Environmental Epidemiology最新文献

Background: Antibiotic consumption is influenced by multiple factors, including environmental conditions. In tropical regions, climate variability may contribute to seasonal patterns of infectious diseases and prescribing behaviors. This study examined the association between climatic variables and antibiotic use in a tertiary hospital in southern Thailand.

Methods: We analyzed 7,696 prescriptions of tetracyclines (n = 971), beta-lactams and penicillins (n = 4,208), and macrolides (n = 2,517) dispensed from 2021 to 2023. Defined daily doses (DDDs) were modeled using generalized additive models and distributed lag nonlinear models to assess associations with temperature, humidity, and rainfall, incorporating delayed and nonlinear effects.

Results: Tetracycline use peaked in January with over 120 DDDs/biweek and declined sharply thereafter. Distributed lag nonlinear models revealed a 45-60% increase in tetracycline use following temperature drops of ≥2 °C after 3-4 biweeks. Beta-lactam use rose by 20-30% in response to rising temperatures within 1-2 biweeks. Macrolide prescribing decreased by up to 25% in periods of high humidity (>80%) and increased with sudden temperature fluctuations. Increased rainfall (>100 mm/biweek) was significantly associated with higher beta-lactam DDDs.

Conclusion: Climatic factors influence antibiotic consumption patterns in class-specific ways. Incorporating environmental surveillance into antimicrobial stewardship programs may improve preparedness and resource allocation. Further multicenter studies are needed to confirm these findings and assess pathogen-specific implications.

Background: It remains unclear whether individuals living in more walkable neighborhoods spend less time engaging in domain-specific sedentary behaviors, which vary by certain groups. Therefore, this study aimed to examine the associations between neighborhood walkability and total and domain-specific sedentary behavior, and to explore how this relationship varied by sociodemographic factors.

Methods: Participants from AmeriSpeak who completed up to two activities completed over time in 24-hours in 2019 were included. Sedentary behavior outcomes (hours/day) included: (1) total sedentary behavior and (2) domain-specific sedentary behaviors (leisure, work, household, transport, personal, and other sedentary activities). Neighborhood walkability index was classified into four groups (least walkable [referent], below average, above average, and most walkable). Weighted generalized linear regression models were used to examine the associations, adjusting for covariates. Subsequently, such associations were stratified by sociodemographic factors.

Results: Compared with the least walkable neighborhoods, below average, above average, and most walkable neighborhoods were positively associated with longer total sedentary behavior time (β = 0.53, 95% confidence interval [CI] = 0.06, 1.01; β = 0.78, 95% CI = 0.29, 1.27; and β = 1.40, 95% CI = 0.75, 2.05, respectively). For domain-specific sedentary behavior, neighborhoods with below average, above average, and most walkable neighborhoods were positively related to work sedentary behavior. However, neighborhood walkability was not related to other domain-specific sedentary behaviors. Lastly, adults aged 20-39 living in more walkable neighborhoods spent longer total sedentary behavior and work-related sedentary behavior.

Conclusion: Residents living in highly walkable neighborhoods engaged in more total sedentary behavior and work-related sedentary time. Future research should explore how neighborhood environments collectively influence sedentary behavior.

Background: Heavy metals, like lead, arsenic, and cadmium, are linked to increased inflammation even in early life; however, anti-inflammatory diets may offset these effects.

Methods: We evaluated associations between heavy metals and inflammatory biomarkers, and potential effect modification by diet in 399 adolescents aged 10 to 18 at baseline who attended two study visits 2 years apart (773 observations). At baseline, blood lead, urinary arsenic, and cadmium concentrations were measured, and the Children's Dietary Inflammatory Index (C-DII) was calculated. Fasting serum interleukin (IL)-4, IL-10, IL-1β, IL-6, IL-8, high-sensitivity C-reactive protein, and tumor necrosis factor-alpha were measured for both visits. Generalized estimating equation models were fit to assess associations between metal concentrations and repeatedly measured inflammatory biomarkers, adjusting for study visit and baseline sociodemographic and lifestyle variables. Effect modification by diet was assessed by including metal and C-DII tertiles interaction terms.

Results: At baseline, the median age was 13.6 years, 50.4% were females, and 51.1% had a low socioeconomic status. Overall, there were no associations between metals and inflammatory markers in the entire population. In the most anti-inflammatory diet group (C-DII T1), higher blood lead was associated with higher IL-4, IL-1β, IL-6, and IL-8 levels, whereas for the most pro-inflammatory diet (C-DII T3), these associations were inverse (P-trend <0.05). Contrarily, higher urinary arsenic was associated with lower IL-4, IL-6, and IL-8 levels in the anti-inflammatory diet group and positively associated with these cytokines in the pro-inflammatory diet group (P-trend <0.05).

Conclusion: Anti-inflammatory diets may modify adolescents' inflammatory response to lead and arsenic. Heavy metal toxicity mitigation by anti-inflammatory diets requires further research.

The temporal pattern of air pollution exposure may affect cognitive aging. We characterized 10-year trajectories of particulate matter (PM_2.5) and nitrogen dioxide (NO₂) exposure at the United States census tract level using sequence and cluster analysis and evaluated their association with memory among 6750 National Health and Aging Trends Study (NHATS) participants aged 65 or older. For each year between 2000 and 2010, we trichotomized PM_2.5 and NO₂ concentrations in each census tract using the national 2010 25th and 75th percentiles of PM_2.5 (7.9 and 10.8 µg/m³) and NO₂ (4.8 and 10.8 ppb), creating nine mutually exclusive air pollution categories for each census tract each year (e.g., high PM_2.5 and high NO₂, high PM_2.5 and medium NO₂, etc.). We quantified the dissimilarity between each census tract's 10-year PM_2.5 and NO₂ trajectory and all other trajectories in NHATS using sequence analysis, and combined similar air pollution trajectories using hierarchical clustering. We assigned a 10-year air pollution trajectory cluster to each participant based on their residential census tract location in 2011. Episodic memory score in 2011 was the mean of immediate and delayed word recall scores. We estimated the association of air pollution trajectory with this episodic memory score using linear models adjusted for age, gender, education level, race/ethnicity, neighborhood socioeconomic status, census region, and urbanicity. We clustered 1080 unique air pollution trajectories from 2000 to 2010 into nine distinct groups. In general, participants belonging to clusters with higher pollutant concentrations in 2000 had lower memory scores in 2011, even when pollutant concentrations in the cluster later declined. For example, those exposed to high PM_2.5 and high NO₂ concentrations in 2000, with decreasing NO₂ concentration (and consistently high PM_2.5) starting in 2006, had an adjusted mean memory score that was 0.20 units lower (95% confidence interval: -0.35, -0.046) than those in clusters with consistently low concentrations of both pollutants. This application of sequence analysis offers a new approach for characterizing temporal patterns of PM_2.5 and NO₂ exposure, simultaneously incorporating pollutant type, timing, duration, and concentration.

Background: Personal care products are a well-documented source of endocrine-disrupting chemicals (EDCs). Differences in exposure to EDCs are reported, with Black women more commonly using products, such as hair products, containing EDCs. Our previous work identified differences in access to safer hair products between neighborhoods in Boston, Massachusetts; however, limited research has explored what may be driving these differences. Redlining and gentrification are two resource allocation practices that may impact neighborhood-level access to health-promoting services and goods, including access to safer hair products.

Objective: We examined if there is an association between historic and contemporary practices related to resource allocation (i.e., historic redlining and gentrification) with hair product safety (i.e., containing EDCs and other chemicals of concern) among the neighborhoods in Boston, Massachusetts.

Methods: We randomly selected and visited 117 stores in Boston to collect data on hair product availability and safety. We used the Environmental Working Group's (EWG) Skin Deep database to evaluate hair product safety through hazard categories (low, moderate, or high). We collected data on historic and contemporary factors at the census tract level (redlining and gentrification). The associations between the historic and contemporary factors and EWG hazard categories were examined using multinomial logistic regressions.

Results: A total of 39,421 hair products were cataloged in Boston, Massachusetts. Stores in previously Home Owners' Loan Corporation (HOLC) graded C and D-not gentrified areas had increased access to high-hazard hair products (risk ratio [RR] HOLC C = 1.1; 95% confidence interval [CI] = 0.9, 1.4, RR HOLC D = 1.4; 95% CI = 1.1, 1.7). Decreased access to low-hazard hair products was reported among stores in HOLC D-gentrified or intensely gentrified (RR = 0.7; 95% CI = 0.5, 1.1), HOLC C-not gentrified (RR = 0.7; 95% CI = 0.5, 1.0), and HOLC D-not gentrified areas (RR = 0.5; 95% CI = 0.4, 0.8).

Discussion: Differences in access to safer hair products were reported when examining the impacts of both redlining and gentrification. Our findings present evidence of the role of historic and contemporary resource allocation practices on current-day neighborhood-level safer hair product accessibility, which may have potential downstream health consequences.

Introduction: The drying Salton Sea in California is a growing source of wind-blown dust, raising particulate matter (PM) levels in surrounding areas. The impacts of these exposures on children's lung function remain poorly understood. We examined the relationship between PM levels and lung function in children near the Salton Sea.

Methods: We enrolled 491 children (mean age: 10.2 years), who were followed over ~1.5 years, contributing 1,269 lung function assessments. Forced expiratory volume in the first second of exhalation (FEV₁) and forced vital capacity (FVC) were measured using a commercial spirometer. Average PM concentrations were estimated for 3 and 12 months preceding each spirometry assessment, using 12 stationary monitors operated by the California Air Resources Board. Analyses were performed using mixed effects linear models adjusting for demographics and underlying health conditions.

Measurements and results: Each 1 µg/m³ increase in average PM_2.5 exposure over 12 months before assessment was associated with a 31.5 ml lower FVC (95% confidence interval [CI] = -57.2, -5.9) and a 32.7 ml lower FEV₁ (95% CI = -56.4, -8.9). A 10-µg/m³ increase in average PM₁₀ exposure over 12 months was associated with a 146.6 ml reduction in FVC (95% CI = -230.4, -62.9) and a 122.0 ml reduction in FEV₁ (95% CI = -197.8, -46.2). Associations within a 3-month exposure window showed similar results. PM exposure was associated with impaired lung function in both asthmatic and non-asthmatic children, with a slightly greater impact observed in those with asthma.

Conclusion: PM exposure near the Salton Sea is related to reduced lung function of pediatric residents.

Background: Children encounter multiple indoor and outdoor environmental exposures in early life. We assessed the independent effects of indoor home exposures and ambient particulate matter with an aerodynamic diameter ≤2.5 µm (PM_2.5) on early childhood asthma diagnosis.

Methods: We included 6,413 children born 1987-2016 from nine United States prospective birth cohorts from the Environmental Influences on Child Health Outcomes consortium, with complete covariate and outcome data. Exposures were (1) average ambient PM_2.5 levels during the first 3 years of life, and (2) indoor home exposures, including water damage/home dampness during infancy/childhood, dogs/cats at home during infancy, dust mite allergen during infancy/childhood. Asthma was defined as caregiver-reported or doctor-diagnosed asthma anytime from birth to age 5. We applied Cox proportional hazards models, adjusting for individual-level and neighborhood-level confounders. Cohort-specific effects were implemented as fixed effects.

Results: By age 5 years, 10.3%-50.3% of children had developed asthma across general-risk and high-risk cohorts. We found a significant detrimental association of PM_2.5 and water damage/home dampness, and a protective association of dogs in the home with risk of childhood asthma, regardless of PM_2.5 adjustment. The effect of having both water damage/home dampness and high PM_2.5 on asthma diagnosis was greater than that of no water damage/home dampness and having low PM_2.5 (hazard ratio: 1.95 [95% confidence interval = 1.19, 3.20]). There were no significant associations with household cats or dust mites.

Conclusion: Multiple early exposures, such as PM_2.5, home dampness, and absence of dogs in the home, should be considered together as risk factors for childhood asthma.

Background: Novel evidence suggests an association of wildfire smoke exposure with preterm birth (PTB). However, the mechanism and exposure timing of this association are poorly understood.

Objective: We estimate the association of wildfire smoke on PTB phenotypes (spontaneous PTB [sPTB] and medically indicated PTB [mPTB]) as well as hypertensive disorders of pregnancy (HDP).

Study design: Birth cohort data from singleton livebirths in California from 2007 to 2012 were combined with daily zip code-level estimates of wildfire smoke intensity. Satellite-based estimates of wildfire smoke plume boundaries and high-resolution gridded estimates of surface particulate matter 2.5 (PM_2.5) concentrations were used to calculate smoke exposure from 4 weeks preconception through gestational week 20. The two primary exposures were (1) wildfire smoke exposure at distinct gestational ages and (2) concentration of wildfire smoke exposure. Logistic regression models assessed associations between the number of wildfire smoke-exposed days and PTB phenotypes. HDP were also assessed as an outcome, given their major contribution to mPTB. Four primary outcomes were used: (1) overall PTB (<37 weeks), (2) sPTB, (3) mPTB, and (4) HDP.

Results: Of 2,548,347 eligible pregnant individuals, 86% were exposed to at least 1 day of wildfire smoke of any PM_2.5 intensity during the exposure period. Wildfire smoke of any intensity was significantly associated with sPTB during the exposure period (odds ratios [OR] [95% confidence intervals (CI)]: 1.003 [1.0021, 1.0039]). Each additional day of smoke exposure conferred 0.3% increased odds of sPTB. We did not observe an association of wildfire smoke with HDP. Only smoke exposure of any intensity between 14 and 20 weeks was associated with increased odds of mPTB OR CI (95%) (1.0038 [1.0008, 1.0069]). Wildfire smoke exposure of any intensity in the gestational period of smoke exposure was associated in increased odds of all PTB, except for the preconception period.

Conclusions: Our study found an association of wildfire smoke exposure with PTB, which was largely driven by sPTB.

Background: The link between prenatal exposure to metal(loid)s and childhood lung function, including sex-specific effects, has not been completely elucidated. We aimed to examine sex-specific individual and joint effects of prenatal metal(loid)s exposure on children's lung function.

Methods: Analyses included 438 mother-child dyads from the Programming Research in Obesity, Growth, Environment, and Social Stressors birth cohort in Mexico City. Metal(loid)s levels (As, Cd, Co, Cu, Mn, Ni, Pb, Se, and Zn) were measured in maternal blood collected during the second and third trimesters. Lung function in children was assessed once at ages 8-14 years. Multiple linear regression was performed to evaluate individual associations. Mixture effects were assessed through repeated holdout weighted quantile sum regression and hierarchical Bayesian kernel machine regression. Effect modification by sex was examined.

Results: Second-trimester Ni was inversely associated with FEV₁/FVC ratio in the overall sample and in females, while Pb was linked to lower FEV₁ z-score in females. Third-trimester Co and Pb were also negatively associated with FVC z-score in females, with Pb also associated with lower FEV₁ z-score in females. Higher metal mixture concentrations were associated with lower FEV₁/FVC ratio (β = -0.33, 95% confidence interval: -0.48, -0.16) and FEF_25%-75% z-score (β = -0.22, 95% confidence interval: -0.39, -0.07) in females, with similar sex-specific patterns of association in weighted quantile sum and Bayesian kernel machine regression models.

Conclusions: Second-trimester metal mixture exposure is associated with lower childhood lung function; females are potentially more susceptible to these exposures, which underscores the need to understand critical windows of exposure and sex-specific differences.

Background: Patients with Alzheimer's disease and related dementias (ADRD) are vulnerable to environmental stressors such as extreme heat and air pollution, yet their combined health effects remain poorly understood.

Methods: We assessed the joint impact of extreme heat and fine particulate matter exposure (PM_2.5) on the risk of all-cause hospitalization among an ADRD cohort of Medicare beneficiaries aged ≥65 years. Using a time-stratified case-crossover design, we analyzed data from beneficiaries with prior ADRD-related hospitalizations across the contiguous US in 2000-2016. Daily heat index and PM_2.5 concentrations were linked to residential ZIP codes, and conditional logistic regression models were applied to estimate same-day associations during the warm season (May-September), including interaction terms to explore potential synergistic effects.

Results: We found a linear association between heat and hospitalization, with an odds ratio (OR) of 1.017 (95% confidence interval [CI] = 1.004, 1.031) on extreme heat days (99th percentile) versus median. The PM_2.5-hospitalization relationship was nonlinear, with stronger effects at lower concentrations (10 vs. 5 µg/m³ OR = 1.010; 95% CI = 1.005, 1.015). When accounting for changes in PM_2.5, the OR on extreme heat days versus the median was 1.016 (95% CI = 1.001, 1.032).

Conclusion: These findings underscore the need to consider both environmental stressors when assessing health risks in ADRD populations.