Background
Incense burning is an important source of indoor air pollution in many Asian regions. We investigated the associations between household incense burning and lung function, lung function ...growth and respiratory diseases and symptoms in primary school children in Hong Kong.
Methods
A total of 4041 children (mean age: 9.1 years) were recruited from 27 primary schools in Hong Kong. Information on incense burning and medical history of respiratory diseases and symptoms was collected by questionnaire. Spirometry tests were performed to measure the children‘s lung function. A follow‐up study was carried out after 1‐year interval. Linear and logistic regression models were used to investigate the associations between incense burning, lung function, and lung function growth, and respiratory diseases and symptoms, respectively.
Results
At baseline, incense burning was associated with 48.6 mL/min 95% confidence interval (CI): −96.7, −0.5 lower maximum mid‐expiratory flow (MMEF) in boys. In follow‐up, incense burning was associated with reduced peak expiratory flow (PEF) growth in all participants. We also found that incense burning was associated with increased prevalence of bronchitis odds ratio (OR) = 1.39, 95%CI: 1.11, 1.72 and bronchiolitis (OR = 1.72, 95%CI: 1.14, 2.56). Incense burning was also associated with higher prevalence of pneumonia (OR = 2.79, 95%CI: 1.10, 6.87) and wheezing (OR = 1.49, 95%CI: 1.08, 2.05) in boys, but not in girls.
Conclusions
We found that incense burning may adversely affect children‘s respiratory health. Further studies are warranted to elucidate the underlying mechanisms.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Household air pollution (HAP) from solid fuel use for cooking affects 2.5 billion individuals globally and may contribute substantially to disease burden. However, few prospective studies have ...assessed the impact of HAP on mortality and cardiorespiratory disease.
Our goal was to evaluate associations between HAP and mortality, cardiovascular disease (CVD), and respiratory disease in the prospective urban and rural epidemiology (PURE) study.
We studied 91,350 adults 35–70 y of age from 467 urban and rural communities in 11 countries (Bangladesh, Brazil, Chile, China, Colombia, India, Pakistan, Philippines, South Africa, Tanzania, and Zimbabwe). After a median follow-up period of 9.1 y, we recorded 6,595 deaths, 5,472 incident cases of CVD (CVD death or nonfatal myocardial infarction, stroke, or heart failure), and 2,436 incident cases of respiratory disease (respiratory death or nonfatal chronic obstructive pulmonary disease, pulmonary tuberculosis, pneumonia, or lung cancer). We used Cox proportional hazards models adjusted for individual, household, and community-level characteristics to compare events for individuals living in households that used solid fuels for cooking to those using electricity or gas.
We found that 41.8% of participants lived in households using solid fuels as their primary cooking fuel. Compared with electricity or gas, solid fuel use was associated with fully adjusted hazard ratios of 1.12 (95% CI: 1.04, 1.21) for all-cause mortality, 1.08 (95% CI: 0.99, 1.17) for fatal or nonfatal CVD, 1.14 (95% CI: 1.00, 1.30) for fatal or nonfatal respiratory disease, and 1.12 (95% CI: 1.06, 1.19) for mortality from any cause or the first incidence of a nonfatal cardiorespiratory outcome. Associations persisted in extensive sensitivity analyses, but small differences were observed across study regions and across individual and household characteristics.
Use of solid fuels for cooking is a risk factor for mortality and cardiorespiratory disease. Continued efforts to replace solid fuels with cleaner alternatives are needed to reduce premature mortality and morbidity in developing countries. https://doi.org/10.1289/EHP3915.
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CEKLJ, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Abstract
Purpose
Previous epidemiological evidence showed that type 2 diabetes (T2D) is related with gout. However, the causality and the direction of this association are still not definitely ...elucidated. We investigated bidirectional associations of T2D and glycemic traits with serum urate concentrations and gout using a Mendelian randomization approach.
Methods
Summary statistics from the large-scale genomewide association studies conducted for T2D (Ncase = 62 892, Ncontrol = 596 424), fasting glucose (N = 133 010), fasting insulin (N = 133 010), hemoglobin A1c (N = 123 665), homeostasis model assessment of insulin resistance (N = 46 186), urate (N = 110 347), and gout (Ncase = 2115, Ncontrol = 67 259) among participants of European ancestry were analyzed. For each trait of interest, independent genomewide significant (P < 5 × 10−8) single nucleotide polymorphisms were selected as instrumental variables. The inverse-variance weighted method was used for the primary analyses.
Results
Genetic predisposition to higher risk of T2D beta = 0.042; 95% confidence interval (CI) = 0.016-0.068; P = 0.002 and higher levels of fasting insulin (beta = 0.756; 95% CI = 0.408-1.102; P = 1.96e-05) were significantly associated with increased serum urate concentrations. Moreover, we found suggestively significant evidence supporting a causal role of fasting insulin on risk of developing gout (odds ratio = 3.06; 95% CI = 0.88-10.61; P = 0.078). In the reverse direction analysis, genetic predisposition to both urate and gout were not associated with T2D or any of 4 glycemic traits being investigated.
Conclusions
This study provides supportive evidence on causal associations of T2D and fasting insulin with serum urate concentrations and a suggestive association of fasting insulin with risk of gout. Future research is required to examine the underlying biological mechanisms on such relationships.
Parabens are a kind of preservatives widely used in cosmetic and personal care products and ubiquitously detected in the environment. However, little is known on human exposure to these chemicals. ...Our study mainly investigated the urinary parabens in adults from South China to evaluate the cumulative risk of paraben exposure. A total of 562 urine samples were collected from adult workers for the determination of methyl paraben (MeP), ethyl paraben (EtP), propyl paraben (PrP), butyl paraben, and benzyl parabens. High detection frequencies (≥98%) were observed for MeP, EtP, and PrP with median concentrations of 8.88, 5.11, and 1.44 μg/L, respectively. Urinary parabens was 4.5–46.2 fold higher in urine of females than those in males. Urinary MeP was associated with alcohol drinking and a history of tumor, while urinary PrP was negatively associated with education levels of the subjects. There were not significant associations between urinary concentrations of parabens and body mass index, which indicated that obesity was not associated with paraben exposure. Also, parabens did not correlate with human dietary habits. Although the total estimated daily intake (TEDI) of the major compound MeP and EtP in adult workers was lower than the acceptable daily intake (ADI), the TEDI of PrP exceed the ADI for a very few subjects, especially for females and low-educated ones, suggesting potential health risks.
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•Urinary parabens from workers in a nuclear power plant were investigated.•Urinary MeP was associated with alcohol drinking and a history of tumor.•Urinary PrP was negatively associated with workers' education levels.•Obesity was not associated with paraben exposure.•Potential health risks were suggested for females and low-educated workers.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background:
Preserved ratio impaired spirometry (PRISm) is prevalent within the general population. Increased mortality has been reported among subjects with PRISm, but the evidence has never been ...summarised. This systematic review aims to synthesise evidence on the association between PRISm and the risk of all-cause, cardiovascular and respiratory-related mortality.
Methods:
We systematically searched MEDLINE, Embase and Web of Science for population-based cohort studies from inception to April 2023 using the terms related to impaired spirometry and mortality. Titles and abstracts were screened to identify eligible studies that reported mortality estimates for individuals with PRISm. We excluded studies that adopted other definitions of impaired spirometry, had a specific study setting (
e.g.
HIV patients), had an insufficient follow-up period (<1 year) or reported duplicated data. Random-effects meta-analysis was used to produce pooled hazard ratio (HR) with 95% confidence intervals. Between-study heterogeneity was assessed with I
2
.
Results:
Eight studies met the inclusion criteria involving 40 699 individuals with PRISm. All included studies reported increased risk of all-cause mortality among adults with PRISm. Meta-analysis showed that PRISm was associated with an increased risk of all-cause mortality (pooled HR 1.71, 95% CI 1.51–1.93; I
2
=64%), cardiovascular mortality (pooled HR 1.57, 95% CI 1.44–1.72; I
2
=35%) and respiratory-related mortality (pooled HR 1.97, 95% CI 1.55–2.49; I
2
=0%).
Conclusions:
Individuals with PRISm have a significantly increased risk of mortality compared with those with normal spirometry.
Ambient sulfur dioxide (SO2) remains a major air pollutant in developing countries, but epidemiological evidence about its health effects was not abundant and inconsistent.
To evaluate the ...associations between short-term exposure to SO2 and cause-specific mortality in China.
We conducted a nationwide time-series analysis in 272 major Chinese cities (2013–2015). We used the over-dispersed generalized linear model together with the Bayesian hierarchical model to analyze the data. Two-pollutant models were fitted to test the robustness of the associations. We conducted stratification analyses to examine potential effect modifications by age, sex and educational level.
On average, the annual-mean SO2 concentrations was 29.8 μg/m3 in 272 cities. We observed positive and associations of SO2 with total and cardiorespiratory mortality. A 10 μg/m3 increase in two-day average concentrations of SO2 was associated with increments of 0.59% in mortality from total non-accidental causes, 0.70% from total cardiovascular diseases, 0.55% from total respiratory diseases, 0.64% from hypertension disease, 0.65% from coronary heart disease, 0.58% from stroke, and 0.69% from chronic obstructive pulmonary disease. In two-pollutant models, there were no significant differences between single-pollutant model and two-pollutant model estimates with fine particulate matter, carbon monoxide and ozone, but the estimates decreased substantially after adjusting for nitrogen dioxide, especially in South China. The associations were stronger in warmer cities, in older people and in less-educated subgroups.
This nationwide study demonstrated associations of daily SO2 concentrations with increased total and cardiorespiratory mortality, but the associations might not be independent from NO2.
•There was limited evidence on SO2-mortality associations in developing countries.•This is the largest epidemiological study of SO2 in the world.•Daily SO2 was associated with increased total and cardiorespiratory mortality.•The associations were robust to the adjustment of PM2.5, CO and O3, but not to NO2.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The potential benefits of aquatic environments for public health have been understudied in Asia. We investigated the relationships between blue space exposures and health outcomes among a sample of ...predominantly older adults in Hong Kong. Those with a view of blue space from the home were more likely to report good general health, while intentional exposure was linked to greater odds of high wellbeing. Visiting blue space regularly was more likely for those within a 10–15 min walk, and who believed visit locations had good facilities and wildlife present. Longer blue space visits, and those involving higher intensity activities, were associated with higher recalled wellbeing. Our evidence suggests that, at least for older citizens, Hong Kong's blue spaces could be an important public health resource.
•A view of blue space from the home was related to good self-reported health.•Visiting blue spaces regularly was associated with high wellbeing.•Presence of wildlife and good facilities at blue spaces related to visiting regularly.•Safety and presence of wildlife related to recalled wellbeing from a single visit.•Vigorous activity and longer visit durations associated with recalled wellbeing.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
IntroductionNightshift work is prevalent in developed and developing countries in which female nightshift workers are more vulnerable, particularly for mental health.ObjectiveThis study aims to ...investigate if the prevalence of negative emotion differ among male and female nightshift workers and explore the contributing factors using the baseline information of a prospective nightshift worker cohort in Shenzhen, China.MethodsWe recruited 5329 workers and collected their blood/urine samples from 5 industries at the baseline, but only included 834 workers from 2 companies into this report because other 3 companies mainly composed of male workers. We adopted a standardized questionnaire to collect information on lifetime nightshift work, lifestyle factors, housework demands and socio-demographic data.ResultsOverall, 510 workers were males (61.2%) and 324 were females (38.8%). More female than male workers were nightshift workers (90.1% vs. 82.7%), aged≥40 years (20.4% vs. 12.9%) and married (74.4% vs. 58.2%) but less females attained college or above (8.6% vs. 23.5%) and leisure-time exercises (32.7% vs. 50.0%). Significantly more female workers did different housework including cooking (12.7% vs. 9.6%), washing (50.6% vs. 31.4%) and taking care of children/elderly (20.4% vs. 12.2%), and the sex difference in housework demands was particularly prominent among nightshift workers. Female nightshift workers were more prone to negative emotion because of ‘feel exhaust or insufficient energy (40.1% vs. 32.2%)’, ‘worry of significant change of body weight (18.5% vs. 12.6%)’, ‘insomnia/poor sleep (31.5% vs. 21.3%)’, and ‘hard to concentration or forgetful (30.1% vs. 20.4%)’; however, there was no significant sex difference of negative emotion among daytime workers.ConclusionThis study reveals that female nightshift workers were more vulnerable to negative emotion, and nightshift work schedule and high housework burden are the contributing factors.
Evidence on whether an excess risk of incidence and mortality of cardiovascular disease (CVD) among people exposed to a high level of ambient PM2.5 in low- and middle-income countries (LMICs) is ...lacking. This study aimed to investigate the associations between long-term exposure to ambient fine particulate matter<2.5 µm (PM2.5) concentrations and the risk of incidence and mortality of CVD in a large cohort study from 115 communities.
In this cohort study, we followed 42 160 adults aged 35–75 years at baseline who enrolled in the Prospective Urban and Rural Epidemiology Study conducted in China (PURE-China) between 2005 and 2009 with ambient PM2.5 estimates, and followed up until August 2021. Cox proportional hazards frailty models were used to estimate the associations between long-term mean outdoor PM2.5 concentrations and CVD events, CVD mortality, and all-cause mortality.
During a median follow-up period of 11.8 years, we documented 2 190 deaths, including 732 CVD deaths. There were 4 559 (10.8 %) of 42 160 participants who experienced incident total CVD, among them there were 861 myocardial infarctions (MI) and 2 338 S. The 3-year median concentration of ambient PM2.5 before the cohort commencement was 52.7 µg/m3 (interquartile range IQR 30.3–74.6). In full adjusted model, a 10 µg/m3 increase in PM2.5 was associated with a hazard ratio (HR) of 1.12 (95 % CI 1.11–1.14) for major CVD and 1.03 (95 % CI 1.01–1.05) for all-cause mortality. Besides, long-term PM2.5 concentrations had a significantly positive gradient association with total CVD and a similar pattern of associations with other CVD outcomes was observed.
This study demonstrated that long-term ambient PM2.5 concentrations is positively associated with increased risks of CVD in adults aged 35–70 years from China. This finding reinforces the need for policymakers to adopt more effective strategies to improve air quality.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Pesticides have been associated with reproductive disorders, but there is limited research on pesticide exposures and human fertility.
We aimed to investigate the effects of preconception exposure to ...pesticides on time to pregnancy (TTP) and on infertility in a general population of couples planning to become pregnant in Shanghai, China.
A total of 615 women who were planning a pregnancy were enrolled before conception and were prospectively followed for 1 y to observe their TTP. Preconception pesticide exposures were assessed by measuring urinary metabolites of organophosphates (OPs) and pyrethroids (PYRs). Fecundability odds ratios (FORs) and odds ratios (ORs) of infertility were estimated using Cox and logistic regression models, respectively. All analyses were repeated after restricting the sample to nulliparous women (
=569).
After adjusting for age, prepregnancy BMI, current smoking, education, annual household income, age at menarche, and two items from the Perceived Stress Scale (PSS-10), women in the highest quartile of diethylthiophosphate (DETP; an OP metabolite) had significantly longer TTP adjusted FOR=0.68 (95% CI: 0.51, 0.92) and increased infertility adjusted OR=2.17 (95% CI: 1.19, 3.93) compared with women in the lowest quartile. The highest versus lowest quartile of 3-phenoxybenzoic acid (3PBA; a PYR metabolite) was associated with longer TTP and infertility, with significant associations in nulliparous women adjusted FOR=0.72 (95% CI: 0.53, 0.98); adjusted OR for infertility=2.03 (95% CI: 1.10, 3.74).
Our study provides some of the first evidence that preconception OP and PYR exposures are associated with decreased fertility in Chinese couples. Given that OPs and PYRs are rapidly metabolized in humans, more studies are needed to confirm our findings. https://doi.org/10.1289/EHP2987.
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CEKLJ, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
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