Wuhan, China
| | - Yaqi Wang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Institute of Social Development and Health Management, Wuhan University of Science and Technology, 430065, Wuhan, China
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, 9617916487, Khorasan Razavi, Iran.
| | - Helder Relvas
- CESAM & Department of Environment and Planning, University of Aveiro, 3810-193, Aveiro, Portugal
| | - Mohammad Baaghideh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, 9617916487, Khorasan Razavi, Iran
| | - Kai Wang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Institute of Social Development and Health Management, Wuhan University of Science and Technology, 430065, Wuhan, China
| | - Yang Yuan
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Institute of Social Development and Health Management, Wuhan University of Science and Technology, 430065, Wuhan, China
| | - Zhouxin Yin
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Institute of Social Development and Health Management, Wuhan University of Science and Technology, 430065, Wuhan, China
| | - Yunquan Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Institute of Social Development and Health Management, Wuhan University of Science and Technology, 430065, Wuhan, China.
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17
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Masselot P, Chebana F, Campagna C, Lavigne É, Ouarda TBMJ, Gosselin P. Constrained groupwise additive index models. Biostatistics 2023; 24:1066-1084. [PMID: 35791751 PMCID: PMC10583725 DOI: 10.1093/biostatistics/kxac023] [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: 01/25/2021] [Revised: 05/28/2022] [Accepted: 06/06/2022] [Indexed: 10/19/2023] Open
Abstract
In environmental epidemiology, there is wide interest in creating and using comprehensive indices that can summarize information from different environmental exposures while retaining strong predictive power on a target health outcome. In this context, the present article proposes a model called the constrained groupwise additive index model (CGAIM) to create easy-to-interpret indices predictive of a response variable, from a potentially large list of variables. The CGAIM considers groups of predictors that naturally belong together to yield meaningful indices. It also allows the addition of linear constraints on both the index weights and the form of their relationship with the response variable to represent prior assumptions or operational requirements. We propose an efficient algorithm to estimate the CGAIM, along with index selection and inference procedures. A simulation study shows that the proposed algorithm has good estimation performances, with low bias and variance and is applicable in complex situations with many correlated predictors. It also demonstrates important sensitivity and specificity in index selection, but non-negligible coverage error on constructed confidence intervals. The CGAIM is then illustrated in the construction of heat indices in a health warning system context. We believe the CGAIM could become useful in a wide variety of situations, such as warning systems establishment, and multipollutant or exposome studies.
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Affiliation(s)
- Pierre Masselot
- Department of Public Health, Environment and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
| | - Fateh Chebana
- Centre Eau-Terre-Environnement, Institut National de la Recherche Scientifique, 490, rue de la Couronne, Québec (Québec), G1K 9A9, Canada
| | - Céline Campagna
- Centre Eau-Terre-Environnement, Institut National de la Recherche Scientifique, 490, rue de la Couronne, Québec (Québec), G1K 9A9, Canada and Institut National de Santé Publique du Québec, 945, avenue Wolfe Québec (Québec) G1V 5B3 Canada
| | - Éric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario K1G 5Z3, Canada and Air Health Science Division, Health Canada, 269 Laurier Avenue West, Mail Stop 4903B, Ottawa, Ontario K1A0K9 Canada
| | - Taha B M J Ouarda
- Centre Eau-Terre-Environnement, Institut National de la Recherche Scientifique, 490, rue de la Couronne, Québec (Québec), G1K 9A9, Canada
| | - Pierre Gosselin
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada, Institut National de Santé Publique du Québec, Québec, Canada, and Ouranos, Montréal, 550 Sherbrooke Ouest, Tour Ouest, 19eme Étage, Montréal (Québec), H3A 1B9, Canada
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18
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John EE, Astell-Burt T, Yu P, Brennan-Horley C, Feng X. Development of a composite healthy ageing score: evidence from middle-to-older aged Australians. Health Promot Int 2023; 38:daad043. [PMID: 37480585 PMCID: PMC10682690 DOI: 10.1093/heapro/daad043] [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] [Indexed: 07/24/2023] Open
Abstract
We developed and validated a composite healthy ageing score (HAS) to address the absence of a definitive composite score comprising multiple health domains that measure healthy ageing in epidemiology. The HAS is developed from 13 health domains reported to influence healthy ageing. Data to measure these domains was extracted from the 45 and Up Study baseline. We applied best practices for scale validation and development. Physical functioning, cognitive function, mental health, sleep, quality of life, balance, social connections and overall health were retained. Functional capacity and resilience were uncovered as underlying latent structures. The HAS ranges from 0 to 16 with higher scores indicating a better health profile. This research contributes a comprehensive measuring tool, HAS, It enables examination and comparison of individual or collective health profiles and the investigation of the factors that influence their chances of living healthy for longer.
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Affiliation(s)
- Eme Eseme John
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Ping Yu
- Centre for IT Enabled Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Chris Brennan-Horley
- School of Geography and Sustainable Communities, and Australian Centre for Culture, Environment, Society and Space (ACCESS), University of Wollongong, Wollongong, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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19
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Hu H, Liu X, Zheng Y, He X, Hart J, James P, Laden F, Chen Y, Bian J. Methodological Challenges in Spatial and Contextual Exposome-Health Studies. CRITICAL REVIEWS IN ENVIRONMENTAL SCIENCE AND TECHNOLOGY 2023; 53:827-846. [PMID: 37138645 PMCID: PMC10153069 DOI: 10.1080/10643389.2022.2093595] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The concept of the exposome encompasses the totality of exposures from a variety of external and internal sources across an individual's life course. The wealth of existing spatial and contextual data makes it appealing to characterize individuals' external exposome to advance our understanding of environmental determinants of health. However, the spatial and contextual exposome is very different from other exposome factors measured at the individual-level as spatial and contextual exposome data are more heterogenous with unique correlation structures and various spatiotemporal scales. These distinctive characteristics lead to multiple unique methodological challenges across different stages of a study. This article provides a review of the existing resources, methods, and tools in the new and developing field for spatial and contextual exposome-health studies focusing on four areas: (1) data engineering, (2) spatiotemporal data linkage, (3) statistical methods for exposome-health association studies, and (4) machine- and deep-learning methods to use spatial and contextual exposome data for disease prediction. A critical analysis of the methodological challenges involved in each of these areas is performed to identify knowledge gaps and address future research needs.
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Affiliation(s)
- Hui Hu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Xiaokang Liu
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yi Zheng
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Xing He
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Jaime Hart
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Pilgrim Healthcare, Boston, Massachusetts, USA
| | - Francine Laden
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Yong Chen
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
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20
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Graafland N, Essers E, Posthumus A, Gootjes D, Ambrós A, Steegers E, Guxens M. Exposure to outdoor residential noise during pregnancy, embryonic size, fetal growth, and birth outcomes. ENVIRONMENT INTERNATIONAL 2023; 171:107730. [PMID: 36640487 DOI: 10.1016/j.envint.2023.107730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 12/01/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Previous literature suggested that noise exposure during pregnancy was not associated with adverse birth outcomes. However, no studies evaluated the association between noise exposure and embryonic and fetal growth, or mutually assessed other urban environmental exposures such as traffic-related air pollution or natural spaces. METHODS We included 7947 pregnant women from the Generation R Study, the Netherlands. We estimated total (road traffic, aircraft, railway, and industry), road traffic, and railway noise at the participants' home addresses during pregnancy using environmental noise maps. We estimated traffic-related air pollution using land-use regression models, greenness within a 300 m buffer using the normalized difference vegetation index, and distance to blue spaces using topographical maps at the home addresses. Embryonic size (crown-rump length) and fetal growth parameters (head circumference, femur length, and estimated fetal weight) were measured by ultrasound at several gestational ages. Information on neonatal anthropometrics at birth (head circumference, length, and weight) and adverse birth outcomes (preterm birth, low birth weight, and small for gestational age) were retrieved from medical records. RESULTS Higher total noise exposure during pregnancy was associated with larger crown-rump length (0.07 SDS [95%CI 0.00 to 0.14]). No association was found with fetal growth parameters, neonatal anthropometrics, and adverse birth outcomes. Similar results were observed for road traffic noise exposure, while railway noise exposure was not associated with any of the outcomes. Traffic-related air pollution was not associated with crown-rump length. Total noise exposure mediated 15% of the association between exposure to greenness and smaller crown-rump length. No association was observed between distance to blue spaces and total noise exposure. CONCLUSION Exposure to outdoor residential noise during pregnancy was associated with larger embryonic size. Moreover, a reduction of total noise exposure during pregnancy partially mediated the association between exposure to greenness and smaller embryonic size. Additional research is warranted to confirm and further understand these novel findings.
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Affiliation(s)
- Naomi Graafland
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Esmée Essers
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Anke Posthumus
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Dionne Gootjes
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Albert Ambrós
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Eric Steegers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
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Harville EW, Grady SK, Langston MA, Juarez PJ, Vilda D, Wallace ME. The public health exposome and pregnancy-related mortality in the United States: a high-dimensional computational analysis. BMC Public Health 2022; 22:2097. [PMID: 36384521 PMCID: PMC9670647 DOI: 10.1186/s12889-022-14397-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 10/19/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Racial inequities in maternal mortality in the U.S. continue to be stark. METHODS The 2015-2018, 4-year total population, county-level, pregnancy-related mortality ratio (PRM; deaths per 100,000 live births; National Center for Health Statistics (NCHS), restricted use mortality file) was linked with the Public Health Exposome (PHE). Using data reduction techniques, 1591 variables were extracted from over 62,000 variables for use in this analysis, providing information on the relationships between PRM and the social, health and health care, natural, and built environments. Graph theoretical algorithms and Bayesian analysis were applied to PHE/PRM linked data to identify latent networks. RESULTS PHE variables most strongly correlated with total population PRM were years of potential life lost and overall life expectancy. Population-level indicators of PRM were overall poverty, smoking, lack of exercise, heat, and lack of adequate access to food. CONCLUSIONS In this high-dimensional analysis, overall life expectancy, poverty indicators, and health behaviors were found to be the strongest predictors of pregnancy-related mortality. This provides strong evidence that maternal death is part of a broader constellation of both similar and unique health behaviors, social determinants and environmental exposures as other causes of death.
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Affiliation(s)
- E W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
| | - S K Grady
- Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN, USA
| | - M A Langston
- Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN, USA
| | - P J Juarez
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA
| | - D Vilda
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - M E Wallace
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
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22
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Šulc L, Gregor P, Kalina J, Mikeš O, Janoš T, Čupr P. City-scale assessment of long-term air quality impacts on the respiratory and cardiovascular health. Front Public Health 2022; 10:1006536. [PMID: 36438287 PMCID: PMC9687097 DOI: 10.3389/fpubh.2022.1006536] [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: 07/29/2022] [Accepted: 10/17/2022] [Indexed: 11/12/2022] Open
Abstract
Background The impact of the urban environment on human health is a contemporary subject of environmental research. Air pollution is often considered a leading environmental driver. However, a plethora of other factors within the urban exposome may be involved. At the same time, the resolution of spatial data is also an important facet to consider. Generally, systematic tools for accurate health risk assessment in the urban environment are missing or are not implemented. Methods The long-term impact of air quality (PM10, PM2.5, NO2, benzene, and SO2) on respiratory and cardiovascular health was assessed with a log-linear model. We used the most accurate health data in high city scale spatial resolution over the period 2010 to 2018. Selected external exposome parameters were also included in the analysis. Results Statistically significant associations between air pollution and the health of the urban population were found. The strongest association was between benzene and the incidence of bronchitis in the adult population [RR 1.552 95% CI (1.415-1.704) per 0.5 μg/m3 change in benzene concentration]. A similar relation was observed between NO2 and the same health condition [RR 1.483 95% CI (1.227-1.792) per 8.9 μg/m3 of change in NO2]. Other weaker associations were also found between asthma in children and PMs, NO2, or benzene. Cardiovascular-related hospitalizations in the general population were linked with NO2 [RR 1.218 95% CI (1.119-1.325) per 9.7 μg/m3 change in NO2]. The remaining pollutants were slightly less but still significantly associated with cardiovascular-related hospitalizations. Conclusion Our findings are mostly highly statistically significant (p ≤ 0.001) and are in line with current literature on the adverse effects of air pollution on the human population. The results highlight the need for continual improvements in air quality. We propose the implementation of this approach as a systematic tool for the investigation of possible health risks over a long period of time. However, further research involving other variables is an essential step toward understanding the complex urban exposome and its implications for human health. An increase in data spatial resolution is especially important in this respect as well as for improving city health risk management.
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Ding E, Wang Y, Liu J, Tang S, Shi X. A review on the application of the exposome paradigm to unveil the environmental determinants of age-related diseases. Hum Genomics 2022; 16:54. [DOI: 10.1186/s40246-022-00428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/29/2022] [Indexed: 11/11/2022] Open
Abstract
AbstractAge-related diseases account for almost half of all diseases among adults worldwide, and their incidence is substantially affected by the exposome, which is the sum of all exogenous and endogenous environmental exposures and the human body’s response to these exposures throughout the entire lifespan. Herein, we perform a comprehensive review of the epidemiological literature to determine the key elements of the exposome that affect the development of age-related diseases and the roles of aging hallmarks in this process. We find that most exposure assessments in previous aging studies have used a reductionist approach, whereby the effect of only a single environmental factor or a specific class of environmental factors on the development of age-related diseases has been examined. As such, there is a lack of a holistic and unbiased understanding of the effect of multiple environmental factors on the development of age-related diseases. To address this, we propose several research strategies based on an exposomic framework that could advance our understanding—in particular, from a mechanistic perspective—of how environmental factors affect the development of age-related diseases. We discuss the statistical methods and other methods that have been used in exposome-wide association studies, with a particular focus on multiomics technologies. We also address future challenges and opportunities in the realm of multidisciplinary approaches and genome–exposome epidemiology. Furthermore, we provide perspectives on precise public health services for vulnerable populations, public communications, the integration of risk exposure information, and the bench-to-bedside translation of research on age-related diseases.
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Fernández-Barrés S, Robinson O, Fossati S, Márquez S, Basagaña X, de Bont J, de Castro M, Donaire-Gonzalez D, Maitre L, Nieuwenhuijsen M, Romaguera D, Urquiza J, Chatzi L, Iakovides M, Vafeiadi M, Grazuleviciene R, Dedele A, Andrusaityte S, Marit Aasvang G, Evandt J, Hjertager Krog N, Lepeule J, Heude B, Wright J, McEachan RRC, Sassi F, Vineis P, Vrijheid M. Urban environment and health behaviours in children from six European countries. ENVIRONMENT INTERNATIONAL 2022; 165:107319. [PMID: 35667344 DOI: 10.1016/j.envint.2022.107319] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/05/2022] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Urban environmental design is increasingly considered influential for health and wellbeing, but evidence is mostly based on adults and single exposure studies. We evaluated the association between a wide range of urban environment characteristics and health behaviours in childhood. METHODS We estimated exposure to 32 urban environment characteristics (related to the built environment, traffic, and natural spaces) for home and school addresses of 1,581 children aged 6-11 years from six European cohorts. We collected information on health behaviours including total amount of overall moderate-to-vigorous physical activity, physical activity outside school hours, active transport, sedentary behaviours and sleep duration, and developed patterns of behaviours with principal component analysis. We used an exposure-wide association study to screen all exposure-outcome associations, and the deletion-substitution-addition algorithm to build a final multi-exposure model. RESULTS In multi-exposure models, green spaces (Normalized Difference Vegetation Index, NDVI) were positively associated with active transport, and inversely associated with sedentary time (22.71 min/day less (95 %CI -39.90, -5.51) per interquartile range increase in NDVI). Residence in densely built areas was associated with more physical activity and less sedentary time, and densely populated areas with less physical activity outside school hours and more sedentary time. Presence of a major road was associated with lower sleep duration (-4.80 min/day (95 %CI -9.11, -0.48); compared with no major road). Results for the behavioural patterns were similar. CONCLUSIONS This multicohort study suggests that areas with more vegetation, more building density, less population density and without major roads are associated with improved health behaviours in childhood.
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Affiliation(s)
- Sílvia Fernández-Barrés
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain.
| | - Oliver Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK (Norfolk Place, W2 1PG London, UK
| | - Serena Fossati
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Sandra Márquez
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Jeroen de Bont
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - David Donaire-Gonzalez
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology (EEPI), Utrecht University, Utrecht, the Netherlands
| | - Léa Maitre
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Dora Romaguera
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Instituto de Investigación Sanitaria Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma de Mallorca, Spain (Carretera de Valldemossa, 79, 07120 Palma, Balearic Islands, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - José Urquiza
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089-9239, USA
| | - Minas Iakovides
- Environmental Chemical Processes Laboratory (ECPL), Chemistry Department, University of Crete, Heraklion, Crete, Greece; Climate and Atmosphere Research Center (CARE-C), The Cyprus Institute, 20, Konstantinou Kavafi Str., 2121, Aglantzia, Nicosia, Cyprus
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece (Voutes Campus, Heraklion, Crete, GR-71003, Greece
| | - Regina Grazuleviciene
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania (Vileikos g. 8 - 212, LT-44404 Kaunas, Lithuania
| | - Audrius Dedele
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania (Vileikos g. 8 - 212, LT-44404 Kaunas, Lithuania
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania (Vileikos g. 8 - 212, LT-44404 Kaunas, Lithuania
| | - Gunn Marit Aasvang
- Norwegian Institute of Public Health, Oslo, Norway (Lovisenberggata 8, 0456 Oslo, Norway
| | - Jorunn Evandt
- Norwegian Institute of Public Health, Oslo, Norway (Lovisenberggata 8, 0456 Oslo, Norway
| | - Norun Hjertager Krog
- Norwegian Institute of Public Health, Oslo, Norway (Lovisenberggata 8, 0456 Oslo, Norway
| | - Johanna Lepeule
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Development and Respiratory Health, IAB, Grenoble, France
| | - Barbara Heude
- Université de Paris-cité, Center for Research in Epidemiology and StatisticS (CRESS), INSERM, INRAE, F-75004 Paris, France
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK (Bradford Royal Infirmary, Duckworth Lane, BD9 6RJ Bradford, UK
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK (Bradford Royal Infirmary, Duckworth Lane, BD9 6RJ Bradford, UK
| | - Franco Sassi
- Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, UK
| | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK (Norfolk Place, W2 1PG London, UK; Italian Institute of Technology, Genova, Italy
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain (Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain (Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain (Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain.
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Song J, Du P, Yi W, Wei J, Fang J, Pan R, Zhao F, Zhang Y, Xu Z, Sun Q, Liu Y, Chen C, Cheng J, Lu Y, Li T, Su H, Shi X. Using an Exposome-Wide Approach to Explore the Impact of Urban Environments on Blood Pressure among Adults in Beijing-Tianjin-Hebei and Surrounding Areas of China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:8395-8405. [PMID: 35652547 DOI: 10.1021/acs.est.1c08327] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Existing studies mostly explored the association between urban environmental exposures and blood pressure (BP) in isolation, ignoring correlations across exposures. This study aimed to systematically evaluate the impact of a wide range of urban exposures on BP using an exposome-wide approach. A multicenter cross-sectional study was conducted in ten cities of China. For each enrolled participant, we estimated their urban exposures, including air pollution, built environment, surrounding natural space, and road traffic indicator. On the whole, this study comprised three statistical analysis steps, that is, single exposure analysis, multiple exposure analysis and a cluster analysis. We also used deletion-substitution-addition algorithm to conduct variable selection. After considering multiple exposures, for hypertension risk, most significant associations in single exposure model disappeared, with only neighborhood walkability remaining negatively statistically significant. Besides, it was observed that SBP (systolic BP) raised gradually with the increase in PM2.5, but such rising pattern slowed down when PM2.5 concentration reached a relatively high level. For surrounding natural spaces, significant protective associations between green and blue spaces with BP were found. This study also found that high population density and public transport accessibility have beneficially significant association with BP. Additionally, with the increase in the distance to the nearest major road, DBP (diastolic BP) decreased rapidly. When the distance was beyond around 200 m, however, there was no obvious change to DBP anymore. By cluster analysis, six clusters of urban exposures were identified. These findings reinforce the importance of improving urban design, which help promote healthy urban environments to optimize human BP health.
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Affiliation(s)
- Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
| | - Peng Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, Maryland 20742, United States
| | - Jianlong Fang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Yi Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, 288 Herston Road, Herston, Brisbane, Queensland 4006, Australia
| | - Qinghua Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Yingchun Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
| | - Yifu Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, No. 7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
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Li HQ, Feng YW, Yang YX, Leng XY, Zhang PC, Chen SD, Kuo K, Huang SY, Zhang XQ, Dong Y, Han X, Cheng X, Cui M, Tan L, Dong Q, Yu JT. Causal Relations between Exposome and Stroke: A Mendelian Randomization Study. J Stroke 2022; 24:236-244. [PMID: 35677978 PMCID: PMC9194538 DOI: 10.5853/jos.2021.01340] [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] [Received: 04/14/2021] [Accepted: 11/02/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND PURPOSE To explore the causal relationships of elements of the exposome with ischemic stroke and its subtypes at the omics level and to provide evidence for stroke prevention. METHODS We conducted a Mendelian randomization study between exposure and any ischemic stroke (AIS) and its subtypes (large-artery atherosclerotic disease [LAD], cardioembolic stroke [CE], and small vessel disease [SVD]). The exposure dataset was the UK Biobank involving 361,194 subjects, and the outcome dataset was the MEGASTROKE consortium including 52,000 participants. RESULTS We found that higher blood pressure (BP) (systolic BP: odds ratio [OR], 1.02; 95% confidence interval [CI], 1.01 to 1.04; diastolic BP: OR, 1.03; 95% CI, 1.01 to 1.05; pulse pressure: OR, 1.03; 95% CI, 1.00 to 1.06), atrial fibrillation (OR, 1.18; 95% CI, 1.13 to 1.25), and diabetes (OR, 1.13; 95% CI, 1.07 to 1.18) were significantly associated with ischemic stroke. Importantly, higher education (OR, 0.69; 95% CI, 0.60 to 0.79) decreased the risk of ischemic stroke. Higher systolic BP (OR, 1.06; 95% CI, 1.02 to 1.10), pulse pressure (OR, 1.08; 95% CI, 1.02 to 1.14), diabetes (OR, 1.28; 95% CI, 1.13 to 1.45), and coronary artery disease (OR, 1.58; 95% CI, 1.25 to 2.00) could cause LAD. Atrial fibrillation could cause CE (OR, 1.90; 95% CI, 1.71 to 2.11). For SVD, higher systolic BP (OR, 1.04; 95% CI, 1.00 to 1.07), diastolic BP (OR, 1.06; 95% CI, 1.01 to 1.12), and diabetes (OR, 1.22; 95% CI, 1.10 to 1.36) were causal factors. CONCLUSIONS The study revealed elements of the exposome causally linked to ischemic stroke and its subtypes, including conventional causal risk factors and novel protective factors such as higher education.
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Affiliation(s)
- Hong-Qi Li
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yi-Wei Feng
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu-Xiang Yang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xin-Yi Leng
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Prof Can Zhang
- Genetics and Aging Research Unit, McCance Center for Brain Health, Mass General Institute for Neurodegenerative Diseases (MIND), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Shi-Dong Chen
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Kevin Kuo
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shu-Yi Huang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xue-Qing Zhang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yi Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiang Han
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xin Cheng
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Mei Cui
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
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Green Walkability and Physical Activity in UK Biobank: A Cross-Sectional Analysis of Adults in Greater London. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074247. [PMID: 35409927 PMCID: PMC8998308 DOI: 10.3390/ijerph19074247] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/24/2022] [Accepted: 04/01/2022] [Indexed: 02/04/2023]
Abstract
Urban greenspace provides opportunities for outdoor exercise and may increase physical activity, with accompanying health benefits. Areas suitable for walking (walkability) are also associated with increased physical activity, but interactions with greenspace are poorly understood. We investigated associations of walkability and green walkability with physical activity in an urban adult cohort. We used cross-sectional data from Greater London UK Biobank participants (n = 57,726) and assessed walkability along roads and footpaths within 1000 m of their residential addresses. Additionally, we assessed green walkability by integrating trees and low-lying vegetation into the walkability index. Physical activity outcomes included self-reported and accelerometer-measured physical activity and active transport. We assessed associations using log-linear, logistic and linear regression models, adjusted for individual- and area-level confounders. Higher green walkability was associated with favourable International Physical Activity Questionnaire responses and achievement of weekly UK government physical activity guideline recommendations. Participants living in the highest versus lowest quintile of green walkability participated in 2.41 min (95% confidence intervals: 0.22, 4.60) additional minutes of moderate-and-vigorous physical activity per day. Higher walkability and green walkability scores were also associated with choosing active transport modes such as walking and cycling. Our green walkability approach demonstrates the utility in accounting for walkability and greenspace simultaneously to understand the role of the built environment on physical activity.
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Yuchi W, Brauer M, Czekajlo A, Davies HW, Davis Z, Guhn M, Jarvis I, Jerrett M, Nesbitt L, Oberlander TF, Sbihi H, Su J, van den Bosch M. Neighborhood environmental exposures and incidence of attention deficit/hyperactivity disorder: A population-based cohort study. ENVIRONMENT INTERNATIONAL 2022; 161:107120. [PMID: 35144157 DOI: 10.1016/j.envint.2022.107120] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Emerging studies have associated low greenspace and high air pollution exposure with risk of child attention deficit/hyperactivity disorder (ADHD). Population-based studies are limited, however, and joint effects are rarely evaluated. We investigated associations of ADHD incidence with greenspace, air pollution, and noise in a population-based birth cohort. METHODS We assembled a cohort from administrative data of births from 2000 to 2001 (N ∼ 37,000) in Metro Vancouver, Canada. ADHD was identified by hospital records, physician visits, and prescriptions. Cox proportional hazards models were applied to assess associations between environmental exposures and ADHD incidence adjusting for available covariates. Greenspace was estimated using vegetation percentage derived from linear spectral unmixing of Landsat imagery. Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were estimated using land use regression models; noise was estimated using a deterministic model. Exposure period was from birth until the age of three. Joint effects of greenspace and PM2.5 were analysed in two-exposure models and by categorizing values into quintiles. RESULTS During seven-year follow-up, 1217 ADHD cases were diagnosed. Greenspace was associated with lower incidence of ADHD (hazard ratio, HR: 0.90 [0.81-0.99] per interquartile range increment), while PM2.5 was associated with increased incidence (HR: 1.11 [1.06-1.17] per interquartile range increment). NO2 (HR: 1.01 [0.96, 1.07]) and noise (HR: 1.00 [0.95, 1.05]) were not associated with ADHD. There was a 50% decrease in the HR for ADHD in locations with the lowest PM2.5 and highest greenspace exposure, compared to a 62% increase in HR in locations with the highest PM2.5 and lowest greenspace exposure. Effects of PM2.5 were attenuated by greenspace in two-exposure models. CONCLUSIONS We found evidence suggesting environmental inequalities where children living in greener neighborhoods with low air pollution had substantially lower risk of ADHD compared to those with higher air pollution and lower greenspace exposure.
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Affiliation(s)
- Weiran Yuchi
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Michael Brauer
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Agatha Czekajlo
- Department of Forest Resource Management, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Hugh W Davies
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Zoë Davis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Martin Guhn
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Ingrid Jarvis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Michael Jerrett
- Fielding School of Public Health, University of California at Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, the United States
| | - Lorien Nesbitt
- Department of Forest Resource Management, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Tim F Oberlander
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; Department of Pediatrics, The University of British Columbia, 4480 Oak St. Vancouver, Canada
| | - Hind Sbihi
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; BC Centre for Disease Control, Vancouver, Canada
| | - Jason Su
- School of Public Health, University of California at Berkeley, 2121 Berkeley Way West, Berkeley, CA, the United States
| | - Matilda van den Bosch
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada; ISGlobal, Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; Centro de Investigación Biomédica en Red Instituto de Salud Carlos III, Calle de Melchor Fernández Almagro, 3, 28029, Madrid, Spain.
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van den Bosch M, Basagaña X, Mudu P, Kendrovski V, Maitre L, Hjertager Krog N, Aasvang GM, Grazuleviciene R, McEachan R, Vrijheid M, Nieuwenhuijsen MJ. Green CURIOCITY: a study protocol for a European birth cohort study analysing childhood heat-related health impacts and protective effects of urban natural environments. BMJ Open 2022; 12:e052537. [PMID: 35074814 PMCID: PMC8788192 DOI: 10.1136/bmjopen-2021-052537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 01/04/2022] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION The European climate is getting warmer and the impact on childhood health and development is insufficiently understood. Equally, how heat-related health risks can be reduced through nature-based solutions, such as exposure to urban natural environments, is unknown. Green CURe In Outdoor CITY spaces (Green CURIOCITY) will analyse how heat exposure during pregnancy affects birth outcomes and how long-term heat exposure may influence children's neurodevelopment. We will also investigate if adverse effects can be mitigated by urban natural environments. A final goal is to visualise intraurban patterns of heat vulnerability and assist planning towards healthier cities. METHODS AND ANALYSIS We will use existing data from the Human Early-Life Exposure cohort, which includes information on birth outcomes and neurodevelopment from six European birth cohorts. The cohort is linked to data on prenatal heat exposure and impact on birth outcomes will be analysed with logistic regression models, adjusting for air pollution and noise and sociobehavioural covariates. Similarly, impact of cumulative and immediate heat exposure on neurodevelopmental outcomes at age 5 will be assessed. For both analyses, the potentially moderating impact of natural environments will be quantified. For visualisation, Geographical information systems data will be combined to develop vulnerability maps, demonstrating urban 'hot spots' where the risk of negative impacts of heat is aggravated due to sociodemographic and land use patterns. Finally, geospatial and meteorological data will be used for informing GreenUr, an existing software prototype developed by the WHO Regional Office for Europe to quantify health impacts and augment policy tools for urban green space planning. ETHICS AND DISSEMINATION The protocol was approved by the Comité Ético de Investigación Clínica Parc de Salut MAR, Spain. Findings will be published in peer-reviewed journals and presented at policy events. Through stakeholder engagement, the results will also reach user groups and practitioners.
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Affiliation(s)
- Matilda van den Bosch
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Xavier Basagaña
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pierpaolo Mudu
- World Health Organization European Centre for Environment and Health, Bonn, Nordrhein-Westfalen, Germany
| | - Vladimir Kendrovski
- World Health Organization European Centre for Environment and Health, Bonn, Nordrhein-Westfalen, Germany
| | - Léa Maitre
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Gunn Marit Aasvang
- Air Quality and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Regina Grazuleviciene
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, Kaunas, Lithuania
| | | | - Martine Vrijheid
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mark J Nieuwenhuijsen
- Air pollution and Urban Environment, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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30
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Verheyen VJ, Remy S, Govarts E, Colles A, Koppen G, Martin LR, Nielsen F, Bruckers L, Bijnens EM, Vos S, Morrens B, Coertjens D, Loots I, De Decker A, Franken C, Den Hond E, Nelen V, De Henauw S, Covaci A, Van Larebeke N, Teughels C, Nawrot TS, Schoeters G. Determinants of Chronic Biological Stress, Measured as Hair Cortisol Concentration, in a General Population of Adolescents: From Individual and Household Characteristics to Neighborhood Urbanicity. Front Public Health 2021; 9:669022. [PMID: 34888272 PMCID: PMC8650704 DOI: 10.3389/fpubh.2021.669022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 10/14/2021] [Indexed: 11/13/2022] Open
Abstract
Chronic biological stress may adversely affect adolescents' physical and mental health, but insight in the personal and environmental factors that determine chronic stress is limited. We measured 3-month cumulative hair cortisol concentration (HCC) in 419 adolescents, participating in the Flemish Environment and Health Study. Adolescents' health and lifestyle characteristics, household and neighborhood socio-economic status as well as neighborhood urbanicity were assessed as potential determinants of HCC, using multiple linear regression models. We additionally explored heterogeneity of our results by sex. HCC were significantly higher in boys from densely populated neighborhoods, the association was not significant in girls. Accordingly, boys living outside cities had significantly lower HCC than boys, living in cities. HCC was significantly lower in adolescents with an optimal vitality, a measure of a positive mental health status. In adolescent girls, menarcheal status (pre-/postmenarche) was a significant determinant of HCC. Our findings are the first to suggest that residential urbanicity may have an impact on chronic biological stress in a general population of adolescent boys.
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Affiliation(s)
- Veerle J Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | | | - Flemming Nielsen
- Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Liesbeth Bruckers
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Esmée M Bijnens
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Stijn Vos
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Bert Morrens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Dries Coertjens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Ilse Loots
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Annelies De Decker
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Carmen Franken
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Elly Den Hond
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Vera Nelen
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| | - Nicolas Van Larebeke
- Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Radiotherapy and Experimental Cancerology, Ghent University, Ghent, Belgium
| | - Caroline Teughels
- Flemish Planning Bureau for the Environment and Spatial Development, Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
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31
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Vrijheid M, Basagaña X, Gonzalez JR, Jaddoe VWV, Jensen G, Keun HC, McEachan RRC, Porcel J, Siroux V, Swertz MA, Thomsen C, Aasvang GM, Andrušaitytė S, Angeli K, Avraam D, Ballester F, Burton P, Bustamante M, Casas M, Chatzi L, Chevrier C, Cingotti N, Conti D, Crépet A, Dadvand P, Duijts L, van Enckevort E, Esplugues A, Fossati S, Garlantezec R, Gómez Roig MD, Grazuleviciene R, Gützkow KB, Guxens M, Haakma S, Hessel EVS, Hoyles L, Hyde E, Klanova J, van Klaveren JD, Kortenkamp A, Le Brusquet L, Leenen I, Lertxundi A, Lertxundi N, Lionis C, Llop S, Lopez-Espinosa MJ, Lyon-Caen S, Maitre L, Mason D, Mathy S, Mazarico E, Nawrot T, Nieuwenhuijsen M, Ortiz R, Pedersen M, Perelló J, Pérez-Cruz M, Philippat C, Piler P, Pizzi C, Quentin J, Richiardi L, Rodriguez A, Roumeliotaki T, Sabin Capote JM, Santiago L, Santos S, Siskos AP, Strandberg-Larsen K, Stratakis N, Sunyer J, Tenenhaus A, Vafeiadi M, Wilson RC, Wright J, Yang T, Slama R. Advancing tools for human early lifecourse exposome research and translation (ATHLETE): Project overview. Environ Epidemiol 2021; 5:e166. [PMID: 34934888 PMCID: PMC8683140 DOI: 10.1097/ee9.0000000000000166] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 06/28/2021] [Indexed: 11/26/2022] Open
Abstract
Early life stages are vulnerable to environmental hazards and present important windows of opportunity for lifelong disease prevention. This makes early life a relevant starting point for exposome studies. The Advancing Tools for Human Early Lifecourse Exposome Research and Translation (ATHLETE) project aims to develop a toolbox of exposome tools and a Europe-wide exposome cohort that will be used to systematically quantify the effects of a wide range of community- and individual-level environmental risk factors on mental, cardiometabolic, and respiratory health outcomes and associated biological pathways, longitudinally from early pregnancy through to adolescence. Exposome tool and data development include as follows: (1) a findable, accessible, interoperable, reusable (FAIR) data infrastructure for early life exposome cohort data, including 16 prospective birth cohorts in 11 European countries; (2) targeted and nontargeted approaches to measure a wide range of environmental exposures (urban, chemical, physical, behavioral, social); (3) advanced statistical and toxicological strategies to analyze complex multidimensional exposome data; (4) estimation of associations between the exposome and early organ development, health trajectories, and biological (metagenomic, metabolomic, epigenetic, aging, and stress) pathways; (5) intervention strategies to improve early life urban and chemical exposomes, co-produced with local communities; and (6) child health impacts and associated costs related to the exposome. Data, tools, and results will be assembled in an openly accessible toolbox, which will provide great opportunities for researchers, policymakers, and other stakeholders, beyond the duration of the project. ATHLETE's results will help to better understand and prevent health damage from environmental exposures and their mixtures from the earliest parts of the life course onward.
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Affiliation(s)
- Martine Vrijheid
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Corresponding Author. Address: ISGlobal, Institute for Global Health, C. Doctor Aiguader 88, 08003 Barcelona, Spain. E-mail: (M. Vrijheid)
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Juan R. Gonzalez
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Genon Jensen
- Health & Environment Alliance (HEAL), Brussels, Belgium
| | - Hector C. Keun
- Department of Surgery & Cancer and Department of Metabolism, Digestion & Reproduction, Imperial College London, London, United Kingdom
| | - Rosemary R. C. McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford,United Kingdom
| | - Joana Porcel
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Valerie Siroux
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
| | - Morris A. Swertz
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Cathrine Thomsen
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunn Marit Aasvang
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sandra Andrušaitytė
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Karine Angeli
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Maisons-Alfort, France
| | - Demetris Avraam
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
- Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | - Paul Burton
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Mariona Bustamante
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Maribel Casas
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Cécile Chevrier
- University Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Rennes, France
| | | | - David Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Amélie Crépet
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Maisons-Alfort, France
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Esther van Enckevort
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Ana Esplugues
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
- Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Ronan Garlantezec
- CHU de Rennes, University Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Rennes, France
| | - María Dolores Gómez Roig
- Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain
- Maternal and Child Health and Development Network II (SAMID II), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- BCNatal—Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Kristine B. Gützkow
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Department of Child and Adolescence Psychiatry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sido Haakma
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Ellen V. S. Hessel
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Lesley Hoyles
- Department of Biosciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Eleanor Hyde
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Jana Klanova
- RECETOX Centre, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Jacob D. van Klaveren
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Andreas Kortenkamp
- Brunel University London, College of Health, Medicine and Life Sciences, Uxbridge, United Kingdom
| | - Laurent Le Brusquet
- University Paris-Saclay, CNRS, CentraleSupélec, Laboratoire des Signaux et Systèmes, Gif-sur-Yvette, France
| | - Ivonne Leenen
- Health & Environment Alliance (HEAL), Brussels, Belgium
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- University of Basque Country UPV/EHU, Basque Country, Bilbao, Spain
- Biodonostia, Research Health Institute, Donostia-San Sebastian, Spain
| | - Nerea Lertxundi
- University of Basque Country UPV/EHU, Basque Country, Bilbao, Spain
- Biodonostia, Research Health Institute, Donostia-San Sebastian, Spain
| | - Christos Lionis
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Sabrina Llop
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
- Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | - Sarah Lyon-Caen
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
| | - Lea Maitre
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford,United Kingdom
| | - Sandrine Mathy
- University Grenoble Alpes, CNRS, INRAE, Grenoble INP, GAEL, Grenoble, France
| | - Edurne Mazarico
- Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain
- Maternal and Child Health and Development Network II (SAMID II), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- BCNatal—Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- Centre for Health and Environment, Leuven University, Leuven, Belgium
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Rodney Ortiz
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Marie Pedersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Míriam Pérez-Cruz
- Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain
- Maternal and Child Health and Development Network II (SAMID II), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- BCNatal—Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Claire Philippat
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
| | - Pavel Piler
- RECETOX Centre, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Joane Quentin
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Theano Roumeliotaki
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | | | - Susana Santos
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alexandros P. Siskos
- Department of Surgery & Cancer and Department of Metabolism, Digestion & Reproduction, Imperial College London, London, United Kingdom
| | | | - Nikos Stratakis
- ISGlobal, Barcelona, Spain
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Arthur Tenenhaus
- University Paris-Saclay, CNRS, CentraleSupélec, Laboratoire des Signaux et Systèmes, Gif-sur-Yvette, France
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Rebecca C. Wilson
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford,United Kingdom
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford,United Kingdom
| | - Remy Slama
- University Grenoble Alpes, Inserm, CNRS, IAB (Institute for Advanced Biosciences) Joint Research Center, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Grenoble, France
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de Bont J, Márquez S, Fernández-Barrés S, Warembourg C, Koch S, Persavento C, Fochs S, Pey N, de Castro M, Fossati S, Nieuwenhuijsen M, Basagaña X, Casas M, Duarte-Salles T, Vrijheid M. Urban environment and obesity and weight-related behaviours in primary school children. ENVIRONMENT INTERNATIONAL 2021; 155:106700. [PMID: 34144474 DOI: 10.1016/j.envint.2021.106700] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Urban environments are characterised by many factors that may influence children's lifestyle and increase the risk of childhood obesity, but multiple urban exposures have scarcely been studied. OBJECTIVE We evaluated the association between multiple urban exposures and childhood obesity outcomes and weight-related behaviours. METHODS We conducted a cross-sectional study including 2213 children aged 9-12 years in Sabadell, Spain. We estimated ambient air pollution, green spaces, built and food environment, road traffic and road traffic noise at residential addresses through a total of 28 exposure variables in various buffers. Childhood obesity outcomes included body mass index (BMI), waist circumference and body fat. Weight-related behaviours included diet (fast food and sugar-sweetened beverage consumption), physical activity, sedentary behaviour, sleep duration and well-being. Associations between exposures (urban environment) and outcomes (obesity and behaviours) were estimated in single and multiple-exposure regression models and in a hierarchical clustering on principal components (HCPC) analysis. RESULTS Forty percent of children were overweight or obese. In single exposure models, very few associations were observed between the urban exposures and obesity outcomes or weight-related behaviours after correction for multiple testing. In multiple exposure models, PMcoarse, denser unhealthy food environment and land use mix were statistically significant associated with childhood obesity outcomes (e.g 17.7 facilities/km2 increase of unhealthy food environment (OR overweight/obesity status) = 1.20 [95% CI: 1.01; 1.44]). Cluster analysis identified 5 clusters of urban exposures. Compared to the most neutral cluster, the cluster with high air pollution, road traffic, and road noise levels was associated with a higher BMI and higher odds of overweight and obesity (β (zBMI) = 0.17, [95% CI: 0.01, 0.17]; OR (overweight/obesity) = 1.36, [95% CI: 0.99, 1.85]); the clusters were not associated with the weight-related behaviours. CONCLUSIONS This systematic study of many exposures in the urban environment suggests that an exposure pattern characterised by higher levels of ambient air pollution, road traffic and road traffic noise is associated with increased childhood obesity risk and that PMcoarse, land use mix and food environment are separately associated with obesity risk. These findings require follow-up in longitudinal studies and different settings.
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Affiliation(s)
- Jeroen de Bont
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Sandra Márquez
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Sílvia Fernández-Barrés
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Charline Warembourg
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Sarah Koch
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Cecilia Persavento
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Silvia Fochs
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Núria Pey
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Maribel Casas
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain.
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33
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Akaraci S, Feng X, Suesse T, Jalaludin B, Astell-Burt T. Greener neighbourhoods, healthier birth outcomes? Evidence from Australia. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 278:116814. [PMID: 33677222 DOI: 10.1016/j.envpol.2021.116814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/23/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
Growing body of research recognizes the importance of green spaces on the perinatal outcomes however, further evidence from different geographies are warranted. We aimed to investigate association between, and differential responses to, maternal exposure to green space and birthweight. Birth records (n = 82,221) were extracted from the Perinatal Data Collection (PDC) in Sydney's metropolitan area between January 2016 and December 2017. Association between green space quantity and birthweight, term birthweight, low birthweight, term low birthweight and preterm were assessed using linear and logistic regressions. Potential modification by area-level socioeconomic status and maternal country of birth were tested using interaction terms. Difference in birth weight for the ≥40% versus <20% green space within SA2s was 59.0 g (95%CI: 42.9, 75.3) in unadjusted models which dropped to 25.6 g (95%CI: 13.0, 38.2) in adjusted models. Stratified analysis suggested stronger associations for babies of mothers from affluent neighbourhoods, while statistically significant association was not observed in deprived areas. Furthermore, the association was more pronounced among babies to mothers who were born overseas. Associations were consistent for term births. Higher levels of green space were associated with lower odds of preterm birth in adjusted models. However, we did not identify statistically significant association between green space quantity and the risk of low birthweight (LBW). Our study suggests that green space may support healthier birth outcomes and help to reduce the birthweight gap between newborns of mothers born in Australia and overseas. However, disproportionate benefits among women in affluent neighbourhoods may widen socioeconomic inequities in birthweight.
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Affiliation(s)
- Selin Akaraci
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, NSW 2052, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Thomas Suesse
- NIASRA, National Institute for Applied Statistics Research Australia School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Bin Jalaludin
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, NSW 2052, Australia; Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW, 2170, Australia.
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Population Medicine and Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China.
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Association between moderated level of air pollution and fetal growth: the potential role of noise exposure. Sci Rep 2021; 11:11238. [PMID: 34045628 PMCID: PMC8160128 DOI: 10.1038/s41598-021-90788-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/17/2021] [Indexed: 02/07/2023] Open
Abstract
This study aims to analyze, in a population of singletons, the potential confounding or modifying effect of noise on the relationship between fetal growth restriction (FGR) or small for gestational age (SGA) and environmental exposure to air pollution. All women with single pregnancies living in one of two medium-sized cities (Besançon, Dijon) and who delivered at a university hospital between 2005 and 2009 were included. FGR and SGA were obtained from medical records. Outdoor residential exposure to nitrogen dioxide (NO2) and particulate matter (PM10) was quantified at the mother’s address at delivery over defined pregnancy periods; outdoor noise exposure was considered to be the annual average daily noise levels in the façade of building (LAeq,24 h). Adjusted odds ratios (ORa) were estimated by multivariable logistic regressions. Among the 8994 included pregnancies, 587 presented FGR and 918 presented SGA. In the two-exposure models, for SGA, the ORa for a 10-µg/m3 increase of PM10 during the two last months before delivery was 1.18, 95%CI 1.00–1.41 and for FGR, these ORa were for the first and the third trimesters, and the two last months before delivery: 0.77 (0.61–0.97), 1.38 (1.12–1.70), and 1.35 (1.11–1.66), respectively. Noise was not associated with SGA or FGR and did not confound the relationship between air pollution and SGA or FGR. These results are in favor of an association between PM10 exposure and fetal growth, independent of noise, particularly towards the end of pregnancy, and of a lack of association between noise and fetal growth.
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Caudeville J, Regrain C, Tognet F, Bonnard R, Guedda M, Brochot C, Beauchamp M, Letinois L, Malherbe L, Marliere F, Lestremau F, Chardon K, Bach V, Zeman FA. Characterizing environmental geographic inequalities using an integrated exposure assessment. Environ Health 2021; 20:58. [PMID: 33980260 PMCID: PMC8117491 DOI: 10.1186/s12940-021-00736-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/25/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND At a regional or continental scale, the characterization of environmental health inequities (EHI) expresses the idea that populations are not equal in the face of pollution. It implies an analysis be conducted in order to identify and manage the areas at risk of overexposure where an increasing risk to human health is suspected. The development of methods is a prerequisite for implementing public health activities aimed at protecting populations. METHODS This paper presents the methodological framework developed by INERIS (French National Institute for Industrial Environment and Risks) to identify a common framework for a structured and operationalized assessment of human exposure. An integrated exposure assessment approach has been developed to integrate the multiplicity of exposure pathways from various sources, through a series of models enabling the final exposure of a population to be defined. RESULTS Measured data from environmental networks reflecting the actual contamination of the environment are used to gauge the population's exposure. Sophisticated methods of spatial analysis are applied to include additional information and take benefit of spatial and inter-variable correlation to improve data representativeness and characterize the associated uncertainty. Integrated approaches bring together all the information available for assessing the source-to-human-dose continuum using a Geographic Information System, multimedia exposure and toxicokinetic model. DISCUSSION One of the objectives of the integrated approach was to demonstrate the feasibility of building complex realistic exposure scenarios satisfying the needs of stakeholders and the accuracy of the modelling predictions at a fine spatial-temporal resolution. A case study is presented to provide a specific application of the proposed framework and how the results could be used to identify an overexposed population. CONCLUSION This framework could be used for many purposes, such as mapping EHI, identifying vulnerable populations and providing determinants of exposure to manage and plan remedial actions and to assess the spatial relationships between health and the environment to identify factors that influence the variability of disease patterns.
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Affiliation(s)
- Julien Caudeville
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France.
- PériTox, UMR_I 01, CURS, Université de Picardie Jules Verne, Chemin du Thil, 80025, Amiens, France.
| | - Corentin Regrain
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
- PériTox, UMR_I 01, CURS, Université de Picardie Jules Verne, Chemin du Thil, 80025, Amiens, France
- LAMFA, UMR CNRS 7352, Université de Picardie Jules Verne, 33 rue Saint-Leu, 80039, Amiens, France
| | - Frederic Tognet
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
| | - Roseline Bonnard
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
| | - Mohammed Guedda
- LAMFA, UMR CNRS 7352, Université de Picardie Jules Verne, 33 rue Saint-Leu, 80039, Amiens, France
| | - Celine Brochot
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
| | - Maxime Beauchamp
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
| | - Laurent Letinois
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
| | - Laure Malherbe
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
| | - Fabrice Marliere
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
| | - Francois Lestremau
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
| | - Karen Chardon
- PériTox, UMR_I 01, CURS, Université de Picardie Jules Verne, Chemin du Thil, 80025, Amiens, France
| | - Veronique Bach
- PériTox, UMR_I 01, CURS, Université de Picardie Jules Verne, Chemin du Thil, 80025, Amiens, France
| | - Florence Anna Zeman
- Institut National de l'Environnement Industriel et des Risques (INERIS), Parc ALATA BP2, 60550, Verneuil en Halatte, France
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Triguero-Mas M, Anguelovski I, García-Lamarca M, Argüelles L, Perez-Del-Pulgar C, Shokry G, Connolly JJT, Cole HVS. Natural outdoor environments' health effects in gentrifying neighborhoods: Disruptive green landscapes for underprivileged neighborhood residents. Soc Sci Med 2021; 279:113964. [PMID: 34020160 DOI: 10.1016/j.socscimed.2021.113964] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/29/2021] [Accepted: 04/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cities are restoring existing natural outdoor environments (NOE) or creating new ones to address diverse socio-environmental and health challenges. The idea that NOE provide health benefits is supported by the therapeutic landscapes concept. However, several scholars suggest that NOE interventions may not equitably serve all urban residents and may be affected by processes such as gentrification. Applying the therapeutic landscapes concept, this study assesses the impacts of gentrification processes on the associations between NOE and the health of underprivileged, often long-term, neighborhood residents. METHODS We examined five neighborhoods in five cities in Canada, the United States and Western Europe. Our case studies were neighborhoods experiencing gentrification processes and NOE interventions. In each city, we conducted semi-structured qualitative interviews on NOE interventions, equity/justice, gentrification and health (n = 117) with case study neighborhood residents, community-based organizations, neighborhood resident leaders and other stakeholders such as public agencies staff. RESULTS Respondents highlighted a variety of interconnected and overlapping factors: the insufficient benefits of NOE to counterbalance other factors detrimental to health, the use of NOE for city branding and housing marketing despite pollution, unwelcomeness, increase of conflicts, threats to physical displacement for themselves and their social networks, unattractiveness, deficient routes, inadequate NOE maintenance and lack of safety in NOE. CONCLUSIONS Our study demonstrated that underprivileged neighborhood residents were perceived to experience new or improved NOE as what we call "disruptive green landscapes" (i.e. non-therapeutic landscapes with which they were not physically or emotionally engaged) instead of as therapeutic landscapes.
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Affiliation(s)
- Margarita Triguero-Mas
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain.
| | - Isabelle Anguelovski
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain; ICREA, Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Melissa García-Lamarca
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - Lucía Argüelles
- Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain; Internet Interdisciplinary Institute (IN3), Open University of Catalonia (UOC), Barcelona, Spain; Estudis d'Economia i Empresa (EEE), Open University of Catalonia (UOC), Barcelona, Spain
| | - Carmen Perez-Del-Pulgar
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - Galia Shokry
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - James J T Connolly
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain; School of Community and Regional Planning (SCARP), University of British Columbia, Vancouver, Canada
| | - Helen V S Cole
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
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Cadiou S, Slama R. Instability of Variable-selection Algorithms Used to Identify True Predictors of an Outcome in Intermediate-dimension Epidemiologic Studies. Epidemiology 2021; 32:402-411. [PMID: 33652445 DOI: 10.1097/ede.0000000000001340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Machine-learning algorithms are increasingly used in epidemiology to identify true predictors of a health outcome when many potential predictors are measured. However, these algorithms can provide different outputs when repeatedly applied to the same dataset, which can compromise research reproducibility. We aimed to illustrate that commonly used algorithms are unstable and, using the example of Least Absolute Shrinkage and Selection Operator (LASSO), that stabilization method choice is crucial. METHODS In a simulation study, we tested the stability and performance of widely used machine-learning algorithms (LASSO, Elastic-Net, and Deletion-Substitution-Addition [DSA]). We then assessed the effectiveness of six methods to stabilize LASSO and their impact on performance. We assumed that a linear combination of factors drawn from a simulated set of 173 quantitative variables assessed in 1,301 subjects influenced to varying extents a continuous health outcome. We assessed model stability, sensitivity, and false discovery proportion. RESULTS All tested algorithms were unstable. For LASSO, stabilization methods improved stability without ensuring perfect stability, a finding confirmed by application to an exposome study. Stabilization methods also affected performance. Specifically, stabilization based on hyperparameter optimization, frequently implemented in epidemiology, increased the false discovery proportion dramatically when predictors explained a low share of outcome variability. In contrast, stabilization based on stability selection procedure often decreased the false discovery proportion, while sometimes simultaneously lowering sensitivity. CONCLUSIONS Machine-learning methods instability should concern epidemiologists relying on them for variable selection, as stabilizing a model can impact its performance. For LASSO, stabilization methods based on stability selection procedure (rather than addressing prediction stability) should be preferred to identify true predictors.
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Affiliation(s)
- Solène Cadiou
- From the Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
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Huhn S, Escher BI, Krauss M, Scholz S, Hackermüller J, Altenburger R. Unravelling the chemical exposome in cohort studies: routes explored and steps to become comprehensive. ENVIRONMENTAL SCIENCES EUROPE 2021; 33:17. [PMID: 33614387 PMCID: PMC7877320 DOI: 10.1186/s12302-020-00444-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/30/2020] [Indexed: 05/04/2023]
Abstract
Environmental factors contribute to the risk for adverse health outcomes against a background of genetic predisposition. Among these factors, chemical exposures may substantially contribute to disease risk and adverse outcomes. In fact, epidemiological cohort studies have established associations between exposure against individual chemicals and adverse health effects. Yet, in daily life individuals are exposed to complex mixtures in varying compositions. To capture the totality of environmental exposures the concept of the exposome has been developed. Here, we undertake an overview of major exposome projects, which pioneered the field of exposomics and explored the links between chemical exposure and health outcomes using cohort studies. We seek to reflect their achievements with regard to (i) capturing a comprehensive picture of the environmental chemical exposome, (ii) aggregating internal exposures using chemical and bioanalytical means of detection, and (iii) identifying associations that provide novel options for risk assessment and intervention. Various complementary approaches can be distinguished in addressing relevant exposure routes and it emerges that individual exposure histories may not easily be grouped. The number of chemicals for which human exposure can be detected is substantial and highlights the reality of mixture exposures. Yet, to a large extent it depends on targeted chemical analysis with the specific challenges to capture all relevant exposure routes and assess the chemical concentrations occurring in humans. The currently used approaches imply prior knowledge or hypotheses about relevant exposures. Typically, the number of chemicals considered in exposome projects is counted in dozens-in contrast to the several thousands of chemicals for which occurrence have been reported in human serum and urine. Furthermore, health outcomes are often still compared to single chemicals only. Moreover, explicit consideration of mixture effects and the interrelations between different outcomes to support causal relationships and identify risk drivers in complex mixtures remain underdeveloped and call for specifically designed exposome-cohort studies.
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Affiliation(s)
- Sebastian Huhn
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
- Pediatric Epidemiology, Department of Pediatrics, University of Leipzig Medical Center, Leipzig, Germany
| | - Beate I. Escher
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
- Environmental Toxicology, Center for Applied Geosciences, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Martin Krauss
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Stefan Scholz
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Jörg Hackermüller
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Rolf Altenburger
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
- Department of Bioanalytical Ecotoxicology, RWTH-Aachen University, Aachen, Germany
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Verheyen VJ, Remy S, Lambrechts N, Govarts E, Colles A, Poelmans L, Verachtert E, Lefebvre W, Monsieurs P, Vanpoucke C, Nielsen F, Van den Eeden L, Jacquemyn Y, Schoeters G. Residential exposure to air pollution and access to neighborhood greenspace in relation to hair cortisol concentrations during the second and third trimester of pregnancy. Environ Health 2021; 20:11. [PMID: 33573648 PMCID: PMC7879652 DOI: 10.1186/s12940-021-00697-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/01/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Exposure to air pollution during pregnancy has been associated with adverse pregnancy outcomes in studies worldwide, other studies have described beneficial effects of residential greenspace on pregnancy outcomes. The biological mechanisms that underlie these associations are incompletely understood. A biological stress response, which implies release of cortisol, may underlie associations of air pollution exposure and access to neighborhood greenspaces with health. METHODS We explored residential exposure to air pollution and residential access to neighborhood greenspaces in relation to hair cortisol concentrations of participants in a prospective pregnancy cohort study in Flanders, Belgium. Hair samples were collected at the end of the second pregnancy trimester (n = 133) and shortly after delivery (n = 81). Cortisol concentrations were measured in 3-cm scalp-near hair sections, to reflect second and third pregnancy trimester cortisol secretion. We estimated long-term (3 months before sampling) residential exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and black carbon (BC), assessed residential distance to major roads and residential access to neighborhood greenspaces (NHGS). Associations between residential exposures and hair cortisol concentrations were studied using linear regression models while adjusting for season of sampling. RESULTS Three-month mean residential NO2 and BC concentrations were positively associated with third pregnancy trimester hair cortisol concentrations (p = 0.008 and p = 0.017). Access to a large NHGS (10 ha or more within 800 m from residence) was negatively associated with third trimester hair cortisol concentrations (p = 0.019). Access to a large NHGS significantly moderated the association between residential proximity to major roads and second trimester hair cortisol concentrations (p = 0.021). Residential distance to major roads was negatively associated with second trimester hair cortisol concentrations of participants without access to a large NHGS (p = 0.003). The association was not significant for participants with access to a large NHGS. The moderation tended towards significance in the third pregnancy trimester (p < 0.10). CONCLUSIONS Our findings suggest a positive association between long-term residential exposure to air pollution and biological stress during pregnancy, residential access to neighborhood greenspaces may moderate the association. Further research is needed to confirm our results. TRIAL REGISTRATION The IPANEMA study is registered under number NCT02592005 at clinicaltrials.gov .
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Affiliation(s)
- Veerle Josefa Verheyen
- Flemish Institute for Technological Research (VITO), Mol, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Sylvie Remy
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Eva Govarts
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Ann Colles
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Lien Poelmans
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Els Verachtert
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Pieter Monsieurs
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Flemming Nielsen
- The Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lena Van den Eeden
- Department of Obstetrics and Gynecology, Antwerp University Hospital, Antwerp, Belgium
- People and Health, Thomas More University College, Lier, Belgium
| | - Yves Jacquemyn
- Department of Obstetrics and Gynecology, Antwerp University Hospital, Antwerp, Belgium
- Global Health Institute, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
- Antwerp Surgical Training, Anatomy and Research Centre, University of Antwerp, Antwerp, Belgium
| | - Greet Schoeters
- Flemish Institute for Technological Research (VITO), Mol, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- The Department of Public Health, University of Southern Denmark, Odense, Denmark
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Hu CY, Yang XJ, Gui SY, Ding K, Huang K, Fang Y, Jiang ZX, Zhang XJ. Residential greenness and birth outcomes: A systematic review and meta-analysis of observational studies. ENVIRONMENTAL RESEARCH 2021; 193:110599. [PMID: 33307084 DOI: 10.1016/j.envres.2020.110599] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The amount of natural vegetation surrounding homes (residential greenness) has been proposed as a mitigation measure to buffer the adverse health effects of urban living, associated with promoting health and wellbeing including birth outcomes. This study aimed to systematically review the epidemiological evidence on the association of residential greenness with birth outcomes and quantitatively provide summary effect estimates of the current literature. METHODS We extensively searched epidemiological studies related to residential greenness and birth outcomes in three electronic databases (EMBASE, Web of Science, and PubMed) using terms related to residential greenness and birth outcomes before July 10, 2020. Summary effect estimates of residential greenness on birth outcomes including SGA (small for gestational age), PTB (preterm birth), LBW (low birth weight), and birth weight were calculated for each 0.1 unit increase in residential greenness exposure, as well as comparing the highest to the lowest categories using random-effects meta-analyses. We assessed the risk of bias of each individual study, and the overall quality of the body of evidence and level of evidence for each exposure-outcome were also evaluated. RESULTS The initial search identified 161 studies, of which 29 studies were finally included. Meta-analysis for continuous exposure suggested that an increase in residential greenness, measured by NDVI (normalized difference vegetation index) with different buffer sizes, was generally associated with higher birth weights ranging from 7.99 g [95% confidence interval (CI) = 4.29-11.70] to 15.35 g (95% CI = 11.41-19.29) and lower odds of LBW ranging from 0.79 (95% CI = 0.65-0.96) to 0.93 (95% CI = 0.86-1.00), but associations between residential greenness and PTB or SGA were not significant. When introducing the exposure as high versus low categories, similar results were found. The overall evidence for each exposure-outcome combination was considered to be of "moderate" certainty. CONCLUSIONS This study indicated a potential positive association between residential greenness and several birth outcomes. However, because of the moderate to high between-study heterogeneity, further studies with better adjustment of covariates, improved residential greenness assessment in a longitudinal approach throughout pregnancy rather than a cross-sectional approach at time of delivery, and accounting thoroughly for socioeconomic status, are warranted to replicate these findings as well as to explore in greater detail in their implications.
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Affiliation(s)
- Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Jing Yang
- Department of Epidemiology and Biostatistics, School of Public Health, 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
| | - Kun Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kai Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yuan Fang
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA Rotterdam, the Netherlands
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Center for Evidence-Based Practice, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Guillien A, Cadiou S, Slama R, Siroux V. The Exposome Approach to Decipher the Role of Multiple Environmental and Lifestyle Determinants in Asthma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1138. [PMID: 33525356 PMCID: PMC7908097 DOI: 10.3390/ijerph18031138] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/15/2021] [Accepted: 01/23/2021] [Indexed: 12/12/2022]
Abstract
Asthma is a widespread respiratory disease caused by complex contribution from genetic, environmental and behavioral factors. For several decades, its sensitivity to environmental factors has been investigated in single exposure (or single family of exposures) studies, which might be a narrow approach to tackle the etiology of such a complex multifactorial disease. The emergence of the exposome concept, introduced by C. Wild (2005), offers an alternative to address exposure-health associations. After presenting an overview of the exposome concept, we discuss different statistical approaches used to study the exposome-health associations and review recent studies linking multiple families of exposures to asthma-related outcomes. The few studies published so far on the association between the exposome and asthma-related outcomes showed differences in terms of study design, population, exposome definition and statistical methods used, making their results difficult to compare. Regarding statistical methods, most studies applied successively univariate (Exposome-Wide Association Study (ExWAS)) and multivariate (adjusted for co-exposures) (e.g., Deletion-Substitution-Addition (DSA) algorithm) regression-based models. This latest approach makes it possible to assess associations between a large set of exposures and asthma outcomes. However, it cannot address complex interactions (i.e., of order ≥3) or mixture effects. Other approaches like cluster-based analyses, that lead to the identification of specific profiles of exposure at risk for the studied health-outcome, or mediation analyses, that allow the integration of information from intermediate biological layers, could offer a new avenue in the understanding of the environment-asthma association. European projects focusing on the exposome research have recently been launched and should provide new results to help fill the gap that currently exists in our understanding of the effect of environment on respiratory health.
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Affiliation(s)
- Alicia Guillien
- Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, IAB (Institute for Advanced Biosciences), University Grenoble Alpes, 38000 Grenoble, France; (S.C.); (R.S.); (V.S.)
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Mygind L, Kurtzhals M, Nowell C, Melby PS, Stevenson MP, Nieuwenhuijsen M, Lum JAG, Flensborg-Madsen T, Bentsen P, Enticott PG. Landscapes of becoming social: A systematic review of evidence for associations and pathways between interactions with nature and socioemotional development in children. ENVIRONMENT INTERNATIONAL 2021; 146:106238. [PMID: 33189991 DOI: 10.1016/j.envint.2020.106238] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Existing research indicates that spending time in nature is associated with diverse aspects of children's health and wellbeing. Although fundamental to later life chances and health, no systematic reviews, to our knowledge, have focused specifically on the effects of interaction with nature on socioemotional functioning in childhood. OBJECTIVES Amongst children, what is the consistency of associations between the availability of or spending time in nature on socioemotional function and development? Furthermore, which child behaviours and states independently associate with socioemotional function and availability of or spending time in nature, and what is the consistency of associations between these behaviours and states and contact with nature? DATA SOURCES Embase, Environment Complete, MEDLINE, and APA PsycINFO. Eligible studies were backward and forward snowball-searched. STUDY ELIGIBILITY CRITERIA Studies investigating effects of, or associations between, availability of or interaction with nature on socioemotional or proximal outcomes in children under the age of 12 years were included in this review. STUDY APPRAISAL AND SYNTHESIS METHODS The internal validity of studies investigating socioemotional outcomes were based on assessments of elements of study design, conduct, and reporting to identify potential issues related to confounding or other biases. The number of analyses indicating positive, negative, and non-significant associations between availability or interaction with green space and the outcomes were summed. RESULTS A total of 223 eligible full-texts, of which 43 pertained to socioemotional outcomes and 180 to proximal outcomes, met eligibility criteria. Positive associations between availability of and spending time in green space were found with children's intra- and interpersonal socioemotional function and development. Proportions of positive findings ranged from 13.9% to 55% across experimental and observational research, exposures, populations, and contexts. Modifying and mediating factors were identified. We found consistent evidence for improved aspects of cognition and, for children over six years, reduced risk of obesity and overweight in association with green space; consistent links between movement behaviours in the experimental, but not observational research; tentative trends suggesting associations with play, motor skills, language, screen time, and communication skills; little evidence for positive associations between green space and mood, physical wellbeing, and stress; some evidence for associations with healthy birth outcomes, and little evidence for direct associations between availability of green space and asthma and allergy prevalence, however, mediation via, for example, air pollution was likely. LIMITATIONS We identified few studies without either probable or severe risk of bias in at least one item. Improved study quality may therefore result in different results. Restricting analyses to include only studies considered at low risk of bias indicated similar or slightly lower proportions of positive findings. Risk of bias in proximal outcomes was not assessed. CONCLUSIONS The empirical evidence for benefits of availability of and interaction green space for child socioemotional function and development must currently be considered limited. A number of proximal indicators were identified. Systematic review registration number. PROSPERO ID CRD42019135016.
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Affiliation(s)
- Lærke Mygind
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Unit of Medical Psychology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Denmark.
| | - Mette Kurtzhals
- Health Promotion Research, Steno Diabetes Center Copenhagen, The Capital Region of Denmark, Gentofte, Denmark
| | - Clare Nowell
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Paulina S Melby
- Section of Sport, Individual and Society, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Matt P Stevenson
- Health Promotion Research, Steno Diabetes Center Copenhagen, The Capital Region of Denmark, Gentofte, Denmark
| | - Mark Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Publica, Madrid, Spain
| | - Jarrad A G Lum
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Trine Flensborg-Madsen
- Unit of Medical Psychology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Bentsen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Denmark; Department of Geoscience and Natural Resource Management, University of Copenhagen, Frederiksberg, Denmark
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
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Yitshak-Sade M, Fabian MP, Lane KJ, Hart JE, Schwartz JD, Laden F, James P, Fong KC, Kloog I, Zanobetti A. Estimating the Combined Effects of Natural and Built Environmental Exposures on Birthweight among Urban Residents in Massachusetts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8805. [PMID: 33260804 PMCID: PMC7731163 DOI: 10.3390/ijerph17238805] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/13/2020] [Accepted: 11/21/2020] [Indexed: 12/18/2022]
Abstract
Intrauterine growth has health implications both in childhood and adulthood. Birthweight is partially determined by prenatal environmental exposures. We aim to identify important predictors of birthweight out of a set of environmental, built environment exposures, and socioeconomic environment variables during pregnancy (i.e., fine particulate matter (PM2.5), temperature, greenness, walkability, noise, and economic indices). We included all singleton live births of mothers who resided in urban census block-groups and delivered in Massachusetts between 2001 and 2011 (n = 640,659). We used an elastic-net model to select important predictors of birthweight and constructed a multivariate model including the selected predictors, with adjustment for confounders. We additionally used a weighted quantile sum regression to assess the contribution of each exposure to differences in birthweight. All exposures were selected as important predictors of birthweight. In the multivariate model, lower birthweight was significantly associated with lower greenness and with higher temperature, walkability, noise, and segregation of the "high income" group. Treating the exposures individually, nighttime noise had the highest weight in its contribution to lower birthweight. In conclusion, after accounting for individual confounders, maternal environmental exposures, built environment exposures, and socioeconomic environment during pregnancy were important predictors of birthweight, emphasizing the role of these exposures in fetal growth and development.
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Affiliation(s)
- Maayan Yitshak-Sade
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - M. Patricia Fabian
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA; (M.P.F.); (K.J.L.)
| | - Kevin J. Lane
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA; (M.P.F.); (K.J.L.)
| | - Jaime E. Hart
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Joel D. Schwartz
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Francine Laden
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Peter James
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Kelvin C. Fong
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
- School of the Environment, Yale University, New Haven, MA 06511, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer-Sheva 84105, Israel;
| | - Antonella Zanobetti
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (J.E.H.); (J.D.S.); (F.L.); (P.J.); (K.C.F.); (A.Z.)
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de Bont J, Hughes R, Tilling K, Díaz Y, de Castro M, Cirach M, Fossati S, Nieuwenhuijsen M, Duarte-Salles T, Vrijheid M. Early life exposure to air pollution, green spaces and built environment, and body mass index growth trajectories during the first 5 years of life: A large longitudinal study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115266. [PMID: 32745901 DOI: 10.1016/j.envpol.2020.115266] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/12/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
Urban environments are characterized by multiple exposures that may influence body mass index (BMI) growth in early life. Previous studies are few, with inconsistent results and no evaluation of simultaneous exposures. Thus, this study aimed to assess the associations between exposure to air pollution, green spaces and built environment characteristics, and BMI growth trajectories from 0 to 5 years. This longitudinal study used data from an electronic primary care health record database in Catalonia (Spain), including 79,992 children born between January 01, 2011 and December 31, 2012 in urban areas and followed until 5 years of age. Height and weight were measured frequently during childhood and BMI (kg/m2) was calculated. Urban exposures were estimated at census tract level and included: air pollution (nitrogen dioxide (NO2), particulate matter <10 μm (PM10) and <2.5 μm (PM2.5)), green spaces (Normalized Difference Vegetation Index (NDVI) and % green space) and built environment (population density, street connectivity, land use mix, walkability index). Individual BMI trajectories were estimated using linear spline multilevel models with several knot points. In single exposure models, NO2, PM10, PM2.5, and population density were associated with small increases in BMI growth (e.g. β per IQR PM10 increase = 0.023 kg/m2, 95%CI: 0.013, 0.033), and NDVI, % of green spaces and land use mix with small reductions in BMI growth (e.g. β per IQR % green spaces increase = -0.015 kg/m2, 95%CI: -0.026, -0.005). These associations were strongest during the first two months of life. In multiple exposure models, most associations were attenuated, with only those for PM10 and land use mix remaining statistically significant. This large longitudinal study suggests that early life exposure to air pollution, green space and built environment characteristics may be associated with small changes in BMI growth trajectories during the first years of life, and that it is important to account for multiple exposures in urban settings.
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Affiliation(s)
- Jeroen de Bont
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain; Fundació Institut Universitari per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola Del Vallès, Spain
| | - Rachael Hughes
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Yesika Díaz
- Fundació Institut Universitari per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Marta Cirach
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain.
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Torres Toda M, Miri M, Alonso L, Gómez-Roig MD, Foraster M, Dadvand P. Exposure to greenspace and birth weight in a middle-income country. ENVIRONMENTAL RESEARCH 2020; 189:109866. [PMID: 32768705 DOI: 10.1016/j.envres.2020.109866] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
An emerging body of evidence has associated exposure to greenspace during pregnancy with improved fetal growth; however, all available studies have been conducted in high-income countries and the available evidence evaluating such an association for visual access to greenspace, use of green spaces and indoor plants is non-existent. We aimed to evaluate the association between a comprehensive array of indicators of exposure to greenspace during pregnancy, including the aforementioned indicators, and birth weight, in a middle-income country and evaluating air pollution and visual access as possible mechanisms underlying the association. This study was based on 301 pregnant women residing in Su et al. (2019). For each pregnant woman, we characterized exposure to residential surrounding greenspace, visual access to greenspace, residential proximity to green space, use of green spaces, and the number of plant pots at home. We used linear regression models adjusted for relevant covariates including measures of socioeconomic status. We found positive associations of maternal exposure to residential surrounding greenspace across a 100 m buffer, frequent viewing of greenspace through the window, percentage of window area covered by greenspace, residential proximity to any green space regardless of its area, time spent in public green spaces and total time spent in public and private green spaces with birth weight. We also observed positive associations of maternal exposure to residential surrounding greenspace across 300 m and 500 m buffers, residential proximity to a green space with an area ≥5000 m2, and indoor plant pots with birth weight, but none of these associations were statistically significant. The magnitude of the associations tended to be higher among parents with lower socioeconomic status. Mediation through air pollution or visual access was not established. Findings from this study suggested a positive role of different aspects of exposure to greenspace during pregnancy on birth weight in a middle-income country.
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Affiliation(s)
- Maria Torres Toda
- ISGlobal, Barcelona, Spain; Pompeu FabraUniversity, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mohammad Miri
- Non-communicable Diseases Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | | | - Maria Dolores Gómez-Roig
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Sant Joan de Deu and Hospital Clínic), Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain; Spain Maternal and Child Health Development Network, RETICS Funded By the PN I+D+I 2013-2016 (Spain), ISCIII- Sub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (ERDF), Ref. RD16/0022, Madrid, Spain
| | - Maria Foraster
- ISGlobal, Barcelona, Spain; Pompeu FabraUniversity, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Pompeu FabraUniversity, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Wang L, Guo P, Tong H, Wang A, Chang Y, Guo X, Gong J, Song C, Wu L, Wang T, Hopke PK, Chen X, Tang NJ, Mao H. Traffic-related metrics and adverse birth outcomes: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2020; 188:109752. [PMID: 32516633 DOI: 10.1016/j.envres.2020.109752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/09/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
Given the inconsistency of epidemiologic evidence for associations between maternal exposures to traffic-related metrics and adverse birth outcomes, this manuscript aims to provide clarity on this topic. Pooled meta-estimates were calculated using random-effects analyses. Subgroup analyses were conducted by study area, study design, and Newcastle-Ottawa quality score (NOS). Funnel plots and Egger's test were conducted to evaluate the publication bias, and Fail-safe Numbers (Fail-safe N) were measured to evaluate the robustness of models. From the initial 740 studies (last search, July 11, 2019), 26 studies were included in our analysis. The pooled odds ratio for the change in small for gestational age associated with per 500 m decrease in the distance to roads was 1.016 (95% CI: 1.004, 1.029). Subgroup analyses revealed significant positive associations between term low birth weight and traffic density in higher-quality literatures with higher NOS [1.060 (95% CI: 1.002, 1.121)], cohort studies [1.020 (95% CI: 1.006, 1.033)], and studies in North America [1.018 (95% CI: 1.005, 1.131)]. The buffer of traffic density made no difference in the effect size. Traffic density seemed to be a better indicator of traffic pollution than the distance to roads.
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Affiliation(s)
- Lijun Wang
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Pengyi Guo
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China
| | - Hui Tong
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Anxu Wang
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Ying Chang
- Tianjin Center Hospital of Obstetrics and Gynecology, Tianjin Key Laboratory of Human Development and Reproductive Regulation, China
| | - Xuemei Guo
- University Library, Tianjin Medical University, Tianjin, 300070, China
| | - Junming Gong
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China
| | - Congbo Song
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Lin Wu
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Ting Wang
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Philip K Hopke
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China.
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China.
| | - Hongjun Mao
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China.
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Sun Y, Sheridan P, Laurent O, Li J, Sacks DA, Fischer H, Qiu Y, Jiang Y, Yim IS, Jiang LH, Molitor J, Chen JC, Benmarhnia T, Lawrence JM, Wu J. Associations between green space and preterm birth: Windows of susceptibility and interaction with air pollution. ENVIRONMENT INTERNATIONAL 2020; 142:105804. [PMID: 32505016 PMCID: PMC7340571 DOI: 10.1016/j.envint.2020.105804] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 05/24/2023]
Abstract
BACKGROUND Recent studies have reported inconsistent associations between maternal residential green space and preterm birth (PTB, born < 37 completed gestational weeks). In addition, windows of susceptibility during pregnancy have not been explored and potential interactions of green space with air pollution exposures during pregnancy are still unclear. OBJECTIVES To evaluate the relationships between green space and PTB, identify windows of susceptibility, and explore potential interactions between green space and air pollution. METHODS Birth certificate records for all births in California (2001-2008) were obtained. The Normalized Difference Vegetation Index (NDVI) was used to characterized green space exposure. Gestational age was treated as a time-to-event outcome; Cox proportional hazard models were applied to estimate the association between green space exposure and PTB, moderately PTB (MPTB, gestational age < 35 weeks), and very PTB (VPTB, gestational age < 30 weeks), after controlling for maternal age, race/ethnicity, education, and median household income. Month-specific green space exposure was used to identify potential windows of susceptibility. Potential interactions between green space and air pollution [fine particulate matter < 2.5 µm (PM2.5), nitrogen dioxide (NO2), and ozone (O3)] were examined on both additive and multiplicative scales. RESULTS In total, 3,753,799 eligible births were identified, including 341,123 (9.09%) PTBs, 124,631 (3.32%) MPTBs, and 22,313 (0.59%) VPTBs. A reduced risk of PTB was associated with increases in residential NDVI exposure in 250 m, 500 m, 1000 m, and 2000 m buffers. In the 2000 m buffer, the association was strongest for VPTB [adjusted hazard ratio (HR) per interquartile range increase in NDVI: 0.959, 95% confidence interval (CI): 0.942-0.976)], followed by MPTB (HR = 0.970, 95% CI: 0.962-0.978) and overall PTB (HR = 0.972, 95% CI: 0.966-0.978). For PTB, green space during the 3rd - 5th gestational months had stronger associations than those in the other time periods, especially during the 4th gestational month (NDVI 2000 m: HR = 0.970, 95% CI: 0.965-0.975). We identified consistent positive additive and multiplicative interactions between decreasing green space and higher air pollution. CONCLUSION This large study found that maternal exposure to residential green space was associated with decreased risk of PTB, MPTB, and VPTB, especially in the second trimester. There is a synergistic effect between low green space and high air pollution levels on PTB, indicating that increasing exposure to green space may be more beneficial for women with higher air pollution exposures during pregnancy.
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Affiliation(s)
- Yi Sun
- Program in Environmental Health Sciences, University of California, Irvine, CA 92697-3957, USA
| | - Paige Sheridan
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, 9500 Gilman Drive #0725, CA La Jolla 92093, USA
| | - Olivier Laurent
- Program in Public Health, 653 East Peltason Drive, University of California, Irvine CA 92697-3957, USA
| | - Jia Li
- Program in Public Health, 653 East Peltason Drive, University of California, Irvine CA 92697-3957, USA
| | - David A Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Heidi Fischer
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Yang Qiu
- Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, #24 First Ring Road South Section One, Chengdu, Sichuan, China
| | - Yu Jiang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ilona S Yim
- Department of Psychological Science, University of California, Irvine, CA 92697-7085, USA
| | - Luo-Hua Jiang
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, 9500 Gilman Drive #0725, CA La Jolla 92093, USA
| | - Jean M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jun Wu
- Program in Environmental Health Sciences, University of California, Irvine, CA 92697-3957, USA; Program in Public Health, 653 East Peltason Drive, University of California, Irvine CA 92697-3957, USA.
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48
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Lin L, Li Q, Yang J, Han N, Chen G, Jin C, Xu X, Liu Z, Liu J, Luo S, Raat H, Guo Y, Wang H. The associations of residential greenness with fetal growth in utero and birth weight: A birth cohort study in Beijing, China. ENVIRONMENT INTERNATIONAL 2020; 141:105793. [PMID: 32417616 DOI: 10.1016/j.envint.2020.105793] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/17/2020] [Accepted: 05/02/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Although studies have examined the association between residential greenness and birth weight, there is no evidence regarding the association between residential greenness and fetal growth in utero. We aimed to investigate the associations of residential greenness with both fetal growth in utero and birth weight. METHODS A birth cohort (2014-2017) with 18,665 singleton pregnancies was established in Tongzhou Maternal and Child hospital of Beijing, China. Residential greenness was matched with maternal residential address and estimated from remote satellite data using normalized difference vegetation index with 200 m and 500 m buffers (NDVI-200 and NDVI-500). Fetal parameters including estimated fetal weight (EFW), abdominal circumference (AC), head circumference (HC) and femur length (FL) were assessed by ultrasound measurements during pregnancy. Fetal parameters were standardized as gestational-age- and gender-adjusted Z-score and undergrowth was defined as Z-score < -1.88. Birth weight Z-score, low birth weight (LBW) and small for gestational age (SGA) were assessed as birth outcomes. Generalized estimating equations with the autoregressive working correlation structure and generalized linear regression were used to examine the associations of residential greenness with quantitative and categorized outcomes. RESULTS We found an increase Z-score of EFW [0.054, 95% confidence interval (CI): 0.020-0.087], AC (0.045, 95%CI: 0.011-0.080) and HC (0.054, 95%CI: 0.020-0.089) associated with residential greenness above NDVI-500 median compared to less than and equal to NDVI-500 median. Stratified analyses indicated that the associations might be stronger in women exposed to lower levels of particles with aerodynamic diameters ≤2.5 µm. No associations were found in the analyses of NDVI-250 with fetal growth in utero. We didn't observe significant associations of NDVI with birth weight Z-score, LBW and SGA. CONCLUSIONS This study identified a positive association of NDVI-500 and fetal growth in utero, but we didn't observe its association with birth weight measures. Our results suggest that building sufficient green infrastructure might potentially promote early life health.
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Affiliation(s)
- Lizi Lin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China; National Health Commission Key Laboratory of Reproductive Health, Beijing, People's Republic of China
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China; Reproductive Medical Centre, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Jie Yang
- Tongzhou Maternal and Child Health Hospital, Beijing 101101, People's Republic of China
| | - Na Han
- Tongzhou Maternal and Child Health Hospital, Beijing 101101, People's Republic of China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Chuyao Jin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Xiangrong Xu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, People's Republic of China
| | - Shusheng Luo
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China; National Health Commission Key Laboratory of Reproductive Health, Beijing, People's Republic of China.
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Hu H, Zhao J, Savitz DA, Prosperi M, Zheng Y, Pearson TA. An external exposome-wide association study of hypertensive disorders of pregnancy. ENVIRONMENT INTERNATIONAL 2020; 141:105797. [PMID: 32413622 PMCID: PMC7336837 DOI: 10.1016/j.envint.2020.105797] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/22/2020] [Accepted: 05/03/2020] [Indexed: 05/11/2023]
Abstract
It is widely recognized that exogenous factors play an important role in the development of hypertensive disorders of pregnancy (HDP). However, only a few external environmental factors have been studied, often separately, with no attempt to examine the totality of the external environment, or the external exposome. We conducted an external exposome-wide association study (ExWAS) using the Florida Vital Statistics Birth Records including 819,399 women with live births in 2010-2013. A total of 5784 factors characterizing women's surrounding natural, built, and social environment during pregnancy from 10 data sources were collected, harmonized, integrated, and spatiotemporally linked to the women based on pregnancy periods using 250 m buffers around their geocoded residential addresses. A random 50:50 split divided the data into discovery and replication sets, and a 3-phase procedure was used. In phase 1, associations between HDP and individual factors were examined, and Bonferroni adjustment was performed. In phase 2, an elastic net model was used to perform variable selection among significant variables from phase 1. In phase 3, a multivariable logistic regression model including all variables selected by the elastic net model was fitted. Variables that were significant in both the discovery and replication sets were retained. Among the 528 and 490 variables identified in Phase 1, 232 and 224 were selected by the elastic net model in Phase 2, and 67 and 48 variables remained statistically significant in Phase 3 in the discovery and replication sets, respectively. A total of 12 variables were significant in both the discovery and replication sets, including air toxicants (e.g., 2,2,4-trimethylpentane), meteorological factors (e.g., omega or vertical velocity at 125mb pressure level), neighborhood crime and safety (e.g., burglary rate), and neighborhood sociodemographic status (e.g., urbanization). This is the first large external exposome study of HDP. It confirmed some of the previously reported associations and generated unexpected predictors within the environment that may warrant more focused evaluation.
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Affiliation(s)
- Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Jinying Zhao
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - David A Savitz
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Mattia Prosperi
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Yi Zheng
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Thomas A Pearson
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
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50
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Testing the Multiple Pathways of Residential Greenness to Pregnancy Outcomes Model in a Sample of Pregnant Women in the Metropolitan Area of Donostia-San Sebastián. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124520. [PMID: 32586011 PMCID: PMC7345127 DOI: 10.3390/ijerph17124520] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/16/2022]
Abstract
Residential greenness may positively impact diverse human health indicators through the reduction of air pollution, the improvement of psychological health, and the promotion of physical activity. Previous studies indicate a weak but positive association with pregnancy outcomes. Our aim was to test the multiple pathways from residential greenness to pregnancy outcomes model, using residential NO2 concentrations, psychological health, and moderate-to-vigorous physical activity (MVPA) during the first trimester of pregnancy, in a sample of 440 pregnant women residing in Donostia, Spain. Three metrics of residential greenness were calculated around each participant’s home address: normalized difference vegetation index (NDVI) within 300 m, and green space (>5000 m2) availability within 300 and 500 m. Residential NO2 concentrations, psychological health, and MVPA were explored as mediators of the associations between these metrics and the following pregnancy outcomes: birth weight (BW), low birth weight (LBW), prematurity, small for gestational age (SGA), and large for gestational age (LGA). Educational attainment, parity, and body mass index (BMI) were treated as covariates. Counterfactual mediation analyses showed very low to null statistical support for an association between any of the greenspace metrics and pregnancy outcomes in the full sample. Green space availability (300 m) was associated with lower BW and showed a marginal protective effect against LGA.
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