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Prenatal exposure to polycyclic aromatic hydrocarbons and executive functions at school age: Results from a combined cohort study 产前接触多环芳烃与学龄时的执行功能:一项合并队列研究的结果
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-06-15 DOI: 10.1016/j.ijheh.2024.114407
Yu Ni , Adam A. Szpiro , Christine T. Loftus , Tomomi Workman , Alexis Sullivan , Erin R. Wallace , Anne M. Riederer , Drew B. Day , Laura E. Murphy , Ruby H.N. Nguyen , Sheela Sathyanarayana , Emily S. Barrett , Qi Zhao , Daniel A. Enquobahrie , Christopher Simpson , Shaikh I. Ahmad , Jessica A. Arizaga , Brent R. Collett , Karen J. Derefinko , Kurunthachalam Kannan , Catherine J. Karr

Background

Executive functions develop rapidly in childhood, enabling problem-solving, focused attention, and planning. Exposures to environmental toxicants in pregnancy may impair healthy executive function development in children. There is increasing concern regarding polycyclic aromatic hydrocarbons (PAHs) given their ability to transfer across the placenta and the fetal blood-brain barrier, yet evidence from epidemiological studies is limited.

Methods

We examined associations between prenatal PAH exposure and executive functions in 814 children of non-smoking mothers from two U.S. cohorts in the ECHO-PATHWAYS Consortium. Seven mono-hydroxylated PAH metabolites were measured in mid-pregnancy urine and analyzed individually and as mixtures. Three executive function domains were measured at age 8–9: cognitive flexibility, working memory, and inhibitory control. A composite score quantifying overall performance was further calculated. We fitted linear regressions adjusted for socio-demographics, maternal health behaviors, and psychological measures, and examined modification by child sex and stressful life events in pregnancy. Bayesian kernel machine regression was performed to estimate the interactive and overall effects of the PAH mixture.

Results

The results from primary analysis of linear regressions were generally null, and no modification by child sex or maternal stress was indicated. Mixture analyses suggested several pairwise interactions between individual PAH metabolites in varied directions on working memory, particularly interactions between 2/3/9-FLUO and other PAH metabolites, but no overall or individual effects were evident.

Conclusion

We conducted a novel exploration of PAH-executive functions association in a large, combined sample from two cohorts. Although findings were predominantly null, the study carries important implications for future research and contributes to evolving science regarding developmental origins of diseases.

背景执行功能在儿童时期发展迅速,能够帮助儿童解决问题、集中注意力和制定计划。孕期接触环境有毒物质可能会损害儿童执行功能的健康发展。由于多环芳烃(PAHs)能穿过胎盘和胎儿血脑屏障,因此人们越来越关注多环芳烃,但流行病学研究的证据却很有限。方法我们研究了ECHO-PATHWAYS联合会两个美国队列中814名非吸烟母亲所生子女的产前多环芳烃暴露与执行功能之间的关系。对孕中期尿液中的七种单羟基多环芳烃代谢物进行了测定,并对其进行了单独分析和混合物分析。在 8-9 岁时测量了三个执行功能领域:认知灵活性、工作记忆和抑制控制。我们进一步计算了量化总体表现的综合得分。我们根据社会人口统计学、母亲健康行为和心理测量结果进行了线性回归,并研究了儿童性别和孕期生活压力事件的影响。我们进行了贝叶斯核机器回归,以估计多环芳烃混合物的交互效应和总体效应。结果线性回归的主要分析结果一般为空,没有发现儿童性别或母亲压力对其有任何影响。混合物分析表明,单个 PAH 代谢物之间在不同方向上对工作记忆有几种成对的交互作用,尤其是 2/3/9-FLUO 与其他 PAH 代谢物之间的交互作用,但总体或单个效应并不明显。尽管研究结果主要为空,但该研究对未来研究具有重要意义,并有助于发展有关疾病发育起源的科学。
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引用次数: 0
Occupational noise and genetic variants in stress hormone biosynthesis-based genes and rates of blood lipid changes in China: A five-year longitudinal study 中国的职业噪声和基于应激激素生物合成的基因的遗传变异与血脂变化率:五年纵向研究
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-06-14 DOI: 10.1016/j.ijheh.2024.114404
Xiayun Dai , Fan Wang , Lei Ni, Jinfeng Jiang, Jiaojun Liang, Tian Xu, Zhiteng Min, Siqi Chen, Yong Yao, Guilin Yi, Yongbin Luo, Zhiwei Pan, Zhenlong Chen

Lipid profiles are influenced by both noise and genetic variants. However, little is known about the associations of occupational noise and genetic variants with age-related changes in blood lipids, a crucial event in the initiation and evolution of atherosclerotic cardiovascular diseases. We aimed to evaluate the associations of blood lipid change rates with occupational noise and genetic variants in stress hormone biosynthesis-based genes. This cohort was established in 2012 and 2013 and was followed up until 2017. A total of 952 participants were included in the final analysis and all of them were categorized to two groups, the exposed group and control group, according to the exposed noise levels in their working area. Single nucleotide polymorphisms (SNPs) in stress hormone biosynthesis-based genes were genotyped. Five physical examinations were conducted from 2012 to 2017 and lipid measurements were repeated five times. The estimated annual changes (EACs) of blood lipid were calculated as the difference in blood lipid levels between any 2 adjacent examinations divided by their time interval (year). The generalized estimating equations for repeated measures analyses with exchangeable correlation structures were used to evaluate the influence of exposing to noise (versus being a control) and the SNPs mentioned above on the EACs of blood lipids. We found that the participants experienced accelerated age-related decline in high-density lipoprotein cholesterol (HDL-C) levels as they were exposed to noise (β = −0.38, 95% confidence interval (CI), −0.66 to −0.10, P = 0.007), after adjusting for work duration, gender, smoking, alcohol consumption, and pack-years. This trend was only found in participants with COMT-rs165815 TT genotype (β = −1.19, 95% CI, −1.80 to −0.58, P < 0.001), but not in those with the CC or CT genotypes. The interaction of noise exposure and rs165815 was marginally significant (Pinteraction = 0.010) after multiple adjustments. Compared with DDC-rs11978267 AA genotype carriers, participants carrying rs11978267 GG genotype had decreased EAC of triglycerides (TG) (β = −5.06, 95% CI, −9.07 to −1.05, P = 0.013). Participants carrying DBH-rs4740203 CC genotype had increased EAC of total cholesterol (TC) (β = 1.19, 95% CI, 0.06 to 2.33, P = 0.039). However, these findings were not statistically significant after multiple adjustments. These results indicated that Occupational noise exposure was associated with accelerated age-related decreases in HDL-C levels, and the COMT-rs165815 genotype appeared to modify the effect of noise exposure on HDL-C changes among the occupational population.

血脂特征受噪声和遗传变异的影响。然而,人们对职业噪声和遗传变异与血脂年龄相关变化的关系知之甚少,而血脂年龄相关变化是动脉粥样硬化性心血管疾病发生和发展的关键因素。我们的目的是评估血脂变化率与职业噪声和基于应激激素生物合成基因的遗传变异之间的关系。该队列于 2012 年和 2013 年建立,并一直随访至 2017 年。共有952名参与者被纳入最终分析,所有参与者根据其工作区域的暴露噪声水平被分为两组,即暴露组和对照组。对基于应激激素生物合成基因的单核苷酸多态性(SNPs)进行了基因分型。从2012年至2017年进行了五次体检,并重复进行了五次血脂测量。血脂的估计年度变化(EACs)计算方法为任意两次相邻体检之间血脂水平的差值除以其时间间隔(年)。我们使用具有可交换相关结构的重复测量分析的广义估计方程来评估暴露于噪声(相对于作为对照)和上述 SNPs 对血脂 EACs 的影响。我们发现,在对工作时间、性别、吸烟、饮酒量和包年进行调整后,暴露于噪声的参与者的高密度脂蛋白胆固醇(HDL-C)水平会随着年龄的增长而加速下降(β = -0.38,95% 置信区间 (CI),-0.66 至 -0.10,P = 0.007)。只有 COMT-rs165815 TT 基因型的参与者(β = -1.19, 95% CI, -1.80 to -0.58,P <0.001)有这种趋势,而 CC 或 CT 基因型的参与者则没有这种趋势。经多重调整后,噪声暴露与 rs165815 的交互作用略有显著性(Pinteraction = 0.010)。与 DDC-rs11978267 AA 基因型携带者相比,携带 rs11978267 GG 基因型的参与者甘油三酯(TG)的 EAC 值降低(β = -5.06,95% CI,-9.07 至 -1.05,P = 0.013)。携带 DBH-rs4740203 CC 基因型的参与者总胆固醇(TC)的 EAC 增加(β = 1.19,95% CI,0.06 至 2.33,P = 0.039)。然而,经过多次调整后,这些结果在统计学上并不显著。这些结果表明,职业噪声暴露与高密度脂蛋白胆固醇水平随年龄增长而加速下降有关,而 COMT-rs165815 基因型似乎可以改变噪声暴露对职业人群高密度脂蛋白胆固醇变化的影响。
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引用次数: 0
Associations between mycoestrogen exposure and sex steroid hormone concentrations in maternal serum and cord blood in the UPSIDE pregnancy cohort UPSIDE 妊娠队列中雌激素暴露与母体血清和脐带血中性激素浓度之间的关系
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-06-14 DOI: 10.1016/j.ijheh.2024.114405
Carolyn W. Kinkade , Lauren M. Aleksunes , Anita Brinker , Brian Buckley , Jessica Brunner , Christina Wang , Richard K. Miller , Thomas G. O'Connor , Zorimar Rivera-Núñez , Emily S. Barrett

Zearalenone (ZEN) is a fungal-derived toxin found in global food supplies including cereal grains and processed foods, impacting populations worldwide through diet. Because the chemical structure of ZEN and metabolites closely resembles 17β-estradiol (E2), they interact with estrogen receptors α/β earning their designation as ‘mycoestrogens’. In animal models, gestational exposure to mycoestrogens disrupts estrogen activity and impairs fetal growth. Here, our objective was to evaluate relationships between mycoestrogen exposure and sex steroid hormone concentrations in maternal circulation and cord blood for the first time in humans. In each trimester, pregnant participants in the UPSIDE study (n = 297) provided urine for mycoestrogen analysis and serum for hormone analysis. At birth, placental mycoestrogens and cord steroids were measured. We fitted longitudinal models examining log-transformed mycoestrogen concentrations in relation to log-transformed hormones, adjusting for covariates. Secondarily, multivariable linear models examined associations at each time point (1st, 2nd, 3rd trimesters, delivery). We additionally considered effect modification by fetal sex. ZEN and its metabolite, α-zearalenol (α-ZOL), were detected in >93% and >75% of urine samples; >80% of placentas had detectable mycoestrogens. Longitudinal models from the full cohort exhibited few significant associations. In sex-stratified analyses, in pregnancies with male fetuses, estrone (E1) and free testosterone (fT) were inversely associated with ZEN (E1 %Δ: −6.68 95%CI: −12.34, −0.65; fT %Δ: −3.22 95%CI: −5.68, −0.70); while α-ZOL was positively associated with E2 (%Δ: 5.61 95%CI: −1.54, 9.85) in pregnancies with female fetuses. In analysis with cord hormones, urinary mycoestrogens were inversely associated with androstenedione (%Δ: 9.15 95%CI: 14.64, −3.30) in both sexes, and placental mycoestrogens were positively associated with cord fT (%Δ: 37.13, 95%CI: 4.86, 79.34) amongst male offspring. Findings support the hypothesis that mycoestrogens act as endocrine disruptors in humans, as in animal models and livestock. Additional work is needed to understand impacts on maternal and child health.

玉米赤霉烯酮(ZEN)是一种从真菌中提取的毒素,存在于包括谷物和加工食品在内的全球食品供应中,通过饮食影响着全球人口。由于玉米赤霉烯酮及其代谢物的化学结构与 17β-estradiol (E2) 非常相似,因此它们会与雌激素受体 α/β 发生作用,从而被称为 "雌激素"。在动物模型中,妊娠期接触肌醇雌激素会破坏雌激素活性并损害胎儿生长。在这里,我们的目的是首次在人类中评估暴露于霉变雌激素与母体循环和脐带血中性激素浓度之间的关系。在每个孕期,UPSIDE 研究中的孕妇(n = 297)都会提供尿液进行雌激素分析,并提供血清进行激素分析。胎儿出生时,胎盘中的肌醇雌激素和脐带类固醇也被测定。我们建立了纵向模型,在对协变因素进行调整的基础上,检验对数变换后的肌醇浓度与对数变换后的激素的关系。其次,多变量线性模型检验了每个时间点(第一、第二、第三孕期,分娩)的相关性。此外,我们还考虑了胎儿性别对效果的影响。93%的尿样和75%的尿样中检测到ZEN及其代谢物α-玉米赤霉烯醇(α-ZOL);80%的胎盘中检测到肌醇。整个队列的纵向模型几乎没有显示出明显的关联。在性别分层分析中,在男性胎儿妊娠中,雌酮(E1)和游离睾酮(fT)与ZEN成反比(E1 %Δ:-6.68 95%CI:-12.34,-0.65;fT %Δ:-3.22 95%CI:-5.68,-0.70);而在女性胎儿妊娠中,α-ZOL与E2成正比(%Δ:5.61 95%CI:-1.54,9.85)。在对脐带激素进行分析时,男女胎儿尿中的绵雌激素与雄烯二酮呈反向关系(%Δ:9.15 95%CI:14.64,-3.30),而在男性胎儿中,胎盘绵雌激素与脐带绒毛膜促性腺激素呈正向关系(%Δ:37.13,95%CI:4.86,79.34)。研究结果支持这样的假设:与动物模型和家畜一样,霉变雌激素在人体内也起着干扰内分泌的作用。要了解其对母婴健康的影响,还需要做更多的工作。
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引用次数: 0
Cyclophosphamide exposure factors in family caregivers for pediatric cancer patients 儿科癌症患者家庭护理人员接触环磷酰胺的因素
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-06-12 DOI: 10.1016/j.ijheh.2024.114402
Yuko Noda , Yuhki Koga , Kenichiro Yamamura , Junko Miyata , Yuko Hamada , Shouichi Ohga

The exposure of family caregivers to anticancer drugs for pediatric patients with malignancy is a potential health risk that needs to be minimized. We monitored the amount of cyclophosphamide (CPM) that had adhered to the undershirts of patients and the personal protective equipment (PPE) of family caregivers as well as the caregivers' urine levels of CPM within the first three days after the first and second courses of high-dose CPM therapy. Liquid chromatography/mass spectrometry (LC/MS/MS) detected >0.03 ng/ml of CPM in 26% (23/88) of urine samples from 8 of 11 (72.7%) patients’ family caregivers, with a peak of 0.7 ng/ml from 24 to 48 h after administration. Since urine CPM concentrations in family caregivers varied after the first and second courses, the exposure risk factors were analyzed by scoring the PPE-wearing time index (caring minutes × PPE points from wearing masks, gloves, and/or gowns) and CPM adhesion of PPE items with the caring patterns of diaper change, washing body care, oral care, eating assistance, emotional support, and co-sleeping. The closest association was observed for CPM adhesion between oral care gloves and undershirts (correlation coefficient 0.67, p = 0.001). The mixed-effect model analysis indicated only a significant correlation between the PPE-wearing time index and emotional care (playing, cuddling, and physical contact) (p = 0.016). These results suggest that prolonged emotional support results in poor PPE protection, which increases the risk of exposure in family caregivers. Strict PPE care within 48 h after high-dose CPM controls the exposure to high-risk anticancer drugs in caregivers of pediatric patients.

家庭护理人员接触儿科恶性肿瘤患者的抗癌药物是一种潜在的健康风险,需要将这种风险降至最低。我们监测了患者衬衣和家庭护理人员个人防护设备(PPE)上附着的环磷酰胺(CPM)量,以及护理人员在第一和第二疗程大剂量环磷酰胺治疗后三天内尿液中的环磷酰胺含量。液相色谱/质谱法(LC/MS/MS)在 11 位患者家属护理人员中的 8 位(72.7%)26%(23/88)的尿样中检测到了 0.03 纳克/毫升的 CPM,用药后 24 至 48 小时内达到峰值 0.7 纳克/毫升。由于家庭护理人员尿液中的 CPM 浓度在第一和第二个疗程后有所不同,因此通过对 PPE 佩戴时间指数(护理分钟数 × 佩戴口罩、手套和/或病号服的 PPE 分数)和 PPE 物品的 CPM 附着情况与换尿布、清洗身体、口腔护理、协助进食、情感支持和同床共枕等护理模式进行评分,分析了暴露风险因素。口腔护理手套和内衣之间的 CPM 附着力关系最为密切(相关系数 0.67,p = 0.001)。混合效应模型分析表明,仅个人防护设备穿戴时间指数与情感关怀(玩耍、拥抱和身体接触)之间存在显著相关性(p = 0.016)。这些结果表明,长时间的情感支持会导致 PPE 保护效果不佳,从而增加家庭护理人员的暴露风险。大剂量 CPM 后 48 小时内严格的 PPE 护理可控制儿科患者护理人员接触高风险抗癌药物的风险。
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引用次数: 0
Analysis of chemical exposures in racial populations in Canada: An investigation based on the Canadian health measures survey 加拿大种族人口接触化学品情况分析:基于加拿大健康措施调查的一项研究
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-06-08 DOI: 10.1016/j.ijheh.2024.114406
Subramanian Karthikeyan, Tyler Pollock, Mike Walker, Cheryl Khoury, Annie St-Amand

Despite demonstrated disparities in environmental chemical exposures by racial identity, no Canadian study has systematically assessed the feasibility of using a nationally representative dataset to examine differences in chemical concentrations by race. We assessed the feasibility and constraints of analysing chemical exposures in racial populations, including visible minorities and populations of Indigenous identity, using biomonitoring data collected through the Canadian Health Measures Survey (CHMS). Our primary objectives were to assess the ability to 1) generate geometric means and percentiles of chemical concentrations for racial populations by age or sex, 2) statistically compare concentrations among racial populations, and 3) calculate time trends of concentrations by race. We conducted these analyses for several priority chemicals: lead, cadmium, benzene, bisphenol A (BPA), and di(2-ethylhexyl) phthalate (DEHP). Survey participants self-identified as one of the following: White, Black, East and Southeast Asian, South Asian, Middle Eastern, Latin American, First Nations, Metis, and Inuit. Analyses were conducted for individual and combined cycles of the CHMS. Using data from the latest CHMS cycle in which each chemical was measured, we observed that sample sizes were sufficient to report geometric mean concentrations for all races except Inuit. Due to privacy considerations associated with small sample sizes, the 5th and 95th percentile concentrations could not be consistently reported for all racial populations in this analysis. While we were able to statistically compare concentrations among racial populations, the analysis was constrained by the limited number of statistical degrees of freedom available in a single CHMS cycle. Both of these constraints were alleviated by combining multiple cycles of data. The analysis of time trends was less subject to privacy and statistical limitations; we were able to calculate time trends of chemical concentrations for all racial populations. Our findings provide an important baseline for follow-up investigations of descriptive and etiological analyses of environmental chemical exposures and race in the CHMS.

尽管按种族身份划分的环境化学品暴露存在差异,但还没有一项加拿大研究系统地评估了使用具有全国代表性的数据集来检查按种族划分的化学品浓度差异的可行性。我们利用加拿大健康措施调查(CHMS)收集的生物监测数据,评估了分析种族人群(包括有色人种和土著人群)化学物质暴露的可行性和限制因素。我们的主要目标是评估以下能力:1)按年龄或性别生成种族人群化学物质浓度的几何平均数和百分位数;2)统计比较种族人群之间的浓度;3)计算按种族划分的浓度时间趋势。我们对以下几种重点化学品进行了分析:铅、镉、苯、双酚 A (BPA) 和邻苯二甲酸二(2-乙基己基)酯 (DEHP)。调查参与者自我认同为以下人群之一:白人、黑人、东亚和东南亚人、南亚人、中东人、拉丁美洲人、原住民、梅蒂斯人和因纽特人。对 CHMS 的单个周期和合并周期进行了分析。使用最近一次测量每种化学品的 CHMS 周期的数据,我们发现样本量足以报告除因努伊特人以外的所有种族的几何平均浓度。由于样本量较小,考虑到隐私问题,在本分析中无法一致地报告所有种族人群的第 5 百分位数和第 95 百分位数浓度。虽然我们能够对不同种族人群的浓度进行统计比较,但由于单个 CHMS 周期的统计自由度有限,因此分析受到了限制。通过合并多个周期的数据,这两个限制因素都得到了缓解。对时间趋势的分析较少受到隐私和统计方面的限制;我们能够计算出所有种族人群的化学物质浓度的时间趋势。我们的研究结果为后续调查 CHMS 中环境化学暴露和种族的描述性分析和病因分析提供了重要的基础。
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引用次数: 0
Investigating the relationship between extreme weather and cryptosporidiosis and giardiasis in Colorado: A multi-decade study using distributed-lag nonlinear models 调查科罗拉多州极端天气与隐孢子虫病和贾第虫病之间的关系:使用分布式滞后非线性模型的十年研究
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-06-02 DOI: 10.1016/j.ijheh.2024.114403
Elise N. Grover , James L. Crooks , Elizabeth J. Carlton , Sara H. Paull , William B. Allshouse , Rachel H. Jervis , Katherine A. James

Environmentally-mediated protozoan diseases like cryptosporidiosis and giardiasis are likely to be highly impacted by extreme weather, as climate-related conditions like temperature and precipitation have been linked to their survival, distribution, and overall transmission success. Our aim was to investigate the relationship between extreme temperature and precipitation and cryptosporidiosis and giardiasis infection using monthly weather data and case reports from Colorado counties over a twenty-one year period. Data on reportable diseases and weather among Colorado counties were collected using the Colorado Electronic Disease Reporting System (CEDRS) and the Daily Surface Weather and Climatological Summaries (Daymet) Version 3 dataset, respectively. We used a conditional Poisson distributed-lag nonlinear modeling approach to estimate the lagged association (between 0 and 12-months) between relative temperature and precipitation extremes and the risk of cryptosporidiosis and giardiasis infection in Colorado counties between 1997 and 2017, relative to the risk found at average values of temperature and precipitation for a given county and month. We found distinctly different patterns in the associations between temperature extremes and cryptosporidiosis, versus temperature extremes and giardiasis. When maximum or minimum temperatures were high (90th percentile) or very high (95th percentile), we found a significant increase in cryptosporidiosis risk, but a significant decrease in giardiasis risk, relative to risk at the county and calendar-month mean. Conversely, we found very similar relationships between precipitation extremes and both cryptosporidiosis and giardiasis, which highlighted the prominent role of long-term (>8 months) lags. Our study presents novel insights on the influence that extreme temperature and precipitation can have on parasitic disease transmission in real-world settings. Additionally, we present preliminary evidence that the standard lag periods that are typically used in epidemiological studies to assess the impacts of extreme weather on cryptosporidiosis and giardiasis may not be capturing the entire relevant period.

环境介导的隐孢子虫病和贾第虫病等原生动物疾病很可能受到极端天气的严重影响,因为温度和降水等气候相关条件与这些疾病的生存、分布和总体传播成功率有关。我们的目的是利用科罗拉多州各县二十一年间的月度天气数据和病例报告,研究极端气温和降水与隐孢子虫病和贾第鞭毛虫病感染之间的关系。科罗拉多州各县的可报告疾病和天气数据分别通过科罗拉多州疾病电子报告系统(CEDRS)和每日地表天气和气候学摘要(Daymet)第 3 版数据集收集。我们采用条件泊松分布-滞后非线性建模方法,估算了 1997 年至 2017 年科罗拉多州各县相对极端气温和极端降水与隐孢子虫病和贾第鞭毛虫病感染风险之间的滞后关联(0 至 12 个月),与特定县和月份的平均气温和降水值的风险相比。我们发现,极端气温与隐孢子虫病、极端气温与贾第虫病之间的关联模式截然不同。当最高或最低气温较高(第 90 百分位数)或很高(第 95 百分位数)时,我们发现相对于县和历月平均气温而言,隐孢子虫病的风险显著增加,而贾第虫病的风险则显著降低。相反,我们发现极端降水量与隐孢子虫病和贾第虫病之间的关系非常相似,这凸显了长期(大于 8 个月)滞后的突出作用。我们的研究就极端气温和降水在现实环境中对寄生虫病传播的影响提出了新的见解。此外,我们还提出了初步证据,证明流行病学研究中通常用于评估极端天气对隐孢子虫病和贾第虫病影响的标准滞后期可能无法捕捉到整个相关时期。
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引用次数: 0
Shared sanitation in informal settlements: A systematic review and meta-analysis of prevalence, preferences, and quality 非正规住区的共用卫生设施:关于普及率、偏好和质量的系统回顾和荟萃分析
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-05-23 DOI: 10.1016/j.ijheh.2024.114392
Lauren Sprouse , Sarah Lebu , Jackqueline Nguyen , Chimdi Muoghalu , Andromede Uwase , Jiahui Guo , Carrie Baldwin-SoRelle , Carmen Anthonj , Sheillah N. Simiyu , John Apambilla Akudago , Musa Manga

Shared sanitation facilities are not considered a type of basic sanitation by the WHO/UNICEF Joint Monitoring Programme (JMP), though they may be the only alternative to open defecation in urban informal settlements. Additionally, JMP indicators for sanitation do not cover aspects related to the quality of shared sanitation, such as those outlined in the Human Right to Water and Sanitation (HRTWS) framework. Data on the prevalence of shared sanitation within informal settlement areas is limited, and there is a need to understand user preferences, experiences, and barriers to the use of shared sanitation to inform effective policy and practice. This systematic review aims to summarize the prevalence and number of households sharing sanitation in informal settlements globally, as well as user experiences and barriers to successful implementation of shared sanitation. We included studies available in English and published after January 1, 2000. We retrieved 4741 articles from seven databases and included a total of 167 relevant publications. Among included studies, 54 reported the prevalence of shared sanitation in informal settlements, and 138 studies reported on user perceptions and experiences related to shared sanitation quality. A meta-analysis of studies reporting the prevalence of shared sanitation in informal settlements globally revealed an estimated overall prevalence of 67% [95% CI: 61%–73%]. Commonly reported user preferences included cleanliness to promote continued use of shared facilities, privacy with a lockable door, facilities for menstrual hygiene management, safety and protection against violence, 24/7 access, proper lighting, and shared responsibility for facility management — which align with the HRTWS framework and represent barriers to shared sanitation use. Based on the findings of this review, we recommend including the number of households or people sharing a sanitation facility in monitoring of shared sanitation quality, locating sanitation facilities within compounds, where applicable, and promoting safety, dignity, and privacy of all users in the development of shared sanitation quality indicators.

世卫组织/儿童基金会联合监测方案(JMP)并不认为共用卫生设施是一种基本卫生设施,尽管在城市非正规住区,共用卫生设施可能是露天排便的唯一替代方式。此外,联合监测方案的卫生设施指标不包括与共用卫生设施质量有关的方面,如享有饮用水和卫生设施的人权(HRTWS)框架中概述的方面。有关非正规居住区共用卫生设施普及率的数据十分有限,因此有必要了解用户的偏好、经验以及使用共用卫生设施的障碍,以便为有效的政策和实践提供依据。本系统性综述旨在总结全球范围内非正规居住区共用卫生设施的普及率和家庭数量,以及用户的使用经验和成功实施共用卫生设施的障碍。我们纳入了 2000 年 1 月 1 日之后发表的英文研究。我们从 7 个数据库中检索到 4741 篇文章,共纳入 167 篇相关出版物。在纳入的研究中,54 项研究报告了非正规居住区共用卫生设施的普及率,138 项研究报告了用户对共用卫生设施质量的看法和体验。对报告全球非正规居住区共用卫生设施普及率的研究进行荟萃分析后发现,估计总体普及率为 67% [95% CI:61%-73%]。报告中常见的用户偏好包括:清洁以促进共享设施的持续使用、可上锁的隐私门、经期卫生管理设施、安全和防止暴力、全天候使用、适当的照明以及共同承担设施管理责任--这些都符合 HRTWS 框架,也是共享卫生设施使用的障碍。根据本次审查的结果,我们建议在监测共用卫生设施的质量时纳入共用卫生设施的家庭或人数,酌情将卫生设施设在院落内,并在制定共用卫生设施质量指标时促进所有使用者的安全、尊严和隐私。
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引用次数: 0
Runoff microbiome quality assessment of a city center rainwater harvesting zone shows a differentiation of pathogen loads according to human mobility patterns 对市中心雨水收集区进行的径流微生物质量评估显示,病原体负荷随人类流动模式的不同而有所差异。
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-05-22 DOI: 10.1016/j.ijheh.2024.114391
Rayan Bouchali , Claire Mandon , Emmanuelle Danty - Berger , Alain Géloën , Laurence Marjolet , Benjamin Youenou , Adrien C.M. Pozzi , Sophie Vareilles , Wessam Galia , Gislain Lipeme Kouyi , Jean-Yves Toussaint , Benoit Cournoyer

The hygienic quality of urban surfaces can be impaired by multiple sources of microbiological contaminants. These surfaces can trigger the development of multiple bacterial taxa and favor their spread during rain events through the circulation of runoff waters. These runoff waters are commonly directed toward sewer networks, stormwater infiltration systems or detention tanks prior a release into natural water ways. With water scarcity becoming a major worldwide issue, these runoffs are representing an alternative supply for some usage like street cleaning and plant watering. Microbiological hazards associated with these urban runoffs, and surveillance guidelines must be defined to favor these uses. Runoff microbiological quality from a recently implemented city center rainwater harvesting zone was evaluated through classical fecal indicator bacteria (FIB) assays, quantitative PCR and DNA meta-barcoding analyses. The incidence of socio-urbanistic patterns on the organization of these urban microbiomes were investigated. FIB and DNA from Human-specific Bacteroidales and pathogens such as Staphylococcus aureus were detected from most runoffs and showed broad distribution patterns. 16S rRNA DNA meta-barcoding profilings further identified core recurrent taxa of health concerns like Acinetobacter, Mycobacterium, Aeromonas and Pseudomonas, and divided these communities according to two main groups of socio-urbanistic patterns. One of these was highly impacted by heavy traffic, and showed recurrent correlation networks involving bacterial hydrocarbon degraders harboring significant virulence properties. The tpm-based meta-barcoding approach identified some of these taxa at the species level for more than 30 genera. Among these, recurrent pathogens were recorded such as P. aeruginosa, P. paraeruginosa, and Aeromonas caviae. P. aeruginosa and A. caviae tpm reads were found evenly distributed over the study site but those of P. paraeruginosa were higher among sub-catchments impacted by heavy traffic. Health risks associated with these runoff P. paraeruginosa emerging pathogens were high and associated with strong cytotoxicity on A549 lung cells. Recurrent detections of pathogens in runoff waters highlight the need of a microbiological surveillance prior allowing their use. Good microbiological quality can be obtained for certain typologies of sub-catchments with good hygienic practices but not all. A reorganization of Human mobility and behaviors would likely trigger changes in these bacterial diversity patterns and reduce the occurrences of the most hazardous groups.

城市地面的卫生质量可能会受到多种微生物污染物来源的影响。这些地面会引发多种细菌类群的滋生,并在降雨时通过径流水的循环促进其传播。这些径流水通常被引入下水道网络、雨水渗透系统或滞留池,然后再排放到自然水道中。随着水资源短缺成为世界性的重大问题,这些径流水成为街道清洁和植物浇灌等某些用途的替代水源。与这些城市径流相关的微生物危害和监测准则必须加以界定,以有利于这些用途。通过经典的粪便指示菌(FIB)检测、定量 PCR 和 DNA 元条码分析,对最近实施的市中心雨水收集区的径流微生物质量进行了评估。研究还调查了社会城市化模式对这些城市微生物组组织的影响。在大多数径流中都检测到了人类特异性类杆菌和病原体(如金黄色葡萄球菌)的 FIB 和 DNA,并显示出广泛的分布模式。16S rRNA DNA 元条形码分析进一步确定了引起健康关注的核心重复类群,如醋酸杆菌、分枝杆菌、气单胞菌和假单胞菌,并根据社会城市化模式的两大类群划分了这些群落。其中一组受到繁忙交通的严重影响,并显示出涉及细菌碳氢化合物降解器的重复相关网络,这些降解器具有显著的毒力特性。基于 tpm 的元条码方法在物种水平上识别出了其中的 30 多个属。在这些类群中,记录了铜绿假单胞菌、副铜绿假单胞菌和鱼腥单胞菌等反复出现的病原体。铜绿假单胞菌和鱼腥酵母菌的 tpm 读数在研究地点均匀分布,但副铜绿假单胞菌的 tpm 读数在受交通繁忙影响的子流域较高。与这些径流副绿原酸杆菌新病原体相关的健康风险很高,并且对 A549 肺细胞具有很强的细胞毒性。径流水体中病原体的反复检测突出表明,在允许使用径流水体之前,有必要对其进行微生物监测。某些具有良好卫生习惯的子流域可以获得良好的微生物质量,但并非所有子流域都是如此。人类流动性和行为的重组很可能会引发这些细菌多样性模式的变化,并减少最有害菌群的出现。
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引用次数: 0
Drinking water sources, quality, and associated health outcomes in Appalachian Virginia: A risk characterization study in two counties 阿巴拉契亚弗吉尼亚州的饮用水源、水质和相关健康结果:两个县的风险特征研究。
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-05-20 DOI: 10.1016/j.ijheh.2024.114390
Alasdair Cohen , Md Rasheduzzaman , Bethesda O'Connell , Teresa Brown , Mami Taniuchi , Leigh-Anne Krometis , Alan Hubbard , Phillip Scheuerman , Marc Edwards , Amanda Darling , Blaine Pennala , Sarah Price , Breanna Lytton , Erin Wettstone , Suporn Pholwat , Honorine Ward , Daniel R. Hallinger , Steven O. Simmons , Shannon M. Griffin , Jason Kobylanski , Timothy J. Wade

Objectives

In the US, violations of drinking water regulations are highest in lower-income rural areas overall, and particularly in Central Appalachia. However, data on drinking water use, quality, and associated health outcomes in rural Appalachia are limited. We sought to assess public and private drinking water sources and associated risk factors for waterborne pathogen exposures for individuals living in rural regions of Appalachian Virginia.

Methods

We administered surveys and collected tap water, bottled water, and saliva samples in lower-income households in two adjacent rural counties in southwest Virginia (bordering Kentucky and Tennessee). Water samples were tested for pH, temperature, conductivity, total coliforms, E. coli, free chlorine, nitrate, fluoride, heavy metals, and specific pathogen targets. Saliva samples were analyzed for antibody responses to potentially waterborne infections. We also shared water analysis results with households.

Results

We enrolled 33 households (83 individuals), 82% (n = 27) with utility-supplied water and 18% with private wells (n = 3) or springs (n = 3). 58% (n = 19) reported household incomes of <$20,000/year. Total coliforms were detected in water samples from 33% (n = 11) of homes, E. coli in 12%, all with wells or springs (n = 4), and Aeromonas, Campylobacter, and Enterobacter in 9%, all spring water (n = 3). Diarrhea was reported for 10% of individuals (n = 8), but was not associated with E. coli detection. 34% (n = 15) of saliva samples had detectable antibody responses for Cryptosporidium spp., C. jejuni, and Hepatitis E. After controlling for covariates and clustering, individuals in households with septic systems and straight pipes had significantly higher likelihoods of antibody detection (risk ratios = 3.28, 95%CI = 1.01–10.65).

Conclusions

To our knowledge, this is the first study to collect and analyze drinking water samples, saliva samples, and reported health outcome data from low-income households in Central Appalachia. Our findings indicate that utility-supplied water in this region was generally safe, and individuals in low-income households without utility-supplied water or sewerage have higher exposures to waterborne pathogens.

目标:在美国,收入较低的农村地区,尤其是阿巴拉契亚中部地区,违反饮用水法规的情况最为严重。然而,有关阿巴拉契亚农村地区饮用水的使用、质量和相关健康结果的数据却很有限。我们试图评估生活在弗吉尼亚州阿巴拉契亚农村地区的个人的公共和私人饮用水源以及接触水传播病原体的相关风险因素:我们对弗吉尼亚州西南部(与肯塔基州和田纳西州接壤)两个相邻农村县的低收入家庭进行了调查,并收集了自来水、瓶装水和唾液样本。对水样进行了 pH 值、温度、电导率、总大肠菌群、大肠杆菌、游离氯、硝酸盐、氟化物、重金属和特定病原体目标的检测。对唾液样本进行了分析,以检测其对潜在水传播感染的抗体反应。我们还与住户分享了水分析结果:我们登记了 33 个家庭(83 人),其中 82% 的家庭(n = 27)使用公用事业供水,18% 的家庭使用私人水井(n = 3)或泉水(n = 3)。58%(n = 19)的家庭收入为结论收入:据我们所知,这是第一项收集和分析阿巴拉契亚中部低收入家庭的饮用水样本、唾液样本和报告的健康结果数据的研究。我们的研究结果表明,该地区的自来水总体上是安全的,而没有自来水或下水道的低收入家庭中的个人接触水传播病原体的几率更高。
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引用次数: 0
Systematic evidence mapping of potential correlates of exposure for per- and poly-fluoroalkyl substances (PFAS) based on measured occurrence in biomatrices and surveys of dietary consumption and product use 根据生物矩阵中测得的全氟烷基和多氟烷基物质(PFAS)发生率以及膳食消费和产品使用调查,对接触该物质的潜在相关因素进行系统证据分析
IF 6 2区 医学 Q1 Medicine Pub Date : 2024-05-11 DOI: 10.1016/j.ijheh.2024.114384
Chris Holder , Elaine A. Cohen Hubal , Jeanne Luh , Madison G. Lee , Lisa Jo Melnyk , Kent Thomas

Per- and poly-fluoroalkyl substances (PFAS) are widely observed in environmental media and often are found in indoor environments as well as personal-care and consumer products. Humans may be exposed through water, food, indoor dust, air, and the use of PFAS-containing products. Information about relationships between PFAS exposure sources and pathways and the amounts found in human biomatrices can inform source-contribution assessments and provide targets for exposure reduction. This work collected and collated evidence for correlates of PFAS human exposure as measured through sampling of biomatrices and surveys of dietary consumption and use of consumer products and articles. A systematic evidence mapping approach was applied to perform a literature search, conduct title-abstract and full-text screening, and to extract primary data into a comprehensive database for 16 PFAS. Parameters of interest included: sampling dates and locations, cohort descriptors, PFAS measured in a human biomatrix, information about food consumption in 11 categories, use of products/articles in 11 categories, and reported correlation values (and their statistical strength). The literature search and screening process yielded 103 studies with information for correlates of PFAS exposures. Detailed data were extracted and compiled on measures of PFAS correlations between biomatrix concentrations and dietary consumption and other product/article use. A majority of studies (61/103; 59%) were published after 2015 with few (8/103; 8%) prior to 2010. Studies were most abundant for dietary correlates (n = 94) with fewer publications reporting correlate assessments for product use (n = 56), while some examined both. PFOA and PFOS were assessed in almost all studies, followed by PFHxS, PFNA, and PFDA which were included in >50% of the studies. No relevant studies included PFNS or PFPeS. Among the 94 studies of dietary correlates, significant correlations were reported in 83% of the studies for one or more PFAS. The significant dietary correlations most commonly were for seafood, meats/eggs, and cereals/grains/pulses. Among the 56 studies of product/article correlates, significant correlations were reported in 70% of the studies. The significant product/article correlations most commonly were for smoking/tobacco, cosmetics/toiletries, non-stick cookware, and carpet/flooring/furniture and housing. Six of 11 product/article categories included five or fewer studies, including food containers and stain- and water-resistant products. Significant dietary and product/article correlations most commonly were positive. Some studies found a mix of positive and negative correlations depending on the PFAS, specific correlate, and specific response level, particularly for fats/oils, dairy consumption, food containers, and cosmetics/toiletries. Most of the significant findings for cereals/grains/pulses were negative correlations. Substantial evidence was found for correlations betwee

全氟烷基和多氟烷基物质(PFAS)广泛存在于环境介质中,通常在室内环境以及个人护理和消费品中发现。人类可能通过水、食物、室内灰尘、空气以及使用含 PFAS 的产品接触到这些物质。有关全氟辛烷磺酸暴露来源和途径与人体生物体内含量之间关系的信息可以为来源贡献评估提供依据,并为减少暴露提供目标。这项工作收集并整理了通过生物矩阵采样、膳食消费调查以及消费品和物品的使用情况来测量的人类接触 PFAS 的相关证据。采用系统证据图谱法进行文献检索、标题-摘要和全文筛选,并将 16 种全氟辛烷磺酸的原始数据提取到综合数据库中。相关参数包括:采样日期和地点、队列描述符、在人体生物矩阵中测量到的 PFAS、11 个类别的食品消费信息、11 个类别的产品/文章使用情况以及报告的相关值(及其统计强度)。通过文献检索和筛选过程,获得了 103 项研究的相关信息,这些信息涉及 PFAS 暴露的相关因素。我们提取并汇编了生物矩阵浓度与膳食消费和其他产品/微粒使用之间的 PFAS 相关性测量的详细数据。大多数研究(61/103;59%)发表于 2015 年之后,只有少数研究(8/103;8%)发表于 2010 年之前。关于膳食相关性的研究最多(n = 94),而报告产品使用相关性评估的出版物较少(n = 56),但有些研究对两者都进行了研究。几乎所有研究都对全氟辛烷磺酸和全氟辛烷磺酸进行了评估,其次是全氟己烷磺酸、全氟萘磺酸和全氟辛烷磺酸,50%的研究纳入了这些物质。没有相关研究包括 PFNS 或 PFPeS。在 94 项膳食相关性研究中,83% 的研究报告了一种或多种 PFAS 的显著相关性。膳食相关性最常见的是海产品、肉类/蛋类和谷物/谷物/豆类。在 56 项关于产品/物品相关性的研究中,70% 的研究报告了显著的相关性。最常见的具有重大相关性的产品/物品是烟草、化妆品/厕所、不粘锅以及地毯/地板/家具和住房。在 11 个产品/物品类别中,有 6 个类别包含 5 项或更少的研究,包括食品容器和防污防水产品。显著的膳食和产品/物品相关性多为正相关。一些研究发现,根据全氟辛烷磺酸、特定相关物质和特定反应水平的不同,正相关和负相关并存,尤其是脂肪/油、乳制品消费、食品容器和化妆品/盥洗用品。谷物/谷物/豆类的大部分重要发现都是负相关。有大量证据表明,在多个食品类别中,膳食摄入量与几种全氟辛烷磺酸的生物矩阵水平之间存在相关性。除吸烟/烟草外,对产品/物品使用关系的研究相对较少,因此需要开展更多的研究。由此产生的数据库可为进一步评估膳食和产品使用的暴露关系提供信息,并可为更好地了解 PFAS 来源与暴露关系的新研究提供信息。应扩展并实施该搜索策略,以支持这一快速发展领域的活体证据审查。
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International journal of hygiene and environmental health
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