Polygenic susceptibility likely influences individual responses to air pollutants and the risk of asthma. We compared the role of polygenic susceptibility on air pollution-associated asthma between ...German and Japanese women. We investigated women that were enrolled in the German SALIA cohort (n = 771, mean age = 73 years) and the Japanese Shika cohort (n = 847, mean age = 67 years) with known asthma status. Adjusted logistic regression models were used to assess the associations between (1) particulate matter with a median aerodynamic diameter ≤ 2.5μm (PM2.5) and nitrogen dioxide (NO2), (2) polygenic risk scores (PRS), and (3) gene-environment interactions (G × E) with asthma. We found an increased risk of asthma in Japanese women after exposure to low pollutant levels (PM2.5: median = 12.7µg/m3, p-value < 0.001, NO2: median = 8.5µg/m3, p-value < 0.001) and in German women protective polygenic effects (p-value = 0.008). While we found no significant G × E effects, the direction in both groups was that the PRS increased the effect of PM2.5 and decreased the effect of NO2 on asthma. Our study confirms that exposure to low air pollution levels increases the risk of asthma in Japanese women and indicates polygenic effects in German women; however, there was no evidence of G × E effects. Future genome-wide G × E studies should further explore the role of ethnic-specific polygenic susceptibility to asthma.
Fraction of exhaled Nitric Oxide (FeNO) is a marker of airway inflammation. We examined the main effects and interactions of relative humidity (RH) and air pollution on adolescents’ FeNO. Two ...thousand and forty-two participants from the 15-year follow-up of the German GINIplus and LISA birth cohorts were included. Daily meteorological (maximum Tmax, minimum Tmin and mean Tmean temperatures and RH) and air pollution Ozone (O3), nitrogen dioxide (NO2) and particulate matter < 2.5 µm (PM2.5) were assessed. Linear models were fitted with Ln(FeNO) as the outcome. Increases in FeNO indicate an increase in lung inflammation. Increased FeNO was associated with an increase in temperature, PM2.5, O3 and NO2. A 5% increase in RH was associated with a decrease in FeNO. Interactions between RH and high (p = 0.007) and medium (p = 0.050) NO2 were associated with increases in FeNO; while interactions between RH and high (p = 0.042) and medium (p = 0.040) O3 were associated with decreases in FeNO. Adverse effects were present for male participants, participants with low SES, participants with chronic respiratory disease, and participants from Wesel. Short-term weather and air pollution have an effect on lung inflammation in German adolescents. Future research should focus on further assessing the short-term effect of multiple exposures on lung inflammation in adolescents.
Respiratory diseases are a leading cause of mortality and morbidity, and are exacerbated by air pollution and temperature.
To assess published literature on the effect of air pollution modified by ...temperature on respiratory mortality and hospital admissions.
We identified 26,656 papers in PubMed and Web of Science, up to March 2021, and selected for analysis; inclusion criteria included observational studies, short-term air pollution, and temperature exposure. Air pollutants considered were particulate matter with a diameter of 2.5 μg/m3, and 10 μg/m3 (PM2.5, and PM10), ozone (O3), and nitrogen dioxide (NO2). A random-effects model was used for our meta-analysis.
For respiratory mortality we found that when the effect PM10 is modified by high temperatures there is an increased pooled Odds Ratio OR, 95% Confidence Interval (CI) of 1.021 (1.008 to 1.034) and for the effect of O3 the pooled OR is 1.006 (1.001–1.012) during the warm season. For hospital admissions, the effects of PM10 and O3 respectively, during the warm season found an increased pooled OR of 1.011 (0.999–1.024), and 1.015 (0.995–1.036). In our analysis for low temperatures, results were inconsistent.
Exposure to air pollution when modified by high temperature is likely to increase the odds of respiratory mortality and hospital admissions. Analysis on the interaction effect of air pollution and temperature on health outcomes is a relatively new research field and results are largely inconsistent; therefore, further research is encouraged to establish a more conclusive conclusion on the strength and direction of this effect.
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•Air pollution modified by temperature has adverse effects on respiratory health.•PM10 modified by high temperatures increases the odds of respiratory mortality.•O3 exposure during the warm season increases the odds of respiratory mortality.•Effects estimates were inconsistent for low temperatures.
AbstractObjectiveTo assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth.DesignSystematic review and random ...effects meta-analysis.Data sourcesMedline and Web of Science searched up to September 2018, updated in August 2019.Eligibility criteria for selecting studiesClinical studies on associations between high environmental temperatures, and preterm birth, birth weight, and stillbirths.Results14 880 records and 175 full text articles were screened. 70 studies were included, set in 27 countries, seven of which were countries with low or middle income. In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings.ConclusionsAlthough summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health.Systematic review registrationPROSPERO CRD 42019140136 and CRD 42018118113.
Non-optimum ambient temperature has been associated with a variety of health outcomes in the elderly population. However, few studies have examined its adverse effects on neurocognitive function. In ...this study, we explored the temperature-cognition association in elderly women. We investigated 777 elderly women from the German SALIA cohort during the 2007–2010 follow-up. Cognitive function was evaluated using the CERAD-Plus test battery. Modelled data on daily weather conditions were assigned to the residential addresses. The temperature-cognition association over lag 0–10 days was estimated using multivariable regression with distributed lag non-linear model. The daily mean temperature ranged between −6.7 and 26.0 °C during the study period for the 777 participants. We observed an inverse U-shaped association in elderly women, with the optimum temperature (15.3 °C) located at the 68th percentile of the temperature range. The average z-score of global cognitive function declined by −0.31 (95%CI: 0.73, 0.11) for extreme cold (the 2.5th percentile of temperature range) and −0.92 (95%CI: 1.50, −0.33) for extreme heat (the 97.5th percentile of temperature range), in comparison to the optimum temperature. Episodic memory was more sensitive to heat exposure, while semantic memory and executive function were the two cognitive domains sensitive to cold exposure. Individuals living in an urban area and those with a low educational level were particularly sensitive to extreme heat. In summary, non-optimum temperature was inversely associated with cognitive function in elderly women, with the effect size for heat exposure particularly substantial. The strength of association varied by cognitive domains and individual characteristics.
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•Non-optimum temperature was inversely associated with cognition decline in elderly women.•The effect size was more substantial for heat exposure.•Individuals with low educational level and those in urban areas were more affected.
As global temperatures rise, extreme heat events are projected to become more frequent and intense. Extreme heat causes a wide range of health effects, including an overall increase in morbidity and ...mortality. It is important to note that while there is sufficient epidemiological evidence for heat-related increases in all-cause mortality, evidence on the association between heat and cause-specific deaths such as cardiovascular disease (CVD) mortality (and its more specific causes) is limited, with inconsistent findings. Existing systematic reviews and meta-analyses of epidemiological studies on heat and CVD mortality have summarized the available evidence. However, the target audience of such reviews is mainly limited to the specific field of environmental epidemiology. This overarching perspective aims to provide health professionals with a comprehensive overview of recent epidemiological evidence of how extreme heat is associated with CVD mortality. The rationale behind this broad perspective is that a better understanding of the effect of extreme heat on CVD mortality will help CVD health professionals optimize their plans to adapt to the changes brought about by climate change and heat events. To policymakers, this perspective would help formulate targeted mitigation, strengthen early warning systems, and develop better adaptation strategies. Despite the heterogeneity in evidence worldwide, due in part to different climatic conditions and population dynamics, there is a clear link between heat and CVD mortality. The risk has often been found to be higher in vulnerable subgroups, including older people, people with preexisting conditions, and the socioeconomically deprived. This perspective also highlights the lack of evidence from low- and middle-income countries and focuses on cause-specific CVD deaths. In addition, the perspective highlights the temporal changes in heat-related CVD deaths as well as the interactive effect of heat with other environmental factors and the potential biological pathways. Importantly, these various aspects of epidemiological studies have never been fully investigated and, therefore, the true extent of the impact of heat on CVD deaths remains largely unknown. Furthermore, this perspective also highlights the research gaps in epidemiological studies and the potential solutions to generate more robust evidence on the future consequences of heat on CVD deaths.
Links between heat exposure and congenital anomalies have not been explored in detail despite animal data and other strands of evidence that indicate such links are likely. We reviewed articles on ...heat and congenital anomalies from PubMed and Web of Science, screening 14,880 titles and abstracts in duplicate for articles on environmental heat exposure during pregnancy and congenital anomalies. Thirteen studies were included. Most studies were in North America (8) or the Middle East (3). Methodological diversity was considerable, including in temperature measurement, gestational windows of exposure, and range of defects studied. Associations were detected between heat exposure and congenital cardiac anomalies in three of six studies, with point estimates highest for atrial septal defects. Two studies with null findings used self-reported temperature exposures. Hypospadias, congenital cataracts, renal agenesis/hypoplasia, spina bifida, and craniofacial defects were also linked with heat exposure. Effects generally increased with duration and intensity of heat exposure. However, some neural tube defects, gastroschisis, anopthalmia/microphthalmia and congenital hypothyroidism were less frequent at higher temperatures. While findings are heterogenous, the evidence raises important concerns about heat exposure and birth defects. Some heterogeneity may be explained by biases in reproductive epidemiology. Pooled analyses of heat impacts using registers of congenital anomalies are a high priority.
Background
Relative humidity (RH) and air pollution significantly affect respiratory health. However, how RH and air pollution interact and modify each other and affect lung function in adolescence ...is largely unknown. This study assesses the interactive association of RH and air pollution on lung function, i.e. forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), in German adolescents.
Methods
A total of 2,116 participants with available spirometry measurements (
z
-scores of FEV1 and FVC) were included from the 15-year follow-up of the German GINIplus and LISA birth cohort. Daily environmental exposure data included RH, ozone (O
3
), nitrogen dioxide (NO
2
), and particulate matter <2.5 µm (PM
2.5
). Linear models were fitted to assess the main associations of RH, air pollution, and maximum temperature (Tmax) an interaction term between one-day moving average of RH (Lag01) and a categorical air pollution term was then included to assess the modifying association of air pollution on RH and was adjusted for study location, season and chronic respiratory disease (CRD) status. Effect modification was performed for sex and CRD. The results are presented as beta coefficients (
ß
) and 95% confidence intervals (95% CI).
Results
A 5% increase in RH was associated with an increase in FEV1 (
ß
= 0.040–0.045; 95% CI: 0.008 to 0.076) and FVC (
ß
= 0.007–0.012; 95% CI: −0.023 to 0.045) in the main associations models. In the interaction models, there was a significant decrease in FEV1 (
ß
= −0.211; 95% CI: −0.361 to −0.062) and FVC (
ß
= −0.258; 95% CI: −0.403 to −0.0113) per 5% increase in RH on high O
3
days compared to the reference category; while there was a non-significant trend towards a decrease in FEV1 on high PM
2.5
and NO
2
days. Female participants were more likely to experience a decrease in FEV1 than male participants on high-pollution days.
Conclusions
Air pollution interacts and modifies the association of weather on lung function in this cohort of German adolescents. An increase in RH on high air pollution exposure days was associated with a decrease in lung function in German adolescents. Female participants were more sensitive to RH and air pollution.
Climate change, particularly global warming, is amongst the greatest threats to human health. While short-term effects of heat exposure in pregnancy, such as preterm birth, are well documented, ...long-term effects have received less attention. This review aims to systematically assess evidence on the long-term impacts on the foetus of heat exposure in utero.
A search was conducted in August 2019 and updated in April 2023 in MEDLINE(PubMed). We included studies on the relationship of environmental heat exposure during pregnancy and any long-term outcomes. Risk of bias was assessed using tools developed by the Joanna-Briggs Institute, and the evidence was appraised using the GRADE approach. Synthesis without Meta-Analysis (SWiM) guidelines were used.
Eighteen thousand six hundred twenty one records were screened, with 29 studies included across six outcome groups. Studies were mostly conducted in high-income countries (n = 16/25), in cooler climates. All studies were observational, with 17 cohort, 5 case-control and 8 cross-sectional studies. The timeline of the data is from 1913 to 2019, and individuals ranged in age from neonates to adults, and the elderly. Increasing heat exposure during pregnancy was associated with decreased earnings and lower educational attainment (n = 4/6), as well as worsened cardiovascular (n = 3/6), respiratory (n = 3/3), psychiatric (n = 7/12) and anthropometric (n = 2/2) outcomes, possibly culminating in increased overall mortality (n = 2/3). The effect on female infants was greater than on males in 8 of 9 studies differentiating by sex. The quality of evidence was low in respiratory and longevity outcome groups to very low in all others.
Increasing heat exposure was associated with a multitude of detrimental outcomes across diverse body systems. The biological pathways involved are yet to be elucidated, but could include epigenetic and developmental perturbations, through interactions with the placenta and inflammation. This highlights the need for further research into the long-term effects of heat exposure, biological pathways, and possible adaptation strategies in studies, particularly in neglected regions. Heat exposure in-utero has the potential to compound existing health and social inequalities. Poor study design of the included studies constrains the conclusions of this review, with heterogenous exposure measures and outcomes rendering comparisons across contexts/studies difficult.
PROSPERO CRD 42019140136.
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