Ambient Air Pollution Increases the Risk of Cerebrovascular and Neuropsychiatric Disorders through Induction of Inflammation and Oxidative Stress

Sensitive periods for exposure to indoor air pollutants and psychosocial factors in association with symptoms of psychopathology at school-age in a South African birth cohort

Exposure to environmental toxicants and psychosocial stressors during gestation and early life are particularly harmful and may impact brain development. Specifically, exposure to indoor air pollutants (IAP) and psychosocial factors (PF) during these sensitive periods has been shown to predict childhood psychopathology. Here, we investigated sensitive periods for the individual and joint effects of IAP and PF on childhood psychopathology at 6.5 years. We analyzed data from the Drakenstein Child Health Study (N = 599). Exposure to IAP and PF was measured during the second trimester of pregnancy and 4 months postpartum. Childhood psychopathology was assessed at 6.5 years old using the Childhood Behavior Checklist (CBCL). We investigated individual effects of pre- and postnatal exposure to IAP and PF on CBCL scores using adjusted linear regression models, and joint effects of exposures using quantile g-computation and self-organizing maps (SOM). To identify possible sensitive periods, we used a structured life course modeling approach (SLCMA) as well as SOM. Prenatal exposure to IAP or PFs, and the total prenatal mixture assessed using quantile g-computation, were associated with increased psychopathology. SLCMA and SOM models also indicated that the prenatal period is a sensitive period for IAP exposure on childhood psychopathology. Depression and alcohol were associated in both the pre- and postnatal period. In conclusion, pregnancy may be a sensitive period for the effect of IAP on psychopathology. Exposure to maternal depression and alcohol in both periods was also associated with psychopathology. Determining sensitive periods of exposure is vital to ensure effective interventions to reduce psychopathology.

Ambient air pollution and depressed mood in the National Longitudinal Study of Adolescent to Adult Health (Add Health) wave 4

Depression is a major contributor to the global burden of disease. There is limited understanding of how environmental exposures may contribute to depression etiology. We used wave 4 of the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine associations between low-level ambient air pollution exposure and depressed mood in a generally healthy population of over 10 000 24-32 year olds. Annual mean PM2.5 levels in the 2008-2009 study were close to the current US standard. In fully adjusted quasibinomial logistic regression models, there were no meaningful associations between IQR increases in air pollutant and change in depressed mood status regardless of specific pollutant or moving average lags. In interaction effects models, an IQR increase in lag day 0-30 PM2.5 resulted in 1.20 (95% CI, 1.02-1.41) times higher likelihood of having depressed mood but only for persons with chronic lung disease (interaction P = .04); the association was null for participants without chronic lung disease (OR, 0.98; 95% CI, 0.91-1.05). Our findings suggest that among persons with a lifetime history of chronic lung disease, greater exposure to even low-level PM2.5, PM10, and sulfate may be associated with modest increases in the likelihood of having depressed mood. This article is part of a Special Collection on Environmental Epidemiology.

Short-term exposure to PM2.5 and high pollution events on depressive symptoms among adolescents

Association between short-term exposure to fine particulate matter (PM2.5) and adolescent depressive symptoms is an under-investigated area and is worthy of further research. Based on a government surveillance data for 195,687 Chinese adolescents, the mixed-effects logistic regression combined with a distributed lag nonlinear model was used to assess the cumulative effect of PM2.5 exposure on depressive symptoms. In addition, high pollution events were defined according to World Health Organization (WHO) air quality guidelines (AQGs) and the Chinese ambient air quality standards, and the associations of increased high pollution events with depressive symptoms and the associated excess risk were estimated. Our results showed that association between short-term exposure to PM2.5 and depressive symptoms was most significant at lag 0 weeks, with each 10 μg/m3 increase in PM2.5 concentration associated with a 3.11 % (95 % CI: 0.70 %, 5.58 %) change in ORs for depressive symptoms. High pollution events were found to contribute to a maximum 3.12 % (95 % CI: 0.52 %, 5.74 %) excess risk of depressive symptoms when defined as 24-hour average PM2.5 concentration exceeding 37.5 μg/m3, WHO AQG interim target 3. Our results highlight the importance of air quality improvement for adolescent depression prevention, and recommend increased psychological support during high pollution events.

Effect of environmental pollutants particulate matter (PM2.5, PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (NO) and ground level ozone (O3) on epilepsy

BACKGROUND

Epilepsy is a common condition that affects the brain and causes frequent seizures. Impaired brain biology is the world's fastest-growing brain disorder, and exposure to environmental pollutants is the leading cause of mental health impairment. The growing literature suggests that air pollution is an emerging cause of neurological diseases. However, the existing evidence on air pollution and epilepsy is inadequate. This study aimed to investigate the effect of environmental pollutants particulate matter (PM2.5, PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (NO) and ground-level ozone (O3) on epilepsy.

METHODS

This study recorded data on air pollutants and epilepsy using the electronic platforms Pub Med, Web of Science, Scopus, and Google Scholar. The keywords included for the literature search were based on two main aspects: exposure (air pollutants) and outcome (epilepsy). Initially, 78 articles and reports were identified, and after revising the abstracts and full articles, 06 studies were selected for a detailed analysis and discussion. The Odds Ratio (OR) and 95% confidence intervals (CIs) were extracted to investigate the impact between air pollutants and epilepsy. The effect of air pollution on epilepsy has been investigated through a compilation of six studies encompassing 371,515 individuals. The Cochrane chi-squared test (Chi2), fixed-effects design was used when I2 < 50% and P > 0.05; otherwise, a random-effects model was adopted.

RESULTS

The results revealed that exposure to PM2.5 and NO2 were positively and significantly associated with epilepsy (RR = 1.00; 95% CI: 1.00-1.01; p = 0.03), NO2 (RR = 1.03; 95% CI: 1.02-1.03; p < 0.01). However, no association was identified between PM10, SO2, CO, and O3 with epilepsy. The results suggest a potential association between air pollution exposure and epilepsy.

CONCLUSIONS

Air pollutants PM2.5 and NO2 increase the risk of epilepsy. The findings suggest that reducing levels of these pollutants could be a strategic approach to mitigate neurological health risks in populations worldwide. Further research is warranted to elucidate the mechanisms and causal relationships between air pollutants and epilepsy. Public health initiatives aimed at reducing air pollution levels and targeted interventions to protect vulnerable populations hold promise for alleviating the burden of epilepsy associated with environmental exposures.

Particulate matter, socioeconomic status, and cognitive function among older adults in China

BACKGROUND

Both air pollution and low socioeconomic status (SES) are associated with worse cognitive function. The extent to which low SES may compound the adverse effect of air pollution on cognitive function remains unclear.

METHODS

7,087 older adults aged 65 and above were included from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and followed up in 4 waves during 2008-2018. Cognitive function was measured repeatedly at each wave using the modified Chinese Mini-Mental State Examination (MMSE). Concentrations of particulate matter (PM1, PM2.5, and PM10) were evaluated using satellite-based spatiotemporal models. SES was measured based on five components and categorized into three levels (low, middle, and high). Generalized estimating equation models were used to estimate the association of PM and SES with cognitive function. Stratified analyses and effect modification by SES levels were further conducted.

RESULTS

Each 10 µg/m3 increase in PM1, PM2.5, and PM10 was associated with a 0.43 (95 % CI: -0.58, -0.27), 0.29 (95% CI: -0.37, -0.20), and 0.17 (95 % CI: -0.22, -0.13) unit decrease in MMSE scores, respectively. Lower SES was associated with worse cognitive function. Significant effect modifications were observed by SES, with the corresponding association of PM exposure being more pronounced among participants with a lower SES (p-interaction = 0.006, 0.001, and 0.006 for PM1, PM2.5, and PM10, respectively).

CONCLUSIONS

SES is an important effect modifier, and lower SES may compound the detrimental effect of PM on cognitive health. This finding may have implications for identifying vulnerable populations and targeted interventions against air pollution.

Moderating effect of green space on relationship between atmospheric particulate matter and cardiovascular and cerebrovascular disease mortality in Ningxia, China

OBJECTIVE

This study explores the moderating effect of green space on the association between atmospheric particulate matter (PM) and cardiovascular and cerebrovascular disease (CCVD) mortality.

METHODS

Data on CCVD mortality, PM, meteorological factors, and the Normalized Difference Vegetation Index (NDVI) of green spaces in Ningxia from 2010 to 2020 were collected. A time-series generalized additive mixed-effect model (GAMM) was applied to analyze the exposure-response relationship between PM and CCVD mortality. The moderating effect of green spaces was examined using green space buffers of different radii (300 m, 500 m, 1000 m, and 2000 m) and density.

RESULTS

There were 150,356 CCVD deaths in Ningxia during the study period. The annual mean concentrations of PM2.5 and PM10 were 44.44 μg/m³ and 105.30 μg/m³, respectively, with an annual mean NDVI value of 0.25 within a 500 m radius buffer. An increase of 10 μg/m³ in PM2.5 and PM10 concentrations was significantly associated with an elevated risk of CCVD mortality, with the strongest excess risk (ER) observed at lag07 lag. The ER for PM2.5 was 1.43% (95% CI: 0.97%, 1.89%), and for PM10 was 0.55% (95% CI: 0.38%, 0.72%). The interaction analysis indicated that higher green space density could moderate the association between PM exposure and CCVD mortality risk. and as the green space buffer zone expanded, the interaction on CCVD mortality risk progressively strengthened. The independent moderation analysis indicated that an increase in green space buffer zone was associated with a reduced risk, and as green space density increased from Q1 to Q3, the ER for PM2.5-related CCVD mortality decreased from 1.56% to 0.6%, while the ER for PM10-related CCVD mortality decreased from 0.53% to 0.09%. In conclusion, atmospheric PM is associated with increased CCVD mortality risk, while larger green space buffers and higher green space density significantly moderated this association.

Air pollution increases the risk of frailty: China Health and Retirement Longitudinal Study (CHARLS)

The longitudinal association between multiple air pollutants and frailty risk remains unexplored, and it is unclear which factors may modify this relationship. Using data from 10,584 Chinese adults aged 45 years and older in the 2011-2020 waves of the China Health and Retirement Longitudinal Study (CHARLS), we investigated whether exposure to PM1, PM2.5, PM10, O3, and NO2 affects frailty over a median follow-up of seven years. Air pollutant data were obtained from the China High Air Pollutants (CHAP) dataset, and frailty was assessed using a 44-item Frailty Index (FI ≥ 0.25). Time-varying Cox proportional hazards models, adjusted for demographic, socioeconomic, and behavioral factors, indicated that each 10 μg/m³ increase in PM1, PM2.5, PM10, and NO2 corresponded to a 7.8 %, 4.2 %, 3.8 %, and 12.9 % higher risk of frailty, respectively, while O3 showed no significant association. Individuals who were sufficiently active appeared less affected by pollution, whereas those with no formal education were more vulnerable. Implementing future policies and interventions to reduce air pollution can potentially decrease the risk of frailty and promote healthy ageing.

DNA methylation of core clock genes in patients with major depressive disorder: Association with air pollution exposure and disease severity

BACKGROUND

Major Depressive Disorder (MDD) is a multifactorial disease which could be influenced by exposure to air pollution through disruption of sleep-wake cycles and other circadian-related behaviors. Our study aimed to investigate the interplay between air pollution exposure, DNA methylation of core clock genes involved in circadian rhythms, and MDD severity.

METHODS

Four hundred sixteen MDD patients (64 % females) agreed to participate and donated a blood sample to measure DNA methylation of the core clock genes CRY1, PER1, PER2, CLOCK, BMAL1. MDD severity and functioning was assessed using five rating scales. Daily mean estimates of particulate matter with diameter ≤ 2.5 μm (PM2.5) and nitrogen dioxide (NO2) were assigned to study participants based on their residential address, and averaged to estimate different cumulative exposure windows. Multivariate regression models were applied to assess associations between air pollutants and core clock genes methylation and between DNA methylation of those same genes and MDD severity.

RESULTS

PM2.5 exposure in the six months preceding recruitment was associated with CLOCK hypomethylation (β=-0.11, 95 % confidence interval [CI]:0.20; -0.02) and CRY1 hypermethylation (β=0.32, 95 %CI: 0.06; 0.58). All NO2 exposure windows were associated with CRY1 hypermethylation. Increasing methylation of CLOCK was associated with lower MDD severity considering several scales (e.g., Hamilton Depression Rating Scale: β=-7.21, 95 %CI:3.97; -0.44).

CONCLUSIONS

Taken together our findings shed some light on the complex mechanism underlying the pathogenesis of MDD, with a potentially relevant role of the environment and of its impact on epigenetic mechanisms altering the expression of core clock genes.

Association between household solid fuel use and cognitive frailty in a middle-aged and older Chinese population

Objectives

Our research intended to investigate the association between the solid fuels use and the risk of cognitive frailty (CF).

Methods

The research utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide longitudinal study focusing on individuals aged 45 and older. A total of 8,563 participants without CF were enrolled from 2011 and followed up to 2015. Household fuel types include solid fuels (such as coal, crop residue, or wood-burning) and clean fuels (such as solar power, natural gas, liquefied petroleum gas, electricity, or marsh gas). CF was defined as the co-existence of cognitive impairment and physical frailty. Cox proportional hazards models were utilized to evaluate the relationship between the solid fuels use and the risk of CF. Furthermore, sensitivity analyses were conducted.

Results

Over a median follow-up of 4.0 years, 131 subjects were diagnosed with CF. We observed that the solid fuels use for cooking or heating increased the risk of developing CF compared to clean fuels, with HRs of 2.02 (95% CI: 1.25 to 3.25) and 2.38 (95% CI: 1.26 to 4.48), respectively. In addition, participants who use solid fuel for heating (HR: 2.38 [95% CI: 1.26, 4.48]) and cooking (HR: 2.02 [95% CI: 1.25, 3.25]) might experience an increased risk of CF. However, transitioning from solid to clean fuels for cooking could potentially reduce these risks (HR: 0.38 [95% CI: 0.16, 0.88]).

Conclusion

Household solid fuels utilization was closely associated with the risk of CF.

The association between indoor air pollution from solid fuels and cognitive impairment: a systematic review and meta-analysis

This study aimed to comprehensively and methodically evaluate the correlation between cognitive impairment and indoor air pollution from solid fuel used for cooking/heating. PubMed, Web of Science, EMBASE, and Cochrane Library databases were searched up to December January 2023. 13 studies from three countries with a total of 277,001 participants were enrolled. A negative correlation was discovered between solid fuel usage for cooking and total cognitive score (β=-0.73, 95 % CI: -0.90 to -0.55) and episodic memory score (β=-0.23, 95 % CI: -0.30 to -0.17). Household solid fuel usage for cooking was considerably associated with a raised risk of cognitive impairment (HR=1.31, 95 % CI: 1.09-1.57) and cognitive decline (HR=1.24, 95 % CI: 1.18-1.30). Compared to continuous solid fuel use for cooking, sustained use of clean fuel and switching from solid fuel to clean fuel were associated with a lower risk of cognitive decline (OR=0.55, 95 % CI: 0.42-0.73; OR=0.81, 95 % CI: 0.71-0.93). A negative association was found between solid fuel usage for heating and total cognitive score (β=-0.43, 95 % CI: -0.59 to -0.26) and episodic memory score (β=-0.22, 95 % CI: -0.34 to -0.10). Our research provided evidence that exposure to indoor air pollution from solid fuel is a potential cause of cognitive impairment and cognitive decline. Making the switch from solid fuels to cleaner fuels could be an important step in preventing cognitive impairment in the elderly.

Associations between short-term exposure to fine particulate matter with ischemic stroke mortality and the role of green space: a time-series study in Zibo, China

Background

Previous studies on associations between short-term exposure to fine particulate matter (PM2.5) and ischemic stroke (IS) mortality reported inconclusive results. Additionally, whether and how PM2.5 and green space interact to precipitate IS deaths remains unclear. We aimed to examine the impacts of short-term exposure to PM2.5 on IS mortality and the role of green space in the association.

Methods

We collected data on daily IS deaths, daily PM2.5 concentrations, and monthly normalized difference vegetation index (NDVI) in Zibo City from 2015 to 2019. Generalised additive models were adopted to investigate the short-term impacts of PM2.5 on IS mortality, and subgroup analyses were used to examine effect modification by population characteristics. Stratified analyses by green space levels and joint effect model were conducted to test the interactions of PM2.5 and green space on IS mortality.

Results

A total of 10 799 IS deaths were included in our study. Exposure to PM2.5 was associated with an increased risk of IS mortality, with odds ratios (ORs) of 1.0263 (95% confidence interval (CI) = 1.0017, 1.0516) for each interquartile range (IQR) increase in PM2.5 on lag0 and 1.0317 (95% CI = 1.0016, 1.0627) on lag01. The links between PM2.5 and IS mortality were not significantly different across genders, ages, or PM2.5 zones. Furthermore, our results showed that the effects of PM2.5 on IS mortality were higher in low levels of green space. Specifically, for each IQR increase in PM2.5, the ORs (95% CIs) of IS death in the low level and the high level of NDVI were 1.0287 (95% CI = 1.0019, 1.0563) and 0.9934 (95% CI = 0.9296, 1.0615), respectively. In addition, PM2.5 and NDVI exhibited significant interactive effects on IS mortality, with relative excess odds due to interaction (REOI) of greater than 0.

Conclusions

Our findings showed that PM2.5 was significantly associated with increasing odds of IS mortality. Furthermore, there were synergetic impacts between PM2.5 and lack of greenness on IS mortality. Our results suggest that expanding green spaces, such as increasing park coverage and street greening, along with regulating industrial emissions to reduce PM2.5 levels, can help prevent premature deaths from IS.

Oxidative Stress: A New Pathophysiological Pathway in Parkinson's Disease and a Potential Target of the Brain-Sport Crosstalk

Oxidative stress (OS), a condition that occurs when the balance between reactive oxygen species production and antioxidant defense mechanisms is disrupted, has been implicated in the pathogenesis of several neurological conditions, including neurodegenerative and vascular disorders. Ferroptosis is a mechanism mediating OS-induced damage, with growing evidence of specific involvement in both Parkinson's disease (PD) and ischemic stroke. Regular physical activity may have an antioxidant effect by increasing the production and activity of nonenzymatic and enzymatic antioxidants. Among the biological mediators of physical activity, irisin may act as an agent capable of inducing systemic changes and crossing the brain-blood barrier. This review aims to describe the main role of OS in the pathophysiology of PD, highlighting putative neurodegenerative mechanisms and emphasizing the potential targeting by physical activity as a possible shared preventive and symptomatic treatment approach.

A systematic review of air pollution exposure and brain structure and function during development

OBJECTIVES

Air pollutants are known neurotoxicants. In this updated systematic review, we evaluate new evidence since our 2019 systematic review on the effect of outdoor air pollution exposure on childhood and adolescent brain structure and function as measured by magnetic resonance imaging (MRI).

METHODS

Using PubMed, Web of Science, and Scopus we conducted an updated literature search and systematic review of articles published through January 2025, using key terms for air pollution and functional and/or structural MRI. Two raters independently screened all articles using Covidence and implemented the risk of bias instrument for systematic reviews used to inform the World Health Organization Global Air Quality Guidelines.

RESULTS

We identified 29 relevant papers, and 20 new studies met our inclusion criteria. Including six studies from our 2019 review, the 26 publications to date include study populations from the United States, Netherlands, Spain, and United Kingdom. Studies investigated exposure periods spanning pregnancy through early adolescence, and estimated air pollutant exposure levels via personal monitoring, geospatial residential estimates, or school courtyard monitors. Brain MRI occurred when children were on average 6-14.7 years old; however, one study assessed newborns. Several MRI modalities were leveraged, including structural morphology, diffusion tensor imaging, restriction spectrum imaging, arterial spin labeling, magnetic resonance spectroscopy, as well as resting-state and task-based functional MRI. Air pollutants were associated with widespread brain differences, although the magnitude and direction of findings are largely inconsistent, making it difficult to draw strong conclusions.

CONCLUSION

Prenatal and childhood exposure to outdoor air pollution is associated with structural and functional brain variations. Compared to our initial 2019 review comprised of only cross-sectional studies, the current literature now includes longitudinal studies and more advanced neuroimaging methods. Further research is needed to clarify the effects of developmental timing, along with the downstream implications of outdoor air pollution exposure on children's cognitive and mental health.

Durational effect of ambient air pollution on hospital admissions of schizophrenia: a time series analysis

BACKGROUND

Schizophrenia may be exacerbated by ambient air pollution. In this study, we aim to explore the association of air pollution with hospital admission for schizophrenia in Liuzhou, China.

METHODS

The daily concentration of air pollutants was gathered from an average of seven fixed monitoring sites in Liuzhou, while the daily admission data for schizophrenia was received from The Guangxi Zhuang Autonomous Region Brain Hospital. A Poisson generalized linear regression model in conjunction with a distributed lag nonlinear model was utilized to quantify the exposure-lag-response connection between ambient air pollution and schizophrenia hospitalization. The stratification analysis was then carried out by age, gender, and season.

RESULTS

PM2.5, PM10, and SO2 was significantly associated with elevated number of schizophrenia hospitalization. We observed the largest single-day effects of PM2.5 at lag 17 day, PM10 at lag 17 day, and SO2 at lag 28 day, with the corresponding RRs being 1.01611 (95% CI:1.00652-1.02579), 1.01648 (95% CI:1.00603-1.02704), and 1.02001 (95% CI: 1.00001-1.04041), respectively. Stratification analysis revealed that patients who were < 45 years old and female were more vulnerable to hospitalization due to exposure to PM2.5 and PM10. The effects of PM2.5 and PM10 were more noticeable during the cooler seasons than during the warmer one.

CONCLUSIONS

This study reveals that being exposed to PM2.5, PM10, and SO2 may increase the chance of schizophrenia hospitalization.

Ambient Air Pollution and Parkinson's Disease and Alzheimer's Disease: An Updated Meta-Analysis

BACKGROUND

Previous epidemiological evidence regarding the associations between ambient air pollution and two major neurodegenerative diseases, Alzheimer's disease (AD) and Parkinson's disease (PD), remains inconclusive.

OBJECTIVE

This study aimed to evaluate the associations between long-term and short-term exposure to PM2.5 and PM10 (i.e., particulate matter with an aerodynamic diameter of, or smaller than, 2.5 μm or 10 μm), nitrogen dioxide (NO2), ozone, sulfur dioxide, and carbon monoxide and the risks of AD and PD.

METHODS

A random-effects model was used to summarize individual effect estimates in the meta-analysis. A subgroup meta-analysis was further conducted to explore the potential sources of heterogeneity.

RESULTS

In total, 42 eligible studies were included. For each 5 μg/m3 increase in long-term PM2.5 exposure, the odds ratios (ORs) were 1.16 (95% CI: 1.04, 1.30; I2 = 95%) and 1.10 (95% CI: 1.03, 1.17; I2 = 95%) for AD and PD, respectively. For each 5 μg/m3 increase in short-term PM2.5 exposure, the OR was 1.01 (95% CI: 1.002, 1.01; I2 = 77%) for PD. For each 1 ppb increase in long-term NO2 exposure, the OR was 1.01 (95% CI: 1.0002, 1.02; I2 = 79%) for PD.

CONCLUSION

Ambient air pollution, particularly PM2.5, may contribute to the increased risks of neurodegenerative diseases including AD and PD.

Burden of disease in Germany attributed to ambient particulate matter pollution : Findings from the Global Burden of Disease Study 2019

INTRODUCTION

Ambient fine particulate matter pollution with a diameter less than 2.5 micrometers (PM2.5) is a significant risk factor for chronic noncommunicable diseases (NCDs), leading to a substantial disease burden, decreased quality of life, and deaths globally. This study aimed to investigate the disease and mortality burdens attributed to PM2.5 in Germany in 2019.

METHODS

Data from the Global Burden of Disease (GBD) Study 2019 were used to investigate disability-adjusted life-years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), and deaths attributed to ambient PM2.5 pollution in Germany.

RESULTS

In 2019, ambient PM2.5 pollution in Germany was associated with significant health impacts, contributing to 27,040 deaths (2.82% of total deaths), 568,784 DALYs (2.09% of total DALYs), 135,725 YLDs (1.09% of total YLDs), and 433,058 YLLs (2.92% of total YLLs). The analysis further revealed that cardiometabolic and respiratory conditions, such as ischemic heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and diabetes mellitus, were the leading causes of mortality and disease burden associated with ambient PM2.5 pollution in Germany from 1990-2019. Comparative assessments between 1990 and 2019 underscored ambient PM2.5 as a consistent prominent risk factor, ranking closely with traditional factors like smoking, arterial hypertension, and alcohol use contributing to deaths, DALYs, YLDs, and YLLs.

CONCLUSION

Ambient PM2.5 pollution is one of the major health risk factors contributing significantly to the burden of disease and mortality in Germany, emphasizing the urgent need for targeted interventions to address its substantial contribution to chronic NCDs.

What is the relationship between exposure to environmental pollutants and severe mental disorders? A systematic review on shared biological pathways

Severe mental disorders are multi-dimensional constructs, resulting from the interaction of genetic, biological, psychosocial, and environmental factors. Among the latter, pollution and climate change are frequently being considered in the etiopathogenesis of severe mental disorders. This systematic review aims to investigate the biological mechanisms behind the relationship between environmental pollutants, climate change, and mental disorders. An extensive literature search was performed on PubMed, Scopus, and APA PsycInfo databases according to the PRISMA guidelines. Articles were considered eligible if they involved humans or animals examining the association between exposure to environmental pollutants and if the resulting biological mechanisms that may have an impact on mental health and may support or even cause severe mental disorders (SMD) are assessed. For this reason, only studies dealing with biomarkers or biological pathways were taken into account. The 47 papers included in the review were divided into two groups: those conducted on human participants (15 studies) and those utilizing animal models (31 studies); one study included both humans and animals. Studies carried out with humans, which are mainly focused on measuring the impact of particulate matter (PM2.5 and PM10) exposure on mental health, showed an increased risk of depression or psychotic relapses through the inflammation and oxidative stress pathways, or through the alteration of the hypothalamic-pituitary-adrenal (HPA) axis. Animal models showed the potential impact of pollution on brain functioning through increased inflammatory responses, oxidative stress, HPA axis disruption, hippocampal damage, and neurotransmitters dysregulation. Our findings show that environmental pollutants have an impact on human mental health through different biological pathways. The biological mechanisms by which environmental pollution and climate change influence the onset and exacerbation of severe mental disorders are complex and include gene expression, inflammation, oxidative stress, and anatomical brain changes. A better understanding of those pathways is important for the progress of knowledge on the pathophysiology of severe mental disorders according to the one health model, that promotes a collaborative, multisectoral, and transdisciplinary approach across various levels to optimize health outcomes by recognizing the interconnectedness of humans, animals, plants, and their shared environment.

Long-term exposure to low-concentration sulfur dioxide and mental disorders in middle-aged and older urban adults

The World Health Organization loosened the air quality guideline for daily sulfur dioxide (SO2) concentrations from 20 μg/m3 to 40 μg/m3. However, the guideline for SO2 concentrations in 2021 raised public concerns since there was no sufficient evidence that low-concentration SO2 exposure is harmless to the population's health, including mental health. We analyzed the associations between low-concentration SO2 exposure and incidence risks of total and cause-specific mental disorders, including depressive disorder, anxiety disorder, bipolar disorder, and schizophrenia spectrum disorder. 245,820 urban participants with low-concentration SO2 exposure (<8 μg/m3) at baseline were involved in the analyses from the UK Biobank. SO2 exposure (2006-2022) was estimated using high-resolution annual mean concentration maps from the Department for Environment, Food and Rural Affairs. Mental disorders and corresponding symptoms were identified using healthcare records and an online questionnaire, respectively. Associations were examined using both time-independent (2006-2010) and time-dependent (from 2006 to 2022) Cox regression models and logistic regression models with full adjustments for potential confounders. Stratification analyses were further conducted to identify vulnerable populations. Long-term exposure to low-concentration SO2 (per 1.36 μg/m3) was associated with increased risks of mental disorders, depressive disorder, and anxiety disorder with hazard ratios of 1.02 (95% confidence interval [CI]: 1.00, 1.03), 1.11 (95% CI: 1.07, 1.16), and 1.10 (95% CI: 1.06, 1.14) in the time-independent model, respectively. Associations were stronger for younger individuals. Additionally, the low-concentration SO2 exposure was linked to several psychiatric symptoms, such as trouble concentrating and restlessness, with odds ratios of 1.07 (95% CI: 1.04, 1.10) and 1.11 (95% CI: 1.07, 1.14), respectively. This study demonstrated significant associations of long-term exposure to low-concentration SO2 with mental disorders, highlighting the need for stricter regulations for SO2 to better protect public health and improve air quality in urban areas, in support of the Sustainable Development Goals.

Association between chronic ambient heavy metal exposure and mental health in Korean adult patients with asthma and the general population

BACKGROUND

Insufficient evidence is available to confirm the effect of exposure to airborne metals on mental disorders, particularly among asthmatics. We aimed to investigate the effect of airborne metal exposure on mental health responses in asthmatics and the general population.

METHODS

Using nationally representative cross-sectional data, a total of 47,796 adults were analyzed. We assessed the associations between mental health factors, such as perceived stress, depressive symptoms, and suicidal ideation, and individuals' annual average exposure to airborne metals, including lead, cadmium, chromium, copper, manganese, and iron, over 14 years using multiple logistic regression. The associations were compared using the propensity score matching (PSM) method. The odds ratios (OR) and 95% confidence intervals (CI) for mental health outcomes were calculated for an interquartile range (IQR) increase in the concentration of each airborne metal.

RESULTS

Exposure to airborne metals was significantly associated with increased odds of adverse mental health in asthmatics. Significant associations between all ambient heavy metal contaminants and suicidal ideation were found in both asthmatic patients and the general population. After PSM, exposure to all ambient heavy metal contaminants showed significant associations with suicidal ideation in patients with asthma, whereas only iron exposure was significantly associated with suicidal ideation in the general population. After adjusting for perceived stress and depressive symptoms, similar patterns were also observed. Exposure to lead (OR: 1.99; 95% CI: 1.45-2.72) showed particularly a strong association with suicidal ideation in asthmatics.

CONCLUSIONS

This study suggests that exposure to airborne metals significantly increases depressive symptoms and suicidal ideation, especially in individuals with asthma. Additional clinical research is needed to better understand these associations.

Environmental Risk Factors for Parkinson's Disease: A Critical Review and Policy Implications

The age-standardized prevalence of Parkinson's disease (PD) has increased substantially over the years and is expected to increase further. This emphasizes the need to identify modifiable risk factors of PD, which could form a logical entry point for the prevention of PD. The World Health Organization (WHO) has recommended reducing exposure to specific environmental factors that have been reported to be associated with PD, in particular pesticides, trichloroethylene (TCE), and air pollution. In this review we critically evaluate the epidemiological and biological evidence on the associations of these factors with PD and review evidence on whether these putative associations are causal. We conclude that when considered in isolation, it is difficult to determine whether these associations are causal, in large part because of the decades-long lag between relevant exposures and the incidence of manifest PD. However, when considered in tandem with evidence from complementary research lines (such as animal models), it is increasingly likely that these associations reflect harmful causal effects. Fundamentally, whilst we highlight some evidence gaps that require further attention, we believe the current evidence base is sufficiently strong enough to support our call for stronger policy action. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Joint effect of modifiable risk factors on Parkinson's disease: a large-scale longitudinal study

Introduction

Previous researches have often underestimated the diversity and combined effects of risk factors for Parkinson's disease (PD). This study aimed to identify how multiple modifiable risk factors collectively impact PD.

Methods

The study included 452,492 participants from the UK Biobank, utilizing genetic data and 255 phenotypic variables. A broad exposure association study was conducted across seven domains: socioeconomic status, medical history, psychosocial factors, physical measures, early life, local environment, and lifestyle. Risk scores of each domain for each participant were generated. The joint effects of modifiable and genetic risks assessed using Cox proportional hazards model. Population attributable fraction (PAF) was estimated to quantify contribution ratio of risk factors in different domains to the occurrence of PD.

Results

Multiple risk factors significantly (p < 1.96 × 10-4) associated with PD was observed. The top 5 factors were hand grip strength (hazard ratio (HR) = 0.98, p = 1.59 × 10-24), long-standing illness (HR = 1.38, p = 3.63 × 10-20), self-reported nervousness (HR = 1.56, p = 5.9 × 10-20), ever suffered from mental health concerns (HR = 1.42, p = 5.48 × 10-18) and chest pain (HR = 1.42, p = 1.43 × 10-18). Individuals with unfavorable medical history, psychosocial factors, physical measures, and lifestyle had an increased risk of PD by 33 to 51% compared to those with favorable factors (p < 0.001).

Discussion

Results indicated that addressing modifiable risk factors, especially in physical measures and psychological factors, could potentially prevent up to 33.87% of PD cases. In formulating prevention strategies, it is recommended to prioritize domains such as physical measures, psychosocial factors, lifestyle, and medical history.

Association between air pollution and lifestyle with the risk of developing mild cognitive impairment and dementia in individuals with cardiometabolic diseases

Lifestyle factors and ambient air pollution are linked to dementia and CMDs, yet few studies have investigated their impact on dementia risk in CMDs patients at the same time. The Cox proportional hazards model was used to evaluate the influence of lifestyle and ambient air pollution on the dementia risk of the CMDs population among 438,681 participants in the UK Biobank. It is found that the risk of developing mild cognitive impairment and dementia in the population seems to increase with the increase in the number of CMDs. There appears to be a statistically significant association between high levels of ambient air pollution, unhealthy lifestyles, and a higher risk of developing mild cognitive impairment and dementia in the CMDs population. It is found that a healthy lifestyle may have an effect modifier role in the association between ambient air pollution and the risk of mild cognitive impairment and the development of dementia in patients with CMDs. Therefore, maybe people with CMDs can lessen the impact of ambient air pollution on their risk of developing mild cognitive impairment and dementia by improving their lifestyle.

Impact of air pollution on depressive symptoms and the modifying role of physical activity: Evidence from the CHARLS study

The association between air pollution and depressive symptoms has not been thoroughly investigated, and the role of physical activity (PA) is particularly unclear. Although PA has been shown to alleviate depression, it may also increase exposure to air pollution, potentially exacerbating its adverse effects. A total of 17,332 participants aged 45 years and older from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS) were included in this study to assess the causal effect of air pollution on depressive symptoms in China and to clarify the role of PA in this relationship. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D). Data on particulate matter (PM1, PM2.5, and PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) were obtained from the ChinaHighAirPollutants (CHAP) dataset. PA levels were measured using a standardized questionnaire and categorized as low or high. An instrumental variable (IV) approach was used to estimate the causal effect of air pollution on depressive symptoms. Potential effect modification by PA was assessed. The IV estimates showed that all air pollutants were significantly and adversely associated with depressive symptoms, with a per interquartile range (IQR) increase in PM1, PM2.5, PM10, NO2, SO2, O3, and CO associated with 1.57 (95% confidence interval (CI): 1.15, 1.99), 1.49 (95% CI: 1.10, 1.89), 1.71 (95% CI: 1.26, 2.17), 2.22 (95% CI: 1.62, 2.81), 1.30 (95% CI: 0.96, 1.65), 4.67 (95% CI: 3.37, 5.98), and 0.97 (95% CI: 0.71, 1.22) units increase in CES-D scores, respectively. PA significantly modified this association, with higher PA levels mitigating the adverse effects of air pollution on depressive symptoms.

Influence of Aging and Immune Alterations on Susceptibility to Pneumococcal Pneumonia in the Elderly

Pneumonia is a common respiratory infection affecting individuals of all ages, with a significantly higher incidence among the elderly. As the aging population grows, pneumonia is expected to become an increasingly critical health concern. In non-institutionalized elderly individuals, the annual incidence ranges from 25 to 44 per 1000, approximately four times higher than in those under 65. Streptococcus pneumoniae, a Gram-positive diplococcus, is the leading cause of pneumonia-related deaths in older adults. Management of S. pneumoniae infections in the elderly is challenging due to impaired antibody responses to polysaccharides and surface proteins, compounded by rising antibiotic resistance. The underlying mechanisms for increased susceptibility remain unclear, but age-related changes in the immune system, particularly in dendritic cells and T cells, are implicated. This review explores how aging-related immune alterations contribute to the heightened vulnerability of the elderly to S. pneumoniae infections.

Neurotrophin-3 as a mediator in the link between PM2.5 exposure and psychiatric disorders: A Mendelian randomization study

BACKGROUND

The causal relationship between PM2.5 (particulate matter with an aerodynamic diameter ≤2.5 μm) and common mental disorders, along with its neuropathological mechanisms, remains unclear.

METHODS

We used genome-wide association study datasets from the UK Biobank and Psychiatric Genomics Consortium to systematically investigate the causal relationship between PM2.5 and nine common psychiatric disorders using two-sample Mendelian randomization (TSMR) methods. Subsequently, we used two-step MR to investigate the mediating effect of 108 potential mediators in the association between PM2.5 and mental disorders.

RESULTS

Our findings indicated that PM2.5 was positively associated with major depressive disorder (odds ratio (OR): 1.33, 95 % confidence interval (CI): 1.11-1.55), anxiety disorder (OR: 2.96, 95 % CI: 2.13-3.79), schizophrenia (OR: 1.55, 95 % CI: 1.29-1.81), and attention deficit hyperactivity disorder (ADHD) (OR: 1.95, 95 % CI: 1.66-2.24). Unexpectedly, PM2.5 was inversely associated with bipolar disorder (OR: 0.65, 95 % CI: 0.37-0.93). Additionally, PM2.5 was not significantly associated with autism spectrum disorders (OR: 1.24, 95 % CI: 0.83-1.65), post-traumatic stress disorder (OR: 1.51, 95 % CI: 1.11-1.91), obsessive-compulsive disorder (OR: 0.81, 95 % CI: -0.07-1.69), or anorexia nervosa (OR: 1.42, 95 % CI: 0.86-1.98). Further analysis using two-step MR revealed that Neurotrophin-3 mediated 9.86 % of the PM2.5-ADHD association and 5.88 % of the PM2.5-schizophrenia association. Sensitivity analyses supported these findings.

CONCLUSIONS

This TSMR analysis provides a comprehensive examination of the causal relationship between PM2.5 exposure and nine common psychiatric disorders, with mediation analysis offering insight into the underlying mechanisms. This study aims to raise public awareness of how air quality affects mental health through empirical evidence.

Synergistic air pollution exposure elevates depression risk: A cohort study

Depression is a leading mental health disorder worldwide, contributing substantially to the global disease burden. While emerging evidence suggests links between specific air pollutants and depression, the potential interactions among multiple pollutants remain underexplored. Here we show the influence of six common air pollutants on depressive symptoms among middle-aged and older Chinese adults. In single-pollutant models, a 10 μg m-3 increase in SO2, CO, PM10, and PM2.5 is associated with increased risks of depressive symptoms, with odds ratios (95% confidence intervals) of 1.276 (1.238-1.315), 1.007 (1.006-1.008), 1.066 (1.055-1.078), and 1.130 (1.108-1.153), respectively. In two-pollutant models, SO2 remains significantly associated with depressive symptoms after adjusting for other pollutants. Multi-pollutant models uncover synergistic effects, with SO2, CO, NO2, PM10, and PM2.5 exhibiting significant interactions, identifying SO2 as the primary driver of these associations. Mediation analyses further indicate that cognitive and physical impairments partially mediate the relationship between air pollution and depressive symptoms. These findings underscore the critical mental health impacts of air pollution and highlight the need for integrated air quality management strategies. Targeted mitigation of specific pollutants, particularly SO2, is expected to significantly enhance public mental health outcomes.

Interaction effects of exposure to air pollution and social activities on cognitive function in middle-aged and older Chinese adults based on a nationwide cohort study

BACKGROUND

Although there have been many studies on the relationship between ambient air pollution and cognitive functioning in developed countries, there are no studies focusing on the interaction between ambient air pollution and social activities. This study aims to examine interactive effects of ambient air pollution and social activities on cognitive function in Chinese middle-aged and older.

METHODS

This study used nationally representative longitudinal survey data of China Health and Retirement Longitudinal Study (CHARLS) 2013, 2015 and 2018. The study explored the additive interaction effects of air pollutants and social activities on cognitive function in middle-aged and older adults by constructing mixed linear regression analyses containing interaction terms, as well as constructing additive interaction analyses with dummy variables containing four unordered categories that were partitioned according to median. In addition, the study further explored the interaction between air pollution and different types of social activities through an interaction term between air pollution and different types of social activities.

RESULTS

In the model fully adjusted for covariates such as age, sex, region, we found significant coefficients on the interaction term between PM2.5, O3 and social activities on cognitive function (PM2.5, β = -0.018, 95%CI: -0.029, -0.006; O3, β = 0.017, 95%CI: 0.007, 0.027). In the interaction analysis by constructing dummy variables, we found a significant antagonistic effect between PM2.5 and social activities (SI = 0.730, 95%CI: 0.674, 0.785), a possible antagonistic effect between NO2 and social activities (SI = 0.697, 95%CI: 0.648, 0.747), and a possible synergistic effect between O3 and social activities (SI = 1.769, 95%CI: 0.648, 0.747). In addition, the study found significant interactions between simple interaction, leisure and recreational, and intellectual participation social activities and air pollution.

CONCLUSION

Our study demonstrated an antagonistic effect of PM2.5 and social activities on cognitive function in middle-aged and older Chinese adults.

Air pollution is linked to cognitive decline independent of hypersensitive C-reactive protein: insights from middle-aged and older Chinese

BACKGROUND

Long-term air pollution exposure and inflammation are considered to be associated with cognitive decline. However, whether air pollution exposure related cognitive decline is dependent on inflammation remains uncertain.

MATERIALS AND METHODS

The present study collected data from China Health and Retirement Longitudinal Study (CHARLS) at baseline in 2011, with a follow up period in 2015. Concentration of air pollutants (particles with diameters ≤ 1.0 μm [PM1], ≤ 2.5 μm [PM2.5], ≤ 10 μm [PM10], nitrogen dioxide [NO2] and ozone [O3]) were obtained from China High Air Pollutants (CHAP) dataset. Hypersensitive C-reactive protein (hs-CRP), a systemic inflammation marker, was measured in blood of subjects and cognitive function was assessed by standardized questionnaire.

RESULTS

A total of 6434 participants were included in the study. Lower exposure to PM2.5, PM1, PM10 and NO2 were associated with mitigated cognitive decline. The odds ratios (ORs) for air pollutants changes and cognitive decline and 95% confidence intervals (CIs) were as follows: PM2.5-0.934(0.925, 0.943), PM1- 0.945 (0.935,0.955), PM10-0.977(0.972,0.982) and NO2-0.962(0.950,0.975), respectively. Hs-CRP showed no significant correlation with cognitive decline or change in levels of air pollution. The interaction regression analyses, both unadjusted and adjusted, did not uncover any significant correlation between hs-CRP and air pollution with respect to cognitive decline. Bootstrap test exhibited no significant mediating effect of hs-CRP on the relationship between any air pollutants and cognitive decline, the indirect effects of hs-CRP in conjunction with exposure to different air pollutants were all found to be non-significant, with the following bootstrap CIs and p-values: PM2.5-1.000([1.000,1.000], P = 0.480),PM1-1.000([1.000,1.000], P = 0.230),PM10-1.000([1.000,1.000], P = 0.650), O3-1.000([1.000,1.000], P = 0.470), ΔNO2-1.000([1.000,1.000], P = 0.830) .

CONCLUSION

Ambient air pollution exposure was linked to cognitive decline independent of hs-CRP level.

Linking ambient air pollution to mental health: evidence based on the two-sample Mendelian randomization and colocalization study

Growing evidence links air pollution, a ubiquitous environmental stressor, to a higher risk of developing mental disorders, raising significant public health concerns. Mental disorders represent a significant global public health challenge which can have a profound impact on individual lives. In this study, we used Mendelian randomization (MR) to investigate the causal relationship between ambient air pollution and four common mental disorders. Genome-wide association study (GWAS) data for ambient air pollution and summary-level GWAS data for four representative mental disorders were obtained from open-access database. Inverse variance weighted (IVW) method with multiplicative random-effects model was the main analysis. Sensitivity analyses were conducted to validate the results. Bayesian colocalization analysis was conducted to explore the potential shared genetic causal variants between specific air pollutants and mental disorders. A suggestive association was observed between political matter (PM) 2.5 and anxiety disorders (OR 2.96, 95%CI 1.29-6.81, p = 0.010). Exposure to nitrogen dioxide (NO2) was significantly linked to an elevated risk of schizophrenia (OR 1.95, 95% CI 1.45-2.63, p = 1.13E-05) and showed a nominal association with an increased risk of bipolar disorder (OR 1.43, 95% CI 1.09-1.86, p = 0.009). A suggestive causal association was detected between nitrogen oxides (NOx) and anxiety disorder (OR 2.90, 95%CI 1.21-6.97, p = 0.017). No significant association was detected between exposure to PM2.5-10, PM10 and mental disorders. No significant horizonal pleiotropy and heterogeneity was found. The colocalization analysis revealed robust evidence supporting the colocalization of NO2 with schizophrenia at SNP rs12203592. Our findings support causal associations between exposure to ambient air pollution, particularly PM2.5, NO2, and NOx, and an increased risk of specific mental disorders.

Indoor air pollution by solid fuel usages for cooking is longitudinally associated with possible sarcopenia in middle-aged Chinese population

Objectives

The Asia Working Group of Sarcopenia (AWGS) 2019 consensus proposed a new concept named "possible sarcopenia". The present study was to estimate the association between indoor air pollution by solid fuel usages for cooking and possible sarcopenia among middle-aged and older Chinese population.

Methods

A longitudinal cohort analysis was carried out using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 17,708 participants were recruited and followed up in the CHARLS. Cox proportional hazards models were used to estimate the effects of cooking fuel usages on the new onset of possible sarcopenia. Stratified analyses were performed according to gender and age, and sensitivity analyses were performed using the complete dataset.

Results

A total of 4,653 participants were included in the final cohort analysis. During the follow-up of 4 years (2011-2015), a total of 1,532 (32.92%) participants developed new-onset possible sarcopenia. Compared with clean fuel usages for cooking, solid fuel usages were associated with a higher risk of possible sarcopenia (HR = 1.37, 95% CI = 1.23-1.52, p-value < 0.001). After adjusting for potential confounders, there was a trend for association between solid fuel usages and an increased risk of possible sarcopenia. Stratified analyses by gender and age demonstrated a stronger association of the solid fuel usages with possible sarcopenia in the middle-aged female participants (Model 1: HR = 1.83, 95% CI = 1.24-2.69, p-value = 0.002; Model 2: HR = 1.65, 95% CI = 1.10-2.47, p-value = 0.016). Sensitivity analyses indicated that the results were robust.

Conclusion

Indoor air pollution from solid fuel usages for cooking was a modifiable risk factor for sarcopenia, especially in middle-aged female population. These findings provide a new prevention strategy to reduce the growing burden of sarcopenia, especially for middle-aged female individuals using solid fuels for cooking.

Effect of particulate matter on cognitive function among middle-aged and older adults in China: An instrumental variable approach

Emerging studies have suggested the association of ambient air pollution with worse cognitive function; however, causal evidence remains scarce. We aimed to estimate the effect of particulate matter (PM) exposure on overall and domain-specific cognitive function. A total of 14,205 participants aged 45 years and above were drawn from the 2015 wave of the China Health and Retirement Longitudinal Study (CHARLS). Cognitive function was assessed using a standardized questionnaire consisting of two domains: episodic memory and mental status. Participants' exposure to city-level PM (PM1, PM2.5, and PM10) was evaluated using satellite-based spatiotemporal models. To avoid potential endogenous biases, an instrumental variable method with two-stage least squares estimation was employed to examine the effect of air pollution on overall and domain-specific cognitive function. Stratified analysis was further performed based on sociodemographic characteristics. We found PM exposure exertedsignificant adverse effects on overall and domain-specific cognitive function, with mental status being more adversely affected as compared to episodic memory. The effect of PM exposure was more pronounced with smaller particle sizes, with PM1 exhibiting the largest effect size. Moreover, participants with lower education attainment were more adversely affected by PM exposure. Our findings add additional evidence of the potential causal role of PM exposure in worsening overall and domain-specific cognitive function. Efforts to further reduce PM are needed to protect the cognitive health of the aging Chinese population.

Prenatal exposure to ambient air pollution and persistent postpartum depression

BACKGROUND

Ambient air pollution during pregnancy has been linked with postpartum depression up to 12 months, but few studies have investigated its impact on persistent depression beyond 12 months postpartum. This study aimed to evaluate prenatal ambient air pollution exposure and the risk of persistent depression over 3 years after childbirth and to identify windows of susceptibility.

METHODS

This study included 361 predominantly low-income Hispanic/Latina participants with full-term pregnancies in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort. We estimated daily residential PM2.5, PM10, NO2, and O3 concentrations throughout 37 gestational weeks using inverse-distance squared spatial interpolation from monitoring data and calculated weekly averaged levels. Depression was assessed by the 20-item Center for Epidemiologic Studies-Depression (CES-D) scale at 12, 24, and 36 months postpartum, with persistent postpartum depression defined as a CES-D score ≥16 at any of these timepoints. We performed robust Poisson log-linear distributed lag models (DLM) via generalized estimating equations (GEE) to estimate the adjusted risk ratio (RR).

RESULTS

Depression was observed in 17.8 %, 17.5 %, and 13.4 % of participants at 12, 24, and 36 months, respectively. We found one IQR increase (3.9 ppb) in prenatal exposure to NO2 during the identified sensitive window of gestational weeks 13-29 was associated with a cumulative risk ratio of 3.86 (95 % CI: 3.24, 4.59) for persistent depression 1-3 years postpartum. We also found one IQR increase (7.4 μg/m3) in prenatal exposure to PM10 during gestation weeks 12-28 was associated a cumulative risk ratio of 3.88 (95 % CI: 3.04, 4.96) for persistent depression. No clear sensitive windows were identified for PM2.5 or O3.

CONCLUSIONS

Mid-pregnancy PM10 and NO2 exposures were associated with nearly 4-fold increased risks of persistent depression after pregnancy, which has critical implications for prevention of perinatal mental health outcomes.

Higher socioeconomic deprivation in areas predicts cognitive decline in New Zealanders without cognitive impairment

Previous studies identified individual-level socioeconomic factors as key determinants of cognitive health. This study investigated the effect of area-based socioeconomic deprivation on cognitive outcomes in midlife to early late-life New Zealanders without cognitive impairment at baseline. Data stemmed from a subsample of the New Zealand Health, Work and Retirement Study, a cohort study on ageing, who completed face-to-face interviews and were reassessed two years later. Cognitive functioning was measured using Addenbrooke's Cognitive Examination-Revised, adapted for culturally acceptable use in Aotearoa New Zealand. Area-based socioeconomic deprivation was assessed using the New Zealand Deprivation Index (NZDep2006). Linear mixed-effects models analysed the association between area-based socioeconomic deprivation and cognitive outcomes. The analysis included 783 participants without cognitive impairment at baseline (54.7% female, mean age 62.7 years, 25.0% Māori, the Indigenous people of Aotearoa New Zealand). There was an association between higher area-based socioeconomic deprivation and lower cognitive functioning (B = -0.08, 95%CI: -0.15;-0.01; p = .050) and cognitive decline (B = -0.12, 95%CI: -0.20;-0.04, p = .013) over two years, while controlling for covariates. The findings emphasise the importance of considering neighbourhood characteristics and broader socioeconomic factors in strategies aimed at mitigating cognitive health disparities and reducing the impact of dementia in disadvantaged communities.

Effects of air pollutants exposure on frailty risk: A systematic review and meta-analysis

Air pollutants have been investigated to be associated with many health issues. Recently, increasing epidemiological studies have suggested the association between air pollution exposure and risk of frailty with inconsistent findings. This systematic review and meta-analysis was to summarize and evaluate effects of exposure to various air pollutants on risk of frailty. PubMed, Embase, Scopus and Web of Science were systematically searched for relevant studies published before May 11, 2024. Studies that explored the potential relationship between exposure to air pollutants (PM2.5, PM10, O3, NOx, solid fuel, secondhand tobacco, and air quality) and risk of frailty were included. The quality of cross-sectional and cohort studies was evaluated using an eight-item assessment instrument for epidemiological studies and Newcastle-Ottawa Scale, respectively. A total of 9,929 papers were retrieved, of which 20 met the inclusion criteria. Meta-analysis indicated that PM2.5 exposure was significantly associated with frailty assessed by the frailty index [OR (95% CI): 1.24 (1,11-1.38) per 10 μg/m3 increment]. Moreover, solid fuel exposures were significantly associated with an increased risk of frailty assessed by the frailty phenotype [OR (95% CI): 1.91 (1.09-3.34)] or the frailty index [OR (95% CI): 1.25 (1.11-1.41)]. Exposure to PM2.5 and solid fuel increases the risk of frailty. Environmental protection policies and public health measures should be developed to reduce PM2.5 concentrations. Effective measures, such as improving stoves and using clean fuels, should be taken to reduce indoor air pollution levels.

Ambient air pollution and survival in childhood cancer: A nationwide survival analysis

BACKGROUND

Particulate matter consisting of fine particles measuring 2.5 microns or less in diameter (PM2.5), a component of air pollution, has been linked to adverse health outcomes. The objective of this study was to assess the association between ambient PM2.5 exposure and survival in children with cancer in the United States.

METHODS

Individuals aged birth to 19 years who were diagnosed with cancer between January 1, 2004, and December 31, 2019, were selected from the National Cancer Database. The association between the annual PM2.5 level at the patient's zip code of residence at the time of diagnosis and overall survival was evaluated using time-varying Cox proportional hazards models (crude and adjusted for diagnosis year and age). To address concerns that exposure to air pollution is correlated with other social determinants of health, the authors tested the association between PM2.5 levels and survival among sociodemographic subgroups.

RESULTS

Of the 172,550 patients included, 27,456 (15.9%) resided in areas with annual PM2.5 concentrations above the US Environmental Protection Agency (EPA) annual PM2.5 standard of 12 μg/m3. Residing in these high-pollution areas was associated with worse overall survival (adjusted hazard ratio [aHR], 1.06; 95% confidence interval [CI], 1.012-1.10). Similarly, when PM2.5 was evaluated as a linear measure, each unit increase in PM2.5 exposure was associated with worse survival (aHR, 1.011; CI, 1.005-1.017). Exposure to PM2.5 at levels above the EPA standards was also significantly associated with worse overall survival among sociodemographic subgroups.

CONCLUSIONS

Exposure to PM2.5 was significantly associated with worse overall survival among children with cancer, even at levels below EPA air quality standards. These results underscore the importance of setting appropriate air quality standards to protect the health of this sensitive population.

PLAIN LANGUAGE SUMMARY

The authors investigated how living in areas with high air pollution (defined as particulate matter consisting of fine particles measuring 2.5 microns or less in diameter; PM2.5) affects the overall survival of children with cancer in the United States. The results indicated that children living in areas with higher PM2.5 levels, and even at levels below prior and current US Environmental Protection Agency standards, had lower survival rates than children living in areas with lower levels of PM2.5. This finding emphasizes the need for stricter air quality standards to better protect children, particularly those with serious health conditions like childhood cancer.

Effects of major air pollutants on cognitive function in middle-aged and elderly adults: Panel data evidence from China Health and Retirement Longitudinal Study

Background

Although numerous studies have discussed about the impact of air pollution on cognitive function, a consensus has yet to be reached, necessitating further exploration of their relationship. The aim of this study is to reveal the effects of major air pollutants on cognitive function in Chinese middle-aged and older adults, while considering the lagged effects of pollution.

Methods

Panel data were constructed by integrating the air pollutants concentration (particulate matter diameter ≤1 µm (μm) (PM1), PM2.5, PM10, nitrogen dioxide (NO2), and ozone (O3)) among 28 provinces in China and the personal characteristics from China Health and Retirement Longitudinal Study participants during the period of 2011-2015. To explore the effects of single pollutants and their interactions on cognitive function, panel linear regression using ordinary least squares method was employed, and first-order lag effects (two-year interval) of air pollution were introduced into the models.

Results

Our study revealed that, after adjusting for confounding factors, higher levels of particulate matter (PM1, coefficient (Coef.) = -0.093, P = 0.001; PM2.5, Coef. = -0.051, P = 0.001; PM10, Coef. = -0.030, P = 0.001) and NO2 (Coef. = -0.094, P = 0.006) were associated with lower cognitive function scores among the participants. Moreover, the interaction between the five major pollutants exhibited a negative effect on cognitive function(Coef. = -2.89, P = 0.004).

Conclusions

PM1, PM2.5, PM10 have detrimental effects on the cognitive function of middle-aged and elderly adults in China, where increasing particle diameter correlates with a less negative impacts, providing theoretical underpinnings for the formulation of environmental protection policies.

Sufficient sleep and physical activity can relieve the effects of long-term exposure to particulate matter on depressive symptoms among 0.31 million children and adolescents from 103 counties in China

BACKGROUND

Although long-term exposures to air pollutants have been linked to mental disorders, existing studies remain limited and inconsistent. We investigated the relationship between exposure to particulate matter (PM) and depressive symptoms, as well as the potential role of sleep duration and physical activity.

METHOD

Using the surveillance data (2019 to 2022) of common diseases and risk factors among 312,390 students aged 10-25 years, logistic regression, generalized liner model (GLM) and restricted cubic spline (RCS) were employed to investigate the relationship between long-term exposure to PM and depressive symptoms.

RESULT

Significant associations were found between PM1 (OR = 1.21, 95 % CI: 1.12-1.32), PM2.5 (OR = 1.24, 95 % CI: 1.19-1.38), and PM10 (OR = 1.87, 95 % CI: 1.69-2.07) and increased risks of depressive symptoms. Sleep duration and physical activity relieved these associations. The odds ratios (ORs) of PM1, PM2.5, and PM10 on depressive symptoms were lower in group with sufficient sleep (1.02 vs. 1.49, 1.20 vs. 1.80, 2.15 vs. 2.23), lower in group with high level MVPA (1.13 vs. 1.48, 1.14 vs. 1.58, 1.85 vs. 2.38), and lower in group with high level outdoor activity (1.19 vs. 1.55, 1.23 vs. 1.63, 1.83 vs. 2.72).

LIMITATIONS

Conclusions about causality remain speculative because of the cross-sectional design.

CONCLUSION

Sufficient sleep duration and outdoor activity may mitigate the decline in mental health among adults in developing countries caused by long-term exposure to PM. This contribution enhanced our understanding of the mechanisms linking air pollution to mental health.

Mechanistic insights regarding neuropsychiatric and neuropathologic impacts of air pollution

Air pollution is a significant environmental health risk for urban areas and developing countries. Air pollution may contribute to the incidence of cardiopulmonary and metabolic diseases. Evidence also points to the role of air pollution in worsening or developing neurological and neuropsychiatric conditions. Inhaled pollutants include compositionally differing mixtures of respirable gaseous and particulate components of varied sizes, solubilities, and chemistry. Inhalation of combustibles and volatile organic compounds (VOCs) or other irritant particulate matter (PM) may trigger lung sensory afferents which initiate a sympathetic stress response via activation of the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) axes. Activation of SAM and HPA axes are associated with selective inhibition of hypothalamic-pituitary-gonadal (HPG) and hypothalamic-pituitary-thyroid (HPT) axes following exposure. Regarding chronic exposure in susceptible hosts, these changes may become pathological by causing neuroinflammation, neurotransmitter, and neuroendocrine imbalances. Soluble PM, such as metals and nano-size particles may translocate across the olfactory, trigeminal, or vagal nerves through retrograde axonal transport, or through systemic circulation which may disrupt the blood-brain barrier (BBB) and deposit in neural tissue. Neuronal deposition of metallic components can have a negative impact through multiple molecular mechanisms. In addition to systemic translocation, the release of pituitary and stress hormones, altered metabolic hormonal status and resultant circulating metabolic milieu, and sympathetically and HPA-mediated changes in immune markers, may secondarily impact the brain through a variety of regulatory adrenal hormone-dependent mechanisms. Several reviews covering air pollution as a risk factor for neuropsychiatric disorders have been published, but no reviews discuss the in-depth intersection between molecular and stress-related neuroendocrine mechanisms, thereby addressing adaptation and susceptibility variations and link to peripheral tissue effects. The purpose of this review is to discuss evidence regarding neurochemical, neuroendocrine, and molecular mechanisms which may contribute to neuropathology from air pollution exposure. This review also covers bi-directional neural and systemic interactions which may raise the risk for air pollution-related systemic illness.

Association of solid fuel use with cognitive function and the modifying role of lifestyle: A nationwide cohort study in China

BACKGROUND

As opposed to a healthy lifestyle, indoor air pollution from solid fuel use may be harmful for cognitive function. However, the extent to which lifestyle modifies the association between solid fuel use and cognitive function remains unknown.

METHODS

A total of 21,008 individuals aged 16 to 92 were enrolled in 2010 and followed up to 2014 in the China Family Panel Studies (CFPS). Cognitive function was assessed using standardized math and word tests in two waves. Solid fuel use at baseline was assessed by self-reporting of firewood, straw, or coal used for cooking. Lifestyle profile was classified into two groups (favorable vs. unfavorable) based on five modifiable lifestyle factors including alcohol drinking, smoking, body mass index, diet, and physical activity. Linear mixed-effects models were employed to assess the association of solid fuel use and lifestyle with cognitive function. The effect modification of lifestyle was analyzed.

RESULTS

A total of 49.7% of the study population used solid fuels for cooking and 17.4% had a favorable lifestyle. Solid fuel use was associated with a significant decrease in cognitive function (β = -0.29, 95% CI: -0.39, -0.19 for math test; β = -0.62, 95% CI: -0.84, -0.41 for word test). Lifestyle significantly modified this association (p-interaction: 0.006 for math test; 0.016 for word test), with the corresponding association being less pronounced among participants adhering to a favorable lifestyle compared to those with an unfavorable lifestyle.

CONCLUSION

A favorable lifestyle may attenuate the adverse association between solid fuel use and cognitive function. Adopting a favorable lifestyle has the potential to mitigate the adverse neurological effects due to indoor air pollution.

Short-term ozone exposure on stroke mortality and mitigation by greenness in rural and urban areas of Shandong Province, China

BACKGROUND

Short-term exposure to ozone (O3) has been associated with higher stroke mortality, but it is unclear whether this association differs between urban and rural areas. The study aimed to compare the association between short-term exposure to O3 and ischaemic and haemorrhagic stroke mortality across rural and urban areas and further investigate the potential impacts of modifiers, such as greenness, on this association.

METHODS

A multi-county time-series analysis was carried out in 19 counties of Shandong Province from 2013 to 2019. First, we employed generalized additive models (GAMs) to assess the effects of O3 on stroke mortality in each county. We performed random-effects meta-analyses to pool estimates to counties and compare differences in rural and urban areas. Furthermore, a meta-regression model was utilized to assess the moderating effects of county-level features.

RESULTS

Short-term O3 exposure was found to be associated with increased mortality for both stroke subtypes. For each 10-µg/m3 (lag0-3) rise in O3, ischaemic stroke mortality rose by 1.472% in rural areas and 1.279% in urban areas. For each 0.1-unit increase in the Enhanced Vegetation Index (EVI) per county, the ischaemic stroke mortality caused by a 10-µg/m3 rise in O3 decreased by 0.60% overall and 1.50% in urban areas.

CONCLUSIONS

Our findings add to the evidence that short-term O3 exposure increases ischaemic and haemorrhagic stroke mortality and has adverse effects in urban and rural areas. However, improving greenness levels may contribute to mitigating the detrimental effects of O3 on ischaemic stroke mortality.

Exposure to air pollution, genetic susceptibility, and prevalence of sarcopenia in the UK

BACKGROUND

The role of environmental factors, particularly air pollutants, in the prevalence of sarcopenia remains unclear.

OBJECTIVES

This study explored the relationship between the prevalence of sarcopenia and prolonged exposure to air pollutants, and investigated potential interactions with genetic susceptibility and inflammation.

METHODS

Data from 408,117 people at baseline and 35,060 participants in the longitudinal analysis in the UK Biobank were used in this prospective cohort study. Utilizing land use regression models, air pollutants (nitrogen dioxide (NO2), nitric oxides (NOx), and particulate matter with aerodynamic diameters of ≤2.5 μm (PM2.5) and ≤10 μm (PM10) were estimated and classified into quartiles. Alterations in body composition were among the secondary results.

RESULTS

Lastly, 3353 people (0.8 %) developed sarcopenia. Higher levels of air pollutants were linked to an increased prevalence of sarcopenia after controlling for confounding variables (highest vs lowest quartile: NOx, OR, 1.21 [95 % CI, 1.16-1.26]; NO2, OR, 1.22 [95 % CI, 1.16-1.27]; PM2.5, OR, 1.17 [95 % CI, 1.12-1.22]; PM10, OR, 1.15 [95 % CI, 1.10-1.20]; all P<.001). Longitudinal analysis revealed that air pollutants had adverse changes in body composition, including increased muscle fat infiltration and decreased muscle mass. At baseline, the probability of sarcopenia was strongly correlated with NOx, NO2, PM2.5, and PM10, and increased with elevated PRSBMI or CRP levels in subgroup analyses.

CONCLUSION

Air pollutants may contribute to accelerated muscle aging and highlight the importance of environmental factors in sarcopenia development.

The impact of living environmental factors on cognitive function and mild cognitive impairment: evidence from the Chinese elderly population

OBJECTIVES

Mild cognitive impairment represents a pivotal stage in the cognitive decline of older adults, with a considerable risk of advancing to dementia. Recognizing how living environmental factors affect cognition is crucial for crafting effective prevention and intervention strategies. This study seeks to elucidate the relationship between various living environmental factors and cognitive function, with a specific focus on mild cognitive impairment, within a Chinese elderly population.

METHODS

This is a cross-section and longitudinal study. Utilizing data from CHARLS, our cross-sectional analysis included 4,401 participants, while the cohort study comprised 3,177 individuals. We assessed living environmental factors based on household fuel types, water sources, indoor temperatures, residential building types, and ambient PM2.5 levels. We employed multiple linear regression for cross-sectional analyses and Cox proportional hazards regression models for longitudinal assessments to determine the effects of living environments on cognitive function and MCI risk. Stratified analyses, interaction tests, and sensitivity analyses were conducted to further validate our findings.

RESULTS

The findings revealed that, compared to those in high-risk environments, participants in low-risk settings exhibited higher cognitive scores (β = 1.25, 95%CI: 0.85, 1.65), better mental status (β = 0.70, 95%CI: 0.48, 0.92), and improved episodic memory (β = 0.27, 95%CI: 0.13, 0.41). Over a 7-year follow-up, the use of low-risk living environments (HR = 0.67, 95%CI: 0.49, 0.91), including clean fuels (HR = 0.74, 95%CI: 0.57, 0.95) and tap water (HR = 0.84, 95%CI: 0.71, 1.00), demonstrated a protective effect against MCI development. This correlation remained significant regardless of age, gender, residence, education level, smoking, alcohol consumption, and depression.

CONCLUSION

This research provides substantial evidence that living environmental factors significantly affect cognitive function and MCI risk in Chinese older adults. Enhancing living conditions may be a key strategy for promoting cognitive health and preventing MCI in this demographic. Further research is necessary to explore the long-term impacts and potential intervention strategies to optimize living environments for better cognitive outcomes in aging populations.

Effects of Environmental Noise Stress on Mouse Metabolism

Environmental noise is associated with various health outcomes. However, the mechanisms through which these outcomes influence behavior and metabolism remain unclear. This study investigated how environmental noise affects the liver, adipose tissue, and brain metabolic functions, leading to behavioral and body weight changes. Mice were divided into a noise group exposed to construction noise and an unexposed (control) group. Behavior and body weight changes were monitored over 50 days. Early changes in response to noise exposure were assessed by measuring plasma cortisol and glial fibrillary acidic protein expression in brain tissues on days 1, 15, and 30. Chronic responses, including changes in lipoprotein and fat metabolism and neurotransmitters, were investigated by analyzing serum lipoprotein levels and body fat mass and evaluating liver, fat, and brain tissue after 50 days. The noise group showed higher locomotor activity and reduced anxiety in the open-field and Y-maze tests. Noise exposure caused an initial weight loss; however, chronic noise increased fat mass and induced adipocyte hypertrophy. Our findings underscore the role of environmental noise-induced stress in augmenting locomotor activity and reducing anxiety in mice through neurotransmitter modulation while increasing the risk of obesity by decreasing HDL cholesterol levels and promoting adipocyte hypertrophy.

Inflammation and olfactory loss are associated with at least 139 medical conditions

Olfactory loss accompanies at least 139 neurological, somatic, and congenital/hereditary conditions. This observation leads to the question of whether these associations are correlations or whether they are ever causal. Temporal precedence and prospective predictive power suggest that olfactory loss is causally implicated in many medical conditions. The causal relationship between olfaction with memory dysfunction deserves particular attention because this sensory system has the only direct projection to memory centers. Mechanisms that may underlie the connections between medical conditions and olfactory loss include inflammation as well as neuroanatomical and environmental factors, and all 139 of the medical conditions listed here are also associated with inflammation. Olfactory enrichment shows efficacy for both prevention and treatment, potentially mediated by decreasing inflammation.

Exposure to coal dust exacerbates cognitive impairment by activating the IL6/ERK1/2/SP1 signaling pathway

Coal dust (CD) is a common pollutant, and epidemiological surveys indicate that long-term exposure to coal dust not only leads to the occurrence of pulmonary diseases but also has certain impacts on cognitive abilities. However, there is little open-published literature on the effects and specific mechanisms of coal dust exposure on the cognition of patients with Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD). An animal model has been built in this study with clinical population samples to explore the changes in neuroinflammation and cognitive abilities with coal dust exposure. In the animal model, compared to C57BL/6 mice, APP/PS1 mice exposed to coal dust exhibited more severe cognitive impairment, accompanied by significantly elevated levels of neuroinflammatory factors Apolipoprotein E4 (AOPE4) and Interleukin-6 (IL6) in the hippocampus, and more severe neuronal damage. In clinical sample sequencing, it was found that there is significant upregulation of AOPE4, neutrophils, and IL6 expression in the peripheral blood of MCI patients compared to normal individuals. Mechanistically, cell experiments revealed that IL6 could promote the phosphorylation of ERK1/2 and enhance the expression of transcription factor SP1, thereby promoting AOPE4 expression. The results of this study suggest that coal dust can promote the upregulation of IL6 and AOPE4 in patients, exacerbating cognitive impairment.

Joint effects of indoor air pollution and maternal psychosocial factors during pregnancy on trajectories of early childhood psychopathology

Prenatal indoor air pollution and maternal psychosocial factors have been associated with adverse psychopathology. We used environmental-exposure mixture methodology to investigate joint effects of both exposure classes on child behavior trajectories. For 360 children from the South African Drakenstein Child Health Study, we created trajectories of Child Behavior Checklist scores (at 24, 42, and 60 months) using latent-class linear mixed effects models. Indoor air pollutants and psychosocial factors were measured during pregnancy (second trimester). After adjusting for confounding, single-exposure effects (per natural log-1 unit increase) were assessed using polytomous logistic regression models, joint effects using self-organizing maps, and principal component analysis. Three trajectories were chosen for both internalizing and externalizing problems, with "high" (externalizing) or "increasing" (internalizing) being the most adverse trajectories. High externalizing trajectory was associated with increased exposure to particulate matter of ≤ 10 microns in diameter (PM10) (odds ratio [OR] = 1.25; 95% CI, 1.01-1.55) and self-organizing maps exposure profile most associated with smoking (OR = 2.67; 95% CI, 1.14-6.27). Medium internalizing trajectory was associated with increased emotional intimate partner violence (OR = 2.66; 95% CI, 1.17-5.57), increasing trajectory with increased benzene (OR = 1.24; 95% CI, 1.02-1.51) and toluene (1.21; 95% CI, 1.02-1.44) and the principal component most correlated with benzene and toluene (OR = 1.25; 95% CI, 1.02-1.54). Prenatal exposure to environmental pollutants and psychosocial factors was associated with internalizing and externalizing child behavior trajectories. Understanding joint effects of adverse exposure mixtures will facilitate targeted interventions to prevent childhood psychopathology. This article is part of a Special Collection on Mental Health.

Effects of household solid fuel use on sarcopenia in middle-aged and older adults: evidence from a nationwide cohort study

Background

Household solid fuel use is common in global households and has been linked to changes in handgrip strength and muscle mass. However, whether household solid fuel use results in sarcopenia over time is not well elaborated.

Methods

This study employed data from the 2011-2015 China Health and Retirement Longitudinal Study (CHARLS) that recruited 4,932 participants ≥45 years. The Cox proportional hazards regression model was conducted to estimate the impact of household solid fuel use for cooking and heating on sarcopenia development. The analysis was further stratified based on geographic position. Mediation analysis was employed to estimate the potential mediating effects of cognitive function and depressive symptoms associated with household solid fuel use and sarcopenia.

Results

Over the 4-year follow-up, 476 cases of sarcopenia were reported (9.65%), with 254 in males (10.82%) and 222 in females (8.59%). Cooking and heating with solid fuels increased the risk of sarcopenia (Cooking: HR 1.401, 95% CI 1.138-1.724; Heating: HR 1.278, 95% CI 1.040-1.571). Crop residue/wood burning correlated with higher sarcopenia risk (Cooking: 1.420, 95% CI 1.147-1.758; Heating: 1.318, 95% CI 1.062-1.635). Switching to clean cooking fuels significantly reduced sarcopenia risk (HR 0.766, 95% CI 0.599-0.979). Heating with solid fuels was associated with higher sarcopenia risk only in southern China (HR 1.375, 95% CI 1.102-1.715). Additionally, cognitive function and depressive symptoms partially mediated the link between household solid fuel use and sarcopenia.

Conclusion

Household use of solid fuels is associated with an increased risk of sarcopenia. Restricting the use of solid fuels and focusing on cognitive function and depressive symptoms in solid fuel users can help decrease sarcopenia development.

The relationship between air pollution and the occurrence of hypertensive disorders of pregnancy: Evidence from a study in Wuhan, China

Ambient air pollution has been reported to be a risk factor for hypertensive disorders of pregnancy (HDP). Past studies have reported supportive evidence, but evidence from China is scarce and does not integrate the different periods of the pregnancy course. In this study, 1945 pregnant women with HDP and healthy pregnancies between 2016 and 2022 from the Renmin Hospital of Wuhan University registry network database were analysed. The geographic information, biological information and demographic information of the case were fused in the analysis. Machine learning methods were used to obtain the weight of the variable. Then, we used the generalized linear mixed model to evaluate the relationship between increased exposure to each pollutant at different periods of HDP and examined it in different groups. The results showed that SO2 had the predominate impact (12.65 %) on HDP compared with other air pollutants. SO2 exposure was associated with an increased risk of HDP. Increased unit SO2 concentrations were accompanied by an increased risk of HDP (OR = 1.33, 95 % CI: 1.13, 1.566), and the susceptible window for this effect was mainly in the first trimester (OR = 1.242, 95 % CI: 1.092, 1.412). In addition, SO2 exposure was associated with an increased risk of HDP in urban maternity (OR = 1.356, 95 % CI: 1.112, 1.653), obese maternity (OR = 3.58, 95 % CI: 1.608, 7.971), no higher education maternity (OR = 1.348, 95 % CI: 1.065, 1.706), nonzero delivery maternity (OR = 1.981, 95 % CI: 1.439, 2.725), maternal with first time maternity (OR = 1.247, 95 % CI: 1.007, 1.544) and other groups. In summary, SO2 exposure in early pregnancy is one of the risk factors for HDP, and the increased risk of HDP due to increased SO2 exposure may be more pronounced in obese, urban, low-education, and nonzero delivery populations.

Causal relationships between genetically predicted particulate air pollutants and neurodegenerative diseases: A two-sample Mendelian randomization study

Accumulating observational studies have linked particulate air pollutants to neurodegenerative diseases (NDDs). However, the causal links and the direction of their associations remain unclear. Therefore, we adopted a two-sample Mendelian randomization (TSMR) design using the GWAS-based genetic instruments of particulate air pollutants (PM2.5 and PM10) from the UK Biobank to explore their causal influence on four common neurodegenerative diseases. Estimates of causative relationships were generated by the Inverse variance weighted (IVW) method with multiple sensitive analyses. The heterogeneity and pleiotropy tests were additionally performed to verify whether our findings were robust. Genetically predicted PM2.5 and PM10 could elevate the occurrence of AD (odds ratio [OR] = 2.22, 95 % confidence interval [CI] 1.53-3.22, PIVW = 2.85×10-5, PFalsediscovery rate[FDR]= 2.85×10-4 and OR = 2.41, 95 % CI: 1.26-4.60, PIVW = 0.008, PFDR=0.039, respectively). The results were robust in sensitive analysis. However, no evidence of causality was found for other NDDs. Our present study suggests that PM2.5 and PM10 have a detrimental effect on AD, which indicates that improving air quality to prevent AD may have pivotal public health implications.