Microbial contamination of drinking water in Pakistan—a review

Water pollution with pathogenic microorganisms is one of the serious threats to human health, particularly in developing countries. The main objective of this article is to highlight microbial contamination of drinking water, the major factors responsible for microbial contamination, and the resulting health problems in Pakistan. Furthermore, this study will be helpful for researchers and administrative agencies to initiate relevant studies and develop new policies to protect further deterioration of water supply with pathogenic microbes and ensure clean and safe drinking water to the public in Pakistan. In Pakistan, water at the source, in the distribution network, and at the consumer tap is heavily polluted with coliforms and fecal coliforms all over the country. An overview of more than 7,000 water samples reviewed here reveals that an average of over 71 and 58 % samples in the country was contaminated with total coliforms and fecal coliforms, respectively. Drinking water contamination accounts for 20 to 40 % of all diseases in the country, which causes national income losses of Rs 25–58 billion annually (US$0.25–0.58 billion, approximately 0.6–1.44 % of the country’s GDP). Improper disposal of industrial and municipal wastes is the most important factor responsible for water pollution in the country followed by cross-contamination due to old and leaking pipes and lack of water filtration and disinfection facilities. There is an urgent need for emergency steps to stop further deterioration of water quality and improve the existing water quality so as to protect the public from widespread waterborne diseases.     

Short-term effects of atmospheric particulate matter on myocardial infarction: a cumulative meta-analysis

Atmospheric particulate matter (PM) is hypothesized to increase the risk of myocardial infarction (MI). However, the epidemiological evidence is inconsistent. We identified 33 studies with more than 4 million MI patients and applied meta-analysis and meta-regression to assess the available evidence. Twenty-five studies presented the effects of the PM level on hospitalization for MI patients, while eight studies showed the effects on mortality. An increase in PM₁₀ was associated with hospitalization and mortality in myocardial infarction patients (RR per 10 μg/m³?=?1.011, 95 % CI 1.006–1.016; RR per 10 μg/m³?=?1.008, 95 % CI 1.004–1.012, respectively); PM_2.5 also increased the risk of hospitalization and mortality in MI patients (RR per 10 μg/m³?=?1.024, 95 % CI 1.007–1.041 for hospitalization and RR per 10 μg/m³?=?1.012, 95 % CI 1.010–1.015 for mortality). The results of the cumulative meta-analysis indicated that PM₁₀ and PM_2.5 were associated with myocardial infarctionwith the addition of new studies each year. In conclusion, short-term exposure to high PM₁₀ and PM_2.5 levels revealed to increase risk of hospitalization and mortality for myocardial infarction. Policy support of pollution control and individual protection was strongly recommended.     

Pesticide exposure and serum organochlorine residuals among testicular cancer patients and healthy controls

The incidence of testicular cancer (TC) has been increasing worldwide during the last decades. The reasons of the increase remains unknown, but recent findings suggest that organochlorine pesticides (OPs) could influence the development of TC. A hospital-based case-control study of 50 cases and 48 controls was conducted to determine whether environmental exposure to OPs is associated with the risk of TC, and by measuring serum concentrations of OPs, including p,p’-dichlorodiphenyldichloroethylene (p,p’-DDE) isomer and hexachlorobenzene (HCB) in participants. A significant association was observed between TC and household insecticide use (odds ratio [OR] = 3.01, 95 % CI: 1.11-8.14; OR_adjusted = 3.23, 95 % CI: 1.15-9.11). Crude and adjusted ORs for TC were also significantly associated with higher serum concentrations of total OPs (OR = 3.15, 95 % CI: 1.00-9.91; OR_adjusted = 3.34, 95 % CI: 1.09-10.17) in cases compared with controls. These findings give additional support to the results of previous research that suggest that some environmental exposures to OPs may be implicated in the pathogenesis of TC.     

Impact of haze and air pollution-related hazards on hospital admissions in Guangzhou,China

Guangzhou is a metropolitan in south China with unique pollutants and geographic location. Unlike those in western countries and the rest of China, the appearance of haze in Guangzhou is often (about 278 days per year on average of 4 years). Little is known about the influence of these hazes on health. In this study, we investigated whether short-term exposures to haze and air pollution are associated with hospital admissions in Guangzhou. The relationships between haze, air pollution, and daily hospital admissions during 2008–2011 were assessed using generalized additive model. Studies were categorized by gender, age, season, lag, and disease category. In haze episodes, an increase in air pollutant emissions corresponded to 3.46 (95 % CI, 1.67, 5.27) increase in excessive risk (ER) of total hospital admissions at lag 1, 11.42 (95 % CI, 4.32, 18.99) and 11.57 (95 % CI, 4.38, 19.26) increases in ERs of cardiovascular illnesses at lags 2 and 4 days, respectively. As to total hospital admissions, an increase in NO₂ was associated with a 0.73 (95 % CI, 0.11, 1.35) and a 0.28 (95 % CI, 0.11, 0.46) increases in ERs at lag 5 and lag 05, respectively. For respiratory illnesses, increases in NO₂ was associated with a 1.94 (95 % CI, 0.50, 3.40) increase in ER at lag 0, especially among chronic obstructive pulmonary disease. Haze (at lag1) and air pollution (for NO₂ at lag 5 and for SO₂ at lag3) both presented more drastic effects on the 19 to 64 years old and in the females. Together, we demonstrated that haze pollution was associated with total and cardiovascular illnesses. NO₂ was the sole pollutant with the largest risk of hospital admissions for total and respiratory diseases in both single- and multi-pollutant models.     

The acute effects of fine particles on respiratory mortality and morbidity in Beijing, 2004–2009

Recent epidemiological and toxicological studies have shown associations between particulate matter and human health. However, the estimates of adverse health effects are inconsistent across many countries and areas. The stratification and interaction models were employed within the context of the generalized additive Poisson regression equation to examine the acute effects of fine particles on respiratory health and to explore the possible joint modification of temperature, humidity, and season in Beijing, China, for the period 2004–2009. The results revealed that the respiratory health damage threshold of the PM_2.5 concentration was mainly within the range of 20–60 μg/m³, and the adverse effect of excessively high PM_2.5 concentration maintained a stable level. In the most serious case, an increase of 10 μg/m³ PM_2.5 results in an elevation of 4.60 % (95 % CI 3.84–4.60 %) and 4.48 % (95 % CI 3.53–5.41 %) with a lag of 3 days, values far higher than the average level of 0.69 % (95 % CI 0.54–0.85 %) and 1.32 % (95 % CI 1.02–1.61 %) for respiratory mortality and morbidity, respectively. There were strong seasonal patterns of adverse effects with the seasonal variation of temperature and humidity. The growth rates of respiratory mortality and morbidity were highest in winter. And, they increased 1.4 and 1.8 times in winter, greater than in the full year as PM_2.5 increased 10 μg/m³.     

Assessment of bisphenol A released from reusable plastic, aluminium and stainless steel water bottles

Bisphenol A (BPA) is a ubiquitous high volume industrial chemical that is an estrogen and an environmental endocrine disrupting chemical. Bisphenol A is used extensively in the production of consumer goods, polycarbonate plastics, epoxy resins and coatings used to line metallic food and beverage cans. There is great concern regarding the possible harmful effects from exposures that result from BPA leaching into foods and beverages from packaging or storage containers. The objective of this study was to independently assess whether BPA contamination of water was occurring from different types of reusable drinking bottles marketed as alternatives to BPA-containing polycarbonate plastics. Using a sensitive and quantitative BPA-specific competitive enzyme-linked immunosorbent assay we evaluated whether BPA migrated into water stored in polycarbonate or copolyester plastic bottles, and different lined or unlined metallic reusable water bottles. At room temperature the concentration of BPA migrating from polycarbonate bottles ranged from 0.2 to 0.3 mg L⁻¹. Under identical conditions BPA migration from aluminium bottles lined with epoxy-based resins was variable depending on manufacturer ranging from 0.08 to 1.9 mg L⁻¹. Boiling water significantly increased migration of BPA from the epoxy lined bottles. No detectable BPA contamination was observed in water stored in bottles made from Tritan™ copolyester plastic, uncoated stainless steel, or aluminium lined with EcoCare™. The results from this study demonstrate that when used according to manufacturers’ recommendations reusable water bottles constructed from “BPA-free” alternative materials are suitable for consumption of beverages free of BPA contamination.     

Visibility Regulations

Experiments were conducted to investigate the appearance of contaminants in fluorocarbon-film bags which have been widely used as photochemical reactors and storage containers in air pollution research. Clean air stored in such bags was gradually contaminated by a wide range of heavy hydrocarbons (≥ C₅ ) as well as by nitrogen oxides. Warming a bag dramatically increased the contamination rate for hydrocarbons. The substances observed in the bags appear to have originated in the air outside the bags and appeared in the bags due to the permeability of the film. When a bag was stored in a controlled clean environment, the rate of contamination by hydrocarbons was dramatically reduced. Experiments in which high concentration mixtures of hydrocarbons and nitrogen oxides were stored in the bags likewise showed that some high molecular weight hydrocarbons as well as NO and NO₂ permeate through the bag walls. Decontamination of the bags can be accomplished by storing them in a clean environment.     

Low-level arsenic exposure is associated with bladder cancer risk and cigarette smoking: a case–control study among men in Tunisia

Although exposure to high levels of arsenic is associated with excess bladder cancer risk, lower exposures generally are not. This study represents the first biomonitoring of arsenic exposure in Tunisia and focuses on a possible association with bladder cancer risk. In this context, 124 male bladder cancer cases and 220 controls were recruited and blood samples were analyzed to determine the concentration of As. The study subjects were stratified into median groups based on concentrations of arsenic in their blood. Blood arsenic (B-As) was significantly two to threefold higher in bladder cancer cases than in controls (p?<?0.05). The arsenic concentrations were significantly higher among both smokers and workers in construction. However, neither drinking water nor seafood was found to be incriminated as exposure sources. The adjusted risk ratios for B-As concentration categories 0.1–0.67 and ≥0.67 μg/L were 0.18 (95% CI?=?0.014–2.95) and 2.44 (95% CI?=?1.11–5.35), respectively. Arsenic levels were not found to be associated with tumor grade or stage. The considerable risk in the category of highest cumulative exposure argues for an association between bladder cancer risk and low-level arsenic exposure. Future investigations with larger samples and using techniques that allow the distinction of the different arsenic species should better elucidate this association. Furthermore, the modulation of arsenic level according to the histological grade may be of potential to be used as a diagnostic marker of the disease process and its possible relationship etiologically.     

Does area deprivation modify the association between exposure to a nitrate and low-dose atrazine metabolite mixture in drinking water and small for gestational age? A historic cohort study

Birth weight may be influenced by environmental and socio-economic factors that could interact. The main objective of our research was to investigate whether area deprivation may modify the association between drinking water exposure to a mixture of atrazine metabolites and nitrates during the second trimester of pregnancy and prevalence of small for gestational age (SGA) neonates. We conducted a historic cohort study in Deux-Sèvres, France between 2005 and 2010, using birth records, population census and regularly performed drinking water withdrawals at community water systems. Exposure to an atrazine metabolite/nitrate mixture in drinking water was divided into six classes according to the presence or absence of atrazine metabolites and to the terciles of nitrate concentrations in each trimester of pregnancy. We used a logistic regression to model the association between SGA and mixture exposure at the second trimester while taking into account the area deprivation measured by the Townsend index as an effect modifier and controlling for the usual confounders. We included 10,784 woman–neonate couples. The risk of SGA when exposed to second tercile of nitrate without atrazine metabolites was significantly greater in women living in less deprived areas (OR?=?2.99; 95 % CI (1.14, 7.89)), whereas it was not significant in moderately and more deprived areas. One of the arguments used to explain this result is the presence of competing risk factors in poorer districts.     

The effect of anaerobic digestion and storage on indicator microorganisms in swine and dairy manure

The aim of this experimental study was to evaluate the influence of anaerobic digestion and storage on indicator microorganisms in swine and dairy excreta. Samples were collected every 90 days for 15 months at eight farms, four pig, and four dairy farms, four of them having a biogas plant. Moreover, to evaluate storage effects on samples, 20 l of manure and slurry taken at each farm (digested manure only in farms with a biogas plant) were stored in a controlled climatic chamber at 18 °C, for 6 months. The bacterial load and the chemical-physical characteristics of excreta were evaluated at each sampling time, stored slurry, and manure were sampled and analyzed every 2 months. A high variability of the concentration of bacteria in the different excreta types was observed during the experiment, mainly depending on the type and time of treatment. No sample revealed either the presence of Escherichia coli O157:H7 or of Salmonella, usually linked to the temporary rearing of infected animals in facilities. Anaerobic digestion and storage affected in a significant way the reduction of indicator bacteria like lactobacilli, coliforms, and streptococci. Anaerobic digestion lowered coliforms in pig slurry (? 2.80 log, P < 0.05), streptococci in dairy manure (? 2.44 log, P < 0.001) and in pig slurry (? 1.43 log, P < 0.05), and lactobacilli in pig slurry (? 3.03 log, P < 0.05). Storage lowered coliforms and the other indicators counts, in particular in fresh wastes, while clostridia did not show a reduction in concentration.     

Microbiological risk assessment of Agios Georgios source supplies in Northwestern Greece based on faecal coliforms determination and sanitary inspection survey

The assessment of potential risks from microbiological contamination of drinking water supplies is of greatest concern to human health. The study involves the examination of water samples from Agios Georgios source that supplies the capitals, the major towns and several villages of Arta, Preveza and Lefkada prefectures, in Northwestern Greece. The study includes the sanitary inspection survey of the source and the microbiological examination of water samples on a monthly basis during the period February 1996-June 1999 except of Augusts (n=38). The microbiological risk assessment (MRA) approach of World Health Organisation (WHO) guidelines was applied to enhance the source protection. The faecal contamination of the source water was quantified using faecal coliforms (FC) as indicator bacteria. Microbiological analyses indicate that of the 38 samples analyzed the FC failure rate (positive samples) was 63.2% according to the limit set by the 98/83 directive of the European Union. The 36.8% of the source water samples was found in conformity with WHO guidelines, 42.1% of low risk, 21.1% of intermediate risk while there was not found samples of high or very high risk. Failure rates displayed a seasonal trend being greater during the winter, decreased during spring and autumn and lower during summer. This observation was explained partially by a significant positive relationship with the rainfall amount (r(Spearmann)=0.890, P=0.001). The sanitary inspection score was found 5/10 during the whole survey period that corresponds to an intermediate risk of source contamination. The color-code classification for FC contamination was found 36.8% A (blue, no risk), 42.1% B (green, low risk) and 21.1% C (yellow, intermediate risk). The previous risks were combined for the assessment of waterborne risk, which was determined as intermediate to high; therefore there is a need for high action priority. The potential remedial actions were also suggested in order to improve the source protection of such supplies.     

Nitrogen transformations and balance in constructed wetlands for slightly polluted river water treatment using different macrophytes

Nitrogen removal processing in different constructed wetlands treating different kinds of wastewater often varies, and the contribution to nitrogen removal by various pathways remains unclear. In this study, the seasonal nitrogen removal and transformations as well as nitrogen balance in wetland microcosms treating slightly polluted river water was investigated. The results showed that the average total nitrogen removal rates varied in different seasons. According to the mass balance approach, plant uptake removed 8.4–34.3 % of the total nitrogen input, while sediment storage and N₂O emission contributed 20.5–34.4 % and 0.6–1.9 % of nitrogen removal, respectively. However, the percentage of other nitrogen loss such as N₂ emission due to nitrification and denitrification was estimated to be 2.0–23.5 %. The results indicated that plant uptake and sediment storage were the key factors limiting nitrogen removal besides microbial processes in surface constructed wetland for treating slightly polluted river water.     

Urinary concentrations of trichlorophenols in the Korean adult population: results of the National Human Biomonitoring Survey 2009

Trichlorophenols such as 2,4,5-trichlorophenol (2,4,5-TCP) and 2,4,6-trichlorophenol (2,4,6-TCP) are organochlorine compounds to which the general public can be exposed via contaminated food, water, and air. This study assessed exposure to 2,4,5-TCP and 2,4,6-TCP in Koreans age 18–69 years based on the Korean National Human Biomonitoring Survey conducted in 2009. Using data from 1,865 representative Koreans, we found that the geometric mean urinary concentrations of 2,4,5-TCP and 2,4,6-TCP were 83.4 pg/mL [95 % confidence interval (CI)?=?78.6–88.6] and 0.39 ng/mL (95 % CI?=?0.35–0.42), respectively. The creatinine-adjusted geometric mean 2,4,5-TCP and 2,4,6-TCP levels were 78.8 ng/g creatinine (95 % CI?=?73.8–84.1) and 0.36 μg/g creatinine (95 % CI?=?0.33–0.40), respectively. Of the Korean adult population, about 67.5 and 87.5 % had respective urine 2,4,5-TCP and 2,4,6-TCP concentrations >0.05 ng/mL (the limit of detection, LOD). Urine 2,4,5-TCP concentrations were significantly associated with age and place of residence, whereas urine 2,4,6-TCP concentrations were higher in rural residents. These findings suggest that most Koreans had detectable levels of 2,4,5-TCP and 2,4,6-TCP in their urine and that the body burden of 2,4,5-TCP and 2,4,6-TCP varied according to demographic and geographic factors.     

Effects of air pollution on lung function and symptoms of asthma, rhinitis and eczema in primary school children

Health effects of ambient air pollution were studied in three groups of schoolchildren living in areas (suburban, urban and urban-traffic) with different air pollution levels in Eski?ehir, Turkey. This study involved 1,880 students aged between 9 and 13 years from 16 public primary schools. This two-season study was conducted from January 2008 through March 2009. Symptoms of asthma, rhinitis and eczema were determined by the International Study of Asthma and Allergies in Childhood questionnaire in 2008. Two lung function tests were performed by each child for summer and winter seasons with simultaneous ambient air measurements of ozone (O₃), nitrogen dioxide (NO₂) and sulfur dioxide (SO₂) by passive sampling. Effects of air pollution on impaired lung function and symptoms in schoolchildren were estimated by multivariate logistic regression analyses. Girls with impaired lung function (only for the summer season evaluation) were more observed in suburban and urban areas when compared to urban-traffic area ([odds ratio (OR)?=?1.49; 95 % confidence interval (CI) 1.04–2.14] and [OR?=?1.69 (95 % CI 1.06–2.71)] for suburban vs. urban-traffic and urban vs. urban-traffic, respectively). Significant association between ambient ozone concentrations and impaired lung function (for an increase of 10 μg m^?3) was found only for girls for the summer season evaluation [OR?=?1.11 (95 % CI 1.03–1.19)]. No association was found for boys and for the winter season evaluation. No association was found between any of the measured air pollutants and symptoms of current wheeze, current rhinoconjunctivitis and current itchy rash. The results of this study showed that increasing ozone concentrations may cause a sub-acute impairment in lung function of school aged children.     

Screening of endocrine-disrupting phenols, herbicides, steroid estrogens, and estrogenicity in drinking water from the waterworks of 35 Italian cities and from PET-bottled mineral water

We investigated contamination by endocrine-disrupting chemicals in drinking water from 35 major Italian cities and five popular Italian brands of bottled mineral water. The quality of Italian drinking water was assessed by combing chemical analysis with bioassay to quantify specific estrogenic contaminants and to characterize the actual biological effect of the mixture of chemicals present in drinking water including the contribution of not targeted compounds. The selected contaminants were natural and synthetic steroid estrogens, alkylphenols and bisphenol A, linuron, triazine herbicides, and their metabolites. A specific analytical method was developed based on solid phase extraction of 1 L of water and concentration to 100 μL for quantification by electrospray ionization liquid chromatography tandem mass spectrometry, achieving quantification limits of 0.05–0.36 ng/L for herbicides and 0.64–7.70 ng/L for steroids and phenols. No steroid estrogens were detected in any of the samples, while bisphenol A and nonylphenols were detected in the ranges of 0.82–102.00 and 10.30–84.00 ng/L respectively. Herbicides and their degradation products, when present, were found from slightly above the quantification limits up to 49.91 ng/L, mainly from cities in northern Italy. Chemical analyses were complemented by the performance of a bioassay for the determination of the estrogenic activity in the extracts based on the transactivation of estrogen receptor α-transfected reporter HeLa-ERE-Luciferase-Neomycin cell line. Activity was generally low with maximum estrogenicity of 13.6 pg/L estradiol equivalents.     

Evaluating exposure of pedestrians to airborne contaminants associated with non-potable water use for pavement cleaning

Climate change and increasing demography press local authorities to look after affordable water resources and replacement of drinking water for city necessities like street and pavement cleaning by more available raw water. Though, the substitution of drinking by non-drinking resources demands the evaluation of sanitary hazards. This article aims therefore to evaluate the contribution of cleaning water to the overall exposure of city dwellers in case of wet pavement cleaning using crossed physical, chemical and biological approaches. The result of tracer experiments with fluorescein show that liquid water content of the cleaning aerosol produced is about 0.24 g m^?3, rending possible a fast estimation of exposure levels. In situ analysis of the aerosol particles indicates a significant increase in particle number concentration and particle diameter, though without change in particle composition. The conventional bacterial analysis using total coliforms as tracer suggests that an important part of the contamination is issued from the pavement. The qPCR results show a more than 20-fold increase of background genome concentration for Escherichia coli and 10-fold increase for Enterococcus but a negligible contribution of the cleaning water. The fluorescence analysis of the cleaning aerosol confirms the above findings identifying pavement surface as the major contributor to aerosol organic load. The physical, chemical and microbiological approaches used make it possible to describe accurately the cleaning bioaerosol and to identify the existence of significantly higher levels of all parameters studied during the wet pavement cleaning. Though, the low level of contamination and the very short time of passage of pedestrian in the zone do not suggest a significant risk for the city dwellers. As the cleaning workers remain much longer in the impacted area, more attention should be paid to their chronic exposure.     

Urinary levels of phthalate metabolites and associations with demographic characteristics in Korean adults

The objective of this study is to assess human exposure to phthalates and its associations with demographic characteristics of the subjects in the Korean National Human Biomonitoring Survey. The subjects aged between 18 and 69 were selected through nationwide stratified sampling. A total of 1874 urine samples were collected and stored at ?20 °C until measurement for ten selected metabolites of phthalates (MnBP, MiBP, MBzP, MCHP, MnOP, MEHP, MEOHP, MEHHP, MiNP, and MiDP) using high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). The difference in the level of urinary phthalate metabolites by the characteristics of the subjects was tested for statistical significance using SAS Surveyreg procedure. The coefficients and standard errors from multiple linear regressions were exponentiated to estimate the adjusted proportional change (APC) and 95% CIs compared with a referent level. The proportion of data above LOQ was less than 20% for MCHP, MnOP, MiNP, and MiDP. Geometric means of creatinine-adjusted concentrations (unit: μg/g creatinine) of six other phthalate metabolites among Korean adults were 41.7 (95% CI 39.6–43.9) for MnBP, 17.1 (95% CI 16.1–18.1) for MiBP, 15.7 (95% CI 14.4–17.1) for MBzP, 8.65 (95% CI 8.10–9.22) for MEHP, 17.5 (95% CI 16.8–18.3) for MEOHP, and 38.1 (95% CI 36.2–40.2) for MEHHP. Urinary level of phthalates tended to be higher among subjects with older age, females, and those with vigorous daily physical activity and tended to be lower among drinkers and those with higher income. Our results suggest that the level of phthalate exposure is significant among Korean adults and thus warrants further studies to identify major source and route of exposure to phthalates.     

Determination of pharmaceuticals, personal care products, and pesticides in surface and treated waters: method development and survey

Water is fundamental to the existence of life since it is essential to a series of activities, such as agriculture, power generation, and public and industrial supplies. The residual water generated by these activities is released into the environment, reaches the water systems, and becomes a potential risk to nontarget organisms. This paper reports the development and validation of a quantitative method, based on solid-phase extraction and liquid chromatography tandem mass spectrometry, for the simultaneous analysis of 18 pharmaceuticals and personal care products (PPCPs) and 33 pesticides in surface and drinking waters. The accuracy of the method was determined by calculating the recoveries, which ranged from 70 to 120 % for most pesticides and PPCPs, whereas limits of quantification ranged from 0.8 to 40 ng/L. After the validation step, the method was applied to drinking and surface waters. Pesticides and PPCPs were found in concentrations lower than 135.5 ng/L. The evaluation of different water sources with regard to contamination by pesticides and PPCPs has been quite poor in southern Brazil.     

Air pollution and hospital visits for acute upper and lower respiratory infections among children in Ningbo,China: A time-series analysis

Acute upper and lower respiratory infections are main causes of mortality and morbidity in children. Air pollution has been recognized as an important contributor to development and exacerbation of respiratory infections. However, few studies are available in China. In this study, we investigated the short-term effect of air pollution on hospital visits for acute upper and lower respiratory infections among children under 15 years in Ningbo, China. Poisson generalized models were used to estimate the associations between air pollution and hospital visits for acute upper and lower respiratory infections adjusted for temporal, seasonal, and meteorological effects. We found that four pollutants (PM_2.5, PM₁₀, NO₂, and SO₂) were significantly associated with hospital visits for acute upper and lower respiratory infections. The effect estimates for acute upper respiratory infections tended to be higher (PM_2.5 ER = 3.46, 95% CI 2.18, 4.76; PM₁₀ ER = 2.81, 95% CI 1.93, 3.69; NO₂ ER = 11.27, 95% CI 8.70, 13.89; SO₂ ER = 15.17, 95% CI 11.29, 19.19). Significant associations for gaseous pollutants (NO₂ and SO₂) were observed after adjustment for particular matter. Stronger associations were observed among older children and in the cold period. Our study suggested that short-term exposure to outdoor air pollution was associated with hospital visits for acute upper and lower respiratory infections in Ningbo.     

Concentrations of perfluoroalkyl compounds in maternal and umbilical cord sera and birth outcomes in Korea

This study analyzed the concentrations of perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA) and perfluorohexane sulfonate (PFHxS) in maternal and umbilical cord sera at delivery from the general population in Korea. Seventy samples were analyzed with ion-pairing and LC/MS/MS. PFOS, PFOA and PFHxS were detected in both maternal and umbilical cord sera. There was a high correlation of PFC concentrations between maternal and cord serum samples, implying transplacental transport. Ranking of transplacental transfer efficiency was PFOA > PFHxS > PFOS. Student’s t-tests revealed that concentrations of maternal PFOA were related with decreases in birth weight, birth length and ponderal index, suggesting a possible impact on fetal growth. With multiple logistic regression models, maternal PFOS concentration showed a significant inverse association with ponderal index (OR = 0.22; 95% CI, 0.05–0.90). Umbilical cord PFHxS concentration showed a significant inverse association with birth weight (OR = 0.26; 95% CI, 0.08–0.85) or a marginally significant inverse association with birth length (OR = 0.33; 95% CI, 0.09–1.17). This is the first report demonstrating an inverse association of birth outcomes with PFHxS exposure. Concentrations of maternal PFOA were decreased with parity, implying that delivery is one of the major routes for PFOA elimination in women. This study demonstrated prenatal exposure of PFCs through placental transfer which could result in possible developmental effects in the population sampled. Our results may provide data basis to conduct a larger scale investigation into developmental effects of PFCs in the future and contribute to understanding levels of PFC contaminations from a variety of populations in the globe.