The association between exposure to polycyclic aromatic hydrocarbons and birth outcomes: A systematic review and meta-analysis of observational studies

Exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to adverse birth outcomes; however, to date, the available studies on such relations, with the exception of birth weight, has not been systematically synthesized. We conducted a systematic review and meta-analysis of the available observational studies on the association of maternal exposure to PAHs and their metabolites during pregnancy with indicators of fetal growth and gestational age at delivery. We searched Web of Science, PubMed and Scopus systematically for all relevant published papers in English until 13 January 2023. Random effects meta-analysis was applied to synthesize the association estimates. Publication bias was assessed using Egger's regression. A total of 31 articles were included in our review (n = 703,080 participants). Our quality assessment of reviewed papers showed that 19 research had excellent, nine had good, and three had fair quality. Most of the reviewed studies on exposure to PAHs and their metabolites with gestational age and preterm birth (seven studies) reported no statistically significant association. Eight studies were eligible for our meta-analysis. Results of the meta-analysis indicated that higher levels of maternal urinary 1-OHP was associated with lower birth weight, birth length and head circumference and a higher risk of low birth weight (LBW). However, these associations were not statistically significant. Similarly, the combined association between maternal urinary 1-OHP and newborn's Ponderal index (PI) and Cephalization index were not statistically significant. Overall, our systematic review and meta-analysis suggested a potential adverse impact of exposure to PAHs on LBW, HC, and CC; however, further studies are required to be able to draw concrete conclusions on such associations.

The association of exposure to air pollution and depression in women; a cross-sectional study of a middle-income country

Air pollution exposure has been related with mental disorders, especially depression; however, the available evidence on these associations in Low and Middle-Income Countries (LMICs) is scarce. Therefore, we aimed to assess the relationship between particulate matter (PM) exposure and indicators of traffic with depressive symptoms in women of Sabzevar, Iran. This cross-sectional study was based on 741 women aged 15-45 years (adults) in 2019. The annual average of PM₁₀, PM_2.5 and PM₁ at home was estimated using land use regression (LUR) models. Street map of Sabzevar was used to calculate the indicators of traffic, i.e., the proximity to major roads and total street length buffers with 100, 300 and 500 m radii around the participants' homes. We used the Center for Epidemiological Studies- Depression (CESD-20) Scale in the general population to measure depression scores. Quasi-Poisson models and logistic regression were used to examine the association and odds ratios of exposure to air pollution and depression scores adjusted for relevant covariates. Exposure to PM₁₀, PM_2.5 and PM₁ and total street length in 100 m buffer were significantly associated with higher depression scores. In fully adjusted model, an interquartile range (IQR) increase in PM₁₀, PM_2.5 and PM₁ concentration as well as total street length in 100 m buffer was associated with 1.25 (95% CI:1.03, 1.52, P-value = 0.02), 1.16 (95% CI: 1.06, 1.26, P-value< 0.01), 1.16 (95% CI: 1.03, 1.29, P-Value = 0.01) and 1.15 (95% CI: 1.06, 1.25, P-value< 0.01) odds of clinical depression, respectively. For street length in 300 and 500 m buffers and proximity to major roads, no statistically significant increased risk of clinical depression were observed. Overall, our findings recommended that air pollution exposure has increased the risk of clinical depression in women.

A protocol of comprehensive assessment of exposure to greenspace in school children

Evidence on a comprehensive greenspace exposure assessment on primary school children is scarce yet. Therefore, we aimed to assess a comprehensive greenspace exposure on primary school children and their behavioral function. We assessed different aspects of exposure to greenspace as well as behavioral function in 704 primary school children in Sabzevar, Iran, during the COVID-19 pandemic (i.e., 22 September 2020 to 10 March 2021). The greenspace indicators were including Normalized Difference Vegetation Index (NDVI) in 100, 300 and 500m buffers around children's homes based on Landsat 8 images with 30 × 30 m resolution, residential proximity to green space based on the Euclidean distance of the geocoded residential address to (i) the nearest green space of any area and (ii) the nearest green space with an area of at least 5000m² (i.e., major green space) based on land use map of the study area, time spent in public and private green spaces, number of plant pots at home and visual access to greenspace based on a prepared questionnaire. The behavioral development of primary school children was assessed using a Persian online validated version of the Strengths and Difficulties Questionnaire (SDQ) filled by parents.

Association of greenspace exposure with telomere length in preschool children

Exposure to greenspace has been associated with a wide range of health benefits; however, the available evidence on the association of this exposure with telomere length (TL), an early marker of ageing, is still scarce. We investigated the association of greenspace exposure with TL in a sample of 200 preschool children (aged 5-7 years) residing in Sabzevar, Iran (2017). We comprehensively characterized different aspects of greenspace exposure encompassing residential, kindergarten, and total (including both residential and kindergarten) surrounding greenspace (using satellite-derived Normalized Difference Vegetation Index), residential and kindergarten distance to green spaces, time spent in private gardens and public green spaces, and the number of plant pots at home. Relative leukocyte TL (LTL) in blood samples of the study participants was measured using quantitative polymerase chain reaction (qPCR). We applied mixed effects linear regression models with kindergarten and qPCR plate as random effects, to estimate the association of indicators of greenspace exposure (one at a time) with LTL, controlled for relevant covariates. We observed an inverse association between distance from home and kindergarten to green spaces larger than 5000 m² and LTL. Moreover, higher total surrounding greenspace at 300m and 500m buffers and higher surrounding greenspace at 300m buffer around kindergarten and home were associated with longer LTL. Furthermore, longer time spent (h/week) in the public green spaces was associated with longer LTL. Our findings for residential and kindergarten distance to any green space (regardless of the size), residential surrounding greenspace at 100m and 500m buffers, kindergarten surrounding greenspace at 100m buffer, time spent in private gardens (h/week) and the number of plant pots at home were not conclusive. Our findings were generally suggestive for a positive association between greenspace exposure and LTL in preschool children. More studies are needed to confirm these findings in other settings with different climates and populations.

Association of exposure to air pollution and telomere length in preschool children

Exposure to air pollution is associated with adverse health effects; however, the available evidence of its association with telomere length (TL), an early marker of ageing, in children is still scarce with no study available for preschool children. This study aimed to investigate the association of exposure to air pollution and traffic indicators at home and kindergarten with relative leukocyte TL (LTL) in preschool children. This cross-sectional study included 200 preschool children (5-7 years old) recruited from 27 kindergartens in Sabzevar, Iran (2017). Outdoor annual average levels PM₁, PM_2.5, and PM₁₀ at residential address and kindergartens were estimated applying land use regression (LUR) models. Moreover, indoor levels of PMs at kindergartens were measured for four days in each season resulting in a total of 16 days of measurements for each kindergarten. Total streets length in different buffers and distance to major road were calculated as traffic indicators at residential address and kindergartens. We applied quantitative real-time polymerase chain reaction (qRT-PCR) to measure relative LTL in blood samples obtained from children. Mixed linear regression models were developed with qPCR plate and kindergarten as random effects, to estimate association of each pollutant and traffic indicator with LTL, controlled for relevant covariates. Higher concentrations of outdoor PM₁, PM_2.5, and PM₁₀, at home and kindergartens were associated with shorter relative LTL. Similarly, increase in indoor PM_2.5 concentrations at kindergartens was associated with shorter relative LTL (β = -0.18, 95% CI: -0.36, -0.01, P-value < 0.01). Moreover, higher total street length in 100 m buffer around residence and lower residential distance to major roads were associated with shorter relative LTL (β = -0.25, 95% CI: -0.37, -0.13, P-value < 0.01, and 0.32, 95% CI: 0.20, 0.44, P-value < 0.01, respectively). Overall, our study suggested that higher exposure to air pollution and traffic at kindergarten and residential home were associated with shorter relative LTL in preschool children.

Ecological and health risk assessment of exposure to atmospheric heavy metals

In the present study, we assessed the concentration of airborne HMs (Zn, Cu, Pb, and Cd) and their probable sources using the bark of Pinus eldarica as a bio-indicator. Hence, 47 tree bark samples were harvested according to the land uses and biomonitoring techniques in the city of Yazd, Iran. The potential health risks in 13 age groups, ecological risk, as well as the possible relationship between HM concentrations and traffic indicators, were evaluated. The order of average HM concentrations in the P. eldarica bark samples was as Zn > Pb > Cu > Cd. The mean values of non-carcinogenic risks of all HMs in entire age groups were within secure range (HQ < 1); however, the carcinogenic risk of Cd was higher than the allowed level (TCR > 1 × 10^-6). About Pb, it was in the safe level. The main element causing potential ecological risks was Cd, indicating moderate to very high ecological risk in most of the study areas. There was an inverse significant association between distance from major roads and Pb concentration (β = -0.011 95% confidence interval (CI): 0.022, -0.0001). All HMs in bark samples render the negative Moran's index, representing a random spatial distribution pattern. Besides, according to principal component analysis (PCA), the first component accounted for 36.55% of the total variance, dominated by Cd, Pb, Cu, and Zn, respectively, and characterized by vehicle and industrial emissions. Our results infer that industrial activities and traffic are the main sources of HMs pollution in urban environments that should be considered by decision-makers.

Asthma disease as cause of admission to hospitals due to exposure to ambient oxidants in Mashhad, Iran

Nowadays, asthma is one of the most common chronic respiratory diseases, worldwide. Many reports have emphasized the correlation between the short-term exposure to the ambient air pollutants and acute respiratory diseases, especially among children with asthmatic symptoms. The aim of this study was to evaluate the relationship between the exposure to three atmospheric antioxidants (NO₂, SO₂, and O₃) and hospital admission due to asthmatic disease (HAAD) in the city of Mashhad, Iran. The concentrations of atmospheric antioxidants were obtained from the real-time monitoring stations located in the city. The collected data were employed for developing predictive models in the AirQ software. In order to investigate the association between short-term exposure to air pollutants and HAAD, the study participants were categorized into two age groups: less than 15 and from 15 to 64 years old. The results indicated that in people less than 15 years increase in NO₂ (attributable proportion (AP) = 3.775%, 95% CI 0.897-6.883%), SO₂ (AP = 3.649%, 95% CI 1.295-5.937%), and O₃ (AP = 0.554%,95% CI 0.00-3.321) results in increase in HAAD. While for those aged between 15 and 64 years, the AP was 4.192% (95% CI 0.450-7.662%) for NO₂; 0.0% (95% CI 0.00-1.687%) for SO₂; and 0.236% (95% CI 0.00-1.216%) for O₃. The number of asthmatic cases who were less than 15 years admitted to the hospitals during the study period was higher than that of those within the age groups between 15 and 64 years as a consequence of exposure to NO₂ (101 vs. 75), SO₂ (98 vs. 0), and O₃ (15 vs. 3), respectively. To the best of our knowledge, the AirQ model has not been applied before to estimate the effect of atmospheric antioxidant exposure on hospital admission because of asthma disease. Eventually, this model is proposed to be applicable for other cities around the world.

Human health impact assessment of exposure to particulate matter: an AirQ software modeling

The aim of this study was to assess the health impacts related to particulate matter less than 10 μm (PM₁₀) exposure in the city of Yazd, Iran. For this aim, AirQ 2.2.3 software was used to model relationship between short-term exposure to PM₁₀ and disease cases proposed by the World Health Organization (WHO). The annual mean concentration of PM₁₀ was 97 μg/m³. The maximum concentration value of PM₁₀ was measured during the summer (731 μg/m³). 4.988% (95%CI: 3.381-6.542%) of the total mortality, 7.3% (95%CI; 4.19-10.21%) of cardiovascular mortality, and 10.21% (95%CI; 4.19-14.89%) of respiratory mortality were related to the PM₁₀ concentrations. Consequently, the AirQ software can provide valuable information about the importance of air pollution and the substantial impacts of PM₁₀ on the society for policymakers.

A time series analysis of environmental and metrological factors impact on cutaneous leishmaniasis incidence in an endemic area of Dehloran, Iran

The aim of this study was to investigate the relationship between the environmental and metrological variables and cutaneous leishmaniasis (CL) transmission and its prediction in a region susceptible to this disease prevalence using a time series model. The accurate locations of 4437 CL diagnosed from 2011 to 2015 were obtained to be used in the time series model. Temperature, number of days with temperature over 30 °C, and number of earthquake were related to CL incidence using the Seasonal Auto-correlated Integrated Moving Average (SARIMA) model according to the Box-Jenkins method. In addition, the relationship between land use and surface soil type in 500- and 1000-m radius around the CL patients were investigated. The SARIMA models showed significant associations between environmental and meteorological variables and CL incidence adjusted for seasonality and auto-correlation. The result indicated that there are need more robust preventive programs in earthquake-prone areas with high temperature and inceptisol soil type than other areas. In addition, the region with these characteristics should be considered as high-risk areas for CL prevalence.

A comparative study on capability of different tree species in accumulating heavy metals from soil and ambient air

Heavy metals (HMs) in the urban environment can be bio-accumulated by plant tissues. The aim of this study was to compare fourteen different tree species in terms of their capability to accumulate four airborne and soilborne HMs including; zinc (Zn), copper (Cu), lead (Pb), and cadmium (Cd). Samplings were performed during spring, summer, and fall seasons. To compare bioaccumulation ability, bio-concentration factor (BCF), comprehensive bio-concentration index (CBCI), and metal accumulation index (MAI) were applied. Species with the highest accumulation for single metal which shown using BCF did not have the highest CBCI and MAI. Based on CBCI and MAI, Pinus eldarica (7.74), Wistaria sinensis (8.82), Morus alba (8.7), and Nigral morus (27.15) had the highest bioaccumulation capacity of HMs, respectively. Therefore, these species can be used for phytoextraction of HMs pollution and green and buffer zone in the urban.

Investigation of outdoor BTEX: Concentration, variations, sources, spatial distribution, and risk assessment

The aim of this study was to measure BTEX (benzene, toluene, ethylbenzene, and xylenes) concentrations in the ambient air of Tehran, the capital of Iran, and investigate their seasonal variations, probable sources, spatial mapping, and risk assessment. The concentrations of BTEX were measured using a continuous monitoring device installed in seven stations around the city. Spatial mapping procedure was conducted using the inverse distance weighting (IDW) method. Monte Carlo simulation was used to assess the carcinogenic and noncarcinogenic risks imposed by BTEX. The highest and lowest annual mean concentrations of toluene and ethylbenzene were recorded as 16.25 and 3.63 μg m(-3), respectively. The maximum (6.434) and minimum (3.209) toluene/benzene (T/B) ratio was observed in summer and winter, respectively. The spatial distribution of BTEX pollution indicated that the highest concentrations were found along the major roads because of heavy traffic. Spearman's rank correlation coefficients and concentration ratios showed that BTEX were produced by the multiemission sources. The mean of inhalation lifetime cancer risk (LTCR) for benzene was 3.93 × 10(-7), which is lower than the limits recommended by the United States Environmental Protection Agency (US EPA) and the World Health Organization (WHO). The hazard quotient (HQ), noncarcinogenic risk index, for all BTEX compounds was <1. The obtained results showed no threat of BTEX concentrations to human health. However, as the concentrations of BTEX will increase due to the rapid growth of vehicles and industrial activities, much effort is required to control and manage the levels of these compounds in the future.

Mortality and morbidity due to exposure to outdoor air pollution in Mashhad metropolis, Iran. The AirQ model approach

In the past two decades, epidemiological studies have shown that air pollution is one of the causes of morbidity and mortality. In this study the effect of PM10, PM2.5, NO2, SO2 and O3 pollutants on human health among the inhabitants of Mashhad has been evaluated. To evaluate the health effects due to air pollution, the AirQ model software 3.3.2, developed by WHO European Centre for Environment and Health, was used. The daily data related to the pollutants listed above has been used for the short term health effects (total mortality, cardiovascular and respiratory mortality, hospitalization due to cardiovascular and respiratory diseases, chronic obstructive pulmonary disease and acute myocardial infarction). PM2.5 had the most health effects on Mashhad inhabitants. With increasing in each 10μg/m3, relative risk rate of pollutant concentration for total mortality due to PM10, PM2.5, SO₂, NO₂ and O₃ was increased of 0.6%, 1.5%, 0.4%, 0.3% and 0.46% respectively and, the attributable proportion of total mortality attributed to these pollutants was respectively equal to 4.24%, 4.57%, 0.99%, 2.21%, 2.08%, and 1.61% (CI 95%) of the total mortality (correct for the non-accident) occurred in the year of study. The results of this study have a good compatibly with other studies conducted on the effects of air pollution on humans. The AirQ software model can be used in decision-makings as a useful and easy tool.