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Time-varying associations of gestational and childhood triclosan with pubertal and adrenarchal outcomes in early adolescence 妊娠期和儿童期三氯生与青春期和青春期早期肾上腺结果的时变关系
IF 3.6 Q1 Medicine Pub Date : 2024-03-28 DOI: 10.1097/ee9.0000000000000305
H. Laue, B. Lanphear, A.M. Calafat, Kim M. Cecil, Aimin Chen, Yingying Xu, Heidi J. Kalkwarf, J. C. Madan, M. R. Karagas, K. Yolton, A. Fleisch, Joseph M. Braun
Triclosan is an endocrine-disrupting chemical, but associations with pubertal outcomes remain unclear. We examined associations of gestational and childhood triclosan with adolescent hormone concentrations and pubertal stage. We quantified urinary triclosan concentrations twice during pregnancy and seven times between birth and 12 years in participants recruited from Cincinnati, OH (2003–2006). We averaged concentrations across pregnancy and childhood and separately considered individual exposure periods in multiple informant models. At 12 years, we measured serum hormone concentrations (males [n = 72] and females [n = 84]—dehydroepiandrosterone-sulfate, luteinizing hormone, follicle-stimulating hormone; males—testosterone; females—estradiol). Also at age 12 years, participants self-reported physical development and menarchal timing. We estimated associations (95% confidence interval) of triclosan with hormone concentrations, more advanced physical development, and age at menarche. For females, each doubling of childhood triclosan was associated with 16% lower estradiol concentrations (−29%, 0%), with stronger associations for measures closer to adolescence. We found suggestive evidence that higher triclosan at any age was associated with ~10% (for gestational triclosan: −18%, −2%) lower follicle-stimulating hormone concentrations among males and early postnatal (1–3 years) triclosan was associated with 63% (5%, 96%) lower odds of advanced pubic hair development in females. In multiple informant models, each doubling of gestational triclosan concentrations was associated with 5% (0%, 9%) earlier age at menarche, equivalent to 5.5 months. Gestational and childhood triclosan concentrations were related to some pubertal outcomes including hormone concentrations and age at menarche. Our findings highlight the relevance of elucidating potential sex-specific and time-dependent actions of triclosan.
三氯生是一种干扰内分泌的化学物质,但它与青春期结果的关系仍不清楚。我们研究了妊娠期和儿童期三氯生与青春期激素浓度和青春期阶段的关系。 我们对从俄亥俄州辛辛那提市招募的参与者(2003-2006 年)进行了两次孕期尿液三氯生浓度定量分析和七次出生至 12 岁期间尿液三氯生浓度定量分析。我们对整个孕期和儿童期的浓度进行了平均,并在多信息模型中分别考虑了各个暴露期。12 岁时,我们测量了血清激素浓度(男性 [n = 72],女性 [n = 84]-硫酸脱氢表雄酮,黄体生成素,卵泡刺激素;男性-睾酮;女性-雌二醇)。同样在 12 岁时,受试者还自我报告了身体发育情况和男女交配时间。我们估算了三氯生与荷尔蒙浓度、身体发育和初潮年龄的关系(95% 置信区间)。 对于女性来说,童年时期三氯生含量每增加一倍,雌二醇浓度就会降低 16%(-29%,0%),更接近青春期的测量值关联性更强。我们发现,有提示性证据表明,在任何年龄段,三氯生含量越高,男性的卵泡刺激素浓度就会降低约 10%(妊娠期三氯生:-18%,-2%),而产后早期(1-3 岁)三氯生含量越高,女性阴毛提前发育的几率就会降低 63%(5%,96%)。在多信息模型中,妊娠期三氯生浓度每增加一倍,月经初潮年龄提前 5%(0%,9%),相当于提前 5.5 个月。 妊娠期和儿童期的三氯生浓度与一些青春期结果有关,包括激素浓度和初潮年龄。我们的研究结果突显了阐明三氯生潜在的性别特异性和时间依赖性作用的重要性。
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引用次数: 0
Direct potable reuse and birth defects prevalence in Texas: An augmented synthetic control method analysis of data from a population-based birth defects registry 得克萨斯州的直接饮用水回用和出生缺陷发生率:基于人口的出生缺陷登记数据的增强合成控制法分析
IF 3.6 Q1 Medicine Pub Date : 2024-03-18 DOI: 10.1097/ee9.0000000000000300
Jeremy M. Schraw, Kara E. Rudolph, Charles J. Shumate, M. Gribble
Direct potable reuse (DPR) involves adding purified wastewater that has not passed through an environmental buffer into a water distribution system. DPR may help address water shortages and is approved or is under consideration as a source of drinking water for several water-stressed population centers in the United States, however, there are no studies of health outcomes in populations who receive DPR drinking water. Our objective was to determine whether the introduction of DPR for certain public water systems in Texas was associated with changes in birth defect prevalence. We obtained data on maternal characteristics for all live births and birth defects cases regardless of pregnancy outcome in Texas from 2003 to 2017 from the Texas Birth Defects Registry and birth and fetal death records. The ridge augmented synthetic control method was used to model changes in birth defect prevalence (per 10,000 live births) following the adoption of DPR by four Texas counties in mid-2013, with county-level data on maternal age, percent women without a high school diploma, percent who identified as Hispanic/Latina or non-Hispanic/Latina Black, and rural-urban continuum code as covariates. There were nonstatistically significant increases in prevalence of all birth defects collectively (average treatment effect in the treated = 53.6) and congenital heart disease (average treatment effect in the treated = 287.3) since June 2013. The estimated prevalence of neural tube defects was unchanged. We estimated nonstatistically significant increases in birth defect prevalence following the implementation of DPR in four West Texas counties. Further research is warranted to inform water policy decisions.
直接饮用水回用(DPR)是指将未经过环境缓冲的净化废水添加到配水系统中。DPR 可能有助于解决水资源短缺问题,并且已被批准或正在考虑将其作为美国几个水资源紧张的人口中心的饮用水源,但目前还没有对接受 DPR 饮用水的人群的健康状况进行研究。我们的目标是确定德克萨斯州某些公共供水系统引入 DPR 是否与出生缺陷发生率的变化有关。 我们从德克萨斯州出生缺陷登记处以及出生和胎儿死亡记录中获得了 2003 年至 2017 年德克萨斯州所有活产婴儿和出生缺陷病例(无论妊娠结果如何)的产妇特征数据。在德克萨斯州的四个县于 2013 年年中采用 DPR 后,我们使用脊增强合成控制法对出生缺陷发生率(每 10,000 例活产)的变化进行了建模,并将县级数据中的孕产妇年龄、无高中文凭妇女的百分比、被认定为西班牙裔/拉丁裔或非西班牙裔/拉丁裔黑人的百分比以及城乡连续编码作为协变量。 自 2013 年 6 月以来,所有出生缺陷的患病率(受治疗者的平均治疗效果 = 53.6)和先天性心脏病的患病率(受治疗者的平均治疗效果 = 287.3)均出现了非统计学意义上的显著增长。神经管缺陷的估计患病率保持不变。 我们估计,在德克萨斯州西部的四个县实施 DPR 后,出生缺陷患病率出现了非统计学意义上的显著增加。有必要开展进一步研究,为水政策决策提供依据。
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引用次数: 0
Estimating the impacts of nonoptimal temperatures on mortality: A study in British Columbia, Canada, 2001–2021 估算非最佳温度对死亡率的影响:2001-2021 年加拿大不列颠哥伦比亚省研究
IF 3.6 Q1 Medicine Pub Date : 2024-03-14 DOI: 10.1097/ee9.0000000000000303
Rudra K. Shrestha, Ioana Sevcenco, Priscila Casari, Henry Ngo, Anders Erickson, Martin Lavoie, Deena Hinshaw, Bonnie Henry, Xibiao Ye
Studies show that more than 5.1 million deaths annually are attributed to nonoptimal temperatures, including extreme cold and extreme heat. However, those studies mostly report average estimates across large geographical areas. The health risks attributed to nonoptimal temperatures in British Columbia (BC) are reported incompletely or limit the study area to urban centers. In this study, we aim to estimate the attributable deaths linked to nonoptimal temperatures in all five regional health authorities (RHAs) of BC from 2001 to 2021. We applied the widely used distributed lag nonlinear modeling approach to estimate temperature–mortality association in the RHAs of BC, using daily all-cause deaths and 1 × 1 km gridded daily mean temperature. We evaluated the model by comparing the model-estimated attributable number of deaths during the 2021 heat dome to the number of heat-related deaths confirmed by the British Columbia Coroners Service. Overall, between 2001 and 2021, we estimate that 7.17% (95% empirical confidence interval = 3.15, 10.32) of deaths in BC were attributed to nonoptimal temperatures, the majority of which are attributed to cold. On average, the mortality rates attributable to moderate cold, moderate heat, extreme cold, and extreme heat were 47.04 (95% confidence interval [CI] = 45.83, 48.26), 0.94 (95% CI = 0.81, 1.08), 2.88 (95% CI = 2.05, 3.71), and 3.10 (95% CI = 1.79, 4.4) per 100,000 population per year, respectively. Our results show significant spatial variability in deaths attributable to nonoptimal temperatures across BC. We find that the effect of extreme temperatures is significantly less compared to milder nonoptimal temperatures between 2001 and 2021. However, the increased contribution of extreme heat cannot be ruled out in the near future.
研究表明,每年有 510 多万人死于非最佳温度,包括极寒和极热。然而,这些研究大多报告的是大面积地理区域的平均估计值。不列颠哥伦比亚省(BC 省)因非最佳气温而造成的健康风险报告并不完整,或者研究区域仅限于城市中心。在本研究中,我们旨在估算 2001 年至 2021 年不列颠哥伦比亚省所有五个地区卫生局(RHA)中与非正常气温相关的可归因死亡人数。 我们采用广泛使用的分布式滞后非线性建模方法,利用每日全因死亡人数和 1 × 1 千米网格化日平均气温来估算不列颠哥伦比亚省各地区卫生局的气温与死亡之间的关联。我们通过比较模型估计的 2021 年高温穹顶期间的可归因死亡人数和不列颠哥伦比亚省验尸官服务机构确认的高温相关死亡人数,对模型进行了评估。 总体而言,2001 年至 2021 年期间,我们估计不列颠哥伦比亚省有 7.17% 的死亡(95% 经验置信区间 = 3.15,10.32)归因于非最佳温度,其中大部分归因于寒冷。平均而言,中度寒冷、中度炎热、极端寒冷和极端炎热导致的死亡率分别为每年每 10 万人 47.04(95% 置信区间 [CI] = 45.83,48.26)、0.94(95% CI = 0.81,1.08)、2.88(95% CI = 2.05,3.71)和 3.10(95% CI = 1.79,4.4)。 我们的研究结果表明,在整个不列颠哥伦比亚省,因气温不理想而导致的死亡人数存在明显的空间差异。我们发现,与较温和的非最佳气温相比,2001 年至 2021 年期间极端气温的影响要小得多。然而,在不久的将来,极端高温的影响可能会增加。
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引用次数: 0
Exploring autism spectrum disorder (ASD) and attention deficit disorder (ADD/ADHD) in children exposed to polybrominated biphenyl 探究接触多溴联苯儿童的自闭症谱系障碍(ASD)和注意力缺陷障碍(ADD/ADHD)问题
IF 3.6 Q1 Medicine Pub Date : 2024-03-13 DOI: 10.1097/ee9.0000000000000304
G. Christensen, Metrecia L. Terrell, Brad D. Pearce, Robert B. Hood, Hillary Barton, Melanie Pearson, Michele Marcus
Although the causes of attention-deficit/hyperactivity disorder (ADHD) and autism have not been identified, exposure to endocrine-disrupting chemicals, such as polybrominated biphenyl (PBB), during fetal development and early life has been suspected to impact neurological development. This study aims to investigate the association between prenatal and early life exposure to PBB and the development of ADHD and autism later in life. Data from the Michigan PBB Registry, a cohort of Michigan residents who had been exposed to PBB in a mass contamination event in 1973, was leveraged for this nested case-control analysis among two distinct samples: (1) Those who self-reported ADHD or autism diagnosis, and (2) mothers who reported their child’s ADHD or autism diagnosis. PBB exposure was measured in participants of the PBB Registry, and the mother’s PBB level was used in mother-reported analyses. Cases were matched with controls by sex and year of birth. Conditional logistic regression models were used to estimate the association between PBB level and case status. PBB levels were higher among those who were exposed in early life compared with those exposed in utero (geometric mean: 0.300 ng/ml vs. 0.016 ng/ml). Among women in this cohort, a higher than expected proportion of self-reported ADHD diagnosis (11.11%), compared with population estimates. PBB was not associated with ADHD or autism in either self-reported or mother-reported analyses. This study adds to the sparse literature about prenatal and early life exposure to PBB-153 and ADHD and autism. Future studies should examine potential effect modification by sex.
虽然注意力缺陷/多动症(ADHD)和自闭症的病因尚未确定,但人们怀疑在胎儿发育和生命早期接触多溴联苯(PBB)等干扰内分泌的化学物质会影响神经系统的发育。本研究旨在调查产前和生命早期接触多溴联苯与日后患多动症和自闭症之间的关系。 密歇根州多溴联苯登记处是密歇根州居民的一个队列,他们曾在 1973 年的一次大规模污染事件中接触过多溴联苯,本研究利用该登记处的数据对两个不同的样本进行了嵌套病例对照分析:(1) 自我报告患有多动症或自闭症的人,以及 (2) 报告其子女患有多动症或自闭症的母亲。在多溴联苯登记处的参与者中测量了多溴联苯暴露,在母亲报告的分析中使用了母亲的多溴联苯水平。病例与对照组按性别和出生年份进行配对。条件逻辑回归模型用于估计多溴联苯水平与病例状态之间的关系。 与子宫内暴露者相比,早期暴露者的多溴联苯水平更高(几何平均数:0.300 纳克/毫升对 0.016 纳克/毫升)。在该队列的女性中,自我报告诊断为多动症的比例(11.11%)高于预期,高于人口估计值。在自我报告或母亲报告的分析中,多溴联苯均与多动症或自闭症无关。 本研究补充了有关产前和生命早期接触多溴联苯-153与多动症和自闭症的稀少文献。未来的研究应探讨性别对影响的潜在修饰作用。
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引用次数: 0
Ethics guidelines for environmental epidemiologists: 2023 revision 环境流行病学家伦理指南:2023 年修订版
IF 3.6 Q1 Medicine Pub Date : 2024-03-12 DOI: 10.1097/ee9.0000000000000299
Ruth A. Etzel, N. Abbas, Michael P. Anastario, A. Mustapha, Olayinka Osuolale, Atanu Sarkar, Ireneous N. Soyiri, Emile Whaibeh, Colin L. Soskolne
Recognition of the importance to environmental epidemiology of ethical and philosophical deliberation led, in 1996, to the establishment of Ethics Guidelines for the profession. In 1999, these guidelines were adopted by the International Society for Environmental Epidemiology. The guidelines were revised in 2012 and again in 2023 to ensure continued relevance to the major issues facing the field. Comprising normative standards of professional conduct, the guidelines are structured into four subsections: (1) obligations to individuals and communities who participate in research; (2) obligations to society; (3) obligations regarding funders/sponsors and employers; and (4) obligations to colleagues. Through the 2023 revision of the Ethics Guidelines, the International Society for Environmental Epidemiology seeks to ensure the highest possible standards of transparency and accountability for the ethical conduct of environmental epidemiologists engaged in research and public health practice.
由于认识到伦理和哲学思考对环境流行病学的重要性,1996 年制定了该行业的《伦 理准则》。1999 年,国际环境流行病学学会通过了这些准则。该准则于 2012 年进行了修订,并于 2023 年再次修订,以确保继续与该领域面临的主要问题相关。准则包括职业行为规范标准,分为四个小节:(1) 对参与研究的个人和社区的义务;(2) 对社会的义务;(3) 对资助者/赞助商和雇主的义务;(4) 对同事的义务。通过 2023 年道德准则修订版,国际环境流行病学学会力求确保从事研究和公共卫生实践的环境流行病学家的道德行为尽可能达到最高的透明度和问责标准。
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引用次数: 0
Air pollution, traffic noise, greenness, and temperature and the risk of incident type 2 diabetes: Results from the KORA cohort study 空气污染、交通噪音、绿化和温度与 2 型糖尿病发病风险:KORA 队列研究的结果
IF 3.6 Q1 Medicine Pub Date : 2024-03-11 DOI: 10.1097/ee9.0000000000000302
Mahnaz Badpa, A. Schneider, Lars Schwettmann, Barbara Thorand, K. Wolf, A. Peters
Type 2 diabetes (T2D) is a major public health concern, and various environmental factors have been associated with the development of this disease. This study aimed to investigate the longitudinal effects of multiple environmental exposures on the risk of incident T2D in a German population-based cohort. We used data from the KORA cohort study (Augsburg, Germany) and assessed exposure to air pollutants, traffic noise, greenness, and temperature at the participants’ residencies. Cox proportional hazard models were used to analyze the associations with incident T2D, adjusting for potential confounders. Of 7736 participants included in the analyses, 10.5% developed T2D during follow-up (mean: 15.0 years). We found weak or no association between environmental factors and the risk of T2D, with sex and education level significantly modifying the effects of air pollutants. Our study contributes to the growing body of literature investigating the impact of environmental factors on T2D risks and suggests that the impact of environmental factors may be small.
2 型糖尿病(T2D)是一个重大的公共卫生问题,而各种环境因素都与这种疾病的发生有关。本研究旨在调查多种环境暴露对德国人群队列中 2 型糖尿病发病风险的纵向影响。 我们使用了 KORA 队列研究(德国奥格斯堡)的数据,评估了参与者居住地的空气污染物、交通噪音、绿化和温度暴露情况。在对潜在混杂因素进行调整后,我们使用 Cox 比例危险模型来分析与 T2D 发病的关系。 在纳入分析的 7736 名参与者中,10.5% 的人在随访期间(平均 15.0 年)患上了终末期糖尿病。我们发现,环境因素与 T2D 风险之间的关系很弱或没有关系,而性别和教育水平会显著改变空气污染物的影响。 我们的研究为越来越多的研究环境因素对 T2D 风险影响的文献做出了贡献,并表明环境因素的影响可能很小。
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引用次数: 0
Spatiotemporal light exposure modeling for environmental circadian misalignment and solar jetlag 为环境昼夜节律失调和太阳时差建立时空光照模型
IF 3.6 Q1 Medicine Pub Date : 2024-03-07 DOI: 10.1097/ee9.0000000000000301
T. VoPham, M. Ton, Matthew D. Weaver
Light exposure is the most powerful resetting signal for circadian rhythms. The objective of this study was to develop and validate a high-resolution geospatial light exposure model that measures environmental circadian misalignment (or solar jetlag) as the mismatch between the social clock and sun clock, which occurs from geographic variation in light exposure leading to delayed circadian phase from relatively less morning light exposure and greater evening light exposure with increasing westward position within a time zone. The light exposure model (30 m2 spatial resolution) incorporated geospatial data across the United States on time zones, elevation (using Google Earth Engine), sunrise time, and sunset time to estimate solar jetlag scores (higher values indicate higher environmental circadian misalignment). The validation study compared the light exposure model in 2022, which was linked with geocoded residential addresses of n = 20 participants in Boston, MA (eastern time zone position) and Seattle, WA (western time zone position) using a geographic information system, with illuminance values captured from wearable LYS light sensors and with sun times from the Solar Calculator. Western versus eastern positions within a time zone were associated with higher solar jetlag scores from the light exposure model (P < 0.01) and relatively larger differences in sunset time measured using light sensors (social clock) and the Solar Calculator (sun clock) (P = 0.04). We developed and validated a geospatial light exposure model, enabling high spatiotemporal resolution and comprehensive characterization of geographic variation in light exposure potentially impacting circadian phase in epidemiologic studies.
光照是昼夜节律最强有力的重设信号。本研究的目的是开发并验证一个高分辨率的地理空间光照模型,该模型可测量环境昼夜节律失调(或太阳时差),即社会时钟和太阳时钟之间的不匹配,这种失调是由于光照的地理差异造成的,随着时区内位置的西移,晨光照射相对较少,而晚光照射较多,从而导致昼夜节律延迟。 光照模型(空间分辨率为 30 平方米)结合了美国各地的时区、海拔(使用谷歌地球引擎)、日出时间和日落时间等地理空间数据,以估算太阳时差分数(数值越高,表示环境昼夜节律失调越严重)。验证研究将 2022 年的光照射模型与可穿戴式 LYS 光传感器采集的照度值以及太阳计算器的太阳时间进行了比较,该模型使用地理信息系统与马萨诸塞州波士顿(东部时区位置)和华盛顿州西雅图(西部时区位置)的 n = 20 名参与者的地理编码住宅地址进行了链接。 在一个时区内,西部与东部的位置与光照射模型得出的较高太阳时差分数相关(P < 0.01),与使用光传感器(社会时钟)和太阳计算器(太阳时钟)测量的日落时间的相对较大差异相关(P = 0.04)。 我们开发并验证了一个地理空间光照模型,该模型具有高时空分辨率,可全面描述流行病学研究中可能影响昼夜节律的光照地理差异。
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引用次数: 0
Ambient air pollution and mortality: The role of socioeconomic conditions 环境空气污染与死亡率:社会经济条件的作用
IF 3.6 Q1 Medicine Pub Date : 2024-03-07 DOI: 10.1097/ee9.0000000000000297
Felipe Parra do Nascimento, Nelson Gouveia
There is a vast body of literature covering the association between air pollution exposure and nonaccidental mortality. However, the role of socioeconomic status (SES) in this relationship is still not fully understood. We investigated if individual and contextual SES modified the relationship between short-term exposure to ozone (O3), nitrogen dioxide (NO2), and particulate matter with aerodynamic diameter <10 µm (PM10) on cardiovascular, respiratory, and all nonaccidental mortality. We conducted a time-stratified case-crossover study. Analyses were based on information on 280,685 deaths from 2011 to 2015 in the city of São Paulo. Education was used as an individual SES, and information on the district of residence was used to build a contextual SES. Exposure to PM10, NO2, and O3 was accessed from monitoring stations and linked to each case based on the date of death. Conditional logistic regression models were used to estimate the effects of air pollutants, and interaction terms were added to access the effect modification of SES. Individuals with lower education had an increased chance of dying for all nonaccidental outcomes (1.54% [0.91%, 2.14%]) associated with exposure to PM10. Individuals living in lower SES areas had an increased chance of dying for nonaccidental (0.52% [0.16%, 0.88%]), cardiovascular (1.17% [0.88%, 1.46%]), and respiratory (1.70% [0.47%, 2.93%]) causes owing to NO2 exposure. Exposure to air pollutants increases the chance of dying by nonaccidental, cardiovascular, and respiratory causes. Lower educational levels and living on lower contextual SES increased the risk of mortality associated with air pollution exposure.
有大量文献涉及空气污染暴露与非意外死亡之间的关系。然而,社会经济地位(SES)在这种关系中的作用仍未得到充分了解。 我们研究了个体和环境的社会经济地位是否会改变短期暴露于臭氧(O3)、二氧化氮(NO2)和空气动力学直径小于 10 µm 的颗粒物(PM10)对心血管、呼吸系统和所有非意外死亡之间的关系。 我们进行了一项时间分层病例交叉研究。分析基于 2011 年至 2015 年圣保罗市 280,685 例死亡的信息。教育程度被用作个人的社会经济地位,而居住地区的信息则被用来建立背景社会经济地位。可吸入颗粒物(PM10)、二氧化氮(NO2)和臭氧(O3)的暴露量可从监测站获取,并根据死亡日期与每个病例相关联。采用条件逻辑回归模型来估计空气污染物的影响,并添加交互项来获得社会经济地位的影响修正。 受教育程度较低的人因接触 PM10 而导致所有非意外死亡的几率增加(1.54% [0.91%, 2.14%])。生活在社会经济地位较低地区的人因接触二氧化氮而死于非意外事故(0.52% [0.16%, 0.88%])、心血管疾病(1.17% [0.88%, 1.46%])和呼吸系统疾病(1.70% [0.47%, 2.93%])的几率增加。 暴露于空气污染物会增加死于非意外事故、心血管疾病和呼吸系统疾病的几率。较低的教育水平和生活在较低的社会经济地位环境中会增加与接触空气污染有关的死亡风险。
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引用次数: 0
Associations of pollen and cardiovascular disease morbidity in Atlanta during 1993–2018 1993-2018 年间亚特兰大花粉与心血管疾病发病率的关系
IF 3.6 Q1 Medicine Pub Date : 2024-02-29 DOI: 10.1097/ee9.0000000000000296
Brooke L. Lappe, N. Scovronick, R. D'souza, Arie Manangan, Howard H. Chang, S. Ebelt
Pollen exposure is associated with substantial respiratory morbidity, but its potential impact on cardiovascular disease (CVD) remains less understood. This study aimed to investigate the associations between daily levels of 13 pollen types and emergency department (ED) visits for eight CVD outcomes over a 26-year period in Atlanta, GA. We acquired pollen data from Atlanta Allergy & Asthma, a nationally certified pollen counting station, and ED visit data from individual hospitals and the Georgia Hospital Association. We performed time-series analyses using quasi-Poisson distributed lag models, with primary analyses assessing 3-day (lag 0–2 days) pollen levels. Models controlled for temporally varying covariates, including air pollutants. During 1993–2018, there were 1,573,968 CVD ED visits. Most pairwise models of the 13 pollen types and eight CVD outcomes showed no association, with a few exceptions potentially due to chance. We found limited evidence of the impact of pollen on cardiovascular morbidity in Atlanta. Further study on pollen exposures in different climactic zones and exploration of pollen-pollution mixture effects is warranted.
花粉暴露与大量呼吸道疾病相关,但其对心血管疾病(CVD)的潜在影响却鲜为人知。本研究旨在调查美国佐治亚州亚特兰大市 26 年间 13 种花粉的日含量与急诊科(ED)就八种心血管疾病就诊率之间的关系。 我们从国家认证的花粉计数站亚特兰大过敏与哮喘研究所获得了花粉数据,并从各家医院和佐治亚州医院协会获得了急诊室就诊数据。我们使用准泊松分布滞后模型进行了时间序列分析,主要分析评估了 3 天(滞后 0-2 天)的花粉水平。模型控制了随时间变化的协变量,包括空气污染物。 1993-2018 年间,共有 1,573,968 例心血管疾病急诊就诊。13 种花粉类型和 8 种心血管疾病结果的大多数配对模型显示两者之间没有关联,少数例外情况可能是偶然因素所致。 我们发现花粉对亚特兰大心血管疾病发病率影响的证据有限。有必要进一步研究不同气候区的花粉暴露情况,并探讨花粉污染混合物的影响。
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引用次数: 0
Heat-related mortality and ambulance transport after a power outage in the Tokyo metropolitan area 东京市区停电后与高温有关的死亡率和救护车运送情况
IF 3.6 Q1 Medicine Pub Date : 2024-02-19 DOI: 10.1097/ee9.0000000000000292
Lisa Yamasaki, Takuma Kamada, C. Ng, Y. Takane, Ko Nakajima, Kazuki Yamaguchi, Kazutaka Oka, Yasushi Honda, Yoonhee Kim, Masahiro Hashizume
Air conditioners can prevent heat-related illness and mortality, but the increased use of air conditioners may enhance susceptibility to heat-related illnesses during large-scale power failures. Here, we examined the risks of heat-related illness ambulance transport (HIAT) and mortality associated with typhoon-related electricity reduction (ER) in the summer months in the Tokyo metropolitan area. We conducted event study analyses to compare temperature–HIAT and mortality associations before and after the power outage (July to September 2019). To better understand the role of temperature during the power outage, we then examined whether the temperature–HIAT and mortality associations were modified by different power outage levels (0%, 10%, and 20% ER). We computed the ratios of relative risks to compare the risks associated with various ER values to the risks associated without ER. We analyzed the data of 14,912 HIAT cases and 74,064 deaths. Overall, 93,200 power outage cases were observed when the typhoon hit. Event study results showed that the incidence rate ratio was 2.01 (95% confidence interval [CI] = 1.42, 2.84) with effects enduring up to 6 days, and 1.11 (95% CI = 1.02, 1.22) for mortality on the first 3 days after the typhoon hit. Comparing 20% to 0% ER, the ratios of relative risks of heat exposure were 2.32 (95% CI = 1.41, 3.82) for HIAT and 0.95 (95% CI = 0.75, 1.22) for mortality. A 20% ER was associated with a two-fold greater risk of HIAT because of summer heat during the power outage, but there was little evidence for the association with all-cause mortality.
空调可以预防热相关疾病并降低死亡率,但在大规模停电时,空调使用量的增加可能会增加热相关疾病的易感性。在此,我们研究了东京都夏季与台风相关的电力减少(ER)所导致的热相关疾病救护车运送(HIAT)风险和死亡率。 我们进行了事件研究分析,以比较停电前后(2019 年 7 月至 9 月)的温度-HIAT 和死亡率关联。为了更好地了解停电期间温度的作用,我们随后研究了不同的停电水平(0%、10% 和 20% ER)是否会改变温度-HIAT 和死亡率的关联。我们计算了相对风险比,以比较与不同ER值相关的风险和与无ER相关的风险。 我们分析了 14,912 例 HIAT 病例和 74,064 例死亡病例的数据。台风来袭时,共观察到 93,200 个停电案例。事件研究结果显示,台风影响持续时间长达 6 天的发病率比为 2.01(95% 置信区间 [CI] = 1.42,2.84),台风袭击后头 3 天的死亡率比为 1.11(95% 置信区间 = 1.02,1.22)。对比 20% 和 0% 的热暴露,热暴露对 HIAT 的相对风险比为 2.32 (95% CI = 1.41, 3.82),对死亡率的相对风险比为 0.95 (95% CI = 0.75, 1.22)。 在停电期间,20% 的急诊室与夏季高温导致的 HIAT 风险高出两倍相关,但与全因死亡率相关的证据却很少。
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Environmental Epidemiology
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