Environmental Health最新文献

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.

Background: A number of negative developmental outcomes in response to extreme temperature have been documented. Yet, to our knowledge, environmental research has left the question of the effect of temperature on human neurodevelopment largely unexplored. Here, we aimed to investigate the effect of ambient temperature on linguistic development at the age of 2 years-old.

Methods: We used data from the prospective national French birth cohort ELFE (N = 12,163) and highly-resolved exposure models with daily temporal resolution and 200 m to 1 km spatial resolution. We investigated the effect of weekly averages of overall, daytime and night-time temperature in the prenatal (first 30 weeks of gestation) and postnatal (91 weeks after birth) period on vocabulary production scores from the MacArthur-Bates Communicative Development Inventories (MB-CDI) at 2 years-old. Exposure-response and lag-response relationships were modeled with confounder-adjusted distributed lag non-linear models.

Results: Scores at the MB-CDI decreased by 3.2% (relative risk (RR) 0.968, 95% confidence interval (CI): 0.939-0.998) following exposure to severe night-time heat of 15.6 °C (95th percentile) vs. 8.3 °C (median) throughout gestational weeks 14 to 19. In the postnatal period, scores at the MB-CDI decreased by 14.8% (RR 0.852; 95% CI: [0.756-0.96]) for severe overall heat of 21.9 °C (95th percentile) vs. 11.5 °C (median) throughout weeks 1 to 28. Consistent results were found for daytime and night-time heat. We observed positive effects of overall and night-time heat in the first few weeks of pregnancy. Night-time cold in the pre-natal period also resulted in improved scores at the MB-CDI. Adjusting our models for air pollutants (PM2.5, PM10 and NO2) tended to confirm these observations. Finally, there were no significant differences in temperature effects between boys and girls.

Conclusion: In this large cohort study, we showed a negative impact of hot temperatures during pregnancy and after birth on language acquisition. Positive associations observed in the first few weeks of pregnancy are likely the results of methodological artifacts. Positive associations with night-time cold during the prenatal period are likely truly protective, as colder temperatures may encourage staying indoors at a comfortable temperature. Policymakers should consider neurodevelopment impairments as a deleterious effect of climate change.

Background: A United States ethanol company used pesticide-coated seed corn for fuel ethanol production, resulting in highly contaminated byproducts. Improper storage and disposal of the waste led to widespread environmental contamination. Detectable levels of neonicotinoids have been found in soil, water, and air samples, raising questions about the potential impacts to the environment and human health. The study objective was to evaluate the community's perceived physical and mental health impacts and needs resulting from the contamination linked to bioenergy production by a single company.

Methods: A 54-question survey was administered to households located within a 10-mile radius of the facility. Respondents could complete the paper survey and return it by mail or electronically. The general topics were household members' awareness, concerns, and perceptions of environmental and health impacts. Quantitative data were presented as frequencies and percentages, while qualitative data were grouped into themes based on keywords and summarized as counts.

Results: A total of 459 respondents completed the survey, a 38% response rate. The average household size was 2.7 (SD = 1.4). Responding households were primarily single-family homes (89%) that were owned (85%), and were long-time residents (mean = 18.4 years, SD = 15.5). A total of 36% of households included children aged 18 or younger. Respondents were concerned about contaminants affecting water (82%), soil (79%), and air (72%) quality. Most respondents (74%) felt some or a lot of stress related to potentially compromised health; however, 51% did not believe they had health symptoms resulting from the contamination. The most common self-reported symptoms among primary respondents were sinus (n = 17), respiratory (n = 22), cognitive/neurological symptoms (n = 15), and allergies (n = 17). Depression and anxiety were the primary mental health symptoms reported with 31 mentions. The top community need was wanting the environment cleaned-up, including proper removal of waste and land restoration.

Conclusions: This study evaluated community-level perceived impacts of environmental contamination directly related to an ethanol plant's improper handling of production waste containing pesticides. Findings can support immediate actions by state officials and community leaders and serve as a baseline for future health and environmental monitoring.

Background: Long-term exposure to particulate matter with aerodynamic diameter ≤ 2.5 μm (PM_2.5) are linked to thyroid nodules in adults, but epidemiological evidence in children and adolescents and adjustments for key confounders are lacking. This study aimed to explore the association between long-term exposure to PM_2.5 and the prevalence of thyroid nodules in school-aged children and adolescents.

Methods: A cross-sectional study including 10,739 primary and junior high school students was conducted in Jiangsu Province, China, in 2021. Annual PM_2.5 concentrations were estimated by a satellite based space-time model based on machine learning. Individual exposure concentrations were assigned according to the school addresses of the participants. High-resolution diagnostic ultrasound imaging was used to detect the thyroid nodules. After adjustment for covariates, the link between the two-year (2019-2020) average PM_2.5 concentrations and thyroid nodules was estimated using a generalized linear mixed-effects model. The concentration-response (C-R) curves were smoothed using a restricted cubic spline function. Stratified analyses were performed to evaluate the modification effects of covariates on associations.

Results: The average age of the 10,067 participants (51.9% boys) was 11 years, with a thyroid nodule prevalence of 30.5%. A non-linear positive correlation was found between the increase in prevalence of thyroid nodules and two-year average exposure concentration of PM_2.5. The C-R relationship curve between thyroid nodules and PM_2.5 had a J-shaped structure with a threshold value of 39.7 µg/m³. Following covariates adjustment, the odds ratio (OR) and 95% confidence interval (CI) linked to thyroid nodules were 1.515 (1.199, 1.915) for per standard deviation (SD) increase in two-year average PM_2.5 concentrations (> 39.7 µg/m³). The sex-specific associations found among adults were not observed in our stratified analyses.

Conclusions: Our findings demonstrated that long-term exposure to PM_2.5 was associated with a higher prevalence of thyroid nodules in children and adolescents. Strategies that consistently reduce PM_2.5 pollution levels to ease the burden of non-communicable diseases have important public health implications.