Prenatal Air Pollution Exposure and Early Cardiovascular Phenotypes in Young Adults

Exposure to ambient air pollutants increases risk for adverse cardiovascular health outcomes in adults. We aimed to evaluate the contribution of prenatal air pollutant exposure to cardiovascular health, which has not been thoroughly evaluated. The Testing Responses on Youth (TROY) study consists of 768 college students recruited from the University of Southern California in 2007–2009. Participants attended one study visit during which blood pressure, heart rate and carotid artery arterial stiffness (CAS) and carotid artery intima-media thickness (CIMT) were assessed. Prenatal residential addresses were geocoded and used to assign prenatal and postnatal air pollutant exposure estimates using the U.S. Environmental Protection Agency’s Air Quality System (AQS) database. The associations between CAS, CIMT and air pollutants were assessed using linear regression analysis. Prenatal PM₁₀ and PM_2.5 exposures were associated with increased CAS. For example, a 2 SD increase in prenatal PM_2.5 was associated with CAS indices, including a 5% increase (β = 1.05, 95% CI 1.00–1.10) in carotid stiffness index beta, a 5% increase (β = 1.05, 95% CI 1.01–1.10) in Young’s elastic modulus and a 5% decrease (β = 0.95, 95% CI 0.91–0.99) in distensibility. Mutually adjusted models of pre- and postnatal PM_2.5 further suggested the prenatal exposure was most relevant exposure period for CAS. No associations were observed for CIMT. In conclusion, prenatal exposure to elevated air pollutants may increase carotid arterial stiffness in a young adult population of college students. Efforts aimed at limiting prenatal exposures are important public health goals.     

中草药烟熏对空气消毒及预防呼吸道传染病作用的研究

为了空气消毒和预防呼吸道传染病,生产了中草药烟熏剂寿而康空气消毒保健香。经中国人民解放军第二军医大学等单位检测,杀灭空气中细菌有效率99.95%。急性经口毒性试验LD50>5000mg/kg,慢性毒理试验观察未发现中毒和蓄积中毒,属于实际无毒类。现场试验自然菌杀灭率90%以上,对预防呼吸道传染病流感、流脑等效果显著。     

Childhood Household Dysfunction,Social Inequality and Alcohol Related Illness in Young Adulthood. A Swedish National Cohort Study

The aim of this paper is to estimate the cumulative effect of childhood household dysfunction (CHD) on alcohol related illness and death later in life and to test the interaction between CHD and socioeconomic background. The study utilised Swedish national registers including data of a Swedish national cohort born 1973–82 (n = 872 912), which was followed from age 18 to 29–40 years. Cox regression analyses were used to calculate hazard ratios (HR) for alcohol related illness or death in young adulthood. The CHD measure consisted of seven indicators: parental alcohol/drug misuse, mental health problems, criminality, death, divorce, social assistance, and child welfare interventions. Childhood socioeconomic position (SEP) was indicated by parental occupational status. Outcomes were alcohol related inpatient hospital care, specialised outpatient care or deaths. Using the highest socioeconomic group without CHD experience as a reference, those in the same socioeconomic group with one indicator of CHD had HRs of 2.1 [95% CI: 1.7–2.5], two CHD indicators 5.6 [4.4–7.1], three or more indicators 9.4 [7.1–12.4] for retrieving inpatient care. Socioeconomic disadvantage further increased the risks–those with low socioeconomic background and three CHD indicators or more had a HR of 12.5 [10.9–14.3]. Testing for interaction suggests that the combined HRs deviates from additivity [Synergy index: 1.6, 95% CI: 1.4–1.9]. The results for outpatient care were similar, but not as pronounced. In conclusion, this Swedish national cohort study shows that childhood household dysfunction is strongly and cumulatively associated to alcohol related illness later in life and that it interacts with socioeconomic disadvantage.     

Association between Air Pollution and General Outpatient Clinic Consultations for Upper Respiratory Tract Infections in Hong Kong

Background and Objectives

Many studies have shown the adverse effects of air pollution on respiratory health, but few have examined the effects of air pollution on service utilisation in the primary care setting. The aim of this study was to examine the association between air pollution and the daily number of consultations due to upper respiratory tract infections (URTIs) in general outpatient clinics (GOPCs) in Hong Kong.

Methods

Daily data on the numbers of consultations due to URTIs in GOPCs, the concentrations of major air pollutants, and the mean values of metrological variables were retrospectively collected over a 3-year period (2008–2010, inclusive). Generalised additive models were constructed to examine the association between air pollution and the daily number of consultations, and to derive the relative risks and 95% confidence intervals (95% CI) of GOPC consultations for a unit increase in the concentrations of air pollutants.

Results

The mean daily consultations due to URTIs in GOPCs ranged from 68.4 to 253.0 over the study period. The summary relative risks (and 95% CI) of daily consultations in all GOPCs for the air pollutants PM₁₀, NO₂, O₃, and SO₂ were 1.005 (1.002, 1.009), 1.010 (1.006, 1.013), 1.009 (1.006, 1.012), and 1.004 (1.000, 1.008) respectively, per 10 µg/m³ increase in the concentration of each pollutant.

Conclusion

Significant associations were found between the daily number of consultations due to URTIs in GOPCs and the concentrations of air pollutants, implying that air pollution incurs a substantial morbidity and increases the burden of primary health care services.     

室内生物燃料烟雾颗粒物污染与呼吸系统疾病的关系

本文综述了国内外室内生物燃料烟雾颗粒物污染源的种类,烟雾中有害物质的种类及其与呼吸系统疾病的关系,并以慢性阻塞性肺病作为案例阐述了其发病的病因,为制定该类由生物燃料烟雾颗粒诱发的疾病的预防策略提供参考.     

Ambient Air Pollution and the Progression of Atherosclerosis in Adults

Background

Cross-sectional studies suggest an association between exposure to ambient air pollution and atherosclerosis. We investigated the association between outdoor air quality and progression of subclinical atherosclerosis (common carotid artery intima-media thickness, CIMT).

Methodology/Principal Findings

We examined data from five double-blind randomized trials that assessed effects of various treatments on the change in CIMT. The trials were conducted in the Los Angeles area. Spatial models and land-use data were used to estimate the home outdoor mean concentration of particulate matter up to 2.5 micrometer in diameter (PM2.5), and to classify residence by proximity to traffic-related pollution (within 100 m of highways). PM2.5 and traffic proximity were positively associated with CIMT progression. Adjusted coefficients were larger than crude associations, not sensitive to modelling specifications, and statistically significant for highway proximity while of borderline significance for PM2.5 (P = 0.08). Annual CIMT progression among those living within 100 m of a highway was accelerated (5.5 micrometers/yr [95%CI: 0.13–10.79; p = 0.04]) or more than twice the population mean progression. For PM2.5, coefficients were positive as well, reaching statistical significance in the socially disadvantaged; in subjects reporting lipid lowering treatment at baseline; among participants receiving on-trial treatments; and among the pool of four out of the five trials.

Conclusion

Consistent with cross-sectional findings and animal studies, this is the first study to report an association between exposure to air pollution and the progression of atherosclerosis – indicated with CIMT change – in humans. Ostensibly, our results suggest that air pollution may contribute to the acceleration of cardiovascular disease development – the main causes of morbidity and mortality in many countries. However, the heterogeneity of the volunteering populations across the five trials, the limited sample size within trials and other relevant subgroups, and the fact that some key findings reached statistical significance in subgroups rather than the sample precludes generalizations to the general population.     

Lower Respiratory Tract Infections Associated with Rhinovirus during Infancy and Increased Risk of Wheezing during Childhood. A Cohort Study

Background and Objectives

Although association between respiratory syncytial virus infection and later asthma development has been established, little is known about the role of other respiratory viruses. Rhinovirus was considered a mild pathogen of the upper respiratory tract but current evidence suggests that rhinovirus is highly prevalent among children with lower respiratory tract infections (LRTI). The aim of the study was to evaluate whether LRTI hospitalization associated with rhinovirus during infancy was associated with an increased risk of wheezing – a proxy measure of asthma – during childhood.

Methods

During a 12 months period, all infants <1 year admitted to Manhiça District Hospital with symptoms of LRTI who survived the LRTI episode, were enrolled in the study cohort. Nasopharyngeal aspirates were collected on admission for viral determination and study infants were classified according to presence or not of rhinovirus. The study cohort was passively followed-up at the Manhiça District Hospital for up to 4 years and 9 months to evaluate the association between LRTI associated with rhinovirus in infancy and wheezing during childhood.

Findings and Conclusions

A total of 220 infants entered the cohort; 25% of them had rhinovirus detected during the LRTI episode as opposed to 75% who tested negative for rhinovirus. After adjusting for sex and age and HIV infection at recruitment, infants hospitalized with LRTI associated with rhinovirus had higher incidence of subsequent visits with wheezing within the year following hospitalization [Rate ratio=1.68, (95% confidence interval=1.02-2.75); Wald test p-value = 0.039]. No evidence of increased incidence rate of visits with wheezing was observed for the remaining follow-up period. Our data suggest a short term increased risk of wheezing after an initial episode of LRTI with RV.     

Fine Particulate Air Pollution and Hospital Emergency Room Visits for Respiratory Disease in Urban Areas in Beijing,China, in 2013

BackgroundHeavy fine particulate matter (PM_2.5) air pollution occurs frequently in China. However, epidemiological research on the association between short-term exposure to PM_2.5 pollution and respiratory disease morbidity is still limited. This study aimed to explore the association between PM_2.5 pollution and hospital emergency room visits (ERV) for total and cause-specific respiratory diseases in urban areas in Beijing.MethodsDaily counts of respiratory ERV from Jan 1 to Dec 31, 2013, were obtained from ten general hospitals located in urban areas in Beijing. Concurrently, data on PM_2.5 were collected from the Beijing Environmental Protection Bureau, including 17 ambient air quality monitoring stations. A generalized-additive model was used to explore the respiratory effects of PM_2.5, after controlling for confounding variables. Subgroup analyses were also conducted by age and gender.ResultsA total of 92,464 respiratory emergency visits were recorded during the study period. The mean daily PM_2.5 concentration was 102.1±73.6 μg/m³. Every 10 μg/m³ increase in PM_2.5 concentration at lag₀ was associated with an increase in ERV, as follows: 0.23% for total respiratory disease (95% confidence interval [CI]: 0.11%-0.34%), 0.19% for upper respiratory tract infection (URTI) (95%CI: 0.04%-0.35%), 0.34% for lower respiratory tract infection (LRTI) (95%CI: 0.14%-0.53%) and 1.46% for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (95%CI: 0.13%-2.79%). The strongest association was identified between AECOPD and PM_2.5 concentration at lag_0-3 (3.15%, 95%CI: 1.39%-4.91%). The estimated effects were robust after adjusting for SO₂, O₃, CO and NO₂. Females and people 60 years of age and older demonstrated a higher risk of respiratory disease after PM_2.5 exposure.ConclusionPM_2.5 was significantly associated with respiratory ERV, particularly for URTI, LRTI and AECOPD in Beijing. The susceptibility to PM_2.5 pollution varied by gender and age.     

An Association between Air Pollution and Daily Outpatient Visits for Respiratory Disease in a Heavy Industry Area

In this work we used daily outpatient data from the Landseed Hospital in a heavily industrial area in northern Taiwan to study the associations between daily outpatient visits and air pollution in the context of a heavily polluted atmospheric environment in Chung-Li area during the period 2007–2011. We test the normality of each data set, control for the confounding factors, and calculate correlation coefficient between the outpatient visits and air pollution and meteorology, and use multiple linear regression analysis to seek significance of these associations. Our results show that temperature and relative humidity tend to be negatively associated with respiratory diseases. NO and are two main air pollutants that are positively associated with respiratory diseases, followed by , , , CO, and . Young outpatients (age 0–15 years) are most sensitive to changing air pollution and meteorology factors, followed by the eldest (age 66 years) and age 16–65 years of outpatients. Outpatients for COPD diseases are most sensitive to air pollution and meteorology factors, followed by allergic rhinitis, asthma, and pneumonia diseases. In the context of sex difference to air pollution and meteorological factors, male outpatients are more sensitive than female outpatients in the 16–65 age groups, while female outpatients are more sensitive than male outpatients in the young 0–15 age groups and in the eldest age groups. In total, female outpatients are more sensitive to air pollution and meteorological factors than male outpatients.     

The Clinic and Elsewhere: Illness,Sexuality, and Social Experience Among Young African American Men in Baltimore,Maryland

This paper is concerned with how disclosure becomes self-production for young adults within the setting of the sexually transmitted disease (STD) clinic. The STD clinic is a special medical environment where the process of disclosure is not just a way of accessing treatment; it is also a process through which illness, sexuality, and social experience become entangled in telling. Illness according to medical categories is reshaped in the social world, bringing a different set of criteria to bear on the definition of illness. The concern we raise regards how meaning is secured simultaneously through the experience of illness and social relations. Using data from a series of clinic-based ethnographic interviews, we examine the narratives of three young men. Together, the narratives demonstrate the interrelatedness of illness and self-production in various forms. In one case the tension between interpersonal violence and self-preservation is central. In another, the place of knowledge in family relationships renders the entire picture of the social unstable. The paper signals a number of issues absent in clinical and epidemiological depictions of vulnerability, particularly in the context of the urban United States.     

Trajectories of Television Watching from Childhood to Early Adulthood and Their Association with Body Composition and Mental Health Outcomes in Young Adults

IntroductionPrior studies examining longitudinal patterns of television (TV) watching have tended to use analytical approaches which do not allow for heterogeneity in the variation of TV watching over time. In the current study, we used latent class analysis (LCA) to examine the relationships between television watching (from childhood to early adulthood) and body fat percentage (%) and mental health.MethodsData were collected from 2411 participants (50% female) from the Raine Study, a prospective birth cohort study in Australia. Participants were followed up over 15 years and answered questions about hours of TV watching per week at six time-points (5, 8, 10, 14, 17 and 20yrs). Trajectories of television watching were estimated using LCA and appropriate regression models used to test the association of television watching class with percentage body fat (measured by DXA) and mental health (DASS-21) at age 20. Physical activity was used as a covariate.ResultsThree distinct trajectories of TV watching were identified. Class 1 (47.4%) had consistently high (>14 hrs/wk) levels of TV watching, Class 2 (37.9%) was characterised by an increase in TV watching over adolescence and Class 3 (14.7%) had consistently lower (<14 hrs/wk) TV watching over 15 years. Sex was used as an active covariate in the latent class model and was significantly associated with class membership (p<0.001), with females comprising 45%, 47% and 59% of Class 1, 2 and 3 respectively. In females, membership in Class 2 or 3 was associated with lower body fat % at age 20, compared to Class 1 (p<0.001). For males, membership in Class 2 was associated with lower body fat % compared with males in Class 1 (p = 0.026). Membership of TV watching class and mental health were not related (p>0.05).ConclusionsTV watching from childhood to young adulthood appears to be a relatively stable behavior for around two thirds of participants, but not everyone tracks consistently. This study identified a subset of participants with low levels of TV watching in childhood and also that this group, despite an increase in TV watching over adolescence, maintained a lower level of body fat in young adulthood.     

Food Intake in Healthy Young Adults: Effects of Time Pressure and Social Factors

Some factors influencing food intake and subjective responses to meals were assessed in 2 groups (n=40 and n=36) of healthy university students. Both groups were studied for 6 days and included both “structured” and “unstructured” times. A questionnaire was completed by all subjects at 3 h intervals while awake. The questionnaires asked the subjects to state the factors that led them to choose to eat or not to eat a meal in the previous 3 h. If they ate a meal, they were required to describe the type of meal eaten and their responses to it—their hunger before it, their enjoyment of the meal itself, and their degree of satisfaction afterwards. Subjects were also asked to describe the type of meal that they would like to have eaten (the desired meal) in the absence of any restraints due to time pressure, cost, and so on. In the first group, 3 “structured” (working) and 3 “unstructured” (rest) days were chosen. Consistant with our previous studies, structured days, as compared to unstructured days, were associated with smaller meals and less positive subjective responses to them. Also, the meals that were eaten were often smaller than those that were desired, or were even missed altogether, due to time pressure. Not only were the meals eaten on unstructured days larger and rated, to by the subjects more positively, but also there was an additional positive effect if the meal played a social role. In the second group, 6 days were chosen, during which there were structured and unstructured 3 h periods. Many of the findings (with regard to reasons for eating or not eating a meal, and the effect of meal size upon subjective responses to it, for example) were the same as in the first group. However, the effect of structured vs. unstructured 3 h periods was significantly less marked than the effect of structured vs. unstructured days that had been found in the first group, and effects due to social factors and time pressure were less reliably present. The results indicate that food intake is affected by whether the whole or only part of the day is “structured” or “unstructured.” These findings might be relevant to some problems faced by the workforce, in general, and by night workers, in particular.     

Associations between Pathogens in the Upper Respiratory Tract of Young Children: Interplay between Viruses and Bacteria

Background

High rates of potentially pathogenic bacteria and respiratory viruses can be detected in the upper respiratory tract of healthy children. Investigating presence of and associations between these pathogens in healthy individuals is still a rather unexplored field of research, but may have implications for interpreting findings during disease.

Methodology/Principal Findings

We selected 986 nasopharyngeal samples from 433 6- to 24-month-old healthy children that had participated in a randomized controlled trial. We determined the presence of 20 common respiratory viruses using real-time PCR. Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus were identified by conventional culture methods. Information on risk factors was obtained by questionnaires. We performed multivariate logistic regression analyses followed by partial correlation analysis to identify the overall pattern of associations. S. pneumoniae colonization was positively associated with the presence of H. influenzae (adjusted odds ratio 1.60, 95% confidence interval 1.18–2.16), M. catarrhalis (1.78, 1.29–2.47), human rhinoviruses (1.63, 1.19–2.22) and enteroviruses (1.97, 1.26–3.10), and negatively associated with S. aureus presence (0.59, 0.35–0.98). H. influenzae was positively associated with human rhinoviruses (1.63, 1.22–2.18) and respiratory syncytial viruses (2.78, 1.06–7.28). M. catarrhalis colonization was positively associated with coronaviruses (1.99, 1.01–3.93) and adenoviruses (3.69, 1.29–10.56), and negatively with S. aureus carriage (0.42, 0.25–0.69). We observed a strong positive association between S. aureus and influenza viruses (4.87, 1.59–14.89). In addition, human rhinoviruses and enteroviruses were positively correlated (2.40, 1.66–3.47), as were enteroviruses and human bocavirus, WU polyomavirus, parainfluenza viruses, and human parechovirus. A negative association was observed between human rhinoviruses and coronaviruses.

Conclusions/Significance

Our data revealed high viral and bacterial prevalence rates and distinct bacterial-bacterial, viral-bacterial and viral-viral associations in healthy children, hinting towards the complexity and potential dynamics of microbial communities in the upper respiratory tract. This warrants careful consideration when associating microbial presence with specific respiratory diseases.     

The Chilliwack Respiratory Survey, 1963: Part IV. The Effect of Tobacco Smoking on the Prevalence of Respiratory Disease

Chronic non-specific respiratory disease was found by a survey at Chilliwack, B.C., to affect 29.3% of men and 18.0% of women between the ages of 25 and 74. The habit of current cigarette smoking was found to be the most important single factor associated with respiratory disease, and was found to be related to changes in simple measures of lung function. The authors were unable to confirm the existence of a threshold in lifetime cigarette smoking before respiratory disease occurred.Comparisons were made with a population previously studied at Berlin, New Hampshire, U.S.A., in 1961. At Berlin, where pollution by SO₂ and dust-fall had been thoroughly documented, the comparable prevalence rates for respiratory disease were 40.0% for men and 21.6% for women. When differences between the two populations as to age and number of cigarettes smoked daily were taken into account, the disease rates in these two communities were found to be quite similar. The Chilliwack sample did, however, have significantly higher values for the lung function tests.