1
|
Wang Y, Wang X, Fu P, Jiang H, Wang X, Zhou C. Life Course Patterns of Work History and Cognitive Trajectories Among Community-Dwelling Older Adults. J Gerontol B Psychol Sci Soc Sci 2025; 80:gbae195. [PMID: 39680072 DOI: 10.1093/geronb/gbae195] [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: 05/08/2024] [Indexed: 12/17/2024] Open
Abstract
OBJECTIVES Prior research indicated that diverse work experiences in early and middle life stages are associated with cognitive function in later life. However, whether life course patterns of work history are associated with later life cognitive function in China remains unknown. METHODS Data were derived from the China Health and Retirement Longitudinal Study, and 5,800 participants aged 60 years or older were included. We used sequence analysis to identify the work history patterns between ages 18 and 60. Growth curve modeling was performed to evaluate how the work-history patterns are associated with global and domain-specific (i.e., mental intactness and episodic memory) cognitive function. RESULTS We identified 8 work patterns, distinguished by duration, transitions, timing, and sequence of work history. Compared with individuals exposed to lifelong agricultural work, those engaged in lifelong nonagricultural employed work had better cognitive function in later life and experienced slower rates of cognitive decline in both global cognitive function and the mental intactness domain. In addition, individuals who shifted from agricultural to nonagricultural employed work early (around age 30) had better global cognitive function in later life, whereas the association was not significant for such a transition later (around age 50). DISCUSSION Our study highlights the importance of the duration, sequence, and timing of transitions in work history for cognitive health among older Chinese. Future interventions and policies aimed at improving cognitive function should fully consider the cumulative and dynamic nature of work from a life course perspective.
Collapse
Affiliation(s)
- Yi Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xingzhi Wang
- School of Economics, Shandong University, Jinan, People's Republic of China
| | - Peipei Fu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, People's Republic of China
| | - Hantao Jiang
- Department of Sociology, University of North Carolina at Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Xueqing Wang
- Office of Population Research, School of Public and International Affairs, Princeton University, Princeton, New Jersey, USA
| | - Chengchao Zhou
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, People's Republic of China
| |
Collapse
|
2
|
Park HH, Armstrong MJ, Gorin FA, Lein PJ. Air Pollution as an Environmental Risk Factor for Alzheimer's Disease and Related Dementias. MEDICAL RESEARCH ARCHIVES 2024; 12:5825. [PMID: 39822906 PMCID: PMC11736697 DOI: 10.18103/mra.v12i10.5825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2025]
Abstract
Alzheimer's disease and related dementias are a leading cause of morbidity in our aging populations. Although influenced by genetic factors, fewer than 5% of Alzheimer's disease and related dementia cases are due solely to genetic causes. There is growing scientific consensus that these dementias arise from complex gene by environment interactions. The 2020 Lancet Commission on dementia prevention, intervention, and care identified 12 modifiable risk factors of dementia, including lifestyle, educational background, comorbidities, and environmental exposures to environmental contaminants. In this review, we summarize the current understanding and data gaps regarding the role(s) of environmental pollutants in the etiology of Alzheimer's disease and related dementias with a focus on air pollution. In addition to summarizing findings from epidemiological and experimental animal studies that link airborne exposures to environmental contaminants to increased risk and/or severity of Alzheimer's disease and related dementias, we discuss currently hypothesized mechanism(s) underlying these associations, including peripheral inflammation, neuroinflammation and epigenetic changes. Key data gaps in this rapidly expanding investigative field and approaches for addressing these gaps are also addressed.
Collapse
Affiliation(s)
- Heui Hye Park
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Matthew J. Armstrong
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Fredric A. Gorin
- Department of Molecular Biosciences, School of Veterinary Medicine, and Department of Neurology, School of Medicine, University of California, Davis, CA 95616, USA
| | - Pamela J. Lein
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| |
Collapse
|
3
|
Tomar S, Sharma N, Kumar R. Effect of organic food production and consumption on the affective and cognitive well-being of farmers: analysis using prism of NVivo, etic and emic approach. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2023:1-22. [PMID: 37363037 PMCID: PMC10069358 DOI: 10.1007/s10668-023-03195-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/24/2023] [Indexed: 06/28/2023]
Abstract
Extant research studies support has stressed the significance of nourishment on the physical health of humans. Some of the past academic literature has also hinted at an interconnect between food, thoughts, and action that becomes especially significant in the current era of Anthropocene. Organic farming production and consumption can not only enhance economic well-being but also promote social well-being along with subject well-being. Beyond the individual level, a community level facilitates fostering physical emotional physical and emotional ecosystems. However, several studies have inferred seemingly dubious claims about the impact of natural food intake on the mental well-being of an individual. In light of this impinging need, this first-of-its-kind study focused to search the impact of organic food consumption on the cognitive behaviour of individuals. Interview-based qualitative field research with 30 peasants' families was conducted in two phases in the model organic village of Manj Gaon of Uttarakhand. Results indicate that organic farming has positively impacted the mental well-being of the farmers, and apart from it, physical health, food security, and financial security are the fringe benefits for native organic farmers. However, there are many bottlenecks from the policy perspective such as non-availability of organic seeds, lack of marketplaces, lack of transportation infrastructure, and almost no facility of cold storage and warehouse, especially during the time of summer season. All these significantly hamper the adoption and sustenance of organic food production and consumption. Although many farmers exhibit the attributes of subjective well-being, as an outcome, it is rooted in the consumption of organic food, because better intake leads to a better thought process and eventually the results get reflected in the form of a better human being. To conclude, better thoughts, emotions, mind, and health of a human individual and society are strongly rooted in the adoption of chemical and pesticide-free food, i.e. organic.
Collapse
Affiliation(s)
- Sushant Tomar
- Department of Management Studies, Graphic Era (Deemed to be University), Dehradun, Uttarakhand 248002 India
| | - Neeraj Sharma
- Department of Management Studies, Graphic Era (Deemed to be University), Dehradun, Uttarakhand 248002 India
| | - Rupesh Kumar
- Jindal Global Business School (JGBS), O. P. Jindal Global University, Sonipat, Haryana India
| |
Collapse
|
4
|
Arab A, Mostafalou S. Neurotoxicity of pesticides in the context of CNS chronic diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2718-2755. [PMID: 34663153 DOI: 10.1080/09603123.2021.1987396] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/26/2021] [Indexed: 06/13/2023]
Abstract
Following the introduction and application of pesticides in human life, they have always been along with health concerns both in acute poisoning and chronic toxicities. Neurotoxicity of pesticides in chronic exposures has been known as one of the most important human health problems, as most of these chemicals act through interacting with some elements of nervous system. Pesticide-induced neurotoxicity can be defined in different categories of neurological disorders including neurodegenerative (Alzheimer, Parkinson, amyotrophic lateral sclerosis, multiple sclerosis), neurodevelopmental (attention deficit hyperactivity disorder, autism spectrum disorders, developmental delay, and intellectual disability), neurobehavioral and neuropsychiatric (depression/suicide attempt, anxiety/insomnia, and cognitive impairment) disorders some of which are among the most debilitating human health problems. In this review, neurotoxicity of pesticides in the mentioned categories and sub-categories of neurological diseases have been systematically presented in relation to different route of exposures including general, occupational, environmental, prenatal, postnatal, and paternal.
Collapse
Affiliation(s)
- Ali Arab
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Sara Mostafalou
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran
| |
Collapse
|
5
|
Chittrakul J, Sapbamrer R, Hongsibsong S. Exposure to organophosphate insecticides, inappropriate personal protective equipment use, and cognitive performance among pesticide applicators. Front Public Health 2022; 10:1060284. [PMID: 36466523 PMCID: PMC9712794 DOI: 10.3389/fpubh.2022.1060284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
Inappropriate use of personal protective equipment (PPE) among pesticide applicators may increase urinary organophosphate (OP) metabolite levels and subsequently increase risks of cognitive performance. Therefore, this study aims to (1) compare urinary OP metabolite levels and cognitive performance between pre-and post-pesticide application seasons; (2) PPE use and factors associated with PPE use linked to increased urinary OP metabolite levels during pesticide application; and (3) the association between urinary OP metabolite levels and cognitive performance. This longitudinal follow-up study on 79 pesticide applicators was carried out between October 2021 and January 2022. The applicators were interviewed, collected urine samples, and tested for cognitive performance in pre-and post-pesticide application seasons. The results found that the levels of urinary OP metabolites in post-application season were significantly higher than those in pre-application season (p < 0.001). Multiple linear regression analysis found that increased total diethylphosphate (DEP) and total dialkylphosphate (DAP) levels were associated with not wearing gloves while mixing pesticides [beta (β) ± standard error (SE) = -43.74 ± 18.52, 95% confidence interval (95% CI) = -80.84, -6.64 for total DEP and -50.84 ± 19.26, 95% CI = -89.41, -12.26 for total DAP] and also with not wearing a mask while spraying pesticides (β ± SE = -31.76 ± 12.24, 95% CI = -56.28, -7.24 for total DEP and -33.20 ± 12.63, 95% CI = -58.49, -7.92 for total DAP) after adjusting for covariates. The scores of Montreal Cognitive Assessment-Thai, Thai Mental State Examination, and Mini-Cognitive test in post-pesticide application were significantly lower than those in pre-pesticide application (p < 0.001). However, no association was found between urinary OP metabolite levels and cognitive decline. Our findings indicate that inappropriate PPE use during pesticide application was the major factor affecting urinary OP metabolite levels among pesticide applicators. Wearing gloves when mixing pesticides and a mask when spraying pesticides were key factors in reducing occupational exposure to OP. Exposure to OP at low levels and for short periods of exposure may not affect cognitive performance significantly. Therefore, long-term exposure and exposure to high levels of OP should be investigated further.
Collapse
Affiliation(s)
- Jiraporn Chittrakul
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,*Correspondence: Ratana Sapbamrer ;
| | - Surat Hongsibsong
- School of Health Sciences Research, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| |
Collapse
|
6
|
Sarailoo M, Afshari S, Asghariazar V, Safarzadeh E, Dadkhah M. Cognitive Impairment and Neurodegenerative Diseases Development Associated with Organophosphate Pesticides Exposure: a Review Study. Neurotox Res 2022; 40:1624-1643. [PMID: 36066747 DOI: 10.1007/s12640-022-00552-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 10/14/2022]
Abstract
A significant body of literature emphasizes the role of insecticide, particularly organophosphates (OPs), as the major environmental factor in the etiology of neurodegenerative diseases. This review aims to study the relationship between OP insecticide exposure, cognitive impairment, and neurodegenerative disease development. Human populations, especially in developing countries, are frequently exposed to OPs due to their extensive applications. The involvement of various signaling pathways in OP neurotoxicity are reported, but the OP-induced cognitive impairment and link between OP exposure and the pathophysiology of neurodegenerative diseases are not clearly understood. In the present review, we have therefore aimed to come to new conclusions which may help to find protective and preventive strategies against OP neurotoxicity and may establish a possible link between organophosphate exposure, cognitive impairment, and OP-induced neurotoxicity. Moreover, we discuss the findings obtained from animal and human research providing some support for OP-induced cognitive impairment and neurodegenerative disorders.
Collapse
Affiliation(s)
- Mehdi Sarailoo
- Students Research Committee, School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Salva Afshari
- Students Research Committee, Pharmacy School, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Vahid Asghariazar
- Deputy of Research & Technology, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Elham Safarzadeh
- Department of Microbiology, Parasitology, and Immunology, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Masoomeh Dadkhah
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran.
| |
Collapse
|
7
|
Tiwari S, Sapkota N, Tiwari S, Sapkota B. Association between pesticide exposure and neurobehavioral performance of agricultural workers: A cross-sectional study. Brain Behav 2022; 12:e2641. [PMID: 35666132 PMCID: PMC9304822 DOI: 10.1002/brb3.2641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/17/2022] [Accepted: 05/10/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Pesticide exposure has affected humans' health, especially those directly in contact with a pesticide like agricultural workers. Here, we sought to see a link between pesticide exposure and cognitive impairment among male agricultural workers. METHODS We selected 18-60 years old 100 male agricultural workers who came for their health check-up in the hospital's out-patient department from August 2020 to May 2021. Standardized questionnaires (German Q18 questionnaire) and WHO Neurobehavioral Core Test Battery were used to examine the neurobehavioral performance of the individuals. The data were presented in a descriptive manner and statistically examined using the chi-square test. RESULTS The male agricultural workers' neurobehavioral performance was 46% normal and 54% abnormal. Headaches, impaired focus, short memory, weariness, palpitation, and numbness were the most prevalent neurobehavioral impairments. The chi-square test revealed that spraying frequency (p =.010), personal protective equipment (PPE) use (p < .001), and smoking habits (p =.006) were all linked to neurobehavioral performance, while spraying duration (p =.804), working years (p =.234), pesticide types (p =.816), and spraying time (p =.867) were not linked to neurobehavioral performance. CONCLUSION We found that pesticide exposure has a certain role on neurobehavioral performance in adult male agricultural workers as more people have been affected; however, a considerable number of confounding factors might have played a significant role in giving rise to such results. The government should be concerned about farmer's neurobehavioral performance and implement different approaches to minimize the use of pesticides so that agricultural workers can work without any mental health problems.
Collapse
Affiliation(s)
- Sujan Tiwari
- Institute of Agriculture and Animal Science, Tribhuvan University, Kathmandu, Nepal
| | - Namrata Sapkota
- Net Fresh Hospital, Chitwan, Nepal.,Om Wellness Hospital, Biratnagar, Nepal.,Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,University of Chinese Academy of Science, Beijing, China
| | - Sagun Tiwari
- Department of Neurology and Rehabilitation, Seventh People's Hospital of Shanghai University of TCM, Shanghai, P. R. China.,Shanghai University of TCM, Shanghai, P. R. China.,Life Care Hospital, Chitwan, Nepal
| | | |
Collapse
|
8
|
Bosi M, Malavolti M, Garuti C, Tondelli M, Marchesi C, Vinceti M, Filippini T. Environmental and lifestyle risk factors for early-onset dementia: a systematic review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022336. [PMID: 36533768 PMCID: PMC9828922 DOI: 10.23750/abm.v93i6.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/04/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIM The term early-onset dementia (EOD) encompasses several forms of neurodegenerative diseases characterized by symptom onset before 65 years and leading to severe impact on subjects already in working activities, as well as on their family and caregivers. Despite the increasing incidence, the etiology is still unknown, with possible association of environmental factors, although the evidence is still scarce. In this review, we aimed to assess how several environmental and lifestyle factors may be associated with the onset of this disease. METHODS We conducted a literature search in PubMed and EMBASE databases up to May 6, 2022, to retrieve epidemiological studies evaluating the effect of environmental and lifestyle factors on EOD risk. RESULTS We eventually included 22 studies, ten with cohort and twelve with case-control design. Traumatic injury, especially on the head/brain, some cardiovascular diseases such as atrial fibrillation and stroke, metabolic diseases including diabetes and hypercholesterolemia, and alcohol consumption have been identified as potential risk factors for EOD. Conversely, playing leisure activities including sports (without trauma), higher educational attainment and higher adherence to Mediterranean DASH-Intervention for Neurodegenerative Delay (MIND) diet appeared to be protective for EOD. CONCLUSIONS The literature on environmental risk factors for EOD has been considerably growing in recent years. Overall, it supports an association between some environmental and lifestyle factors with disease risk. However, additional high-quality research is required to confirm these relations and its causal nature (www.actabiomedica.it).
Collapse
Affiliation(s)
- Matteo Bosi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Garuti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy, Department of Neuroscience and Rehabilitation, Division of Neurology, University Hospital of Ferrara, Ferrara, Italy
| | - Manuela Tondelli
- Neurology Unit, Modena University Hospital, Baggiovara, Modena, Italy, Primary Care Department, Local Health Unit of Modena, Modena, Italy
| | - Cristina Marchesi
- Head Office, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy, Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| |
Collapse
|
9
|
Liu C, Xu M. Characteristics and Influencing Factors on the Hollowing of Traditional Villages-Taking 2645 Villages from the Chinese Traditional Village Catalogue (Batch 5) as an Example. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312759. [PMID: 34886484 PMCID: PMC8657079 DOI: 10.3390/ijerph182312759] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022]
Abstract
With the rapid development of urbanization and modernization, the population of traditional villages migrates into surrounding areas, causing the hollowing of traditional villages. The disintegration of China's traditional village means the loss of historical memory and cultural characteristics of ethnic regions, seriously endangering the country's cultural heritage. To better understand the hollowing phenomenon, this study analyzed 2645 villages from the Chinese traditional village catalogue (Batch 5) and evaluated different village attributes, including location, household registration, permanent population, number of traditional buildings, cultural relics, historical buildings, and non-heritage representative projects. We constructed an evaluation index system and used the entropy weight method, comprehensive evaluation method, and correlation analysis method to quantitatively assess the characteristics and influencing factors of hollowing among traditional Chinese villages. The main results are as follows: ① The hollowing index was above 0.5; most traditional villages have entered the stage of high hollowing. ② The traditional villages with hollowing index above 0.9 comprised 92%, and those between 0.8 and 0.9 made up 6%. Those with hollowing index at intervals 0.7-0.8, 0.6-0.7, and 0.5-0.6 accounted for 0.98%, 0.30%, and 0.11%, respectively. ③ Population hollowing is the fundamental cause of traditional village hollowing. In more than 99% of traditional villages, the population hollowing index was greater than 0.7. ④ More than 99% of traditional villages have a building hollowing index greater than 0.4, and more than 92% of the villages had a per capita number below 0.1. ⑤ The cultural hollowing rate for most traditional villages was very high. The cultural hollowing index for more than 99% of traditional villages was greater than 0.7. This study provides references for government administrators and scholars in rural revitalization and traditional village hollowing governance.
Collapse
Affiliation(s)
- Chunla Liu
- Key Laboratory of Geospatial Big Data Mining and Application, College of Geographic Sciences, Hunan Normal University, Changsha 410081, China
- Correspondence:
| | - Mei Xu
- College of Tourism, Central South University of Forestry and Technology, Changsha 410004, China;
| |
Collapse
|
10
|
Hawkey AB, Holloway Z, Dean C, Koburov R, Slotkin TA, Seidler FJ, Levin ED. Neurobehavioral anomalies in zebrafish after sequential exposures to DDT and chlorpyrifos in adulthood: Do multiple exposures interact? Neurotoxicol Teratol 2021; 87:106985. [PMID: 33901621 PMCID: PMC8440335 DOI: 10.1016/j.ntt.2021.106985] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 02/07/2023]
Abstract
A sequence of different classes of synthetic insecticides have been used over the past 70 years. Over this period, the widely-used organochlorines were eventually replaced by organophosphates, with dichlorodiphenyltrichloroethane (DDT) and chlorpyrifos (CPF) as the principal prototypes. Considerable research has characterized the risks of DDT and CPF individually, but little is known about the toxicology of transitioning from one class of insecticides to another, as has been commonplace for agricultural and pest control workers. This study used adult zebrafish to investigate neurobehavioral toxicity following 5-week chronic exposure to either DDT or CPF, to or their sequential exposure (DDT for 5 weeks followed by CPF for 5 weeks). At the end of the exposure period, a subset of fish were analyzed for brain cholinesterase activity. Behavioral effects were initially assessed one week following the end of the CPF exposure and again at 14 months of age using a behavioral test battery covering sensorimotor responses, anxiety-like functions, predator avoidance and social attraction. Adult insecticide exposures, individually or sequentially, were found to modulate multiple behavioral features, including startle responsivity, social approach, predator avoidance, locomotor activity and novel location recognition and avoidance. Locomotor activity and startle responsivity were each impacted to a greater degree by the sequential exposures than by individual compounds, with the latter being pronounced at the early (1-week post exposure) time point, but not 3-4 months later in aging. Social approach responses were similarly impaired by the sequential exposure as by CPF-alone at the aging time point. Fleeing responses in the predator test showed flee-enhancing effects of both compounds individually versus controls, and no additive impact of the two following sequential exposure. Each compound was also associated with changes in recognition or avoidance patterns in a novel place recognition task in late adulthood, but sequential exposures did not enhance these phenotypes. The potential for chemical x chemical interactions did not appear related to changes in CPF metabolism to the active oxon, as prior DDT exposure did not affect the cholinesterase inhibition resulting from CPF. This study shows that the effects of chronic adult insecticide exposures may be relevant to behavioral health initially and much later in life, and that the effects of sequential exposures may be unpredictable based on their constituent exposures.
Collapse
Affiliation(s)
- Andrew B Hawkey
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Zade Holloway
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Cassandra Dean
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Reese Koburov
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA
| | - Theodore A Slotkin
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Frederic J Seidler
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Edward D Levin
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA; Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC 27710, USA.
| |
Collapse
|
11
|
Farnham A, Fuhrimann S, Staudacher P, Quirós-Lépiz M, Hyland C, Winkler MS, Mora AM. Long-Term Neurological and Psychological Distress Symptoms among Smallholder Farmers in Costa Rica with a History of Acute Pesticide Poisoning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179021. [PMID: 34501611 PMCID: PMC8431685 DOI: 10.3390/ijerph18179021] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022]
Abstract
Studies suggest that acute pesticide poisonings (APP) may be linked with long-term neurological effects. To examine long-term neurological and psychological distress symptoms associated with having experienced an APP, we conducted a cross-sectional study of 300 conventional and organic smallholder farmers from Zarcero County, Costa Rica, May–August 2016. We collected self-reported data on sociodemographic characteristics, occupational history, pesticide exposure, APPs, neurological and psychological distress symptoms (using the Brief Symptom Inventory (BSI)). Adjusted logistic regression models were fit. A total of 14% of the farmers (98% male) reported experiencing at least one APP during their lifetime. Self-reported APP was associated with neurological symptoms during the 12 months prior to interview (e.g., fainting (Odds Ratio: 7.48, 95% Confidence Interval: 1.83, 30.74), shaking hands (3.50; 1.60, 7.60), numbness/tingling in hands or feet (3.23; 1.66, 6.32), insomnia (2.53; 1.34, 4.79), accelerated heartrate (2.42; 1.03, 5.47), dizziness (2.38; 1.19, 4.72), increased irritability/anger (2.37; 1.23, 4.55), low energy (2.33; 1.23, 4.46), and difficulty concentrating (2.01; 1.05, 3.85)). Farmers who reported an APP in the ten years prior to interview experienced increased odds of abnormal BSI scores for hostility (4.51; 1.16, 17.70) and paranoid ideation (3.76; 0.99, 18.18). Having experienced an APP may be associated with long-term neurological and psychological distress symptoms.
Collapse
Affiliation(s)
- Andrea Farnham
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland; (S.F.); (M.S.W.)
- Swiss TPH, University of Basel, Petersplatz 1, 4001 Basel, Switzerland
- Correspondence:
| | - Samuel Fuhrimann
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland; (S.F.); (M.S.W.)
- Swiss TPH, University of Basel, Petersplatz 1, 4001 Basel, Switzerland
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80177, 3508 TD Utrecht, The Netherlands
| | - Philipp Staudacher
- Swiss Federal Institute of Aquatic Science and Technology (Eawag), Ueberlandstrasse 133, 8600 Dübendorf, Switzerland;
- Institute of Biogeochemistry and Pollutant Dynamics, Department of Environmental Systems Science, ETH Zürich, Universitätstrasse 16, 8092 Zürich, Switzerland
| | - Marcela Quirós-Lépiz
- Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia 83-3000, Costa Rica; (M.Q.-L.); (C.H.); (A.M.M.)
| | - Carly Hyland
- Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia 83-3000, Costa Rica; (M.Q.-L.); (C.H.); (A.M.M.)
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California at Berkeley, 1995 University Avenue, Suite 265, Berkeley, CA 94720-7392, USA
| | - Mirko S. Winkler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland; (S.F.); (M.S.W.)
- Swiss TPH, University of Basel, Petersplatz 1, 4001 Basel, Switzerland
| | - Ana M. Mora
- Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia 83-3000, Costa Rica; (M.Q.-L.); (C.H.); (A.M.M.)
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California at Berkeley, 1995 University Avenue, Suite 265, Berkeley, CA 94720-7392, USA
| |
Collapse
|
12
|
Hossain MM, Belkadi A, Al-Haddad S, Richardson JR. Deltamethrin Exposure Inhibits Adult Hippocampal Neurogenesis and Causes Deficits in Learning and Memory in Mice. Toxicol Sci 2021; 178:347-357. [PMID: 32976580 DOI: 10.1093/toxsci/kfaa144] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Deficits in learning and memory are often associated with disruption of hippocampal neurogenesis, which is regulated by numerous processes, including precursor cell proliferation, survival, migration, and differentiation to mature neurons. Recent studies demonstrate that adult born neurons in the dentate gyrus (DG) in the hippocampus can functionally integrate into the existing neuronal circuitry and contribute to hippocampal-dependent learning and memory. Here, we demonstrate that relatively short-term deltamethrin exposure (3 mg/kg every 3 days for 1 month) inhibits adult hippocampal neurogenesis and causes deficits in learning and memory in mice. Hippocampal-dependent cognitive functions were evaluated using 2 independent hippocampal-dependent behavioral tests, the novel object recognition task and Morris water maze. We found that deltamethrin-treated mice exhibited profound deficits in novel object recognition and learning and memory in water maze. Deltamethrin exposure significantly decreased bromodeoxyuridine (BrdU)-positive cells (39%) and Ki67+ cells (47%) in the DG of the hippocampus, indicating decreased cellular proliferation. In addition, deltamethrin-treated mice exhibited a 44% decrease in nestin-expressing neural progenitor cells and a 38% reduction in the expression of doublecortin (DCX), an early neuronal differentiation marker. Furthermore, deltamethrin-exposed mice exhibited a 25% reduction in total number of granule cells in the DG. These findings indicate that relatively short-term exposure to deltamethrin causes significant deficits in hippocampal neurogenesis that is associated with impaired learning and memory.
Collapse
Affiliation(s)
- Muhammad M Hossain
- Department of Environmental Health Sciences, Robert Stempel College of Public Health & Social work, Florida International University, Miami, Florida 33199.,Department of Pharmaceutical Sciences, Center for Neurodegenerative Disease and Aging, Northeast Ohio Medical University, Rootstown, Ohio 44272
| | - Abdelmadjid Belkadi
- Department of Environmental Health Sciences, Robert Stempel College of Public Health & Social work, Florida International University, Miami, Florida 33199.,Department of Pharmaceutical Sciences, Center for Neurodegenerative Disease and Aging, Northeast Ohio Medical University, Rootstown, Ohio 44272
| | - Sara Al-Haddad
- Department of Pharmaceutical Sciences, Center for Neurodegenerative Disease and Aging, Northeast Ohio Medical University, Rootstown, Ohio 44272
| | - Jason R Richardson
- Department of Environmental Health Sciences, Robert Stempel College of Public Health & Social work, Florida International University, Miami, Florida 33199.,Department of Pharmaceutical Sciences, Center for Neurodegenerative Disease and Aging, Northeast Ohio Medical University, Rootstown, Ohio 44272
| |
Collapse
|
13
|
Park DW, Yang YS, Lee YU, Han SJ, Kim HJ, Kim SH, Kim JP, Cho SJ, Lee D, Song N, Han Y, Hee Kim H, Cho BS, Chung JK, Kim AG. Pesticide Residues and Risk Assessment from Monitoring Programs in the Largest Production Area of Leafy Vegetables in South Korea: A 15-Year Study. Foods 2021; 10:foods10020425. [PMID: 33672067 PMCID: PMC7919649 DOI: 10.3390/foods10020425] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 01/05/2023] Open
Abstract
Leafy vegetables are widely consumed in South Korea, especially in the form of kimchi and namul (seasoned vegetables) and are used for wrapping meat. Therefore, the management of pesticide residues in leafy vegetables is very important. A total of 17,977 samples (49 leafy vegetables) were mainly collected in the largest production area of leafy vegetables (Gwangju Metropolitan City and Chonnam Province) in South Korea. They were analyzed within the government's monitoring programs (Gwangju Metropolitan City) of pesticide residues between 2005 and 2019. Pesticide residues were found in 2815 samples (15.7%), and 426 samples (2.4%) from among these exceeded the specified maximum residue limits (MRLs). Samples exceeding the MRLs were mostly detected in spinach, ssamchoo (brassica lee ssp. namai), crown daisy, lettuce, and perilla leaves. Azoxystrobin, dimethomorph, and procymidone were the most frequently detected pesticides. However, procymidone, diniconazole, and lufenuron were found to most frequently exceed the MRLs. The rate of MRLs exceeding has been managed below the average (2.4%) more recently than in the past in this area. Further, leafy vegetables with the most violations of the MRLs in our study in South Korea were not harmful to health by a risk assessment (the range of the hazard index was 0.001-7.6%).
Collapse
Affiliation(s)
- Duck Woong Park
- Gakhwa Agricultural Products Inspection Center, Health and Environment Research Institute of Gwangju, 260, Dongmun-daero, Buk-gu, Gwangju 61138, Korea; (Y.S.Y.); (Y.-U.L.); (S.J.H.); (H.J.K.); (A.G.K.)
- Correspondence:
| | - Yong Shik Yang
- Gakhwa Agricultural Products Inspection Center, Health and Environment Research Institute of Gwangju, 260, Dongmun-daero, Buk-gu, Gwangju 61138, Korea; (Y.S.Y.); (Y.-U.L.); (S.J.H.); (H.J.K.); (A.G.K.)
| | - Yeong-Un Lee
- Gakhwa Agricultural Products Inspection Center, Health and Environment Research Institute of Gwangju, 260, Dongmun-daero, Buk-gu, Gwangju 61138, Korea; (Y.S.Y.); (Y.-U.L.); (S.J.H.); (H.J.K.); (A.G.K.)
| | - Sue Ji Han
- Gakhwa Agricultural Products Inspection Center, Health and Environment Research Institute of Gwangju, 260, Dongmun-daero, Buk-gu, Gwangju 61138, Korea; (Y.S.Y.); (Y.-U.L.); (S.J.H.); (H.J.K.); (A.G.K.)
| | - Hye Jin Kim
- Gakhwa Agricultural Products Inspection Center, Health and Environment Research Institute of Gwangju, 260, Dongmun-daero, Buk-gu, Gwangju 61138, Korea; (Y.S.Y.); (Y.-U.L.); (S.J.H.); (H.J.K.); (A.G.K.)
| | - Sun-Hee Kim
- Seobu Agro-Fishery Products Inspection Center, Health and Environment Research Institute of Gwangju, 16, Maewol 2-ro, Seo-gu, Gwangju 62072, Korea; (S.-H.K.); (J.P.K.); (S.J.C.); (D.L.); (N.S.); (Y.H.); (H.H.K.)
| | - Jong Pil Kim
- Seobu Agro-Fishery Products Inspection Center, Health and Environment Research Institute of Gwangju, 16, Maewol 2-ro, Seo-gu, Gwangju 62072, Korea; (S.-H.K.); (J.P.K.); (S.J.C.); (D.L.); (N.S.); (Y.H.); (H.H.K.)
| | - Sun Ju Cho
- Seobu Agro-Fishery Products Inspection Center, Health and Environment Research Institute of Gwangju, 16, Maewol 2-ro, Seo-gu, Gwangju 62072, Korea; (S.-H.K.); (J.P.K.); (S.J.C.); (D.L.); (N.S.); (Y.H.); (H.H.K.)
| | - Davin Lee
- Seobu Agro-Fishery Products Inspection Center, Health and Environment Research Institute of Gwangju, 16, Maewol 2-ro, Seo-gu, Gwangju 62072, Korea; (S.-H.K.); (J.P.K.); (S.J.C.); (D.L.); (N.S.); (Y.H.); (H.H.K.)
| | - Nanju Song
- Seobu Agro-Fishery Products Inspection Center, Health and Environment Research Institute of Gwangju, 16, Maewol 2-ro, Seo-gu, Gwangju 62072, Korea; (S.-H.K.); (J.P.K.); (S.J.C.); (D.L.); (N.S.); (Y.H.); (H.H.K.)
| | - Yujin Han
- Seobu Agro-Fishery Products Inspection Center, Health and Environment Research Institute of Gwangju, 16, Maewol 2-ro, Seo-gu, Gwangju 62072, Korea; (S.-H.K.); (J.P.K.); (S.J.C.); (D.L.); (N.S.); (Y.H.); (H.H.K.)
| | - Hyo Hee Kim
- Seobu Agro-Fishery Products Inspection Center, Health and Environment Research Institute of Gwangju, 16, Maewol 2-ro, Seo-gu, Gwangju 62072, Korea; (S.-H.K.); (J.P.K.); (S.J.C.); (D.L.); (N.S.); (Y.H.); (H.H.K.)
| | - Bae-Sik Cho
- Health and Environment Research Institute of Gwangju, 584, Mujin-daero, Seo-gu, Gwangju 61954, Korea; (B.-S.C.); (J.K.C.)
| | - Jae Keun Chung
- Health and Environment Research Institute of Gwangju, 584, Mujin-daero, Seo-gu, Gwangju 61954, Korea; (B.-S.C.); (J.K.C.)
| | - Ae Gyeong Kim
- Gakhwa Agricultural Products Inspection Center, Health and Environment Research Institute of Gwangju, 260, Dongmun-daero, Buk-gu, Gwangju 61138, Korea; (Y.S.Y.); (Y.-U.L.); (S.J.H.); (H.J.K.); (A.G.K.)
| |
Collapse
|
14
|
Liu L, Zhang C, Lv X, Lai X, Xu L, Feng J, Song Y, Wang S, Zhan S. Sex-specific associations between lipids and cognitive decline in the middle-aged and elderly: a cohort study of Chinese adults. ALZHEIMERS RESEARCH & THERAPY 2020; 12:164. [PMID: 33287901 PMCID: PMC7722300 DOI: 10.1186/s13195-020-00731-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/23/2020] [Indexed: 11/19/2022]
Abstract
Background Studies regarding the lipid-cognition relationship have increasingly gained popularity but have generated much mixed results. To date, few studies have focused on the difference between sexes. Methods This study included 6792 Chinese adults aged over 45 years (women, 48.56%; mean age, 57.28 years), who were free of severe conditions known to affect cognitive function at the baseline (2011). Blood concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and triglycerides (TG) were assessed at baseline, and both continuous and categorical values were used in final analyses. Global cognitive functions were assessed by the word recall test and the mental status test in 2011, 2013, and 2015, respectively. We graded participants into three groups according to the cognitive change slopes: no decline (≥ 0), moderate decline (median to 0), and severe decline (< median). Sex-specific associations between blood lipids and cognitive decline were analyzed using ordinal logistic models, adjusting for sociodemographic information, lifestyle behaviors, and health status. Results Higher baseline TC and LDL-C concentrations exhibited no significant association with 5-year cognitive decline in men but were significantly associated with greater 5-year cognitive decline in women [odds ratio (OR) 1.026, 95% confidence interval (CI) 1.003, 1.050; OR 1.026, CI 1.002, 1.051, respectively]. For higher serum HDL-c levels, a significantly protective effect on cognition was observed in men, but a slightly adverse effect was found in women (not significant after Bonferroni correction). TG presented almost no effect on later cognition in either sex. Conclusion Different associations between sexes were observed for the lipid-cognition relationship, and maintaining serum cholesterol levels at an appropriate range may have a positive effect on cognitive health.
Collapse
Affiliation(s)
- Lili Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Chen Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jing 5 road, Huaiyin District, Jinan, 250021, China
| | - Xiaozhen Lv
- Beijing Dementia Key Laboratory, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital (Institute of Mental Health), 51 Huayuanbei Road, Haidian District, Beijing, 100191, China
| | - Xuefeng Lai
- School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Lu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jingnan Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yongfeng Song
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jing 5 road, Huaiyin District, Jinan, 250021, China.
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China. .,Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China. .,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, 100191, China.
| |
Collapse
|
15
|
Park S, Choi JR, Kim SK, Lee S, Lee K, Kim JY, Oh SS, Koh SB. Increased risk of atherosclerosis associated with pesticide exposure in rural areas in Korea. PLoS One 2020; 15:e0232531. [PMID: 32357160 PMCID: PMC7194402 DOI: 10.1371/journal.pone.0232531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 04/16/2020] [Indexed: 12/15/2022] Open
Abstract
Atherosclerosis is a progressive inflammation in systemic vessels, and pesticide exposure has been emerging as its risk factor. This cross-sectional study investigated the association between pesticide exposure and the risk of atherosclerosis in a rural population in Korea using carotid intima-media thickness (CIMT). This study used dataset from the baseline survey of the Korea Farmers Cohort Study between November 2005 and January 2008, and the final analysis included 477 participants. Well-structured questionnaires were used to estimate pesticide exposure. CIMT ≥ 0.9 mm was established for carotid atherosclerosis. Multiple logistic regression analyses were undertaken to evaluate the association between pesticide exposure and atherosclerosis, adjusting demographic and health-related confounders. Even after adjustments, the increased risk of atherosclerosis was significantly associated with pesticide exposure, such as a lifetime history of farming (odds ratio [OR] 3.25 95% confidence interval [CI] 1.51–6.98), a history of using pesticide (OR 3.42 95% CI 1.63–7.16), using pesticide 10 times or more annually (OR 2.55 95% CI 1.21–5.39), and higher cumulative exposure index level (OR 3.63 95% CI 1.65–7.97). Further prospective studies are required to elucidate effects of pesticide exposure on the risk of atherosclerosis.
Collapse
Affiliation(s)
- Sungjin Park
- Department of Occupational and Environmental Medicine, Cheonan Medical Center, Cheonan, Korea
| | - Jung Ran Choi
- Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung-Kyung Kim
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Institute of Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Solam Lee
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyungsuk Lee
- National Academy of Agricultural Science, Rural Development Administration, Jeonju, Korea
| | - Jang-Young Kim
- Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Division of Cardiology, Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung-Soo Oh
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Institute of Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sang-Baek Koh
- Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Institute of Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
- Center for Global Health and Social Medicine, Institute of Poverty Alleviation and International Development, Yonsei University, Wonju, Korea
- * E-mail:
| |
Collapse
|
16
|
|