Environmental Health最新文献

High arsenic (As) exposure (≥ 100 µg/l) is associated with cardiovascular (CVD) outcomes, however, the CVD risk from low-to-moderate As exposure (< 100 µg/l) has been less explored. There is a paucity of systematic reviews that comprehensively evaluate both urine and water As exposure metrics in assessing As-related CVD outcomes within the general population. To fill this gap, this review sought to update and consolidate data regarding the correlation between low-to-moderate As exposure and specific CVD outcomes, including stroke, ischemic heart disease (IHD), acute myocardial infarction (AMI), and heart failure (HF). A search for peer-reviewed articles indexed in PubMed, Embase, CINAHL, the Global Medicos Index, and Web of Science and unpublished dissertations in Prospero until October 31, 2024, was performed. Nineteen studies were included. Relative risks were pooled by contrasting the highest v/s lowest exposure groups across studies. Positive associations were observed between urine As and stroke incidence, and water As with IHD incidence. Associations between water As and IHD and AMI mortality were suggestive and became stronger after excluding ecological studies. Sex-stratified analyses suggested an increased risk for all groups with strongest indication of an increased risk of AMI mortality in men. Increased risk was suggested for HF but only two studies assessed this outcome. These findings underscore potential risk for CVD outcomes in relation to low-to-moderate As exposure, and highlight the necessity for additional rigorous, well-structured studies to more clearly delineate the possible effects of low-to-moderate As exposure on different CVD outcomes.

Background: Asthma exacerbations remain a significant global health issue despite advances in management. Fine particulate matter (PM_2.5, particles ≤ 2.5 μm in diameter) is a known trigger for asthma exacerbations. However, studies on the acute effects of PM_2.5, particularly in regions with relatively low pollution levels, are limited. This study examined the time-lagged association between daily PM_2.5 exposure and asthma exacerbations in Songkhla province, southern Thailand, where PM_2.5 concentrations frequently approach the World Health Organization's (WHO) Global Air Quality Guidelines. Approximately 41% of days during the study period had PM_2.5 concentrations below the 2021 Guideline level of 15 µg/m³. Additionally, the province is periodically affected by seasonal transboundary haze from forest fires.

Methods: A case-crossover study was conducted using daily PM_2.5 and meteorological data from January 2010 to December 2023, alongside health records of asthma patients from Songklanagarind Hospital. District-level daily PM_2.5 concentrations were estimated through inverse distance weighted interpolation. Conditional logistic regression, incorporating time-lagged models and cubic splines, was applied.

Results: The study included 11,848 case days and 39,810 control days, with a mean daily PM_2.5 concentration of 18.2 µg/m³. PM_2.5 concentrations > 50 µg/m³ were significantly associated with asthma exacerbations at multiple time lags (lag0, lag2, and lag01 to lag03), with odds ratios ranging from 1.41 to 1.64, compared to the lowest concentration group (PM_2.5 0-15 µg/m³). Temperature showed no significant effect, while relative humidity was positively associated with asthma exacerbations at lag3, lag06, and lag07. Subgroup analyses revealed associations between PM_2.5 exposure and asthma exacerbations at early lags for both males and females. Additionally, children aged 6-11 years and 12-17 years exhibited greater susceptibility to asthma exacerbations, particularly at PM_2.5 concentrations of 15-25 µg/m³.

Conclusion: This study underscores the short-term effects of PM_2.5 on asthma exacerbations, particularly during high-pollution episodes of transboundary haze in regions that generally experience low levels of air pollution. These findings emphasize the importance of achieving the WHO air quality targets to mitigate the health impacts from PM_2.5.

Background: Visceral leishmaniasis is a neglected life-threatening sandfly-borne disease, which brings a growing public health threat in Central China around the Taihang Mountains. However, the spatiotemporal dynamics of visceral leishmaniasis in the local community and the potential driving factors remain poorly understood.

Methods: We analyzed the spatiotemporal patterns of new reported visceral leishmaniasis cases in the region from 2006 to 2023, and combined random forest modeling approach with environmental covariates to identify the main influencing factors related to transmission risk of the disease.

Results: Our results show that there was a total number of 800 reported human visceral leishmaniasis cases, affecting 29 cities, and 113 counties across the region, exhibiting a geographic expansion of the disease during this period, especially in Shanxi province. Two high-risk clusters were identified in the study. Environmental change-related factors, including standardized precipitation deviation, forest cumulative change ratio, and normalized difference vegetation index (NDVI) cumulative change, played important roles in increasing the transmission risk of visceral leishmaniasis, with their relative contributions summing up to 66.17%.

Conclusions: Our findings provide a better understanding of the spatiotemporal dynamics and driving factors of visceral leishmaniasis recurrence across Central China around the Taihang Mountains, which underscore prevention and control measures should be taken immediately to reduce the risk.

Introduction: Per- and polyfluoroalkyl substances (PFAS) are endocrine-disrupting chemicals and widespread environmental contaminants. PFAS cross the placental barrier and reach the developing fetus with potential impacts on many organ systems. There are no studies of PFAS in residents of central Arkansas despite reports of environmental contamination in the region. We aimed to quantify PFAS concentrations in repeated serum samples from participants living in central Arkansas and to investigate relationships with maternal cardiometabolic health during pregnancy.

Methods: Participants were enrolled during early pregnancy in a longitudinal study (NCT01131117) from 2010 to 2014. PFAS concentrations were measured in serum from each trimester (first trimester n = 282, second trimester n = 217, and third trimester n = 195). PFAS were compared across pregnancy. Linear and linear-mixed effects models were used to investigate relationships between trimester-specific PFAS levels, as single exposures, and maternal outcomes. Effects of PFAS as an exposure mixture were estimated using quantile g-computation.

Results: Six PFAS were detected in more than 70% of the maternal serum samples: PFOS, PFOA, PFBS, PFHxS, PFNA, and PFHxA. In adjusted linear-mixed models and quantile g-computation models, maternal serum PFAS levels were significantly negatively associated with triglycerides [effect estimates (β)= -16.29; 95% confidence interval (CI)= -24.95, -7.63], total cholesterol (β= -12.77; 95%CI= -19.80, -5.74), low-density lipoproteins (β= -10.83; 95%CI = -16.72, -4.93), high-density lipoproteins (β= -4.10; 95%CI= -6.23, -1.96), and pulse (β= -1.60; 95%CI= -2.85, -0.35). Maternal serum PFAS, as a mixture, was not associated with maternal diastolic blood pressure, but separately, PFAS_sum, PFOS, PFOA and PFNA had significant positive associations.

Conclusion: This study evaluated PFAS exposures during pregnancy in central Arkansas. We show that PFAS exposure during pregnancy influences maternal cardiometabolic outcomes and a case in point that future studies are needed to determine the impact on maternal health and to investigate potential interventions to limit the effects of PFAS exposure during pregnancy.

Background: Hot weather can negatively impact mental health and increase the risk of suicide. The relationship between heat and risk of suicide is not fully understood, and varies geographically across regions with differing climates, cultures, and socio-economic factors. The objective of this study was to investigate the relationship between hot summer days and suicides in British Columbia, Canada (BC).

Methods: A time-stratified case-crossover design was used to estimate the relationship between hot days (exposure) and suicide (outcome), considering same-day and two-day mean temperature. Conditional logistic regression was used to estimate the odds ratio (OR) for the association between hot days and suicides for three outcomes including: (1) suicide attempts by self-poisoning extracted from BC Drug and Poison Information Centre (DPIC) database (2012-2023); (2) completed suicides by self-poisoning extracted from BC vital statistics (2004-2023); and (3) completed suicides by violent methods extracted from BC vital statistics (2004-2023). Analyses were stratified by sex, age, ecological region, substance types used in self-poisonings, and by methods of violent suicide.

Results: There were 9,599 suicide attempts via self-poisoning and 2,571 suicide deaths included in this study. Overall, hot days were associated with increased odds of self-poisoning suicide attempts and deaths, but not with suicide deaths via violent methods. The odds ratio [95% confidence interval] for suicide attempts via self-poisoning on hot days was 1.19 [1.11, 1.29], and 1.48 [1.12, 1.95] for suicide deaths. There was no effect of hot days on suicide deaths by violent methods. The associations varied by day of exposure, sex, age groups, and geography. The effect of hot days was greatest for suicide attempts and deaths involving opioids and elevated for suicide attempts involving opioid and analgesia combinations, analgesics alone, and alcohol.

Conclusions: The risk of suicide via self-poisoning was increased on hot summer days in BC, Canada. However, the relationship was influenced by other factors that vary among individuals and geographies. Policy decisions and future research for suicide-prevention during hot weather should consider sub-population susceptibility.

Background: Increasing temperatures across the globe, including in Europe, pose one of the biggest threats to human health and wellbeing. Different kinds of inequalities, determined by age, sex/gender, isolation, socio-economic status, occupation, living in the city, and health situation, create vulnerability factors influencing people's heat-related mortality risk and their daily experiences during summer.

Methods: Our study uses an interdisciplinary approach to research how intersecting inequalities generate vulnerabilities to heat stress among older adults (65+) in two European cities: Warsaw and Madrid. We combine three methodological approaches juxtaposing quantitative and qualitative data: (1) epidemiological analysis that uses daily mortality data in Warsaw and Madrid coupled with meteorological station temperature data from HadISD; (2) the OLS regression based on the survey conducted in Warsaw and Madrid in 2022; and (3) the focus group interviews conducted in Warsaw in 2021.

Results: Our data confirms that good health and financial situation protect people both from mortality risk and negative heat experiences. Interestingly, both air conditioning (A/C) usage and being physically active increase the negative heat experiences people reported. Finally, we identified two vulnerability paradoxes understood as situations when a person or a group might be more at risk but not experience or perceive negative impacts of heat. These paradoxes affect the oldest adults (80+) and older people living alone in both cities.

Conclusions: Studies on vulnerability and adaptation need to incorporate both large scale top-down data sets and bottom-up, localized data based on individual experience. Combining various methods and disciplinary approaches enables identification of inequality factors and vulnerability paradoxes that remain unnoticed or underestimated while increasing people's vulnerability to heat stress.

Aim: The purpose of this study was to quantify the global burden of ischemic heart disease associated with lead exposure, utilizing data from the Global Burden of Disease (GBD) Study, 2021.

Methods: Data on the burden of ischemic heart disease (IHD) associated with lead exposure were compiled globally from 1990 to 2021. These data were further stratified by dimensions including gender, age, GBD regions, and countries. Utilizing the Joinpoint regression model, we analyzed long-term trends in the burden of IHD disease associated with lead exposure and derived estimated annual percentage changes (EAPC). For future projections, we used an ARIMA model to predict potential trends in the burden of IHD disease associated with lead exposure over the next decade.

Results: The study's findings reveal that in 2021, there were 590,370 deaths attributed to IHD (95% UI (Uncertainty interval (UI) is derived from the Bayesian school of statistical analysis used in the GBD studies. Unlike the frequency school of thought, which constructs confidence intervals (CI), the Bayesian school of thought views probability as a measure of confidence in an event, and in this approach the actual mean is viewed as a random variable dependent on the data and prior knowledge, with UI indicating that there is a specific probability (e.g., 95%) that the actual mean will fall within the interval.): -83,778 to 1,233,628) and 11,854,661 disability-adjusted life years (DALYs) (95% UI: -1,668,553 to 24,791,275) globally due to lead exposure, reflecting an increasing and then stabilizing trend from 1990 to 2021. Comparative analysis across study regions indicated a higher disease burden for IHD in regions with lower Socio-Demographic Index (SDI) values, contrasting with the lower burden in regions with higher SDI values. Furthermore, IHD mortality and DALYs peak in the 70-80 age cohort, with males exhibiting higher rates compared to females. Decadal projections indicate a downward trend in IHD mortality and DALYs for regions with higher SDI, in contrast to an anticipated upward trend in regions with lower SDI.

Conclusion: The global burden of ischemic heart disease associated with lead exposure is increasing, particularly in regions with low SDI values and within the elderly population. Considering the profound threat posed by lead exposure to the global burden of IHD, there is an imperative to consistently reinforce and execute robust prevention strategies to mitigate environmental lead exposure.

Metalloestrogens are ionic metals and metalloids that can activate estrogen receptor, and are suspected to play a role in breast cancer occurrence. This study explored the relationship between dietary exposure profiles to metalloestrogens and estrogen-receptor positive breast cancer (ERP-BC) risk among women in the French E3N cohort.A prospective study was conducted involving 66 722 women who completed a food frequency questionnaire in 1993. Food consumption data were combined with food contamination data obtained from the Second French Total Diet Study, to estimate the dietary intake of 14 metalloestrogens. A principal component analysis was performed to identify the main dietary exposure profiles to metalloestrogens. The retained principal components were included in Cox regression models, used to estimate Hazard Ratios (HR) and their 95% confidence intervals (95% CI) for the associations between the adherence to the identified profiles and ERP-BC risk identified until 2014, adjusted for confounding factors selected using a directed acyclic graph.After an average follow-up of 17.7 years, 3 739 incident cases of ERP-BC were identified. Four principal components were retained, explaining 80.5% of the variance. A statistically significant positive association between the third principal component, mainly characterized by dietary intake of inorganic arsenic and vanadium, and ERP-BC risk was estimated (HR: 1.04, 95% CI: 1.00-1.07, p-value: 0.03). No statistically significant association was found when evaluating the effect of each metalloestrogen individually.The results suggests that even relatively low levels of exposure to inorganic arsenic and vanadium, when combined, could increase the risk of ERP-BC.

Background: Climate change is intensifying extreme heat events, posing significant risks to cardiovascular health. While sex differences in heat vulnerability have been observed, the evidence remains inconsistent. This systematic review and meta-analysis examined sex-specific associations between extreme heat exposure and cardiovascular disease (CVD) outcomes over the past decade.

Methods: We searched PubMed, Embase, and Scopus for studies published between 2004 and 2024 that reported sex-stratified cardiovascular outcomes associated with heat exposure following the PRISMA guidelines. The quality of the evidence was evaluated following the Navigation Guide Criteria. Random-effects meta-analysis was conducted to calculate pooled relative risk ratios (RRR) comparing males to females for studies addressing incremental temperature increase. Heat wave studies were synthesized narratively due to methodological heterogeneity.

Results: Of 6126 articles, 79 met inclusion criteria (62 in meta-analysis, 17 in narrative synthesis), primarily from East Asia, Europe, and North America. A 1 °C temperature increase was associated with elevated cardiovascular risks for both sexes. The pooled relative risk ratio (RRR) comparing males to females was 1.008 [1.002-1.014] for mortality, suggesting slightly higher female vulnerability, but not for morbidity (RRR 0.996 [0.987-1.004]). Significant heterogeneity was noted (Mortality I² = 50.3%, Morbidity I² = 70.3%). Heat wave studies showed inconsistent sex-specific impacts across populations.

Conclusions: Females showed marginally higher vulnerability to heat-related cardiovascular mortality compared to males, while no significant sex differences were observed for morbidity outcomes. Future research should focus on understanding these mechanisms and developing sex-specific interventions.

Background: Although various occupational and environmental exposures are suspected risk factors for acute myeloid leukaemia (AML), the aetiology of AML is largely unknown. We present an analysis of the spatial distribution of AML in Denmark on an unprecedented, detailed scale. Such investigations have the potential to uncover geographical areas of increased risk, which may in turn be tied to environmental or occupational exposures.

Methods: Individuals diagnosed with AML during 2000-2020 were obtained from the Danish National Acute Leukaemia Registry and assigned to a parish based on their residence six months prior to diagnosis. The incidence rate ratio (IRR) by parish was calculated as the ratio between the age- and sex-standardised incidence rate and the national incidence rate. The IRRs were smoothed using a spatial Poisson distributed generalised linear mixed model with a conditional autoregressive correlation structure. Parishes with a smoothed IRR > 1.10 with a posterior probability > 75% were considered to have an increased risk of AML.

Results: The study included 5,177 AML cases. The spatial model showed a homogeneous distribution of AML in Denmark with no parishes having an increased risk.

Conclusion: The study indicates that the risk of developing AML in Denmark is not affected by place of residence, suggesting that if an unknown environmental or occupational risk factor is present, it does not seem to be associated with specific areas.