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Zhang CL, Maccarone JR, Grady ST, Collins CM, Moy ML, Hart JE, Kang CM, Coull BA, Schwartz JD, Koutrakis P, Garshick E. Indoor and ambient black carbon and fine particulate matter associations with blood biomarkers in COPD patients. Sci Total Environ 2024; 927:171897. [PMID: 38522542 DOI: 10.1016/j.scitotenv.2024.171897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Systemic inflammation contributes to cardiovascular risk and chronic obstructive pulmonary disease (COPD) pathophysiology. Associations between systemic inflammation and exposure to ambient fine particulate matter (PM ≤ 2.5 μm diameter; PM2.5), and black carbon (BC), a PM2.5 component attributable to traffic and other sources of combustion, infiltrating indoors are not well described. METHODS Between 2012 and 2017, COPD patients completed in-home air sampling over one-week intervals, up to four times (seasonally), followed by measurement of plasma biomarkers of systemic inflammation, C-reactive protein (CRP) and interleukin-6 (IL-6), and endothelial activation, soluble vascular adhesion molecule-1 (sVCAM-1). Ambient PM2.5, BC and sulfur were measured at a central site. The ratio of indoor/ambient sulfur in PM2.5, a surrogate for fine particle infiltration, was used to estimate indoor BC and PM2.5 of ambient origin. Linear mixed effects regression with a random intercept for each participant was used to assess associations between indoor and indoor of ambient origin PM2.5 and BC with each biomarker. RESULTS 144 participants resulting in 482 observations were included in the analysis. There were significant positive associations between indoor BC and indoor BC of ambient origin with CRP [%-increase per interquartile range (IQR);95 % CI (13.2 %;5.2-21.8 and 11.4 %;1.7-22.1, respectively)]. Associations with indoor PM2.5 and indoor PM2.5 of ambient origin were weaker. There were no associations with IL-6 or sVCAM-1. CONCLUSIONS In homes of patients with COPD without major sources of combustion, indoor BC is mainly attributable to the infiltration of ambient sources of combustion indoors. Indoor BC of ambient origin is associated with increases in systemic inflammation in patients with COPD, even when staying indoors.
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Affiliation(s)
- Cathy L Zhang
- Research and Development Service, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA 02132, USA
| | - Jennifer R Maccarone
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, Boston, MA 02132, USA; The Pulmonary Center, Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, USA
| | - Stephanie T Grady
- Boston University School of Public Health, 715 Albany St, Boston, MA 02118, USA
| | - Christina M Collins
- Research and Development Service, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA 02132, USA
| | - Marilyn L Moy
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, Boston, MA 02132, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Choong-Min Kang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA
| | - Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, Boston, MA 02132, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
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Klompmaker JO, Hart JE, Dominici F, James P, Roscoe C, Schwartz J, Yanosky JD, Zanobetti A, Laden F. Associations of fine particulate matter with incident cardiovascular disease; comparing models using ZIP code-level and individual-level fine particulate matter and confounders. Sci Total Environ 2024; 926:171866. [PMID: 38521279 PMCID: PMC11034806 DOI: 10.1016/j.scitotenv.2024.171866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/23/2024] [Accepted: 03/19/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND PM2.5 has been positively associated with cardiovascular disease (CVD) incidence. Most evidence has come from cohorts and administrative databases. Cohorts typically have extensive information on potential confounders and residential-level exposures. Administrative databases are usually more representative but typically lack information on potential confounders and often only have exposures at coarser geographies (e.g., ZIP code). The weaknesses in both types of studies have been criticized for potentially jeopardizing the validity of their findings for regulatory purposes. METHODS We followed 101,870 participants from the US-based Nurses' Health Study (2000-2016) and linked residential-level PM2.5 and individual-level confounders, and ZIP code-level PM2.5 and confounders. We used time-varying Cox proportional hazards models to examine associations with CVD incidence. We specified basic models (adjusted for individual-level age, race and calendar year), individual-level confounder models, and ZIP code-level confounder models. RESULTS Residential- and ZIP code-level PM2.5 were strongly correlated (Pearson r = 0.88). For residential-level PM2.5, the hazard ratio (HR, 95 % confidence interval) per 5 μg/m3 increase was 1.06 (1.01, 1.11) in the basic and 1.04 (0.99, 1.10) in the individual-level confounder model. For ZIP code-level PM2.5, the HR per 5 μg/m3 was 1.04 (0.99, 1.08) in the basic and 1.02 (0.97, 1.08) in the ZIP code-level confounder model. CONCLUSION We observed suggestive positive, but not statistically significant, associations between long-term PM2.5 and CVD incidence, regardless of the exposure or confounding model. Although differences were small, associations from models with individual-level confounders and residential-level PM2.5 were slightly stronger than associations from models with ZIP code-level confounders and PM2.5.
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Affiliation(s)
- Jochem O Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Charlie Roscoe
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
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Dong J, Browning MHEM, Reuben A, McAnirlin O, Yuan S, Stephens C, Maisonet M, Zhang K, Hart JE, James P, Yeager R. The paradox of high greenness and poor health in rural Central Appalachia. Environ Res 2024; 248:118400. [PMID: 38309568 DOI: 10.1016/j.envres.2024.118400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024]
Abstract
While many studies have found positive correlations between greenness and human health, rural Central Appalachia is an exception. The region has high greenness levels but poor health. The purpose of this commentary is to provide a possible explanation for this paradox: three sets of factors overwhelming or attenuating the health benefits of greenness. These include environmental (e.g., steep typography and limited access to green space used for outdoor recreation), social (e.g., chronic poverty, declining coal industry, and limited access to healthcare), and psychological and behavioral factors (e.g., perceptions about health behaviors, healthcare, and greenness). The influence of these factors on the expected health benefits of greenness should be considered as working hypotheses for future research. Policymakers and public health officials need to ensure that greenness-based interventions account for contextual factors and other determinants of health to ensure these interventions have the expected health benefits.
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Affiliation(s)
- Jiaying Dong
- School of Architecture, Huaqiao University, Xiamen, China; Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | - Matthew H E M Browning
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA.
| | - Aaron Reuben
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Olivia McAnirlin
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | - Shuai Yuan
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | | | - Mildred Maisonet
- Biostatistics and Epidemiology Department, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Kuiran Zhang
- Virtual Reality and Nature Lab, Department of Parks, Recreation & Tourism Management, Clemson University, Clemson, SC, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ray Yeager
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, KY, USA
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Silva EL, Mínguez-Alarcón L, Coull B, Hart JE, James-Todd T, Calafat AM, Ford JB, Hauser R, Mahalingaiah S. Benzophenone-3 and ovarian reserve. Fertil Steril 2024:S0015-0282(24)00266-8. [PMID: 38697237 DOI: 10.1016/j.fertnstert.2024.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE To evaluate the association between urinary benzophenone-3 concentrations and measures of ovarian reserve (OR) among women in the Environment and Reproductive Health (EARTH) Study seeking fertility treatment at Massachusetts General Hospital in Boston, Massachusetts. DESIGN Prospective cohort study. METHODS Women from the EARTH cohort contributed spot urine samples before assessment of OR outcomes. Antral follicle count (AFC) and day-3 follicle stimulating hormone (FSH) levels were evaluated as part of standard infertility workups during unstimulated menstrual cycles. Quasi-Poisson and linear regression models were used to evaluate the association of specific gravity (SG)-adjusted urinary benzophenone-3 concentrations with AFC and FSH, respectively, with adjustment for age and physical activity. In secondary analyses, models were stratified by age. Sensitivity analyses assessed for confounding by season by restricting to women with exposure and outcome measured in the same season and stratifying by summer vs. non-summer months and for confounding by sunscreen use by restricting to women who filled out product questionnaires and adjusting for and stratifying by average sunscreen use score. RESULTS The study included 142 women (mean age ± SD, 36.1 ± 4.6; range, 22-45 years) enrolled between 2009 and 2017 with both urinary benzophenone-3 and AFC and 57 women with benzophenone-3 and FSH measurements. Most women were white (78%) and highly educated (49% with a graduate degree). Women contributed a mean of 2.7 urine samples (range, 1-10) with 37% contributing 2 or more samples. Benzophenone-3 was detected in 98% of samples. Geometric mean (GM) SG-corrected urinary benzophenone-3 concentration was 85.9 μ g/L (geometric standard deviation 6.2). There were no associations of benzophenone-3 with AFC and day-3 FSH in the full cohort. In stratified models, a 1-unit increase in log GM benzophenone-3 was associated with AFC 0.91 (95% CI, 0.86, 0.97) times lower among women ≤35 years old and was associated with FSH 0.73 (95% CI, 0.12, 1.34) IU/L higher among women >35 years old. Effect estimates from models stratified by season and sunscreen use were null. CONCLUSION In main models, urinary benzophenone-3 was not associated with OR. However, younger may be vulnerable to potential effects of benzophenone-3 on AFC. Further research is warranted.
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Affiliation(s)
- Emily L Silva
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, 655 Huntington Avenue, Boston, MA 02115, USA.
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, 655 Huntington Avenue, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, 655 Huntington Avenue, Boston, MA 02115, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Building 2, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, 655 Huntington Avenue, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, 655 Huntington Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Building 2, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, GA 30341-3724, USA
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, 655 Huntington Avenue, Boston, MA 02115, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, 655 Huntington Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Building 2, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, 655 Huntington Avenue, Boston, MA 02115, USA; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit St #4f, Boston, MA 02114, USA
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Chen J, Hart JE, VoPham T, Elliott EG, Birmann BM, Laden F. Association of residential exposure to hazardous air pollutants with risk of non-Hodgkin lymphoma and multiple myeloma. Cancer Epidemiol Biomarkers Prev 2024:743233. [PMID: 38656285 DOI: 10.1158/1055-9965.epi-23-1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/13/2024] [Accepted: 04/22/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Certain hazardous air pollutants (HAPs) are known or suspected to pose immunological or cancer risk to humans, but evidence is limited from the general population. METHODS We assessed associations between residential exposure to HAPs at the Census tract level and incident non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) in the Nurses' Health Study (NHS, 1986-2012) and NHSII (1989-2019). We used covariate-adjusted proportional hazards models to estimate hazard ratios (HRs) of NHL, major NHL subtypes, and MM per interquartile range increase in exposure to a given HAP and pooled the cohort-specific estimates using fixed-effects meta-analyses. RESULTS There were 810 NHL and 158 MM cases in NHS (1,700,707 person-years), and 379 NHL and 59 MM cases in NHSII (2,820,772 person-years). Most HRs approximated unity. Meta-analyses did not show consistent evidence of associations between any HAP exposure and risk of NHL or MM. CONCLUSIONS Exposure to HAPs was not consistently associated with risks of NHL or MM in these nationwide prospective cohorts of women. IMPACT This is the first nationwide study assessing associations between residential HAP exposures and risk of lymphoid malignances in prospective cohorts and focuses on women, who have frequently been underrepresented in (primarily occupational) studies of exposure to HAPs.
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Affiliation(s)
- Jie Chen
- Harvard University, Boston, United States
| | - Jaime E Hart
- Brigham and Womens Hospital and Harvard Medical School, Boston, MA, United States
| | - Trang VoPham
- Fred Hutchinson Cancer Center, Seattle, WA, United States
| | | | - Brenda M Birmann
- Brigham and Womens Hospital and Harvard Medical School, Boston, MA, United States
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Bogl LH, Strohmaier S, Hu FB, Willett WC, Eliassen AH, Hart JE, Sun Q, Chavarro JE, Field AE, Schernhammer ES. Maternal One-Carbon Nutrient Intake and Risk of Being Overweight or Obese in Their Offspring-A Transgenerational Prospective Cohort Study. Nutrients 2024; 16:1210. [PMID: 38674900 PMCID: PMC11054902 DOI: 10.3390/nu16081210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
We aimed to investigate the associations between maternal intake of folate, vitamin B12, B6, B2, methionine, choline, phosphatidylcholine and betaine during the period surrounding pregnancy and offspring weight outcomes from birth to early adulthood. These associations were examined among 2454 mother-child pairs from the Nurses' Health Study II and Growing Up Today Study. Maternal energy-adjusted nutrient intakes were derived from food frequency questionnaires. Birth weight, body size at age 5 and repeated BMI measurements were considered. Overweight/obesity was defined according to the International Obesity Task Force (<18 years) and World Health Organization guidelines (18+ years). Among other estimands, we report relative risks (RRs) for offspring ever being overweight with corresponding 95% confidence intervals across quintiles of dietary factors, with the lowest quintile as the reference. In multivariate-adjusted models, higher maternal intakes of phosphatidylcholine were associated with a higher risk of offspring ever being overweight (RRQ5vsQ1 = 1.16 [1.01-1.33] p-trend: 0.003). The association was stronger among offspring born to mothers with high red meat intake (high red meat RRQ5vsQ1 = 1.50 [1.14-1.98], p-trend: 0.001; low red meat RRQ5vsQ1 = 1.05 [0.87-1.27], p-trend: 0.46; p-interaction = 0.13). Future studies confirming the association between a higher maternal phosphatidylcholine intake during pregnancy and offspring risk of being overweight or obese are needed.
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Affiliation(s)
- Leonie H. Bogl
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Wien, Austria; (L.H.B.); (S.S.)
- School of Health Professions, Bern University of Applied Sciences, 3012 Bern, Switzerland
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Wien, Austria; (L.H.B.); (S.S.)
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - A. Heather Eliassen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Alison E. Field
- Department of Epidemiology, Brown University, Providence, RI 02903, USA
| | - Eva S. Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Wien, Austria; (L.H.B.); (S.S.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
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Bozigar M, Laden F, Hart JE, Redline S, Huang T, Whitsel EA, Nelson EJ, Grady ST, Levy JI, Peters JL. Aircraft noise exposure and body mass index among female participants in two Nurses' Health Study prospective cohorts living around 90 airports in the United States. Environ Int 2024; 187:108660. [PMID: 38677085 DOI: 10.1016/j.envint.2024.108660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE Aircraft noise exposure is linked to cardiovascular disease risk. One understudied candidate pathway is obesity. This study investigates the association between aircraft noise and obesity among female participants in two prospective Nurses' Health Study (NHS and NHSII) cohorts. METHODS Aircraft day-night average sound levels (DNL) were estimated at participant residential addresses from modeled 1 dB (dB) noise contours above 44 dB for 90 United States (U.S.) airports in 5-year intervals 1995-2010. Biennial surveys (1994-2017) provided information on body mass index (BMI; dichotomized, categorical) and other individual characteristics. Change in BMI from age 18 (BMI18; tertiles) was also calculated. Aircraft noise exposures were dichotomized (45, 55 dB), categorized (<45, 45-54, ≥55 dB) or continuous for exposure ≥45 dB. Multivariable multinomial logistic regression using generalized estimating equations were adjusted for individual characteristics and neighborhood socioeconomic status, greenness, population density, and environmental noise. Effect modification was assessed by U.S. Census region, climate boundary, airline hub type, hearing loss, and smoking status. RESULTS At baseline, the 74,848 female participants averaged 50.1 years old, with 83.0%, 14.8%, and 2.2% exposed to <45, 45-54, and ≥55 dB of aircraft noise, respectively. In fully adjusted models, exposure ≥55 dB was associated with 11% higher odds (95% confidence interval [95%CI]: -1%, 24%) of BMIs ≥30.0, and 15% higher odds (95%CI: 3%, 29%) of membership in the highest tertile of BMI18 (ΔBMI 6.7 to 71.6). Less-pronounced associations were observed for the 2nd tertile of BMI18 (ΔBMI 2.9 to 6.6) and BMI 25.0-29.9 as well as exposures ≥45 versus <45 dB. There was evidence of DNL-BMI trends (ptrends ≤ 0.02). Stronger associations were observed among participants living in the West, arid climate areas, and among former smokers. DISCUSSION In two nationwide cohorts of female nurses, higher aircraft noise exposure was associated with higher BMI, adding evidence to an aircraft noise-obesity-disease pathway.
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Affiliation(s)
- Matthew Bozigar
- School of Nutrition and Public Health, College of Health, Oregon State University, 160 SW 26th Street, Corvallis, OR 97331, USA.
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Susan Redline
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Department of Medicine, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02215, USA
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Elizabeth J Nelson
- College of Arts and Sciences, Boston University, 725 Commonwealth Avenue, Boston, MA 02215, USA
| | - Stephanie T Grady
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA
| | - Junenette L Peters
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA
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Matthaios VN, Holland I, Kang CM, Hart JE, Hauptman M, Wolfson JM, Gaffin JM, Phipatanakul W, Gold DR, Koutrakis P. The effects of urban green space and road proximity to indoor traffic-related PM 2.5, NO 2, and BC exposure in inner-city schools. J Expo Sci Environ Epidemiol 2024:10.1038/s41370-024-00669-8. [PMID: 38615139 DOI: 10.1038/s41370-024-00669-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Since there are known adverse health impacts of traffic-related air pollution, while at the same time there are potential health benefits from greenness, it is important to examine more closely the impacts of these factors on indoor air quality in urban schools. OBJECTIVE This study investigates the association of road proximity and urban greenness to indoor traffic-related fine particulate matter (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in inner-city schools. METHODS PM2.5, NO2, and BC were measured indoors at 74 schools and outdoors at a central urban over a 10-year period. Seasonal urban greenness was estimated using the Normalized Difference Vegetation Index (NDVI) with 270 and 1230 m buffers. The associations between indoor traffic-related air pollution and road proximity and greenness were investigated with mixed-effects models. RESULTS The analysis showed linear decays of indoor traffic-related PM2.5, NO2, and BC by 60%, 35%, and 22%, respectively for schools located at a greater distance from major roads. The results further showed that surrounding school greenness at 270 m buffer was significantly associated (p < 0.05) with lower indoor traffic-related PM2.5: -0.068 (95% CI: -0.124, -0.013), NO2: -0.139 (95% CI: -0.185, -0.092), and BC: -0.060 (95% CI: -0.115, -0.005). These associations were stronger for surrounding greenness at a greater distance from the schools (buffer 1230 m) PM2.5: -0.101 (95% CI: -0.156, -0.046) NO2: -0.122 (95% CI: -0.169, -0.075) BC: -0.080 (95% CI: -0.136, -0.026). These inverse associations were stronger after fully adjusting for regional pollution and meteorological conditions. IMPACT STATEMENT More than 90% of children under the age of 15 worldwide are exposed to elevated air pollution levels exceeding the WHO's guidelines. The study investigates the impact that urban infrastructure and greenness, in particular green areas and road proximity, have on indoor exposures to traffic-related PM2.5, NO2, and BC in inner-city schools. By examining a 10-year period the study provides insights for air quality management, into how road proximity and greenness at different buffers from the school locations can affect indoor exposure.
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Affiliation(s)
- V N Matthaios
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Department of Public Health Policy and Systems, University of Liverpool, Liverpool, UK.
| | - I Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, USA
| | - C M Kang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - M Hauptman
- Harvard Medical School, Boston, MA, USA
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - J M Wolfson
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J M Gaffin
- Harvard Medical School, Boston, MA, USA
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA
| | - W Phipatanakul
- Harvard Medical School, Boston, MA, USA
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA
| | - D R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - P Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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9
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Turner SL, Beccia A, Feeny G, Raffoul A, Jackson D, Sarda V, Rich-Edwards J, Chavarro J, Hart JE, Austin SB. Nurses' use of 'wellness' supplements during the COVID-19 pandemic in the United States. J Adv Nurs 2024. [PMID: 38515173 DOI: 10.1111/jan.16162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/20/2023] [Accepted: 03/02/2024] [Indexed: 03/23/2024]
Abstract
AIM Quantify disparities and identify correlates and predictors of 'wellness' supplement use among nurses during the first year of the pandemic. DESIGN Longitudinal secondary analysis of Nurses' Health Studies 2 and 3 and Growing Up Today Study data. METHODS Sample included 36,518 total participants, 12,044 of which were nurses, who completed surveys during the first year of the COVID-19 pandemic (April 2020 to April 2021). Analyses were conducted in March 2023. Modified Poisson models were used to estimate disparities in 'wellness' supplement use between nurses and non-healthcare workers and, among nurses only, to quantify associations with workplace-related predictors (occupational discrimination, PPE access, workplace setting) and psychosocial predictors (depression/anxiety, county-level COVID-19 mortality). Models included race/ethnicity, gender identity, age and cohort as covariates. RESULTS Nurses were significantly more likely to use all types of supplements than non-healthcare workers. Lacking personal protective equipment and experiencing occupational discrimination were significantly associated with new immune supplement use. Depression increased the risk of using weight loss, energy and immune supplements. CONCLUSION Nurses' disproportionate use of 'wellness' supplements during the COVID-19 pandemic may be related to workplace and psychosocial stressors. Given well-documented risks of harm from the use of 'wellness' supplements, the use of these products by nurses is of concern. IMPACT 'Wellness' supplements promoting weight loss, increased energy, boosted immunity and cleansing of organs are omnipresent in today's health-focused culture, though their use has been associated with harm. This is of added concern among nurses given their risk of COVID-19 infection at work. Our study highlighted the risk factors associated with use of these products (lacking PPE and experiencing occupational discrimination). Findings support prior research suggesting a need for greater public health policy and education around the use of 'wellness' supplements. REPORTING METHOD STROBE guidelines were followed throughout manuscript. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was involved.
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Affiliation(s)
- Samantha L Turner
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Ariel Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Gwenneth Feeny
- Faculty of Health Sciences, McMcaster University, Hamilton, Ontario, Canada
| | - Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Destiny Jackson
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Janet Rich-Edwards
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jorge Chavarro
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Spatial and Contextual Exposomics and Epidemiology Laboratory, Harvard Medical School, Boston, Massachusetts, USA
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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10
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Garshick E, Redlich CA, Korpak A, Timmons AK, Smith NL, Nakayama K, Baird CP, Ciminera P, Kheradmand F, Fan VS, Hart JE, Koutrakis P, Kuschner W, Ioachimescu O, Jerrett M, Montgrain PR, Proctor SP, Wan ES, Wendt CH, Wongtrakool C, Blanc PD. Chronic respiratory symptoms following deployment-related occupational and environmental exposures among US veterans. Occup Environ Med 2024; 81:59-65. [PMID: 37968126 PMCID: PMC10872566 DOI: 10.1136/oemed-2023-109146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/30/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVES Characterise inhalational exposures during deployment to Afghanistan and Southwest Asia and associations with postdeployment respiratory symptoms. METHODS Participants (n=1960) in this cross-sectional study of US Veterans (Veterans Affairs Cooperative Study 'Service and Health Among Deployed Veterans') completed an interviewer-administered questionnaire regarding 32 deployment exposures, grouped a priori into six categories: burn pit smoke; other combustion sources; engine exhaust; mechanical and desert dusts; toxicants; and military job-related vapours gas, dusts or fumes (VGDF). Responses were scored ordinally (0, 1, 2) according to exposure frequency. Factor analysis supported item reduction and category consolidation yielding 28 exposure items in 5 categories. Generalised linear models with a logit link tested associations with symptoms (by respiratory health questionnaire) adjusting for other covariates. OR were scaled per 20-point score increment (normalised maximum=100). RESULTS The cohort mean age was 40.7 years with a median deployment duration of 11.7 months. Heavy exposures to multiple inhalational exposures were commonly reported, including burn pit smoke (72.7%) and VGDF (72.0%). The prevalence of dyspnoea, chronic bronchitis and wheeze in the past 12 months was 7.3%, 8.2% and 15.6%, respectively. Burn pit smoke exposure was associated with dyspnoea (OR 1.22; 95% CI 1.06 to 1.47) and chronic bronchitis (OR 1.22; 95% CI 1.13 to 1.44). Exposure to VGDF was associated with dyspnoea (OR 1.29; 95% CI 1.14 to 1.58) and wheeze (OR 1.18; 95% CI 1.02 to 1.35). CONCLUSION Exposures to burn pit smoke and military occupational VGDF during deployment were associated with an increased odds of chronic respiratory symptoms among US Veterans.
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Affiliation(s)
- Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, West Roxbury, Massachusetts, USA
- Harvard Medical School, Brigham and Women's Hospital Channing Division of Network Medicine, Boston, Massachusetts, USA
| | - Carrie A Redlich
- Occupational and Environmental Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Anna Korpak
- Seattle Epidemiologic Research and Information Center, Department of Veteran Affairs Office of Research and Development, VA Puget Sound Health Care System Seattle Division, Seattle, Washington, USA
| | - Andrew K Timmons
- Seattle Epidemiologic Research and Information Center, Department of Veteran Affairs Office of Research and Development, VA Puget Sound Health Care System Seattle Division, Seattle, Washington, USA
| | - Nicholas L Smith
- Seattle Epidemiologic Research and Information Center, Department of Veteran Affairs Office of Research and Development, VA Puget Sound Health Care System Seattle Division, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Karen Nakayama
- Seattle Epidemiologic Research and Information Center, Department of Veteran Affairs Office of Research and Development, VA Puget Sound Health Care System Seattle Division, Seattle, Washington, USA
| | | | - Paul Ciminera
- Health Services Policy and Oversight, Office of the Assistant Secretary of Defense for Health Affairs, Washington, District of Columbia, USA
| | - Farrah Kheradmand
- Department of Medicine, Michael E DeBakey VA Medical Center, Houston, Texas, USA
- Baylor College of Medicine, Houston, Texas, USA
| | - Vincent S Fan
- VA Puget Sound HCS Seattle Division, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jaime E Hart
- Harvard Medical School, Brigham and Women's Hospital Channing Division of Network Medicine, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Ware Kuschner
- VA Palo Alto Health Care System, Palo Alto, California, USA
- Stanford University School of Medicine, Stanford, California, USA
| | - Octavian Ioachimescu
- Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin, USA
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Michael Jerrett
- University of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California, USA
| | - Phillipe R Montgrain
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Susan P Proctor
- US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA
| | - Emily S Wan
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, West Roxbury, Massachusetts, USA
- Harvard Medical School, Brigham and Women's Hospital Channing Division of Network Medicine, Boston, Massachusetts, USA
| | - Christine H Wendt
- Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis VA Medical Center, Minneapolis, Minnesota, USA
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Cherry Wongtrakool
- Atlanta VA Medical Center, Decatur, Georgia, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Paul D Blanc
- San Francisco VA Health Care System, San Francisco, California, USA
- Division of Occupational, Environmental, and Climate Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
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11
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Pan K, Jukic AM, Mishra GD, Mumford SL, Wise LA, Schisterman EF, Ley SH, Charlton BM, Chavarro JE, Hart JE, Sidney S, Xiong X, Barbosa-Leiker C, Schliep K, Shaffer JG, Bazzano LA, Harville EW. The association between preconception cannabis use and gestational diabetes mellitus: The Preconception Period Analysis of Risks and Exposures Influencing health and Development (PrePARED) consortium. Paediatr Perinat Epidemiol 2024; 38:69-85. [PMID: 37751914 PMCID: PMC11000150 DOI: 10.1111/ppe.13008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND The metabolic changes that ultimately lead to gestational diabetes mellitus (GDM) likely begin before pregnancy. Cannabis use might increase the risk of GDM by increasing appetite or promoting fat deposition and adipogenesis. OBJECTIVES We aimed to assess the association between preconception cannabis use and GDM incidence. METHODS We analysed individual-level data from eight prospective cohort studies. We identified the first, or index, pregnancy (lasting ≥20 weeks of gestation with GDM status) after cannabis use. In analyses of pooled individual-level data, we used logistic regression to estimate study-type-specific odds ratios (OR) and 95% confidence intervals (CI), adjusting for potential confounders using random effect meta-analysis to combine study-type-specific ORs and 95% CIs. Stratified analyses assessed potential effect modification by preconception tobacco use and pre-pregnancy body mass index (BMI). RESULTS Of 17,880 participants with an index pregnancy, 1198 (6.7%) were diagnosed with GDM. Before the index pregnancy, 12.5% of participants used cannabis in the past year. Overall, there was no association between preconception cannabis use in the past year and GDM (OR 0.97, 95% CI 0.79, 1.18). Among participants who never used tobacco, however, those who used cannabis more than weekly had a higher risk of developing GDM than those who did not use cannabis in the past year (OR 2.65, 95% CI 1.15, 6.09). This association was not present among former or current tobacco users. Results were similar across all preconception BMI groups. CONCLUSIONS In this pooled analysis of preconception cohort studies, preconception cannabis use was associated with a higher risk of developing GDM among individuals who never used tobacco but not among individuals who formerly or currently used tobacco. Future studies with more detailed measurements are needed to investigate the influence of preconception cannabis use on pregnancy complications.
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Affiliation(s)
- Ke Pan
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Anne Marie Jukic
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Gita D. Mishra
- School of Public Health, University of Queensland, Herston, QLD, Australia
| | - Sunni L. Mumford
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren A. Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Enrique F. Schisterman
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sylvia H. Ley
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Brittany M. Charlton
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jorge E. Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Xu Xiong
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | - Karen Schliep
- Division of Public Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey G. Shaffer
- Department of Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Lydia A. Bazzano
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Emily W. Harville
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
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12
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Fiffer MR, Li H, Iyer HS, Nethery RC, Sun Q, James P, Yanosky JD, Kaufman JD, Hart JE, Laden F. Associations between air pollution, residential greenness, and glycated hemoglobin (HbA1c) in three prospective cohorts of U.S. adults. Environ Res 2023; 239:117371. [PMID: 37839528 PMCID: PMC10873087 DOI: 10.1016/j.envres.2023.117371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND While studies suggest impacts of individual environmental exposures on type 2 diabetes (T2D) risk, mechanisms remain poorly characterized. Glycated hemoglobin (HbA1c) is a biomarker of glycemia and diagnostic criterion for prediabetes and T2D. We explored associations between multiple environmental exposures and HbA1c in non-diabetic adults. METHODS HbA1c was assessed once in 12,315 women and men in three U.S.-based prospective cohorts: the Nurses' Health Study (NHS), Nurses' Health Study II (NHSII), and Health Professionals Follow-up Study (HPFS). Residential greenness within 270 m and 1,230 m (normalized difference vegetation index, NDVI) was obtained from Landsat. Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were estimated from nationwide spatiotemporal models. Three-month and one-year averages prior to blood draw were assigned to participants' addresses. We assessed associations between single exposure, multi-exposure, and component scores from Principal Components Analysis (PCA) and HbA1c. Fully-adjusted models built on basic models of age and year at blood draw, BMI, alcohol use, and neighborhood socioeconomic status (nSES) to include diet quality, race, family history, smoking status, postmenopausal hormone use, population density, and season. We assessed interactions between environmental exposures, and effect modification by population density, nSES, and sex. RESULTS Based on HbA1c, 19% of participants had prediabetes. In single exposure fully-adjusted models, an IQR (0.14) higher 1-year 1,230 m NDVI was associated with a 0.27% (95% CI: 0.05%, 0.49%) lower HbA1c. In basic component score models, a SD increase in Component 1 (high loadings for 1-year NDVI) was associated with a 0.19% (95% CI: 0.04%, 0.34%) lower HbA1c. CI's crossed the null in multi-exposure and fully-adjusted component score models. There was little evidence of associations between air pollution and HbA1c, and no evidence of effect modification. CONCLUSIONS Among non-diabetic adults, environmental exposures were not consistently associated with HbA1c. More work is needed to elucidate biological pathways between the environment and prediabetes.
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Affiliation(s)
- Melissa R Fiffer
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; University of Illinois Chicago, Children's Environmental Health Initiative, Chicago, IL, USA.
| | - Huichu Li
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA
| | - Hari S Iyer
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Dana-Farber Cancer Institute, Division of Population Sciences, Boston, MA, USA; Rutgers Cancer Institute of New Jersey, Section of Cancer Epidemiology and Health Outcomes, New Brunswick, NJ, USA
| | - Rachel C Nethery
- Harvard T.H. Chan School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Qi Sun
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter James
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; Harvard Medical School and Harvard Pilgrim Health Care Institute, Department of Population Medicine, Boston, MA, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, USA
| | - Joel D Kaufman
- Department of Epidemiology, University of Washington, Seattle, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, USA
| | - Jaime E Hart
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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13
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Roscoe C, Grady ST, Hart JE, Iyer HS, Manson JE, Rexrode KM, Rimm EB, Laden F, James P. Association between Noise and Cardiovascular Disease in a Nationwide U.S. Prospective Cohort Study of Women Followed from 1988 to 2018. Environ Health Perspect 2023; 131:127005. [PMID: 38048103 PMCID: PMC10695265 DOI: 10.1289/ehp12906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Long-term noise exposure is associated with cardiovascular disease (CVD), including acute cardiovascular events such as myocardial infarction and stroke. However, longitudinal cohort studies in the U.S. of long-term noise and CVD are almost exclusively from Europe and few modeled nighttime noise, when an individual is likely at home or asleep, separately from daytime noise. We aimed to examine the prospective association of outdoor long-term nighttime and daytime noise from anthropogenic sources with incident CVD using a U.S.-based, nationwide cohort of women. METHODS We linked L 50 nighttime and L 50 daytime anthropogenic modeled noise estimates from a U.S. National Parks Service model (L 50 : sound pressure levels exceeded 50 percent of the time) to geocoded residential addresses of 114,116 participants in the Nurses' Health Study. We used time-varying Cox proportional hazards models to estimate risk of incident CVD, coronary heart disease (CHD), and stroke associated with long-term average (14-y measurement period) noise exposure, adjusted for potential individual- and area-level confounders and CVD risk factors (1988-2018; biennial residential address updates; monthly CVD updates). We assessed effect modification by population density, region, air pollution, vegetation cover, and neighborhood socioeconomic status, and explored mediation by self-reported average nightly sleep duration. RESULTS Over 2,548,927 person-years, there were 10,331 incident CVD events. In fully adjusted models, the hazard ratios for each interquartile range increase in L 50 nighttime noise (3.67 dBA) and L 50 daytime noise (4.35 dBA), respectively, were 1.04 (95% CI: 1.02, 1.06) and 1.04 (95% CI: 1.02, 1.07). Associations for total energy-equivalent noise level (L eq ) measures were stronger than for the anthropogenic statistical L 50 noise measures. Similar associations were observed for CHD and stroke. Interaction analyses suggested that associations of L 50 nighttime and L 50 daytime noise with CVD did not differ by prespecified effect modifiers. We found no evidence that inadequate sleep (< 5 h/night) mediated associations of L 50 nighttime noise and CVD. DISCUSSION Outdoor L 50 anthropogenic nighttime and daytime noise at the residential address was associated with a small increase in CVD risk in a cohort of adult female nurses. https://doi.org/10.1289/EHP12906.
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Affiliation(s)
- Charlotte Roscoe
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Population Sciences, Dana Faber Cancer Institute, Boston, Massachusetts, USA
| | - Stephanie T. Grady
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hari S. Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - JoAnn E. Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Kathryn M. Rexrode
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Eric B. Rimm
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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Chen F, Chen JT, Hart JE, Coull BA, Scammell MK, Chu MT, Adamkiewicz G. Disparities in joint exposure to environmental and social stressors in urban households in Greater Boston. Environ Res 2023; 238:117104. [PMID: 37689339 PMCID: PMC10763609 DOI: 10.1016/j.envres.2023.117104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVES Understanding how environmental and social stressors cluster is critical to explaining and addressing health disparities. It remains unclear how these stressors cluster at fine spatial resolution in low to medium-income, urban households. We explored patterns of environmental and social exposures at the household-level and potential predictors of these joint exposures in two environmental justice communities in the Greater Boston area. METHODS We recruited 150 households in Chelsea, MA and the Dorchester neighborhood of Boston, MA, between 2016 and 2019 and collected data on two domains: environmental and social stressor. For each domain, we fit Latent Class Analysis (LCA) models to exposure data to assess intra-domain variability, and cross-classified the resultant classes to identify joint exposure profiles. We compared differences in the distribution of these profiles by participants' demographic and household characteristics using χ2, Fisher's exact, Analysis of Variance, and Kruskal-Wallis tests. RESULTS We identified two latent classes in each domain: High environmental (n = 90; 60.4%), Low environmental (n = 59; 39.6%), High Social (n = 31; 20.8%), and Low Social (n = 118; 79.2%). Cross-classification yielded four joint exposure profiles: Both Low (n = 46, 30.9%); Both High (n = 18, 12.1%); High environmental-Low Social (n = 72, 48.3%); and Low environmental-High Social (n = 13, 8.7%). Significant group differences were found by housing type (e.g., single-family vs. multi-family) (Fisher's exact p = 0.0016), housing tenure (p = 0.0007), and study site (p < 0.0001). We also observed differences by race/ethnicity, income, and education: households that were Hispanic/Latinx, below the poverty level, and with lower education were more likely to be in the Both High group. CONCLUSIONS Our analyses confirmed that environmental and social stressors cluster in socially disadvantaged households. Housing type, housing tenure, and location of the residence were also strong predictors of cluster membership, with renter and multi-family residents at risk of high exposures to environmental and social stressors.
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Affiliation(s)
- Futu Chen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Hospital and Harvard Medical School, Boston, MA, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Madeleine K Scammell
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - MyDzung T Chu
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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15
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Borchert W, Grady ST, Chen J, DeVille NV, Roscoe C, Chen F, Mita C, Holland I, Wilt GE, Hu CR, Mehta U, Nethery RC, Albert CM, Laden F, Hart JE. Air Pollution and Temperature: a Systematic Review of Ubiquitous Environmental Exposures and Sudden Cardiac Death. Curr Environ Health Rep 2023; 10:490-500. [PMID: 37845484 PMCID: PMC11016309 DOI: 10.1007/s40572-023-00414-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE OF REVIEW Environmental exposures have been associated with increased risk of cardiovascular mortality and acute coronary events, but their relationship with out-of-hospital cardiac arrest (OHCA) and sudden cardiac death (SCD) remains unclear. SCD is an important contributor to the global burden of cardiovascular disease worldwide. RECENT FINDINGS Current literature suggests a relationship between environmental exposures and cardiovascular disease, but their relationship with OHCA/SCD remains unclear. A literature search was conducted in PubMed, Embase, Web of Science, and Global Health. Of 5138 studies identified by our literature search, this review included 30 studies on air pollution, 42 studies on temperature, 6 studies on both air pollution and temperature, and 1 study on altitude exposure and OHCA/SCD. Particulate matter air pollution, ozone, and both hot and cold temperatures are associated with increased risk of OHCA/SCD. Pollution and other exposures related to climate change play an important role in OHCA/SCD incidence.
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Affiliation(s)
- William Borchert
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA.
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA.
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Stephanie T Grady
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Jie Chen
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicole V DeVille
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV, USA
| | - Charlotte Roscoe
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Futu Chen
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA
| | - Carol Mita
- Countway Library, Harvard Medical School, Boston, MA, USA
| | - Isabel Holland
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Grete E Wilt
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Cindy R Hu
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Unnati Mehta
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Harvard Kenneth C. Griffin Graduate School of Arts and Sciences, Cambridge, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel C Nethery
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Christine M Albert
- Department of Cardiology, Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
- Division of Preventative Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1301, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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16
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Wilt GE, Roscoe CJ, Hu CR, Mehta UV, Coull BA, Hart JE, Gortmaker S, Laden F, James P. Minute level smartphone derived exposure to greenness and consumer wearable derived physical activity in a cohort of US women. Environ Res 2023; 237:116864. [PMID: 37648192 DOI: 10.1016/j.envres.2023.116864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Inconsistent results have been found in the literature on associations of greenness, or vegetation quantity, and physical activity. However, few studies have assessed associations between mobility-based greenness and physical activity from mobile health data from smartphone and wearable devices with fine spatial and temporal resolution. METHODS We assessed mobility-based greenness exposure and wearable accelerometer data from participants in the US-based prospective Nurses' Health Study 3 cohort Mobile Health (mHealth) Substudy (2018-2020). We recruited 500 female participants with instructions to wear devices over four 7-day sampling periods equally spaced throughout the year. After restriction criteria there were 337 participants (mean age 36 years) with n = 639,364 unique observations. Normalized Difference Vegetation Index (NDVI) data were derived from 30 m x 30 m Landsat-8 imagery and spatially joined to GPS points recorded every 10 min. Fitbit proprietary algorithms provided physical activity summarized as mean number of steps per minute, which we averaged during the 10-min period following a GPS-based greenness exposure assessment. We utilized Generalized Additive Mixed Models to examine associations (every 10 min) between greenness and physical activity adjusting for neighborhood and individual socioeconomic status, Census region, season, neighborhood walkability, daily mean temperature and precipitation. We assessed effect modification through stratification and interaction models and conducted sensitivity analyses. RESULTS Mean 10-min step count averaged 7.0 steps (SD 14.9) and greenness (NDVI) averaged 0.3 (SD 0.2). Contrary to our hypotheses, higher greenness exposure was associated non-linearly with lower mean steps per minute after adjusting for confounders. We observed statistically significant effect modification by Census region and season. DISCUSSION We utilized objective physical activity data at fine temporal and spatial scales to present novel estimates of the association between mobility-based greenness and step count. We found higher levels of greenness were inversely associated with steps per minute.
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Affiliation(s)
- Grete E Wilt
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Charlotte J Roscoe
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Division of Population Sciences, Dana Farber Cancer Institute, Boston, MA, United States
| | - Cindy R Hu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Unnati V Mehta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Steven Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
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17
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Pan K, Bazzano LA, Betha K, Charlton BM, Chavarro JE, Cordero C, Gunderson EP, Haggerty CL, Hart JE, Jukic AM, Ley SH, Mishra GD, Mumford SL, Schisterman EF, Schliep K, Shaffer JG, Sotres-Alvarez D, Stanford JB, Wilcox AJ, Wise LA, Yeung E, Harville EW. Large-Scale Data Harmonization Across Prospective Studies. Am J Epidemiol 2023; 192:2033-2049. [PMID: 37403415 PMCID: PMC10988223 DOI: 10.1093/aje/kwad153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 04/11/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023] Open
Abstract
The Preconception Period Analysis of Risks and Exposures Influencing Health and Development (PrePARED) Consortium creates a novel resource for addressing preconception health by merging data from numerous cohort studies. In this paper, we describe our data harmonization methods and results. Individual-level data from 12 prospective studies were pooled. The crosswalk-cataloging-harmonization procedure was used. The index pregnancy was defined as the first postbaseline pregnancy lasting more than 20 weeks. We assessed heterogeneity across studies by comparing preconception characteristics in different types of studies. The pooled data set included 114,762 women, and 25,531 (22%) reported at least 1 pregnancy of more than 20 weeks' gestation during the study period. Babies from the index pregnancies were delivered between 1976 and 2021 (median, 2008), at a mean maternal age of 29.7 (standard deviation, 4.6) years. Before the index pregnancy, 60% of women were nulligravid, 58% had a college degree or more, and 37% were overweight or obese. Other harmonized variables included race/ethnicity, household income, substance use, chronic conditions, and perinatal outcomes. Participants from pregnancy-planning studies had more education and were healthier. The prevalence of preexisting medical conditions did not vary substantially based on whether studies relied on self-reported data. Use of harmonized data presents opportunities to study uncommon preconception risk factors and pregnancy-related events. This harmonization effort laid the groundwork for future analyses and additional data harmonization.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Emily W Harville
- Correspondence to Dr. Emily W. Harville, Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA 70112 (e-mail: )
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18
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Wilt GE, Roscoe C, Hu CR, Iyer HS, Mehta UV, Coull BA, Hart JE, Gortmaker S, Laden F, James P. Examining Exposure Differences between Residential and Smartphone Mobility-Based Greenness in a Cohort of the Nurses' Health Study. Environ Health Perspect 2023; 131:117701. [PMID: 37962438 PMCID: PMC10644896 DOI: 10.1289/ehp13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Grete E. Wilt
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Charlotte Roscoe
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Population Sciences, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Cindy R. Hu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Hari S. Iyer
- Division of Population Sciences, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Unnati V. Mehta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Brent A. Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Steven Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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19
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Maccarone J, Grady ST, Moy ML, Hart JE, Kang CM, Coull BA, Schwartz JD, Koutrakis P, Zhang J, Garshick E. Indoor (residential) and ambient particulate matter associations with urinary oxidative stress biomarkers in a COPD cohort. Sci Total Environ 2023; 897:165352. [PMID: 37419349 PMCID: PMC10529440 DOI: 10.1016/j.scitotenv.2023.165352] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/18/2023] [Accepted: 07/04/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVES Oxidative stress contributes to chronic obstructive pulmonary disease (COPD) pathophysiology. Associations between indoor (residential) exposure to particulate matter ≤2.5 μm in diameter (PM2.5) and one of its components, black carbon (BC), and oxidative stress are ill-defined. METHODS Between 2012 and 2017, 140 patients with COPD completed in-home air sampling over one week intervals, followed by collection of urine samples to measure oxidative stress biomarkers, malondialdehyde (MDA), a marker of lipid peroxidation, and 8-hydroxy-2' -deoxyguanosine (8-OHdG), a marker of oxidative DNA damage. Ambient (central site) BC and PM2.5 were measured, and the ratio of indoor/ambient sulfur in PM2.5, a surrogate for residential ventilation and particle infiltration, was used to estimate indoor BC and PM2.5 of outdoor origin. Mixed effects linear regression models with a participant-specific random intercept were used to assess associations with oxidative biomarkers, adjusting for personal characteristics. RESULTS There were positive associations (% increase per IQR; 95 % CI) of directly measured indoor BC with total MDA (6.96; 1.54, 12.69) and 8-OHdG (4.18; -0.67, 9.27), and similar associations with both indoor BC of outdoor origin and ambient BC. There were no associations with directly measured indoor PM2.5, but there were positive associations between indoor PM2.5 of outdoor origin and total MDA (5.40; -0.91, 12.11) and 8-OHdG (8.02; 2.14, 14.25). CONCLUSIONS In homes with few indoor combustion sources, directly measured indoor BC, estimates of indoor BC and PM2.5 of outdoor origin, and ambient BC, were positively associated with urinary biomarkers of oxidative stress. This suggests that the infiltration of particulate matter from outdoor sources, attributable to traffic and other sources of combustion, promotes oxidative stress in COPD patients.
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Affiliation(s)
- Jennifer Maccarone
- VA Boston Healthcare System, Boston, MA, USA; The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA.
| | | | - Marilyn L Moy
- VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Brent A Coull
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Junfeng Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Eric Garshick
- VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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20
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Chowdhury-Paulino IM, Hart JE, James P, Iyer HS, Wilt GE, Booker BD, Nethery RC, Laden F, Mucci LA, Markt SC. Association between Outdoor Light at Night and Prostate Cancer in the Health Professionals Follow-up Study. Cancer Epidemiol Biomarkers Prev 2023; 32:1444-1450. [PMID: 37462694 PMCID: PMC10592318 DOI: 10.1158/1055-9965.epi-23-0208] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/07/2023] [Accepted: 07/14/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Circadian disruption is a potential risk factor for advanced prostate cancer, and light at night (LAN) exposure may disrupt circadian rhythms. We evaluated whether outdoor LAN increases the risk of prostate cancer. METHODS We prospectively followed 49,148 participants in the Health Professionals Follow-up Study from 1986 through 2016. We estimated baseline and cumulative time-varying outdoor LAN with ∼1 km2 resolution using data from the US Defense Meteorological Satellite Program's Operational Linescan System, which was assigned to participants' geocoded addresses. Participants reside in all 50 U.S. states and reported a work or home address. We used multivariable Cox models to estimate HRs and 95% confidence intervals (CI) for the association between outdoor LAN and risk of overall (7,175 cases) and fatal (915 cases) prostate cancer adjusting for individual and contextual factors. RESULTS There was no association between the interquartile range increase in cumulative LAN and total (HR, 1.02; 95% CI, 0.98-1.06) or fatal (HR, 1.05; 95% CI, 0.96-1.15) prostate cancer in adjusted models. However, there was a positive association between baseline LAN and total prostate cancer among non-movers (HR, 1.06; 95% CI, 1.00-1.14) including among highly screened participants (HR, 1.11; 95% CI, 1.01-1.23). CONCLUSIONS There was a suggestive positive association between baseline outdoor LAN and total prostate cancer. Additional studies with different measures of outdoor LAN and in more diverse populations are necessary. IMPACT To our knowledge, this is the first longitudinal cohort study exploring the relationship between outdoor LAN and prostate cancer.
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Affiliation(s)
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Hari S. Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Grete E. Wilt
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Benjamin D. Booker
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rachel C. Nethery
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Lorelei A. Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sarah C. Markt
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, USA
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21
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Raffoul A, Beccia AL, Jackson DA, Sarda V, Hart JE, Chavarro JE, Austin SB. Associations between weight discrimination and the use of potentially harmful dietary supplements during the COVID-19 pandemic in the United States. Soc Sci Med 2023; 335:116232. [PMID: 37708694 PMCID: PMC10567056 DOI: 10.1016/j.socscimed.2023.116232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
The dietary supplements industry disproportionately markets potentially harmful products promising weight loss, cleansing/detoxing, and boosted energy and immunity to women. The COVID-19 pandemic heightened consumer concerns around health and body weight, which may have increased women's risks of using supplements, particularly if they had a higher weight and experienced weight discrimination. This study aimed to estimate inequities in prevalence and change in use of weight-loss, cleanse/detox, immunity, and energy supplements in the first year of the pandemic and to assess the extent to which the relationship between weight and supplement use differs across discrimination experiences. We drew upon longitudinal data from cisgender women in the U.S. COVID-19 Pandemic Substudy of the Nurses' Health Study II and 3 and Growing Up Today Study cohorts, collected over 5 waves from April/May 2020 to April 2021 (N = 51,814). Modified Poisson generalized estimating equation models, adjusted for age, cohort, race/ethnicity, wave, and Census region, estimated the relative excess risk due to interaction (RERI) between weight status and weight discrimination on prevalence of supplement use. Weight status categories were derived from body mass index (BMI), and weight discrimination was assessed using the attributions item of the Everyday Discrimination Scale. Baseline prevalence of supplement use was 2.7% for weight-loss, 3.3% for cleanse/detox, 4.2% for energy, and 22.6% for immune. Respondents with BMIs of 25-29.9 kg/m2 and 30-34.9 kg/m2 who experienced weight discrimination had RERI values of 0.89 (95% CI 0.14, 1.65) and 1.00 (95% CI 0.25, 1.75) for weight-loss and 0.57 (95% CI 0.13, 1.02) and 0.60 (95% CI 0.19, 1.01) for energy supplements, respectively, indicating this group had excess risk of use compared to lower BMI respondents who experienced no weight discrimination. The findings demonstrate the disproportionate impact of weight discrimination on use of potentially harmful supplements among cisgender women with higher weights during the pandemic.
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Affiliation(s)
- Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Ariel L Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
| | - Destiny A Jackson
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jorge E Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Hood RB, Hart JE, Laden F, Rosner B, Chavarro JE, Gaskins AJ. Exposure to Particulate Matter Air Pollution and Age of Menarche in a Nationwide Cohort of U.S. Girls. Environ Health Perspect 2023; 131:107003. [PMID: 37792557 PMCID: PMC10549984 DOI: 10.1289/ehp12110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND It remains unclear whether in utero and childhood exposure to air pollution affects pubertal development, particularly age of menarche in girls. OBJECTIVE The aim of this study was to determine whether residential ambient particulate matter (PM) exposure in utero and during childhood is associated with age of menarche. METHODS We studied 5,201 girls in the Growing Up Today Study 2 (2004-present) who were 10-17 y of age at enrollment (47.7% premenarchal; 52.3% postmenarchal). Exposure to three size fractions of PM [fine PM with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), PM with aerodynamic diameters between 2.5 μ m and 10 μ m (PM 2.5 - 10 ), and PM with aerodynamic diameter 10 μ m (PM 10 )] was assigned based on maternal residential address, updated every 2 y, using nationwide spatiotemporal models. We estimated average PM exposure in utero, and time-varying windows: annual average exposure in the prior 1 and 2 y and cumulative average from birth. Age of menarche was self-reported on three surveys administered in 2004, 2006, and 2008. We calculated hazard ratios (HR) for menarche for an interquartile range (IQR) increase in PM exposure using Cox proportional hazard models adjusting for potential confounders. RESULTS Girls attained menarche at 12.3 y of age on average. In the adjusted model, higher residential exposure to ambient PM 2.5 during all time windows was associated with earlier age of menarche. The HRs of menarche for each IQR (4 μ g / m 3 ) increase in exposure to PM 2.5 during the in utero period, 1 y prior to menarche, and throughout childhood were 1.03 [95% confidence interval (CI): 1.00, 1.06], 1.06 (95% CI: 1.02, 1.10) and 1.06 (95% CI: 1.02, 1.10), respectively. Effect estimates for PM 10 exposure were similar, albeit attenuated, for all time windows. PM 2.5 - 10 exposure was not associated with age of menarche. DISCUSSION Among a large, nationwide, prospective cohort of U.S. girls, higher exposure to PM 2.5 and PM 10 in utero and throughout childhood was associated with an earlier age of menarche. Our results suggest that PM 2.5 and PM 10 may have endocrine-disrupting properties that could lead to altered timing of menarche. https://doi.org/10.1289/EHP12110.
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Affiliation(s)
- Robert B. Hood
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jorge E. Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Audrey J. Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
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23
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McHugh EG, Grady ST, Collins CM, Moy ML, Hart JE, Coull BA, Schwartz JD, Koutrakis P, Zhang J, Garshick E. Pulmonary, inflammatory, and oxidative effects of indoor nitrogen dioxide in patients with COPD. Environ Epidemiol 2023; 7:e271. [PMID: 37840862 PMCID: PMC10569754 DOI: 10.1097/ee9.0000000000000271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/26/2023] [Accepted: 08/29/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Indoor nitrogen dioxide (NO2) sources include gas heating, cooking, and infiltration from outdoors. Associations with pulmonary function, systemic inflammation, and oxidative stress in patients with chronic obstructive pulmonary disease (COPD) are uncertain. Methods We recruited 144 COPD patients at the VA Boston Healthcare System between 2012 and 2017. In-home NO2 was measured using an Ogawa passive sampling badge for a week seasonally followed by measuring plasma biomarkers of systemic inflammation (C-reactive protein [CRP] and interleukin-6 [IL-6]), urinary oxidative stress biomarkers (8-hydroxy-2'deoxyguanosine [8-OHdG] and malondialdehyde [MDA]), and pre- and postbronchodilator spirometry. Linear mixed effects regression with a random intercept for each subject was used to assess associations with weekly NO2. Effect modification by COPD severity and by body mass index (BMI) was examined using multiplicative interaction terms and stratum-specific effect estimates. Results Median (25%ile, 75%ile) concentration of indoor NO2 was 6.8 (4.4, 11.2) ppb. There were no associations observed between NO2 with CRP, 8-OHdG, or MDA. Although the confidence intervals were wide, there was a reduction in prebronchodilator FEV1 and FVC among participants with more severe COPD (FEV1: -17.36 mL; -58.35, 23.60 and FVC: -28.22 mL; -91.49, 35.07) that was greater than in patients with less severe COPD (FEV1: -1.64 mL; -24.80, 21.57 and FVC: -6.22 mL; -42.16, 29.71). In participants with a BMI <30, there was a reduction in FEV1 and FVC. Conclusions Low-level indoor NO2 was not associated with systemic inflammation or oxidative stress. There was a suggestive association with reduced lung function among patients with more severe COPD and among patients with a lower BMI.
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Affiliation(s)
- Erin G McHugh
- Research and Development Service, VA Boston Healthcare System, Boston, Massachusetts
| | - Stephanie T Grady
- Research and Development Service, VA Boston Healthcare System, Boston, Massachusetts
- Boston University School of Public Health, Boston, Massachusetts
| | - Christina M Collins
- Research and Development Service, VA Boston Healthcare System, Boston, Massachusetts
| | - Marilyn L Moy
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Jaime E Hart
- Harvard Medical School, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Joel D Schwartz
- Harvard Medical School, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - J Zhang
- Duke University Nicholas School of the Environment, Durham, North Carolina
| | - Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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Nguyen DD, Levy JI, Kim C, Lane KJ, Simon MC, Hart JE, Whitsel EA, VoPham T, Malwitz A, Peters JL. Characterizing temporal trends in populations exposed to aircraft noise around U.S. airports: 1995-2015. J Expo Sci Environ Epidemiol 2023:10.1038/s41370-023-00575-5. [PMID: 37735518 DOI: 10.1038/s41370-023-00575-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Aircraft noise is a key concern for communities surrounding airports, with increasing evidence for health effects and inequitable distributions of exposure. However, there have been limited national-scale assessments of aircraft noise exposure over time and across noise metrics, limiting evaluation of population exposure patterns. OBJECTIVE We evaluated national-scale temporal trends in aviation noise exposure by airport characteristics and across racial/ethnic populations in the U.S. METHODS Noise contours were modeled for 90 U.S. airports in 5-year intervals between 1995 and 2015 using the Federal Aviation Administration's Aviation Environmental Design Tool. We utilized linear fixed effects models to estimate changes in noise exposure areas for day-night average sound levels (DNL) of 45, 65, and a nighttime equivalent sound level (Lnight) of 45 A-weighted decibels (dB[A]). We used group-based trajectory modeling to identify distinct groups of airports sharing underlying characteristics. We overlaid noise contours and Census tract data from the U.S. Census Bureau and American Community Surveys for 2000 to 2015 to estimate exposure changes overall and by race/ethnicity. RESULTS National-scale analyses showed non-monotonic trends in mean exposed areas that peaked in 2000, followed by a 37% decrease from 2005 to 2010 and a subsequent increase in 2015. We identified four distinct trajectory groups of airports sharing latent characteristics related to size and activity patterns. Those populations identifying as minority (e.g., Hispanic/Latino, Black/African American, Asian) experienced higher proportions of exposure relative to their subgroup populations compared to non-Hispanic or White populations across all years, indicating ethnic and racial disparities in airport noise exposure that persist over time. SIGNIFICANCE Overall, these data identified differential exposure trends across airports and subpopulations, helping to identify vulnerable communities for aviation noise in the U.S. IMPACT STATEMENT We conducted a descriptive analysis of temporal trends in aviation noise exposure in the U.S. at a national level. Using data from 90 U.S. airports over a span of two decades, we characterized the noise exposure trends overall and by airport characteristics, while estimating the numbers of exposed by population demographics to help identify the impact on vulnerable communities who may bear the burden of aircraft noise exposure.
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Affiliation(s)
- Daniel D Nguyen
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Chanmin Kim
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Statistics, Sungkyunkwan University, Seoul, South Korea
| | - Kevin J Lane
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Matthew C Simon
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
- John A. Volpe National Transportation Systems Center, U.S. Department of Transportation, Cambridge, MA, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Trang VoPham
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Andrew Malwitz
- John A. Volpe National Transportation Systems Center, U.S. Department of Transportation, Cambridge, MA, USA
| | - Junenette L Peters
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
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Klompmaker JO, Laden F, James P, Benjamin Sabath M, Wu X, Dominici F, Zanobetti A, Hart JE. Long-term exposure to summer specific humidity and cardiovascular disease hospitalizations in the US Medicare population. Environ Int 2023; 179:108182. [PMID: 37683506 PMCID: PMC10545022 DOI: 10.1016/j.envint.2023.108182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION Most climate-health studies focus on temperature; however, less is known about health effects of exposure to atmospheric moisture. Humid air limits sweat evaporation from the body and can in turn exert strain on the cardiovascular system. We evaluated associations of long-term exposure to summer specific humidity with cardiovascular disease (CVD), coronary heart disease (CHD) and cerebrovascular disease (CBV) hospitalization. METHODS We built an open cohort consisting of ∼63 million fee-for-service Medicare beneficiaries, aged ≥65, living in the contiguous US (2000-2016). We assessed zip code level summer average specific humidity and specific humidity variability, based on daily estimates from the Gridded Surface Meteorological dataset (∼4km spatial resolution). To estimate associations of summer specific humidity with first CVD, CHD, and CBV hospitalization, we used Cox-equivalent Poisson models adjusted for individual and area-level socioeconomic status indicators, temperature, and winter specific humidity. RESULTS Higher summer average specific humidity was associated with an increased risk of CVD, CHD, and CBV hospitalization. We found hazard ratios (HRs) of 1.07 (95%CI: 1.07, 1.08) for CVD hospitalization, 1.08 (95%CI: 1.08, 1.09) for CHD hospitalization, and 1.07 (95%CI: 1.07, 1.08) for CBV hospitalization per IQR increase (4.0 g of water vapor/kg of dry air) in summer average specific humidity. Associations of summer average specific humidity were strongest for beneficiaries eligible for Medicaid and for beneficiaries with an unknown or other race. Higher summer specific humidity variability was also associated with increased risk of CVD, CHD, and CBV hospitalization. Associations were not affected by adjustment for temperature and regions of the US, as well as exclusion of potentially prevalent cases. CONCLUSION Long-term exposure to higher summer average specific humidity and specific humidity variability were positively associated with CVD hospitalization. As global warming could increase humidity levels, our findings are important to assess potential health impacts of climate change.
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Affiliation(s)
- Jochem O Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - M Benjamin Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Xiao Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
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Iyer HS, Vaselkiv JB, Stopsack KH, Roscoe C, DeVille NV, Zhang Y, Penney KL, Balk SP, Fiorentino M, Hart JE, James P, De Vivo I, Mucci LA, Laden F, Rebbeck TR. Influence of Neighborhood Social and Natural Environment on Prostate Tumor Histology in a Cohort of Male Health Professionals. Am J Epidemiol 2023; 192:1485-1498. [PMID: 37139568 PMCID: PMC10948945 DOI: 10.1093/aje/kwad112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/19/2023] [Accepted: 05/01/2023] [Indexed: 05/05/2023] Open
Abstract
Adverse neighborhood social and natural (green space) environments may contribute to the etiology of prostate cancer (CaP), but mechanisms are unclear. We examined associations between neighborhood environment and prostate intratumoral inflammation in 967 men diagnosed with CaP with available tissue samples from 1986-2009 in the Health Professionals Follow-up Study. Exposures were linked to work or residential addresses in 1988. We estimated indices of neighborhood socioeconomic status (nSES) and segregation (Index of Concentration at the Extremes (ICE)) using US Census tract-level data. Surrounding greenness was estimated using seasonal averaged Normalized Difference Vegetation Index (NDVI) data. Surgical tissue underwent pathological review for acute and chronic inflammation, corpora amylacea, and focal atrophic lesions. Adjusted odds ratios (aORs) for inflammation (ordinal) and focal atrophy (binary) were estimated using logistic regression. No associations were observed for acute or chronic inflammation. Each interquartile-range increase in NDVI within 1,230 m of the participant's work or home address (aOR = 0.74, 95% confidence interval (CI): 0.59, 0.93), in ICE-income (aOR = 0.79, 95% CI: 0.61, 1.04), and in ICE-race/income (aOR = 0.79, 95% CI: 0.63, 0.99) was associated with lower odds of postatrophic hyperplasia. Interquartile-range increases in nSES (aOR = 0.76, 95% CI: 0.57, 1.02) and ICE-race/income (aOR = 0.73, 95% CI: 0.54, 0.99) were associated with lower odds of tumor corpora amylacea. Histopathological inflammatory features of prostate tumors may be influenced by neighborhood.
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Affiliation(s)
- Hari S Iyer
- Correspondence to Dr. Hari Iyer, Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, 120 Albany Street, New Brunswick, NJ 08901 (e-mail: )
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Iyer HS, Kensler KH, Vaselkiv JB, Stopsack KH, Roscoe C, Bandera EV, Qin B, Jang TL, Lotan TL, James P, Hart JE, Mucci LA, Laden F, Rebbeck TR. Associations between Etiologic or Prognostic Tumor Tissue Markers and Neighborhood Contextual Factors in Male Health Professionals Diagnosed with Prostate Cancer. Cancer Epidemiol Biomarkers Prev 2023; 32:1120-1123. [PMID: 37249585 PMCID: PMC10527012 DOI: 10.1158/1055-9965.epi-23-0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/25/2023] [Accepted: 05/19/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND There is growing evidence that unfavorable neighborhood contexts may influence prostate cancer progression. Whether these associations may be explained in part by differences in tumor-level somatic alterations remain unclear. METHODS Data on tumor markers (PTEN, p53, ERG, and SPINK1) were obtained from 1,157 participants with prostate cancer in the Health Professionals Follow-up Study. Neighborhood greenness, socioeconomic status, and the income Index of Concentration at Extremes were obtained from satellite and census data and linked to participants' address at diagnosis and at study enrollment. Exposures were scaled to an interquartile range and modeled as tertiles. Bivariate associations between tertiles of neighborhood factors and tumor markers were assessed in covariate adjusted logistic regression models to estimate ORs and 95% confidence intervals. RESULTS There was no association between any of the neighborhood contextual factors and PTEN, p53, ERG, or SPINK1 in bivariate or multivariable adjusted models. Results were generally consistent when modeling exposure using exposure at diagnosis or at study enrollment. CONCLUSIONS In this multilevel study of men with prostate cancer, we found no evidence of associations between neighborhood context and tumor tissue markers. IMPACT Our results provide some of the first empirical data in support of the hypothesis that prostate cancer risk conferred by tumor tissue markers may arise independently of underlying neighborhood context. Prospective studies in more diverse populations are needed to confirm these findings.
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Affiliation(s)
- Hari S. Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | - Kevin H. Kensler
- Division of Epidemiology, Population Health Sciences, Weill Cornell Medicine, New York, USA
| | - Jane B. Vaselkiv
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Konrad H. Stopsack
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Charlotte Roscoe
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, USA
| | - Elisa V. Bandera
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | - Bo Qin
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | - Thomas L. Jang
- Urologic Oncology Program, Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | - Tamara L. Lotan
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Peter James
- Division of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, USA
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, USA
| | - Lorelei A. Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, USA
| | - Timothy R. Rebbeck
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, USA
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Grady ST, Hart JE, Laden F, Roscoe C, Nguyen DD, Nelson EJ, Bozigar M, VoPham T, Manson JE, Weuve J, Adar SD, Forman JP, Rexrode K, Levy JI, Peters JL. Associations between long-term aircraft noise exposure, cardiovascular disease, and mortality in US cohorts of female nurses. Environ Epidemiol 2023; 7:e259. [PMID: 37545808 PMCID: PMC10402956 DOI: 10.1097/ee9.0000000000000259] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/01/2023] [Indexed: 08/08/2023] Open
Abstract
There is limited research examining aircraft noise and cardiovascular disease (CVD) risk. The objective of this study was to investigate associations of aircraft noise with CVD among two US cohorts, the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII). Methods Between 1994 and 2014, we followed 57,306 NHS and 60,058 NHSII participants surrounding 90 airports. Aircraft noise was modeled above 44 A-weighted decibels (dB(A)) and linked to geocoded addresses. Based on exposure distributions, we dichotomized exposures at 50 dB(A) and tested sensitivity of this cut-point by analyzing aircraft noise as categories (<45, 45-49, 50-54, ≥55) and continuously. We fit cohort-specific Cox proportional hazards models to estimate relationships between time-varying day-night average sound level (DNL) and CVD incidence and CVD and all-cause mortality, adjusting for fixed and time-varying individual- and area-level covariates. Results were pooled using random effects meta-analysis. Results Over 20 years of follow-up, there were 4529 CVD cases and 14,930 deaths. Approximately 7% (n = 317) of CVD cases were exposed to DNL ≥50 dB(A). In pooled analyses comparing ≥50 with <50 dB(A), the adjusted hazard ratio for CVD incidence was 1.00 (95% confidence interval: 0.89, 1.12). The corresponding adjusted hazard ratio for all-cause mortality was 1.02 (95% confidence interval: 0.96, 1.09). Patterns were similar for CVD mortality in NHS yet underpowered. Conclusions Among participants in the NHS and NHSII prospective cohorts who generally experience low exposure to aircraft noise, we did not find adverse associations of aircraft noise with CVD incidence, CVD mortality, or all-cause mortality.
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Affiliation(s)
- Stephanie T. Grady
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Charlotte Roscoe
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Daniel D. Nguyen
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | | | - Matthew Bozigar
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Trang VoPham
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - JoAnn E. Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Sara D. Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - John P. Forman
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kathryn Rexrode
- Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jonathan I. Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Junenette L. Peters
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
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29
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Leung M, Modest AM, Hacker MR, Wylie BJ, Wei Y, Schwartz J, Iyer HS, Hart JE, Coull BA, Laden F, Weisskopf MG, Papatheodorou S. Traffic-Related Air Pollution and Ultrasound Parameters of Fetal Growth in Eastern Massachusetts. Am J Epidemiol 2023; 192:1105-1115. [PMID: 36963378 PMCID: PMC10893850 DOI: 10.1093/aje/kwad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/30/2022] [Accepted: 03/23/2023] [Indexed: 03/26/2023] Open
Abstract
Previous studies have examined the association between prenatal nitrogen dioxide (NO2)-a traffic emissions tracer-and fetal growth based on ultrasound measures. Yet, most have used exposure assessment methods with low temporal resolution, which limits the identification of critical exposure windows given that pregnancy is relatively short. Here, we used NO2 data from an ensemble model linked to residential addresses at birth to fit distributed lag models that estimated the association between NO2 exposure (resolved weekly) and ultrasound biometric parameters in a Massachusetts-based cohort of 9,446 singleton births from 2011-2016. Ultrasound biometric parameters examined included biparietal diameter (BPD), head circumference, femur length, and abdominal circumference. All models adjusted for sociodemographic characteristics, time trends, and temperature. We found that higher NO2 was negatively associated with all ultrasound parameters. The critical window differed depending on the parameter and when it was assessed. For example, for BPD measured after week 31, the critical exposure window appeared to be weeks 15-25; 10-parts-per-billion higher NO2 sustained from conception to the time of measurement was associated with a lower mean z score of -0.11 (95% CI: -0.17, -0.05). Our findings indicate that reducing traffic emissions is one potential avenue to improving fetal and offspring health.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Stefania Papatheodorou
- Correspondence to Dr. Stefania Papatheodorou, Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA, 02115 (e-mail: )
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Roscoe C, T Grady S, Hart JE, Iyer HS, Manson JE, Rexrode KM, Rimm EB, Laden F, James P. Exposure to Noise and Cardiovascular Disease in a Nationwide US Prospective Cohort Study of Women. medRxiv 2023:2023.06.07.23291083. [PMID: 37398490 PMCID: PMC10312856 DOI: 10.1101/2023.06.07.23291083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background: Long-term noise exposure is associated with cardiovascular disease (CVD), including acute cardiovascular events such as myocardial infarction and stroke. However, longitudinal cohort studies of long-term noise and CVD are almost exclusively from Europe, and few modelled nighttime and daytime noise separately. We aimed to examine the prospective association of outdoor long-term nighttime and daytime noise from anthropogenic sources with incident CVD using a US-based, nationwide cohort of women. Methods: We linked L50 (median) nighttime and L50 daytime modelled anthropogenic noise estimates from a US National Park Service model to geocoded residential addresses of 114,116 participants in the Nurses' Health Study. We used time-varying Cox proportional hazards models to estimate risk of incident CVD, coronary heart disease (CHD), and stroke associated with long-term average noise exposure, adjusted for potential individual- and area-level confounders and CVD risk factors (1988-2018). We assessed effect modification by population density, region, air pollution, vegetation cover, and neighborhood socioeconomic status, and explored mediation by self-reported average nightly sleep duration. Results: Over 2,544,035 person-years, there were 10,331 incident CVD events. In fully-adjusted models, the hazard ratios for each interquartile range increase in L50 nighttime noise (3.67 dBA) and L50 daytime noise (4.35 dBA), respectively, were 1.04 (95% CI 1.02, 1.06) and 1.04 (95% CI 1.02, 1.07). Similar associations were observed for CHD and stroke. Stratified analyses suggested that associations of nighttime and daytime noise with CVD did not differ by prespecified effect modifiers. We found no evidence that inadequate sleep (< 5 hours per night) mediated associations of noise and CVD. Discussion: Outdoor median nighttime and daytime noise at the residential address was associated with a small increase in CVD risk in a cohort of adult female nurses.
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Ma W, Murray E, Nguyen LH, Drew DA, Ding M, Stopsack KH, Rich-Edwards JW, Hart JE, Figueiredo JC, Lacey JV, Patel AV, Bhupathiraju SN, Chan AT, Martinez ME. Physical Activity, Sedentary Behavior, and Risk of Coronavirus Disease 2019. Am J Med 2023; 136:568-576.e3. [PMID: 36657558 PMCID: PMC9842390 DOI: 10.1016/j.amjmed.2022.12.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Data on the associations of prepandemic physical activity and sedentary behavior with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) severity, particularly milder illness, have been limited. METHODS We used data from 43,913 participants within the Nurses' Health Study II and Health Professionals Follow-Up Study who responded to periodic COVID-related surveys from May 2020 through March 2021. History of physical activity from the prepandemic period was assessed as the metabolic equivalents of task (MET)-hours per week of various activities of different intensity and sedentary behavior assessed from reports of time spent sitting from questionnaires completed 2016-2017. Multivariable logistic regression models were fitted to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for risk of SARS-CoV-2 infection and COVID-19 severity, as well as predicted COVID-19 defined using a validated symptom-based algorithm. RESULTS Higher levels of prepandemic physical activity were associated with a lower risk for SARS-CoV-2 infection. Compared to participants with <3 MET-hours per week, the multivariable-adjusted OR was 0.86 (95% CI: 0.74, 0.99; P trend =.07) for those with ≥27 MET-hours per week. Higher physical activity levels were also associated with lower risk of symptomatic SARS-CoV-2 infection (OR: 0.84; 95% CI: 0.72, 0.99; P trend = .05) and predicted COVID-19 (OR: 0.87; 95% CI: 0.78, 0.97; P trend = .01). Longer time sitting at home watching TV (OR: 0.85; 95% CI: 0.73, 0.97) or for other tasks (OR: 0.78; 95% CI: 0.66, 0.92) was associated with a lower risk of SARS-CoV-2 infection. CONCLUSIONS Our findings support a protective association between prepandemic physical activity and lower risk and severity of COVID-19.
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Affiliation(s)
- Wenjie Ma
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Mass; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
| | | | - Long H Nguyen
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Mass; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
| | - David A Drew
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Mass; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
| | - Ming Ding
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Mass
| | - Konrad H Stopsack
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Mass
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Mass; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
| | - Jane C Figueiredo
- Samuel Oschin Comprehensive Cancer Center at Cedars-Sinai, Los Angeles, Calif
| | - James V Lacey
- Department of Computational and Quantitative Medicine, Beckman Research Institute of City of Hope, Duarte, Calif
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Kennesaw, Ga
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
| | - Andrew T Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Mass; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass.
| | - Maria Elena Martinez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla; Moores Cancer Center, University of California, San Diego, La Jolla
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Wang S, Minguez-Alarcon L, Capotosto MP, Mitsunami M, Gaskins AJ, Charlton BM, Hart JE, Rich-Edwards JW, Chavarro JE. Pregnancy Intention, Changes in Pregnancy Intention, and Pregnancy Incidence Among Female Nurses in North America. JAMA Netw Open 2023; 6:e2311301. [PMID: 37133861 PMCID: PMC10157424 DOI: 10.1001/jamanetworkopen.2023.11301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/20/2023] [Indexed: 05/04/2023] Open
Abstract
Importance Pregnancy intention assessment is a key element of preconception and contraceptive care. The association between a single screening question and the incidence of pregnancy is unknown. Objective To prospectively evaluate the dynamics of pregnancy intention and pregnancy incidence. Design, Setting, and Participants This prospective cohort study (the Nurses' Health Study 3) was conducted from June 1, 2010, to April 1, 2022, in 18 376 premenopausal, nonpregnant female nurses aged 19 to 44 years. Main Outcomes and Measures Pregnancy intention and pregnancy status were assessed at baseline and approximately every 3 to 6 months thereafter. Cox proportional hazards regression models were used to estimate the association between pregnancy intention and pregnancy incidence. Results A total of 18 376 premenopausal, nonpregnant women (mean [SD] age, 32.4 [6.5] years) participated in the study. At baseline, 1008 women (5.5%) were trying to conceive, 2452 (13.3%) were contemplating pregnancy within 1 year, and the remaining 14 916 (81.2%) were neither trying to conceive nor thought they would be pregnant within 1 year. A total of 1314 pregnancies were documented within 12 months of pregnancy intention assessment. The cumulative incidence of pregnancy was 38.8% in women actively trying to conceive (median [IQR] time to pregnancy, 3.3 [1.5-6.7] months), 27.6% in women contemplating pregnancy (median [IQR] time to pregnancy, 6.7 [4.2-9.3] months), and 1.7% in women neither trying to conceive nor contemplating pregnancy (median [IQR] time to pregnancy, 7.8 [5.2-10.5] months) among those who became pregnant. Women who were actively trying to conceive were 23.1 times (95% CI, 19.5-27.4 times) and women who were contemplating pregnancy were 13.0 times (95% CI, 11.1-15.2 times) more likely to conceive within 12 months than women who were neither attempting nor contemplating pregnancy. Among women contemplating pregnancy at baseline who did not get pregnant during follow up, 18.8% were actively trying and 27.6% were not trying by 12 months. Conversely, only 4.9% of women neither trying to conceive nor contemplating pregnancy within 1 year at baseline changed pregnancy intention during follow up. Conclusions and Relevance In this cohort study of reproductive-aged nurses in North America, pregnancy intention was highly fluid among women who were contemplating pregnancy but relatively stable among women trying to conceive and women who were neither trying to conceive nor contemplating pregnancy. Pregnancy intention was strongly associated with pregnancy incidence, but the median time to pregnancy points to a relatively short time window to initiate preconception care.
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Affiliation(s)
- Siwen Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lidia Minguez-Alarcon
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Makiko Mitsunami
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Audrey J. Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Brittany M. Charlton
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Janet W. Rich-Edwards
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Bozigar M, Huang T, Redline S, Hart JE, Grady ST, Nguyen DD, James P, Nicholas B, Levy JI, Laden F, Peters JL. Associations between Aircraft Noise Exposure and Self-Reported Sleep Duration and Quality in the United States-Based Prospective Nurses' Health Study Cohort. Environ Health Perspect 2023; 131:47010. [PMID: 37058435 PMCID: PMC10104165 DOI: 10.1289/ehp10959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/21/2023] [Accepted: 03/03/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Sleep disruption is linked with chronic disease, and aircraft noise can disrupt sleep. However, there are few investigations of aircraft noise and sleep in large cohorts. OBJECTIVES We examined associations between aircraft noise and self-reported sleep duration and quality in the Nurses' Health Study, a large prospective cohort. METHODS Aircraft nighttime equivalent sound levels (Lnight) and day-night average sound levels (DNL) were modeled around 90 U.S. airports from 1995 to 2015 in 5-y intervals using the Aviation Environmental Design Tool and linked to geocoded participant residential addresses. Lnight exposure was dichotomized at the lowest modeled level of 45 A-weighted decibels [dB(A)] and at multiple cut points for DNL. Multiple categories of both metrics were compared with < 45 dB(A). Self-reported short sleep duration (< 7 h/24-h day) was ascertained in 2000, 2002, 2008, 2012, and 2014, and poor sleep quality (frequent trouble falling/staying asleep) was ascertained in 2000. We analyzed repeated sleep duration measures using generalized estimating equations and sleep quality by conditional logistic regression. We adjusted for participant-level demographics, behaviors, comorbidities, and environmental exposures (greenness and light at night) and examined effect modification. RESULTS In 35,226 female nurses averaging 66.1 years of age at baseline, prevalence of short sleep duration and poor sleep quality were 29.6% and 13.1%, respectively. In multivariable models, exposure to Lnight ≥ 45 dB(A) was associated with 23% [95% confidence interval (CI): 7%, 40%] greater odds of short sleep duration but was not associated with poor sleep quality (9% lower odds; 95% CI: - 30 % , 19%). Increasing categories of Lnight and DNL ≥ 45 dB(A) suggested an exposure-response relationship for short sleep duration. We observed higher magnitude associations among participants living in the West, near major cargo airports, and near water-adjacent airports and among those reporting no hearing loss. DISCUSSION Aircraft noise was associated with short sleep duration in female nurses, modified by individual and airport characteristics. https://doi.org/10.1289/EHP10959.
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Affiliation(s)
- Matthew Bozigar
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Susan Redline
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Stephanie T. Grady
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Daniel D. Nguyen
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Bradley Nicholas
- Volpe National Transportation Systems Center, U.S. Department of Transportation, Cambridge, Massachusetts, USA
| | - Jonathan I. Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Junenette L. Peters
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
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Austin SB, Beccia AL, Raffoul A, Jackson DA, Sarda V, Hart JE, Chavarro JE, Rich-Edwards J. Financial precarity, food insecurity, and psychological distress prospectively linked with use of potentially dangerous dietary supplements during the pandemic in the US. Front Public Health 2023; 11:1120942. [PMID: 36935695 PMCID: PMC10018192 DOI: 10.3389/fpubh.2023.1120942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Supplements sold with claims to promote weight loss, cleansing/detoxing, increased energy, or boosted immunity can be dangerous, and consumers experiencing extreme stressors may be especially vulnerable to deceptive claims. The purpose of our study was to investigate associations of financial strain and psychological distress during the COVID-19 pandemic with use of supplements sold for weight loss, cleanse/detox, energy, or immunity. Methods We used repeated-measures data gathered over five survey waves from April/May 2020-April 2021 from the COVID-19 Substudy (N = 54,951), within three prospective US national cohorts (Nurses' Health Study 2, Nurses' Health Study 3, and Growing Up Today Study), to investigate longitudinal associations between financial strain and psychological distress and risk of use of potentially dangerous types of supplements. Surveys assessed use of supplements prior to and during the first year of the pandemic, as well as financial precarity, food insecurity, depressive and anxiety symptoms, perceived stress, and daily hassles. We fit sociodemographic-adjusted modified Poisson GEE models to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for associations between baseline or lagged time-varying predictors and prevalent or incident (i.e., new-onset) use of each supplement type. Results At baseline in April/May 2020, soon after pandemic onset, current use of supplement types was: weight loss 2.7%; cleanse/detox 3.2%; energy 4.4%; immune 22.6%. By the end of the study period, cumulative incidence was: weight loss 3.5%; cleanse/detox 3.7%; energy 4.5%; immune 21.3%. In prevalent-use analyses, financial precarity, food insecurity, and psychological distress were associated with up to 2.4 times the risk of use of these types of supplements across the study period. Similarly, in incident-use analyses, financial precarity and psychological distress were associated with up to 2.1 times the risk of initiating use; whereas, high food insecurity was associated with nearly 1.8 times higher risk of onset of weight-loss supplements use but was not associated with onset of use of other types of supplements. Discussion We found consistent evidence that during the first year of the pandemic, participants experiencing elevated financial strain and psychological distress were at heightened risk of initiating use of potentially dangerous types of supplements. Our findings raise concerns about deceptive claims about the safety and product effectiveness by manufacturers of these supplements to profit from vulnerable consumers during the pandemic.
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Affiliation(s)
- S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Ariel L. Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Destiny A. Jackson
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Jorge E. Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Janet Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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YI LI, Hart JE, Wilt G, Hu C, Laden F, Chavarro J, James P. Abstract 52: Using Smartphone-Based Digital Phenotyping to Understand Lifestyle and Behavioral Risks of Cardiometabolic Diseases: The Beiwe Smartphone Sub-Study of Nurses’ Health Study 3 and Growing Up Today Study. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Background:
Emerging evidence has suggested lifestyle and behavioral factors such as physical activity, diet, and sleep may be associated with cardiometabolic health outcomes in US adults. However, these studies typically have limited temporal or spatial coverage. The current study aimed to fill in this gap by applying smartphone-based digital phenotyping to collect dynamic, high temporal resolution measures of lifestyle and behavioral factors.
Methods:
Participants (N = 2,127 as of Sep 7
th
, 2022) of the Beiwe Smartphone Sub-study of Nurses’ Health Study 3 (NHS3) and Growing Up Today Study (GUTS) completed microsurveys delivered by the Beiwe smartphone application for a year each. Starting July 2021, a microsurvey was delivered every 10 days, covering one of the 12 different topics, including emotions, stress, physical activity, green space, pets, diet, sleep, and sitting. These questionnaires aimed to measure various aspects of participants’ key health behaviors, to combine with objectively assessed high-resolution GPS and accelerometer data that participants provided during the same period.
Results:
Between July 28
th
, 2021, and Sep 7
th
, 2022, 2,127 participants completed 22,039 microsurveys delivered by the Beiwe application. The mean follow-up for participants was 116 days (SD=124, range=221). During this period, each participant on average submitted 10 microsurveys (SD=10, range=39). The topic completed most consistently (N=1,955 responses) was pets (the first microsurvey), and 43.3% of responses from participants reported a park visit in the past week. Additionally, 71.2% of responses from participants reported they spent at least a few minutes walking for exercise in the past week. Furthermore, during the same period, participants on average provided 177 days (SD=123, range=218) of GPS data and 181 days (SD=181, range=224) of accelerometer data.
Conclusions:
In this study, the smartphone-based digital phenotyping technology was implemented to collect intensive longitudinal data on lifestyle and behavioral factors in two well-established prospective cohorts. The efforts so far have resulted in a rich dataset on health behaviors, which can be linked to locations and future cardiometabolic health outcomes.
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Affiliation(s)
- LI YI
- Harvard Sch of Public Health, Boston, MA
| | | | - Grete Wilt
- Harvard Sch of Public Health, Boston, MA
| | - Cindy Hu
- Harvard Sch of Public Health, Boston, MA
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Żebrowska M, Strohmaier S, Westgarth C, Huttenhower C, Erber AC, Haghayegh S, Eliassen AH, Huang T, Laden F, Hart JE, Rosner B, Kawachi I, Chavarro JE, Okereke OI, Schernhammer ES. Relationship between pet ownership and risk of high depressive symptoms in adolescence and young adulthood. J Affect Disord 2023; 323:554-561. [PMID: 36464093 PMCID: PMC9839520 DOI: 10.1016/j.jad.2022.11.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/25/2022] [Accepted: 11/20/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Only few longitudinal studies with high risk of bias have examined relationship between pets and adolescents' mental health. METHODS Our prospective cohort study followed depression-free US adolescents aged 12-18, enrolled in the Growing Up Today Study from pet ownership assessment in 1999 to possible occurrence of high depressive symptoms defined based on the McKnight Risk Factor Survey between 2001 and 2003. Propensity-score-adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated using generalized estimating equation models. RESULTS Among 9631 adolescents [42.4 % male, mean age 14.9 years (SD 1.6)], we found no association between pet ownership and risk of high depressive symptoms (ORany_pet = 1.14; 95%CI, 0.95-1.38). Stratified analyses revealed no evidence of effect modification by sex, but effect modification by maternal history of depression (depressed mothers ORany_pet = 0.83; 95 % CI: 0.58-1.19, non-depressed mothers ORany_pet = 1.27; 95 % CI: 1.02-1.58; Pintx = 0.03), which differed further by children's sex. Effects were more pronounced among children with a history of childhood abuse (ORany_pet = 0.41 (0.14-1.15); Pintx ≤0.03). No major differences by type of pet owned were observed in any of these analyses. LIMITATIONS Our sample is predominantly white and all are offspring of nurses with a similar academic background which could affect generalizability. CONCLUSIONS Overall, we found no association between pet ownership and depression during adolescence, however subgroup analyses indicated some individuals may benefit from a pet. Future longitudinal studies with more detailed exposure assessments, including pet attachment are needed to further explore the potential of human-animal interaction on mental health.
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Affiliation(s)
- Magdalena Żebrowska
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Carri Westgarth
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Curtis Huttenhower
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Astrid C Erber
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Shahab Haghayegh
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bernard Rosner
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ichiro Kawachi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jorge E Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Olivia I Okereke
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Eva S Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Chen K, Klompmaker JO, Roscoe CJ, Nguyen LH, Drew DA, James P, Laden F, Fecht D, Wang W, Gulliver J, Wolf J, Steves CJ, Spector TD, Chan AT, Hart JE. Associations between greenness and predicted COVID-19-like illness incidence in the United States and the United Kingdom. Environ Epidemiol 2023; 7:e244. [PMID: 36788976 PMCID: PMC9916094 DOI: 10.1097/ee9.0000000000000244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023] Open
Abstract
Green spaces may be protective against COVID-19 incidence. They may provide outdoor, ventilated, settings for physical and social activities and therefore decrease transmission risk. We examined the association between neighborhood greenness and COVID-19-like illness incidence using individual-level data. Methods The study population includes participants enrolled in the COVID Symptom Study smartphone application in the United Kingdom and the United States (March-November 2020). All participants were encouraged to report their current health condition and suspected risk factors for COVID-19. We used a validated symptom-based classifier that predicts COVID-19-like illness. We estimated the Normalized Difference Vegetation Index (NDVI), for each participant's reported neighborhood of residence for each month, using images from Landsat 8 (30 m2). We used time-varying Cox proportional hazards models stratified by age, country, and calendar month at study entry and adjusted for the individual- and neighborhood-level risk factors. Results We observed 143,340 cases of predicted COVID-19-like illness among 2,794,029 participants. Neighborhood NDVI was associated with a decreased risk of predicted COVID-19-like illness incidence in the fully adjusted model (hazard ratio = 0.965, 95% confidence interval = 0.960, 0.970, per 0.1 NDVI increase). Stratified analyses showed protective associations among U.K. participants but not among U.S. participants. Associations were slightly stronger for White individuals, for individuals living in rural neighborhoods, and for individuals living in high-income neighborhoods compared to individuals living in low-income neighborhoods. Conclusions Higher levels of greenness may reduce the risk of predicted COVID-19-like illness incidence, but these associations were not observed in all populations.
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Affiliation(s)
- Kelly Chen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jochem O. Klompmaker
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Charlotte J. Roscoe
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Long H. Nguyen
- Clinical & Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - David A. Drew
- Clinical & Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Weiyi Wang
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - John Gulliver
- Centre for Environmental Health and Sustainability, George Davies Centre, University of Leicester, Leicester, United Kingdom
| | | | - Claire J. Steves
- Kings College Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Tim D. Spector
- Kings College Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Andy T. Chan
- Clinical & Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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Klompmaker JO, Laden F, James P, Sabath MB, Wu X, Schwartz J, Dominici F, Zanobetti A, Hart JE. Effects of long-term average temperature on cardiovascular disease hospitalizations in an American elderly population. Environ Res 2023; 216:114684. [PMID: 36334826 PMCID: PMC10236856 DOI: 10.1016/j.envres.2022.114684] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/05/2022] [Accepted: 10/25/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Short-term exposure to high or low temperatures is associated with increased mortality and morbidity. Less is known about effects of long-term exposure to high or low temperatures. Prolonged exposure to high or low temperatures might contribute to pathophysiological mechanisms, thereby influencing the development of diseases. Our aim was to evaluate associations of long-term temperature exposure with cardiovascular disease (CVD) hospitalizations. METHODS We constructed an open cohort consisting of all fee-for-service Medicare beneficiaries, aged ≥65, living in the contiguous US from 2000 through 2016 (∼61.6 million individuals). We used data from the 4 km Gridded Surface Meteorological dataset to assess the summer (June-August) and winter (December-February) average daily maximum temperature for each year for each zip code. Cox-equivalent Poisson models were used to estimate associations with first CVD hospitalization, after adjustment for potential confounders. We performed stratified analyses to assess potential effect modification by sex, age, race, Medicaid eligibility and relative humidity. RESULTS Higher summer average and lower winter average temperatures were associated with an increased risk of CVD hospitalization. We found a HR of 1.068 (95% CI: 1.063, 1.074) per IQR increase (5.2 °C) for summer average temperature and a HR of 1.022 (95% CI: 1.017, 1.028) per IQR decrease (11.7 °C) for winter average temperature. Positive associations of higher summer average temperatures were strongest for individuals aged <75 years, Medicaid eligible, and White individuals. Positive associations of lower winter average temperatures were strongest for individuals aged <75 years and Black individuals, and individuals living in low relative humidity areas. CONCLUSIONS Living in areas with high summer average temperatures or low winter average temperatures could increase the risk of CVD hospitalizations. The magnitude of the associations of summer and winter average temperatures differs by demographics and relative humidity levels.
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Affiliation(s)
- Jochem O Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Massachusetts 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Massachusetts 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Massachusetts 02115, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - M Benjamin Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Xiao Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Massachusetts 02115, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Massachusetts 02115, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Massachusetts 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
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Klompmaker JO, Hart JE, Bailey CR, Browning MH, Casey JA, Hanley JR, Minson CT, Ogletree SS, Rigolon A, Laden F, James P. Racial, Ethnic, and Socioeconomic Disparities in Multiple Measures of Blue and Green Spaces in the United States. Environ Health Perspect 2023; 131:17007. [PMID: 36696102 PMCID: PMC9875842 DOI: 10.1289/ehp11164] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Several studies have evaluated whether the distribution of natural environments differs between marginalized and privileged neighborhoods. However, most studies restricted their analyses to a single or handful of cities and used different natural environment measures. OBJECTIVES We evaluated whether natural environments are inequitably distributed based on socioeconomic status (SES) and race/ethnicity in the contiguous United States. METHODS We obtained SES and race/ethnicity data (2015-2019) for all U.S. Census tracts. For each tract, we calculated the Normalized Different Vegetation Index (NDVI) for 2020, NatureScore (a proprietary measure of the quantity and quality of natural elements) for 2019, park cover for 2020, and blue space for 1984-2018. We used generalized additive models with adjustment for potential confounders and spatial autocorrelation to evaluate associations of SES and race/ethnicity with NDVI, NatureScore, park cover, and odds of containing blue space in all tracts (n=71,532) and in urban tracts (n=45,338). To compare effect estimates, we standardized NDVI, NatureScore, and park cover so that beta coefficients presented a percentage increase or decrease of the standard deviation (SD). RESULTS Tracts with higher SES had higher NDVI, NatureScore, park cover, and odds of containing blue space. For example, urban tracts in the highest median household income quintile had higher NDVI [44.8% of the SD (95% CI: 42.8, 46.8)] and park cover [16.2% of the SD (95% CI: 13.5, 19.0)] compared with urban tracts in the lowest median household income quintile. Across all tracts, a lower percentage of non-Hispanic White individuals and a higher percentage of Hispanic individuals were associated with lower NDVI and NatureScore. In urban tracts, we observed weak positive associations between percentage non-Hispanic Black and NDVI, NatureScore, and park cover; we did not find any clear associations for percentage Hispanics. DISCUSSION Multiple facets of the natural environment are inequitably distributed in the contiguous United States. https://doi.org/10.1289/EHP11164.
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Affiliation(s)
- Jochem O. Klompmaker
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Matthew H.E.M. Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, South Carolina, USA
| | - Joan A. Casey
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | | | - Christopher T. Minson
- NatureQuant, Eugene, Oregon, USA
- Department of Human Physiology, University of Oregon, Eugene, Oregon, USA
| | - S. Scott Ogletree
- OPENspace Research Centre, School of Architecture and Landscape Architecture, University of Edinburgh, Edinburgh, UK
| | - Alessandro Rigolon
- Department of City and Metropolitan Planning, University of Utah, Salt Lake City, Utah, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
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Li H, Hart JE, Mahalingaiah S, Nethery RC, James P, Bertone-Johnson E, Eliassen AH, Laden F. Environmental Exposures and Anti-Müllerian Hormone: A Mixture Analysis in the Nurses' Health Study II. Epidemiology 2023; 34:150-161. [PMID: 36455251 PMCID: PMC9720700 DOI: 10.1097/ede.0000000000001547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Previous studies have linked environmental exposures with anti-Müllerian hormone (AMH), a marker of ovarian reserve. However, associations with multiple environment factors has to our knowledge not been addressed. METHODS We included a total of 2,447 premenopausal women in the Nurses' Health Study II (NHSII) who provided blood samples during 1996-1999. We selected environmental exposures linked previously with reproductive outcomes that had measurement data available in NHSII, including greenness, particulate matter, noise, outdoor light at night, ultraviolet radiation, and six hazardous air pollutants (1,3-butadiene, benzene, diesel particulate matter, formaldehyde, methylene chloride, and tetrachloroethylene). For these, we calculated cumulative averages from enrollment (1989) to blood draw and estimated associations with AMH in adjusted single-exposure models, principal component analysis (PCA), and hierarchical Bayesian kernel machine regression (BKMR). RESULTS Single-exposure models showed negative associations of AMH with benzene (percentage reduction in AMH per interquartile range [IQR] increase = 5.5%, 95% confidence interval [CI] = 1.0, 9.8) and formaldehyde (6.1%, 95% CI = 1.6, 10). PCA identified four major exposure patterns but only one with high exposure to air pollutants and light at night was associated with lower AMH. Hierarchical BKMR pointed to benzene, formaldehyde, and greenness and suggested an inverse joint association with AMH (percentage reduction comparing all exposures at the 75th percentile to median = 8.2%, 95% CI = 0.7, 15.1). Observed associations were mainly among women above age 40. CONCLUSIONS We found exposure to benzene and formaldehyde to be consistently associated with lower AMH levels. The associations among older women are consistent with the hypothesis that environmental exposures accelerate reproductive aging.
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Affiliation(s)
- Huichu Li
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Rachel C. Nethery
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Elizabeth Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Leung M, Laden F, Coull BA, Modest AM, Hacker MR, Wylie BJ, Iyer HS, Hart JE, Wei Y, Schwartz J, Weisskopf MG, Papatheodorou S. Ambient temperature during pregnancy and fetal growth in Eastern Massachusetts, USA. Int J Epidemiol 2022:6887251. [PMID: 36495569 DOI: 10.1093/ije/dyac228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/29/2022] [Indexed: 12/14/2022] Open
Abstract
Abstract
Background
Left unabated, rising temperatures pose an escalating threat to human health. The potential effects of hot temperatures on fetal health have been under-explored. Here, we examined the association between prenatal ambient temperature exposure and fetal growth measures in a Massachusetts-based pregnancy cohort.
Methods
We used ultrasound measurements of biparietal diameter (BPD), head circumference (HC), femur length and abdominal circumference (AC), in addition to birthweight (BW), from 9446 births at Beth Israel Deaconess Medical Center from 2011 to 2016. Ultrasound scans were classified into three distinct gestational periods: 16–23 weeks, 24–31 weeks, 32+ weeks; and z-scores were created for each fetal growth measure using the INTERGROWTH-21st standards. We fitted distributed lag models to estimate the time-varying association between weekly temperature and fetal growth, adjusting for sociodemographic characteristics, seasonal and long-term trends, humidity and particulate matter (PM2.5).
Results
Higher ambient temperature was associated with smaller fetal growth measures. The critical window of exposure appeared to be Weeks 1–20 for ultrasound parameters, and high temperatures throughout pregnancy were important for BW. Associations were strongest for head parameters (BPD and HC) in early to mid-pregnancy, AC late in pregnancy and BW. For example, a 5ºC higher cumulative temperature exposure was associated with a lower mean AC z-score of -0.26 (95% CI: -0.48, -0.04) among 24–31-Week scans, and a lower mean BW z-score of -0.32 (95% CI: -0.51, -0.12).
Conclusion
Higher temperatures were associated with impaired fetal growth. This has major health implications given that extreme temperatures are more common and escalating.
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Affiliation(s)
- Michael Leung
- Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School , Boston, MA, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Anna M Modest
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center , Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School , Boston, MA, USA
| | - Michele R Hacker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center , Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School , Boston, MA, USA
| | - Blair J Wylie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center , Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School , Boston, MA, USA
| | - Hari S Iyer
- Division of Population Sciences, Dana-Farber Cancer Institute , Boston, MA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School , Boston, MA, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Joel Schwartz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
| | - Marc G Weisskopf
- Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA, USA
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Klompmaker JO, Laden F, Browning MHEM, Dominici F, Jimenez MP, Ogletree SS, Rigolon A, Zanobetti A, Hart JE, James P. Associations of Greenness, Parks, and Blue Space With Neurodegenerative Disease Hospitalizations Among Older US Adults. JAMA Netw Open 2022; 5:e2247664. [PMID: 36538329 PMCID: PMC9856892 DOI: 10.1001/jamanetworkopen.2022.47664] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/31/2022] [Indexed: 12/24/2022] Open
Abstract
Importance Exposure to natural environments has been associated with health outcomes related to neurological diseases. However, the few studies that have examined associations of natural environments with neurological diseases report mixed findings. Objective To evaluate associations of natural environments with hospital admissions for Alzheimer disease and related dementias (ADRD) and Parkinson disease (PD) among older adults in the US. Design, Setting, and Participants This open cohort study included fee-for-service Medicare beneficiaries aged 65 years or older who lived in the contiguous US from January 1, 2000, to December 31, 2016. Beneficiaries entered the cohort on January 1, 2000, or January 1 of the year after enrollment. Data from US Medicare enrollment and Medicare Provider Analysis and Review files, which contain information about individual-level covariates and all hospital admissions for Medicare fee-for-service beneficiaries, were analyzed between January 2021 and September 2022. Exposures Differences in IQRs for zip code-level greenness (normalized difference vegetation index [NDVI]), percentage park cover, and percentage blue space cover (surface water; ≥1.0% vs <1.0%). Main Outcomes and Measures The main outcome was first hospitalizations with a primary or secondary discharge diagnosis of ADRD or PD. To examine associations of exposures to natural environments with ADRD and PD hospitalization, we used Cox-equivalent Poisson models. Results We included 61 662 472 and 61 673 367 Medicare beneficiaries in the ADRD and PD cohorts, respectively. For both cohorts, 55.2% of beneficiaries were women. Most beneficiaries in both cohorts were White (84.4%), were not eligible for Medicaid (87.6%), and were aged 65 to 74 years (76.6%) at study entry. We observed 7 737 609 and 1 168 940 first ADRD and PD hospitalizations, respectively. After adjustment for potential individual- and area-level confounders (eg, Medicaid eligibility and zip code-level median household income), NDVI was negatively associated with ADRD hospitalization (hazard ratio [HR], 0.95 [95% CI, 0.94-0.96], per IQR increase). We found no evidence of an association of percentage park and blue space cover with ADRD hospitalization. In contrast, NDVI (HR, 0.94 [95% CI, 0.93-0.95], per IQR increase), percentage park cover (HR, 0.97 [95% CI, 0.97-0.98], per IQR increase), and blue space cover (HR, 0.97 [95% CI, 0.96-0.98], ≥1.0% vs <1.0%) were associated with a decrease in PD hospitalizations. Patterns of effect modification by demographics differed between exposures. Conclusions and Relevance The findings of this cohort study suggest that some natural environments are associated with a decreased risk of ADRD and PD hospitalization.
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Affiliation(s)
- Jochem O. Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Francesca Dominici
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Marcia P. Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - S. Scott Ogletree
- OPENspace Research Centre, School of Architecture and Landscape Architecture, University of Edinburgh, Edinburgh, United Kingdom
| | - Alessandro Rigolon
- Department of City and Metropolitan Planning, University of Utah, Salt Lake City
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
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Iyer HS, Hart JE, Fiffer MR, Elliott EG, Yanosky JD, Kaufman JD, Puett RC, Laden F. Impacts of long-term ambient particulate matter and gaseous pollutants on circulating biomarkers of inflammation in male and female health professionals. Environ Res 2022; 214:113810. [PMID: 35798268 PMCID: PMC10234694 DOI: 10.1016/j.envres.2022.113810] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/30/2022] [Accepted: 06/30/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Systemic inflammation may serve as a biological mechanism linking air pollution to poor health but supporting evidence from studies of long-term pollutant exposure and inflammatory cytokines is inconsistent. OBJECTIVE We studied associations between multiple particulate matter (PM) and gaseous air pollutants and pro- and anti-inflammatory cytokines within two nationwide cohorts of men and women. METHODS Data were obtained from 16,151 women in the Nurses' Health Study and 7,930 men in the Health Professionals' Follow-up Study with at least one measure of circulating adiponectin, C-Reactive Protein (CRP), Interleukin-6 (IL-6) or soluble tumor necrosis-factor receptor-2 (sTNFR-2). Exposure to PM with aerodynamic diameter ≤2.5, 2.5-10, and ≤10 μm (PM2.5, PM2.5-10, PM10) and nitrogen dioxide (NO2) was estimated using spatio-temporal models and were linked to participants' addresses at the time of blood draw. Averages of the 1-, 3-, and 12-months prior to blood draw were examined. Associations between each biomarker and pollutant were estimated from linear regression models adjusted for individual and contextual covariates. RESULTS In adjusted models, we observed a 2.72% (95% CI: 0.43%, 5.95%), 3.11% (-0.12%, 6.45%), and 3.67% (0.19%, 7.26%) increase in CRP associated with a 10 μg/m3 increase in 1-, 3-, and 12- month averaged NO2 in women. Among men, there was a statistically significant 5.96% (95% CI: 0.07%, 12.20%), 6.99% (95% CI: 0.29%, 14.15%), and 8.33% (95% CI: 0.35%, 16.94%) increase in CRP associated with a 10 μg/m3 increase in 1-, 3-, and 12-month averaged PM2.5-10, respectively. Increasing PM2.5-10 was associated with increasing IL-6 and sTNFR-2 among men over shorter exposure durations. There were no associations with exposures to PM2.5 or PM10, or with adiponectin. Findings were robust to sensitivity analyses restricting to disease-free controls and non-movers. CONCLUSIONS Across multiple long-term pollutant exposures and inflammatory markers, associations were generally weak. Focusing on specific pollutant-inflammatory mechanisms may clarify pathways.
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Affiliation(s)
- Hari S Iyer
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Jaime E Hart
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, USA; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Melissa R Fiffer
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Elise G Elliott
- Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, USA; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA; Health Effects Institute, Boston, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, USA
| | - Joel D Kaufman
- Department of Epidemiology, University of Washington, Seattle, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, USA
| | - Robin C Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, USA; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, USA
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Wang S, Mortazavi J, Hart JE, Hankins JA, Katuska LM, Farland LV, Gaskins AJ, Wang YX, Tamimi RM, Terry KL, Rich-Edwards JW, Missmer SA, Chavarro JE. A prospective study of the association between SARS-CoV-2 infection and COVID-19 vaccination with changes in usual menstrual cycle characteristics. Am J Obstet Gynecol 2022; 227:739.e1-739.e11. [PMID: 35841938 PMCID: PMC9277995 DOI: 10.1016/j.ajog.2022.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/23/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite anecdotal reports, the impacts of SARS-CoV-2 infection or COVID-19 vaccination on menstrual health have not been systemically investigated. OBJECTIVE This study aimed to examine the associations of SARS-CoV-2 infection and COVID-19 vaccination with menstrual cycle characteristics. STUDY DESIGN This study prospectively observed 3858 premenopausal women in the Nurses' Health Study 3 living in the United States or Canada who received biannual follow-up questionnaires between January 2011 and December 2021 and completed additional monthly and quarterly surveys related to the COVID-19 pandemic between April 2020 and November 2021. History of positive SARS-CoV-2 test, COVID-19 vaccination status, and vaccine type were self-reported in surveys conducted in 2020 and 2021. Current menstrual cycle length and regularity "before COVID-19" were reported at baseline between 2011 and 2016, and current menstrual cycle length and regularity "after COVID-19" were reported in late 2021. Pre- to post-COVID change in menstrual cycle length and regularity was calculated between reports. Logistic or multinomial logistic regression models were used to assess the associations between SARS-CoV-2 infection and COVID-19 vaccination and change in menstrual cycle characteristics. RESULTS The median age at baseline and the median age at end of follow-up were 33 years (range, 21-51) and 42 years (range, 27-56), respectively, with a median follow-up time of 9.2 years. This study documented 421 SARS-CoV-2 infections (10.9%) and 3527 vaccinations (91.4%) during follow-up. Vaccinated women had a higher risk of increased cycle length than unvaccinated women (odds ratio, 1.48; 95% confidence interval, 1.00-2.19), after adjusting for sociodemographic and behavioral factors. These associations were similar after in addition accounting for pandemic-related stress. COVID-19 vaccination was only associated with change to longer cycles in the first 6 months after vaccination (0-6 months: odds ratio, 1.67 [95% confidence interval, 1.05-2.64]; 7-9 months: odds ratio, 1.43 [95% confidence interval, 0.96-2.14]; >9 months: odds ratio, 1.41 [95% confidence interval, 0.91-2.18]) and among women whose cycles were short, long, or irregular before vaccination (odds ratio, 2.82 [95% confidence interval, 1.51-5.27]; odds ratio, 1.10 [95% confidence interval, 0.68-1.77] for women with normal length, regular cycles before vaccination). Messenger RNA and adenovirus-vectored vaccines were both associated with this change. SARS-CoV-2 infection was not associated with changes in usual menstrual cycle characteristics. CONCLUSION COVID-19 vaccination may be associated with short-term changes in usual menstrual cycle length, particularly among women whose cycles were short, long, or irregular before vaccination. The results underscored the importance of monitoring menstrual health in vaccine clinical trials. Future work should examine the potential biological mechanisms.
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Affiliation(s)
- Siwen Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jasmine Mortazavi
- Department of Obstetrics, Gynecology, and Reproductive Biologym, Michigan State University College of Human Medicine, Grand Rapids, MI
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jennifer A Hankins
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Laura M Katuska
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
| | - Audrey J Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Yi-Xin Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Rulla M Tamimi
- Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Kathryn L Terry
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Stacey A Missmer
- Department of Obstetrics, Gynecology, and Reproductive Biologym, Michigan State University College of Human Medicine, Grand Rapids, MI; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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Sakaki JR, Gao S, Ha K, Chavarro JE, Chen MH, Sun Q, Hart JE, Chun OK. Childhood beverage intake and risk of hypertension and hyperlipidaemia in young adults. Int J Food Sci Nutr 2022; 73:954-964. [PMID: 35761780 PMCID: PMC9951226 DOI: 10.1080/09637486.2022.2091524] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
An epidemiological analysis assessing beverage consumption and risk factors for cardiovascular disease was conducted. Participants were 9-16 years old at enrolment, completed food frequency questionnaires in 1996-2001 and self-reported outcomes in 2010-2014. Exclusion criteria included missing data on relevant variables and covariates, prevalent disease before 2005, and implausible/extreme weight or energy intake. Intakes of orange juice, apple/other fruit juice, sugar-sweetened beverages and diet soda were related to the risk of incident hypertension or hyperlipidaemia using Cox proportional hazards regression, adjusting for diet, energy intake, age, smoking, physical activity and body mass index. There were 9,043 participants with 618 cases of hypertension and 850 of hyperlipidaemia in 17 years of mean follow-up. Sugar-sweetened beverage intake but not fruit juice nor diet soda was associated with hypertension (hazard ratio (95% confidence interval): 1.16 (1.03, 1.31)) in males. This study can guide beverage consumption as it relates to early predictors of cardiovascular disease.
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Affiliation(s)
- Junichi R. Sakaki
- Department of Nutritional Sciences, University of Connecticut, 27 Manter Rd., Unit 4017, Storrs, CT 06269
| | - Simiao Gao
- Department of Statistics, University of Connecticut, 215 Glenbrook Rd., U-4120, Storrs, CT, 06269
| | - Kyungho Ha
- Department of Food Science and Nutrition, Jeju National University, Jeju, South Korea
| | - Jorge E. Chavarro
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, 215 Glenbrook Rd., U-4120, Storrs, CT, 06269
| | - Qi Sun
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, 3rd Fl West, Boston, MA 02215.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Ock K. Chun
- Department of Nutritional Sciences, University of Connecticut, 27 Manter Rd., Unit 4017, Storrs, CT 06269
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Klompmaker JO, Laden F, Browning MHEM, Dominici F, Ogletree SS, Rigolon A, Hart JE, James P. Associations of parks, greenness, and blue space with cardiovascular and respiratory disease hospitalization in the US Medicare cohort. Environ Pollut 2022; 312:120046. [PMID: 36049575 PMCID: PMC10236532 DOI: 10.1016/j.envpol.2022.120046] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/09/2022] [Accepted: 08/22/2022] [Indexed: 05/07/2023]
Abstract
Natural environments have been linked to decreased risk of cardiovascular disease (CVD) and respiratory disease (RSD) mortality. However, few cohort studies have looked at associations of natural environments with CVD or RSD hospitalization. The aim of this study was to evaluate these associations in a cohort of U.S. Medicare beneficiaries (∼63 million individuals). Our open cohort included all fee-for-service Medicare beneficiaries (2000-2016), aged ≥65, living in the contiguous U.S. We assessed zip code-level park cover based on the United States Geological Survey Protected Areas Database, average greenness (Normalized Difference Vegetation Index, NDVI), and percent blue space cover based on Landsat satellite images. Cox-equivalent Poisson models were used to estimate associations of the exposures with first CVD and RSD hospitalization in the full cohort and among those living in urban zip codes (≥1000 persons/mile2). NDVI was weakly negatively correlated with percent park cover (Spearman ρ = -0.23) and not correlated with percent blue space (Spearman ρ = 0.00). After adjustment for potential confounders, percent park cover was not associated with CVD or RSD hospitalization in the full or urban population. An IQR (0.27) increase in NDVI was negatively associated with CVD (HR: 0.97, 95%CI: 0.96, 0.97), but not with RSD hospitalization (HR: 0.99, 95%CI: 0.98, 1.00). In urban zip codes, an IQR increase in NDVI was positively associated with RSD hospitalization (HR: 1.02, 95%CI: 1.00, 1.03). In stratified analyses, percent park cover was negatively associated with CVD and RSD hospitalization for Medicaid eligible individuals and individuals living in low socioeconomic status neighborhoods in the urban population. We observed no associations of percent blue space cover with CVD or RSD hospitalization. This study suggests that natural environments may benefit cardiorespiratory health; however, benefits may be limited to certain contexts and certain health outcomes.
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Affiliation(s)
- Jochem O Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Landmark Center, 401 Park Drive, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Landmark Center, 401 Park Drive, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, 181 Longwood Avenue, Massachusetts 02115, USA
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC 29634, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - S Scott Ogletree
- OPENspace Research Centre, School of Architecture and Landscape Architecture, University of Edinburgh, Edinburgh, UK
| | - Alessandro Rigolon
- Department of City and Metropolitan Planning, The University of Utah, 375 South 1530 East, Salt Lake City, UT 84112, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Landmark Center, 401 Park Drive, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Landmark Center, 401 Park Drive, Boston, MA 02115, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
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Marquet O, Hirsch JA, Kerr J, Jankowska MM, Mitchell J, Hart JE, Laden F, Hipp JA, James P. GPS-based activity space exposure to greenness and walkability is associated with increased accelerometer-based physical activity. Environ Int 2022; 165:107317. [PMID: 35660954 PMCID: PMC10187790 DOI: 10.1016/j.envint.2022.107317] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/30/2022] [Accepted: 05/19/2022] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Built and natural environments may provide opportunities for physical activity. However, studies are limited by primarily using residential addresses to define exposure and self-report to measure physical activity. We quantified associations between global positioning systems (GPS)-based activity space measures of environmental exposure and accelerometer-based physical activity. METHODS Using a nationwide sample of working female adults (N = 354), we obtained seven days of GPS and accelerometry data. We created Daily Path Area activity spaces using GPS data and linked these activity spaces to spatial datasets on walkability (EPA Smart Location Database at the Census block group level) and greenness (satellite vegetation at 250 m resolution). We utilized generalized additive models to examine nonlinear associations between activity space exposures and accelerometer-derived physical activity outcomes adjusted for demographic characteristics, socioeconomic factors, and self-rated health. RESULTS Higher activity space walkability was associated with higher levels of moderate-vigorous physical activity, and higher activity space greenness was associated with greater numbers of steps per week. No strong relationships were observed for sedentary behavior or light physical activity. Highest levels of moderate-vigorous physical activity were observed for participants with both high walkability and high greenness in their activity spaces. CONCLUSION This study contributes evidence that higher levels of physical activity occur in environments with more dense, diverse, and well-connected built environments, and with higher amounts of vegetation. These data suggest that urban planners, landscape architects, and policy makers should implement and evaluate environmental interventions to encourage higher levels of physical activity.
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Affiliation(s)
- Oriol Marquet
- Institute of Environmental Science and Technology, Autonomous University of Barcelona, Spain.
| | - Jana A Hirsch
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA
| | - Marta M Jankowska
- Beckman Research Institute, Population Sciences, City of Hope, Duarte, CA, USA
| | - Jonathan Mitchell
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - J Aaron Hipp
- Center for Geospatial Analytics, NC State University, USA; Department of Parks, Recreation, and Tourism Management, NC State University, USA
| | - Peter James
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Barbhaiya M, Hart JE, Malspeis S, Tedeschi SK, VoPham T, Sparks JA, Karlson EW, Laden F, Costenbader KH. Association of Ultraviolet B Radiation and Risk of Systemic Lupus Erythematosus Among Women in the Nurses' Health Studies. Arthritis Care Res (Hoboken) 2022:10.1002/acr.24974. [PMID: 35724272 PMCID: PMC9910058 DOI: 10.1002/acr.24974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 06/02/2022] [Accepted: 06/16/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Ultraviolet (UV) radiation exposure is associated with photosensitivity, rashes, and flares in systemic lupus erythematosus (SLE). However, it is not known whether UV exposure increases risk of developing SLE. We examined UV exposure and SLE risk in a large prospective cohort. METHODS The Nurses' Health Study (NHS) enrolled 121,700 US female nurses in 1976; in 1989, 116,429 nurses were enrolled in NHS II. Biennial questionnaires collected lifestyle and medical data. Self-reported incident SLE by American College of Rheumatology classification criteria was confirmed by medical record review. Ambient UV exposure was estimated by linking geocoded residential addresses with a spatiotemporal UV exposure model. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) across tertiles of time-varying cumulative average UV. We examined SLE risk overall and stratified by anti-Ro/La antibodies and by cutaneous manifestations from 1976 through 2014 (NHS)/2015 (NHS II), adjusting for confounders. RESULTS With 6,054,665 person-years of exposure, we identified 297 incident SLE cases; the mean ± SD age at diagnosis was 49.8 ± 10.6 years. At diagnosis, 16.8% of women had +anti-Ro/La, and 80% had either +anti-Ro/La or ≥1 cutaneous manifestation. Compared with the lowest UV exposure tertile, risk of overall SLE was increased, but not significantly (HR 1.28 [95%CI 0.96-1.70]). Women in the highest tertile had increased risk of malar rash (HR 1.62 [95% CI 1.04-2.52]). CONCLUSION Cumulative UV exposure was not associated with SLE risk. Higher UV exposure, however, was associated with increased risk of malar rash at presentation. UV exposure may trigger SLE onset with malar rash among susceptible women.
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Affiliation(s)
- Medha Barbhaiya
- Division of Rheumatology, Hospital For Special Surgery, New York, NY,Departments of Medicine and Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Jaime E. Hart
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Susan Malspeis
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Sara K. Tedeschi
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Boston, MA
| | - Jeffrey A. Sparks
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Elizabeth W. Karlson
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Francine Laden
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Karen H. Costenbader
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
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Busenkell E, Collins CM, Moy ML, Hart JE, Grady ST, Coull BA, Schwartz JD, Koutrakis P, Garshick E. Modification of associations between indoor particulate matter and systemic inflammation in individuals with COPD. Environ Res 2022; 209:112802. [PMID: 35101396 PMCID: PMC9159533 DOI: 10.1016/j.envres.2022.112802] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/12/2022] [Accepted: 01/21/2022] [Indexed: 06/03/2023]
Abstract
RATIONALE Little is known about personal characteristics and systemic responses to particulate pollution in patients with COPD. OBJECTIVES Assess whether diabetes, obesity, statins and non-steroidal anti-inflammatory medications (NSAIDs) modify associations between indoor black carbon (BC) and fine particulate matter ≤2.5 μm in diameter (PM2.5) on systemic inflammation and endothelial activation. METHODS 144 individuals with COPD without current smoking and without major in-home combustion sources were recruited at Veterans Affairs Boston Healthcare System. PM2.5 and BC were measured in each participant's home seasonally for a week (up to 4 times; 482 observations) and plasma biomarkers of systemic inflammation [C-reactive protein (CRP); interleukin-6 (IL-6)] and endothelial activation [soluble vascular adhesion molecule-1 (sVCAM-1)] measured. Linear mixed effects regression with a random intercept was used, and effect modification assessed with multiplicative interaction terms and stratum specific estimates. RESULTS Median (25%ile, 75%ile) indoor BC and PM2.5 were 0.6 (0.5,0.7) μg/m3 and 6.8 (4.8,10.4) μg/m3, respectively. Although p-values for effect modification were not statistically significant, there were positive associations (%-increase/interquartile range; 95% CI) between CRP and BC greater among non-statin (18.8%; 3.6-36.3) than statin users (11.1%; 2.1-20.9). There were also positive associations greater among non-statin users between PM2.5 and CRP. For IL-6, associations with BC and PM2.5 were also greater among non-statin users. Associations between CRP and BC were greater (20.3%; 4.5-38.5) in persons with diabetes than without diabetes (10.3%; 0.92-20.6) with similar effects of PM2.5. There were no consistent associations that differed based on obesity. Effect modification was not observed for NSAID use, or with any factor considered with sVCAM-1. CONCLUSIONS Associations between indoor BC and PM2.5 and CRP were greater in patients with diabetes and those not taking statins, and with IL-6 if not taking statins. These results suggest that these characteristics may modify the systemic response to indoor BC and PM2.5 in persons with COPD.
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Affiliation(s)
- Emma Busenkell
- Research and Development Service, VA Boston Healthcare System, Boston, MA, USA
| | - Christina M Collins
- Research and Development Service, VA Boston Healthcare System, Boston, MA, USA
| | - Marilyn L Moy
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Jaime E Hart
- Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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50
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Kim CS, Grady ST, Hart JE, Laden F, VoPham T, Nguyen DD, Manson JE, James P, Forman JP, Rexrode KM, Levy JI, Peters JL. Long-term aircraft noise exposure and risk of hypertension in the Nurses' Health Studies. Environ Res 2022; 207:112195. [PMID: 34627796 PMCID: PMC8810661 DOI: 10.1016/j.envres.2021.112195] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/21/2021] [Accepted: 10/06/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Aircraft noise can affect populations living near airports. Chronic exposure to aircraft noise has been associated with cardiovascular disease, including hypertension. However, previous studies have been limited in their ability to characterize noise exposures over time and to adequately control for confounders. OBJECTIVES The aim of this study was to examine the association between aircraft noise and incident hypertension in two cohorts of female nurses, using aircraft noise exposure estimates with high spatial resolution over a 20-year period. METHODS We obtained contour maps of modeled aircraft noise levels over time for 90 U.S. airports and linked them with geocoded addresses of participants in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHS II) to assign noise exposure for 1994-2014 and 1995-2013, respectively. We used time-varying Cox proportional hazards models to estimate hypertension risk associated with time-varying noise exposure (dichotomized at 45 and 55 dB(A)), adjusting for fixed and time-varying confounders. Results from both cohorts were pooled via random effects meta-analysis. RESULTS In meta-analyses of parsimonious and fully-adjusted models with aircraft noise dichotomized at 45 dB(A), hazard ratios (HR) for hypertension incidence were 1.04 (95% CI: 1.00, 1.07) and 1.03 (95% CI: 0.99, 1.07), respectively. When dichotomized at 55 dB(A), HRs were 1.10 (95% CI: 1.01, 1.19) and 1.07 (95% CI: 0.98, 1.15), respectively. After conducting fully-adjusted sensitivity analyses limited to years in which particulate matter (PM) was obtained, we observed similar findings. In NHS, the PM-unadjusted HR was 1.01 (95% CI: 0.90, 1.14) and PM-adjusted HR was 1.01 (95% CI: 0.89, 1.14); in NHS II, the PM-unadjusted HR was 1.08 (95% CI: 0.96, 1.22) and the PM-adjusted HR was 1.08 (95% CI: 0.95, 1.21). Overall, in these cohorts, we found marginally suggestive evidence of a positive association between aircraft noise exposure and hypertension.
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Affiliation(s)
- Chloe S Kim
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA; Electric Power Research Institute (EPRI), Palo Alto, CA, USA
| | - Stephanie T Grady
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Trang VoPham
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Daniel D Nguyen
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - JoAnn E Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter James
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - John P Forman
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kathryn M Rexrode
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Junenette L Peters
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
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