Abstract
Background
Studies on the association between smoke haze (hereafter ‘haze’) and adverse health effects have increased in recent years due to extreme weather conditions and the increased ...occurrence of vegetation fires. The possible adverse health effects on under-five children (U5Y) is especially worrying due to their vulnerable condition. Despite continuous repetition of serious haze occurrence in Southeast Asia, epidemiological studies in this region remained scarce. Furthermore, no study had examined the association accounting for three important aspects (time lag, duration and intensity) concurrently.
Objective
This study aimed to examine the association between haze and U5Y mortality in Malaysia, considering time lag, duration and intensity of exposure.
Methods
We performed a time-stratified case-crossover study using a generalized additive model to examine the U5Y mortality related to haze in 12 districts in Malaysia, spanning from 2014 to 2016. A ‘haze day’ was characterized by intensity based on concentrations of particulate matter (PM) and duration (continuity of haze occurrence, up to 3 days).
Results
We observed the highest but non-significant odds ratios (ORs) of U5Y mortality at lag 4 of Intensity-3. Lag patterns revealed the possibility of higher acuteness at prolonged and intensified haze. Stratifying the districts by the 95th-percentile of PM distribution, the ‘low’ category demonstrated marginal positive association at Intensity-2 Duration-3 OR: 1.210 (95% confidence interval: 1.000, 1.464).
Conclusions
We found a null association between haze and U5Y mortality. The different lag patterns of the association observed over different duration and intensity suggest consideration of these aspects in future studies.
Between 1997 and 2000, all states in the United States (US) enacted the State Children's Health Insurance Programme (SCHIP) to provide publicly funded health insurance coverage for children in ...low-income families. However, only 15 states including the District of Columbia initially chose to provide coverage for children of newly arrived immigrants in their SCHIP. We exploit the resulting state and time variation in the implementation of the programme in a difference-in-differences framework to estimate the effect of a publicly funded children's health insurance benefit on immigrant women's fertility. While estimates from full samples show that the net effect of the programme was indistinguishable from zero, we find a significant positive effect on the fertility of unmarried immigrant women, both at the extensive and at the intensive margin. Our findings have important policy implications for societies experiencing a persistent decline in fertility.
Road dust, contains enhanced amounts of light rare earth elements (LREEs) in rare earth industrial cities, which poses a serious health risk particularly to children. Road dust samples were collected ...from Baotou, the largest rare earth industrial city in northern China, and sieved into six size fractions. The pollution characteristics of the LREEs (La, Ce, Pr, and Nd) in the size-fractioned road dust were investigated, and the LREEs exposure dose of children via ingestion of road dust was evaluated. The results showed that the finer size fractions of road dust had enhanced REEs concentrations, and the pollution level was found to be elevated with a decrease in particle size. Ce was the most abundant element, with concentrations ranging from 105 to 5420 mg·kg−1, followed by La, Nd and Pr. REEs mining activities had a major contribution to the LREEs in the road dust and crust, among which coal combustion emissions could also be a potential source. The average daily intake dose of LREEs through ingestion of road dust by children ranged from 4.27 × 10−4 to 2.63 × 10−2 mg·kg−1·day−1 and was significantly affected by particle size. Road dust exposure is notably affected by particle size, and there is a serious risk to children of LREEs uptake from fine particles (<100 μm) of road dust.
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•Road dust has been heavily polluted by LREEs in REEs mining areas.•The contamination level of Ce was the highest.•Children's exposure to LREEs via road dust ingestion is non-negligible.•Road dust exposure risk was notably affected by particle size.
Children frequently receive low-value services that do not improve health, but it is unknown whether the receipt of these services differs between publicly and privately insured children.
We analyzed ...2013-2014 Medicaid Analytic eXtract and IBM MarketScan Commercial Claims and Encounters databases. Using 20 measures of low-value care (6 diagnostic testing measures, 5 imaging measures, and 9 prescription drug measures), we compared the proportion of publicly and privately insured children in 12 states who received low-value services at least once or twice in 2014; the proportion of publicly and privately insured children who received low-value diagnostic tests, imaging tests, and prescription drugs at least once; and the proportion of publicly and privately insured children eligible for each measure who received the service at least once.
Among 6 951 556 publicly insured children and 1 647 946 privately insured children, respectively, 11.0% and 8.9% received low-value services at least once, 3.9% and 2.8% received low-value services at least twice, 3.2% and 3.8% received low-value diagnostic tests at least once, 0.4% and 0.4% received low-value imaging tests at least once, and 8.4% and 5.5% received low-value prescription drug services at least once. Differences in the proportion of eligible children receiving each service were typically small (median difference among 20 measures, public minus private: +0.3 percentage points).
In 2014, 1 in 9 publicly insured and 1 in 11 privately insured children received low-value services. Differences between populations were modest overall, suggesting that wasteful care is not highly associated with payer type. Efforts to reduce this care should target all populations regardless of payer mix.
Heavy metals are considered to seriously threatens food safety and children’s health. Children are particularly vulnerable to environmental threats because they respond differently to stressors than ...adults, largely due to their immature immune systems. Thus, highly sensitive and specific technology is urgently required to detect toxic heavy metals in food rapidly. This review aims to present electrochemical (bio)sensors for detecting heavy metals, especially in focusing on nickel, lead, cadmium, mercury, arsenic, and aluminum, with the various electrode modification materials and provide a broad overview of heavy metals toxicosis as a background for sustained investigations of the toxicology these compounds of children health importance.
Epidemiological studies have implicated air pollution in the causation of neurodevelopmental disorders, including attention-deficit hyperactivity disorder (ADHD), but definitive evidence of this ...linkage is lacking.
We examined the association between cumulative exposure to air pollutants from birth to diagnosis, particularly particulate matter of <10μm (PM10) and nitric dioxide (NO2), and childhood ADHD.
We used the National Health Insurance Service-National Sample Cohort (2002−2012), a population-wide health insurance claims dataset. A total of 8936 infants (age 0) born between January 2002 and December 2002 were followed-up for a 10-year period (2003−2012). ADHD was defined as per ICD-10 code F90.0. Exposure levels of PM10 and NO2 were extrapolated using geographic information systems and collated with the subjects' administrative district code, and individual exposure levels assigned. Hazard ratios (HRs) were calculated for the development of ADHD, after adjusting for gender, metropolitan area, income, and history of diseases.
During the study period, ADHD occurred in 314 subjects (3.5%). With the increase in 1μg/m3 of air pollutants, the HRs of childhood ADHD were 1.18 (95% CI: 1.15–1.21) in case of PM10 and 1.03 (95% CI: 1.02–1.04) in case of NO2. Compared with infants with the lowest tertile of PM10 or NO2 exposure, those with the highest tertile of PM10 (HR=3.88; 95% CI: 2.87–5.23) or NO2 (HR=2.10; 95% CI, 1.54–2.85) exposure had a 2 to 3 fold increased risk for ADHD.
Exposure to PM10 and NO2 was associated with the incidence of ADHD in childhood.
•Ambient PM10 and NO2 is considered as a source of neurodevelopmental toxicants.•We followed up the risk of childhood ADHD on exposure to air pollution in infancy.•Infancy exposed to high air pollution had an increased risk for childhood ADHD.
Due to the rapid pace of urbanization, the lead-zinc slags previously located outside the settlement turned out to be within the city of Shymkent and began to pose a serious threat to the ...environment. Therefore, the purpose of the study was to investigate the impact of lead-zinc slags on the environment of Shymkent. It has been revealed that the fields of ruderal plant species are inversely correlated with the lead content in the soil, for phyto-indication of the state of soils, the most informative indicators are the phytocenotic composition and the projective covering of soils with vegetation. At the same time, the proportion of annual species in the control is 53.5±5.6%; with an increase in the toxic load, their role gradually weakens, reaching from 14496.0±105.1 mg/kg Pb2+ to 5.2± 0.4%. It was found that Dodartia orientalis, Centaurea squarrosa Willd., Plantago lancetofolium are hyperaccumulators of lead ions, while electron microscopic images showed that lead ions accumulate in the intercellular space of plants, forming significant conglomerates of 10-75 nm. The negative influence of lead-zinc waste has been established, which leads to the accumulation of lead in the blood of children and, as a consequence, is the cause of various diseases. The maximum lead content in the amount of 103 micrograms / dl was found in the blood of children in the area of the city, located 800-1000 m from the slag storage site. Developing hypochromic anemia in children indicates its toxic origin. It was revealed that 90% of children have such pathologies as biliary dyskinesia, dental caries, small anomalies of heart development.
Abstract
Background
Recent advancements in drilling technology led to a rapid increase in natural gas development (NGD). Air pollution may be elevated in these areas and may vary by drilling type ...(conventional and unconventional), production volume and gas flaring. Impacts of NGD on paediatric asthma are largely unknown. This study quantifies associations between specific NGD activities and paediatric asthma hospitalizations in Texas.
Methods
We leveraged a database of Texas inpatient hospitalizations between 2000 and 2010 at the zip code level by quarter to examine associations between NGD and paediatric asthma hospitalizations, where our primary outcome is 0 vs ≥1 hospitalization. We used quarterly production reports to assess additional drilling-specific exposures at the zip code-level including drilling type, production and gas flaring. We developed logistic regression models to assess paediatric asthma hospitalizations by zip code-quarter-year observations, thus capturing spatiotemporal exposure patterns.
Results
We observed increased odds of ≥1 paediatric asthma hospitalization in a zip code per quarter associated with increasing tertiles of NGD exposure and show that spatiotemporal variation impacts results. Conventional drilling, compared with no drilling, is associated with odds ratios up to 1.23 95% confidence interval (CI): 1.13, 1.34, whereas unconventional drilling is associated with odds ratios up to 1.59 (95% CI: 1.46, 1.73). Increasing production volumes are associated with increased paediatric asthma hospitalizations in an exposure–response relationship, whereas associations with flaring volumes are inconsistent.
Conclusions
We found evidence of associations between paediatric asthma hospitalizations and NGD, regardless of drilling type. Practices related to production volume may be driving these positive associations.
•Early childhood is a critical period for telomere biology.•Prior studies of urinary As and telomere length in children have had mixed findings.•We examined urinary As and telomere length in 5–7 year ...old Bangladeshi children.•Urinary As was associated with significant decreases in relative telomere length.•Arsenic exposure may be related to telomere shortening in early to mid-childhood.
Telomere length has been associated with the occurrence and progression of common chronic and age-related diseases, and in younger populations, may represent a biomarker of disease susceptibility. Early childhood is a critical period for telomere biology as this period is characterized by a rapid decline in telomere length due to a large turnover of highly proliferative cells and may represent a period of unique sensitivity to environmental insults. Arsenic (As) exposure has been associated with both telomere lengthening and shortening in adults and children and some evidence suggests the effects may differ by level and timing of exposure.
Given the lack of clarity across studies, we investigated the association between urinary As and leukocyte telomere length among 476 five- to seven-year-old children enrolled in the Bangladesh Environmental Research in Children's Health (BiRCH) cohort.
In a series of multivariable models, adjusted for key covariates, we examined associations between urinary As and relative telomere length (RTL) of whole blood DNA.
We observed small but consistent, negative associations between urinary As and RTL, such that a doubling of urinary As was associated with a −0.017 (95% CI: −0.030, −0.005; p = 0.0056) decrease in RTL, in fully adjusted models. We also observed a somewhat stronger inverse relationship between urinary As concentration and RTL among children born to fathers ≥ 30 years of age at the time of birth, than those < 30 years; however, we did not observe a statistically significant interaction.
Our study suggests that As influences RTL, with detectable associations in early to mid-childhood. Further studies are needed to confirm our findings and investigate the potential long-term impacts of telomere shortening in childhood on later life health outcomes. Additional studies exploring how dose and timing of exposure may relate to RTL are critical to understanding As’s relationship to telomere length.
BACKGROUND:Research on spending persistence has not focused on Medicaid and the Children’s Health Insurance Program (Medicaid/CHIP), which includes a complex and growing population.
OBJECTIVE OF THE ...STUDY:The objective of the study was to describe patterns of expenditure persistence, mortality, and disenrollment among nondually eligible Medicaid/CHIP enrollees and identify factors predicting these outcomes.
RESEARCH DESIGN:The study is based on New Jersey Medicaid/CHIP claims data from 2011 to 2014. Descriptive and multinomial regression methods were used to characterize persistently extreme spenders, defined as those appearing in the top 1% of statewide spending every year, according to demographics, Medicaid/CHIP eligibility, nursing facility residence, patient risk scores, and clinical diagnostic categories measured in 2011. Similar analyses were done for persistently high spenders (ie, always in the top 10% but not always top 1%) as well as decedents, disenrollees, and moderate spenders (ie, at least 1 year outside of the top 10%).
SUBJECTS:Nondually eligible NJ Medicaid/CHIP enrollees in 2011.
RESULTS:One fourth of extreme spenders in 2011 remained in that category throughout 2011–2014. Almost all (89.3%) of the persistently extreme spenders were aged, blind, or disabled. Within the aged, blind, or disabled population, the strongest predictors of persistently extreme spending were diagnoses involving developmental disability, HIV/AIDS, central nervous system conditions, psychiatric disorders, type 1 diabetes, and renal conditions. Individuals in nursing facilities and those with very high risk scores were more likely to die or have persistently high spending than to have persistently extreme spending.
CONCLUSIONS:The study highlights unique features of spending persistence within Medicaid/CHIP and provides methodological contributions to the broader persistence literature.
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