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Ulziikhuu B, Gombojav E, Banzrai C, Batsukh S, Enkhtuya E, Boldbaatar B, Bellinger DC, Lanphear BP, McCandless LC, Nepomnaschy P, Salvante K, Weinberg J, Allen RW. Who benefits most from a prenatal HEPA filter air cleaner intervention on childhood cognitive development? The UGAAR randomized controlled trial. ENVIRONMENTAL RESEARCH 2023; 231:115991. [PMID: 37121346 DOI: 10.1016/j.envres.2023.115991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/05/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Air pollution exposure during pregnancy affects children's brain function. Maternal stress and nutrition, socioeconomic status, and the child's sex may modify this relationship. OBJECTIVE To identify characteristics of children with the largest increases in full-scale IQ (FSIQ) after their mothers used HEPA filter air cleaners during pregnancy. METHODS In this randomized controlled trial we randomly assigned women to receive 1-2 air cleaners or no air cleaners during pregnancy. We analyzed maternal hair samples for cortisol and dehydroepiandrosterone (DHEA). When the children were 48 months old, we measured FSIQ with the Wechsler Preschool and Primary Scale of Intelligence. We evaluated ten potential modifiers of the intervention-FSIQ relationship using interaction terms in separate regression models. To account for correlations between modifiers, we also used a single regression model containing main effects and intervention x modifier terms for all potential modifiers. RESULTS Among 242 mother-child dyads with complete data, the intervention was associated with a 2.3-point increase (95% CI: -1.5, 6.0 points) in mean FSIQ. The intervention improved mean FSIQ among children of mothers in the bottom (5.4 points; 95% CI: -0.8, 11.5) and top (6.1 points; 95% CI: 0.5, 11.8) cortisol tertiles, but not among those whose mothers were in the middle tertile. The largest between-group difference in the intervention's effect was a 7.5-point (95% CI: -0.7, 15.7) larger increase in mean FSIQ among children whose mothers did not take vitamins than among children whose mothers did take vitamins (interaction p-value = 0.07). We also observed larger benefits among children whose mothers did not complete university, and those with lower hair DHEA concentrations, hair cortisol concentrations outside the middle tertile, or more perceived stress. CONCLUSION The benefits of reducing air pollution during pregnancy on brain development may be greatest for children whose mothers who do not take vitamins, experience more stress, or have less education.
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Affiliation(s)
| | | | | | - Sarangerel Batsukh
- Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Enkhtuul Enkhtuya
- Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | | | | | | | | | | | | | - Joanne Weinberg
- University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada
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Zhang S, Hu J, Xiao G, Chen S, Wang H. Urban particulate air pollution linked to dyslipidemia by modification innate immune cells. CHEMOSPHERE 2023; 319:138040. [PMID: 36739990 DOI: 10.1016/j.chemosphere.2023.138040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
Air particulate matter (PM) is an essential risk factor for lipid metabolism disorders. However, the underlying mechanism remains unclear. In this cross-sectional study, 216 healthcare workers were recruited to estimate the associations among the daily exposure dose (DED) of air PM, innate immune cells, and plasma lipid levels. All participants were divided into two groups according to the air particulate combined DED (DED-PMC). The peripheral white blood cell counts, lymphocyte counts, and monocyte counts and percentages were higher in the higher-exposure group (HEG) than in the lower-exposure group (LEG), whereas the percentage of natural-killer cells was lower in the HEG than in the LEG. The plasma concentrations of the total cholesterol, triglycerides, LDL-C, and apolipoprotein B were higher in the HEG than in the LEG, whereas the HDL-C and apolipoprotein A1 were lower in the HEG than in the LEG. A dose-effect analysis indicated that when the DED of the air PM increased, there were increased peripheral monocyte counts and percentages, a decreased NK cell percentage, elevated plasma concentrations of total cholesterol, triglycerides, LDL-C, and apolipoprotein B, and reduced plasma levels of HDL-C and apolipoprotein A1. In addition, the modification of the innate immune cells was accompanied by alterations in the plasma lipid levels in a dose-dependent manner. Mediation effect analysis suggested innate immune cells were the potential mediators for the associations among air PM exposure on abnormal lipid metabolism. These results indicated that chronic exposure to air PM may disturb lipid metabolism by altering the distribution of innate immune cells in the peripheral blood, ultimately advancing cardiovascular disease risk.
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Affiliation(s)
- Shaocheng Zhang
- Department of Clinical Laboratory Medicine, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Juan Hu
- Department of Clinical Laboratory Medicine, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Guangjun Xiao
- Department of Clinical Laboratory Medicine, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Shu Chen
- Department of Clinical Laboratory Medicine, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Huanhuan Wang
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, 610500, Sichuan, China.
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Dreher A, Yusuf R, Ashraf H, Ahmed SAKS, Gao W, Strümpell C, Loerbroks A. Workplace stressors and their association with hair cortisol concentrations among ready-made garment workers in Bangladesh: A cross-sectional study. J Occup Health 2023; 65:e12426. [PMID: 37752694 PMCID: PMC10522888 DOI: 10.1002/1348-9585.12426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
OBJECTIVES Psychosocial working conditions of ready-made garment (RMG) workers have been associated with poorer self-reported health outcomes. However, no such research has been done with respect to physiological markers that are considered to reflect stress. We consequently aimed to investigate associations of psychosocial working conditions with such a marker, that is, hair cortisol, among RMG workers in Bangladesh. METHODS We conducted semi-structured face-to-face interviews in labor colonies in the Mirpur area, Dhaka, Bangladesh, in February and March 2021 with individuals identifying as garment workers. The interview inquired after various workplace stressors and resources (i.e., workplace support, workplace bullying, vertical trust, beneficial leadership, work-family conflict, and financial issues including savings, debts, financial obligations, and financial support). In addition, hair samples of 2 cm length were collected from participants. Hair cortisol concentrations (HCC) were determined based on liquid chromatography-tandem mass spectrometry (LC-MS/MS). Linear regression models were run to detect possible associations of workplace stressors and resources with HCC. RESULTS In total, data of 576 participants were included in the analysis (71.9% female, mean age = 25.9 years). Mean HCC was 4.4 pg/mg (standard deviation = 2.1 pg/mg). The sole variable significantly associated with increased HCC was "having to keep your job to support your children or spouse financially" (β = 0.28 [95% confidence interval 0.02-0.55]). CONCLUSIONS The sole workplace stressor significantly associated with increased HCC was the necessity to keep one's job to support children or spouse financially. This observation can, however, barely be disentangled from the fact that one has children/a spouse.
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Affiliation(s)
- Annegret Dreher
- Faculty of Medicine, Institute of Occupational, Social, and Environmental Medicine, Centre for Health and SocietyHeinrich‐Heine‐University DüsseldorfDüsseldorfGermany
| | - Rita Yusuf
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD)Independent UniversityDhakaBangladesh
| | - Hasan Ashraf
- Department of AnthropologyJahangirnagar UniversityDhakaBangladesh
| | - Syed A. K. Shifat Ahmed
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD)Independent UniversityDhakaBangladesh
| | - Wei Gao
- Faculty of Psychology, Chair of Biological PsychologyTechnical University DresdenDresdenGermany
| | - Christian Strümpell
- Institute of Social and Cultural AnthropologyUniversity of HamburgHamburgGermany
| | - Adrian Loerbroks
- Faculty of Medicine, Institute of Occupational, Social, and Environmental Medicine, Centre for Health and SocietyHeinrich‐Heine‐University DüsseldorfDüsseldorfGermany
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Riva A, Rebecchi A, Capolongo S, Gola M. Can Homes Affect Well-Being? A Scoping Review among Housing Conditions, Indoor Environmental Quality, and Mental Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15975. [PMID: 36498051 PMCID: PMC9736414 DOI: 10.3390/ijerph192315975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
The purpose of the scoping review is to explore the relationship between housing conditions, indoor environmental quality (IEQ), and mental health implications on human well-being. In fact, time spent at home increased due to the recent COVID-19 lockdown period, and social-sanitary emergencies are expected to grow due to the urbanization phenomenon. Thus, the role of the physical environment in which we live, study, and work, has become of crucial importance, as the literature has recently highlighted. This scoping review, conducted on the electronic database Scopus, led to the identification of 366 articles. This, after the screening processes based on the inclusion criteria, led to the final inclusion of 31 papers related specifically to the OECD area. The review allowed the identification of five housing conditions [house type, age, and floor level; housing qualities; household composition; neighborhood; green spaces] that, by influencing the IEQ parameters, had impacts on the mental health outcomes addressed. By synthesizing the contributions of the review, a list of design recommendations has been provided. These will serve as a basis for future researchers, from which to develop measures to reduce inequalities in housing by making them healthier, more resilient, and salutogenic.
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Affiliation(s)
- Alessia Riva
- School of Architecture, Urban Planning, Construction Engineering (AUIC) of Politecnico di Milano, 20133 Milano, Italy
| | - Andrea Rebecchi
- Design & Health Lab., Department of Architecture, Built Environment and Construction Engineering (ABC) of Politecnico di Milano, 20133 Milano, Italy
| | - Stefano Capolongo
- Design & Health Lab., Department of Architecture, Built Environment and Construction Engineering (ABC) of Politecnico di Milano, 20133 Milano, Italy
| | - Marco Gola
- Design & Health Lab., Department of Architecture, Built Environment and Construction Engineering (ABC) of Politecnico di Milano, 20133 Milano, Italy
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Abstract
PURPOSE OF REVIEW There is increasing interest in the links between exposure to air pollution and a range of health outcomes. The association with mental health however is much less established. This article reviews developments in the field over the past 12 months, highlighting the evidence for causation, associations between multiple air pollutants and mental health outcomes, and assesses the challenges of researching this topic. RECENT FINDINGS Increasingly rigorous methods are being applied to the investigation of a broader range of mental health outcomes. These methods include basic science, neuroimaging, and observational studies representing diverse geographical locations. Cohort studies with linked high-resolution air pollutant exposure data are common, facilitating advanced analytic methods. To date, meta-analyses have demonstrated small and significant positive associations between long-term exposure to fine particulate matter and depressive symptoms and cognitive decline. Methodological complexities in measuring exposure and outcome pose ongoing difficulties for the field. SUMMARY Literature on this topic has recently seen an appreciable expansion. Work that better estimates daily exposure, controls for complex confounders, and is driven by hypotheses founded in candidate causal mechanisms would help clarify associations, and inform targeted interventions and policymakers.
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Powell-Wiley TM, Baumer Y, Baah FO, Baez AS, Farmer N, Mahlobo CT, Pita MA, Potharaju KA, Tamura K, Wallen GR. Social Determinants of Cardiovascular Disease. Circ Res 2022; 130:782-799. [PMID: 35239404 PMCID: PMC8893132 DOI: 10.1161/circresaha.121.319811] [Citation(s) in RCA: 199] [Impact Index Per Article: 99.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Social determinants of health (SDoH), which encompass the economic, social, environmental, and psychosocial factors that influence health, play a significant role in the development of cardiovascular disease (CVD) risk factors as well as CVD morbidity and mortality. The COVID-19 pandemic and the current social justice movement sparked by the death of George Floyd have laid bare long-existing health inequities in our society driven by SDoH. Despite a recent focus on these structural drivers of health disparities, the impact of SDoH on cardiovascular health and CVD outcomes remains understudied and incompletely understood. To further investigate the mechanisms connecting SDoH and CVD, and ultimately design targeted and effective interventions, it is important to foster interdisciplinary efforts that incorporate translational, epidemiological, and clinical research in examining SDoH-CVD relationships. This review aims to facilitate research coordination and intervention development by providing an evidence-based framework for SDoH rooted in the lived experiences of marginalized populations. Our framework highlights critical structural/socioeconomic, environmental, and psychosocial factors most strongly associated with CVD and explores several of the underlying biologic mechanisms connecting SDoH to CVD pathogenesis, including excess stress hormones, inflammation, immune cell function, and cellular aging. We present landmark studies and recent findings about SDoH in our framework, with careful consideration of the constructs and measures utilized. Finally, we provide a roadmap for future SDoH research focused on individual, clinical, and policy approaches directed towards developing multilevel community-engaged interventions to promote cardiovascular health.
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Affiliation(s)
- Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD.,Intramural Research Program, National Institute on Minority Health and Health Disparities (T.M.P.-W.), National Institutes of Health, Bethesda, MD
| | - Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Foster Osei Baah
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Andrew S Baez
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Nicole Farmer
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, MD (N.F., G.R.W.)
| | - Christa T Mahlobo
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD.,The Pennsylvania State University (C.T.M.)
| | - Mario A Pita
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Kameswari A Potharaju
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (T.M.P.-W., Y.B., F.O.B., A.S.B., C.T.M., M.A.P., K.A.P.), National Institutes of Health, Bethesda, MD
| | - Kosuke Tamura
- Neighborhood Social and Geospatial Determinants of Health Disparities Laboratory, Population and Community Sciences Branch, Intramural Research Program, National Institute on Minority Health and Health Disparities (K.T.), National Institutes of Health, Bethesda, MD
| | - Gwenyth R Wallen
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, MD (N.F., G.R.W.)
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Zhang S, Chen S, Xiao G, Zhao M, Li J, Dong W, Hu J, Yuan T, Li Y, Liu L. The associations between air pollutant exposure and neutralizing antibody titers of an inactivated SARS-CoV-2 vaccine. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:13720-13728. [PMID: 34599446 PMCID: PMC8486374 DOI: 10.1007/s11356-021-16786-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
Air pollution is a critical risk factor for the prevalence of COVID-19. However, few studies have focused on whether air pollution affects the efficacy of the SARS-CoV-2 vaccine. To better guide the knowledge surrounding this vaccination, we conducted a cross-section study to identify the relationships between air pollutant exposure and plasma neutralizing antibody (NAb) titers of an inactivated SARS-CoV-2 vaccine (Vero cell, CoronaVac, SINOVΛC, China). We recruited 239 healthcare workers aged 21-50 years who worked at Suining Central Hospital. Of these, 207 were included in this study, depending on vaccination date. The data regarding air pollutants were collected to calculate individual daily exposure dose (DED). The geometric mean of all six pollutant DEDs was applied to estimate the combined toxic effects (DEDcomplex). Then, the participants were divided into two groups based on the mean value of DEDcomplex. The median plasma NAb titer was 12.81 AU/mL, with 85.99% vaccine efficacy in healthcare workers against SARS-CoV-2. In exposure group, observations included lower plasma NAb titers (median: 11.13 AU/mL vs. 14.56 AU/mL), more peripheral counts of white blood cells and monocytes (mean: 6.71 × 109/L vs. 6.29 × 109/L and 0.49 × 109/L vs. 0.40 × 109/L, respectively), and a higher peripheral monocyte ratio (7.38% vs. 6.50%) as compared to the reference group. In addition, elevated air pollutant DEDs were associated with decreased plasma NAb titers. To our knowledge, this study is the first to report the relationship between air pollutant exposure and plasma NAb titers of the SARS-CoV-2 vaccine. This suggests that long-term exposure to air pollutants may inhibit plasma NAb expression by inducing chronic inflammation. Therefore, to achieve early herd immunity and hopefully curb the COVID-19 epidemic, vaccinations should be administered promptly to those eligible, and environmental factors should be considered as well.
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Affiliation(s)
- Shaocheng Zhang
- Department of Clinical Laboratory Medicine, Suining Central Hospital, 127 Deshengxi Rd., Suining, 629000, Sichuan, People's Republic of China.
| | - Shu Chen
- Department of Clinical Laboratory Medicine, Suining Central Hospital, 127 Deshengxi Rd., Suining, 629000, Sichuan, People's Republic of China
| | - Guangjun Xiao
- Department of Clinical Laboratory Medicine, Suining Central Hospital, 127 Deshengxi Rd., Suining, 629000, Sichuan, People's Republic of China
| | - Mingcai Zhao
- Department of Clinical Laboratory Medicine, Suining Central Hospital, 127 Deshengxi Rd., Suining, 629000, Sichuan, People's Republic of China
| | - Jia Li
- Department of Clinical Laboratory Medicine, Suining Central Hospital, 127 Deshengxi Rd., Suining, 629000, Sichuan, People's Republic of China
| | - Wenjuan Dong
- Department of Public Health Administration and Health Education, Suining Central Hospital, Suining, 629000, Sichuan, People's Republic of China
| | - Juan Hu
- Department of Clinical Laboratory Medicine, Suining Central Hospital, 127 Deshengxi Rd., Suining, 629000, Sichuan, People's Republic of China
| | - Tianqi Yuan
- Maccura Biotechnology Co. Ltd., Chengdu, 611731, Sichuan, People's Republic of China
| | - Yong Li
- Maccura Biotechnology Co. Ltd., Chengdu, 611731, Sichuan, People's Republic of China
| | - Lianghua Liu
- Department of Clinical Laboratory Medicine, Suining Central Hospital, 127 Deshengxi Rd., Suining, 629000, Sichuan, People's Republic of China
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