1
|
Orina F, Amukoye E, Bowyer C, Chakaya J, Das D, Devereux G, Dobson R, Dragosits U, Gray C, Kiplimo R, Lesosky M, Loh M, Meme H, Mortimer K, Ndombi A, Pearson C, Price H, Twigg M, West S, Semple S. Household carbon monoxide (CO) concentrations in a large African city: An unquantified public health burden? Environ Pollut 2024; 351:124054. [PMID: 38677455 DOI: 10.1016/j.envpol.2024.124054] [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: 12/08/2023] [Revised: 04/10/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024]
Abstract
Carbon monoxide (CO) is a poisonous gas produced by incomplete combustion of carbon-based fuels that is linked to mortality and morbidity. Household air pollution from burning fuels on poorly ventilated stoves can lead to high concentrations of CO in homes. There are few datasets available on household concentrations of CO in urban areas of sub-Saharan African countries. CO was measured every minute over 24 h in a sample of homes in Nairobi, Kenya. Data on household characteristics were gathered by questionnaire. Metrics of exposure were summarised and analysis of temporal changes in concentration was performed. Continuous 24-h data were available from 138 homes. The mean (SD), median (IQR) and maximum 24-h CO concentration was 4.9 (6.4), 2.8 (1.0-6.3) and 44 ppm, respectively. 50% of homes had detectable CO concentrations for 847 min (14h07m) or longer during the 24-h period, and 9% of homes would have activated a CO-alarm operating to European specifications. An association between a metric of total CO exposure and self-reported exposure to vapours >15 h per week was identified, however this were not statistically significant after adjustment for the multiple comparisons performed. Mean concentrations were broadly similar in homes from a more affluent area and an informal settlement. A model of typical exposure suggests that cooking is likely to be responsible for approximately 60% of the CO exposure of Nairobi schoolchildren. Household CO concentrations are substantial in Nairobi, Kenya, despite most homes using gas or liquid fuels. Concentrations tend to be highest during the evening, probably associated with periods of cooking. Household air pollution from cooking is the main source of CO exposure of Nairobi schoolchildren. The public health impacts of long-term CO exposure in cities in sub-Saharan Africa may be considerable and should be studied further.
Collapse
Affiliation(s)
- F Orina
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - E Amukoye
- Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - C Bowyer
- Faculty of Creative and Cultural Industries, University of Portsmouth, Portsmouth, UK
| | - J Chakaya
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - D Das
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh EH14 4AP, UK; Department of Environment and Geography, University of York, YO10 5NG, UK
| | - G Devereux
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - R Dobson
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, UK
| | - U Dragosits
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, Midlothian EH26 0QB, UK
| | - C Gray
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - R Kiplimo
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - M Lesosky
- National Heart and Lung Institute, Imperial College London, London, SW3 6LR, UK
| | - M Loh
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh EH14 4AP, UK
| | - H Meme
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - K Mortimer
- Cambridge Africa, Department of Pathology, University of Cambridge, Cambridge, UK; Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - A Ndombi
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - C Pearson
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, Midlothian EH26 0QB, UK
| | - H Price
- Biological and Environmental Sciences, University of Stirling, Stirling, FK9 4LA, UK
| | - M Twigg
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, Midlothian EH26 0QB, UK
| | - S West
- Stockholm Environment Institute, University of York, YO10 5NG, UK
| | - S Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, UK.
| |
Collapse
|
2
|
Ng W, Loh M, Yew YW. Investigating causal relationships between genetically determined increased risk of attention-deficit/hyperactivity disorder (ADHD) and atopic dermatitis (AD): A Mendelian randomization analysis. Exp Dermatol 2023; 32:1468-1475. [PMID: 37317926 DOI: 10.1111/exd.14851] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/08/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Abstract
Atopic dermatitis (AD) is a chronic, inflammatory skin condition with a huge disease burden. Attention-deficit/hyperactivity disorder (ADHD) is often diagnosed in children, and is associated with symptoms of inattention, hyperactivity and impulsive behaviour. Observational studies have demonstrated associations between AD and ADHD. However, to date, there has been no formal assessment of causal relationship between the two. We aim to evaluate causal relationships between genetically increased risk of AD and ADHD using Mendelian randomization (MR) approach. Two-sample bi-directional MR was conducted to elucidate potential causal relationships between genetically increased risk of AD and ADHD, using the largest and most recent genome-wide association study datasets for AD and ADHD-EArly Genetics & Lifecourse Epidemiology AD consortium (21 399 cases and 95 464 controls) and Psychiatric Genomics Consortium (20 183 cases and 35 191 controls). Genetically determined increased risk of AD is not associated with ADHD based on genetic information: odds ratio (OR) of 1.02 (95% CI -0.93 to 1.11; p = 0.705). Similarly, genetic determined increased risk of ADHD is not associated with an increased risk of AD: OR of 0.90 (95% CI -0.76 to 1.07; p = 0.236). Horizontal pleiotropy was not observed from the MR-Egger intercept test (p = 0.328) Current MR analysis showed no causal relationship between genetically increased risk of AD and ADHD in either direction in individuals of European descent. Any observed associations between AD and ADHD in previous population studies could possibly be due to confounding lifestyle factors such as psychosocial stress and sleeping habits.
Collapse
Affiliation(s)
- W Ng
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - M Loh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- School of Public Health, Imperial College London, London, UK
- National Skin Centre, Singapore, Singapore
| | - Y W Yew
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- National Skin Centre, Singapore, Singapore
| |
Collapse
|
3
|
Loh M, Niu L, Arden M, Burk RD, Diaz A, Schlecht NF. Long-acting reversible contraception and condom use: A cohort study of female adolescents and young adults in New York City. Contraception 2023; 125:110081. [PMID: 37263371 DOI: 10.1016/j.contraception.2023.110081] [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: 07/01/2022] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES This study aimed to determine whether condom use varied between adolescents and young women using long-acting reversible contraception (LARC) vs non-LARC hormonal methods and assess if the initiation of LARC was associated with lower condom use. STUDY DESIGN This study used data from a large longitudinal study of sexually active females aged 13-25 years. Questionnaires assessed contraception, condom use, sexual history, and partner characteristics at the baseline visit and every 6 months. Log-binomial regression analyses examined associations between hormonal contraceptive methods and condom use, and the moderating effects of age and number of sexual partners. Exploratory analyses compared condom use based on partner characteristics. RESULTS Of 1512 participants, 1116 reported LARC or non-LARC hormonal method use during any study visit. Among baseline and new LARC users, 75.7% and 84.7% reported intrauterine device (IUD) use, respectively. Condom use at baseline among hormonal non-LARC users (37.5%) was significantly higher (p < 0.01) than LARC users (23.5%). Condom use among LARC vs non-LARC users was moderated by age in that LARC was associated with lower condom use among participants aged 13-18 years, but not those aged 19-25 years. Number of sexual partners was not a significant moderator. Among participants with increased sexually transmitted infection (STI) risk based on partner characteristics, LARC users had lower condom use compared to non-LARC users. CONCLUSIONS Condom discontinuation was common following initiation of LARC and hormonal non-LARC methods. However, condom use was lower in LARC users at baseline, among younger adolescents, and if partners had risk factors for STIs. IMPLICATIONS Condom discontinuation following initiation of highly effective contraception increases the risk of STI. Young women using LARC may be at greater risk than non-LARC users given lower condom use despite having partners with risk factors for STIs. Condom use counseling for STI protection is critical for adolescents.
Collapse
Affiliation(s)
- Miranda Loh
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Li Niu
- Faculty of Psychology, Beijing Normal University, Beitaipingzhuang, Haidian District, Beijing, China
| | - Martha Arden
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Robert D Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States; Department of Pediatrics (Genetics), Albert Einstein College of Medicine, Bronx, NY, United States; Department Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, United States; Department Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| |
Collapse
|
4
|
Price HD, Bowyer CJ, Büker P, Gray CM, Hahn M, Lambe F, Loh M, Medcalf AJ, Njoora TK, Waelde C, Wainwright M, West SE. From reflection diaries to practical guidance for transdisciplinary research: learnings from a Kenyan air pollution project. Sustain Sci 2023; 18:1429-1444. [PMID: 37124120 PMCID: PMC10113976 DOI: 10.1007/s11625-023-01317-0] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 03/07/2023] [Indexed: 05/03/2023]
Abstract
Transdisciplinary research (TDR) approaches have been cited as essential for overcoming the intractable sustainability challenges that the world is currently facing, including air pollution, water management and climate change. However, such approaches can be difficult to undertake in practice and can consequently fail to add value. Therefore, examples of what works in practice (and what does not) are helpful to guide future research. In this study, we used a conceptual TDR framework as the basis to examine and evaluate the strengths and weaknesses of our approach in a project exploring air pollution in an informal settlement in Nairobi, Kenya. Reflection diaries exploring experiences of participation in the project were undertaken by the project team (comprising academic and community partners) at multiple time points throughout the project. These reflection diaries played an important role in evaluation and for providing space for team learning. Diaries were thematically coded according to the TDR framework to explore aspects of the project that worked well, and areas which presented challenges. We draw upon our reflections, and the extant literature, to make practical recommendations for researchers undertaking TDR projects in future. Recommendations focus on three key project stages (pre-funding, funded period, post-funding) and include; building the team in a way that includes all key stakeholders in relevant and appropriate roles, giving everyone sufficient time to work on the project, and ensuring regular and open communication. Building these recommendations into the design and delivery of transdisciplinary sustainability science projects will support progress towards achieving the Sustainable Development Goals (SDGs). Supplementary Information The online version contains supplementary material available at 10.1007/s11625-023-01317-0.
Collapse
Affiliation(s)
- Heather D. Price
- Biological and Environmental Sciences, University of Stirling, Stirling, UK
| | - Cressida J. Bowyer
- Faculty of Creative and Cultural Industries, University of Portsmouth, Portsmouth, UK
| | - Patrick Büker
- Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Bonn, Germany
| | - Cindy M. Gray
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Matthew Hahn
- Theatre for Development Practitioner, Folkestone, UK
| | - Fiona Lambe
- Stockholm Environment Institute, Stockholm, Sweden
| | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | | | | | | | | | - Sarah E. West
- Stockholm Environment Institute - York, Department of Environment and Geography, University of York, York, UK
| |
Collapse
|
5
|
Niu W, Wang W, Huang C, Zhang Z, Ma L, Li R, Cherrie J, Miller MR, Loh M, Chen J, Lin C, Wu S, Guo X, Deng F. Cardiopulmonary benefits of respirator intervention against near road ambient particulate matters in healthy young adults: A randomized, blinded, crossover, multi-city study. Chemosphere 2022; 308:136437. [PMID: 36126736 DOI: 10.1016/j.chemosphere.2022.136437] [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: 07/04/2022] [Revised: 08/26/2022] [Accepted: 09/10/2022] [Indexed: 06/15/2023]
Abstract
Wearing a respirator is generally the most convenient individual intervention against ambient particulate matter (PM), and therefore there has been considerable research into its effectiveness. However, the effects of respirator intervention under different PM concentration settings have been insufficiently elucidated. We conducted a randomized, blinded, crossover intervention study in four representative cities in China in which 128 healthy university students spent 2-h walking along a busy road wearing either a real or a sham respirator and then spent the next 5-h indoors away from traffic pollution. Lung function, blood pressure, and heart rate variability were continuously measured throughout the visit. Linear mixed-effect models were fitted to evaluate the protective effects of respirator intervention on the cardiopulmonary indicators. Results showed that the beneficial effects of respirator intervention were only occasionally significant at specific time points or in specific cities or in selected parameters. Overall, respirator intervention was associated with reduced SBP (6.2 vs. 11.5 mmHg compared to baseline, p < 0.05) and increased LF (44 vs. 35 ms2 compared to baseline, p < 0.05) over the 2-h walk, but no significant effects were found over the 7-h period. Respirators have significant effect modifications on the associations between PM2.5/PM10 and the cardiopulmonary indicators, but the directions of effects were inconsistent. The intercity difference in the effects of respirator intervention was found significant, with Taiyuan and Shanghai to be the two cities with lower personal PM concentrations but more pronounced benefits. In conclusion, reducing personal exposure to PM can have some beneficial effects in some scenarios. However, respirators may not provide sufficient protection from air pollution overall, and we should avoid over-reliance on respirators and accelerate efforts to reduce emissions of pollutants in the first place. Despite standardized procedures, we found inconsistency in results across cities, consistent with the previous literature.
Collapse
Affiliation(s)
- Wei Niu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Zhihong Zhang
- Department of Environmental Health, School of Public Health, Shanxi Medical University, Shanxi, 030001, China
| | - Le Ma
- School of Public Health, Xi'an Jiaotong University, Shaanxi, 710061, China; Heriot Watt University, Riccarton, Edinburgh, EH14 4AS, UK; Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh, EH14 4AP, UK
| | - Rui Li
- Hubei Key Laboratory of Genetic Regulation and Integrative Biology, School of Life Sciences, Central China Normal University, Wuhan, 430079, China
| | - John Cherrie
- Heriot Watt University, Riccarton, Edinburgh, EH14 4AS, UK
| | - Mark R Miller
- University/BHF Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, 47 Little France Crescent Edinburgh, EH16 4TJ, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh, EH14 4AP, UK
| | - Jiahui Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Chun Lin
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, NINE, 9 Little France Road, Edinburgh Bioquarter, Edinburgh, EH16 4UX, UK
| | - Shaowei Wu
- School of Public Health, Xi'an Jiaotong University, Shaanxi, 710061, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
| |
Collapse
|
6
|
Elitzur S, Vora A, Burkhardt B, Inaba H, Attarbaschi A, Baruchel A, Escherich G, Gibson B, Liu H, Loh M, Moorman A, Moricke A, Pieters R, Uyttebroeck A, Baird S, Bartram J, Ben-Harosh M, Bertrand Y, Buitenkamp T, Caldwell K, Drut R, Geerlinks A, Grainger J, Haouy S, Heaney N, Huang M, Ingham D, Krenova Z, Kuhlen M, Lehrnbecher T, Manabe A, Niggli F, Paris C, Revel-Vilk S, Rohrlich P, Sandeep B, Sinno M, Szczepanski T, Tamesberger M, Warrier R, Wolfl M, Nirel R, Izraeli S, Borkhardt A, Schmiegelow K. EBV-DRIVEN LYMPHOID NEOPLASMS ASSOCIATED WITH ALL MAINTENANCE THERAPY: AN INTERNATIONAL OBSERVATINAL STUDY. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00201-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
7
|
Meyer L, Roy RP, Huang B, Kimura S, Polonen P, Delgado-Martin C, Vincent T, Ryan T, Wood B, Liu Y, Zhang J, Mullighan C, Horton T, Loh M, Devidas M, Raetz E, Hayashi R, Winter S, Dunsmore K, Hunger S, Teachey D, Hermiston M, Olshen AB. A TARGETED GENE EXPRESSION CLASSIFIER IDENTIFIES PEDIATRIC T-ALL PATIENTS AT HIGH RISK FOR END INDUCTION MINIMAL RESIDUAL DISEASE POSITIVITY. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00243-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
8
|
Hosseini P, Mueller W, Rhodes S, Pembrey L, van Tongeren M, Pearce N, Loh M, Fletcher T. Transmission and Control of SARS-CoV-2 in the Food Production Sector: A Rapid Narrative Review of the Literature. Int J Environ Res Public Health 2022; 19:12104. [PMID: 36231415 PMCID: PMC9566159 DOI: 10.3390/ijerph191912104] [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: 08/26/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
This review aimed to provide an overview of the literature assessing the extent of COVID-19 transmission in the food processing sector along with the risk factors associated with COVID-19 infection/mortality rates in this setting, and the preventive measures used to reduce transmission. An electronic search was conducted using scientific databases, including Web of Science, OVID, PubMed and MedRxiv. The search strategy identified 26 papers that met the inclusion criteria. Six of these studies were based in the UK and the country with the most papers was the USA, with a total of nine papers. Findings showed some evidence of a high transmission level of SARS-CoV-2 within some areas of the food production sector. Risk factors associated with the spread included ethnicity, poor ventilation, lack of social distancing and lack of sick pay. The preventative measures included/recommended were social distancing, testing, adequate ventilation, cleaning regimes and access to PPE. Additional research focusing on the food production sector could show the potential variations in transmission and risk between each sub-sector. Future research focusing on the application of various preventative measures and their efficacy by sub-sector would be beneficial, while further qualitative research could help provide in-depth information regarding knowledge gaps.
Collapse
Affiliation(s)
- Paniz Hosseini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | | | - Sarah Rhodes
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester M13 9PL, UK
| | - Lucy Pembrey
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Martie van Tongeren
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester M13 9PL, UK
| | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh EH14 4AP, UK
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester M13 9PL, UK
| | - Tony Fletcher
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| |
Collapse
|
9
|
Mueller W, Wilkinson P, Milner J, Loh M, Vardoulakis S, Petard Z, Cherrie M, Puttaswamy N, Balakrishnan K, Arvind DK. The relationship between greenspace and personal exposure to PM 2.5 during walking trips in Delhi, India. Environ Pollut 2022; 305:119294. [PMID: 35436507 DOI: 10.1016/j.envpol.2022.119294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/27/2021] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
The presence of urban greenspace may lead to reduced personal exposure to air pollution via several mechanisms, for example, increased dispersion of airborne particulates; however, there is a lack of real-time evidence across different urban contexts. Study participants were 79 adolescents with asthma who lived in Delhi, India and were recruited to the Delhi Air Pollution and Health Effects (DAPHNE) study. Participants were monitored continuously for exposure to PM2.5 (particulate matter with an aerodynamic diameter of less than 2.5 μm) for 48 h. We isolated normal day-to-day walking journeys (n = 199) from the personal monitoring dataset and assessed the relationship between greenspace and personal PM2.5 using different spatial scales of the mean Normalised Difference Vegetation Index (NDVI), mean tree cover (TC), and proportion of surrounding green land use (GLU) and parks or forests (PF). The journeys had a mean duration of 12.7 (range 5, 53) min and mean PM2.5 personal exposure of 133.9 (standard deviation = 114.8) μg/m3. The within-trip analysis showed weak inverse associations between greenspace markers and PM2.5 concentrations only in the spring/summer/monsoon season, with statistically significant associations for TC at the 25 and 50 m buffers in adjusted models. Between-trip analysis also indicated inverse associations for NDVI and TC, but suggested positive associations for GLU and PF in the spring/summer/monsoon season; no overall patterns of association were evident in the autumn/winter season. Associations between greenspace and personal PM2.5 during walking trips in Delhi varied across metrics, spatial scales, and season, but were most consistent for TC. These mixed findings may partly relate to journeys being dominated by walking along roads and small effects on PM2.5 of small pockets of greenspace. Larger areas of greenspace may, however, give rise to observable spatial effects on PM2.5, which vary by season.
Collapse
Affiliation(s)
- William Mueller
- Research, Institute of Occupational Medicine, Edinburgh, UK; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
| | - Paul Wilkinson
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - James Milner
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Miranda Loh
- Research, Institute of Occupational Medicine, Edinburgh, UK
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Zoë Petard
- Centre for Speckled Computing, School of Informatics, University of Edinburgh, Scotland, UK
| | - Mark Cherrie
- Research, Institute of Occupational Medicine, Edinburgh, UK
| | - Naveen Puttaswamy
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - D K Arvind
- Centre for Speckled Computing, School of Informatics, University of Edinburgh, Scotland, UK
| |
Collapse
|
10
|
Mueller W, Milner J, Loh M, Vardoulakis S, Wilkinson P. Exposure to urban greenspace and pathways to respiratory health: An exploratory systematic review. Sci Total Environ 2022; 829:154447. [PMID: 35283125 DOI: 10.1016/j.scitotenv.2022.154447] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 05/11/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND/OBJECTIVE Urban greenspace may have a beneficial or adverse effect on respiratory health. Our objective was to perform an exploratory systematic review to synthesise the evidence and identify the potential causal pathways relating urban greenspace and respiratory health. METHODS We followed PRISMA guidelines on systematic reviews and searched five databases for eligible studies during 2000-2021. We incorporated a broad range of urban greenspace and respiratory health search terms, including both observational and experimental studies. Screening, data extraction, and risk of bias, assessed using the Navigation Guide criteria, were performed independently by two authors. We performed a narrative synthesis and discuss suggested pathways to respiratory health. RESULTS We identified 108 eligible papers (n = 104 observational, n = 4 experimental). The most common greenspace indicators were the overall greenery or vegetation (also known as greenness), green land use/land cover of physical area classes (e.g., parks, forests), and tree canopy cover. A wide range of respiratory health indicators were studied, with asthma prevalence being the most common. Two thirds (n = 195) of the associations in these studies were positive (i.e., beneficial) with health, with 31% (n = 91) statistically significant; only 9% (n = 25) of reported associations were negative (i.e., adverse) with health and statistically significant. The most consistent positive evidence was apparent for respiratory mortality. There were n = 35 (32%) 'probably low' and n = 73 (68%) 'probably high' overall ratings of bias. Hypothesised causal pathways for health benefits included lower air pollution, more physically active populations, and exposure to microbial diversity; suggested mechanisms with poorer health included exposure to pollen and other aeroallergens. CONCLUSION Many studies showed positive association between urban greenspace and respiratory health, especially lower respiratory mortality; this is suggestive, but not conclusive, of causal effects. Results underscore the importance of contextual factors, greenspace metric employed, and the potential bias of subtle selection factors, which should be explored further.
Collapse
Affiliation(s)
- William Mueller
- Institute of Occupational Medicine, Edinburgh, UK; London School of Hygiene & Tropical Medicine, UK.
| | - James Milner
- London School of Hygiene & Tropical Medicine, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Australian National University, Australia
| | | |
Collapse
|
11
|
Mueller W, Loh M, Fletcher T, Rhodes S, Pembrey L, Pearce N, van Tongeren M. An Ecological Study of COVID-19 Infection Rates within the UK Food and Drink Processing Industry. Ann Work Expo Health 2022; 67:147-152. [PMID: 35704063 PMCID: PMC9214181 DOI: 10.1093/annweh/wxac042] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/29/2022] [Accepted: 06/03/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Food processing facilities represent critical infrastructure that have stayed open during much of the COVID-19 pandemic. Understanding the burden of COVID-19 in this sector is thus important to help reduce the potential for workplace infection in future outbreaks. METHODS We undertook a workplace survey in the UK food and drink processing sector and collected information on workplace size, characteristics (e.g. temperature, ventilation), and experience with COVID-19 (e.g. numbers of positive cases). For each site, we calculated COVID-19 case rates per month per 1000 workers. We performed an ecological analysis using negative binomial regression to assess the association between COVID-19 rates and workplace and local risk factors. RESULTS Respondents from 33 companies including 66 individual sites completed the survey. COVID-19 cases were reported from the start of the pandemic up to June 2021. Respondents represented a range of industry subgroups, including grain milling/storage (n = 16), manufacture of malt (n = 14), manufacture of prepared meals (n = 12), manufacture of beverages (n = 8), distilling (n = 5), manufacture of baked goods (n = 5), and other (n = 6), with a total of 15 563 workers across all sites. Average monthly case rates per 1000 workers ranged from 0.9 in distilling to 6.1 in grain milling/storage. Incidence rate ratios were partially attenuated after adjusting for several local and workplace factors, though risks for one subgroup (grain milling/storage) remained elevated. Certain local and workplace characteristics were related to higher infection rates, such as higher deprivation (5 km only), a lower proportion of remote workers, lower proportion of workers in close proximity, and higher numbers of workers overall. CONCLUSIONS Our analysis suggests some heterogeneity in the rates of COVID-19 across sectors of the UK food and drink processing industry. Infection rates were associated with deprivation, the proportions of remote workers and workers in close proximity, and the number of workers.
Collapse
Affiliation(s)
- William Mueller
- Author to whom correspondence should be addressed. Tel: +44 131 449 8013; e-mail:
| | - Miranda Loh
- Research Institute of Occupational Medicine, Edinburgh, UK,Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Tony Fletcher
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Sarah Rhodes
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lucy Pembrey
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Neil Pearce
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| |
Collapse
|
12
|
Lindsay D, Killington A, Fouhy K, Loh M, Malakar P. The CDC biofilm bioreactor is a suitable method to grow biofilms, and test their sanitiser susceptibilities, in the dairy context. Int Dairy J 2022. [DOI: 10.1016/j.idairyj.2021.105264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
13
|
Kleovoulou EG, Konstantinou C, Constantinou A, Kuijpers E, Loh M, Galea KS, Stierum R, Pronk A, Makris KC. Stakeholders' Perceptions of Environmental and Public Health Risks Associated with Hydrocarbon Activities in and around the Vasilikos Energy Center, Cyprus. Int J Environ Res Public Health 2021; 18:ijerph182413133. [PMID: 34948743 PMCID: PMC8702061 DOI: 10.3390/ijerph182413133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
The Vasilikos Energy Center (VEC) is a large hydrocarbon industrial hub actively operating in Cyprus. There is strong public interest by the communities surrounding VEC to engage with all stakeholders towards the sustainable development of hydrocarbon in the region. The methodological framework of the exposome concept would allow for the holistic identification of all relevant environmental exposures by engaging the most relevant stakeholders in industrially contaminated sites. The main objectives of this study were to: (i) evaluate the stakeholders’ perceptions of the environmental and public health risks and recommended actions associated with the VEC hydrocarbon activities, and (ii) assess the stakeholders’ understanding and interest towards exposome-based technologies for use in oil and gas applications. Methods: Six major groups of stakeholders were identified: local authorities, small-medium industries (SMIs) (including multi-national companies), small-medium enterprises (SMEs), academia/professional associations, government, and the general public residing in the communities surrounding the VEC. During 2019–2021, a suite of stakeholder engagement initiatives was deployed, including semi-structured interviews (n = 32), a community survey for the general public (n = 309), technical meetings, and workshops (n = 4). Results from the semi-structured interviews, technical meetings and workshops were analyzed through thematic analysis and results from the community survey were analyzed using descriptive statistics. Results: Almost all stakeholders expressed the need for the implementation of a systematic health monitoring system for the VEC broader area and its surrounding residential communities, including frequent measurements of air pollutant emissions. Moreover, stricter policies by the government about licensing and monitoring of hydrocarbon activities and proper communication to the public and the mass media emerged as important needs. The exposome concept was not practiced by the SMEs, but SMIs showed willingness to use it in the future as part of their research and development activities. Conclusions: The sustainable development of hydrocarbon exploitation and processing prospects for Cyprus involves the VEC. Continuous and active collaboration and mutual feedback among all stakeholders involved with the VEC is essential, as this may allow future environmental and occupational health initiatives to be formalized.
Collapse
Affiliation(s)
- Eleni G. Kleovoulou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3041, Cyprus; (E.G.K.); (C.K.); (A.C.)
| | - Corina Konstantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3041, Cyprus; (E.G.K.); (C.K.); (A.C.)
| | - Andria Constantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3041, Cyprus; (E.G.K.); (C.K.); (A.C.)
| | - Eelco Kuijpers
- The Netherlands Organization for Applied Scientific Research TNO, 3584 CB Utrecht, The Netherlands; (E.K.); (R.S.); (A.P.)
| | - Miranda Loh
- Institute of Occupational Medicine (IOM), Edinburgh EH14 4AP, UK; (M.L.); (K.S.G.)
| | - Karen S. Galea
- Institute of Occupational Medicine (IOM), Edinburgh EH14 4AP, UK; (M.L.); (K.S.G.)
| | - Rob Stierum
- The Netherlands Organization for Applied Scientific Research TNO, 3584 CB Utrecht, The Netherlands; (E.K.); (R.S.); (A.P.)
| | - Anjoeka Pronk
- The Netherlands Organization for Applied Scientific Research TNO, 3584 CB Utrecht, The Netherlands; (E.K.); (R.S.); (A.P.)
| | - Konstantinos C. Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3041, Cyprus; (E.G.K.); (C.K.); (A.C.)
- Correspondence:
| |
Collapse
|
14
|
Dancer SJ, Cormack K, Loh M, Coulombe C, Thomas L, Pravinkumar SJ, Kasengele K, King MF, Keaney J. Healthcare-acquired clusters of COVID-19 across multiple wards in a Scottish health board. J Hosp Infect 2021; 120:23-30. [PMID: 34863874 PMCID: PMC8634690 DOI: 10.1016/j.jhin.2021.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/10/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022]
Abstract
Background Healthcare-acquired COVID-19 has been an additional burden on hospitals managing increasing numbers of patients with SARS-CoV-2. One acute hospital (W) among three in a Scottish healthboard experienced an unexpected surge of COVID-19 clusters. Aim To investigate possible causes of COVID-19 clusters at Hospital W. Methods Daily surveillance provided total numbers of patients and staff involved in clusters in three acute hospitals (H, M and W) and care homes across the healthboard. All clusters were investigated and documented, along with patient boarding, community infection rates and outdoor temperatures from October 2020 to March 2021. Selected SARS-CoV-2 strains were genotyped. Findings There were 19 COVID-19 clusters on 14 wards at Hospital W during the six-month study period, lasting from two to 42 days (average, five days; median, 14 days) and involving an average of nine patients (range 1–24) and seven staff (range 0–17). COVID-19 clusters in Hospitals H and M reflected community infection rates. An outbreak management team implemented a control package including daily surveillance; ward closures; universal masking; screening; restricting staff and patient movement; enhanced cleaning; and improved ventilation. Forty clusters occurred across all three hospitals before a January window-opening policy, after which there were three during the remainder of the study. Conclusion The winter surge of COVID-19 clusters was multi-factorial, but clearly exacerbated by moving trauma patients around the hospital. An extended infection prevention and control package including enhanced natural ventilation helped reduce COVID-19 clusters in acute hospitals.
Collapse
Affiliation(s)
- S J Dancer
- Department of Microbiology, NHS Lanarkshire & Edinburgh Napier University, UK.
| | - K Cormack
- Quality Directorate, NHS Lanarkshire, UK
| | - M Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | - C Coulombe
- Infection Prevention & Control, NHS Lanarkshire, UK
| | - L Thomas
- Infection Prevention & Control, NHS Lanarkshire, UK
| | | | - K Kasengele
- Department of Public Health, NHS Lanarkshire, UK
| | - M-F King
- School of Civil Engineering, University of Leeds, Leeds, UK
| | | |
Collapse
|
15
|
Dalan R, Mina T, Nur Azizah NA, Tong T, Loh M, Wansaicheong G, Chambers J. Sex modifies the association between body mass index and carotid artery intima media thickness in the multi-ethnic Singapore population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2525] [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: 11/14/2022] Open
Abstract
Abstract
Background and aims
Globally cardiovascular disease (CVD) risk is higher in men than in women in the younger age group but the risk is attenuated in later life with an unexpected higher risk in women in some populations. A better understanding of sex differences in CVD is needed. Carotid artery intima-media thickness (CIMT) has been proposed for CVD risk assessment in individuals at intermediate risk. We study the gender interactions in the associations of the traditional cardiovascular risk factors with CIMT.
Methods
We performed carotid ultrasonography in the large population health study-HELIOS conducted in Singapore. Measurements were performed as per Mannheim consensus, at the far wall of bilateral common carotid artery at 8 sites in each participant. We report the average of all measurements (avgCIMT) and maximum value (maxCIMT). We analysed 2061 healthy participants recruited between 2018–2020. Inclusion criteria for this analysis: non-smokers, not known to have diabetes, hypertension, hyperlipidemia or ischemic heart disease. Individuals with systolic blood pressure >160 mm Hg or fasting glucose >7.0 mmol/L on recruitment were excluded. Multivariable linear regression analysis was performed to examine the association between CIMT and cardiovascular risk factors in the healthy population adjusting for age, sex and ethnicity. All analysis was performed using Stata version 16.0.
Results
After exclusion, 1407 healthy participants were included in the analysis. Median (IQR) avgCIMT: 0.56 (0.50, 0.65) in men; 0.54 (0.50, 0.58) in women. Median (IQR) maxCIMT: 0.64 (0.57, 0.76) in men; 0.61 (0.54, 0.70) in women. The avgCIMT and the maxCIMT were higher in males when compared to women and all traditional cardiovascular risk factors associated with CIMT after adjustment for age, sex and ethnicity (P<0.05) (Table 1). Interaction tests in multivariable model adjusted for age, ethnicity, pulse pressure, non HDL-C and HbA1c showed a significant interaction between sex and body mass index (BMI) with predicted effects on avgCIMT and maxCIMT being relatively higher in males at the same BMI when compared to females (P-interaction <0.01) (Figure 1).
Conclusion
Sex modifies the relationship between BMI and CIMT in Singapore's multi-ethnic population. Understanding the intermediary mechanisms involved will help in developing personalized preventive strategies.
Funding Acknowledgement
Type of funding sources: None. Figure 1
Collapse
Affiliation(s)
- R Dalan
- Tan Tock Seng Hospital, Endocrinology, Singapore, Singapore
| | - T Mina
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
| | - N A Nur Azizah
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
| | - T Tong
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
| | - M Loh
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
| | | | - J Chambers
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
| |
Collapse
|
16
|
Cherrie JW, Cherrie MPC, Smith A, Holmes D, Semple S, Steinle S, Macdonald E, Moore G, Loh M. Contamination of Air and Surfaces in Workplaces with SARS-CoV-2 Virus: A Systematic Review. Ann Work Expo Health 2021; 65:879-892. [PMID: 34329379 PMCID: PMC8385829 DOI: 10.1093/annweh/wxab026] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 02/08/2021] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES This systematic review aimed to evaluate the evidence for air and surface contamination of workplace environments with SARS-CoV-2 RNA and the quality of the methods used to identify actions necessary to improve the quality of the data. METHODS We searched Web of Science and Google Scholar until 24 December 2020 for relevant articles and extracted data on methodology and results. RESULTS The vast majority of data come from healthcare settings, with typically around 6% of samples having detectable concentrations of SARS-CoV-2 RNA and almost none of the samples collected had viable virus. There were a wide variety of methods used to measure airborne virus, although surface sampling was generally undertaken using nylon flocked swabs. Overall, the quality of the measurements was poor. Only a small number of studies reported the airborne concentration of SARS-CoV-2 virus RNA, mostly just reporting the detectable concentration values without reference to the detection limit. Imputing the geometric mean air concentration assuming the limit of detection was the lowest reported value, suggests typical concentrations in healthcare settings may be around 0.01 SARS-CoV-2 virus RNA copies m-3. Data on surface virus loading per unit area were mostly unavailable. CONCLUSIONS The reliability of the reported data is uncertain. The methods used for measuring SARS-CoV-2 and other respiratory viruses in work environments should be standardized to facilitate more consistent interpretation of contamination and to help reliably estimate worker exposure.
Collapse
Affiliation(s)
- John W Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
- Heriot Watt University, Institute of Biological Chemistry, Biophysics and Bioengineering, Riccarton, Edinburgh, UK
| | - Mark P C Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
- University of Edinburgh, School of Geosciences, Edinburgh, UK
| | - Alice Smith
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - David Holmes
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - Sean Semple
- University of Stirling, Institute for Social Marketing and Health, Stirling, UK
| | - Susanne Steinle
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - Ewan Macdonald
- University of Glasgow, Institute of Health and Wellbeing, Glasgow, UK
| | - Ginny Moore
- National Infection Service, Public Health England, Porton Down, Salisbury, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| |
Collapse
|
17
|
Hu D, Jia X, Cui L, Liu J, Chen J, Wang Y, Niu W, Xu J, Miller MR, Loh M, Deng F, Guo X. Exposure to fine particulate matter promotes platelet activation and thrombosis via obesity-related inflammation. J Hazard Mater 2021; 413:125341. [PMID: 33596527 DOI: 10.1016/j.jhazmat.2021.125341] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 11/17/2020] [Revised: 01/21/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Short-term exposure to fine particulate matter (PM2.5) increases thrombotic risk particularly in obese individuals, but the underlying mechanisms remain unclear. This study aims to compare the effects of PM2.5 on inflammation and platelet activation in obese versus normal-weight adults, and investigate potential causal pathways. We conducted a panel study measuring blood markers in 44 obese and 53 normal-weight adults on 3 separate occasions in 2017-2018. Associations between PM2.5/black carbon (BC) and biomarkers were estimated using mixed-effect models. An interaction analysis compared PM2.5/BC-related effects between subgroups. Biomarker combinations and mediation analysis were performed to elucidate the biological pathways. There was a significant "low-high-low" trend of PM2.5 levels across the 3 study periods. Increases in pro-inflammatory cytokines and changes of platelet activation and aggregation markers were associated with PM2.5/BC in obese subgroup only. Among obese subjects, the combination of pro-inflammatory cytokines and that of platelet markers increased 26.8% (95% CI: 16.0%, 37.9%) and 14.7% (95% CI: 1.9%, 27.0%) per IQR increase in PM2.5 over 5-day and 7-day averages. Inflammation mediated 24.5% of the pathways through which PM2.5 promoted platelet activation. This study suggested obese people are susceptible to pro-thrombotic impacts of PM2.5 exposures. PM2.5 may aggravate thrombosis through obesity-related inflammation.
Collapse
Affiliation(s)
- Dayu Hu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xu Jia
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Liyan Cui
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Junxiu Liu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing 100191, China
| | - Jiahui Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yazheng Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wei Niu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Junhui Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Mark R Miller
- University/BHF Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh EH14 4AP, UK
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| |
Collapse
|
18
|
Kuijpers E, van Wel L, Loh M, Galea KS, Makris KC, Stierum R, Fransman W, Pronk A. A Scoping Review of Technologies and Their Applicability for Exposome-Based Risk Assessment in the Oil and Gas Industry. Ann Work Expo Health 2021; 65:1011-1028. [PMID: 34219141 DOI: 10.1093/annweh/wxab039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/18/2021] [Accepted: 05/12/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Oil and gas workers have been shown to be at increased risk of chronic diseases including cancer, asthma, chronic obstructive pulmonary disease, and hearing loss, among others. Technological advances may be used to assess the external (e.g. personal sensors, smartphone apps and online platforms, exposure models) and internal exposome (e.g. physiologically based kinetic modeling (PBK), biomonitoring, omics), offering numerous possibilities for chronic disease prevention strategies and risk management measures. The objective of this study was to review the literature on these technologies, by focusing on: (i) evaluating their applicability for exposome research in the oil and gas industry, and (ii) identifying key challenges that may hamper the successful application of such technologies in the oil and gas industry. METHOD A scoping review was conducted by identifying peer-reviewed literature with searches in MEDLINE/PubMed and SciVerse Scopus. Two assessors trained on the search strategy screened retrieved articles on title and abstract. The inclusion criteria used for this review were: application of the aforementioned technologies at a workplace in the oil and gas industry or, application of these technologies for an exposure relevant to the oil and gas industry but in another occupational sector, English language and publication period 2005-end of 2019. RESULTS In total, 72 articles were included in this scoping review with most articles focused on omics and bioinformatics (N = 22), followed by biomonitoring and biomarkers (N = 20), external exposure modeling (N = 11), PBK modeling (N = 10), and personal sensors (N = 9). Several studies were identified in the oil and gas industry on the application of PBK models and biomarkers, mainly focusing on workers exposed to benzene. The application of personal sensors, new types of exposure models, and omics technology are still in their infancy with respect to the oil and gas industry. Nevertheless, applications of these technologies in other occupational sectors showed the potential for application in this sector. DISCUSSION AND CONCLUSION New exposome technologies offer great promise for personal monitoring of workers in the oil and gas industry, but more applied research is needed in collaboration with the industry. Current challenges hindering a successful application of such technologies include (i) the technological readiness of sensors, (ii) the availability of data, (iii) the absence of standardized and validated methods, and (iv) the need for new study designs to study the development of disease during working life.
Collapse
Affiliation(s)
| | | | - Miranda Loh
- Institute of Occupational Medicine (IOM), Edinburgh, UK
| | - Karen S Galea
- Institute of Occupational Medicine (IOM), Edinburgh, UK
| | - Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | | | | | | |
Collapse
|
19
|
Mueller W, Tantrakarnapa K, Johnston HJ, Loh M, Steinle S, Vardoulakis S, Cherrie JW. Exposure to ambient particulate matter and biomass burning during pregnancy: associations with birth weight in Thailand. J Expo Sci Environ Epidemiol 2021; 31:672-682. [PMID: 33603098 PMCID: PMC8263346 DOI: 10.1038/s41370-021-00295-8] [Citation(s) in RCA: 3] [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: 06/22/2020] [Revised: 12/12/2020] [Accepted: 01/18/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND There is a growing evidence that exposure to ambient particulate air pollution during pregnancy is associated with adverse birth outcomes, including reduced birth weight (BW). The objective of this study was to quantify associations between BW and exposure to particulate matter (PM) and biomass burning during pregnancy in Thailand. METHODS We collected hourly ambient air pollutant data from ground-based monitors (PM with diameter of <10 µm [PM10], Ozone [O3], and nitrogen dioxide [NO2]), biomass burning from satellite remote sensing data, and individual birth weight data during 2015-2018. We performed a semi-ecological analysis to evaluate the association between mean trimester exposure to air pollutants and biomass burning with BW and low-birth weight (LBW) (<2500 g), adjusting for gestation age, sex, previous pregnancies, mother's age, heat index, season, year, gaseous pollutant concentrations, and province. We examined potential effect modification of PM10 and biomass burning exposures by sex. RESULTS There were 83,931 eligible births with a mean pregnancy PM10 exposure of 39.7 µg/m3 (standard deviation [SD] = 7.7). The entire pregnancy exposure was associated with reduced BW both for PM10 (-6.81 g per 10 µg/m3 increase in PM10 [95% CI = -12.52 to -1.10]) and biomass burning (-6.34 g per 1 SD increase in fires/km2 [95% CI = -11.35 to -1.34]) only after adjustment for NO2. In contrast with these findings, a reduced odds ratio (OR) of LBW was associated with PM10 exposure only in trimesters one and two, with no relationship across the entire pregnancy period. Associations with biomass burning were limited to increased ORs of LBW with exposure in trimester three, but only for male births. CONCLUSION Based on our results, we encourage further investigation of air pollution, biomass burning and BW in Thailand and other low-income and middle-income countries.
Collapse
Affiliation(s)
| | - Kraichat Tantrakarnapa
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Helinor Jane Johnston
- School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | | | - Sotiris Vardoulakis
- Institute of Occupational Medicine, Edinburgh, UK
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - John W Cherrie
- Institute of Occupational Medicine, Edinburgh, UK.
- School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh, UK.
| |
Collapse
|
20
|
Loh M, Smith R, Forde M, Mills D. IV treatment increase? Br Dent J 2021; 230:324. [PMID: 33772162 PMCID: PMC7995384 DOI: 10.1038/s41415-021-2847-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
21
|
Loh M, Smith R, Forde M, Mills D. Phone call success. Br Dent J 2021; 230:326. [PMID: 33772169 DOI: 10.1038/s41415-021-2860-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
22
|
Campbell SJ, Wolfer K, Utinger B, Westwood J, Zhang ZH, Bukowiecki N, Steimer SS, Vu TV, Xu J, Straw N, Thomson S, Elzein A, Sun Y, Liu D, Li L, Fu P, Lewis AC, Harrison RM, Bloss WJ, Loh M, Miller MR, Shi Z, Kalberer M. Atmospheric conditions and composition that influence PM 2.5 oxidative potential in Beijing, China. Atmos Chem Phys 2021; 21:5549-5573. [PMID: 34462630 PMCID: PMC7611584 DOI: 10.5194/acp-21-5549-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Epidemiological studies have consistently linked exposure to PM2.5 with adverse health effects. The oxidative potential (OP) of aerosol particles has been widely suggested as a measure of their potential toxicity. Several acellular chemical assays are now readily employed to measure OP; however, uncertainty remains regarding the atmospheric conditions and specific chemical components of PM2.5 that drive OP. A limited number of studies have simultaneously utilised multiple OP assays with a wide range of concurrent measurements and investigated the seasonality of PM2.5 OP. In this work, filter samples were collected in winter 2016 and summer 2017 during the atmospheric pollution and human health in a Chinese megacity campaign (APHH-Beijing), and PM2.5 OP was analysed using four acellular methods: ascorbic acid (AA), dithiothreitol (DTT), 2,7-dichlorofluorescin/hydrogen peroxidase (DCFH) and electron paramagnetic resonance spectroscopy (EPR). Each assay reflects different oxidising properties of PM2.5, including particle-bound reactive oxygen species (DCFH), superoxide radical production (EPR) and catalytic redox chemistry (DTT/AA), and a combination of these four assays provided a detailed overall picture of the oxidising properties of PM2.5 at a central site in Beijing. Positive correlations of OP (normalised per volume of air) of all four assays with overall PM2.5 mass were observed, with stronger correlations in winter compared to summer. In contrast, when OP assay values were normalised for particle mass, days with higher PM2.5 mass concentrations (μgm-3) were found to have lower mass-normalised OP values as measured by AA and DTT. This finding supports that total PM2.5 mass concentrations alone may not always be the best indicator for particle toxicity. Univariate analysis of OP values and an extensive range of additional measurements, 107 in total, including PM2.5 composition, gas-phase composition and meteorological data, provided detailed insight into the chemical components and atmospheric processes that determine PM2.5 OP variability. Multivariate statistical analyses highlighted associations of OP assay responses with varying chemical components in PM2.5 for both mass- and volume-normalised data. AA and DTT assays were well predicted by a small set of measurements in multiple linear regression (MLR) models and indicated fossil fuel combustion, vehicle emissions and biogenic secondary organic aerosol (SOA) as influential particle sources in the assay response. Mass MLR models of OP associated with compositional source profiles predicted OP almost as well as volume MLR models, illustrating the influence of mass composition on both particle-level OP and total volume OP. Univariate and multivariate analysis showed that different assays cover different chemical spaces, and through comparison of mass- and volume-normalised data we demonstrate that mass-normalised OP provides a more nuanced picture of compositional drivers and sources of OP compared to volume-normalised analysis. This study constitutes one of the most extensive and comprehensive composition datasets currently available and provides a unique opportunity to explore chemical variations in PM2.5 and how they affect both PM2.5 OP and the concentrations of particle-bound reactive oxygen species.
Collapse
Affiliation(s)
- Steven J. Campbell
- Department of Environmental Sciences, University of Basel, Basel, Switzerland
- Department of Chemistry, University of Cambridge, Cambridge, UK
| | - Kate Wolfer
- Department of Environmental Sciences, University of Basel, Basel, Switzerland
| | - Battist Utinger
- Department of Environmental Sciences, University of Basel, Basel, Switzerland
| | - Joe Westwood
- Department of Chemistry, University of Cambridge, Cambridge, UK
| | - Zhi-Hui Zhang
- Department of Environmental Sciences, University of Basel, Basel, Switzerland
- Department of Chemistry, University of Cambridge, Cambridge, UK
| | - Nicolas Bukowiecki
- Department of Environmental Sciences, University of Basel, Basel, Switzerland
| | | | - Tuan V. Vu
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Jingsha Xu
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Nicholas Straw
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Steven Thomson
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Atallah Elzein
- Wolfson Atmospheric Chemistry Laboratories, Department of Chemistry, University of York, York, UK
| | - Yele Sun
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Di Liu
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Linjie Li
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Pingqing Fu
- Institute of Surface Earth System Science, Tianjin University, Tianjin, China
| | - Alastair C. Lewis
- Wolfson Atmospheric Chemistry Laboratories, Department of Chemistry, University of York, York, UK
- National Centre for Atmospheric Science, University of York, York, UK
| | - Roy M. Harrison
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - William J. Bloss
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | - Mark R. Miller
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Zongbo Shi
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Markus Kalberer
- Department of Environmental Sciences, University of Basel, Basel, Switzerland
- Department of Chemistry, University of Cambridge, Cambridge, UK
| |
Collapse
|
23
|
Duroseau N, Loh M, Sanders L, Arden M. Options for Teens with No Options: A Self-Managed Second Trimester Abortion. J Pediatr Adolesc Gynecol 2021; 34:226-227. [PMID: 33242593 PMCID: PMC9616640 DOI: 10.1016/j.jpag.2020.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Several states have deemed abortions as nonessential services, effectively calling for a halt to abortion care during the COVID-19 pandemic. In response, women might elect for self-managed abortions by obtaining abortion medications online. CASE A 15-year-old girl presented with abdominal cramping and vaginal discharge after taking misoprostol obtained from an online retailer for a self-managed abortion in her second trimester during the COVID-19 pandemic. Her exam showed products of conception protruding from the vagina. The patient was emergently evaluated for an incomplete and possible septic abortion and underwent a dilation and evacuation procedure.
Collapse
Affiliation(s)
- Nathalie Duroseau
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Kravis Children's Hospital, Mount Sinai Hospital, New York, New York.
| | - Miranda Loh
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Kravis Children's Hospital, Mount Sinai Hospital, New York, New York
| | - Leslie Sanders
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Kravis Children's Hospital, Mount Sinai Hospital, New York, New York
| | - Martha Arden
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Kravis Children's Hospital, Mount Sinai Hospital, New York, New York
| |
Collapse
|
24
|
Mueller W, Wilkinson P, Milner J, Vardoulakis S, Steinle S, Pärkkä J, Parmes E, Cluitmans L, Kuijpers E, Pronk A, Sarigiannis D, Karakitsios S, Chapizanis D, Maggos T, Stamatelopoulou A, Loh M. Neighbourhood and path-based greenspace in three European countries: associations with objective physical activity. BMC Public Health 2021; 21:282. [PMID: 33541323 PMCID: PMC7860634 DOI: 10.1186/s12889-021-10259-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/17/2021] [Indexed: 11/29/2022] Open
Abstract
Background Greenspace has been associated with health benefits in many contexts. An important pathway may be through outdoor physical activity. We use a novel approach to examine the link between greenspace microenvironments and outdoor physical activity levels in the HEALS study conducted in Edinburgh (UK), the Netherlands, and Athens and Thessaloniki (Greece). Methods Using physical activity tracker recordings, 118 HEALS participants with young children were classified with regard to daily minutes of moderate to vigorous physical activity (MVPA); 60 were classified with regard to the metabolic equivalent task (MET)-minutes for each of the 1014 active trips they made. Greenspace indicators were generated for Normalised Difference Vegetation Index (NDVI), tree cover density (TCD), and green land use (GLU). We employed linear mixed-effects models to analyse (1) daily MVPA in relation to greenspace within 300 m and 1000 m of residential addresses and (2) trip MET-minutes in relation to average greenspace within a 50 m buffer of walking/cycling routes. Models were adjusted for activity, walkability, bluespace, age, sex, car ownership, dog ownership, season, weekday/weekend day, and local meteorology. Results There was no clear association between MVPA-minutes and any residential greenspace measure. For example, in fully adjusted models, a 10 percentage point increase in NDVI within 300 m of home was associated with a daily increase of 1.14 (95% CI − 0.41 to 2.70) minutes of MVPA. However, we did find evidence to indicate greenspace markers were positively linked to intensity and duration of activity: in fully adjusted models, 10 percentage point increases in trip NDVI, TCD, and GLU were associated with increases of 10.4 (95% CI: 4.43 to 16.4), 10.6 (95% CI: 4.96 to 16.3), and 3.36 (95% CI: 0.00 to 6.72) MET-minutes, respectively. The magnitude of associations with greenspace tended to be greater for cycling. Conclusions More strenuous or longer walking and cycling trips occurred in environments with more greenspace, but levels of residential greenspace did not have a clear link with outdoor MVPA. To build on our research, we suggest future work examine larger, more diverse populations and investigate the influence of greenspace for trip purpose and route preference. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10259-0.
Collapse
Affiliation(s)
- William Mueller
- Institute of Occupational Medicine, Edinburgh, UK. .,London School of Hygiene & Tropical Medicine, London, UK.
| | - Paul Wilkinson
- London School of Hygiene & Tropical Medicine, London, UK
| | - James Milner
- London School of Hygiene & Tropical Medicine, London, UK
| | - Sotiris Vardoulakis
- Institute of Occupational Medicine, Edinburgh, UK.,National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | | | - Juha Pärkkä
- , VTT Technical Research Centre of Finland, Finland
| | - Eija Parmes
- , VTT Technical Research Centre of Finland, Finland
| | | | | | | | | | | | | | - Thomas Maggos
- National Centre for Scientific Research 'Demokritos', Athens, Greece
| | | | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh, UK
| |
Collapse
|
25
|
Scholten B, Kenny L, Duca RC, Pronk A, Santonen T, Galea KS, Loh M, Huumonen K, Sleeuwenhoek A, Creta M, Godderis L, Jones K. Biomonitoring for Occupational Exposure to Diisocyanates: A Systematic Review. Ann Work Expo Health 2021; 64:569-585. [PMID: 32313948 PMCID: PMC7328470 DOI: 10.1093/annweh/wxaa038] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/24/2020] [Accepted: 04/02/2020] [Indexed: 11/14/2022] Open
Abstract
Diisocyanates are a group of chemicals that are widely used in occupational settings. They are known to induce various health effects, including skin- and respiratory tract sensitization resulting in allergic dermatitis and asthma. Exposure to diisocyanates has been studied in the past decades by using different types of biomonitoring markers and matrices. The aim of this review as part of the HBM4EU project was to assess: (i) which biomarkers and matrices have been used for biomonitoring diisocyanates and what are their strengths and limitations; (ii) what are (current) biomonitoring levels of the major diisocyanates (and metabolites) in workers; and (iii) to characterize potential research gaps. For this purpose we conducted a systematic literature search for the time period 2000–end 2018, thereby focussing on three types of diisocyanates which account for the vast majority of the total isocyanate market volume: hexamethylene diisocyanate (HDI), toluene diisocyanate (TDI), and 4,4′-methylenediphenyl diisocyanate (MDI). A total of 28 publications were identified which fulfilled the review inclusion criteria. The majority of these studies (93%) investigated the corresponding diamines in either urine or plasma, but adducts have also been investigated by several research groups. Studies on HDI were mostly in the motor vehicle repair industry [with urinary hexamethylene diamine result ranging from 0.03 to 146.5 µmol mol−1 creatinine]. For TDI, there is mostly data on foam production [results for urinary toluene diamine ranging from ~0.01 to 97 µmol mol−1 creatinine] whereas the available MDI data are mainly from the polyurethane industry (results for methylenediphenyl diamine range from 0.01 to 32.7 µmol mol−1 creatinine). About half of the studies published were prior to 2010 hence might not reflect current workplace exposure. There is large variability within and between studies and across sectors which could be potentially explained by several factors including worker or workplace variability, short half-lives of biomarkers, and differences in sampling strategies and analytical techniques. We identified several research gaps which could further be taken into account when studying diisocyanates biomonitoring levels: (i) the development of specific biomarkers is promising (e.g. to study oligomers of HDI which have been largely neglected to date) but needs more research before they can be widely applied, (ii) since analytical methods differ between studies a more uniform approach would make comparisons between studies easier, and (iii) dermal absorption seems a possible exposure route and needs to be further investigated. The use of MDI, TDI, and HDI has been recently proposed to be restricted in the European Union unless specific conditions for workers’ training and risk management measures apply. This review has highlighted the need for a harmonized approach to establishing a baseline against which the success of the restriction can be evaluated.
Collapse
Affiliation(s)
- Bernice Scholten
- Risk Assessment for Products in Development, TNO Quality of Life, Zeist, The Netherlands
| | - Laura Kenny
- Health and Safety Executive (HSE), Harpur Hill, Buxton, UK
| | - Radu-Corneliu Duca
- Unit Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, National Health Laboratory, Dudelange, Luxembourg
| | - Anjoeka Pronk
- Risk Assessment for Products in Development, TNO Quality of Life, Zeist, The Netherlands
| | | | - Karen S Galea
- Centre for Human Exposure Science (CHES), Institute of Occupational Medicine (IOM), Edinburgh, UK
| | - Miranda Loh
- Centre for Human Exposure Science (CHES), Institute of Occupational Medicine (IOM), Edinburgh, UK
| | | | - Anne Sleeuwenhoek
- Centre for Human Exposure Science (CHES), Institute of Occupational Medicine (IOM), Edinburgh, UK
| | - Matteo Creta
- Centre Environment and Health, KU Leuven, Leuven, Belgium
| | - Lode Godderis
- Centre Environment and Health, KU Leuven, Leuven, Belgium.,External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Kate Jones
- Health and Safety Executive (HSE), Harpur Hill, Buxton, UK
| |
Collapse
|
26
|
Andrianou XD, Pronk A, Galea KS, Stierum R, Loh M, Riccardo F, Pezzotti P, Makris KC. Exposome-based public health interventions for infectious diseases in urban settings. Environ Int 2021; 146:106246. [PMID: 33181410 PMCID: PMC7834142 DOI: 10.1016/j.envint.2020.106246] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 08/04/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 05/18/2023]
Abstract
The COVID-19 pandemic placed public health measures against infectious diseases at the core of global health challenges, especially in cities where more than half of the global population lives. SARS-CoV-2 is an exposure agent recently added to the network of exposures that comprise the human exposome, i.e. the totality of all environmental exposures throughout one's lifetime. At the same time, the application of measures to tackle SARS-CoV-2 transmission leads to changes in the exposome components and in characteristics of urban environments that define the urban exposome, a complementary concept to the human exposome, which focuses on monitoring urban health. This work highlights the use of a comprehensive systems-based approach of the exposome for better capturing the population-wide and individual-level variability in SARS-CoV-2 spread and its associated urban and individual exposures towards improved guidance and response. Population characteristics, the built environment and spatiotemporal features of city infrastructure, as well as individual characteristics/parameters, socioeconomic status, occupation and biological susceptibility need to be simultaneously considered when deploying non-pharmacological public health measures. Integrating individual and population characteristics, as well as urban-specific parameters is the prerequisite in urban exposome studies. Applications of the exposome approach in cities/towns could facilitate assessment of health disparities and better identification of vulnerable populations, as framed by multiple environmental, urban design and planning co-exposures. Exposome-based applications in epidemics control and response include the implementation of exposomic tools that have been quite mature in non-communicable disease research, ranging from biomonitoring and surveillance to sensors and modeling. Therefore, the exposome can be a novel tool in risk assessment and management during epidemics and other major public health events. This is a unique opportunity for the research community to exploit the exposome concept and its tools in upgrading and further developing site-specific public health measures in cities.
Collapse
Affiliation(s)
- Xanthi D Andrianou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Infectious Diseases, Italian National Institute of Health, Rome, Italy
| | - Anjoeka Pronk
- The Netherlands Organisation for Applied Scientific Research TNO, Utrecht, the Netherlands
| | - Karen S Galea
- Institute of Occupational Medicine (ΙΟΜ), Edinburgh, UK
| | - Rob Stierum
- The Netherlands Organisation for Applied Scientific Research TNO, Utrecht, the Netherlands
| | - Miranda Loh
- Institute of Occupational Medicine (ΙΟΜ), Edinburgh, UK
| | - Flavia Riccardo
- Department of Infectious Diseases, Italian National Institute of Health, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Italian National Institute of Health, Rome, Italy
| | - Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
| |
Collapse
|
27
|
Steinle S, Johnston HJ, Loh M, Mueller W, Vardoulakis S, Tantrakarnapa K, Cherrie JW. In Utero Exposure to Particulate Air Pollution during Pregnancy: Impact on Birth Weight and Health through the Life Course. Int J Environ Res Public Health 2020; 17:E8948. [PMID: 33271938 PMCID: PMC7730886 DOI: 10.3390/ijerph17238948] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/05/2020] [Accepted: 11/25/2020] [Indexed: 12/16/2022]
Abstract
In high-income countries, and increasingly in lower- and middle-income countries, chronic non-communicable diseases (NCDs) have become the primary health burden. It is possible that in utero exposure to environmental pollutants such as particulate matter (PM) may have an impact on health later in life, including the development of NCDs. Due to a lack of data on foetal growth, birth weight is often used in epidemiologic studies as a proxy to assess impacts on foetal development and adverse birth outcomes since it is commonly recorded at birth. There are no research studies with humans that directly link PM exposure in utero to birth weight (BW) and subsequently, the effects of lower BW on health outcomes in old age. It is, however, plausible that such associations exist, and it is thus important to assess the potential public health impacts of PM across the life course, and it is plausible to use birth weight as an indicator of risk. We therefore split this narrative review into two parts. In the first part, we evaluated the strength of the evidence on the impact of PM exposure during the entire pregnancy on birth weight outcomes in ten meta-analyses. In the second part, we reviewed the literature linking lower birth weight to childhood and adult chronic cardiovascular disease to explore the potential implications of PM exposure in utero on health later in life. Within the reviewed meta-studies on birth weight, there is sufficient evidence that PM pollution is associated with lower birth weight, i.e., the majority of meta-studies found statistically significant reductions in birth weight. From the second part of the review, it is evident that there is good evidence of associations between lower birth weight and subsequent cardiovascular disease risk. It is thus plausible that in utero exposure to PM is associated with lower birth weight and persisting biological changes that could be associated with adverse health effects in adulthood. Based on the reviewed evidence, however, the magnitude of later life cardiovascular health impacts from in utero exposure and its impact on BW are likely to be small compared to health effects from exposure to particulate air pollution over a whole lifetime.
Collapse
Affiliation(s)
- Susanne Steinle
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (S.S.); (M.L.); (W.M.); (S.V.)
| | - Helinor J. Johnston
- Institute of Biological Chemistry, Biophysics and Bioengineering, School of Engineering and Physical Sciences, Heriot Watt University, Riccarton, Edinburgh EH14 4AS, UK;
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (S.S.); (M.L.); (W.M.); (S.V.)
| | - William Mueller
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (S.S.); (M.L.); (W.M.); (S.V.)
| | - Sotiris Vardoulakis
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (S.S.); (M.L.); (W.M.); (S.V.)
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra ACT 2601, Australia
| | - Kraichat Tantrakarnapa
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, MAHIDOL University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand;
| | - John W. Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (S.S.); (M.L.); (W.M.); (S.V.)
- Institute of Biological Chemistry, Biophysics and Bioengineering, School of Engineering and Physical Sciences, Heriot Watt University, Riccarton, Edinburgh EH14 4AS, UK;
| |
Collapse
|
28
|
Hu D, Cui L, Qi Y, Jia X, Chen J, Niu W, Miller MR, Loh M, Zhou H, Deng F, Liu J, Guo X. Identification of potential markers for internal exposure to ambient ozone in oral cavity of healthy adults. Environ Res 2020; 190:109907. [PMID: 32758550 DOI: 10.1016/j.envres.2020.109907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/01/2020] [Revised: 06/16/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ozone is a highly oxidative gaseous pollutant associated with adverse health outcomes, but markers for internal exposure to ambient ozone are not well-established. METHODS We aimed to evaluate the feasibility and suitability of the markers in oral microbiome for ambient ozone exposure. Between March and May in 2018, 97 healthy adults were examined on 2 or 3 occasions for oral swab sampling. Hourly concentrations of ambient ozone 1-7 days preceding sampling were collected. Mixed-effect models were fitted to examine the associations between ambient ozone and the diversity and taxon abundances of oral microbiome. Receiver operating characteristic (ROC) curves estimated the accuracies of markers to delineate between samples exposed to different concentrations of ambient ozone. The associations between the makers and lung function were further examined by linear mixed effect models. RESULTS The averages of daily mean concentrations of ambient ozone (O3-daily), maximum 8-h means (O3-8hmax) and 1-h maximums (O3-1hmax) were respectively 72 μg/m³, 123 μg/m³ and 144 μg/m³. O3-daily was positively associated with α-diversity of oral microbiome, but the exposure-response curves only yielded positive associations in the range of O3-daily from 60 μg/m³ to 75 μg/m³. Results of O3-8hmax and O3-1hmax were consistent with these of O3-daily. With an interquartile range increase in O3-daily at lag04, the abundance of Proteobacteria decreased by 3.1% (95% CI: -4.0%, -2.2%) and Firmicutes increased by 3.3% (95% CI: 2.3%, 4.3%), whilst the Proteobacteria:Firmicutes ratio (P/F) decreased by 0.9 (95% CI: -1.5, -0.4). The areas under ROC curves for Proteobacteria, Firmicutes and P/F were 0.8535, 0.7569 and 0.8929, respectively. Proteobacteria and P/F were associated with forced expiratory volume in the first second and fractional exhaled nitric oxide significantly. CONCLUSION Ambient ozone disturbs oral microbial homeostasis. Proteobacteria, Firmicutes and their ratio may be potential markers for short-term ambient ozone exposure, and indicators of airway inflammation or lung function decline.
Collapse
Affiliation(s)
- Dayu Hu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Liyan Cui
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Yuze Qi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Xu Jia
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Jiahui Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Wei Niu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Mark R Miller
- University/BHF Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh, EH144AP, UK
| | - Hui Zhou
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
| | - Junxiu Liu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| |
Collapse
|
29
|
Lin C, Hu D, Jia X, Chen J, Deng F, Guo X, Heal MR, Cowie H, Wilkinson P, Miller MR, Loh M. The relationship between personal exposure and ambient PM 2.5 and black carbon in Beijing. Sci Total Environ 2020; 737:139801. [PMID: 32783824 DOI: 10.1016/j.scitotenv.2020.139801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/06/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
This study is part of the "Air Polluion Impacts on Cardiopulmonary disease in Beijing: an integrated study of Exposure Science, Toxicologenomics & Environmental Epidemiology (APIC-ESTEE)" project under the UK-China joint research programme "Atmospheric Pollution and Human Health in a Chinese Megacity (APHH-China)". The aim is to capture the spatio-temporal variability in people's exposure to fine particles (PM2.5) and black carbon (BC) air pollution in Beijing, China. A total of 120 students were recruited for a panel study from ten universities in Haidian District in northwestern Beijing from December 2017 to June 2018. Real-time personal concentrations of PM2.5 and BC were measured over a 24-h period with two research-grade portable personal exposure monitors. Personal microenvironments (MEs) were determined by applying an algorithm to the handheld GPS unit data. On average, the participants spent the most time indoors (79% in Residence and 16% in Workplace), and much less time travelling by Walking, Cycling, Bus and Metro. Similar patterns were observed across participant gender and body-mass index classifications. The participants were exposed to 33.8 ± 27.8 μg m-3 PM2.5 and to 1.9 ± 1.2 μg m-3 BC over the 24-h monitoring period, on average 24.3 μg m-3 (42%) and 0.8 μg m-3 (28%) lower, respectively, than the concurrent fixed-site ambient measurements. Relative differences between personal and ambient BC concentrations showed greater variability across the MEs, highlighting significant contributions from Dining and travelling by Bus, which involve potential combustion of fuels. This study demonstrates the potential value of personal exposure monitoring in investigating air pollution related health effects, and in evaluating the effectiveness of pollution control and intervention measures.
Collapse
Affiliation(s)
- Chun Lin
- Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK; School of Chemistry, University of Edinburgh, David Brewster Road, Edinburgh EH9 3FJ, UK
| | - Dayu Hu
- Department of Occupational & Environmental Health Sciences, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China
| | - Xu Jia
- Department of Occupational & Environmental Health Sciences, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China
| | - Jiahui Chen
- Department of Occupational & Environmental Health Sciences, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China
| | - Furong Deng
- Department of Occupational & Environmental Health Sciences, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational & Environmental Health Sciences, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China
| | - Mathew R Heal
- School of Chemistry, University of Edinburgh, David Brewster Road, Edinburgh EH9 3FJ, UK
| | - Hilary Cowie
- Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK
| | - Paul Wilkinson
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Mark R Miller
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK.
| |
Collapse
|
30
|
Affiliation(s)
- John W Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK.,Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Riccarton, Edinburgh, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - Robert J Aitken
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| |
Collapse
|
31
|
Mueller W, Loh M, Vardoulakis S, Johnston HJ, Steinle S, Precha N, Kliengchuay W, Tantrakarnapa K, Cherrie JW. Ambient particulate matter and biomass burning: an ecological time series study of respiratory and cardiovascular hospital visits in northern Thailand. Environ Health 2020; 19:77. [PMID: 32620124 PMCID: PMC7333306 DOI: 10.1186/s12940-020-00629-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 12/03/2019] [Accepted: 06/23/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Exposure to particulate matter (PM) emitted from biomass burning is an increasing concern, particularly in Southeast Asia. It is not yet clear how the source of PM influences the risk of an adverse health outcome. The objective of this study was to quantify and compare health risks of PM from biomass burning and non-biomass burning sources in northern Thailand. METHODS We collected ambient air pollutant data (PM with a diameter of < 10 μm [PM10], PM2.5, Carbon Monoxide [CO], Ozone [O3], and Nitrogen Dioxide [NO2]) from ground-based monitors and daily outpatient hospital visits in Thailand during 2014-2017. Outpatient data included chronic lower respiratory disease (CLRD), ischaemic heart disease (IHD), and cerebrovascular disease (CBVD). We performed an ecological time series analysis to evaluate the association between daily air pollutants and outpatient visits. We used the 90th and 95th percentiles of PM10 concentrations to determine days of exposure to PM predominantly from biomass burning. RESULTS There was significant intra annual variation in PM10 levels, with the highest concentrations occurring during March, coinciding with peak biomass burning. Incidence Rate Ratios (IRRs) between daily PM10 and outpatient visits were elevated most on the same day as exposure for CLRD = 1.020 (95% CI: 1.012 to 1.028) and CBVD = 1.020 (95% CI: 1.004 to 1.035), with no association with IHD = 0.994 (95% CI: 0.974 to 1.014). Adjusting for CO tended to increase effect estimates. We did not find evidence of an exposure response relationship with levels of PM10 on days of biomass burning. CONCLUSIONS We found same-day exposures of PM10 to be associated with certain respiratory and cardiovascular outpatient visits. We advise implementing measures to reduce population exposures to PM wherever possible, and to improve understanding of health effects associated with burning specific types of biomass in areas where such large-scale activities occur.
Collapse
Affiliation(s)
- W. Mueller
- Institute of Occupational Medicine, Edinburgh, EH14 4AP UK
| | - M. Loh
- Institute of Occupational Medicine, Edinburgh, EH14 4AP UK
| | - S. Vardoulakis
- Institute of Occupational Medicine, Edinburgh, EH14 4AP UK
- Australian National University, Canberra, Australia
| | - H. J. Johnston
- Heriot Watt University, School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Riccarton, Edinburgh, EH14 4AS UK
| | - S. Steinle
- Institute of Occupational Medicine, Edinburgh, EH14 4AP UK
| | - N. Precha
- Mahidol University, Bangkok, Thailand
- Walailak University, Nakhon Si Thammarat, Thailand
| | | | | | - J. W. Cherrie
- Institute of Occupational Medicine, Edinburgh, EH14 4AP UK
- Heriot Watt University, School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Riccarton, Edinburgh, EH14 4AS UK
| |
Collapse
|
32
|
Pastor A, Conn J, O'Brien CL, Teng J, Loh M, Collins L, MacIsaac RJ, Bonomo Y. Clinicians feel comfortable discussing alcohol but not illicit drug use with young adults with Type 1 diabetes: a survey of clinicians. Diabet Med 2020; 37:1076-1078. [PMID: 31529510 DOI: 10.1111/dme.14136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- A Pastor
- Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - J Conn
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | - C L O'Brien
- Mental Health Services, University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - J Teng
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - M Loh
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - L Collins
- Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - R J MacIsaac
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - Y Bonomo
- Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
33
|
Loh M, Cherrie JW, Aitken RJ. Decontamination of respirators in the covid-19 pandemic. BMJ 2020; 369:m1986. [PMID: 32423975 DOI: 10.1136/bmj.m1986] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Miranda Loh
- Institute of Occupational Medicine (IOM), Edinburgh EH9 1AX, UK
| | - John W Cherrie
- Institute of Occupational Medicine (IOM), Edinburgh EH9 1AX, UK
| | - Robert J Aitken
- Institute of Occupational Medicine (IOM), Edinburgh EH9 1AX, UK
| |
Collapse
|
34
|
Teran PR, Wong R, Van Ramshorst RD, Loh M, Cherian S, Ahlers-Schmidt CR, Okut H, Kelly N. Evaluation of Legislative Advocacy Alerts for Pediatric Residents. Clin Pediatr (Phila) 2020; 59:500-504. [PMID: 32037863 DOI: 10.1177/0009922820904596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Rudolph Wong
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Miranda Loh
- University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Sheeba Cherian
- University of Texas at Austin Dell Medical School, Austin, TX, USA
| | | | - Hayrettin Okut
- University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Nancy Kelly
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
35
|
Kiburg KV, Ward GM, Vogrin S, Steele K, Mulrooney E, Loh M, McLachlan SA, Sundararajan V, MacIsaac RJ. Impact of type 2 diabetes on hospitalization and mortality in people with malignancy. Diabet Med 2020; 37:362-368. [PMID: 31559651 DOI: 10.1111/dme.14147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2019] [Indexed: 02/06/2023]
Abstract
AIM To compare the characteristics of and outcomes for people with malignancies with and without a co-diagnosis of diabetes. METHODS Emergency department and hospital discharge data from a single centre for the period between 1 January 2015 and 31 December 2017 were used to identify people with a diagnosis of a malignancy and diabetes. Multivariate Cox regression models were used to estimate the effect of diabetes on all-cause mortality. A truncated negative binomial regression model was used to assess the impact of diabetes on length of hospital inpatient stay. Prentice-Williams-Peterson total time models were used to assess the effect of diabetes on number of emergency department re-presentations and inpatient re-admissions. RESULTS Of 7004 people identified with malignancies, 1195 (17.1%) were also diagnosed with diabetes. A diagnosis of diabetes was associated with a greater number of inpatient re-admissions [adjusted hazard ratio 1.13 (95% CI 1.03, 1.24)], a greater number of emergency department re-presentations [adjusted hazard ratio 1.13 (95% CI 1.05, 1.22)] and longer length of stay [adjusted incidence rate ratio 1.14 (95% CI 1.04, 1.25)]. A co-diagnosis of diabetes was also associated with a 48% increased risk of all-cause mortality [adjusted hazard ratio 1.48 (95% CI 1.22-1.76)]. CONCLUSIONS People with malignancies and diabetes had significantly more emergency department presentations, more inpatient admissions, longer length of hospital stay and higher rates of all-cause mortality compared to people with a malignancy without diabetes.
Collapse
Affiliation(s)
- K V Kiburg
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Australia
- Department of Medicine, University of Melbourne, Fitzroy, Australia
- St Vincent's Institute of Medical Research, Fitzroy, Australia
| | - G M Ward
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Australia
- Department of Medicine, University of Melbourne, Fitzroy, Australia
- Department of Clinical Biochemistry, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - S Vogrin
- Department of Medicine, University of Melbourne, Fitzroy, Australia
| | - K Steele
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - E Mulrooney
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - M Loh
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - S A McLachlan
- Department of Medicine, University of Melbourne, Fitzroy, Australia
- Medical Oncology, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - V Sundararajan
- Department of Medicine, University of Melbourne, Fitzroy, Australia
- Department of Public Health, La Trobe University, Melbourne, VIC, Australia
| | - R J MacIsaac
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Australia
- Department of Medicine, University of Melbourne, Fitzroy, Australia
- St Vincent's Institute of Medical Research, Fitzroy, Australia
| |
Collapse
|
36
|
Mueller W, Steinle S, Pärkkä J, Parmes E, Liedes H, Kuijpers E, Pronk A, Sarigiannis D, Karakitsios S, Chapizanis D, Maggos T, Stamatelopoulou A, Wilkinson P, Milner J, Vardoulakis S, Loh M. Urban greenspace and the indoor environment: Pathways to health via indoor particulate matter, noise, and road noise annoyance. Environ Res 2020; 180:108850. [PMID: 31670081 DOI: 10.1016/j.envres.2019.108850] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 05/28/2019] [Revised: 10/18/2019] [Accepted: 10/20/2019] [Indexed: 05/06/2023]
Abstract
BACKGROUND/AIM The exposome includes urban greenspace, which may affect health via a complex set of pathways, including reducing exposure to particulate matter (PM) and noise. We assessed these pathways using indoor exposure monitoring data from the HEALS study in four European urban areas (Edinburgh, UK; Utrecht, Netherlands; Athens and Thessaloniki, Greece). METHODS We quantified three metrics of residential greenspace at 50 m and 100 m buffers: Normalised Difference Vegetation Index (NDVI), annual tree cover density, and surrounding green land use. NDVI values were generated for both summer and the season during which the monitoring took place. Indoor PM2.5 and noise levels were measured by Dylos and Netatmo sensors, respectively, and subjective noise annoyance was collected by questionnaire on an 11-point scale. We used random-effects generalised least squares regression models to assess associations between greenspace and indoor PM2.5 and noise, and an ordinal logistic regression to model the relationship between greenspace and road noise annoyance. RESULTS We identified a significant inverse relationship between summer NDVI and indoor PM2.5 (-1.27 μg/m3 per 0.1 unit increase [95% CI -2.38 to -0.15]) using a 100 m residential buffer. Reduced (i.e., <1.0) odds ratios (OR) of road noise annoyance were associated with increasing summer (OR = 0.55 [0.31 to 0.98]) and season-specific (OR = 0.55 [0.32 to 0.94]) NDVI levels, and tree cover density (OR = 0.54 [0.31 to 0.93] per 10 percentage point increase), also at a 100 m buffer. In contrast to these findings, we did not identify any significant associations between greenspace and indoor noise in fully adjusted models. CONCLUSIONS We identified reduced indoor levels of PM2.5 and noise annoyance, but not overall noise, with increasing outdoor levels of certain greenspace indicators. To corroborate our findings, future research should examine the effect of enhanced temporal resolution of greenspace metrics during different seasons, characterise the configuration and composition of green areas, and explore mechanisms through mediation modelling.
Collapse
Affiliation(s)
- William Mueller
- Institute of Occupational Medicine, Edinburgh, UK; London School of Hygiene & Tropical Medicine, UK.
| | | | - Juha Pärkkä
- VTT Technical Research Centre of Finland, Finland
| | - Eija Parmes
- VTT Technical Research Centre of Finland, Finland
| | | | | | | | | | | | | | - Thomas Maggos
- National Centre for Scientific Research 'Demokritos', Athens, Greece
| | | | | | - James Milner
- London School of Hygiene & Tropical Medicine, UK
| | | | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh, UK
| |
Collapse
|
37
|
Dong W, Liu S, Chu M, Zhao B, Yang D, Chen C, Miller MR, Loh M, Xu J, Chi R, Yang X, Guo X, Deng F. Different cardiorespiratory effects of indoor air pollution intervention with ionization air purifier: Findings from a randomized, double-blind crossover study among school children in Beijing. Environ Pollut 2019; 254:113054. [PMID: 31473392 DOI: 10.1016/j.envpol.2019.113054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 05/13/2019] [Revised: 08/10/2019] [Accepted: 08/12/2019] [Indexed: 05/27/2023]
Abstract
Indoor air pollution is associated with numerous adverse health outcomes. Air purifiers are widely used to reduce indoor air pollutants. Ionization air purifiers are becoming increasingly popular for their low power consumption and noise, yet its health effects remain unclear. This randomized, double-blind crossover study is conducted to explore the cardiorespiratory effects of ionization air purification among 44 children in Beijing. Real or sham purification was performed in classrooms for 5 weekdays. Size-fractionated particulate matter (PM), black carbon (BC), ozone (O3), and negative air ions (NAI) were monitored, and cardiorespiratory functions were measured. Mixed-effect models were used to establish associations between exposures and health parameters. Real purification significantly decreased PM and BC, e.g. PM0.5, PM2.5, PM10 and BC were decreased by 48%, 44%, 34% and 50%, respectively. O3 levels were unchanged, while NAI was increased from 12 cm-3 to 12,997 cm-3. Real purification was associated with a 4.4% increase in forced exhaled volume in 1 s (FEV1) and a 14.7% decrease in fractional exhaled nitrogen oxide (FeNO). However, heart rate variability (HRV) was altered negatively. Interaction effects of NAI and PM were observed only on HRV, and alterations in HRV were greater with high NAI. Ionization air purifier could bring substantial respiratory benefits, however, the potential negative effects on HRV need further investigation.
Collapse
Affiliation(s)
- Wei Dong
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Mengtian Chu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Bin Zhao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Chen Chen
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Mark R Miller
- University/BHF Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, 47 Little France Crescent Edinburgh, EH16 4TJ, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh, EH14 4AP, UK
| | - Junhui Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Rui Chi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xuan Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| |
Collapse
|
38
|
Huang J, Song Y, Chu M, Dong W, Miller MR, Loh M, Xu J, Yang D, Chi R, Yang X, Wu S, Guo X, Deng F. Cardiorespiratory responses to low-level ozone exposure: The inDoor Ozone Study in childrEn (DOSE). Environ Int 2019; 131:105021. [PMID: 31349208 DOI: 10.1016/j.envint.2019.105021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 04/28/2019] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Indoor air pollution has emerged as a significant environmental and public health concern in recent years. However, evidence regarding the cardiorespiratory effects of indoor ozone is limited, and the underlying biological mechanisms are unclear, especially in children. Our study aimed to assess the cardiorespiratory responses to indoor ozone exposure in children. METHODS A repeated-measure study was conducted in 46 middle-school children in Beijing, China. Real-time concentrations of ozone, along with co-pollutants including particulate matter (PM) and black carbon (BC), were monitored in classrooms from Monday to Friday. Three repeated health measurements of cardiorespiratory functions, including ambulatory electrocardiogram (ECG), blood pressure, fractional exhaled nitric oxide (FeNO) and lung function, were performed on each participant. Mixed-effect models were used to evaluate the effects of indoor ozone exposure. RESULTS The mean (SD) indoor ozone concentration was 8.7 (6.6) ppb during the study period, which was largely below the current guideline and standards. However, even this low-level ozone exposure was associated with reduced cardiac autonomic function and increased heart rate (HR) in children. For instance, per interquartile range (IQR) increase in ozone at 2-hour moving average was associated with -7.8% (95% CI: -9.9%, -5.6%) reduction in standard deviation of all normal-to-normal intervals (SDNN), and 2.6% (95% CI: 1.6%, 3.6%) increment in HR. In addition, the associations were stronger at high BC levels (BC ≥ 3.7 μg/m3). No significant associations were found for airway inflammation and pulmonary function. CONCLUSIONS Exposure to low-level indoor ozone that is not associated with respiratory effects was significantly related to disturbed cardiac autonomic function and increased HR in children, which suggested a possible mechanism through which ozone may affect cardiovascular health in children, and indicated more protective measures should be taken to alleviate the acute adverse effects of indoor ozone in this susceptible population.
Collapse
Affiliation(s)
- Jing Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Mengtian Chu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Wei Dong
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Mark R Miller
- University/BHF Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh, UK
| | - Junhui Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Rui Chi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xuan Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| |
Collapse
|
39
|
Cherrie JW, Wang S, Mueller W, Wendelboe-Nelson C, Loh M. In-mask temperature and humidity can validate respirator wear-time and indicate lung health status. J Expo Sci Environ Epidemiol 2019; 29:578-583. [PMID: 30382241 PMCID: PMC6760615 DOI: 10.1038/s41370-018-0089-y] [Citation(s) in RCA: 20] [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: 04/24/2018] [Accepted: 10/08/2018] [Indexed: 05/29/2023]
Abstract
The effectiveness of respiratory protection is dependent on many factors, including the duration and times during the day when it is worn. To date, these factors could only be assessed by direct observation of the respirator user. We describe the novel use of a data-logging temperature and humidity sensor (iButton Hygrochron) located inside a facemask to quantify respirator wear-time through supervised experiments (Phase 1) and an unsupervised wearing trial (Phase 2). Additionally, in Phase 1 the in-mask temperature was compared with measurements of exhaled breath temperature. We found humidity responds more rapidly than temperature to donning a mask, so it was considered a more sensitive measure of wear-time, particularly for short durations. Supervised tests showed that this method can provide accurate and precise estimates of wear-time, although the approach may be unsuitable for use in situations where there is high ambient humidity. In-mask temperature is closely associated with exhaled breath temperature, which is linked to lung inflammation. This technique could provide a useful way of evaluating the effectiveness of respirators in protecting health in real-life situations.
Collapse
Affiliation(s)
- John W Cherrie
- Heriot Watt University, Institute of Biological Chemistry, Biophysics and Bioengineering, Edinburgh, EH14 4AS, UK.
- Centre for Human Exposure Science, Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK.
| | - Shuohui Wang
- Heriot Watt University, Institute of Biological Chemistry, Biophysics and Bioengineering, Edinburgh, EH14 4AS, UK
| | - William Mueller
- Centre for Human Exposure Science, Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
| | - Charlotte Wendelboe-Nelson
- Heriot Watt University, Institute of Biological Chemistry, Biophysics and Bioengineering, Edinburgh, EH14 4AS, UK
| | - Miranda Loh
- Centre for Human Exposure Science, Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
| |
Collapse
|
40
|
Franken R, Maggos T, Stamatelopoulou A, Loh M, Kuijpers E, Bartzis J, Steinle S, Cherrie JW, Pronk A. Comparison of methods for converting Dylos particle number concentrations to PM2.5 mass concentrations. Indoor Air 2019; 29:450-459. [PMID: 30756427 DOI: 10.1111/ina.12546] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 09/04/2018] [Revised: 01/16/2019] [Accepted: 02/10/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study was to (a) develop a method for converting particle number concentrations (PNC) obtained by Dylos to PM2.5 mass concentrations, (b) compare this conversion with similar methods available in the literature, and (c) compare Dylos PM2.5 obtained using all available conversion methods with gravimetric samples. Data were collected in multiple residences in three European countries using the Dylos and an Aerodynamic Particle Sizer (APS, TSI) in the Netherlands or an optical particle counter (OPC, GRIMM) in Greece. Two statistical fitted curves were developed based on Dylos PNC and either an APS or an OPC particle mass concentrations (PMC). In addition, at the homes of 16 volunteers (UK and Netherlands), Dylos measurements were collected along with gravimetric samples. The Dylos PNC were transformed to PMC using all the fitted curves obtained during this study (and three found in the literature) and were compared with gravimetric samples. The method developed in the present study using an OPC showed the highest correlation (Pearson (R) = 0.63, Concordance (ρc ) = 0.61) with gravimetric data. The other methods resulted in an underestimation of PMC compared to gravimetric measurements (R = 0.65-0.55, ρc = 0.51-0.24). In conclusion, estimation of PM2.5 concentrations using the Dylos is acceptable for indicative purposes.
Collapse
Affiliation(s)
- Remy Franken
- Netherlands Organisation for Applied Scientific Research TNO, Zeist, The Netherlands
| | - Thomas Maggos
- Environmental Research Laboratory I.N.RA.S.T.E.S., NCSR "DEMOKRITOS", Athens, Greece
| | | | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | - Eelco Kuijpers
- Netherlands Organisation for Applied Scientific Research TNO, Zeist, The Netherlands
| | | | | | - John W Cherrie
- Institute of Occupational Medicine, Edinburgh, UK
- Institute for Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh, UK
| | - Anjoeka Pronk
- Netherlands Organisation for Applied Scientific Research TNO, Zeist, The Netherlands
| |
Collapse
|
41
|
Abstract
Eating disorders affect millions of children, adolescents, and their families worldwide, and the pediatric primary care provider is often the first line of evaluation for these patients. Eating disorders affect nearly every system in the body, and signs and symptoms vary depending on patient behaviors (restrictive eating, binge eating, purging). Because the diagnosis is not always straightforward, a clinician's ability to recognize the potential medical complications of eating disorders early in their course can help facilitate timely treatment and an appropriate level of support. Most of these medical complications improve or resolve with nutritional rehabilitation and cessation of eating disorder behaviors. Refeeding severely underweight patients should be approached with caution as there is potential for significant fluid and electrolyte derangement that may worsen a patient's clinical status. Prompt recognition of the medical complications of eating disorders can improve short-term and long-term health in these children and adolescents. [Pediatr Ann. 2018;47(6):e238-e243.].
Collapse
|
42
|
Pan L, Dong W, Li H, Miller MR, Chen Y, Loh M, Wu S, Xu J, Yang X, Shima M, Deng F, Guo X. Association patterns for size-fractioned indoor particulate matter and black carbon and autonomic function differ between patients with chronic obstructive pulmonary disease and their healthy spouses. Environ Pollut 2018; 236:40-48. [PMID: 29414364 DOI: 10.1016/j.envpol.2018.01.064] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 01/18/2018] [Accepted: 01/18/2018] [Indexed: 05/09/2023]
Abstract
BACKGROUND The effect of health status on the relationship between particulate matter (PM) and black carbon (BC) and cardiac autonomic function has not been examined sufficiently directly comparing patients with healthy participants. OBJECTIVES To evaluate the association patterns between size-fractioned indoor PM and BC and cardiac autonomic function in chronic obstructive pulmonary disease (COPD) patients and their healthy spouses. METHODS Twenty-four-hour heart rate variability (HRV) and heart rate (HR) was measured in eight pairs of stable COPD patients and their healthy spouses. Real-time size-fractioned indoor PM and BC levels were monitored on the same, and preceding, days. Mixed-effects models were used to estimate the changes in health indices and pollutants after controlling for potential confounding variables. RESULTS Increases in size-fractioned PM and BC were associated with alterations in cardiac autonomic function in both COPD patients and their healthy spouses. However, the association patterns differed between the two groups. In COPD group, an IQR (13.65 μg/m3) increase in PM0.5 at 12-h moving average was associated with reductions of 14.62% (95% CI: -21.74%, -6.86%) in total power (TP) and 10.14% (95% CI: -16.11%, -3.76%) in high frequency (HF) power. In healthy volunteers, however, TP and HF declined immediately upon exposure to PM and then returned to normal levels gradually. In this group, an IQR increase in PM0.5 at 5 min moving average was associated a 20.30% (95% CI: -25.49%, -14.73%) reduction in TP and a 31.79% (95% CI: -36.48%, -26.72%) reduction in HF. CONCLUSIONS Exposure to indoor PM and BC was associated with cardiac autonomic dysfunction in COPD patients and their healthy spouses. Exposure had a greater lagged effect on HRV in COPD patients than in healthy participants. These findings will aid the formulation of targeted measures to prevent the adverse effects of indoor air pollution for individuals with different health statuses.
Collapse
Affiliation(s)
- Lu Pan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Wei Dong
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Mark R Miller
- University/BHF Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, 47 Little France Crescent Edinburgh, EH16 4TJ, UK
| | - Yahong Chen
- Respiratory Department, Peking University Third Hospital, No. 49 North Garden Road, Beijing 100191, China
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh, EH14 4AP, UK
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Junhui Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Xuan Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| |
Collapse
|
43
|
Dong W, Pan L, Li H, Miller MR, Loh M, Wu S, Xu J, Yang X, Shan J, Chen Y, Deng F, Guo X. Association of size-fractionated indoor particulate matter and black carbon with heart rate variability in healthy elderly women in Beijing. Indoor Air 2018; 28:373-382. [PMID: 29315830 DOI: 10.1111/ina.12449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 09/26/2017] [Accepted: 12/22/2017] [Indexed: 05/09/2023]
Abstract
Associations between size-fractionated indoor particulate matter (PM) and black carbon (BC) and heart rate variability (HRV) and heart rate (HR) in elderly women remain unclear. Twenty-nine healthy elderly women were measured for 24-hour HRV/HR indices. Real-time size-fractionated indoor PM and BC were monitored on the same day and on the preceding day. Mixed-effects models were applied to investigate the associations between pollutants and HRV/HR indices. Increases in size-fractionated indoor PM were significantly associated with declines in power in the high-frequency band (HF), power in the low-frequency band (LF), and standard deviation of all NN intervals (SDNN). The largest decline in HF was 19% at 5-minute moving average for an interquartile range (IQR) increase (24 μg/m3 ) in PM0.5 . The results showed that smaller particles could lead to greater reductions in HRV indices. The reported associations were modified by body mass index (BMI): Declines in HF at 5-minute average for an IQR increase in PM0.5 were 34.5% and 1.0% for overweight (BMI ≥25 kg/m2 ) and normal-weight (BMI <25 kg/m2 ) participants, respectively. Moreover, negative associations between BC and HRV indices were found to be significant in overweight participants. Increases in size-fractionated indoor PM and BC were associated with compromised cardiac autonomic function in healthy elderly women, especially overweight ones.
Collapse
Affiliation(s)
- W Dong
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - L Pan
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - H Li
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - M R Miller
- University/BHF Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - M Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | - S Wu
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - J Xu
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - X Yang
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - J Shan
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - Y Chen
- Respiratory Department, Peking University Third Hospital, Beijing, China
| | - F Deng
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - X Guo
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| |
Collapse
|
44
|
Cherrie JW, Apsley A, Cowie H, Steinle S, Mueller W, Lin C, Horwell CJ, Sleeuwenhoek A, Loh M. Effectiveness of face masks used to protect Beijing residents against particulate air pollution. Occup Environ Med 2018; 75:446-452. [PMID: 29632130 PMCID: PMC5969371 DOI: 10.1136/oemed-2017-104765] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/12/2018] [Accepted: 03/12/2018] [Indexed: 11/23/2022]
Abstract
Objectives Many residents in Beijing use disposable face masks in an attempt to protect their health from high particulate matter (PM) concentrations. Retail masks may be certified to local or international standards, but their real-life performance may not confer the exposure reduction potential that is marketed. This study aimed to evaluate the effectiveness of a range of face masks that are commercially available in China. Methods Nine masks claiming protection against fine PM (PM2.5) were purchased from consumer outlets in Beijing. The masks’ filtration efficiency was tested by drawing airborne diesel exhaust through a section of the material and measuring the PM2.5 and black carbon (BC) concentrations upstream and downstream of the filtering medium. Four masks were selected for testing on volunteers. Volunteers were exposed to diesel exhaust inside an experimental chamber while performing sedentary tasks and active tasks. BC concentrations were continuously monitored inside and outside the mask. Results The mean per cent penetration for each mask material ranged from 0.26% to 29%, depending on the flow rate and mask material. In the volunteer tests, the average total inward leakage (TIL) of BC ranged from 3% to 68% in the sedentary tests and from 7% to 66% in the active tests. Only one mask type tested showed an average TIL of less than 10%, under both test conditions. Conclusions Many commercially available face masks may not provide adequate protection, primarily due to poor facial fit. Our results indicate that further attention should be given to mask design and providing evidence-based guidance to consumers.
Collapse
Affiliation(s)
- John W Cherrie
- Institute of Occupational Medicine, Centre for Human Exposure Science, Edinburgh, UK.,Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh, UK
| | - Andrew Apsley
- Institute of Occupational Medicine, Centre for Human Exposure Science, Edinburgh, UK
| | - Hilary Cowie
- Institute of Occupational Medicine, Centre for Human Exposure Science, Edinburgh, UK
| | - Susanne Steinle
- Institute of Occupational Medicine, Centre for Human Exposure Science, Edinburgh, UK
| | - William Mueller
- Institute of Occupational Medicine, Centre for Human Exposure Science, Edinburgh, UK
| | - Chun Lin
- School of Chemistry, University of Edinburgh, Edinburgh, UK
| | - Claire J Horwell
- Department of Earth Sciences, Institute of Hazard, Risk and Resilience, Durham University, Durham, UK
| | - Anne Sleeuwenhoek
- Institute of Occupational Medicine, Centre for Human Exposure Science, Edinburgh, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Centre for Human Exposure Science, Edinburgh, UK
| |
Collapse
|
45
|
Hodas N, Loh M, Shin HM, Li D, Bennett D, McKone TE, Jolliet O, Weschler CJ, Jantunen M, Lioy P, Fantke P. Indoor inhalation intake fractions of fine particulate matter: review of influencing factors. Indoor Air 2016; 26:836-856. [PMID: 26562829 DOI: 10.1111/ina.12268] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 07/10/2015] [Accepted: 11/02/2015] [Indexed: 05/21/2023]
Abstract
Exposure to fine particulate matter (PM2.5 ) is a major contributor to the global human disease burden. The indoor environment is of particular importance when considering the health effects associated with PM2.5 exposures because people spend the majority of their time indoors and PM2.5 exposures per unit mass emitted indoors are two to three orders of magnitude larger than exposures to outdoor emissions. Variability in indoor PM2.5 intake fraction (iFin,total ), which is defined as the integrated cumulative intake of PM2.5 per unit of emission, is driven by a combination of building-specific, human-specific, and pollutant-specific factors. Due to a limited availability of data characterizing these factors, however, indoor emissions and intake of PM2.5 are not commonly considered when evaluating the environmental performance of product life cycles. With the aim of addressing this barrier, a literature review was conducted and data characterizing factors influencing iFin,total were compiled. In addition to providing data for the calculation of iFin,total in various indoor environments and for a range of geographic regions, this paper discusses remaining limitations to the incorporation of PM2.5 -derived health impacts into life cycle assessments and makes recommendations regarding future research.
Collapse
Affiliation(s)
- N Hodas
- Division of Chemical Engineering, California Institute of Technology, Pasadena, CA, USA
- Department of Environmental Science and Management, Portland State University, Portland, OR, USA
| | - M Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | - H-M Shin
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - D Li
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - D Bennett
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - T E McKone
- School of Public Health, University of California, Berkeley, CA, USA
- Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - O Jolliet
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - C J Weschler
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
- International Centre for Indoor Environment and Energy, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - M Jantunen
- Department of Environmental Health, National Institute for Health and Welfare, Helsinki, Finland
| | - P Lioy
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - P Fantke
- Department of Management Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| |
Collapse
|
46
|
Ramirez-Andreotta MD, Lothrop N, Wilkinson ST, Root RA, Artiola JF, Klimecki W, Loh M. Analyzing Patterns of Community Interest at a Legacy Mining Waste Site to Assess and Inform Environmental Health Literacy Efforts. J Environ Stud Sci 2016; 6:543-555. [PMID: 27595054 PMCID: PMC5007004 DOI: 10.1007/s13412-015-0297-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Understanding a community's concerns and informational needs is crucial to conducting and improving environmental health research and literacy initiatives. We hypothesized that analysis of community inquiries over time at a legacy mining site would be an effective method for assessing environmental health literacy efforts and determining whether community concerns were thoroughly addressed. Through a qualitative analysis, we determined community concerns at the time of being listed as a Superfund site. We analyzed how community concerns changed from this starting point over the subsequent years, and whether: 1) communication materials produced by the USEPA and other media were aligned with community concerns; and 2) these changes demonstrated a progression of the community's understanding resulting from community involvement and engaged research efforts. We observed that when the Superfund site was first listed, community members were most concerned with USEPA management, remediation, site-specific issues, health effects, and environmental monitoring efforts related to air/dust and water. Over the next five years, community inquiries shifted significantly to include exposure assessment and reduction methods and issues unrelated to the site, particularly the local public water supply and home water treatment systems. Such documentation of community inquiries over time at contaminated sites is a novel method to assess environmental health literacy efforts and determine whether community concerns were thoroughly addressed.
Collapse
Affiliation(s)
- Monica D. Ramirez-Andreotta
- Department of Soil, Water and Environmental Science, The University of Arizona. Tucson, Arizona 85721
- Corresponding author: Department of Soil, Water and Environmental Science, University of Arizona, 1177 E Fourth Street, Rm. 429, Tucson, Arizona 85721, Phone Number: 520-621-7228, Fax Number: 520-621-1647,
| | - Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, The University of Arizona. Tucson, Arizona 85721
| | - Sarah T. Wilkinson
- Superfund Research Program, The University of Arizona. Tucson, Arizona 85721
| | - Robert A. Root
- Department of Soil, Water and Environmental Science, The University of Arizona. Tucson, Arizona 85721
- Department of Pharmacology and Toxicology, The University of Arizona. Tucson, Arizona 85721
| | - Janick F. Artiola
- Department of Soil, Water and Environmental Science, The University of Arizona. Tucson, Arizona 85721
| | - Walter Klimecki
- Department of Pharmacology and Toxicology, The University of Arizona. Tucson, Arizona 85721
| | - Miranda Loh
- Mel and Enid Zuckerman College of Public Health, The University of Arizona. Tucson, Arizona 85721
| |
Collapse
|
47
|
Ramirez-Andreotta MD, Brody JG, Lothrop N, Loh M, Beamer PI, Brown P. Improving Environmental Health Literacy and Justice through Environmental Exposure Results Communication. Int J Environ Res Public Health 2016; 13:E690. [PMID: 27399755 PMCID: PMC4962231 DOI: 10.3390/ijerph13070690] [Citation(s) in RCA: 44] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 06/18/2016] [Accepted: 07/04/2016] [Indexed: 11/16/2022]
Abstract
Understanding the short- and long-term impacts of a biomonitoring and exposure project and reporting personal results back to study participants is critical for guiding future efforts, especially in the context of environmental justice. The purpose of this study was to evaluate learning outcomes from environmental communication efforts and whether environmental health literacy goals were met in an environmental justice community. We conducted 14 interviews with parents who had participated in the University of Arizona's Metals Exposure Study in Homes and analyzed their responses using NVivo, a qualitative data management and analysis program. Key findings were that participants used the data to cope with their challenging circumstances, the majority of participants described changing their families' household behaviors, and participants reported specific interventions to reduce family exposures. The strength of this study is that it provides insight into what people learn and gain from such results communication efforts, what participants want to know, and what type of additional information participants need to advance their environmental health literacy. This information can help improve future report back efforts and advance environmental health and justice.
Collapse
Affiliation(s)
- Monica D Ramirez-Andreotta
- Department of Soil, Water, and Environmental Science, University of Arizona, 1177 East 4th Street, Tucson, AZ 85721, USA.
| | - Julia Green Brody
- Silent Spring Institute, 320 Nevada Street, Suite 302, Newton, MA 02460, USA.
| | - Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona 1295 N Martin Ave, Tucson, AZ 85724, USA.
| | - Miranda Loh
- Mel and Enid Zuckerman College of Public Health, University of Arizona 1295 N Martin Ave, Tucson, AZ 85724, USA.
- Institute of Occupational Medicine, Research Avenue North Riccarton, Currie EH14 4AP, UK.
| | - Paloma I Beamer
- Mel and Enid Zuckerman College of Public Health, University of Arizona 1295 N Martin Ave, Tucson, AZ 85724, USA.
| | - Phil Brown
- Department of Sociology and Anthropology and Department of Health Sciences, Northeastern University, 360 Huntington Avenue, 310INV, Boston, MA 02115, USA.
| |
Collapse
|
48
|
Beamer PI, Klimecki WT, Loh M, Van Horne YO, Sugeng AJ, Lothrop N, Billheimer D, Guerra S, Lantz RC, Canales RA, Martinez FD. Association of Children's Urinary CC16 Levels with Arsenic Concentrations in Multiple Environmental Media. Int J Environ Res Public Health 2016; 13:E521. [PMID: 27223295 PMCID: PMC4881146 DOI: 10.3390/ijerph13050521] [Citation(s) in RCA: 20] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/06/2016] [Accepted: 05/16/2016] [Indexed: 02/08/2023]
Abstract
Arsenic exposure has been associated with decreased club cell secretory protein (CC16) levels in adults. Further, both arsenic exposure and decreased levels of CC16 in childhood have been associated with decreased adult lung function. Our objective was to determine if urinary CC16 levels in children are associated with arsenic concentrations in environmental media collected from their homes. Yard soil, house dust, and tap water were taken from 34 homes. Urine and toenail samples were collected from 68 children. All concentrations were natural log-transformed prior to data analysis. There were associations between urinary CC16 and arsenic concentration in soil (b = -0.43, p = 0.001, R² = 0.08), water (b = -0.22, p = 0.07, R² = 0.03), house dust (b = -0.37, p = 0.07, R² = 0.04), and dust loading (b = -0.21, p = 0.04, R² = 0.04). In multiple analyses, only the concentration of arsenic in soil was associated with urinary CC16 levels (b = -0.42, p = 0.02, R² = 0.14 (full model)) after accounting for other factors. The association between urinary CC16 and soil arsenic may suggest that localized arsenic exposure in the lungs could damage the airway epithelium and predispose children for diminished lung function. Future work to assess this possible mechanism should examine potential associations between airborne arsenic exposures, CC16 levels, lung function, and other possible confounders in children in arsenic-impacted communities.
Collapse
Affiliation(s)
- Paloma I Beamer
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Department of Chemical and Environmental Engineering, University of Arizona, 1133 E. James E. Rogers Way, Tucson, AZ 85721, USA.
| | - Walter T Klimecki
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, P.O. Box 210207, Tucson, AZ 85724, USA.
| | - Miranda Loh
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK.
| | - Yoshira Ornelas Van Horne
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Anastasia J Sugeng
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Dean Billheimer
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Stefano Guerra
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
| | - Robert Clark Lantz
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Department of Cellular and Molecular Medicine, University of Arizona, P.O. Box 245044, Tucson, AZ 85724, USA.
| | - Robert A Canales
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Fernando D Martinez
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
| |
Collapse
|
49
|
Ramirez-Andreotta MD, Brody JG, Lothrop N, Loh M, Beamer PI, Brown P. Reporting back environmental exposure data and free choice learning. Environ Health 2016; 15:2. [PMID: 26748908 PMCID: PMC4707004 DOI: 10.1186/s12940-015-0080-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [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: 06/25/2015] [Accepted: 12/05/2015] [Indexed: 05/07/2023]
Abstract
Reporting data back to study participants is increasingly being integrated into exposure and biomonitoring studies. Informal science learning opportunities are valuable in environmental health literacy efforts and report back efforts are filling an important gap in these efforts. Using the University of Arizona's Metals Exposure Study in Homes, this commentary reflects on how community-engaged exposure assessment studies, partnered with data report back efforts are providing a new informal education setting and stimulating free-choice learning. Participants are capitalizing on participating in research and leveraging their research experience to meet personal and community environmental health literacy goals. Observations from report back activities conducted in a mining community support the idea that reporting back biomonitoring data reinforces free-choice learning and this activity can lead to improvements in environmental health literacy. By linking the field of informal science education to the environmental health literacy concepts, this commentary demonstrates how reporting data back to participants is tapping into what an individual is intrinsically motivated to learn and how these efforts are successfully responding to community-identified education and research needs.
Collapse
Affiliation(s)
- Monica D Ramirez-Andreotta
- Department of Soil, Water, and Environmental Science, University of Arizona, 1177 E Fourth Street, Rm. 429, Tucson, Arizona, USA.
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA.
| | | | - Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA.
| | - Miranda Loh
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA.
- Institute of Occupational Medicine, Edinburgh, UK.
| | - Paloma I Beamer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA.
| | - Phil Brown
- Department of Sociology and Anthropology and Department of Health Sciences, Northeastern University, Boston, MA, USA.
| |
Collapse
|
50
|
Loh A, Loh M, Loh C, Athanassopoulos T, Davies M. The recurrence of severe perianal crohns disease in a vram flap reconstruction post disease excision – The clinical implications of extraneous crohns disease in flap reconstruction and options to consider. Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|