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Kunutsor SK, Lehoczki A, Laukkanen JA. The untapped potential of cold water therapy as part of a lifestyle intervention for promoting healthy aging. GeroScience 2024:10.1007/s11357-024-01295-w. [PMID: 39078461 DOI: 10.1007/s11357-024-01295-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/19/2024] [Indexed: 07/31/2024] Open
Abstract
Healthy aging is a crucial goal in aging societies of the western world, with various lifestyle strategies being employed to achieve it. Among these strategies, hydrotherapy stands out for its potential to promote cardiovascular and mental health. Cold water therapy, a hydrotherapy technique, has emerged as a lifestyle strategy with the potential capacity to evoke a wide array of health benefits. This review aims to synthesize the extensive body of research surrounding cold water therapy and its beneficial effects on various health systems as well as the underlying biological mechanisms driving these benefits. We conducted a search for interventional and observational cohort studies from MEDLINE and EMBASE up to July 2024. Deliberate exposure of the body to cold water results in distinct physiological responses that may be linked to several health benefits. Evidence, primarily from small interventional studies, suggests that cold water therapy positively impacts cardiometabolic risk factors, stimulates brown adipose tissue and promotes energy expenditure-potentially reducing the risk of cardiometabolic diseases. It also triggers the release of stress hormones, catecholamines and endorphins, enhancing alertness and elevating mood, which may alleviate mental health conditions. Cold water therapy also reduces inflammation, boosts the immune system, promotes sleep and enhances recovery following exercise. The optimal duration and temperature needed to derive maximal benefits is uncertain but current evidence suggests that short-term exposure and lower temperatures may be more beneficial. Overall, cold water therapy presents a potential lifestyle strategy to enhancing physical and mental well-being, promoting healthy aging and extending the healthspan, but definitive interventional evidence is warranted.
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Affiliation(s)
- Setor K Kunutsor
- Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R2H 2A6, Canada.
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK.
| | - Andrea Lehoczki
- Department of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Wellbeing Services County of Central Finland, Department of Medicine, Finland District, Jyväskylä, Finland
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Fischer S, Naegeli K, Cardone D, Filippini C, Merla A, Hanusch KU, Ehlert U. Emerging effects of temperature on human cognition, affect, and behaviour. Biol Psychol 2024; 189:108791. [PMID: 38599369 DOI: 10.1016/j.biopsycho.2024.108791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/26/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024]
Abstract
Human body core temperature is tightly regulated within approximately 37 °C. Global near surface temperature has increased by over 1.2 °C between 1850 and 2020. In light of the challenge this poses to human thermoregulation, the present perspective article sought to provide an overview on the effects of varying ambient and body temperature on cognitive, affective, and behavioural domains of functioning. To this end, an overview of observational and experimental studies in healthy individuals and individuals with mental disorders was provided. Within body core temperature at approximately 37 °C, relatively lower ambient and skin temperatures appear to evoke a need for social connection, whereas comparably higher temperatures appear to facilitate notions of other as closer and more sociable. Above-average ambient temperatures are associated with increased conflicts as well as incident psychotic and depressive symptoms, mental disorders, and suicide. With mild hypo- and hyperthermia, paradoxical effects are observed: whereas the acute states are generally characterised by impairments in cognitive performance, anxiety, and irritability, individuals with depression experience longer-term symptom improvements with treatments deliberately inducing these states for brief amounts of time. When taken together, it has thus become clear that temperature is inexorably associated with human cognition, affect, and (potentially) behaviour. Given the projected increase in global warming, further research into the affective and behavioural sequelae of heat and the mechanisms translating it into mental health outcomes is urgently warranted.
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Affiliation(s)
- Susanne Fischer
- University of Zurich, Institute of Psychology, Zurich, Switzerland.
| | - Kathrin Naegeli
- University of Zurich, Department of Geography, Zurich, Switzerland
| | - Daniela Cardone
- University G. d'Annunzio of Chieti-Pescara, Department of Engineering and Geology, Chieti, Italy
| | - Chiara Filippini
- University G. d'Annunzio of Chieti-Pescara, Department of Engineering and Geology, Chieti, Italy
| | - Arcangelo Merla
- University G. d'Annunzio of Chieti-Pescara, Department of Engineering and Geology, Chieti, Italy
| | - Kay-Uwe Hanusch
- Bern University of Applied Sciences, Department of Health Sciences, Berne, Switzerland
| | - Ulrike Ehlert
- University of Zurich, Institute of Psychology, Zurich, Switzerland
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Li XY, Yin X, Lu JJ, Li QR, Xing WQ, Han Q, Ji H, Li SZ, Yang HM, Guo JR, Wang ZQ, Xu B. Ubiquitinome Analysis Uncovers Alterations in Synaptic Proteins and Glucose Metabolism Enzymes in the Hippocampi of Adolescent Mice Following Cold Exposure. Cells 2024; 13:570. [PMID: 38607009 PMCID: PMC11011669 DOI: 10.3390/cells13070570] [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: 12/18/2023] [Revised: 02/08/2024] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
Cold exposure exerts negative effects on hippocampal nerve development in adolescent mice, but the underlying mechanisms are not fully understood. Given that ubiquitination is essential for neurodevelopmental processes, we attempted to investigate the effects of cold exposure on the hippocampus from the perspective of ubiquitination. By conducting a ubiquitinome analysis, we found that cold exposure caused changes in the ubiquitination levels of a variety of synaptic-associated proteins. We validated changes in postsynaptic density-95 (PSD-95) ubiquitination levels by immunoprecipitation, revealing reductions in both the K48 and K63 polyubiquitination levels of PSD-95. Golgi staining further demonstrated that cold exposure decreased the dendritic-spine density in the CA1 and CA3 regions of the hippocampus. Additionally, bioinformatics analysis revealed that differentially ubiquitinated proteins were enriched in the glycolytic, hypoxia-inducible factor-1 (HIF-1), and 5'-monophosphate (AMP)-activated protein kinase (AMPK) pathways. Protein expression analysis confirmed that cold exposure activated the mammalian target of rapamycin (mTOR)/HIF-1α pathway. We also observed suppression of pyruvate kinase M2 (PKM2) protein levels and the pyruvate kinase (PK) activity induced by cold exposure. Regarding oxidative phosphorylation, a dramatic decrease in mitochondrial respiratory-complex I activity was observed, along with reduced gene expression of the key subunits NADH: ubiquinone oxidoreductase core subunit V1 (Ndufv1) and Ndufv2. In summary, cold exposure negatively affects hippocampal neurodevelopment and causes abnormalities in energy homeostasis within the hippocampus.
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Affiliation(s)
- Xin-Yue Li
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Xin Yin
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Jing-Jing Lu
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Qian-Ru Li
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Wan-Qun Xing
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Qi Han
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Hong Ji
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Shi-Ze Li
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Huan-Min Yang
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Jing-Ru Guo
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
| | - Zhi-Quan Wang
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Bin Xu
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing 163319, China; (X.-Y.L.)
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Moes MI, Elia A, Gennser M, Keramidas ME. Combined effects of mild hypothermia and nitrous-oxide-induced narcosis on manual and cognitive performance. Am J Physiol Regul Integr Comp Physiol 2024; 326:R197-R209. [PMID: 38189165 PMCID: PMC11283895 DOI: 10.1152/ajpregu.00246.2023] [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: 11/08/2023] [Revised: 12/18/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
Divers are at enhanced risk of suffering from acute cognitive deterioration because of the low ambient temperatures and the narcotic action of inert gases inspired at high pressures. Yet, the behavioral effects of cold and inert gas narcosis have commonly been assessed in isolation and during short-term provocations. We therefore evaluated the interactive influence of mild hypothermia and narcosis engendered by a subanesthetic dose of nitrous oxide (N2O; a normobaric intervention analog of hyperbaric nitrogen) on cognitive function during prolonged iterative exposure. Fourteen men partook in two ∼12-h sessions (separated by ≥4 days), wherein they performed sequentially three 120-min cold (20°C) water immersions (CWIs), while inhaling, in a single-blinded manner, either normal air or a normoxic gas mixture containing 30% N2O. CWIs were separated by a 120-min rewarming in room-air breathing conditions. Before the first CWI and during each CWI, subjects performed a finger dexterity test, and the Spaceflight Cognitive Assessment Tool for Windows (WinSCAT) test assessing aspects of attention, memory, learning, and visuospatial ability. Rectal and skin temperatures were, on average, reduced by ∼1.2 °C and ∼8 °C, respectively (P < 0.001). Cooling per se impaired (P ≤ 0.01) only short-term memory (∼37%) and learning (∼18%); the impairments were limited to the first CWI. N2O also attenuated (P ≤ 0.02) short-term memory (∼37%) and learning (∼35%), but the reductions occurred in all CWIs. Furthermore, N2O invariably compromised finger dexterity, attention, concentration, working memory, and spatial processing (P < 0.05). The present results demonstrate that inert gas narcosis aggravates, in a persistent manner, basic and higher-order cognitive abilities during protracted cold exposure.
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Affiliation(s)
- Maaike I Moes
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Antonis Elia
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Mikael Gennser
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Michail E Keramidas
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
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Néma J, Zdara J, Lašák P, Bavlovič J, Bureš M, Pejchal J, Schvach H. Impact of cold exposure on life satisfaction and physical composition of soldiers. BMJ Mil Health 2024:e002237. [PMID: 36599485 DOI: 10.1136/military-2022-002237] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/07/2022] [Indexed: 01/05/2023]
Abstract
This article has been retracted.
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Affiliation(s)
- Jiří Néma
- Department of Military Medical Services Organisation and Management, University of Defence in Brno Faculty of Military Health Sciences, Hradec Kralove, Czech Republic
| | - J Zdara
- Department of Military Medical Services Organisation and Management, University of Defence in Brno Faculty of Military Health Sciences, Hradec Kralove, Czech Republic
| | - P Lašák
- Department of Military Internal Medicine and Military Hygiene, University of Defence in Brno Faculty of Military Health Sciences, Hradec Kralove, Czech Republic
| | - J Bavlovič
- Department of Molecular Pathology and Biology, University of Defence in Brno Faculty of Military Health Sciences, Hradec Kralove, Czech Republic
| | - M Bureš
- Department of Computer Science, Czech Technical University in Prague, Prague, Czech Republic
| | - J Pejchal
- Department of Toxicology and Military Pharmacy, University of Defence in Brno Faculty of Military Health Sciences, Hradec Kralove, Czech Republic
| | - H Schvach
- Department of Military Medical Services Organisation and Management, University of Defence in Brno Faculty of Military Health Sciences, Hradec Kralove, Czech Republic
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López-Ojeda W, Hurley RA. Cold-Water Immersion: Neurohormesis and Possible Implications for Clinical Neurosciences. J Neuropsychiatry Clin Neurosci 2024; 36:A4-177. [PMID: 38986020 DOI: 10.1176/appi.neuropsych.20240053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Affiliation(s)
- Wilfredo López-Ojeda
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC) and Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (López-Ojeda, Hurley); Department of Psychiatry and Behavioral Medicine (López-Ojeda, Hurley) and Department of Radiology (Hurley), Wake Forest University School of Medicine, Winston-Salem, N.C
| | - Robin A Hurley
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC) and Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (López-Ojeda, Hurley); Department of Psychiatry and Behavioral Medicine (López-Ojeda, Hurley) and Department of Radiology (Hurley), Wake Forest University School of Medicine, Winston-Salem, N.C
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Dewi ES, Zakiya FA, Mei KW, Arimbawa G, Evi N. The Impact of Aromatherapy Gelatin Cold Compresses on the Concentration Level of Students in the Covid-19 Pandemic Online Class. SAGE Open Nurs 2024; 10:23779608241228901. [PMID: 38362464 PMCID: PMC10868485 DOI: 10.1177/23779608241228901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/19/2023] [Accepted: 12/22/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction Stressful circumstances presented by the Covid-19 pandemic led to reduced levels of study concentration among students, and these conditions had been linked with dopamine levels. Objectives This study aimed to evaluate the impact of aromatherapy gelatin cold compress in increasing the study concentration of students by decreasing stress levels and elevating dopamine levels during the Covid-19 pandemic online class. Methods The study participants consisted of 42 students, who were selected using the simple random sampling method. Subsequently, the participants were comparably divided into control and treatment groups. Compress intervention was given to the treatment group on the forehead for 10 min before studying online. The Visual Analog Scale (VAS) and Stroop test were then used to determine stress and concentration levels of the students, respectively. The catecholamine fractionated urine was used to measure dopamine levels. Analysis was carried out using Paired T-test and Independent T-test with α = 0.05 and CI = 95%. Results The mean value of the VAS before and after treatment was 5.81 ± 2.48 and 5.28 ± 2.61 in the control (p = 0.205), as well as 6.28 ± 1.62 and 4.38 ± 1.89 in the treatment group (p = 0.000). The mean interference score of the Stroop test before and after treatment was 13.16 ± 1.05 and 13.22 ± 1.31 among the controls (p = 0.947), while 13.35 ± 6.94 and 8.92 ± 5.91 were recorded in the treatment group (p = 0.000). The average dopamine levels before and after the intervention were 145.50 ± 7.94 mg/mL and 146.65 ± 8.23 mg/mL creatinine among the controls (p = 0.542), while 145.35 ± 1.03 mg/mL and 265.18 ± 1.27 mg/mL creatinine were obtained in the treatment group (p = 0.01). Furthermore, the results showed that the creatinine levels were within the normal ranges. The Independent T-test of stress, concentration, and dopamine levels obtained p = 0.024, p = 0.010, and p = 0.090, respectively. Conclusion Aromatherapy gelatin cold compress was effective in increasing study concentration by decreasing stress levels and increasing dopamine levels during the Covid-19 pandemic online class.
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Affiliation(s)
- Elvira Sari Dewi
- Department of Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Fifi Afifatus Zakiya
- Bachelor of Nursing Science Study Program, Faculty of Health Sciences, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Karina Wulan Mei
- Bachelor of Nursing Science Study Program, Faculty of Health Sciences, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Gusde Arimbawa
- Bachelor of Nursing Science Study Program, Faculty of Health Sciences, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Nurul Evi
- Department of Public Health, Faculty of Sports, Universitas Negeri Malang, Malang, East Java, Indonesia
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Saunders S, Furby W, Chillingsworth K, Walker EF, White G. A preliminary study of the thermal strain experienced by dive support boat personnel. Int J Circumpolar Health 2023; 82:2199491. [PMID: 37067541 PMCID: PMC10114968 DOI: 10.1080/22423982.2023.2199491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
Anecdotal evidence indicated some British military dive support boat personnel suffer from uncomfortably cold hands and feet, which could impair their performance and be associated with reductions in core body temperature. This study collected preliminary data on thermal stress and cognitive performance of personnel taking part in a cold-weather training exercise. Six men were monitored during four boat transits in a range of climatic conditions (air temperature +1.2°C to -10.5°C, wind chill -4.5°C to 19.3°C). Core body temperature was measured with a radio pill and 12 skin sites (ISO 9886 plus hand, finger, foot and toe) with iButtons or thermistors. Self-reported thermal comfort and thermal sensation was also recorded. Reaction time and selective attention were measured pre- and post-transit. Participants' physical characteristics and personal clothing ensembles were recorded. No participant became hypothermic. Most participants' hand, foot and digit temperatures fell to below 15°C, indicating a risk of impaired dexterity, in addition to that arising from gloves. During the trial, hand and digit temperatures occasionally fell below 10°C. The limited data collected showed personal clothing choices could provide adequate thermal protection for these conditions and temperatures, and highlighted inter-individual variation and the need to allow for significant variation of day-to-day environmental conditions.
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Affiliation(s)
- Samantha Saunders
- Human Performance Group, Defence Science and Technology Laboratory (Dstl), Salisbury, Wiltshire, UK
| | - Will Furby
- Human Performance Group, Defence Science and Technology Laboratory (Dstl), Salisbury, Wiltshire, UK
| | - Kieran Chillingsworth
- Human Performance Group, Defence Science and Technology Laboratory (Dstl), Salisbury, Wiltshire, UK
| | - Ella F Walker
- Human Performance Group, Defence Science and Technology Laboratory (Dstl), Salisbury, Wiltshire, UK
| | - Graham White
- Human Performance Group, Defence Science and Technology Laboratory (Dstl), Salisbury, Wiltshire, UK
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Wallace PJ, Gagnon DD, Hartley GL, Taber MJ, Cheung SS. Effects of skin and mild core cooling on cognitive function in cold air in men. Physiol Rep 2023; 11:e15893. [PMID: 38114071 PMCID: PMC10730300 DOI: 10.14814/phy2.15893] [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: 11/02/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
This study tested the effects of skin and core cooling on cognitive function in 0°C cold air. Ten males completed a randomized, repeated measures study consisting of four environmental conditions: (i) 30 min of exposure to 22°C thermoneutral air (TN), (ii) 15 min to 0°C cold air which cooled skin temperature to ~27°C (CS), (iii) 0°C cold air exposure causing mild core cooling of ∆-0.3°C from baseline (C-0.3°C) and (iv) 0°C cold air exposure causing mild core cooling of ∆-0.8°C from baseline (C-0.8°C). Cognitive function (reaction time [ms] and errors made [#]) were tested using a simple reaction test, a two-six item working memory capacity task, and vertical flanker task to assess executive function. There were no condition effects (all p > 0.05) for number of errors made on any task. There were no significant differences in reaction time relative to TN for the vertical flanker and item working memory capacity task. However, simple reaction time was slower in C-0.3°C (297 ± 33 ms) and C-0.8°C (296 ± 41 ms) compared to CS (267 ± 26 ms) but not TN (274 ± 38). Despite small changes in simple reaction time (~30 ms), executive function and working memory was maintained in 0°C cold air with up to ∆-0.8°C reduction in core temperature.
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Affiliation(s)
- Phillip J. Wallace
- Environmental Ergonomics Laboratory, Department of KinesiologyBrock UniversitySt. CatharinesOntarioCanada
| | - Dominique D. Gagnon
- Faculty of Sports and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Clinic for Sports and Exercise Medicine, Department of Sports and Exercise Medicine, Faculty of MedicineUniversity of Helsinki MäkelänkatuHelsinkiFinland
- School of Kinesiology and Health SciencesLaurentian UniversitySudburyOntarioCanada
| | - Geoffrey L. Hartley
- Department of Physical and Health EducationNipissing UniversityNorth BayOntarioCanada
| | - Michael J. Taber
- Environmental Ergonomics Laboratory, Department of KinesiologyBrock UniversitySt. CatharinesOntarioCanada
- NM Consulting Inc.St. CatharinesOntarioCanada
| | - Stephen S. Cheung
- Environmental Ergonomics Laboratory, Department of KinesiologyBrock UniversitySt. CatharinesOntarioCanada
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Matre D, Sallinen M, Phillips AJK, Moen LV, Nilsen KB, Haugen F. Night work, season and alertness as occupational safety hazards in the Arctic: protocol for the Noralert observational crossover study among Norwegian process operators. BMJ Open 2023; 13:e075107. [PMID: 37793926 PMCID: PMC10551971 DOI: 10.1136/bmjopen-2023-075107] [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: 04/27/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION The objective of this study is to determine the effects of night work, Arctic seasonal factors and cold working environments on human functions relevant to safety. The study aims to quantify the contribution of (1) several consecutive night shifts, (2) seasonal variation on sleepiness, alertness and circadian rhythm and (3) whether a computational model of sleep, circadian rhythms and cognitive performance can accurately predict the observed sleepiness and alertness. METHODS AND ANALYSIS In an observational crossover study of outdoor and indoor workers (n=120) on a three-shift schedule from an industrial plant in Norway (70 °N), measurements will be conducted during the summer and winter. Sleep duration and quality will be measured daily by smartphone questionnaire, aided by actigraphy and heart rate measurements. Sleepiness and alertness will be assessed at regular intervals by the Karolinska Sleepiness Scale and the psychomotor vigilance test, respectively. Saliva samples will assess melatonin levels, and a blood sample will measure circadian time. Thermal exposures and responses will be measured by sensors and by thermography. ETHICS AND DISSEMINATION All participants will give written informed consent to participate in the study, which will be conducted in accordance with the Declaration of Helsinki. The Norwegian Regional Committee for Medical Research Ethics South-East D waivered the need for ethics approval (reference 495816). Dissemination plans include academic and lay publications, and partnerships with national and regional policymakers.
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Affiliation(s)
- Dagfinn Matre
- National Institute of Occupational Health, Oslo, Norway
| | - Mikael Sallinen
- Finnish Institute of Occupational Health, Työterveyslaitos, Finland
| | | | | | | | - Fred Haugen
- National Institute of Occupational Health, Oslo, Norway
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He C, Yin P, Liu Z, Huang J, Chen Y, Gao X, Xu Y, Wang C, Cai W, Gong P, Luo Y, Ji JS, Kan H, Chen R, Zhou M. Projections of excess deaths related to cold spells under climate and population change scenarios: A nationwide time series modeling study. ENVIRONMENT INTERNATIONAL 2023; 178:108034. [PMID: 37348158 DOI: 10.1016/j.envint.2023.108034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/23/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Future climate change is likely to alter cold spell-related disease burden. Few projection studies have considered the potential impact of the aging population with changing population size on cold spell-related disease burdens. METHODS We derived the association between cold spells and daily mortality for 272 main cities in mainland China. We combined these associations with modeled daily temperatures from three different climate models under two climate change scenarios and three population scenarios to project excess deaths related to cold spells. Furthermore, we used the factor separation method to calculate the independent contribution of future population size, age structure, and climate change on projected deaths attributable to cold spells. FINDINGS Compared to the baseline period, future excess deaths related to cold spells are expected to increase over most of the decades under RCP 2.6 (81.5% in 2050 s and 37% in 2090 s) and RCP 4.5 (55.5% in 2050 s and -19% in 2090 s). The factor analysis indicated that the rise of the aged population (≥65) substantially would amplify the excess deaths related to cold spells (increase by 101.1% in the 2050 s and 146.2% in the 2090 s). For the near future (2021-2040), population aging could fully offset the influence of decreased cold-spell days. In the middle of this century (2051-2070), the total excess deaths will exhibit significant variation across three scenarios. By the end of 21 century (2081-2100), the population shrinking would reduce the total excess deaths. INTERPRETATION Excess deaths related to cold spells may still increase in a warming climate and future demographic shifts would produce considerable influences in this increase for different periods.
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Affiliation(s)
- Cheng He
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhao Liu
- School of Linkong Economics and Management, Beijing Institute of Economics and Management, Beijing, China
| | - Jianbin Huang
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
| | - Yidan Chen
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing, China
| | - Xuejie Gao
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China; Climate Change Research Center, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Ying Xu
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Can Wang
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing, China
| | - Wenjia Cai
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
| | - Peng Gong
- Institute for Climate and Carbon Neutrality, Department of Earth Sciences and Geography, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yong Luo
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | - Renjie Chen
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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12
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Peng YY, Lu XM, Li S, Tang C, Ding Y, Wang HY, Yang C, Wang YT. Effects and mechanisms of extremely cold environment on body response after trauma. J Therm Biol 2023; 114:103570. [PMID: 37344028 DOI: 10.1016/j.jtherbio.2023.103570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/07/2023] [Accepted: 04/07/2023] [Indexed: 06/23/2023]
Abstract
With the outbreak of the Ukrainian crisis, extremely cold environment warfare has once again become the focus of international attention. People exposed to extremely cold environments may suffer from cold damage, further aggravate trauma, trigger high disability and mortality rates, and even cause serious sequelae. To declare the effects and mechanisms of the extremely cold environment on the body after trauma, this paper reviews, firstly, physiological reaction of human body in an extremely cold environment. Then, the post-traumatic body response in an extremely cold environment was introduced, and finally, the sequelae of trauma in extremely cold environment was further summarized in the paper. The results indicated that extremely cold environment can cause a series of damage to the body, especially the body after trauma. The extremely cold factor is a double-edged sword, showing a favorable and unfavorable side in different aspects. Moreover, in addition to the trauma suffered by the body, the subsequent sequelae such as cognitive dysfunction, anxiety, depression and even post-traumatic stress disorder may also be induced. The paper summarizes the human body's physiological response in an extremely cold environment, and declares the effects and mechanisms of the extremely cold environment on the body after trauma, which may provide a theoretical basis for effectively improving the level of combat trauma treatment in extremely cold regions.
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Affiliation(s)
- Yu-Yuan Peng
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China; College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Xiu-Min Lu
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Sen Li
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Can Tang
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Yang Ding
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, 400054, China
| | - Hai-Yan Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Ce Yang
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yong-Tang Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China.
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13
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Cognition and Neuropsychological Changes at Altitude-A Systematic Review of Literature. Brain Sci 2022; 12:brainsci12121736. [PMID: 36552195 PMCID: PMC9775937 DOI: 10.3390/brainsci12121736] [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: 11/21/2022] [Revised: 12/05/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
High-altitude (HA) exposure affects cognitive functions, but studies have found inconsistent results. The aim of this systematic review was to evaluate the effects of HA exposure on cognitive functions in healthy subjects. A structural overview of the applied neuropsychological tests was provided with a classification of superordinate cognitive domains. A literature search was performed using PubMed up to October 2021 according to PRISMA guidelines. Eligibility criteria included a healthy human cohort exposed to altitude in the field (at minimum 2440 m [8000 ft]) or in a hypoxic environment in a laboratory, and an assessment of cognitive domains. The literature search identified 52 studies (29 of these were field studies; altitude range: 2440 m-8848 m [8000-29,029 ft]). Researchers applied 112 different neuropsychological tests. Attentional capacity, concentration, and executive functions were the most frequently studied. In the laboratory, the ratio of altitude-induced impairments (64.7%) was twice as high compared to results showing no change or improved results (35.3%), but altitudes studied were similar in the chamber compared to field studies. In the field, the opposite results were found (66.4 % no change or improvements, 33.6% impairments). Since better acclimatization can be assumed in the field studies, the findings support the hypothesis that sufficient acclimatization has beneficial effects on cognitive functions at HA. However, it also becomes apparent that research in this area would benefit most if a consensus could be reached on a standardized framework of freely available neurocognitive tests.
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14
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Kienast C, Biere K, Coker RH, Genov NN, Jörres M, Maggioni MA, Mascarell-Maricic L, Schalt A, Genov M, Gunga HC, Steinach M. Adiponectin, leptin, cortisol, neuropeptide Y and profile of mood states in athletes participating in an ultramarathon during winter: An observational study. Front Physiol 2022; 13:970016. [PMID: 36579027 PMCID: PMC9791263 DOI: 10.3389/fphys.2022.970016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022] Open
Abstract
Background: The Montane® Yukon Arctic Ultra (YAU) is one of the longest (690 km) and coldest (+10.6°C-43.9°C) ultramarathons worldwide. Taking part in an ultramarathon is associated with great physiological and psychological stress, which can affect one's mood, level of hormones, and peptides. The current study aimed to identify relationships between peptides, hormones, and mood states in participants during this ultramarathon. Methods: The study cohort consisted of 36 participants (19 men, 17 women, 38.64 ± 9.12 years) split into a finisher (n = 10), non-finisher (n = 19), and control group (n = 7). Data were collected at four time points: baseline (PRE), during (D1 after 277 km, D2 after 383 km), and after the race (POST). Questionnaires were used to assess ratings of perceived exertion (RPE), total quality of recovery (TQR), and profile of mood states (POMS-SF). Serum NPY, leptin, adiponectin, and cortisol were measured. Results: Among non-finishers, scores for confusion, anger, depression, and tension-anxiety (PRE vs. D2, p < 0.05) increased, while vigor decreased (PRE vs. D1, p < 0.05). In contrast, finishers' tension-anxiety scores decreased (PRE vs. D1, p < 0.05). Fatigue increased in finishers (PRE vs. POST, p < 0.05) and non-finishers (PRE vs. D1, p < 0.05). In non-finishers, depressive mood correlated positively with leptin, anger, and confusion at several time points (p < 0.001). In finishers, NPY correlated with TQR at PRE (p < 0.05), while leptin correlated negatively with TQR at POST (p < 0.05). Tension-anxiety correlated highly with perceived exertion in non-finishers (p < 0.001) and with cortisol in finishers (p < 0.05) and non-finishers (p < 0.001). In finishers, confusion correlated negatively with NPY (p < 0.01). Conclusion: The study reveals an essential interplay between hormones and mood states affecting performance: Leptin was associated with anger and a depressive mood state in non-finishers and worse recovery in finishers. In contrast, NPY appeared linked to a lower confusion score and heightened recovery in finishers. A simultaneous increase in depressed mood, anger, tension-anxiety, and confusion might harm performance and lead to race failure.
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Affiliation(s)
- Camilla Kienast
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany,*Correspondence: Camilla Kienast,
| | - Katharina Biere
- Laboratory of Translational Research “Stress and Immunity”, Department of Anaesthesiology, University Hospital LMU Munich, Munich, Germany
| | - Robert H. Coker
- Montana Center for Work Physiology and Exercise Metabolism, University of Montana, Missoula, MT, United States
| | | | - Marc Jörres
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Martina Anna Maggioni
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Lea Mascarell-Maricic
- Charité—Universitätsmedizin Berlin, Clinic for Psychiatry and Psychotherapy, Berlin, Germany
| | - Adriane Schalt
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Magdalena Genov
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Hanns-Christian Gunga
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Mathias Steinach
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
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15
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Khovalyg D, Ravussin Y. Interindividual variability of human thermoregulation: Toward personalized ergonomics of the indoor thermal environment. Obesity (Silver Spring) 2022; 30:1345-1350. [PMID: 35746863 PMCID: PMC9542158 DOI: 10.1002/oby.23454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/18/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The study was undertaken to show the magnitude of interindividual differences in energy expenditure (i.e., heat production) under normal living conditions with the aim of providing physiological evidence to support the advancement of a personalized thermal conditioning approach. METHODS Three sets of experimental protocols with six participants were conducted at neutral and mild cold temperatures. Energy expenditure, local skin temperatures, and core body temperature were measured continuously, while cognitive performance and thermal sensation were surveyed intermittently. The protocols were designed to study the effects of several normal day activities, low-level physical activity and eating a meal, on metabolic and physiological parameters. RESULTS Large interindividual differences among the subjects were demonstrated using non-normalized data by design. The resting metabolic rate difference was 58%, the percentage change in energy expenditure during standing compared to sitting was up to 31%, and the difference in mechanical work efficiency between the least and the most efficient individual was 39.1%. Energy expenditure increase due to the meal effect was 11.2% to 23.3% at neutral and 9.9% to 33.9% at mild cold temperatures across individuals. CONCLUSIONS Large interindividual differences in metabolic rate under typical everyday living and office activities suggest facilitating personalized thermal conditioning instead of providing uniform temperature. Therefore, it is necessary to find noninvasive markers that can be easily measured and used as surrogates for human heat production to individualize the climate control of buildings.
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Affiliation(s)
- Dolaana Khovalyg
- Laboratory of Integrated Comfort Engineering (ICE)École Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
| | - Yann Ravussin
- Laboratory of Energetics and Advanced Nutrition (LEAN), Department of Endocrinology, Metabolism and Cardiovascular Systems (EMC), Faculty of Science and MedicineUniversity of Fribourg (UNIFR)FribourgSwitzerland
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16
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Sheehan MC. 2021 Climate and Health Review - Uncharted Territory: Extreme Weather Events and Morbidity. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2022; 52:189-200. [PMID: 35229682 DOI: 10.1177/00207314221082452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Extreme weather events (EWEs) affected health in every world region during 2021, placing the planet in "uncharted territory." Portraying the human impacts of EWEs is part of a health frame that suggests public knowledge of these risks will spur support for needed policy change. The health frame has gained traction since the Paris COP21 (United Nations Climate Change Conference) and arguably helped to achieve modest progress at the Glasgow COP26. However, reporting rarely covers the full picture of health impacts from EWEs, instead focusing on cost of damages, mortality, and displacement. This review summarizes data for 30 major EWEs of 2021 and, based on the epidemiological literature, discusses morbidity-related exposures for four hazards that marked the year: wildfire smoke; extreme cold and power outages; extreme, precipitation-related flooding; and drought. A very large likely burden of morbidity was found, with particularly widespread exposure to risk of respiratory outcomes (including interactions with COVID-19) and mental illnesses. There is need for a well-disseminated global annual report on EWE morbidity, including affected population estimates and evolving science. In this way, the public health frame may be harnessed to bolster evidence for the broader and promising frame of "urgency and agency" for climate change action.
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Affiliation(s)
- Mary C Sheehan
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, USA.,Public Policy Center, Pompeu Fabra University, Barcelona, Spain
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Yu T, Zhou L, Xu J, Kan H, Chen R, Chen S, Hua H, Liu Z, Yan C. Effects of prenatal exposures to air sulfur dioxide/nitrogen dioxide on toddler neurodevelopment and effect modification by ambient temperature. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 230:113118. [PMID: 34979314 DOI: 10.1016/j.ecoenv.2021.113118] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Emerging evidence suggests that prenatal exposure to ambient SO2 or NO2 induces fetal brain-damage. However, effects of prenatal exposure to SO2 or NO2 on toddler neurodevelopment and the effect-modification by ambient temperature remain unclear. Therefore, a prospective birth-cohort study was conducted from 2010 to 2012 in Shanghai, and 225 mother-child pairs were followed-up from mid-to-late pregnancy until 24-36 months postpartum. During the whole pregnancy, daily SO2/NO2 and temperature levels were obtained for each woman. Gesell-Development-Schedule was used to assess toddler neurodevelopment in the domains of gross-motor, fine-motor, adaptive-behavior, language and social-behavior. Distributed-lag-nonlinear-models simultaneously accounting for exposure-response and lag-response associations were applied to assess the impacts of prenatal SO2/NO2 exposure on neurodevelopment. Each 10-μg/m3 increase in weekly average SO2 concentrations had adverse associations with gross-motor in gestational-weeks 1-6, with adaptive-behavior in weeks 26-30, and with language in weeks 30-36 (developmental-quotient changes: - 1.17% to - 0.12%, P-values < 0.05). Each 10-μg/m3 increase in weekly average NO2 concentrations had adverse associations with gross-motor in gestational-weeks 33-36, with fine-motor in weeks 26-36 and with social-behavior in weeks 31-36 (developmental-quotient changes: - 0.91% to - 0.20%, P-values < 0.05). The cumulative effects for the whole pregnancy showed that each 10-μg/m3 increase in SO2 induced significant deficits in gross-motor and adaptive-behavior (developmental-quotient changes: - 4.71% and - 4.06%, respectively, P < 0.05). We found prenatal cumulative SO2 exposure induced more deficits in low temperature in language and adaptive-behavior than in high/moderate temperature. Thus, prenatal ambient SO2/NO2 exposure in specific time-windows (1st and 3rd trimesters for SO2; 3rd trimester for NO2) could impair toddler neurodevelopment and low temperature may aggravate the SO2-induced neurotoxicity.
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Affiliation(s)
- Ting Yu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Leilei Zhou
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092 China
| | - Jian Xu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Haidong Kan
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032 China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai 200032 China
| | - Renjie Chen
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032 China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai 200032 China
| | - Shuwen Chen
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Hui Hua
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Zhiwei Liu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Chonghuai Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092 China
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