Associations between differences in anemia-related blood cell parameters and short-term exposure to ambient particle pollutants in middle-aged and elderly residents in Beijing, China

Air pollution likely reduces hemoglobin levels in urban fruit bats

Air pollution is one of the world's most substantial environmental problems. Air pollution is more severe in urban environments. Besides humans, other animals also inhabit cities. Despite the significant impact of air pollution on health, there is limited research on its effects on wildlife in general and specifically on bats, which are common in cities. Egyptian fruit bats dwell in both rural and urban environments. We assessed the exposure to particulate matter (PM)2.5 pollution and compared it to blood hemoglobin (HGB) levels in fruit bat populations roosting at different degrees of urbanization. We found a significant negative correlation between PM2.5 exposure and HGB levels. Bats that roost and forage in highly urban-polluted areas exhibited low HGB levels. This is a first attempt to examine the effect of urbanization-related pollution on bat health, revealing a negative correlation between air pollution and HGB levels that might detrimentally affect bats' health in the long run.

The Association Between Ambient Particulate Matter Exposure and Anemia in HIV/AIDS Patients

BACKGROUND

Anemia is common among HIV/AIDS patients, impacting prognosis. Particulate matter (PM) exposure is an understudied, potentially modifiable risk factor in this group.

METHODS

We gathered 36,266 hemoglobin (Hb) measurements from 6808 HIV/AIDS patients from the HIV/AIDS Comprehensive Response Information Management System from 1 January 2004 to 31 December 2021. We evaluated the relationship between Hb levels and short-term PM exposure using linear mixed-effects models. We used logistic regression to estimate the association of long-term PM exposure with baseline anemia prevalence and time-varying Cox models to estimate the association of long-term PM exposure with follow-up incidence of anemia. Mediation analysis explored the role of chronic kidney disease (CKD) in the association between PM exposure and anemia.

RESULTS

For every 5 µg/m³ increase in 28-day average PM 1 , Hb levels decreased by 0.43 g/l. For a 10 µg/m³ increase in PM 2.5 , Hb decreased by 0.55 g/l; for the same increase in PM 10, Hb decreased by 0.35 g/l. A 5 µg/m³ increase in 1-year average PM 1 corresponded to a 7% higher prevalence of anemia at baseline, a 10 µg/m³ increase in PM 2.5 to 8% higher prevalence, and a 10 µg/m³ increase in PM 10 to 6% higher prevalence. These rises in average PM concentrations during follow-up were associated with increased incident anemia by 54% (PM 1 ), 72% (PM 2.5 ), and 51% (PM 10 ). CKD partially mediated the positive associations between PM exposure and the incidence of anemia.

CONCLUSION

PM exposure was associated with lower Hb levels and higher incidence of anemia in HIV/AIDS patients and CKD with mediating estimated effects in PM-induced anemia.

Association between exposure to smoke from cooking fuels and anaemia among women of reproductive age in Ghana

In low- and middle-income countries, indoor air pollution (IAP) is a serious public health concern, especially for women and children who cook with solid fuels. IAP exposure has been linked to a number of medical conditions, including pneumonia, ischemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lung cancer, and anaemia. Around 500 million women of reproductive age (WRA) suffer from anaemia globally, with an estimated 190 million cases in sub-Saharan Africa (SSA). This study, which is based on prior research, investigates the relationship between IAP exposure and anaemia among WRA in Ghana. A diverse sample of 2,406 WRA living in Ghana were interviewed, of which 58.06% were anaemic and used high-pollutant fuels for cooking. Age, place of residence, region, education level, religion, ethnicity, wealth index, type of drinking water, type of toilet facility, and type of cooking fuels were all found to be significantly linked with anaemic state by bivariate analysis. Type of cooking fuels utilized, age, region of residence, and the type of residence were shown to be significant predictors of anaemia status using sequential binary logit regression models. The results emphasise the critical need for efforts to promote the usage of clean cooking fuel in an attempt to lower anaemia prevalence in Ghana. To reduce dependency on solid fuels for cooking, initiatives should promote the use of cleaner cooking fuels and enhance the socioeconomic status of households. These interventions could have significant public health effects by reducing the burden of anaemia and improving maternal and child health outcomes due to the prevalence of anaemia among WRA. Overall, this study sheds light on the relationship between IAP exposure and anaemia in Ghana and highlights the demand for focused public health initiatives to address this serious health problem.

Association of adverse childhood experiences with anemia in older Chinese: Guangzhou Biobank Cohort Study

To examine the association of adverse childhood experiences (ACEs) with anemia among older people. 24,116 participants aged 50 years or above were recruited. Multivariable linear and logistic regression was used to assess the associations of self-reported ACEs number with hemoglobin concentrations (g/dL) and presence of anemia. Older individuals with two or more ACEs, versus no ACEs, showed lower hemoglobin concentrations (β =  - 0.08 g/dL, 95% confidence intervals (CI) - 0.12 to - 0.03) and higher odds of anemia (odds ratio = 1.26, 95% CI 1.01-1.59). A more pronounced association between ACEs and anemia in the lower education group was found, while the association became non-significant in those with higher education (P for ACEs-education interaction = 0.02). ACEs was associated with anemia in older people, and the association was stronger in those with lower education, highlighting the significance of early-life psychological stressors assessment and consideration of education background in geriatric care.

Anemia is associated with long-term exposure to PM2.5 and its components: a large population-based study in Southwest China

Background

Anemia is linked to PM2.5 (particulate matter with aerodynamic diameters of ⩽2.5 μm) exposure, which can increase the risk of various negative health outcomes. It remains unclear which PM2.5 components are associated with anemia and the respective contribution of each component to this association.

Objective

This study aimed at investigating the association between PM2.5 and anemia in the general population and to identify the most critical PM2.5 toxic components in this association.

Design

Cross-sectional study.

Methods

Our study involved a large cohort of 73,511 individuals aged 30-79 from China's multi-ethnic population. We employed satellite observations and the chemical transport model (GEOS-Chem)to estimate the long-term exposure to PM2.5 and its components. Anemia was defined, according to WHO guidelines, as Hb levels below 130 g/L for men and below 120 g/L for women. Through logistic regression, we investigated the association between PM2.5 components and anemia. By utilizing weighted quantile sum (WQS) analysis, we identified key components and gained insights into their combined impact on anemia. Overall, our study sheds light on the relationship between PM2.5 exposure, its constituents, and the risk of anemia in a large cohort.

Results

PM2.5 and three components, nitrate (NIT), organic matter (OM), and soil particles (SOIL), were associated with anemia. Per-standard deviation increase in the 3-year average concentrations of PM2.5 [odds ratio (OR): 1.14, 95% confidence interval (CI): 1.01, 1.28], NIT (1.20, 1.06, 1.35), OM (1.17, 1.04, 1.32), and SOIL (1.22, 1.11, 1.33) were associated with higher odds of anemia. In WQS regression analysis, the WQS index was associated with anemia (OR: 1.29, 95% CI: 1.13, 1.47). SOIL has the highest weight among all PM2.5 components.

Conclusions

Long-term exposure to PM2.5 and its constituents is associated with anemia. Moreover, SOIL might be the most critical component of the relationship between PM2.5 and anemia. Our research increases the evidence of the association between PM2.5 and anemia in the general population, and targeted emission control measures should be taken into consideration to mitigate the adverse effects of PM2.5-related anemia.

Effect of PM concentration on anemia blood indicators reduced by air purifiers

Housewives perform daily household chores, which directly expose them to indoor particulate matter (PM). Indoor PM exposure is a potential factor that increases systemic inflammation and affects hematopoietic action. This study investigated the decrease in indoor PM concentration by air purifiers on indicators of anemia, such as hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). We analyzed the data of 40 housewives who were subjected to an air purifier intervention in Seoul and Ulsan, Republic of Korea. Indoor exposure levels of PM2.5 and PM10 were analyzed with sensor adjusted and gravimetric measurement. We also investigated the same anemia indicators before and after the installation of an air purifier for three months (short-term: one month, long-term: three months). Statistical analysis was performed by a multiple linear model and a linear mixed model. The indoor PM exposure levels and air purifier use were related to anemia indicators (hemoglobin and MCHC). The increase in indoor PM2.5 level was associated with a decrease in MCHC (β: 0.034, P = 0.031) and hemoglobin (β: 0.013, P = 0.04). The decrease in indoor PM2.5 concentration by air purifier was associated with an increase in MCHC (β: 0.204, P = 0.087) and hemoglobin (β: 0.190, P = 0.039). In particular, after air purifier intervention, the amounts of MCHC and hemoglobin significantly increased. Our results suggest that indoor air purifier use could decrease indoor PM level and the risk of anemia to housewives. Because the effect on anemia is subacute, it was confirmed three months after air purifier operation. In conclusion, anemia indicators can be improved by PM reduction management.

Kitchen ventilation attenuated the associations of solid fuel use and long duration for cooking with the increased prevalence of normocytic anemia

Evidence on the potential risk factors of normocytic anemia, the most prevalent morphology subtype of anemia, was scarce to date. The purpose of this study is to investigate the association of cooking fuel use or daily cooking duration with normocytic anemia and further explore the modification effect of mechanical ventilation. Participants totaling 29,448 from the Henan Rural Cohort were included in this study. Normocytic anemia was defined by hemoglobin (based on the World Health Organization criteria) and mean corpuscular volume. Cooking-related data was collected by questionnaire, and the average daily cooking duration was calculated by the weekly cooking frequency and the cooking duration of each meal. Logistic regression models were employed to derive the combined and independent associations of cooking fuel type and daily cooking duration with normocytic anemia and the modification effect of ventilation. Compared with people who never cooked, both clean fuel and solid fuel users were significantly associated with increased prevalent normocytic anemia [OR (95% CI) = 1.196 (1.014, 1.411) and 1.335 (1.105, 1.614), respectively], and the effect estimates on normocytic anemia risk were 1.260 (1.043, 1.523), 1.320 (1.104, 1.578), and 1.310 (1.081, 1.587) in participants who daily cooked < 1 h/day, 1-2 h/day, and ≥ 2 h/day, respectively. These relationships were attenuated in subjects with mechanical ventilation (All P < 0.05). Cooking with solid fuel or for a long duration are independently associated with prevalent normocytic anemia in rural population, and mechanical ventilation could attenuate these associations. Future efforts to reduce the burden of anemia could target the universal use of ventilation and solid fuel use or cooking duration reduction.Clinical trial registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375.

Kitchen ventilation alleviated adverse associations of domestic fuel use and long-duration cooking with platelet indices as biomarkers of cardiovascular diseases

BACKGROUND

Abnormal platelet activity is considered as a potential mechanism of cardiovascular diseases (CVDs) related to household air pollution (HAP). However, evidence remains lacking for the association of HAP with platelet activity in low-middle income countries.

METHODS

27,349 individuals were obtained from the Henan Rural Cohort Study. A questionnaire was used to collect data on cooking fuel types, cooking frequency and time as well as kitchen ventilation which indirectly reflected HAP. Platelet activity was indicated by platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), ratio of mean platelet volume to platelet count (MPVP), platelet-large cell ratio (P-LCR) and plateletcrit (PCT). Associations of HAP with platelet activity were assessed by generalized linear mixed models.

RESULTS

Compared with the ones without cooking, participants who cooking using solid fuel, clean fuel, short- and long-duration cooking were at a high risk for increased platelet size (PDW, MPV, MPVP and P-LCR) but decreased PLT and PCT; long-duration cooking participants with non-using exhaust hood/extractor by solid fuel use were associated with a 0.259 f. (95%CI: 0.100, 0.418 fL), 0.115 f. (95%CI: 0.050, 0.181 fL), 0.001 (95%CI: 0.000, 0.003) and 0.928% (95%CI: 0.425, 1.431%) increment in PDW, MPV, MPVP and P-LCR values and these associations were prominent in women relative than that in men.

CONCLUSION

Using exhaust hood/extractor attenuated the positive associations of solid fuel use and long-duration cooking with increased platelet size in all participants and these associations were prominent in women, indicating that improving kitchen ventilation may be an effective strategy to reduce platelet dysfunction related to HAP, especially for women.

Urban Air Pollution and Emergency Department Visits for Neoplasms and Outcomes of Blood Forming and Metabolic Systems

This study focused on investigating possible associations between exposure to urban air pollution and the number of emergency department (ED) visits for various health outcomes. The outcomes were grouped into four chapters of the International Classification of Diseases Tenth Revision (ICD-10) system (i.e., Chapter II-IV: “Neoplasms”, “Diseases of the blood”, “Endocrine, nutritional and metabolic diseases”, and XVIII: “Symptoms, signs and abnormal clinical and laboratory findings“). The data were collected for the city of Toronto, Canada, (2004–2015, 4292 days). Four gaseous air pollutants (carbon monoxide (CO), nitrogen dioxide (NO₂), ground level ozone (O₃), and sulfur dioxide (SO₂)) and fine particulate matter (PM_2.5), and two calculated air quality health indexes (AQHI) based on Toronto were used. The statistical models were constructed by applying the conditional Poisson regression. The exposure was assessed over a maximum of 15 days (time lags 0–14 days). An analysis was performed with the following strata: sex, age, and seasons. Relative risks (RR) and their 95% confidence intervals (95%CI) were estimated for an increase in concentration by a one interquartile range (IQR). For the AQHI (composed of NO₂, O₃, and PM_2.5), IQR = 1, the estimations for lag 1 and all patients, are RR = 1.023 (95%CI: 1.008, 1.038), 1.026 (1.012, 1.040), 1.013 (1.003, 1.024), and 1.007 (1.003, 1.010) for Chapters II–IV and XVIII, respectively. The results show that in the four large, analyzed health groups, the impact of air quality mainly occurs over a short period (from current day to a maximum of 3 days after exposure).

Effects of PM2.5 and its constituents on hemoglobin during the third trimester in pregnant women

Anemia has been a public health issue evoking global concern, and the low hemoglobin (Hb) concentration links to adverse pregnancy outcomes. However, the associations of PM2.5 and its constituents with Hb and anemia in pregnant women remain unclear. In this retrospective birth cohort study, 7932 pregnant women who delivered in the First Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2018 were included. The Hb during the third trimester in pregnant women was assessed before delivery. PM2.5 and its constituents (BC, NH4+, NO3-, OM, SO42-, and Dust) during pregnancy were retrieved from the V4.CH.03 product constructed by the Atmospheric Composition Analysis Group. Generalized linear regression model was applied to investigate the effects of PM2.5 and its constituents on Hb and anemia during the third trimester in pregnant women. The means and standard deviations of PM2.5, BC, NH4+, NO3-, OM, SO42-, and Dust were 69.56 (15.24), 10.02 (2.72), 8.11 (1.77), 14.96 (5.42), 15.36 (4.11), 10.08 (1.20), and 10.98 (1.85) μg/m3, respectively. Per IQR increase (μg/m3) of PM2.5, BC, NO3-, and OM linked to - 0.75 (- 1.50, - 0.01), - 0.85 (- 1.65, - 0.04), - 0.79 (- 1.56, - 0.03), and - 0.73 (- 1.44, - 0.03) g/L decrease of Hb during the third trimester in multiparous pregnant women, but not for NH4+, SO42-, Dust, and primiparous pregnant women. PM2.5 and its constituents had no significant association with anemia, except for Dust (OR: 0.90, 95% CI: 0.82, 0.99, per IQR increase) in primiparous pregnant women. Besides, SO42- was of lag effects on Hb and anemia in multiparous pregnant women. Moreover, non-linear associations were found among PM2.5 and its constituents, Hb, and anemia. Therefore, exposure to PM2.5 and some constituents of PM2.5 was associated with reduced Hb level during the third trimester in multiparous pregnant women. Related departments and pregnant women should take targeted actions to eliminate the detrimental effects of PM2.5 and its constituents on pregnancy outcomes.