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•This study included one million RTI cases during 2006–2021 across China.•We projected the heatwave-related RTI at provincial and national level until 2090s.•Compared with ...non-heatwaves, the risks of RTI increase by 3.61% during heatwaves.•Modifications by age, occupations, mechanisms of RTI, and regions were observed.•The heatwave-related RTI will substantially increase in the future.
Previous studies have demonstrated health impacts of climate change, but evidence on heatwaves’ associations with road traffic injury (RTI) is limited. In this study, individual information of RTI cases in May-September during 2006–2021 in China were obtained from the National Injury Surveillance System. Daily maximum temperatures (TMmax) during 2006–2021 were collected from the ERA-5 reanalysis, and the projected daily TMmax during 2020–2099 were obtained from the latest Coupled Model Intercomparison Project Phase 6 Shared Socioeconomic Pathways scenarios (SSPs). We used a time-stratified case-crossover analysis to investigate the association between short-term exposure (lag01 days) to heatwaves (exceeding the 92.5th percentile of daily TMmax for ≥ three consecutive days) and RTI, and to project heatwave-related RTI until 2099 across China. Finally, a total of 1 031 082 RTI cases were included in the analyses. Compared with non-heatwaves, the risks of RTI increased by 3.61 % during heatwaves. Greater associations were found in people aged 15–64 years, in people with transportation occupation, for non-motor traffic vehicle injuries, for severe RTI cases, and in Western China particularly in Qinghai province. We projected substantial increases in attributable fraction (AF) of heatwave-related RTI in the future, particularly in Western and Southwest China. The national average increase in AF (per decade) during 2020s-2090s was 0.036 % for SSP1-2.6 scenario, and 0.267 % for SSP5-8.5 scenario. This study provided evidence on the associations of heatwaves with RTI, and the heatwave-related RTI will substantially increase in the future.
Long-term consumption of arsenic-contaminated rice has become a public health issue that urgently needs to be addressed. In this study, mice were exposed to arsenic in rice (low dose, 0.91 mg/kg; ...medium dose, 9.1 mg/kg) for 30 days and 60 days, respectively, and the effects on pathological structures of spleen and skin, as well as the structure of the fecal microbiome were examined. The findings revealed dose/time cumulative effects on pathological changes, with even a low dose exposure for 30 days causing destruction of splenic follicular structure and thickening of dermal keratinized and epidermal layers. The Firmicutes/Bacteroidetes ratio in the community and the positive/negative ratio in network links were higher in arsenic groups, suggesting that arsenic resulted in a less healthy and unstable microbiome for the host. Thus lifetime consumption of arsenic in rice may have potential health effects on humans and must be carefully assessed to safeguard human health. Furthermore, in arsenic groups, arsenic-resistant bacteria or arsenic hazards remediation bacteria changed to be the dominant bacteria and acted as the core bacteria in the network modules. Some microbial arsenic transforming genes (arsC, arsR, arsA, ACR3, and aoxB) differed, indicating that the gut microbiome changed to withstand arsenic stress. Furthermore, Faecalibaculum, Lachnospiraceae_NK4A136_group, Angelakisella, Ruminiclostridium, and Desulfovibrionaceae are positively associated with arsenic dosage and may be useful in the early detection of arsenicals.
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•Arsenic resulted in dose/time cumulative effects on pathological changes of spleen and skin.•Arsenic resulted in a less healthy and unstable microbiome for the host.•Several microbial biomarkers may be useful in the early detection of arsenicals.
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•This is a national cohort study focusing on PM2.5 and hyphenation across China.•Long-term exposure to PM2.5 may increase blood pressure and risk of hypertension.•We found different ...effects of PM2.5 components on blood pressure and hypertension.•BC and OM have greater effects on SBP in patients with hypertensive than others.•These effects were modified by sex, urbanicity, smoking status, and cooking fuel type.
Epidemiological evidence on the association of PM2.5 (particulate matter with aerodynamic diameter ≤ 2.5 μm) and its specific components with hypertension and blood pressure is limited.
We applied information of participants from the World Health Organization's (WHO) Study on Global Ageing and Adult Health (SAGE) to estimate the associations of long-term PM2.5 mass and its chemical components exposure with blood pressure (BP) and hypertension incidence in Chinese adults ≥ 50 years during 2007–2018. Generalized linear mixed model and Cox proportional hazard model were applied to investigate the effects of PM2.5 mass and its chemical components on the incidence of hypertension and BP, respectively.
Each interquartile range (IQR = 16.80 μg/m3) increase in the one-year average of PM2.5 mass concentration was associated with a 17 % increase in the risk of hypertension (HR = 1.17, 95 % CI: 1.10, 1.24), and the population attributable fraction (PAF) was 23.44 % (95 % CI: 14.69 %, 31.55 %). Each IQR μg/m3 increase in PM2.5 exposure was also related to increases of systolic blood pressure (SBP) by 2.54 mmHg (95 % CI:1.99, 3.10), and of diastolic blood pressure (DBP) by 1.36 mmHg (95 % CI: 1.04, 1.68). Additionally, the chemical components of SO42−, NO3−, NH4+, OM, and BC were also positively associated with an increased risk of hypertension incidence and elevated blood pressure.
These results indicate that long-term exposure to PM2.5 mass and its specific components may be major drivers of escalation in hypertension diseases.
While ambient formaldehyde (HCHO) concentrations are increasing worldwide, there was limited research on its health effects.
To assess the association of long-term exposure to ambient HCHO with the ...risk of respiratory (RESP) mortality and the associated mortality burden in China.
Annual and seasonal RESP death and tropospheric HCHO vertical columns data were collected in 466 counties/districts across China during 2013–2016. A difference-in-differences approach combined with a generalized linear mixed-effects regression model was employed to assess the exposure-response association between long-term ambient HCHO exposure and RESP mortality risk. Additionally, we computed the attributable fraction (AF) to gauge the proportion of RESP mortality attributable to HCHO exposure.
This analysis encompassed 560,929 RESP deaths. The annual mean ambient HCHO concentration across selected counties/districts was 8.02×1015 ± 2.22×1015 molec.cm−2 during 2013–2016. Each 1.00×1015 molec.cm−2 increase in ambient HCHO was associated with a 1.61 % increase excess risk (ER), 95 % confidence interval (CI): 1.20 %, 2.03 % in the RESP mortality risk. The AF of RESP mortality attributable to HCHO was 12.16 % (95 %CI:9.33 %, 14.88 %), resulting in an annual average of 125,422 (95 %CI:96,404, 153,410) attributable deaths in China. Stratified analyses suggested stronger associations in individuals aged ≥65 years old (ER=1.87 %, 95 %CI:1.43 %, 2.32 %), in cold seasons (ER=1.00 %, 95 %CI:0.56 %, 1.44 %), in urban areas (ER=1.65 %, 95 %CI:1.15 %, 2.16 %), and in chronic obstructive pulmonary disease patients (ER=1.95 %, 95 %CI:1.42 %, 2.48 %).
This study suggested that long-term HCHO exposure may significantly increase the risk of RESP mortality, leading to a substantial mortality burden. Targeted measures should be implemented to control ambient HCHO pollution promptly.
•First study to find the effect of long-term ambient HCHO exposure on respiratory death•The respiratory death burden from ambient HCHO exposure varies widely by region•Measures should be taken to protect the populations vulnerable to HCHO exposure
Assisted reproduction technology (ART) has advanced significantly, raising concerns regarding its impact on the secondary sex ratio (SSR), which is the sex ratio at birth in offspring. This study ...aimed to explore factors affecting SSR in singletons, singletons from twin gestation, and twins from twin gestation within the context of ART.
A retrospective analysis was conducted on data from 8335 births involving 6,223 couples undergoing ART. Binary logistic regression assessed relationships between parental and embryonic factors and SSR in singletons and singletons from twin gestation. Multinomial logistic regression models were utilized to identify factors influencing SSR in twins from twin gestation.
Secondary infertility (OR = 1.164, 95% CI: 1.009-1.342), advanced paternal age (OR = 1.261, 95% CI: 1.038-1.534), and blastocyst embryo transfer (OR = 1.339, 95% CI: 1.030-1.742) were associated with an increased SSR, while frozen embryo transfer (FET) showed a negative association with SSR (OR = 0.738, 95% CI: 0.597-0.912) in singletons. A longer duration of gonadotropin (Gn) usage reduced SSR in singletons (OR = 0.961, 95% CI: 0.932-0.990) and singletons from twin gestation (OR = 0.906, 95% CI: 0.838-0.980). In singletons from twin gestation, male-induced infertility (OR = 2.208, 95% CI: 1.120-4.348) and higher Gn dosage (OR = 1.250, 95% CI: 1.010-1.548) were significantly associated with an increased SSR. Women aged > 35 years and intracytoplasmic sperm injection (ICSI) were associated with lower SSR (OR = 0.539, 95% CI: 0.293-0.990 and OR = 0.331, 95% CI: 0.158-0.690, respectively). In twins from twin gestation, paternal age exceeded maternal age (OR = 0.682, 95% CI: 0.492-0.945) and higher Gn dosage (OR = 0.837, 95% CI: 0.715-0.980) were associated with a higher proportion of male twins. Cleavage stage transfer (OR = 1.754, 95% CI: 1.133-2.716) resulted in a higher percentage of boy-girl twins compared to blastocyst transfer.
This study demonstrates the complex interplay of various factors in determining the SSR in ART, highlighting the importance of considering infertility type, paternal age, fertilization method, embryo transfer stage, and Gn use duration when assessing SSR. Nevertheless, further research with a large sample size is necessary to confirm and expand upon the findings of this study.
is a widely known medicinal entomogenous fungus, which parasitizes the soil-borne larva of Thitarodes (Hepialidae, Lepidoptera) distributed in the Qinghai-Tibetan Plateau and its adjacent areas. ...Previous research has involved artificial cultivation of Chinese cordyceps (the fungus-caterpillar complex), but it is difficult to achieve large-scale cultivation because the coupling relation between the crucial microbes and their hosts is not quite clear. To clarify the influence of the internal microbial community on the occurrence of Chinese cordyceps, in this study, the unfertilized eggs of Thitarodes of different sampling sites were chosen to analyze the bacterial and fungal communities via 16S rRNA and ITS sequencing for the first time. The results showed that for bacteria, 348 genera (dominant genera include Wolbachia, Spiroplasma, Carnobacterium, Sphingobium, and Acinetobacter) belonging to 26 phyla (dominant phyla include Proteobacteria, Firmicutes, Tenericutes, Actinobacteria, Acidobacteria, and Bacteroidetes), 58 classes, 84 orders, and 120 families were identified from 1294 operational taxonomic units (OTUs). The dominant bacterial genus (Spiroplasma) may be an important bacterial factor promoting the occurrence of Chinese cordyceps. For fungi, 289 genera, mainly including
,
, and
, were identified, and they belonged to 5 phyla (Ascomycota, Basidiomycota, Chytridiomycota, Glomeromycota, and Zygomycota), 26 classes, 82 orders, and 165 families. Eight bacterial OTUs and 12 fungal OTUs were shared among all of the detected samples and were considered as core species. Among them, Wolbachia, Spiroplasma,
,
, and
may play important roles in helping the host larva to digest foods, adapt to extreme environments, or resist pathogens. On the other hand, the external (soil) microbial community was synchronously and comparatively analyzed. Comparative analysis revealed that external microbial factors might play a more significant role in the occurrence of Chinese cordyceps, owing to the significant differences revealed by α-diversity and β-diversity analyses among different groups. In summary, the results of this study may contribute to the large-scale cultivation of Chinese cordyceps.
The first 1000 days of life, encompassing pregnancy and the first 2 years after birth, represent a critical period for human health development. Despite this significance, there has been limited ...research into the associations between mixed exposure to air pollutants during this period and the development of asthma/wheezing in children. Furthermore, the finer sensitivity window of exposure during this crucial developmental phase remains unclear.
This study aims to assess the relationships between prenatal and postnatal exposures to various ambient air pollutants (particulate matter 2.5 PM
, carbon monoxide CO, sulfur dioxide SO
, nitrogen dioxide NO
, and ozone O
) and the incidence of childhood asthma/wheezing. In addition, we aimed to pinpoint the potential sensitivity window during which air pollution exerts its effects.
We conducted a prospective birth cohort study wherein pregnant women were recruited during early pregnancy and followed up along with their children. Information regarding maternal and child characteristics was collected through questionnaires during each round of investigation. Diagnosis of asthma/wheezing was obtained from children's medical records. In addition, maternal and child exposures to air pollutants (PM
CO, SO
, NO
, and O
) were evaluated using a spatiotemporal land use regression model. To estimate the mutual associations of exposure to mixed air pollutants with the risk of asthma/wheezing in children, we used the quantile g-computation model.
In our study cohort of 3725 children, 392 (10.52%) were diagnosed with asthma/wheezing. After the follow-up period, the mean age of the children was 3.2 (SD 0.8) years, and a total of 14,982 person-years were successfully followed up for all study participants. We found that each quartile increase in exposure to mixed air pollutants (PM
, CO, SO
, NO
, and O
) during the second trimester of pregnancy was associated with an adjusted hazard ratio (HR) of 1.24 (95% CI 1.04-1.47). Notably, CO made the largest positive contribution (64.28%) to the mutual effect. After categorizing the exposure according to the embryonic respiratory development stages, we observed that each additional quartile of mixed exposure to air pollutants during the pseudoglandular and canalicular stages was associated with HRs of 1.24 (95% CI 1.03-1.51) and 1.23 (95% CI 1.01-1.51), respectively. Moreover, for the first year and first 2 years after birth, each quartile increment of exposure to mixed air pollutants was associated with HRs of 1.65 (95% CI 1.30-2.10) and 2.53 (95% CI 2.16-2.97), respectively. Notably, SO
made the largest positive contribution in both phases, accounting for 50.30% and 74.70% of the association, respectively.
Exposure to elevated levels of mixed air pollutants during the first 1000 days of life appears to elevate the risk of childhood asthma/wheezing. Specifically, the second trimester, especially during the pseudoglandular and canalicular stages, and the initial 2 years after birth emerge as crucial susceptibility windows.
Chinese Clinical Trial Registry ChiCTR-ROC-17013496; https://tinyurl.com/2ctufw8n.
Although the health impacts of ambient ozone (O3) have been widely assessed, studies simultaneously investigating the acute and chronic effects of O3 on mortality from respiratory diseases (RESP) are ...scarce.
We extracted personal information of all recorded deaths from RESP throughout 2013–2018 in six provinces in China. The daily, seasonal, and annual mean air pollutant concentrations at the township/subdistrict level were estimated by a random forest model. The acute association between the maximum daily average 8h ozone (MDA8 O3) and RESP mortality was examined by a time-stratified case-crossover study design, and the chronic association was estimated by a difference-in-differences (DID) analysis approach. We also calculated the attributable fraction (AF) of RESP mortality attributable to MDA8 O3.
There were 1,034,226 RESP deaths included in this study. The excess risks (ERs) of overall RESP mortality for each 10 μg/m3 increase in short-term (lag03 days) and long-term (one-year average) exposure to MDA8 O3 were 0.38 % (95%CI: 0.26 %, 0.50 %) and 4.37 % (3.91 %, 4.84 %), respectively. The AFs of overall RESP mortality ascribed to short- and long-term MDA8 O3 exposures were 3.00 % (2.03 %, 3.95 %) and 29.45 % (26.86 %, 31.95 %), respectively. The average annual number of RESP deaths attributable to short-term MDA8 O3 exposure was 30,790 and 302,254 were attributable to long-term MDA8 O3 exposure across China during 2013–2018.
Both short- and long-term exposure to ambient MDA8 O3 were positively associated with RESP mortality, and long-term exposure to MDA8 O3 may lead to a greater RESP mortality burden than short-term exposure to MDA8 O3.
Depression is a social and public health problem of great concern globally. Identifying and managing the factors influencing depression are crucial for preventing and decreasing the burden of ...depression.BACKGROUNDDepression is a social and public health problem of great concern globally. Identifying and managing the factors influencing depression are crucial for preventing and decreasing the burden of depression.Our objectives are to explore the association between residential greenness and the incidence of depression in an older Chinese population and to calculate the disease burden of depression prevented by greenness exposure.OBJECTIVESOur objectives are to explore the association between residential greenness and the incidence of depression in an older Chinese population and to calculate the disease burden of depression prevented by greenness exposure.This study was the Chinese part of the World Health Organization Study on Global AGEing and Adult Health (WHO SAGE). We collected the data of 8,481 residents ≥50 years of age in China for the period 2007-2018. Average follow-up duration was 7.00 (±2.51) years. Each participant was matched to the yearly maximum normalized difference vegetation index (NDVI) at their residential address. Incidence of depression was assessed using the Composite International Diagnostic Interview (CIDI), self-reports of depression, and/or taking depression medication. Association between greenness and depression was examined using the time-dependent Cox regression model with stratified analysis by sex, age, urbanicity, annual family income, region, smoking, drinking, and household cooking fuels. Furthermore, the prevented fraction (PF) and attributable number (AN) of depression prevented by exposure to greenness were estimated.METHODSThis study was the Chinese part of the World Health Organization Study on Global AGEing and Adult Health (WHO SAGE). We collected the data of 8,481 residents ≥50 years of age in China for the period 2007-2018. Average follow-up duration was 7.00 (±2.51) years. Each participant was matched to the yearly maximum normalized difference vegetation index (NDVI) at their residential address. Incidence of depression was assessed using the Composite International Diagnostic Interview (CIDI), self-reports of depression, and/or taking depression medication. Association between greenness and depression was examined using the time-dependent Cox regression model with stratified analysis by sex, age, urbanicity, annual family income, region, smoking, drinking, and household cooking fuels. Furthermore, the prevented fraction (PF) and attributable number (AN) of depression prevented by exposure to greenness were estimated.Residential greenness was negatively associated with depression. Each interquartile range (IQR) increase in NDVI 500-m buffer was associated with a 40% decrease hazard ratio (HR)=0.60; 95% confidence interval (CI): 0.37, 0.97 in the risk of depression incidence among the total participants. Subgroup analyses showed negative associations in urban residents (HR=0.32; 95% CI: 0.12, 0.86) vs. rural residents, in high-income residents (HR=0.28; 95% CI: 0.11, 0.71) vs. low-income residents, and in southern China (HR=0.50; 95% CI: 0.26, 0.95) vs. northern China. Over 8.0% (PF=8.69%; 95% CI: 1.38%, 15.40%) and 1,955,199 (95% CI: 310,492; 3,464,909) new cases of depression may be avoided by increasing greenness exposures annually across China.RESULTSResidential greenness was negatively associated with depression. Each interquartile range (IQR) increase in NDVI 500-m buffer was associated with a 40% decrease hazard ratio (HR)=0.60; 95% confidence interval (CI): 0.37, 0.97 in the risk of depression incidence among the total participants. Subgroup analyses showed negative associations in urban residents (HR=0.32; 95% CI: 0.12, 0.86) vs. rural residents, in high-income residents (HR=0.28; 95% CI: 0.11, 0.71) vs. low-income residents, and in southern China (HR=0.50; 95% CI: 0.26, 0.95) vs. northern China. Over 8.0% (PF=8.69%; 95% CI: 1.38%, 15.40%) and 1,955,199 (95% CI: 310,492; 3,464,909) new cases of depression may be avoided by increasing greenness exposures annually across China.The findings suggest protective effects of residential greenness exposure on depression incidence in the older population, particularly among urban residents, high-income residents, and participants living in southern China. The construction of residential greenness should be included in community planning. https://doi.org/10.1289/EHP13947.DISCUSSIONThe findings suggest protective effects of residential greenness exposure on depression incidence in the older population, particularly among urban residents, high-income residents, and participants living in southern China. The construction of residential greenness should be included in community planning. https://doi.org/10.1289/EHP13947.
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