Few studies have investigated the short-term respiratory effects of ambient air pollution in chronic obstructive pulmonary disease (COPD) patients in the context of high pollution levels in Asian ...cities.
A panel of 23 stable COPD patients was repeatedly measured for biomarkers of airway inflammation including exhaled nitric oxide (FeNO) and exhaled hydrogen sulfide (FeH2S) (215 measurements) and recorded for daily respiratory symptoms (794person-days) in two study periods in Beijing, China in January–September 2014. Daily ambient air pollution data were obtained from nearby central air-monitoring stations. Mixed-effects models were used to estimate the associations between exposures and health measurements with adjustment for potential confounders including temperature and relative humidity.
Increasing levels of air pollutants were associated with significant increases in both FeNO and FeH2S. Interquartile range (IQR) increases in PM2.5 (76.5μg/m3, 5-day), PM10 (75.0μg/m3, 5-day) and SO2 (45.7μg/m3, 6-day) were associated with maximum increases in FeNO of 13.6% (95% CI: 4.8%, 23.2%), 9.2% (95% CI: 2.1%, 16.8%) and 34.2% (95% CI: 17.3%, 53.4%), respectively; and the same IQR increases in PM2.5 (6-day), PM10 (6-day) and SO2 (7-day) were associated with maximum increases in FeH2S of 11.4% (95% CI: 4.6%, 18.6%), 7.8% (95% CI: 2.3%, 13.7%) and 18.1% (95% CI: 5.5%, 32.2%), respectively. Increasing levels of air pollutants were also associated with increased odds ratios of sore throat, cough, sputum, wheeze and dyspnea.
FeH2S may serve as a novel biomarker to detect adverse respiratory effects of air pollution. Our results provide potential important public health implications that ambient air pollution may pose risk to respiratory health in the context of high pollution levels in densely-populated cities in the developing world.
•Few studies have investigated air pollution effects in COPD patients in China.•Air pollution was associated with increased exhaled nitric oxide and hydrogen sulfide.•Air pollution was also associated with increased odds ratios of respiratory symptoms.•Exhaled hydrogen sulfide may serve as a novel marker to detect air pollution effects.•Air pollution may pose risk to respiratory health in highly-polluted areas.
Ambient air pollution has been associated with activation of systemic inflammation and hypercoagulability and increased plasma homocysteine, but the chemical constituents behind the association are ...not well understood. We examined the relations of various chemical constituents of fine particles (PM(2.5)) and biomarkers of inflammation, coagulation and homocysteine in the context of traffic-related air pollution.
A panel of 40 healthy college students underwent biweekly blood collection for 12 times before and after their relocation from a suburban campus to an urban campus with changing air pollution contents in Beijing. Blood samples were measured for circulatory biomarkers of high-sensitivity C reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), fibrinogen, plasminogen activator inhibitor type 1 (PAI-1), tissue-type plasminogen activator (t-PA), von Willebrand factor (vWF), soluble platelet selectin (sP-selectin), and total homocysteine (tHcy). Various air pollutants were measured in a central air-monitoring station in each campus and 32 PM(2.5) chemical constituents were determined in the laboratory. We used three different mixed-effects models (single-constituent model, constituent-PM(2.5) joint model and constituent residual model) controlling for potential confounders to estimate the effects of PM(2.5) chemical constituents on circulatory biomarkers.
We found consistent positive associations between the following biomarkers and PM(2.5) chemical constituents across different models: TNF-α with secondary organic carbon, chloride, zinc, molybdenum and stannum; fibrinogen with magnesium, iron, titanium, cobalt and cadmium; PAI-1 with titanium, cobalt and manganese; t-PA with cadmium and selenium; vWF with aluminum. We also found consistent inverse associations of vWF with nitrate, chloride and sodium, and sP-selectin with manganese. Two positive associations of zinc with TNF-α and of cobalt with fibrinogen, and two inverse associations of nitrate with vWF, and of manganese with sP-selectin, were independent of the other constituents in two-constituent models using constituent residual data. We only found weak air pollution effects on hs-CRP and tHcy.
Our results provide clues for the potential roles that PM(2.5) chemical constituents may play in the biological mechanisms through which air pollution may influence the cardiovascular system.
Physical function impairment in patients with low back pain (LBP) occurs due to the influence of psychosocial factors. Only a few studies have objectively evaluated physical function. We aimed to ...objectively assess the physical functions of individuals subjects with LBP, and clarify the association between physical function and psychosocial factors. We enrolled 411 individuals with LBP working in special needs schools. We examined their degree of pain, and the psychosocial factors strength through the STarT Back Tool, which categorized them into the low-risk, medium-risk, and high-risk groups. We assessed their abdominal muscle endurance, lower limb muscle strength, and hip joint flexibility. The relationships between these physical functions and psychosocial factors were analyzed by logistic regression models. Those in the high-risk group had significantly lower abdominal muscle and lower limb muscle strength (p<0.001). After adjusting for confounding factors, the odds ratios of the high-risk compared to the low-risk group for low abdominal muscle endurance, lower limb muscle strength, and restricted right and left Straight Leg Raising were 5.47, 3.14, 2.65, and 3.12, respectively (95% CIs: 2.35–12.74, 1.43–6.89, 1.08–6.55, and 1.20–8.11, respectively). Therefore, the low physical function observed in the high-risk group was associated with their psychosocial factors.
Varicella-zoster virus (VZV) causes varicella as a primary infection and remains latent in the ganglia until it becomes reactivated to cause herpes zoster. Individuals with varicella develop adaptive ...humoral and cell-mediated immunity. Compromised cell-mediated immunity is thought to contribute to the development of herpes zoster. Recent evidence suggests that changes in the epidemiology of varicella have affected the epidemiology of herpes zoster. The incidence of herpes zoster is higher in older adults; thus, the herpes zoster vaccine is recommended for older adults. However, the incidence of herpes zoster is expected to rise among younger individuals; hence, vaccination with the varicella vaccine should also be considered in younger adults. In order to determine the need for vaccination in different populations, it is important to establish methods to accurately assess the activity of cell-mediated immunity and humoral immunity.
This research aimed to examine the efficacy of the early initiation of breastfeeding within 1 h of birth, early skin-to-skin contact, and rooming-in for the continuation of exclusive breastfeeding ...until 6 months postpartum. The research used data from the Japan Environment and Children's Study (JECS), a nationwide government-funded birth cohort study. A total of 80,491 mothers in Japan between January 2011 and March 2014 who succeeded or failed to exclusively breastfeed to 6 months were surveyed in JECS. Multiple logistic regression model was used to analyse the data. The percentage of mothers who succeeded in exclusively breastfeeding to 6 months is 37.4%. Adjusted odds ratios were analysed for all 35 variables. Early initiation of breastfeeding (adjusted odds ratio AOR: 1.455 1.401-1.512), early skin-to-skin contact (AOR: 1.233 1.165-1.304), and rooming-in (AOR: 1.567 1.454-1.690) affected continuation of exclusive breastfeeding. Regional social capital (AOR: 1.133 1.061-1.210) was also discovered to support the continuation of breastfeeding. In contrast, the most influential inhibiting factors were starting childcare (AOR: 0.126 0.113-0.141), smoking during pregnancy (AOR: 0.557 0.496-0.627), and obese body type during early pregnancy (AOR: 0.667 0.627-0.710).
PM2.5 samples were collected inside and outside a primary school classroom in Beijing in 2015 and analysed for 11 polycyclic aromatic hydrocarbons (PAHs) and 10 nitro-PAHs (NPAHs). In the sampling ...period in the heating season (namely, the heating period), the median concentrations of indoor and outdoor PAHs were 223 ng/m3 and 264 ng/m3, respectively, and those of indoor and outdoor NPAHs were 3.61 ng/m3 and 5.12 ng/m3, respectively. The concentrations of PAHs and NPAHs were consistently higher in the heating period than those (indoor PAHs: 8.75 ng/m3, outdoor PAHs: 8.95 ng/m3, indoor NPAHs: 0.25 ng/m3, outdoor NPAHs: 0.40 ng/m3) in the sampling period in the non-heating season (namely, the non-heating period). In both periods, total PAHs and total NPAHs in indoor PM2.5, as well as most individual PAHs and NPAHs, were positively correlated with the outdoor PAH and NPAH concentrations (p < 0.05). This finding suggests that indoor PAHs and NPAHs are largely dependent on outdoor inputs. It is inferred from the diagnostic ratios that PAHs and NPAHs in indoor and outdoor PM2.5 were affected jointly by coal combustion and vehicular emission in the heating period and mainly derived from vehicle exhaust in the non-heating period. Both indoor and outdoor PM2.5 showed considerable benzoapyrene equivalent toxicity (BaPeq), especially in the heating period. Benzocfluorene (BcFE) had relatively low concentrations but large contributions to BaPeq in both periods. This is the first report of PM2.5-bound BcFE inside and outside classrooms in Beijing. This result indicates that neglecting PAHs with low abundance but high toxicity leads to a significant underestimation of the overall PAH toxicity. The inhalation cancer risk (CR) of PAHs and NPAHs in PM2.5 during the primary school year exceeded the acceptable level as defined by the U.S. EPA, emphasizing its impact on the lifetime CR in schoolchildren.
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•PM2.5-bound PAHs and NPAHs inside a classroom mainly came from outside.•PAHs and NPAHs in both indoor and outdoor PM2.5 pose a threat to children's health.•This is the first report on benzocfluorene (BcFE) on a campus in Beijing.•BcFE was the largest contributor to PAH toxicity among the detected congeners.
This study investigated the spatial and temporal distributions of particulate and gaseous air pollutants in a primary school in Beijing and assessed their health impact on the children. The results ...show that air quality inside the classroom was greatly affected by the input of outdoor pollutants; high levels of pollution were observed during both the heating and nonheating periods and indicate that indoor and outdoor air pollution posed a threat to the children's health. Traffic sources near the primary school were the main contributors to indoor and outdoor pollutants during both periods. Moreover, air quality in this primary school was affected by coal combustion and atmospheric reactions during the heating and nonheating periods, respectively. Based on the estimation by exposure-response functions and the weighting of indoor and outdoor pollutants during different periods, the levels of PM2.5, PM 10 and O3 at school had adverse respiratory health effects on children. Longer exposures during the nonheating period contributed to higher health risks. These results emphasized that emission sources nearby had a direct impact on air quality in school and children's respiratory health. Therefore, measures should be taken for double control on air pollution inside and outside the classroom to protect children from it.
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•Air pollution inside and outside a primary school classroom in Beijing was serious.•Sources nearby directly affected school's air quality and children's airway health.•Indoor air quality was greatly affected by the input of outdoor pollutants.•Health effects were estimated by weighting indoor and outdoor pollutants.•The polluted air on campus increased the risk of respiratory health in children.
Occupational asbestos exposure occurs in many workplaces and is a well‐known cause of mesothelioma and lung cancer. However, the association between nonoccupational asbestos exposure and those ...diseases is not clearly described. The aim of this study was to investigate cause‐specific mortality among the residents of Amagasaki, a city in Japan with many asbestos factories, and evaluate the potential excess mortality due to established and suspected asbestos‐related diseases. The study population consisted of 143 929 residents in Amagasaki City before 1975 until 2002, aged 40 years or older on January 1, 2002. Follow‐up was carried out from 2002 to 2015. Standardized mortality ratio (SMR) with its 95% confidence interval (CI) was calculated by sex, using the mortality rate of the Japanese population as reference. A total of 38 546 deaths (including 303 from mesothelioma and 2683 from lung cancer) were observed. The SMRs in the long‐term residents’ cohort were as follows: death due to all causes, 1.12 (95% CI, 1.10‐1.13) in men and 1.07 (95% CI, 1.06‐1.09) in women; lung cancer, 1.28 (95% CI, 1.23‐1.34) in men and 1.23 (95% CI, 1.14‐1.32) in women; and mesothelioma, 6.75 (95% CI, 5.83‐7.78) in men and 14.99 (95% CI, 12.34‐18.06) in women. These SMRs were significantly higher than expected. The increased SMR of mesothelioma suggests the impact of occupational asbestos exposure among men and nonoccupational asbestos exposure among women in the long‐term residents’ cohort. In addition, the high level of excess mortality from mesothelioma has persisted, despite the mixture of crocidolite and chrysotile no longer being used for three or four decades.
Our paper provides an investigation on the cause‐specific mortality among the residents in a unique urban area where asbestos‐related factories were concentrated in Japan. The excess mortality due to mesothelioma suggests the impact of occupational asbestos exposure in men and nonoccupational asbestos exposure in women in the cohort.
The Edinburgh Postnatal Depression Scale (EPDS) is frequently used to screen for postpartum depression. However, its factor structure exhibits noticeable inconsistencies between studies. We examined ...the EPDS at two postpartum time points using a large dataset from outside Western countries. Participants were 91,063 mothers in an ongoing birth cohort of the Japan Environment and Children's Study. One-, two-, and three-factor structures of the EPDS at 1- and 6-months postpartum were extracted using exploratory factor analysis (EFA) with oblique rotation. Goodness-of-fit indices of extracted factor structures were compared with prior ones by conducting a confirmatory factor analysis (CFA). CFA revealed that a three-factor model extracted from the current EFA-anxiety (items 3, 4, 5, and 6), depression (items 7, 9, and 10), and anhedonia (items 1 and 2)-showed acceptably high goodness-of-fit and invariability across time. These three factors explained about 65% of the total variance with good reliability (all Cronbach's αs ≥ 0.70). Most three-factor structures (vs. two-) showed higher goodness-of-fit indices. In conclusion, although we only examined the postpartum period, the EPDS likely comprises three dimensions: anxiety, depression, and anhedonia. Our findings raise questions about the one- or two-factor structure of the EPDS.Trial registration: UMIN000030786.
Accurate estimates of the concentrations of fine particulate matter (PM2.5) components at high spatial and temporal resolution is essential for assessing their impact on human health. In this study, ...we developed prediction models of daily concentrations of major PM2.5 components (sulfate, nitrate, ammonium, elemental carbon, and organic carbon) in the Kansai region, Japan, from 2010 to 2017 using the random forest algorithm. The objective is to establish a modeling approach for obtaining accurate daily estimates of PM2.5 component concentrations using temporally sparse monitoring data covering only 15% of the study period. We used gaseous and particulate pollutant concentrations, chemical transport model outputs, simulated meteorological parameters, and conventional land use and traffic-related variables to produce daily estimations at 1 km × 1 km resolution. We evaluated our models via spatial and temporal cross-validation and obtained R2 values of 0.59–0.86 for individual components. The model reproduced the day-to-day variations well, with Pearson’s correlation coefficients of 0.75–0.88 between estimates and independent data collected at continuous monitors. We estimated the daily concentrations of PM2.5 components from 2010 to 2017 at a 1 km × 1 km resolution. The annual trends of the components were obtained by temporally and spatially aggregating the daily estimations. Our modeling approach enabled accurate estimates of the daily PM2.5 component levels using temporally sparse monitoring data. The estimated concentrations will be further utilized in a birth cohort study to assess the potential health impacts of PM2.5 components.
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•Daily concentrations of PM2.5 components were estimated using temporally sparse data.•Models for sulfate, nitrate, ammonium, elemental, and organic carbon were built.•Gaseous and particulate pollutant concentrations were used as model predictors.•The models exhibited high accuracy and well reproduced the day-to-day variations.•Our approach enabled accurate daily estimations using temporally sparse data.
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