Environmental Epidemiology最新文献

Extreme heat (EH) is a leading cause of weather-related fatalities in the United States. In Massachusetts, average temperatures have increased by 1.9 °C since the 20th century, higher than the global average increase of 1.1 °C. EH disproportionately impacts communities, exacerbating social inequities. This study examined the risks of heat-related hospitalizations in each small area of the Greater Boston Metropolitan Area using Medicare data (2000-2016). EH events included daily heat index (HI), days with an HI above the 90th percentile, and heat waves (≥2 consecutive EH days). We applied a case-crossover design to estimate area-specific associations between EH and hospitalizations and assessed effect modifications by an individual (age ≥85, sex, Medicaid dual eligibility) and ZIP-code characteristics (green space, poverty, educational attainment, and household income). Results were pooled using random effects meta-analysis. Area-specific analysis revealed higher hospitalization risks in Boston compared with surrounding areas. Pooled results indicated heat-related hospitalizations increased by 9.0% (95% CI = 5.7, 12.3) per 10 °C rise in HI, 14.4% (95% CI = 8.8, 20.3) on EH days, and 17.9% (95% CI = 11.1, 25.1) during heat waves. Risks were more pronounced in Boston, and some indications of elevated risk among males and residents in low-income, low-education areas. These findings underscore that heat-related health risks may be different across the level of geographic units and suggest the need for targeted public health strategies to mitigate the impacts of EH.

Background: Prenatal air pollutants have been associated with adverse birth outcomes, and DNA methylation (DNAm) changes in placenta may contribute to these associations. DNAm-based epigenetic gestational age (GA) estimators are emerging biomarkers for aging/biological age that can reflect early-life exposures and predict long-term health outcomes. We leveraged 103 mother-offspring pairs from the Early Autism Risk Longitudinal Investigation cohort to assess associations between prenatal air pollution and placental epigenetic GA at birth.

Methods: Prenatal air pollution concentrations (NO₂, O₃, PM_2.5, and PM₁₀) were estimated from weekly data from monitoring stations near maternal residence and calculated for preconception and pregnancy periods. DNAm from fetal-side placenta samples was measured on Illumina HumanMethylation450 BeadChip. Epigenetic GA was computed using Lee's robust placenta clock algorithm. GA acceleration/deceleration was the residual of predicted epigenetic GA on chronologic GA, adjusted (intrinsic) or unadjusted (extrinsic) for cell type proportions. We used linear regressions to examine associations between average air pollution levels in each period and GA acceleration/deceleration, and weekly distributed lag models to examine critical exposure windows.

Results: Higher pregnancy average O₃ and PM₁₀ exposures were associated with decelerated intrinsic (β = -0.65 and -0.79) and extrinsic GA (β = -0.69 and -0.74) at birth (per 10-unit increment). Trimester-specific analyses revealed higher O₃ and PM₁₀ exposures in trimesters 2 to 3 associated with decelerated GA at birth. Weekly distributed lag models suggested pregnancy weeks 21 to 31 and 21 to 29 were critical windows of O₃ and PM₁₀ exposures, respectively.

Conclusions: Prenatal air pollution exposures, especially during mid- to late-pregnancy, were associated with lower biological maturity at birth.

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: Persistent organic pollutants (POPs) are widespread, hazardous chemicals, but their impact on emotional and behavioral development is not well understood. This study aimed to investigate whether prenatal exposure to POPs influences internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms from early childhood to adolescence.

Methods: We utilized longitudinally collected data from 467 mother-child pairs in the Rhea study. Concentrations of hexachlorobenzene, dichlorodiphenyldichloroethylene, and six polychlorinated biphenyl congeners (PCBs) were determined in maternal serum samples collected during early pregnancy. Mothers reported their children's internalizing, externalizing, and ADHD symptoms at ages 4 (Strengths and Difficulties Questionnaire, ADHD Test), 6, 11, and 15 years (Child Behavior Checklist, Conners' Parent Rating Scale). The associations between prenatal pollutant exposure and longitudinally studied outcomes were assessed using generalized estimating equation models.

Results: In utero exposure to hexachlorobenzene and dichlorodiphenyldichloroethylene was not associated with emotional or behavioral outcomes. Prenatal exposure to PCBs was associated with decreased internalizing symptoms from childhood through adolescence and reduced ADHD symptoms at age 4 (adjusted β [95% confidence interval]: -0.17 [-0.29, -0.05], and -0.16 [-0.30, -0.02], per doubling of exposure, respectively). Sensitivity analyses confirmed these findings, though the association between PCB exposure and internalizing symptoms was not observed in women with sufficient gestational weight gain.

Conclusions: Our findings suggest that prenatal POP exposure does not adversely affect emotional and behavioral development from preschool age through adolescence. Further research is warranted to elucidate the potential impact of gestational POP exposure on developmental trajectories.

Background: Extremes in humidity can induce bronchoconstriction and trigger breathing symptoms in people with asthma. Less is known about how humidity influences measurements of lung health in children and adolescents. Our objective was to assess the extent to which short-term exposures to high and low relative humidity (RH) are associated with lung function and fractional exhaled nitric oxide (FeNO) in adolescents.

Methods: We included adolescents (mean age 13.2 y, SD: 0.9) from a northeast US prospective prebirth cohort (n = 1019). We assigned daily RH levels to geocoded participant addresses. We defined low or high RH as ≤10^th or ≥90^th internal percentiles, respectively, of the cohort-specific RH distribution and the reference RH as the median. We evaluated the linearity of associations of RH in the 1-7 days before assessment with forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), and FeNO using generalized additive models with penalized splines (df = 3). We log-transformed FeNO due to non-normality. For nonlinear relationships, we used distributed lag nonlinear models to explore the cumulative effects of lag 1-7 day RH on FEV₁, FVC, and FeNO.

Results: Median RH was 65.6% (interquartile range [IQR] = 19.8%), 10th percentile 47.2%, 90th percentile 86.6%. Mean FeNO (SD) was 25.9ppb (26.9ppb). High (vs. median) RH was associated with 38.0% higher FeNO (95% CI = 10.3, 72.7). Exposure to low (vs. median) RH was associated with 186.2 ml lower FEV₁ (95% CI = -299.2, -73.3) and -130.2 ml lower FVC (95% CI = -251.9, -8.5).

Conclusion: Short-term exposures to extremes of RH were associated with lower lung function and higher FeNO, a measure of airway inflammation, in adolescents.

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.

Objective: We examined if racial residential segregation (RRS) - a fundamental cause of disease - is independently associated with air pollution after accounting for other neighborhood and individual-level sociodemographic factors, to better understand its potential role as a confounder of air pollution-health studies.

Methods: We compiled data from eight large cohorts, restricting to non-Hispanic Black and White urban-residing participants observed at least once between 1999 and 2005. We used 2000 decennial census data to derive a spatial RRS measure (divergence index) and neighborhood socioeconomic status (NSES) index for participants' residing Census tracts, in addition to participant baseline data, to examine associations between RRS and sociodemographic factors (NSES, education, race) and residential exposure to spatiotemporal model-predicted PM_2.5 and NO₂ levels. We fit random-effects meta-analysis models to pool estimates across adjusted cohort-specific multilevel models.

Results: Analytic sample included eligible participants in CHS (N = 3,605), MESA (4,785), REGARDS (22,649), NHS (90,415), NHSII (91,654), HPFS (32,625), WHI-OS (77,680), and WHI-CT (56,639). In adjusted univariate models, a quartile higher RRS was associated with 3.73% higher PM_2.5 exposure (95% CI: 2.14%, 5.32%), and an 11.53% higher (95% CI: 10.83%, 12.22%) NO₂ exposure on average. In fully adjusted models, higher RRS was associated with 3.25% higher PM_2.5 exposure (95% CI: 1.45%, 5.05%; P < 0.05) and 10.22% higher NO₂ exposure (95% CI: 6.69%, 13.74%; P < 0.001) on average.

Conclusions: Our findings indicate that RRS is associated with the differential distribution of poor air quality independent of NSES or individual race, suggesting it may be a relevant confounder to be considered in future air pollution epidemiology studies.