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Cotter DL, Morrel J, Sukumaran K, Cardenas-Iniguez C, Schwartz J, Herting MM. Prenatal and childhood air pollution exposure, cellular immune biomarkers, and brain connectivity in early adolescents. Brain Behav Immun Health 2024; 38:100799. [PMID: 39021436 PMCID: PMC11252082 DOI: 10.1016/j.bbih.2024.100799] [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: 11/28/2023] [Revised: 05/10/2024] [Accepted: 05/21/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Ambient air pollution is a neurotoxicant with hypothesized immune-related mechanisms. Adolescent brain structural and functional connectivity may be especially vulnerable to ambient pollution due to the refinement of large-scale brain networks during this period, which vary by sex and have important implications for cognitive, behavioral, and emotional functioning. In the current study we explored associations between air pollutants, immune markers, and structural and functional connectivity in early adolescence by leveraging cross-sectional sex-stratified data from the Adolescent Brain Cognitive Development℠ Study®. Methods Pollutant concentrations of fine particulate matter, nitrogen dioxide, and ozone were assigned to each child's primary residential address during the prenatal period and childhood (9-10 years-old) using an ensemble-based modeling approach. Data collected at 11-13 years-old included resting-state functional connectivity of the default mode, frontoparietal, and salience networks and limbic regions of interest, intracellular directional and isotropic diffusion of available white matter tracts, and markers of cellular immune activation. Using partial least squares correlation, a multivariate data-driven method that identifies important variables within latent dimensions, we investigated associations between 1) pollutants and structural and functional connectivity, 2) pollutants and immune markers, and 3) immune markers and structural and functional connectivity, in each sex separately. Results Air pollution exposure was related to white matter intracellular directional and isotropic diffusion at ages 11-13 years, but the direction of associations varied by sex. There were no associations between pollutants and resting-state functional connectivity at ages 11-13 years. Childhood exposure to nitrogen dioxide was negatively correlated with white blood cell count in males. Immune biomarkers were positively correlated with white matter intracellular directional diffusion in females and both white matter intracellular directional and isotropic diffusion in males. Lastly, there was a reliable negative correlation between lymphocyte-to-monocyte ratio and default mode network resting-state functional connectivity in females, as well as a compromised immune marker profile associated with lower resting-state functional connectivity between the salience network and the left hippocampus in males. In post-hoc exploratory analyses, we found that the PLSC-identified white matter tracts and resting-state networks related to processing speed and cognitive control performance from the NIH Toolbox. Conclusions We identified novel links between childhood nitrogen dioxide and cellular immune activation in males, and brain network connectivity and immune markers in both sexes. Future research should explore the potentially mediating role of immune activity in how pollutants affect neurological outcomes as well as the potential consequences of immune-related patterns of brain connectivity in service of improved brain health for all.
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Affiliation(s)
- Devyn L. Cotter
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jessica Morrel
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kirthana Sukumaran
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carlos Cardenas-Iniguez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Megan M. Herting
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Children's Hospital Los Angeles, Los Angeles, CA, USA
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Yang Y, Wu H, Zeng Y, Xu F, Zhao S, Zhang L, An Z, Li H, Li J, Song J, Wu W. Short-term exposure to air pollution on peripheral white blood cells and inflammation biomarkers: a cross-sectional study on rural residents. BMC Public Health 2024; 24:1702. [PMID: 38926692 PMCID: PMC11201365 DOI: 10.1186/s12889-024-19116-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Effects of short-term exposure to ambient air pollution on systemic immunological and inflammatory biomarkers in rural population have not been adequately characterized. From May to July 2021, 5816 participants in rural villages of northern Henan Province, China, participated in this cross-sectional study. Blood biomarkers of systemic inflammation were determined including peripheral white blood cells (WBC), eosinophils (EOS), basophils (BAS), monocytes (MON), lymphocytes (LYM), neutrophils (NEU), neutrophil-lymphocyte ratio (NLR), and serum high-sensitivity C-reactive protein (hs-CRP). The concentrations of ambient fine particulate matter (PM2.5), PM10, nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were assessed up to 7 days prior to the blood draw. A generalized linear model was used to analyze the associations between air pollution exposure and the above-mentioned blood biomarkers. Significantly positive associations were revealed between PM2.5, CO and WBC; CO, O3 and LYM; PM2.5, PM10, SO2, CO and NEU; PM2.5, PM10, SO2, CO and NLR; PM2.5, PM10, SO2, NO2, CO, O3 and hs-CRP. Meanwhile, negative associations were found between SO2 and WBC; PM2.5, PM10, NO2, CO, or O3 and EOS; PM2.5, SO2, or CO and BAS; SO2, NO2 or O3 and MON; PM2.5, PM10, SO2, or NO2 and LYM. Moreover, men, individuals with normal body mass index (BMI), current smokers, and those older than 60 years were found vulnerable to air pollution effects. Taken together, short-term exposure to air pollution was associated with systemic inflammatory responses, providing insight into the potential mechanisms for air pollution-induced detrimental systemic effects in rural residents.
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Affiliation(s)
- Yishu Yang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Hui Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Yuling Zeng
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Fei Xu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Shuaiqi Zhao
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Ling Zhang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Zhen An
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Huijun Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Juan Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Jie Song
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China
| | - Weidong Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China.
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, Henan Province, China.
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Liu C, Zhao X, Guo L, Yu Q, Zhang W, Peng Z, Gao Y, Gong X, Li P, Jiao H, Zhou T, Zhang Q, Song S, Jiang G. Emerging N-(1,3-dimethylbutyl)-N'-phenyl-p-phenylenediamine (6PPD) and 6PPD quinone in paired human plasma and urine from Tianjin, China: Preliminary assessment with demographic factors. JOURNAL OF HAZARDOUS MATERIALS 2024; 476:134818. [PMID: 38901252 DOI: 10.1016/j.jhazmat.2024.134818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/07/2024] [Accepted: 06/03/2024] [Indexed: 06/22/2024]
Abstract
With increasing concerns about N-(1,3-Dimethylbutyl)-N'-phenyl-p-phenylenediamine (6PPD) and 6PPD-quinone (6PPD-Q), relevant environmental investigations and toxicological research have sprung up in recent years. However, limited information could be found for human body burden assessment. This work collected and analyzed 200 samples consisting of paired urine and plasma samples from participants (50 male and 50 female) in Tianjin, China. Low detection frequencies (DF, <15 %) were found except for urinary 6PPD-Q (86 %), which suggested the poor residue tendency of 6PPD and 6PPD-Q in blood. The low DFs also lead to no substantial association between two chemicals. Data analysis based on urinary 6PPD-Q showed a significant difference between males and females (p < 0.05). No significant correlation was found for other demographic factors (Body Mass Index (BMI), age, drinking, and smoking). The mean values of daily excretion (ng/kg bw/day) calculated using urinary 6PPD-Q for females and males were 7.381 ng/kg bw/day (female) and 3.360 ng/kg bw/day (male), and apparently female suffered higher daily exposure. Further analysis with daily excretion and ALT (alanine aminotransferase)/TSH (thyroid stimulating hormone)/ blood cell analysis indicators found a potential correlation with 6PPD-Q daily excretion and liver/immune functions. Considering this preliminary assessment, systematic research targeting the potential organs at relevant concentrations is required.
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Affiliation(s)
- Chunyu Liu
- National Institute of Metrology, Beijing 100029, China; School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin 300384, China
| | - Xingchen Zhao
- School of Environmental Science and Engineering, Shandong University, Jinan 250100, China
| | - Liqiong Guo
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Tianjin Fourth Central Hospital, Tianjin 300140, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China
| | - Qilin Yu
- Key Laboratory of Molecular Microbiology and Technology, Ministry of Education, Department of Microbiology, College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Weifei Zhang
- National Institute of Metrology, Beijing 100029, China
| | - Zijuan Peng
- National Institute of Metrology, Beijing 100029, China
| | - Yan Gao
- National Institute of Metrology, Beijing 100029, China
| | - Xiaoyun Gong
- National Institute of Metrology, Beijing 100029, China
| | - Penghui Li
- School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin 300384, China.
| | - Hui Jiao
- National Institute of Metrology, Beijing 100029, China
| | - Tao Zhou
- National Institute of Metrology, Beijing 100029, China
| | - Qinghe Zhang
- National Institute of Metrology, Beijing 100029, China
| | - Shanjun Song
- National Institute of Metrology, Beijing 100029, China; School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin 300384, China.
| | - Guibin Jiang
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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Abdrabouh AES. Toxicological and histopathological alterations in the heart of young and adult albino rats exposed to mosquito coil smoke. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:93070-93087. [PMID: 37501034 PMCID: PMC10447284 DOI: 10.1007/s11356-023-28812-2] [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: 05/26/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
Mosquito coil repellents are well-known indoor air pollutant with significant health concerns. The present study investigated the toxic effects of mosquito coil smoke on the heart of young and adult male rats. The animals were subjected to the smoke for 6 h/day, 6 days/week, for 4 weeks. Within the first hour after lighting the coil, significant amounts of formaldehyde, total volatile organic compounds, and particulate matter (PM2.5 and PM10) were detected. Both exposed ages, particularly the young group, showed a significant increase in the activities of serum aspartate aminotransferase, lactate dehydrogenase, creatine kinase-MB, and the levels of troponin I, myoglobin, Na+ levels, lipid profile, and inflammatory markers (interleukin-6 and C-reactive protein) as well as a significant decrease in K+ levels and cardiac Na-K ATPase activity, indicating development of cardiac inflammation and dysfunction. Furthermore, the toxic stress response was validated by significant downregulation at expression of the detoxifying enzyme cytochrome p450. Histopathological studies in both age groups, especially the young group, revealed cardiomyocyte degeneration and necrotic areas. Moreover, upregulation at the pro-apoptotic markers, caspase3, P53, and cytochrome C expressions, was detected by immunohistochemical approach in heart sections of the exposed groups. Finally, the myocardial dysfunctional effects of the coil active ingredient, meperfluthrin, were confirmed by the docking results which indicated a high binding affinity of meperfluthrin, with Na-K ATPase and caspase 3. In conclusion, both the young and adult exposed groups experienced significant cardiac toxicity changes evidenced by cell apoptosis and histopathological alterations as well as disruption of biochemical indicators.
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Serafini MM, Maddalon A, Iulini M, Galbiati V. Air Pollution: Possible Interaction between the Immune and Nervous System? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192316037. [PMID: 36498110 PMCID: PMC9738575 DOI: 10.3390/ijerph192316037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/14/2022] [Accepted: 11/26/2022] [Indexed: 06/01/2023]
Abstract
Exposure to environmental pollutants is a serious and common public health concern associated with growing morbidity and mortality worldwide, as well as economic burden. In recent years, the toxic effects associated with air pollution have been intensively studied, with a particular focus on the lung and cardiovascular system, mainly associated with particulate matter exposure. However, epidemiological and mechanistic studies suggest that air pollution can also influence skin integrity and may have a significant adverse impact on the immune and nervous system. Air pollution exposure already starts in utero before birth, potentially causing delayed chronic diseases arising later in life. There are, indeed, time windows during the life of individuals who are more susceptible to air pollution exposure, which may result in more severe outcomes. In this review paper, we provide an overview of findings that have established the effects of air pollutants on the immune and nervous system, and speculate on the possible interaction between them, based on mechanistic data.
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Li M, Ma Y, Fu Y, Liu J, Hu H, Zhao Y, Huang L, Tan L. Association between air pollution and
CSF sTREM2
in cognitively normal older adults: The
CABLE
study. Ann Clin Transl Neurol 2022; 9:1752-1763. [PMID: 36317226 PMCID: PMC9639632 DOI: 10.1002/acn3.51671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/04/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives Ambient air pollution aggravates the process of Alzheimer's disease (AD) pathology. Currently, the exact inflammatory mechanisms underlying these links from clinical research remain largely unclear. Methods This study included 1,131 cognitively intact individuals from the Chinese Alzheimer's Biomarker and LifestylE database with data provided on cerebrospinal fluid (CSF) AD biomarkers (amyloid beta‐peptide 42 [Aβ42], total tau [t‐tau], and phosphorylated tau [p‐tau]), neuroinflammatory (CSF sTREM2), and systemic inflammatory markers (high sensitivity C‐reactive protein and peripheral immune cells). The 2‐year averaged levels of ambient fine particulate matter with diameter <2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) were estimated at each participant's residence. Multiple‐adjusted models were approached to detect associations of air pollution with inflammatory markers and AD‐related proteins. Results Ambient 2‐year averaged exposure of PM2.5 was associated with changes of neuroinflammatory markers, that is, CSF sTREM2 (β = −0.116, p = 0.0002). Similar results were found for O3 exposure among the elderly (β = −0.111, p = 0.0280) or urban population (β = −0.090, p = 0.0144). No significant evidence supported NO2 related to CSF sTREM2. For potentially causal associations with accumulated AD pathologies, the total effects of PM2.5 on CSF amyloid‐related protein (CSF Aβ42 and p‐tau/Aβ42) were partly mediated by CSF sTREM2, with proportions of 14.22% and 47.15%, respectively. Additional analyses found inverse associations between peripheral inflammatory markers with PM2.5 and NO2, but a positive correlation with O3. Interpretation These findings demonstrated a strong link between PM2.5 exposure and microglial dysfunction. Furthermore, CSF sTREM2 as a key mediator modulated the influences of PM2.5 exposure on AD amyloid pathologies.
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Affiliation(s)
- Meng Li
- Department of Neurology Qingdao Municipal Hospital, Qingdao University Qingdao China
| | - Ya‐Hui Ma
- Department of Neurology Qingdao Municipal Hospital, Qingdao University Qingdao China
| | - Yan Fu
- Department of Neurology Qingdao Municipal Hospital, Qingdao University Qingdao China
| | - Jia‐Yao Liu
- Department of Neurology Qingdao Municipal Hospital, Qingdao University Qingdao China
| | - He‐Ying Hu
- Department of Neurology Qingdao Municipal Hospital, Qingdao University Qingdao China
| | - Yong‐Li Zhao
- Department of Neurology Qingdao Municipal Hospital, Qingdao University Qingdao China
| | - Liang‐Yu Huang
- Department of Neurology Qingdao Municipal Hospital, Qingdao University Qingdao China
| | - Lan Tan
- Department of Neurology Qingdao Municipal Hospital, Qingdao University Qingdao China
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Orysiak J, Młynarczyk M, Piec R, Jakubiak A. Lifestyle and environmental factors may induce airway and systemic inflammation in firefighters. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:73741-73768. [PMID: 36094704 PMCID: PMC9465149 DOI: 10.1007/s11356-022-22479-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
Health status depends on multiple genetic and non-genetic factors. Nonheritable factors (such as lifestyle and environmental factors) have stronger impact on immune responses than genetic factors. Firefighters work is associated with exposure to air pollution and heat stress, as well as: extreme physical effort, mental stress, or a changed circadian rhythm, among others. All these factors can contribute to both, short-term and long-term impairment of the physical and mental health of firefighters. Increased levels of some inflammatory markers, such as pro-inflammatory cytokines or C-reactive protein (CRP) have been observed in firefighters, which can lead to local, acute inflammation that promotes a systemic inflammatory response. It is worth emphasizing that inflammation is one of the main hallmarks of cancer and also plays a key role in the development of cardiovascular and respiratory diseases. This article presents possible causes of the development of an inflammatory reaction in firefighters, with particular emphasis on airway inflammation caused by smoke exposure.
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Affiliation(s)
- Joanna Orysiak
- Central Institute for Labour Protection - National Research Institute, Czerniakowska St. 16, 00-701, Warsaw, Poland.
| | - Magdalena Młynarczyk
- Central Institute for Labour Protection - National Research Institute, Czerniakowska St. 16, 00-701, Warsaw, Poland
| | - Robert Piec
- Institute of Internal Security, The Main School of Fire Service, Słowackiego St. 52/54, 01-629, Warsaw, Poland
| | - Agnieszka Jakubiak
- Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Żwirki and Wigury St. 61, 02-091, Warsaw, Poland
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Abdrabouh AE. Inflammatory and proapoptotic effects of inhaling gasoline fumes on the lung and ameliorative effects of fenugreek seeds. Sci Rep 2022; 12:14446. [PMID: 36002599 PMCID: PMC9402566 DOI: 10.1038/s41598-022-18607-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
Impacts of inhaling gasoline fumes on the lungs of adult male rats and the alleviating role of fenugreek seeds were evaluated. Twenty-four rats were divided into four groups, unexposed control and fenugreek groups, gasoline exposed groups for 6 h/6 day/week for 10 weeks with and without supplementation of fenugreek seed powder in food (5% w/w). Rats exposed to gasoline fumes showed significant elevation in lung tumor necrosis factor-α, as an inflammatory marker, and the proapoptotic marker Bax with a reduction in the antiapoptotic marker Bcl2. Moreover, remarkable elevations in transforming growth factor-β1, collagen and hydroxyproline were observed as fibrotic markers. Lung oxidative stress markers (hydrogen peroxides, malondialdehyde, and protein carbonyl) increased significantly along with marked decrease in total antioxidant capacity, superoxide dismutase, and catalase levels. Additionally, marked decreases in white and red blood cell counts, hemoglobin content, platelet count, accompanied by elevated red cell distribution width percentage were observed, supporting the inflammatory status. Histopathological changes represented by hematoxylin&eosin, immunohistochemistry staining for Bax&Bcl2, and transmission electron microscopy supported the negative impacts of gasoline fumes compared to the control group. Fenugreek seeds supplementation with gasoline exposure showed pronounced alleviation of lung biochemical and histopathological changes compared to the gasoline-exposed group.
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Affiliation(s)
- Abeer E Abdrabouh
- Zoology Department, Faculty of Science, Mansoura University, Mansoura, Egypt.
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The Association of Carcinoembryonic Antigen (CEA) and Air Pollutants—A Population-Based Study. ATMOSPHERE 2022. [DOI: 10.3390/atmos13030466] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Air pollutants are substances in the air that have harmful effects on humans and the ecological environment. Although slight elevations in carcinoembryonic antigen (CEA) are commonly observed in apparently healthy persons, potential associations between CEA levels and chronic low-grade inflammation induced by air pollution have yet to be documented. We conducted a community-based cross-sectional study to estimate the association between short-term exposure to ambient air pollution and the CEA. A total of 9728 participants from health examinations were enrolled for the analysis and linked with their residential air pollutant data including ozone (O3), nitrogen dioxide (NO2), carbon monoxide (CO), sulphur dioxide (SO2), and particulate matter (PM10). The results showed that every increase of 1 ppm O3 significantly increased the mean differences of the CEA blood concentration by 0.005 ng/mL. Each increase of 1 ppm CO significantly reduced the mean differences of the CEA blood concentration by 0.455 ng/mL. Although smoking and alcohol drinking also increased the CEA levels, with adjustment of these confounders we identified a significant association between serum CEA in the general population and levels of the air pollutants O3 and CO. In conclusion, the serum CEA concentrations and short-term air pollutants O3 and CO exposure were found to have a significant relationship; however, its mechanism is still unclear. Moreover, long-term air pollution exposure and changes in CEA concentration still need to be further evaluated.
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