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Radua J, De Prisco M, Oliva V, Fico G, Vieta E, Fusar-Poli P. Impact of air pollution and climate change on mental health outcomes: an umbrella review of global evidence. World Psychiatry 2024; 23:244-256. [PMID: 38727076 PMCID: PMC11083864 DOI: 10.1002/wps.21219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
The impact of air pollution and climate change on mental health has recently raised strong concerns. However, a comprehensive overview analyzing the existing evidence while addressing relevant biases is lacking. This umbrella review systematically searched the PubMed/Medline, Scopus and PsycINFO databases (up to June 26, 2023) for any systematic review with meta-analysis investigating the association of air pollution or climate change with mental health outcomes. We used the R metaumbrella package to calculate and stratify the credibility of the evidence according to criteria (i.e., convincing, highly suggestive, suggestive, or weak) that address several biases, complemented by sensitivity analyses. We included 32 systematic reviews with meta-analysis that examined 284 individual studies and 237 associations of exposures to air pollution or climate change hazards and mental health outcomes. Most associations (n=195, 82.3%) involved air pollution, while the rest (n=42, 17.7%) regarded climate change hazards (mostly focusing on temperature: n=35, 14.8%). Mental health outcomes in most associations (n=185, 78.1%) involved mental disorders, followed by suicidal behavior (n=29, 12.4%), access to mental health care services (n=9, 3.7%), mental disorders-related symptomatology (n=8, 3.3%), and multiple categories together (n=6, 2.5%). Twelve associations (5.0%) achieved convincing (class I) or highly suggestive (class II) evidence. Regarding exposures to air pollution, there was convincing (class I) evidence for the association between long-term exposure to solvents and a higher incidence of dementia or cognitive impairment (odds ratio, OR=1.139), and highly suggestive (class II) evidence for the association between long-term exposure to some pollutants and higher risk for cognitive disorders (higher incidence of dementia with high vs. low levels of carbon monoxide, CO: OR=1.587; higher incidence of vascular dementia per 1 μg/m3 increase of nitrogen oxides, NOx: hazard ratio, HR=1.004). There was also highly suggestive (class II) evidence for the association between exposure to airborne particulate matter with diameter ≤10 μm (PM10) during the second trimester of pregnancy and the incidence of post-partum depression (OR=1.023 per 1 μg/m3 increase); and for the association between short-term exposure to sulfur dioxide (SO2) and schizophrenia relapse (risk ratio, RR=1.005 and 1.004 per 1 μg/m3 increase, respectively 5 and 7 days after exposure). Regarding climate change hazards, there was highly suggestive (class II) evidence for the association between short-term exposure to increased temperature and suicide- or mental disorders-related mortality (RR=1.024), suicidal behavior (RR=1.012), and hospital access (i.e., hospitalization or emergency department visits) due to suicidal behavior or mental disorders (RR=1.011) or mental disorders only (RR=1.009) (RR values per 1°C increase). There was also highly suggestive (class II) evidence for the association between short-term exposure to increased apparent temperature (i.e., the temperature equivalent perceived by humans) and suicidal behavior (RR=1.01 per 1°C increase). Finally, there was highly suggestive (class II) evidence for the association between the temporal proximity of cyclone exposure and severity of symptoms of post-traumatic stress disorder (r=0.275). Although most of the above associations were small in magnitude, they extend to the entire world population, and are therefore likely to have a substantial impact. This umbrella review classifies and quantifies for the first time the global negative impacts that air pollution and climate change can exert on mental health, identifying evidence-based targets that can inform future research and population health actions.
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Affiliation(s)
- Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Michele De Prisco
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Vincenzo Oliva
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Giovanna Fico
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South-London (OASIS) service, South London and Maudlsey NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
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Yang R, He J, Zhong KK, Fan MX, Bao T, Liu XC, Zhong Q. Relationship of solid fuels use with cognitive function and efficacy of switching to cleaner fuels or using ventilation: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2024; 249:118314. [PMID: 38331145 DOI: 10.1016/j.envres.2024.118314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/06/2024] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND A growing number of studies have examined the relation between solid fuels use and cognitive function in the mid-elderly, but results are inconsistent. Therefore, a systematic review and meta-analysis was carried out to evaluate their relevance and the efficacy of switching to cleaner fuels or using ventilation. METHOD We used PubMed, Web of Science, and Cochrane Library databases to identify 17 studies in which the primary outcome variable was cognitive function decline or cognitive disorders, and the exposure measure was solid fuels use. The final search date of August 31, 2023. The effect size of odds ratio (OR), regression coefficient (β), and 95% confidence interval (CI) were pooled. Heterogeneity and the possibility of publication bias were assessed by using the Q-statistic and Begg's test, respectively. RESULT Among the 17 included papers, the study participants were ≥45 years old. Eleven studies assessed the relationship between solid fuels use and cognitive function decline [number of studies (n) = 11, β = -0.144; I2 = 97.7%]. Five studies assessed the relationship between solid fuels use and cognitive disorders (n = 5, OR = 1.229; I2 = 41.1%). Switching from using solid fuels to clean fuels could reduce the risk of cognitive function decline as compared to those who remained on using solid fuels (n = 2; β = 0.710; I2 = 82.4%). Among participants using solid fuels, who cooked without on ventilated stoves were correlated with an enhanced risk of cognitive disorders as compared to participants who cooked with ventilated stoves (n = 2; OR = 1.358; I2 = 44.7%). CONCLUSION Our meta-analysis showed a negative relationship between solid fuels use with cognitive function, and a positive relationship with cognitive disorders. Cleaner fuels, using ventilation, improved cookstoves can reduce the adverse health hazards of solid fuels use.
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Affiliation(s)
- Rui Yang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jie He
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Kang-Kang Zhong
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Ming-Xuan Fan
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Teng Bao
- Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Xue-Chun Liu
- Department of Neurology, The Second People's Hospital of Hefei, Hefei Hospital Afliated to Anhui Medical University, Hefei, Anhui, China.
| | - Qi Zhong
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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Peng H, Wang M, Wang Y, Niu Z, Suo F, Liu J, Zhou T, Yao S. The association between indoor air pollution from solid fuels and cognitive impairment: a systematic review and meta-analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2024:reveh-2023-0158. [PMID: 38413202 DOI: 10.1515/reveh-2023-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/26/2024] [Indexed: 02/29/2024]
Abstract
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.
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Affiliation(s)
- Hongye Peng
- 47839 Beijing University of Chinese Medicine , Beijing, China
| | - Miyuan Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Beijing, China
| | - Yichong Wang
- Digestive Disease Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, P.R. China
| | - Zuohu Niu
- Department of Infections, 12517 Beijing Hospital of Traditional Chinese Medicine, Capital Medical University , Beijing, China
| | - Feiya Suo
- Department of Traditional Chinese Medicine, 532949 Dongguan People's Hospital , Guangzhou, China
| | - Jixiang Liu
- 47839 Beijing University of Chinese Medicine , Beijing, China
| | - Tianhui Zhou
- 47839 Beijing University of Chinese Medicine , Beijing, China
| | - Shukun Yao
- Department of Gastroenterology, 36635 China-Japan Friendship Hospital , Beijing, China
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Blanco MN, Shaffer RM, Li G, Adar SD, Carone M, Szpiro AA, Kaufman JD, Larson TV, Hajat A, Larson EB, Crane PK, Sheppard L. Traffic-related air pollution and dementia incidence in the Adult Changes in Thought Study. ENVIRONMENT INTERNATIONAL 2024; 183:108418. [PMID: 38185046 PMCID: PMC10873482 DOI: 10.1016/j.envint.2024.108418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
BACKGROUND While epidemiologic evidence links higher levels of exposure to fine particulate matter (PM2.5) to decreased cognitive function, fewer studies have investigated links with traffic-related air pollution (TRAP), and none have examined ultrafine particles (UFP, ≤100 nm) and late-life dementia incidence. OBJECTIVE To evaluate associations between TRAP exposures (UFP, black carbon [BC], and nitrogen dioxide [NO2]) and late-life dementia incidence. METHODS We ascertained dementia incidence in the Seattle-based Adult Changes in Thought (ACT) prospective cohort study (beginning in 1994) and assessed ten-year average TRAP exposures for each participant based on prediction models derived from an extensive mobile monitoring campaign. We applied Cox proportional hazards models to investigate TRAP exposure and dementia incidence using age as the time axis and further adjusting for sex, self-reported race, calendar year, education, socioeconomic status, PM2.5, and APOE genotype. We ran sensitivity analyses where we did not adjust for PM2.5 and other sensitivity and secondary analyses where we adjusted for multiple pollutants, applied alternative exposure models (including total and size-specific UFP), modified the adjustment covariates, used calendar year as the time axis, assessed different exposure periods, dementia subtypes, and others. RESULTS We identified 1,041 incident all-cause dementia cases in 4,283 participants over 37,102 person-years of follow-up. We did not find evidence of a greater hazard of late-life dementia incidence with elevated levels of long-term TRAP exposures. The estimated hazard ratio of all-cause dementia was 0.98 (95 % CI: 0.92-1.05) for every 2000 pt/cm3 increment in UFP, 0.95 (0.89-1.01) for every 100 ng/m3 increment in BC, and 0.96 (0.91-1.02) for every 2 ppb increment in NO2. These findings were consistent across sensitivity and secondary analyses. DISCUSSION We did not find evidence of a greater hazard of late-life dementia risk with elevated long-term TRAP exposures in this population-based prospective cohort study.
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Affiliation(s)
- Magali N Blanco
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Rachel M Shaffer
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Ge Li
- VA Northwest Network Mental Illness Research, Education, and Clinical Center, Virginia Puget Sound Health Care System, Seattle, WA, USA; Geriatric Research, Education, and Clinical Center, Virginia Puget Sound Health Care System, Seattle, WA, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Sara D Adar
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Marco Carone
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
| | - Timothy V Larson
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Civil & Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA
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Thompson R, Smith RB, Karim YB, Shen C, Drummond K, Teng C, Toledano MB. Air pollution and human cognition: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 859:160234. [PMID: 36427724 DOI: 10.1016/j.scitotenv.2022.160234] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/01/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND This systematic review summarises and evaluates the literature investigating associations between exposure to air pollution and general population cognition, which has important implications for health, social and economic inequalities, and human productivity. METHODS The engines MEDLINE, Embase Classic+Embase, APA PsycInfo, and SCOPUS were searched up to May 2022. Our inclusion criteria focus on the following pollutants: particulate matter, NOx, and ozone. The cognitive abilities of interest are: general/global cognition, executive function, attention, working memory, learning, memory, intelligence and IQ, reasoning, reaction times, and processing speed. The collective evidence was assessed using the NTP-OHAT framework and random-effects meta-analyses. RESULTS Eighty-six studies were identified, the results of which were generally supportive of associations between exposures and worsened cognition, but the literature was varied and sometimes contradictory. There was moderate certainty support for detrimental associations between PM2.5 and general cognition in adults 40+, and PM2.5, NOx, and PM10 and executive function (especially working memory) in children. There was moderate certainty evidence against associations between ozone and general cognition in adults age 40+, and NOx and reasoning/IQ in children. Some associations were also supported by meta-analysis (N = 14 studies, all in adults aged 40+). A 1 μg/m3 increase in NO2 was associated with reduced performance on general cognitive batteries (β = -0.02, p < 0.05) as was a 1 μg/m3 increase in PM2.5 exposure (β = -0.02, p < 0.05). A 1μgm3 increase in PM2.5 was significantly associated with lower verbal fluency by -0.05 words (p = 0.01) and a decrease in executive function task performance of -0.02 points (p < 0.001). DISCUSSION Evidence was found in support of some exposure-outcome associations, however more good quality research is required, particularly with older teenagers and young adults (14-40 years), using multi-exposure modelling, incorporating mechanistic investigation, and in South America, Africa, South Asia and Australasia.
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Affiliation(s)
- Rhiannon Thompson
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Rachel B Smith
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, UK
| | - Yasmin Bou Karim
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Chen Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Kayleigh Drummond
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Chloe Teng
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Mireille B Toledano
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Environmental Exposures and Health, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, UK.
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Blanco MN, Bi J, Austin E, Larson TV, Marshall JD, Sheppard L. Impact of Mobile Monitoring Network Design on Air Pollution Exposure Assessment Models. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:440-450. [PMID: 36508743 PMCID: PMC10615227 DOI: 10.1021/acs.est.2c05338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Short-term mobile monitoring campaigns are increasingly used to assess long-term air pollution exposure in epidemiology. Little is known about how monitoring network design features, including the number of stops and sampling temporality, impacts exposure assessment models. We address this gap by leveraging an extensive mobile monitoring campaign conducted in the greater Seattle area over the course of a year during all days of the week and most hours. The campaign measured total particle number concentration (PNC; sheds light on ultrafine particulate (UFP) number concentration), black carbon (BC), nitrogen dioxide (NO2), fine particulate matter (PM2.5), and carbon dioxide (CO2). In Monte Carlo sampling of 7327 total stops (278 sites × 26 visits each), we restricted the number of sites and visits used to estimate annual averages. Predictions from the all-data campaign performed well, with cross-validated R2s of 0.51-0.77. We found similar model performances (85% of the all-data campaign R2) with ∼1000 to 3000 randomly selected stops for NO2, PNC, and BC, and ∼4000 to 5000 stops for PM2.5 and CO2. Campaigns with additional temporal restrictions (e.g., business hours, rush hours, weekdays, or fewer seasons) had reduced model performances and different spatial surfaces. Mobile monitoring campaigns wanting to assess long-term exposure should carefully consider their monitoring designs.
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Affiliation(s)
- Magali N Blanco
- Department of Environmental and Occupational Health Sciences, School of Public Health, Hans Rosling Center for Population Health, University of Washington, 3980 15th Avenue NE, Seattle, Washington98195, United States
| | - Jianzhao Bi
- Department of Environmental and Occupational Health Sciences, School of Public Health, Hans Rosling Center for Population Health, University of Washington, 3980 15th Avenue NE, Seattle, Washington98195, United States
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, School of Public Health, Hans Rosling Center for Population Health, University of Washington, 3980 15th Avenue NE, Seattle, Washington98195, United States
| | - Timothy V Larson
- Department of Environmental and Occupational Health Sciences, School of Public Health, Hans Rosling Center for Population Health, University of Washington, 3980 15th Avenue NE, Seattle, Washington98195, United States
- Department of Civil & Environmental Engineering, College of Engineering, University of Washington, 201 More Hall, Box 352700, Seattle, Washington98195, United States
| | - Julian D Marshall
- Department of Civil & Environmental Engineering, College of Engineering, University of Washington, 201 More Hall, Box 352700, Seattle, Washington98195, United States
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, School of Public Health, Hans Rosling Center for Population Health, University of Washington, 3980 15th Avenue NE, Seattle, Washington98195, United States
- Department of Biostatistics, School of Public Health, Hans Rosling Center for Population Health, University of Washington, 3980 15th Avenue NE, Seattle, Washington98195, United States
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Pan R, Zhang Y, Xu Z, Yi W, Zhao F, Song J, Sun Q, Du P, Fang J, Cheng J, Liu Y, Chen C, Lu Y, Li T, Su H, Shi X. Exposure to fine particulate matter constituents and cognitive function performance, potential mediation by sleep quality: A multicenter study among Chinese adults aged 40-89 years. ENVIRONMENT INTERNATIONAL 2022; 170:107566. [PMID: 36219911 DOI: 10.1016/j.envint.2022.107566] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/02/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
Although exposure to fine particulate matter (PM2.5) has been associated with cognitive decline, little is known about which PM2.5 constituents are more harmful. Recent study on the association between PM2.5 and sleep quality prompted us to propose that sleep quality may mediate the adverse effects of PM2.5 components on cognitive decline. Understanding the association between PM2.5 constituents and cognitive function, as well as the mediating role of sleep quality provides a future intervention target for improving cognitive function. Using data involving 1834 participants from a multicenter cross-sectional study in nine cities of the Beijing-Tianjin-Hebei (BTH) region in China, we undertook multivariable linear regression analyses to quantify the association of annual moving-average PM2.5 and its chemical constituents with cognitive function and to assess the modifying role of exposure characteristic in this association. Besides, we examined the extent to which this association of PM2.5 constituents with cognitive function was mediated via sleep quality by a mediation analysis. We observed significantly negative associations between an increase of one interquartile range increase in PM2.5 [-0.876 (95 % CI: -1.205, -0.548)], organic carbon [-0.481 (95 % CI: -0.744, -0.219)], potassium [-0.344 (95 % CI: -0.530, -0.157)], iron [-0.468 (95 % CI: -0.646, -0.291)], and ammonium ion [-0.125 (95 % CI: -0.197, -0.052)] and cognitive decline. However, we didn't find any individual components more harmful than PM2.5. Poor sleep quality partially mediated the estimated associations, which were explained ranging from 2.28 % to 11.99 %. Stratification analyses showed that people living in areas with lower greenspace were more susceptible to specific PM2.5 components. Our study suggests that the adverse effect of suffering from PM2.5 components is more pronounced among individuals with poor sleep quality, amplifying environmental inequalities in health. Besides reducing environmental pollution, improving sleep quality may be another measure worth considering to improve cognition if our research is confirmed in the future.
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Affiliation(s)
- Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yi Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Qinghua Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Peng Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jianlong Fang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yingchun Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Yifu Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
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Jin Y, Zhou X, Deng L, Xiong X, Li Y, Wei Q, Dong B, Qiu S. Association between the domestic use of solid cooking fuel and increased prevalence of depression and cognitive impairment in a big developing country: A large-scale population-based study. Front Public Health 2022; 10:1038573. [PMID: 36504928 PMCID: PMC9731231 DOI: 10.3389/fpubh.2022.1038573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies have suggested that air pollution affects physiological and psychological health. Using solid fuel at home is a significant source of indoor air pollution. The associations between solid fuel use and depressive symptoms and cognitive health were unclear among older adults from low- and middle-income countries (LMICs). Methods To evaluate the association of solid fuel use with depressive symptoms and cognitive health among older adults, we obtained data from the Longitudinal Aging Study in India (LASI) and excluded subjects younger than 60 years and without critical data (solid fuel use, depressive symptoms, and cognitive health). The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to assess depressive symptoms, with more than ten indicative of depression. Cognitive health was assessed using measures from the Health and Retirement Study (HRS), and subjects with the lowest 10th percentile were considered to have cognitive impairment. The participants' responses defined solid fuel use. Multivariable logistic regression, linear regression, subgroup analysis, and interaction tests were performed to appraise the relationship between solid fuel use and depression and cognitive impairment. Results A total of 29,789 participants over 60 years old were involved in this study. Almost half of the participants (47.5%) reported using solid fuel for home cooking. Compared with clean fuel use, solid fuel use was related to an increased prevalence of depression [odds ratio (OR) 1.09, 95% CI 1.03-1.16] and higher CES-D-10 scores (β 0.23, 95% CI 0.12-0.35) after fully adjusted covariables. Using solid fuel was also related to a higher risk of cognitive impairment (OR 1.21, 95% CI 1.11-1.32) and a lower cognitive score (β -0.63, 95% CI -0.79 to -0.47) compared with those who used clean fuel. In the subgroup analysis, the prevalence of depression increased in females and non-smokers. The association of solid fuel use with depression and cognitive impairment exists in subgroups of BMI, economic status, caste, living area, education, and drinking. Conclusions The use of solid fuel at home was associated with an increased prevalence of depression and cognitive impairment among older adults in India.
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Affiliation(s)
- Yuming Jin
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Xianghong Zhou
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Linghui Deng
- National Clinical Research Center of Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xingyu Xiong
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yifan Li
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center of Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China,Birong Dong
| | - Shi Qiu
- Department of Urology, National Clinical Research Center for Geriatrics, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China,Institute of Oncology Research (IOR) and Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland,*Correspondence: Shi Qiu
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9
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Shkirkova K, Lamorie-Foote K, Zhang N, Li A, Diaz A, Liu Q, Thorwald MA, Godoy-Lugo JA, Ge B, D'Agostino C, Zhang Z, Mack WJ, Sioutas C, Finch CE, Mack WJ, Zhang H. Neurotoxicity of Diesel Exhaust Particles. J Alzheimers Dis 2022; 89:1263-1278. [PMID: 36031897 DOI: 10.3233/jad-220493] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Air pollution particulate matter (PM) is strongly associated with risks of accelerated cognitive decline, dementia and Alzheimer's disease. Ambient PM batches have variable neurotoxicity by collection site and season, which limits replicability of findings within and between research groups for analysis of mechanisms and interventions. Diesel exhaust particles (DEP) offer a replicable model that we define in further detail. OBJECTIVE Define dose- and time course neurotoxic responses of mice to DEP from the National Institute of Science and Technology (NIST) for neurotoxic responses shared by DEP and ambient PM. METHODS For dose-response, adult C57BL/6 male mice were exposed to 0, 25, 50, and 100μg/m3 of re-aerosolized DEP (NIST SRM 2975) for 5 h. Then, mice were exposed to 100μg/m3 DEP for 5, 100, and 200 h and assayed for amyloid-β peptides, inflammation, oxidative damage, and microglial activity and morphology. RESULTS DEP exposure at 100μg/m3 for 5 h, but not lower doses, caused oxidative damage, complement and microglia activation in cerebral cortex and corpus callosum. Longer DEP exposure for 8 weeks/200 h caused further oxidative damage, increased soluble Aβ, white matter injury, and microglial soma enlargement that differed by cortical layer. CONCLUSION Exposure to 100μg/m3 DEP NIST SRM 2975 caused robust neurotoxic responses that are shared with prior studies using DEP or ambient PM0.2. DEP provides a replicable model to study neurotoxic mechanisms of ambient PM and interventions relevant to cognitive decline and dementia.
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Affiliation(s)
- Kristina Shkirkova
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Krista Lamorie-Foote
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Nathan Zhang
- Dornsife College, University of Southern California, Los Angeles, CA, USA
| | - Andrew Li
- Dornsife College, University of Southern California, Los Angeles, CA, USA
| | - Arnold Diaz
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Qinghai Liu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Max A Thorwald
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Jose A Godoy-Lugo
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Brandon Ge
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carla D'Agostino
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Zijiao Zhang
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Wendy J Mack
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Constantinos Sioutas
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Caleb E Finch
- Dornsife College, University of Southern California, Los Angeles, CA, USA.,Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - William J Mack
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hongqiao Zhang
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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10
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Ma YH, Chen HS, Liu C, Feng QS, Feng L, Zhang YR, Hu H, Dong Q, Tan L, Kan HD, Zhang C, Suckling J, Zeng Y, Chen RJ, Yu JT. Association of Long-term Exposure to Ambient Air Pollution With Cognitive Decline and Alzheimer's Disease-Related Amyloidosis. Biol Psychiatry 2022; 93:780-789. [PMID: 35953319 DOI: 10.1016/j.biopsych.2022.05.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Air pollution induces neurotoxic reactions and may exert adverse effects on cognitive health. We aimed to investigate whether air pollutants accelerate cognitive decline and affect neurobiological signatures of Alzheimer's disease (AD). METHODS We used a population-based cohort from the Chinese Longitudinal Healthy Longevity Survey with 31,573 participants and a 10-year follow-up (5878 cognitively unimpaired individuals in Chinese Longitudinal Healthy Longevity Survey followed for 5.95 ± 2.87 years), and biomarker-based data from the Chinese Alzheimer's Biomarker and Lifestyle study including 1131 participants who underwent cerebrospinal fluid measurements of AD-related amyloid-β (Aβ) and tau proteins. Cognitive impairment was determined by education-corrected performance on the China-Modified Mini-Mental State Examination. Annual exposures to fine particulate matter (PM2.5), ground-level ozone (O3), and nitrogen dioxide (NO2) were estimated at areas of residence. Exposures were aggregated as 2-year averages preceding enrollments using Cox proportional hazards or linear models. RESULTS Long-term exposure to PM2.5 (per 20 μg/m3) increased the risk of cognitive impairment (hazard ratio, 1.100; 95% CI: 1.026-1.180), and similar associations were observed from separate cross-sectional analyses. Exposures to O3 and NO2 yielded elevated risk but with nonsignificant estimates. Individuals exposed to high PM2.5 manifested increased amyloid burdens as reflected by cerebrospinal fluid-AD biomarkers. Moreover, PM2.5 exposure-associated decline in global cognition was partly explained by amyloid pathology as measured by cerebrospinal fluid-Aβ42/Aβ40, P-tau/Aβ42, and T-tau/Aβ42, with mediation proportions ranging from 16.95% to 21.64%. CONCLUSIONS Long-term exposure to PM2.5 contributed to the development of cognitive decline, which may be partly explained by brain amyloid accumulation indicative of increased AD risk.
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Affiliation(s)
- Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China; Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hua-Shuai Chen
- School of Business, Xiangtan University, Xiangtan, Hunan, China
| | - Cong Liu
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Qiu-Shi Feng
- Department of Sociology, National University of Singapore, Singapore
| | - Lei Feng
- Department of Psychological Medicine and Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore
| | - Ya-Ru Zhang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hao Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Hai-Dong Kan
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Can Zhang
- Genetics and Aging Research Unit, McCance Center for Brain Health, Mass General Institute for Neurodegenerative Diseases, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Medical School of Duke University, Center for Healthy Aging and Development Studies, National School of Development, Raissun Institute for Advanced Studies, Peking University, Beijing, China
| | - Ren-Jie Chen
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
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11
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Tseng TWJ, Carter E, Yan L, Chan Q, Elliott P, Ezzati M, Kelly F, Schauer JJ, Wu Y, Yang X, Zhao L, Baumgartner J. Household air pollution from solid fuel use as a dose-dependent risk factor for cognitive impairment in northern China. Sci Rep 2022; 12:6187. [PMID: 35418188 PMCID: PMC9008006 DOI: 10.1038/s41598-022-10074-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/15/2022] [Indexed: 11/09/2022] Open
Abstract
The relationship between exposure to household air pollution (HAP) from solid fuel use and cognition remains poorly understood. Among 401 older adults in peri-urban northern China enrolled in the INTERMAP-China Prospective Study, we estimated the associations between exposure to HAP and z-standardized domain-specific and overall cognitive scores from the Montreal Cognitive Assessment. Interquartile range increases in exposures to fine particulate matter (53.2-µg/m3) and black carbon (0.9-µg/m3) were linearly associated with lower overall cognition [- 0.13 (95% confidence interval: - 0.22, - 0.04) and - 0.10 (- 0.19, - 0.01), respectively]. Using solid fuel indoors and greater intensity of its use were also associated with lower overall cognition (range of point estimates: - 0.13 to - 0.03), though confidence intervals included zero. Among individual cognitive domains, attention had the largest associations with most exposure measures. Our findings indicate that exposure to HAP may be a dose-dependent risk factor for cognitive impairment. As exposure to HAP remains pervasive in China and worldwide, reducing exposure through the promotion of less-polluting stoves and fuels may be a population-wide intervention strategy to lessen the burden of cognitive impairment.
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Affiliation(s)
- Tzu-Wei Joy Tseng
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1130 Pine Ave W, Montreal, QC, H3A 1A3, Canada
| | - Ellison Carter
- Institute on the Environment, University of Minnesota, Saint Paul, MN, USA
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, CO, USA
| | - Li Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- NIHR Imperial College London Biomedical Research Centre, London, UK
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Frank Kelly
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - James J Schauer
- Department of Civil and Environmental Engineering, University of Wisconsin, Madison, USA
- Environmental Chemistry & Technology Program, University of Wisconsin, Madison, USA
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Beijing, China
| | - Xudong Yang
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China
| | - Liancheng Zhao
- National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1130 Pine Ave W, Montreal, QC, H3A 1A3, Canada.
- Institute for Health and Social Policy, McGill University, Montreal, Canada.
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12
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Zang ST, Wu QJ, Li XY, Gao C, Liu YS, Jiang YT, Zhang JY, Sun H, Chang Q, Zhao YH. Long-term PM 2.5 exposure and various health outcomes: An umbrella review of systematic reviews and meta-analyses of observational studies. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:152381. [PMID: 34914980 DOI: 10.1016/j.scitotenv.2021.152381] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Adverse effects from exposure to particulate matter <2.5 μm in diameter (PM2.5) on health-related outcomes have been found in a range of experimental and epidemiological studies. This study aimed to assess the significance, validity, and reliability of the relationship between long-term PM2.5 exposure and various health outcomes. The Embase, PubMed, Web of Science, CNKI, WANFANG, VIP, and SinoMed databases and reference lists of the retrieved review articles were searched to obtain meta-analysis and systematic reviews focusing on PM2.5-related outcomes as of August 31, 2021. Random-/fixed-effects models were applied to estimate summary effect size and 95% confidence intervals (CIs). The quality of included meta-analyses was evaluated based on the AMSTAR 2 tool. Small-study effect and excess significance bias studies were conducted to further assess the associations. Registered PROSPERO number: CRD42020200606. This included 24 articles involving 71 associations between PM2.5 exposure and the health outcomes. The evidence for the positive association of 10 μg/m3 increments of long-term exposure to PM2.5 and stroke incidence in Europe was convincing (effect size = 1.07, 95% CI: 1.05-1.10). There was evidence that was highly suggestive of a positive association between 10 μg/m3 increments of long-term exposure to PM2.5 and the following health-related outcomes: mortality of lung cancer (effect size = 1.11, 95% CI: 1.08-1.13) and Alzheimer's disease (effect size = 4.79, 95% CI: 2.79-8.21). There was highly suggestive evidence that chronic obstructive pulmonary disease risk is positively associated with higher long-term PM2.5 exposure versus lower long-term PM2.5 exposure (effect size = 2.32, 95% CI: 1.88-2.86). In conclusion, the positive association of long-term exposure to PM2.5 and stroke incidence in Europe was convincing. Given the validity of numerous associations of long-term exposure to PM2.5 and health-related outcomes is subject to biases, more robust evidence is urgently needed.
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Affiliation(s)
- Si-Tian Zang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Xin-Yu Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Chang Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ya-Shu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yu-Ting Jiang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jia-Yu Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Hui Sun
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
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13
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Zang ST, Luan J, Li L, Yu HX, Wu QJ, Chang Q, Zhao YH. Ambient air pollution and COVID-19 risk: Evidence from 35 observational studies. ENVIRONMENTAL RESEARCH 2022; 204:112065. [PMID: 34534520 PMCID: PMC8440008 DOI: 10.1016/j.envres.2021.112065] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/28/2021] [Accepted: 09/12/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND AND AIMS The coronavirus disease 2019 (COVID-19) pandemic is severely threatening and challenging public health worldwide. Epidemiological studies focused on the influence of outdoor air pollution (AP) on COVID-19 risk have produced inconsistent conclusions. We aimed to quantitatively explore this association using a meta-analysis. METHODS We searched for studies related to outdoor AP and COVID-19 risk in the Embase, PubMed, and Web of Science databases. No language restriction was utilized. The search date entries were up to August 13, 2021. Pooled estimates and 95% confidence intervals (CIs) were obtained with random-/fixed-effects models. PROSPERO registration number: CRD42021244656. RESULTS A total of 35 articles were eligible for the meta-analysis. For long-term exposure to AP, COVID-19 incidence was positively associated with 1 μg/m3 increase in nitrogen dioxide (NO2; effect size = 1.042, 95% CI 1.017-1.068), particulate matter with diameter <2.5 μm (PM2.5; effect size = 1.056, 95% CI 1.039-1.072), and sulfur dioxide (SO2; effect size = 1.071, 95% CI 1.002-1.145). The COVID-19 mortality was positively associated with 1 μg/m3 increase in nitrogen dioxide (NO2; effect size = 1.034, 95% CI 1.006-1.063), PM2.5 (effect size = 1.047, 95% CI 1.025-1.1071). For short-term exposure to air pollutants, COVID-19 incidence was positively associated with 1 unit increase in air quality index (effect size = 1.001, 95% CI 1.001-1.002), 1 μg/m3 increase NO2 (effect size = 1.014, 95% CI 1.011-1.016), particulate matter with diameter <10 μm (PM10; effect size = 1.005, 95% CI 1.003-1.008), PM2.5 (effect size = 1.003, 95% CI 1.002-1.004), and SO2 (effect size = 1.015, 95% CI 1.007-1.023). CONCLUSIONS Outdoor air pollutants are detrimental factors to COVID-19 outcomes. Measurements beneficial to reducing pollutant levels might also reduce the burden of the pandemic.
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Affiliation(s)
- Si-Tian Zang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China; Clinical Research Center, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China.
| | - Jie Luan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China; Clinical Research Center, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China.
| | - Ling Li
- Center for Precision Medicine Research and Training, University of Macau, Avenida da Universidade Taipa, Macau, 999078, China.
| | - Hui-Xin Yu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China; Clinical Research Center, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China.
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China; Clinical Research Center, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China.
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China; Clinical Research Center, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China.
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China.
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14
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Southerland VA, Brauer M, Mohegh A, Hammer MS, van Donkelaar A, Martin RV, Apte JS, Anenberg SC. Global urban temporal trends in fine particulate matter (PM 2·5) and attributable health burdens: estimates from global datasets. Lancet Planet Health 2022; 6:e139-e146. [PMID: 34998505 PMCID: PMC8828497 DOI: 10.1016/s2542-5196(21)00350-8] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/08/2021] [Accepted: 11/23/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND With much of the world's population residing in urban areas, an understanding of air pollution exposures at the city level can inform mitigation approaches. Previous studies of global urban air pollution have not considered trends in air pollutant concentrations nor corresponding attributable mortality burdens. We aimed to estimate trends in fine particulate matter (PM2·5) concentrations and associated mortality for cities globally. METHODS We use high-resolution annual average PM2·5 concentrations, epidemiologically derived concentration response functions, and country-level baseline disease rates to estimate population-weighted PM2·5 concentrations and attributable cause-specific mortality in 13 160 urban centres between the years 2000 and 2019. FINDINGS Although regional averages of urban PM2·5 concentrations decreased between the years 2000 and 2019, we found considerable heterogeneity in trends of PM2·5 concentrations between urban areas. Approximately 86% (2·5 billion inhabitants) of urban inhabitants lived in urban areas that exceeded WHO's 2005 guideline annual average PM2·5 (10 μg/m3), resulting in an excess of 1·8 million (95% CI 1·34 million-2·3 million) deaths in 2019. Regional averages of PM2·5-attributable deaths increased in all regions except for Europe and the Americas, driven by changes in population numbers, age structures, and disease rates. In some cities, PM2·5-attributable mortality increased despite decreases in PM2·5 concentrations, resulting from shifting age distributions and rates of non-communicable disease. INTERPRETATION Our study showed that, between the years 2000 and 2019, most of the world's urban population lived in areas with unhealthy levels of PM2·5, leading to substantial contributions to non-communicable disease burdens. Our results highlight that avoiding the large public health burden from urban PM2·5 will require strategies that reduce exposure through emissions mitigation, as well as strategies that reduce vulnerability to PM2·5 by improving overall public health. FUNDING NASA, Wellcome Trust.
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Affiliation(s)
- Veronica A Southerland
- Milken Institute School of Public Health, George Washington University, Washington DC, USA
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Arash Mohegh
- Milken Institute School of Public Health, George Washington University, Washington DC, USA
| | - Melanie S Hammer
- McKelvey School of Engineering, Washington University in St Louis, St Louis, MO, USA
| | - Aaron van Donkelaar
- McKelvey School of Engineering, Washington University in St Louis, St Louis, MO, USA; Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
| | - Randall V Martin
- McKelvey School of Engineering, Washington University in St Louis, St Louis, MO, USA
| | - Joshua S Apte
- Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, CA, USA; School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Susan C Anenberg
- Milken Institute School of Public Health, George Washington University, Washington DC, USA.
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Gao Q, Zang E, Bi J, Dubrow R, Lowe SR, Chen H, Zeng Y, Shi L, Chen K. Long-term ozone exposure and cognitive impairment among Chinese older adults: A cohort study. ENVIRONMENT INTERNATIONAL 2022; 160:107072. [PMID: 34979350 PMCID: PMC8821373 DOI: 10.1016/j.envint.2021.107072] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/03/2021] [Accepted: 12/28/2021] [Indexed: 06/12/2023]
Abstract
Ambient particulate matter pollution has been linked to impaired cognitive performance, but the effect of ambient ozone exposure on cognitive function remains largely unknown. We examined the association of long-term ozone exposure with the risk of cognitive impairment among a national representative cohort of 9,544 Chinese older adults (aged 65 years and over) with baseline normal cognition from the Chinese Longitudinal Healthy Longevity Survey (2005-2018). The ozone exposure of each participant was measured by annual mean ozone concentrations for the county of residence. Cognitive function was assessed by the Chinese version of the Mini-Mental State Examination (MMSE). We defined cognitive impairment as an MMSE score below 18 points accompanied by an MMSE score that declined ≥ 4 points from baseline. Cox proportional hazards models were applied to explore the association of ozone exposure with cognitive impairment. During the mean follow-up time of 6.5 years, 2,601 older adults developed cognitive impairment. Each 10-μg/m3 increase in annual mean ozone exposure was associated with a 10.4% increased risk of cognitive impairment. The exposure-response relationship between ozone exposure and risk of cognitive impairment showed a linear trend. Sensitivity analyses revealed the association to be robust. We found that older adults from Eastern, Central, and Southern China were particularly susceptible. Our results show that ozone is a risk factor for late-life cognitive decline. Reducing ambient ozone pollution may help delay the onset of cognitive impairment among older adults.
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Affiliation(s)
- Qi Gao
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, United States; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut, United States
| | - Emma Zang
- Department of Sociology, Yale University, New Haven, Connecticut, United States
| | - Jun Bi
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China.
| | - Robert Dubrow
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, United States; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut, United States
| | - Sarah R Lowe
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut, United States; Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States
| | - Huashuai Chen
- Business School of Xiangtan University, Xiangtan, Hunan, China; Center for the Study of Aging and Human Development, Duke Medical School, Durham, NC, United States
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Duke Medical School, Durham, NC, United States; Center for Healthy Aging and Development Studies, National School of Development, Raissun Institute for Advanced Studies, Peking University, Beijing, China
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, United States; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut, United States.
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16
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Saenz JL, Adar SD, Zhang YS, Wilkens J, Chattopadhyay A, Lee J, Wong R. Household use of polluting cooking fuels and late-life cognitive function: A harmonized analysis of India, Mexico, and China. ENVIRONMENT INTERNATIONAL 2021; 156:106722. [PMID: 34182193 PMCID: PMC8380666 DOI: 10.1016/j.envint.2021.106722] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Exposure to high levels of air pollution is associated with poor health, including worse cognitive function. Whereas many studies of cognition have assessed outdoor air pollution, we evaluate how exposure to air pollution from combustion of polluting household fuels relates with cognitive function using harmonized data from India, Mexico, and China. MATERIALS & METHODS We analyze adults age 50+ in three nationally representative studies of aging with common data collection methods: the 2017-2019 Longitudinal Aging Study in India (n = 50,532), 2015 Mexican Health and Aging Study (n = 12,883), and 2013 China Health and Retirement Longitudinal Study (n = 12,913). Use of polluting fuels was assessed by self-report of wood, coal, kerosene, crop residue, or dung for cooking. Cognitive function was measured by performance across several cognitive domains and summarized into a total cognition score. We used linear regression, by country, to test how polluting cooking fuel use relates with cognition adjusting for key demographic and socioeconomic factors. RESULTS Approximately 47%, 12%, and 48% of respondents in India, Mexico, and China, respectively, relied primarily on polluting cooking fuel, which was more common in rural areas. Using polluting cooking fuels was consistently associated with poorer cognitive function in all countries, independent of demographic and socioeconomic characteristics. Adjusted differences in cognitive function between individuals using polluting and clean cooking fuel were equivalent to differences observed between individuals who were 3 years of age apart in Mexico and China and 6 years of age apart in India. Across countries, associations between polluting cooking fuel use and poorer cognition were larger for women. CONCLUSIONS Results suggest that household air pollution from the use of polluting cooking fuel may play an important role in shaping cognitive outcomes of older adults in countries where reliance on polluting fuels for domestic energy needs still prevails. As these countries continue to age, public health efforts should seek to reduce reliance on these fuels.
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Affiliation(s)
- Joseph L Saenz
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States.
| | - Sara D Adar
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Yuan S Zhang
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, United States
| | - Jenny Wilkens
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Aparajita Chattopadhyay
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India.
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States; Department of Economics, University of Southern California, Los Angeles, CA, United States
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
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17
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Bansal E, Hsu HH, de Water E, Martínez-Medina S, Schnaas L, Just AC, Horton M, Bellinger DC, Téllez-Rojo MM, Wright RO. Prenatal PM2.5 exposure in the second and third trimesters predicts neurocognitive performance at age 9-10 years: A cohort study of Mexico City children. ENVIRONMENTAL RESEARCH 2021; 202:111651. [PMID: 34246643 PMCID: PMC8578200 DOI: 10.1016/j.envres.2021.111651] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Prenatal exposure to fine particulate matter air pollution (PM2.5) is an important, under-studied risk factor for neurodevelopmental dysfunction. We describe the relationships between prenatal PM2.5 exposure and vigilance and inhibitory control, executive functions related to multiple health outcomes in Mexico City children. METHODS We studied 320 children enrolled in Programming Research in Obesity, GRowth, Environment and Social Stressors, a longitudinal birth cohort study in Mexico City. We used a spatio-temporal model to estimate daily prenatal PM2.5 exposure at each participant's residential address. At age 9-10 years, children performed three Go/No-Go tasks, which measure vigilance and inhibitory control ability. We used Latent class analysis (LCA) to classify performance into subgroups that reflected neurocognitive performance and applied multivariate regression and distributed lag regression modeling (DLM) to test overall and time-dependent associations between prenatal PM2.5 exposure and Go/No-Go performance. RESULTS LCA detected two Go/No-Go phenotypes: high performers (Class 1) and low performers (Class 2). Predicting odds of Class 1 vs Class 2 membership based on prenatal PM2.5 exposure timing, logistic regression modeling showed that average prenatal PM2.5 exposure in the second and third trimesters correlated with increased odds of membership in low-performance Class 2 (OR = 1.59 (1.16, 2.17), p = 0.004). Additionally, DLM analysis identified a critical window consisting of gestational days 103-268 (second and third trimesters) in which prenatal PM2.5 exposure predicted poorer Go/No-Go performance. DISCUSSION Increased prenatal PM2.5 exposure predicted decreased vigilance and inhibitory control at age 9-10 years. These findings highlight the second and third trimesters of gestation as critical windows of PM2.5 exposure for the development of vigilance and inhibitory control in preadolescent children. Because childhood development of vigilance and inhibitory control informs behavior, academic performance, and self-regulation into adulthood, these results may help to describe the relationship of prenatal PM2.5 exposure to long-term health and psychosocial outcomes. The integrative methodology of this study also contributes to a shift towards more holistic analysis.
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Affiliation(s)
- Esha Bansal
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, 3 West, New York, NY, United States.
| | - Hsiao-Hsien Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, 3 West, New York, NY, United States.
| | - Erik de Water
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Twin Cities, 2450 Riverside Avenue, Minneapolis, MN, United States.
| | - Sandra Martínez-Medina
- Division of Community Interventions Research, National Institute of Perinatology, Calle Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Mexico City, Mexico.
| | - Lourdes Schnaas
- Division of Community Interventions Research, National Institute of Perinatology, Calle Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Mexico City, Mexico.
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, 3 West, New York, NY, United States.
| | - Megan Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, 3 West, New York, NY, United States.
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States.
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Ministry of Health, Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, Mexico.
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, 3 West, New York, NY, United States; The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, 3 West, New York, NY, United States.
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18
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Åström DO, Adolfsson R, Segersson D, Forsberg B, Oudin A. Local Contrasts in Concentration of Ambient Particulate Air Pollution (PM2.5) and Incidence of Alzheimer's Disease and Dementia: Results from the Betula Cohort in Northern Sweden. J Alzheimers Dis 2021; 81:83-85. [PMID: 33749652 PMCID: PMC8203233 DOI: 10.3233/jad-201538] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Exposure to fine particulate air pollution (PM2.5) is emerging as a risk factor for Alzheimer's disease (AD), but existing studies are still limited and heterogeneous. We have previously studied the association between dementia (AD and vascular dementia) and PM2.5 stemming from vehicle exhaust and wood-smoke in the Betula cohort in Northern Sweden. The aim of this commentary is to estimate the association between total PM2.5 and dementia in the Betula cohort, which is more relevant to include in future meta-estimates than the source-specific estimates. The hazard ratio for incident dementia associated with a 1μg/m3 increase in local PM2.5 was 1.38 (95% confidence interval: 0.99 -1.92). The interpretation of our results is that they indicate an association between local contrasts in concentration of PM2.5 at the residential address and incidence of dementia in a low-level setting.
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Affiliation(s)
- Daniel Oudin Åström
- Sustainable health, Department for Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Rolf Adolfsson
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - David Segersson
- Swedish Meteorological and Hydrological Institute, Norrköping, Sweden
| | - Bertil Forsberg
- Sustainable health, Department for Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anna Oudin
- Sustainable health, Department for Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Environment, Society and Health, Occupational and Environmental Medicine, Department for Laboratory Medicine, Lund University, Lund, Sweden
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19
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Saenz JL. Solid cooking fuel use and cognitive decline among older Mexican adults. INDOOR AIR 2021; 31:1522-1532. [PMID: 33896051 PMCID: PMC8380681 DOI: 10.1111/ina.12844] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/29/2021] [Accepted: 04/09/2021] [Indexed: 05/02/2023]
Abstract
Studies of air pollution and cognition often rely on measures from outdoor environments. Many individuals in low- and middle-income countries are exposed to indoor air pollution from combustion of solid cooking fuels. Little is known about how solid cooking fuel use affects cognitive decline over time. This study uses data from the 2012, 2015, and 2018 Mexican Health and Aging Study (n = 14 245, age 50+) to assess how use of wood or coal for cooking fuel affects cognition of older adults relative to use of gas. It uses latent change score modeling to determine how using solid cooking fuel affected performance in Verbal Learning, Verbal Recall, Visual Scanning, and Verbal Fluency. Solid cooking fuel was used by 17% of the full sample but was more common in rural areas. Solid fuel users also had lower socioeconomic status. Compared to those using gas, solid fuel users had lower baseline scores and faster decline in Verbal Learning (β = -0.18, p < 0.05), Visual Scanning (β = -1.00, p < 0.001), and Verbal Fluency (β = -0.33, p < 0.001). Indoor air pollution from solid cooking fuels may represent a modifiable risk factor for cognitive decline. Policy should focus on facilitating access to clean cooking fuels.
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Affiliation(s)
- Joseph L. Saenz
- University of Southern California, Leonard Davis School of Gerontology, Los Angeles, CA
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20
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Kriit HK, Forsberg B, Åström DO, Oudin A. Annual dementia incidence and monetary burden attributable to fine particulate matter (PM 2.5) exposure in Sweden. Environ Health 2021; 20:65. [PMID: 34044832 PMCID: PMC8161951 DOI: 10.1186/s12940-021-00750-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM2.5) air pollution and resulting monetary estimates are lacking. METHODS We used data on average population-weighted exposure to ambient PM2.5 for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish population above 60 years of age, we used the latest concentration response functions (CRF) between PM2.5 exposure and dementia incidence, based on ten longitudinal cohort studies, for the population above 60 years of age. To estimate the monetary burden of attributable cases, we calculated total costs related to dementia, including direct and indirect lifetime costs and intangible costs by including quality-adjusted life years (QALYs) lost. Two different monetary valuations of QALYs in Sweden were used to estimate the monetary value of reduced quality-of-life from two different payer perspectives. RESULTS The annual number of dementia cases attributable to PM2.5 exposure was estimated to be 820, which represents 5% of the annual dementia cases in Sweden. Direct and indirect lifetime average cost per dementia case was estimated to correspond € 213,000. A reduction of PM2.5 by 1 μg/m3 was estimated to yield 101 fewer cases of dementia incidences annually, resulting in an estimated monetary benefit ranging up to 0.01% of the Swedish GDP in 2019. CONCLUSION This study estimated that 5% of annual dementia cases could be attributed to PM2.5 exposure, and that the resulting monetary burden is substantial. These findings suggest the need to consider airborne toxic pollutants associated with dementia incidence in public health policy decisions.
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Affiliation(s)
- Hedi Katre Kriit
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Daniel Oudin Åström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Anna Oudin
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Tornblad Institute, Biskopsgatan 7, 223v62, Lund, Sweden
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21
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Sullivan KJ, Ran X, Wu F, Chang CCH, Sharma R, Jacobsen E, Berman S, Snitz BE, Sekikawa A, Talbott EO, Ganguli M. Ambient fine particulate matter exposure and incident mild cognitive impairment and dementia. J Am Geriatr Soc 2021; 69:2185-2194. [PMID: 33904156 DOI: 10.1111/jgs.17188] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/14/2021] [Accepted: 04/04/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVE Poor air quality is implicated as a risk factor for cognitive impairment and dementia. Few studies have examined these associations longitudinally in well-characterized population-based cohorts with standardized annual assessment of both mild cognitive impairment (MCI) and dementia. We investigated the association between estimated ambient fine particulate matter (PM2.5 ) and risk of incident MCI and dementia in a post-industrial region known for historically poor air quality. SETTING/PARTICIPANTS Adults aged 65+ years in a population-based cohort (n = 1572). MEASUREMENTS Census tract level PM2.5 from Environmental Protection Agency (EPA) air quality monitors; Clinical Dementia Rating (CDR)®. DESIGN We estimated ambient PM2.5 exposure (μg/m3 , single-year and 5-year averages) by geocoding participants' residential addresses to census tracts with daily EPA PM2.5 measurements from 2002 to 2014. Using Bayesian spatial regression modeling adjusted for age, sex, education, smoking history, and household income, we examined the association between estimated PM2.5 exposure and risk of incident MCI (CDR = 0.5) and incident dementia (CDR ≥ 1.0). RESULTS Modeling estimated single-year exposure, each 1 μg/m3 higher ambient PM2.5 was associated with 67% higher adjusted risk of incident dementia (hazard ratio [HR] = 1.669, 95% credible interval [CI]: 1.298, 2.136) and 75% higher adjusted risk of incident MCI (HR = 1.746, 95% CI: 1.518, 2.032). Estimates were higher when modeling 5-year ambient PM2.5 exposure for incident dementia (HR = 2.082, 95% CI: 1.528, 3.015) and incident MCI (HR = 3.419, 95% CI: 2.806, 4.164). CONCLUSIONS Higher estimated ambient PM2.5 was associated with higher risk of incident MCI and dementia, particularly when considering longer-term exposure, and independent of demographic characteristics and smoking history. Targeting poor air quality may be a reasonable population-wide intervention to reduce the risk of cognitive impairment in older adults, particularly in regions exceeding current recommendations for safe exposure to PM2.5 .
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Affiliation(s)
- Kevin J Sullivan
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Xinhui Ran
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Fan Wu
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chung-Chou H Chang
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ravi Sharma
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Erin Jacobsen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Akira Sekikawa
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Evelyn O Talbott
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary Ganguli
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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