Environmental Health最新文献

Background: Air pollution is an important non-classical cardiovascular risk factor. Ischemic stroke (IS) is an increasing healthcare challenge, with the ageing population and associated presence of atrial fibrillation worldwide. In patients with IS, intravenous thrombolysis (IVT) is an effective treatment method within 4.5 hours from symptoms onset. Our aim was to assess the association between exposure to air pollution and IVT-treated IS, allowing for high temporal precision in exposure assessment.

Methods: We conducted a retrospective population-based cohort study including 5.4 million inhabitants in Eastern Poland in the Years 2011-20. IVT-treated IS patients were enrolled into this study based on ICD-10 and ICD-9 code (I63 with 99.101/99.102/99.103). To ensure high spatial resolution, we used the GEM-AQ model for air quality modeling. Generalized linear mixed model with a Poisson distribution and random intercepts were used to examine municipality-specific associations between short-term exposure to air pollutants and IVT-treated IS.

Results: We recorded 96,189 IS cases with a dominance of females (52.5%) and patients 65 years old and over (78.8%). 10,486 (10.9%) patients received IVT treatment. In this group there was lower share of women (51.3% vs. 52.7%, p < 0.001), fewer elderly individuals (76% vs. 79.1%, p < 0.001), and lower in-hospital mortality (13.6% vs. 15.5%, p < 0.001). The rate of IVT use increased significantly from 3.2% in 2011 to 18.3% in 2020 (Kendall's τ = 0.956, p < 0.001). Exposure to benzo(a)pyrene was associated with the highest negative effects, causing 10.3% and 13.5% increase in risk of IVT-treated IS on LAG 0 and LAG 0-6 in the overall population, respectively. There was also an association between increased PM2.5 and IVT-treated incidence across all analyzed populations. Exposure to NO₂ significantly increased the risk of IVT-treated IS only in females. Increases in SO₂ and O₃ levels did not influence IVT-treated incidence. There were no age or sex differences in the effects of air pollution exposure.

Conclusions: Exposure to air pollution might serve as a trigger for IVT-treated IS, exerting a comparable effect across different sexes and age groups. The IVT-treated IS group was characterized by improved survival. Public health efforts should focus on reducing air pollution levels and ensuring rapid access to advanced IS treatment in high-risk, highly polluted areas.

Trial registration: ClinicalTrials.gov (NCT05198492).

Background: Household air pollution (HAP) from biomass fuel combustion is a major contributor to respiratory morbidity and mortality among children in sub-Saharan Africa (SSA). Despite the growing body of evidence, the effects of prenatal and postnatal HAP exposure on child respiratory outcomes remain incompletely understood.

Methods: We conducted a systematic review and meta-analysis of studies reporting the impact of prenatal and/or postnatal exposure to HAP on respiratory health in children aged < 18 years in SSA. We searched eight major databases up to March 31, 2025, and assessed risk of bias using ROB2.0 and ROBINS-I tools. Random-effects models were used to estimate pooled relative risks (RR) and mean differences (MD), with heterogeneity assessed by I² statistics.

Results: Eighteen studies met the inclusion criteria, including randomized trials, cross-sectional, and case-control designs from ten SSA countries. Exposure to CO, NO₂, PM₁₀, and PM_2.5 was significantly associated with increased risk of respiratory disease. CO exposure was linked to respiratory symptoms (mean concentration = 0.44 ppm; 95% CI [0.27, 0.62]), NO₂ to pulmonary tuberculosis (mean concentration = 20.16 ppm; 95% CI [14.15, 26.16]), and PM₁₀ and PM_2.5 to acute respiratory infections (mean concentration = 61.25 µg/m³ and 27.36 µg/m³ respectively; p < 0.001). Postnatal and prenatal exposures both increased the risk of pneumonia and impaired lung function, including reduced FVC and FEV1. Improved cookstove interventions reduced general respiratory symptoms (RR = 0.80; 95% CI [0.75, 0.85]) but showed limited effect on severe outcomes such as pneumonia. Overall, our findings yielded moderate evidence.

Conclusion: Prenatal and postnatal exposure to HAP is associated with increased respiratory morbidity and impaired lung function among children in SSA. While clean cooking interventions may reduce symptoms, substantial pollutant reductions are needed to achieve meaningful health outcomes. Future research should focus on longitudinal designs, refined exposure assessment, and the identification of critical exposure windows to inform targeted interventions.

Background: Industry-funded research poses a threat to the validity of scientific inference on carcinogenic hazards. Scientists require tools to better identify and characterize industry sponsored research across bodies of evidence to reduce the possible influence of industry bias in evidence synthesis reviews. We applied a novel large language model (LLM)-based tool named InfluenceMapper to demonstrate and evaluate its performance in identifying relationships to industry in research on the carcinogenicity of benzene, cobalt, and aspartame.

Methods: All epidemiological, animal cancer, and mechanistic studies included in systematic reviews on the carcinogenicity of the three agents by the IARC Monographs programme. Selected agents were recently evaluated by the Monographs and are of commercial interest by major industries. InfluenceMapper extracted disclosed entities in study publications and classified up to 40 possible disclosed relationship types between each entity and the study and between each entity and author. A human classified entities as 'industry or industry-funded' and assessed relationships with industry for potential conflicts of interest. Positive predictive values described the extent of true positive relationships identified by InfluenceMapper compared to human assessment.

Results: Analyses included 2,046 studies for all three agents. We identified 320 disclosed industry or industry-funded entities from InfluenceMapper output that were involved in 770 distinct study-entity and author-entity relationships. For each agent, between 4 and 8% of studies disclosed funding by industry and 1-4% of studies had at least one author who disclosed receiving industry funding directly. Industry trade associations for all three agents funded 22 studies published in 16 journals over a 37-year span. Aside from funding, the most prevalent disclosed relationships with industry were receiving data, holding employment, paid consulting, and providing expert testimony. Positive predictive values were excellent (≥ 98%) for study-entity relationships but declined for relationships with individual authors.

Conclusions: LLM-based tools can significantly expedite and bolster the detection of disclosed conflicts of interest from industry sponsored research in cancer prevention. Possible use cases include facilitating the assessment of bias from industry studies in evidence synthesis reviews and alerting scientists to the influence of industry on scientific inference. Persistent challenges in ascertaining conflicts of interest underscore the urgent need for standardized, transparent, and enforceable disclosures in biomedical journals.

Background: Rapid industrialization has exacerbated ambient air pollution in Yichang, China, posing cardiovascular health risks. This study evaluates the short-term impact of ambient air pollutants on cardiovascular disease (CVD) outpatient visits and assesses the effectiveness of environmental policies implemented post-2018.

Methods: We analyzed 510,831 CVD outpatient records alongside daily concentrations of PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃ from five monitoring stations. Generalized additive Poisson regression with distributed lag non-linear models (DLNM) quantified associations between ambient air pollutant exposure (per interquartile range (IQR) increase) and daily visits, adjusting for meteorological factors, time trends, and COVID-19. Effects pre- and post-2018 policy implementation (targeting riverside chemical industry relocation) were compared.

Results: Short-term exposure to NO₂ (lag05, RR = 1.253, 95% CI: 1.192-1.317), SO₂ (lag0, RR = 1.053, 95% CI: 1.011-1.096), and CO (lag01, RR = 1.063, 95% CI: 1.016-1.111) was significantly associated with increased cardiovascular disease outpatient visits. Concentrations of five major ambient air pollutants (excluding O₃) showed significant reductions after 2018 (P < 0.001). The associations of SO₂, CO, and PM₁₀ with CVD visits were attenuated after 2018. NO₂ effects were stronger in colder seasons and remained robust in two-pollutant models. No statistically significant associations were observed for PM₂.₅, PM₁₀, and O₃.

Conclusion: Short-term exposure to NO₂, SO₂, and CO demonstrated statistically significant positive associations with cardiovascular disease outpatient visits. Environmental policies reduced ambient air pollutant levels and attenuated health impacts, supporting continued air quality interventions.

Background: Child stunting affects a substantial number of children globally, with an estimated 149 million worldwide. Environmental factors, including poor nutrition, household environment, inadequate sanitation, and meteorological variables have also significantly contributed to child stunting. Apart from temperature and rainfall, large-scale events such as drought have been found to influence the risk of stunting. While previous studies focused on post-natal drought, this research investigates the impact of pre-natal drought on childhood stunting in low- and middle-income countries.

Methods: We used nationally representative survey data of under 5 stunted children collected between 2013 and 2019 from Demographic and Health Survey (DHS) surveys for 32 low-income to middle-income countries in combination with high-resolution weather data from ERA5-Land climate re-analysis in generating the drought index (Standardized Precipitation-Evapotranspiration Index) that was then classified into various pre-natal and post-natal exposure periods. We used a generalized additive mixed-effect multivariable logistic regression modelling approach to assess the association between pre-natal drought and the risk of stunting.

Results: In examining the association between pre-natal drought exposure and under-5 child stunting, we analyzed a total of 284,702 children with geolocated, anthropometric data, composed of 147,448 (51%) girls and 137,254 (49%) boys. Pre-natal (or pre-natal) drought exposure on a long-term time scale increased the risk of under-5 stunting by 2.07% (95% CI: 0.48%, 3.63%). Pre-natal drought exposure particularly in the second and third trimesters were associated with 1.76% (95% CI: 0.22%, 3.27%) and 1.60% (95% CI: 0.15%, 3.02%) increase in the risk of under-5 childhood stunting, respectively. We found marginally significant association between the first trimester pre-natal drought exposure and the risk of stunting (1.53%; 95% CI: -0.13, 3.16%).

Conclusion: Our large-scale population study of 32 LMICs has found that pre-natal drought exposure was significantly associated with under-5 child stunting, with pronounced risks during the second and third trimesters exposures. Drought plays a significant role in exacerbating child stunting, underscoring the necessity for effective drought management strategies and interventions to safeguard child nutrition and development.

This commentary argues that the field of criminology can aid in addressing PFAS (per- and polyfluoroalkyl substances) pollution, providing levers to achieve public health aims of drastically lowering and abating new PFAS emissions while addressing historic exposure. Based on a European example of the large DuPont de Nemours (now Chemours) industrial facility in Dordrecht, the Netherlands, we frame the history of PFAS exposures as a crime. We discuss how PFAS pollution emerged in part due to knowledge asymmetries, perpetuated by the close alignment of corporate and governmental interests, and the fragmentation of regulatory enforcement, both historic and contemporary.