Environmental Epidemiology最新文献

Background: Prenatal exposure to environmental chemicals may be associated with autism or autistic-like behaviors. Previous studies suggest that these associations are stronger when folic acid (FA) supplementation is lower.

Methods: We used data from the Maternal-Infant Research on Environmental Chemicals study, a Canadian pregnancy and birth cohort (2008-2011). We considered five separate chemical mixtures (measured during the first trimester of pregnancy): metals, organochlorine pesticides, per- and polyfluoroalkyl substances (PFAS), polychlorinated biphenyls (PCBs), and persistent organic pollutants (POPs; including organochlorine pesticides, PFAS, PCBs, and one polybrominated diphenyl ether congener). Autistic-like behaviors were documented in 601 3-4-year-old children with the social responsiveness scale-2 (SRS-2), where higher T-scores denote more behaviors. We used quantile g-computation to estimate the mixture-SRS-2 associations and assessed whether gestational FA supplementation and plasma total folate concentrations modified these associations.

Results: The PFAS mixture was associated with decreased SRS-2 T-scores (Ψ = -0.5; 95% confidence interval [CI] = -1.1, 0.1). The metal-SRS-2 associations were stronger in the positive direction among participants with high (>1,000 μg/d) FA supplementation (Ψ = 2.4; 95% CI = 0.8, 3.9) versus those with adequate (400-1,000 μg/d) supplementation (Ψ = -0.2; 95% CI = -1.1, 0.7) (p-interaction = 0.003). Plasma total folate concentrations similarly modified these associations (p-interaction = 0.01). The associations between the PFAS, PCB, and POP mixtures and SRS-2 T-scores were stronger in the positive direction among participants with low (<400 μg/d) versus adequate FA supplementation. This was not observed when assessing modification by plasma total folate concentrations.

Conclusion: Our results suggest that the metal mixture is more strongly associated with autistic-like behaviors among participants with higher folate exposure, and the PFAS, PCB, and POP mixtures are more strongly associated with autistic-like behaviors among participants with low FA supplementation.

Background: Characterization of US sociodemographic disparities in air pollution respiratory effects has often been limited by lack of participant diversity, geography, exposure characterization, and small sample size.

Methods: We included 34 sites comprising 23,234 children (born 1981-2021) from the Environmental influences on Child Health Outcomes (ECHO) Program with data on asthma diagnosis until age 10 (182,008 person-years). Predicted annual exposure to fine particulate matter (1988-2021), nitrogen dioxide (2000-2016), and ground ozone (2000-2016) were assigned based on residential histories. For each pollutant, we fitted time-varying Cox models adjusted for time trend, site, and several area- and individual-level sociodemographic features that were separately considered as modifiers via an interaction with exposure.

Results: The hazard ratio of incident asthma by age 10 years was 1.19 (95% CI = 1.10, 1.28), 1.19 (95% CI = 1.05, 1.34), and 1.11 (95% CI = 1.01, 1.22) of an interquartile range increase in prior-year exposure to fine particulate matter (6.17 µg/m³), nitrogen dioxide (15.37 ppb), and ozone (6.87 ppb), respectively. For both fine particulate and nitrogen dioxide, children from areas with a higher proportion of Black residents or with a higher population density had greater pollution-associated risks of incident asthma. For ozone, asthma risks were enhanced in less dense areas.

Conclusions: US efforts to mitigate childhood asthma risk by reducing air pollution would benefit from addressing root structural causes of vulnerability and susceptibility, including spatial patterning in air pollution sources and exposures as well as social and economic disadvantage.

Background: Prolonged exposure to sunlight increases the risk of skin cancer. However, multiple sunlight-related health benefits have been identified. The overall effect of sun exposure on mortality remains inconclusive. This study investigated the association between daylight exposure and mortality (all-cause and cause-specific: cancer, cardiovascular disease (CVD), and noncancer non-CVD mortalities).

Methods: This study utilized the Adventist Health Study (AHS) 2 cohort of North America. Sun exposure was defined using time spent outdoors during daylight in warmer and cooler months. Mortality outcomes were identified through 2015. Multivariable Cox regression was used to examine the association between sun exposure and mortality.

Results: This study included 83,205 AHS-2 participants enrolled between 2002 and 2007. We observed nonlinear (reverse J-shaped) associations between time outdoors in warmer months and the risks of all-cause, CVD, and noncancer non-CVD mortalities. Compared with spending 30 min/day during daylight in warmer months, spending 2 hours/day was associated with a lower risk of all-cause (hazard ratio: 0.90; 95% confidence interval = 0.86, 0.93), CVD (0.89; 0.83, 0.95), and noncancer non-CVD mortalities (0.83; 0.78, 0.89), but was not significantly associated with cancer mortality risk (1.02; 0.93, 1.13) after adjusting for physical activity and important confounders. All associations were weaker with the time spent outdoors in cooler months.

Conclusions: Moderate time outdoors in daylight during warmer months could be associated with lower risks of all-cause, CVD, and noncancer non-CVD mortality; however, there was no clear evidence of an association with cancer mortality. Epidemiological studies need to investigate the balance between sun exposure's health benefits and risks.

Background: Population-level interventions that promote healthy aging through modifications to the built environment are likely to be more effective than individual-level interventions. Few studies have examined the influence of multiple built environment factors on measures of healthy aging.

Objectives: We leveraged detailed data from a population-based cohort study to examine how multiple aspects of the built environment were associated with grip strength, a well-accepted measure of age-related health status.

Methods: A cross-sectional analysis was conducted among 15,068 participants of the British Columbia Generations Project. Geospatial measures of air pollution (PM_2.5, SO₂, and NO₂), greenness, light-at-night, and walkability were linked to participant residential postal codes. Grip strength was measured using a digital hydraulic hand dynamometer. Logistic regression analyses were used to estimate the odds of having sex-specific clinically weak measures of grip strength in association with each built environment factor. The other built environment factors, demographics, and lifestyle factors were evaluated as confounders.

Results: Increased SO₂ and greenness were statistically significantly associated with increased and decreased odds of having clinically weak grip strength, respectively, after adjusting for demographic, lifestyle, and other built environment factors.

Conclusion: Our findings suggest that built environment factors are compelling targets for improving age-related health, though the mechanisms underlying associations with these factors, particularly greenness, remain uncertain.

Background: This systematic review aimed to estimate relative risks for incident ischemic heart disease (IHD), myocardial infarction (MI), and stroke in relation to long-term road traffic noise exposure and to evaluate exposure-response functions.

Methods: We systematically searched databases for longitudinal studies in humans on incident IHD, MI, and/or stroke, including quantitative estimates on individual exposure to residential road traffic noise based on validated models or measurements. Risk of bias was evaluated in each study based on predefined criteria. Pooled linear exposure-response functions were generated from random-effect models in meta-analyses of study-specific risk estimates. Restricted cubic spline models were used to capture potential nonlinear associations.

Results: Twenty eligible studies were identified based on more than 8.4 million individuals, mostly from Europe, including between 160,000 and 240,000 cases for each of the outcomes. Pooled relative risk estimates were 1.017 (95% confidence interval [CI]: 0.990, 1.044) for IHD, 1.029 (95% CI: 1.011, 1.048) for MI, and 1.025 (95% CI: 1.009, 1.041) for stroke per 10 dB L_den in road traffic noise exposure. Risk estimates appeared higher in combined analyses of studies with a low risk of exposure assessment bias. Restricted cubic spline analyses of these studies showed clear risk increases with exposure for all three cardiovascular outcomes.

Conclusions: The evidence indicates that long-term exposure to road traffic noise increases the incidence of IHD, including MI, and stroke. Given the abundant exposure, traffic noise is a cardiovascular risk factor of public health importance. High-quality assessment of noise exposure appears essential for the risk estimation.

Residential relocation can be leveraged as a natural experiment. This study examined the changes in environmental exposures due to residential relocation in two samples of within-city movers in Bradford (UK); 2089 residents (66% women, mean [SD] age, 47.80 [19.88] years) with preexisting common mental disorders-related prescriptions and 12,699 residents (60% women, mean [SD] age, 42.47 [17.40] years) without the same prescriptions at baseline (January-April 2021). Study data were extracted from National Health Service health records. The outcome was the presence of an active prescription for anxiolytics or antidepressants (yes/no) 1 year after relocation (January-April 2022). Change scores were calculated for several exposures, including the normalized difference vegetation index, distance decay to green spaces, coarse (PM₁₀) and fine particulate matter (PM_2.5), and nitrogen dioxide (NO₂) at pre- and postmove addresses. Logistic regression models were used for each change score exposure, adjusting for covariates selected using a direct acyclic graph validated against the data. Participants without prescriptions at baseline were likely to relocate to less green and less polluted areas compared with those with preexisting medication. A total of 15% of participants without prescriptions at baseline had an active prescription at follow-up. For these, increases in normalized difference vegetation index were associated with lower odds of having active prescriptions at follow-up [OR (odds ratio) = 0.93 (95% confidence interval [CI] = 0.88, 0.98), P = 0.007], whereas increases in PM_2.5 [OR = 1.1 (95% CI = 1.04, 1.16), P < 0.001] and PM₁₀ [OR = 1.12 (95% CI = 1.06-1.19), P < 0.001] concentrations were associated with higher odds. Changes in environmental exposures due to residential relocation showed an influence on mental health only for those participants without active prescriptions in the baseline.

Background: Compound extreme weather events are severe weather conditions that can jointly magnify human health risks beyond any single event alone. Drought and heatwaves are extreme weather conditions associated with adverse health, but their combined impact is poorly understood.

Methods: We designed a case-crossover study to estimate heatwave-associated mortality stratified by drought conditions in 183,725 US Veteran patients (2016-2021) with chronic obstructive pulmonary disease (COPD). A conditional logistic regression with distributed lag models was applied. Droughts were categorized into binary and categorical metrics, and we further explored the timing of heatwaves as a risk factor.

Results: Our results indicate that drought amplifies heatwaves with hotter temperatures and longer durations during drought conditions, and the percentage of mortality attributable to heatwaves during drought was 7.41% (95% confidence interval [CI]: 2.91, 12.28) compared with 2.91% (95% CI: 0.00, 4.76) for heatwaves during nondrought conditions. Heatwaves that occurred during drought conditions in the late warm season had a larger association with mortality compared with late-season heatwaves during nondrought conditions, 7.41% (95% CI: 1.96, 13.04) of mortality events and 0.99% (95% CI: -1.01, 3.85) of mortality events attributable to these exposures, respectively.

Conclusion: Compound drought and heatwave events trend toward increased mortality risk among patients with COPD and present a growing human health threat under climate change. Existing heat warnings and vulnerability maps may include drought conditions to better capture heat-related public health risks.

Background: Prenatal exposure to environmental factors, such as greenspace and active living environments, has been associated with numerous health benefits, including improved neurodevelopmental outcomes. Although cerebral palsy (CP) is not typically linked to these exposures, emerging evidence suggests that exposure to environmental factors during pregnancy may influence brain development, making it important to explore their potential role in CP risk.

Methods: We conducted a retrospective cohort study using health administrative data from Ontario, Canada, between 1 April 2002 and 31 December 2020. We identified 1,436,411 mother-infant pairs, of which 2,883 were diagnosed with CP during the follow-up period. Exposures of interest included the Normalized Difference Vegetation Index (NDVI), Green View Index (GVI), and park proximity. The Canadian Active Living Environments index was also utilized. Cox proportional hazards models estimated hazard ratios (HRs) for CP risk associated with these environmental exposures, adjusting for potential confounders.

Results: Interquartile range (IQR) increases in NDVI (HR = 1.040; 95% confidence interval [CI]: 0.987, 1.096; per IQR = 0.1) and GVI (HR =0.989; 95% CI: 0.943, 1.038; per IQR = 10.05%) were not significantly associated with CP risk. Similar results were found for quartile increases of NDVI and GVI. Residential proximity to parks at birth was associated with a reduction in CP risk (HR = 0.946; 95% CI: 0.904, 0.990; per 0.06 increase in park proximity index), after adjusting for active living environment and air pollution.

Conclusions: Our study suggests that living closer to parks reduces the risk of CP. Further research should investigate these protective effects and consider other dimensions of greenspace quality and usability.

Background: Millions of people in the United States live near Superfund sites and may be exposed to hazardous chemicals from those sites. However, there is limited research on chemicals present at sites and the demographics of nearby communities. We aimed to identify subgroups of Superfund sites with similar contaminant profiles and evaluate whether sociodemographic characteristics vary by type of site.

Methods: We used US Environmental Protection Agency Superfund data to identify sites active in the year 2000. Census tract centroids located within 3 miles of every Superfund site were identified and a weighted average of census tract-level sociodemographics using the 2000 US Census was calculated. Superfund sites with similar contaminant profiles were identified using latent class analysis. We compared the median sociodemographic characteristics, overall and by contaminant latent class, with those of the overall 2000 US Census.

Results: We identified seven latent classes based on 12 contaminant categories from 1332 Superfund sites active in 2000. Overall, there were few differences in sociodemographics observed by the presence of any Superfund site compared with the overall US Census. After stratifying by contaminant profile, we observed evidence of disparities for two classes of sites, defined by (1) high diversity of chemical exposure and lumber industry and (2) batteries and metals, which were more likely to have higher hazard scores and to be near communities with higher proportions of non-White individuals, lower socioeconomic status, and higher social vulnerability.

Conclusion: Disadvantaged communities, with higher social vulnerability, were more likely to be near certain Superfund sites with higher hazard scores.

A cross-sectional analysis was performed to investigate associations between environmental temperatures and injury occurrence in two professional male football (soccer) leagues. Data from seven seasons of the German Bundesliga (2142 matches) and four seasons of the Australian A-League (470 matches) were included. Injuries were collated via media reports for the Bundesliga and via team staff reports in the A-League and comprised injury incidence, mechanisms (contact, noncontact), locations (e.g., ankle, knee, and thigh), and types (e.g., muscle and tendon, joint and ligament). Weather data included ambient air temperature (temperature or T) and wet bulb globe temperature (WBGT), which were collected from online sources retrospectively. Generalized linear mixed models were analyzed to examine associations between temperature or WBGT and injury occurrence for each league, respectively. Additionally, matches were grouped into categories of 5°C temperature steps to compare for injury occurrence. Results showed no relationship existed between either temperature or WBGT and any injury occurrence, mechanisms, locations or types for the Bundesliga (P > 0.10). A trend for an increase in injury occurrence in higher WBGT existed in the A-League (P = 0.05). Comparisons between 5°C temperature categories showed no significant differences for injury occurrence for either temperature or WBGT in either League (P > 0.05). Within the observed temperature ranges (-11.2 to 37.1°C T; -12.2 to 29.6°C WBGT) environmental temperature had no relationship with the rate or type of injury occurrence in professional football. Nevertheless, the number of matches at extreme heat within this study was limited and other factors (e.g., playing intensity, season stage, ground conditions) likely co-influence the relationship with injuries.