Associations between short/medium-term variations in black smoke air pollution and mortality in the Glasgow conurbation,UK

ObjectivesTo examine associations between short/medium-term variations in black smoke air pollution and mortality in the population of Glasgow and the adjacent towns of Renfrew and Paisley over a 25-year period at different time lags (0–30 days).MethodsGeneralised linear (Poisson) models were used to investigate the relationship between lagged black smoke concentrations and daily mortality, with allowance for confounding by cold temperature, between 1974 and 1998.ResultsWhen a range of lag periods were investigated significant associations were noted between temperature-adjusted black smoke exposure and all-cause mortality at lag periods of 13–18 and 19–24 days, and respiratory mortality at lag periods of 1–6, 7–12, and 13–18 days. Significant associations between cardiovascular mortality and temperature-adjusted black smoke were not observed. After adjusting for the effects of temperature a 10 μg m^− 3 increase in black smoke concentration on a given day was associated with a 0.9% [95% Confidence Interval (CI): 0.3–1.5%] increase in all cause mortality and a 3.1% [95% CI: 1.4–4.9%] increase in respiratory mortality over the ensuing 30-day period. In contrast for a 10 μg m^− 3 increase in black smoke concentration over 0–3 day lag period, the temperature adjusted exposure mortality associations were substantially lower (0.2% [95% CI: − 0.0–0.4%] and 0.3% [95% CI: − 0.2–0.8%] increases for all-cause and respiratory mortality respectively).ConclusionsThis study has provided evidence of association between black smoke exposure and mortality at longer lag periods than have been investigated in the majority of time series analyses.     

Saharan dust,particulate matter and cause-specific mortality: A case–crossover study in Barcelona (Spain)

BackgroundStudies measuring health effects of Saharan dust based on large particulate matter (PM) fraction groups may be masking some effects. Long distant transport reduces the amount of heavier and larger particles in the Saharan air masses increasing the relative contribution of smaller particles that may be more innocuous. This study investigates the association between different PM fractions and daily mortality during Saharan and non-Saharan days in Barcelona, Spain.MethodsWe collected daily PM₁, PM_2.5–1 and PM_10–2.5 fractions, and cause-specific mortality (cardiovascular, respiratory and cerebrovascular) between March 2003 and December 2007. Changes of effects between Saharan and non-Saharan dust days were assessed using a time-stratified case–crossover design.ResultsDuring non-Saharan dust days we found statistically significant (p < 0.05) effects of PM_10–2.5 for cardiovascular (odds ratio for increase of an interquartile range, OR = 1.033, 95% confidence interval: 1.006–1.060) and respiratory mortality (OR = 1.044, 95% CI: 1.001–1.089). During Saharan dust days strongest cardiovascular effects were found for the same fraction (OR = 1.085, 95% CI: 1.017–1.158) with an indication of effect modification (p = 0.111). Effects of PM_2.5–1 during Saharan dust days were about the double than in non-dust days for cardiovascular and respiratory mortality, but these differences were not statistically significant.ConclusionOur results using independent fractions of PMs provide further evidence that the effects of short-term exposure to PM during Saharan dust days are associated with both cardiovascular and respiratory mortality. A better understanding of which of the different PM size fractions brought by Saharan dust is more likely to accelerate adverse effects may help better understand mechanisms of toxicity.     

Changing patterns of the temperature–mortality association by time and location in the US,and implications for climate change

The shape of the non-linear relationship between temperature and mortality varies among cities with different climatic conditions. There has been little examination of how these curves change over space and time. We evaluated the short-term effects of hot and cold temperatures on daily mortality over six 7-year periods in 211 US cities, comprising over 42 million deaths. Cluster analysis was used to group the cities according to similar temperatures and relative humidity. Temperature–mortality functions were calculated using B-splines to model the heat effect (lag 0) and the cold effect on mortality (moving average lags 1–5). The functions were then combined through meta-smoothing and subsequently analyzed by meta-regression. We identified eight clusters. At lag 0, Cluster 5 (West Coast) had a RR of 1.14 (95% CI: 1.11,1.17) for temperatures of 27 °C vs 15.6 °C, and Cluster 6 (Gulf Coast) has a RR of 1.04 (95% CI: 1.03,1.05), suggesting that people are acclimated to their respective climates. Controlling for cluster effect in the multivariate-meta regression we found that across the US, the excess mortality from a 24-h temperature of 27 °C decreased over time from 10.6% to 0.9%. We found that the overall risk due to the heat effect is significantly affected by summer temperature mean and air condition usage, which could be a potential predictor in building climate-change scenarios.     

Association between long-term exposure to air pollution and mortality in France: A 25-year follow-up study

IntroductionLong-term exposure to air pollution (AP) has been shown to have an impact on mortality in numerous countries, but since 2005 no data exists for France.ObjectivesWe analyzed the association between long-term exposure to air pollution and mortality at the individual level in a large French cohort followed from 1989 to 2013.MethodsThe study sample consisted of 20,327 adults working at the French national electricity and gas company EDF-GDF. Annual exposure to PM₁₀, PM_10–2.5, PM_2.5, NO₂, O₃, SO₂, and benzene was assessed for the place of residence of participants using a chemistry-transport model and taking residential history into account. Hazard ratios were estimated using a Cox proportional-hazards regression model, adjusted for selected individual and contextual risk factors. Hazard ratios were computed for an interquartile range (IQR) increase in air pollutant concentrations.ResultsThe cohort recorded 1967 non-accidental deaths. Long-term exposures to baseline PM_2.5, PM_10-25, NO₂ and benzene were associated with an increase in non-accidental mortality (Hazard Ratio, HR = 1.09; 95% CI: 0.99, 1.20 per 5.9 μg/m³, PM_10-25; HR = 1.09;95% CI: 1.04, 1.15 per 2.2 μg/m³, NO₂: HR = 1.14; 95% CI: 0.99, 1.31 per 19.3 μg/m³ and benzene: HR = 1.10; 95% CI: 1.00, 1.22 per 1.7 μg/m³).The strongest association was found for PM₁₀: HR = 1.14; 95% CI: 1.05, 1.25 per 7.8 μg/m³. PM₁₀, PM_10-25 and SO₂ were associated with non-accidental mortality when using time varying exposure. No significant associations were observed between air pollution and cardiovascular and respiratory mortality.ConclusionLong-term exposure to fine particles, nitrogen dioxide, sulfur dioxide and benzene is associated with an increased risk of non-accidental mortality in France. Our results strengthen existing evidence that outdoor air pollution is a significant environmental risk factor for mortality. Due to the limited sample size and the nature of our study (occupational), further investigations are needed in France with a larger representative population sample.     

Tobacco smoke increases the risk of otitis media among Greenlandic Inuit children while exposure to organochlorines remain insignificant

BackgroundPrenatal exposure to environmental levels of organochlorines (OCs) has been demonstrated to have immunotoxic effects in humans. We investigated the relationship between prenatal exposure to OCs and the occurrence of otitis media (OM) among Inuit children in Greenland.MethodsWe estimated the concentration of 14 PCB congeners and 11 pesticides in maternal and cord blood samples and in breast milk in a population-based cohort of 400 mother–child pairs. At follow-up, we examined the children's ears and used their medical records to assess the OM occurrence and severity. Multivariate regression analyses were used with adjustments for passive smoking, crowding, dietary habits, parent's educational level, breast feeding and the use of child-care.ResultsThe children were 4–10 years of age at follow-up and 223 (85%) participated. We found no association between prenatal OC exposure and the development of OM. Factors associated with the child's hazard of OM during the first 4 years of life were: mother's history of OM (HR 1.70, 95% CI 1.11–2.59, p = 0.01); mother's smoking habits: current (HR 2.47, 95% CI 1.45–4.21, p < 0.01) and previous (HR 2.00, 95% CI 1.19–3.36, p < 0.01); number of smokers in the home (HR 1.17, 95% CI 1.05–1.31, p < 0.01). After adjustment mothers' smoking habits remained significant.ConclusionWe found no relationship between high levels of prenatal exposure of OCs and occurrence of OM. Passive smoking was found as the strongest environmental risk factor for the development of OM.Interventions to reduce passive smoke in children's environment are needed.     

Effect of heat waves on morbidity and mortality due to Parkinson's disease in Madrid: A time-series analysis

BackgroundParkinson's disease (PD) is one of the factors which are associated with a higher risk of mortality during heat waves. The use of certain neuroleptic medications to control some of this disease's complications would appear to be related to an increase in heat-related mortality.ObjectiveTo analyse the relationship and quantify the short-term effect of high temperatures during heat wave episodes in Madrid on daily mortality and PD-related hospital admissions.MethodsWe used an ecological time-series study and fit Poisson regression models. We analysed the daily number of deaths due to PD and the number of daily PD-related emergency hospital admissions in the city of Madrid, using maximum daily temperature (°C) as the main environmental variable and chemical air pollution as covariates. We controlled for trend, seasonalities, and the autoregressive nature of the series.ResultsThere was a maximum daily temperature of 30 °C at which PD-related admissions were at a minimum. Similarly, a temperature of 34 °C coincides with an increase in the number of admissions. For PD-related admissions, the Relative Risk (RR) for every increase of 1 °C above the threshold temperature was 1.13 IC95%:(1.03–1.23) at lags 1 and 5; and for daily PD-related mortality, the RR was 1.14 IC95%:(1.01–1.28) at lag 3.ConclusionOur results indicate that suffering from PD is a risk factor that contributes to the excess morbidity and mortality associated with high temperatures, and is relevant from the standpoint of public health prevention plans.     

Analysing the health effects of simultaneous exposure to physical and chemical properties of airborne particles

BackgroundAirborne particles are a complex mix of organic and inorganic compounds, with a range of physical and chemical properties. Estimation of how simultaneous exposure to air particles affects the risk of adverse health response represents a challenge for scientific research and air quality management. In this paper, we present a Bayesian approach that can tackle this problem within the framework of time series analysis.MethodsWe used Dirichlet process mixture models to cluster time points with similar multipollutant and response profiles, while adjusting for seasonal cycles, trends and temporal components. Inference was carried out via Markov Chain Monte Carlo methods. We illustrated our approach using daily data of a range of particle metrics and respiratory mortality for London (UK) 2002–2005. To better quantify the average health impact of these particles, we measured the same set of metrics in 2012, and we computed and compared the posterior predictive distributions of mortality under the exposure scenario in 2012 vs 2005.ResultsThe model resulted in a partition of the days into three clusters. We found a relative risk of 1.02 (95% credible intervals (CI): 1.00, 1.04) for respiratory mortality associated with days characterised by high posterior estimates of non-primary particles, especially nitrate and sulphate. We found a consistent reduction in the airborne particles in 2012 vs 2005 and the analysis of the posterior predictive distributions of respiratory mortality suggested an average annual decrease of − 3.5% (95% CI: − 0.12%, − 5.74%).ConclusionsWe proposed an effective approach that enabled the better understanding of hidden structures in multipollutant health effects within time series analysis. It allowed the identification of exposure metrics associated with respiratory mortality and provided a tool to assess the changes in health effects from various policies to control the ambient particle matter mixtures.     

Associations between ultrafine and fine particles and mortality in five central European cities — Results from the UFIREG study

BackgroundEvidence on health effects of ultrafine particles (UFP) is still limited as they are usually not monitored routinely. The few epidemiological studies on UFP and (cause-specific) mortality so far have reported inconsistent results.ObjectivesThe main objective of the UFIREG project was to investigate the short-term associations between UFP and fine particulate matter (PM) < 2.5 μm (PM_2.5) and daily (cause-specific) mortality in five European Cities. We also examined the effects of PM < 10 μm (PM₁₀) and coarse particles (PM_2.5–10).MethodsUFP (20–100 nm), PM and meteorological data were measured in Dresden and Augsburg (Germany), Prague (Czech Republic), Ljubljana (Slovenia) and Chernivtsi (Ukraine). Daily counts of natural and cardio-respiratory mortality were collected for all five cities. Depending on data availability, the following study periods were chosen: Augsburg and Dresden 2011–2012, Ljubljana and Prague 2012–2013, Chernivtsi 2013–March 2014. The associations between air pollutants and health outcomes were assessed using confounder-adjusted Poisson regression models examining single (lag 0–lag 5) and cumulative lags (lag 0–1, lag 2–5, and lag 0–5). City-specific estimates were pooled using meta-analyses methods.ResultsResults indicated a delayed and prolonged association between UFP and respiratory mortality (9.9% [95%-confidence interval: − 6.3%; 28.8%] increase in association with a 6-day average increase of 2750 particles/cm³ (average interquartile range across all cities)). Cardiovascular mortality increased by 3.0% [− 2.7%; 9.1%] and 4.1% [0.4%; 8.0%] in association with a 12.4 μg/m³ and 4.7 μg/m³ increase in the PM_2.5- and PM_2.5–10-averages of lag 2–5.ConclusionsWe observed positive but not statistically significant associations between prolonged exposures to UFP and respiratory mortality, which were independent of particle mass exposures. Further multi-centre studies are needed investigating several years to produce more precise estimates on health effects of UFP.     

Non-specific physical symptoms and electromagnetic field exposure in the general population: Can we get more specific? A systematic review

ObjectiveA systematic review of observational studies was performed to address the strength of evidence for an association between actual and perceived exposure to electromagnetic fields (EMF) and non-specific physical symptoms (NSPS) in the general population. To gain more insight into the magnitude of a possible association, meta-analyses were conducted.MethodsLiterature databases Medline, Embase, SciSearch, PsychInfo, Psyndex and Biosis and additional bibliographic sources such as reference sections of key publications were searched for the detection of studies published between January 2000 and April 2011.ResultsTwenty-two studies met our inclusion criteria. Qualitative assessment of the epidemiological evidence showed either no association between symptoms and higher EMF exposure or contradictory results. To strengthen our conclusions, random effects meta-analyses were performed, which produced the following results for the association with actual EMF; for symptom severity: Headache odds ratio (OR) = 1.65; 95% confidence interval (CI) = 0.88–3.08, concentration problems OR = 1.28; 95% CI = 0.56–2.94, fatigue-related problems OR = 1.15; 95% CI = 0.59–2.27, dizziness-related problems OR = 1.38; 95% CI = 0.92–2.07. For symptom frequency: headache OR = 1.01; 95% CI = 0.66–1.53, fatigue OR = 1.12; 95% CI = 0.60–2.07 and sleep problems OR = 1.18; 95% CI = 0.80–1.74. Associations between perceived exposure and NSPS were more consistently observed but a meta-analysis was not performed due to considerable heterogeneity between the studies.ConclusionsThis systematic review and meta-analysis finds no evidence for a direct association between frequency and severity of NSPS and higher levels of EMF exposure. An association with perceived exposure seems to exist, but evidence is still limited because of differences in conceptualization and assessment methods.     

Climate change,extreme events and increased risk of salmonellosis in Maryland,USA: Evidence for coastal vulnerability

BackgroundSalmonella is a leading cause of acute gastroenteritis worldwide. Patterns of salmonellosis have been linked to weather events. However, there is a dearth of data regarding the association between extreme events and risk of salmonellosis, and how this risk may disproportionately impact coastal communities.MethodsWe obtained Salmonella case data from the Maryland Foodborne Diseases Active Surveillance Network (2002–2012), and weather data from the National Climatic Data Center (1960–2012). We developed exposure metrics related to extreme temperature and precipitation events using a 30 year baseline (1960–1989) and linked them with county-level salmonellosis data. Data were analyzed using negative binomial Generalized Estimating Equations.ResultsWe observed a 4.1% increase in salmonellosis risk associated with a 1 unit increase in extreme temperature events (incidence rate ratio (IRR):1.041; 95% confidence interval (CI):1.013–1.069). This increase in risk was more pronounced in coastal versus non-coastal areas (5.1% vs 1.5%). Likewise, we observed a 5.6% increase in salmonellosis risk (IRR:1.056; CI:1.035–1.078) associated with a 1 unit increase in extreme precipitation events, with the impact disproportionately felt in coastal areas (7.1% vs 3.6%).ConclusionsTo our knowledge, this is the first empirical evidence showing that extreme temperature/precipitation events—that are expected to be more frequent and intense in coming decades—are disproportionately impacting coastal communities with regard to salmonellosis. Adaptation strategies need to account for this differential burden, particularly in light of ever increasing coastal populations.     

Association between maternal exposure to perfluorooctanoic acid (PFOA) from electronic waste recycling and neonatal health outcomes

ObjectivePerfluorooctanoic acid (PFOA) has applications in numerous industrial and consumer products. The widespread prevalence of PFOA in humans demonstrated in recent studies has drawn considerable interest from the public. We aimed to evaluate the exposure of mothers to PFOA and the potential hazards to neonates in a primitive electronic waste recycling area, Guiyu, China, and a control area, Chaonan, China.MethodsOur investigation included analyses of maternal serum samples, health effect examinations, and other relevant factors. Questionnaires were administered and maternal serum samples were collected for 167 pregnant women. Solid phase extraction method was used for all analytical sample preparation, and analyses were completed using high performance liquid chromatography tandem mass spectrometry method.ResultsThe PFOA concentration was higher in maternal serum samples from Guiyu than in samples from Chaonan (median 16.95, range 5.5–58.5 ng mL^− 1; vs. 8.7, range 4.4–30.0 ng mL^− 1; P < 0.001). Residence in Guiyu, involvement in e-waste recycling, husband's involvement in e-waste and use of the family residence as workshop were significant factors contributing to PFOA exposure. Maternal PFOA concentrations were significantly different between normal births and adverse birth outcomes including premature delivery, term low birth weight, and stillbirths. After adjusting for potential confounders, PFOA was negatively associated with gestational age [per lg-unit: β = − 15.99 days, 95% confidence interval (CI), − 27.72 to − 4.25], birth weight (per lg-unit: β = − 267.3 g, 95% CI, − 573.27 to − 37.18), birth length (per lg-unit: β = − 1.91 cm, 95% CI, − 3.31 to − 0.52), and Apgar scores (per lg-unit: β = − 1.37, 95% CI, − 2.42 to − 0.32), but not associated with ponderal index.ConclusionsMothers from Guiyu were exposed to higher levels of PFOA than those from control areas. Prenatal exposure to PFOA was associated with decreased neonatal physical development and adverse birth outcomes.     

Maternal urinary bisphenol A levels and infant low birth weight: A nested case–control study of the Health Baby Cohort in China

BackgroundExposure to bisphenol A (BPA), a known endocrine disruptor, has been demonstrated to affect fetal development in animal studies, but findings in human studies have been inconsistent.ObjectivesWe investigated whether maternal exposure to BPA during pregnancy is associated with an increased risk of infant low birth weight (LBW).MethodsA total 452 mother-infant pairs (113 LBW cases and 339 matched controls) were selected from the participants enrolled in the prospective Health Baby Cohort (HBC) in Wuhan city, China, during 2012–2014. BPA concentrations were measured in maternal urine samples collected at delivery, and the information of birth outcomes was retrieved from the medical records. A conditional logistic regression was used to evaluate the relationship between urinary BPA levels and LBW.ResultsMothers with LBW infants had significantly higher urinary BPA levels (median: 4.70 μg/L) than the control mothers (median: 2.25 μg/L) (p < 0.05). Increased risk of LBW was associated with higher maternal urinary levels of BPA [adjusted odds ratio (OR) = 3.13 for the medium tertile, 95% confidence interval (CI): 1.21, 8.08; adjusted OR = 2.49 for the highest tertile, 95% CI: 0.98, 6.36]. The association was more pronounced among female infants than among male infants, with a statistical evidence of heterogeneity in risk (p = 0.03).ConclusionsPrenatal exposure to higher levels of BPA may potentially increase the risk of delivering LBW infants, especially for female infants. This is the first case–control study to examine the association in China.     

Serum perfluorinated chemicals,glucose homeostasis and the risk of diabetes in working-aged Taiwanese adults

BackgroundThe link among perfluoroalkyl and polyfluoroalkyl substances (PFASs), abnormal glucose homeostasis and the risk of diabetes has been intensively debated with conflicting evidence.ObjectivesWe evaluated the associations among PFASs, oral glucose tolerance testing (OGTT) curves and diabetes prevalence in 571 working-aged Taiwanese participants.MethodsExposure measures included serum perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluoroundecanoic acid (PFUA). Outcomes were OGTT curves and prevalent diabetes defined by fasting blood glucose (FBG) ≥ 126 mg/dL, 2-h glucose ≥ 200 mg/dL, or glycated hemoglobin ≥ 6.5%. Analyses were performed with multiple logistic regression and functional data analysis.ResultsA total of 39 participants (6.8%) had diabetes in this study. After full adjustment, the increase in the geometric means of FBG, 2-h glucose concentrations, and area under the OGTT curve (AUC₁₂₀) with a doubling increase in PFOS was 3% (95% CI 1–4), 8% (5–12), and 6% (4–9), respectively. Compared to the lowest-quartile of PFOS concentrations (< 2.4 ng/ml), the OGTT trajectories were significantly steeper in participants of the highest-quartile PFOS exposure (> 4.8 ng/ml) and the vertical shifting of the mean curve for each PFOS quartile showed a dose–response pattern. The adjusted odds ratio for diabetes comparing the highest to lowest quartile was 3.37 (95% CI 1.18–9.65). For PFOA, PFNA, and PFUA, the opposite pattern of OGTT trajectory and the opposite risk profile for diabetes were observed.ConclusionsChronic PFOS exposure was associated with impaired glucose homeostasis and the increased prevalence of diabetes. However, PFOA, PFNA, and PFUA showed a potential protective effect against glucose intolerance and the risk of diabetes. Future research focusing on clarifying possible differential effects of different species of PFASs on glucose homeostasis and establishing the prospective associations between PFASs and diabetes is needed.     

Living near nuclear power plants and thyroid cancer risk: A systematic review and meta-analysis

There has been public concern regarding the safety of residing near nuclear power plants, and the extent of risk for thyroid cancer among adults living near nuclear power plants has not been fully explored. In the present study, a systematic review and meta-analysis of epidemiologic studies was conducted to investigate the association between living near nuclear power plants and the risk of thyroid cancer. A comprehensive literature search was performed on studies published up to March 2015 on the association between nuclear power plants and thyroid cancer risk. The summary standardized incidence ratio (SIR), standardized mortality ratio (SMR), and 95% confidence intervals (CIs) were calculated using a random-effect model of meta-analysis. Sensitivity analyses were performed by study quality. Thirteen studies were included in the meta-analysis, covering 36 nuclear power stations in 10 countries. Overall, summary estimates showed no significant increased thyroid cancer incidence or mortality among residents living near nuclear power plants (summary SIR = 0.98; 95% CI 0.87–1.11, summary SMR = 0.80; 95% CI 0.62–1.04). The pooled estimates did not reveal different patterns of risk by gender, exposure definition, or reference population. However, sensitivity analysis by exposure definition showed that living less than 20 km from nuclear power plants was associated with a significant increase in the risk of thyroid cancer in well-designed studies (summary OR = 1.75; 95% CI 1.17–2.64). Our study does not support an association between living near nuclear power plants and risk of thyroid cancer but does support a need for well-designed future studies.     

Fine particulate matter and risk of preterm birth and pre-labor rupture of membranes in Perth,Western Australia 1997–2007: A longitudinal study

ObjectiveA recent longitudinal study reported an association between fine particulate (PM_2.5) exposure and preterm birth (PTB) in a US cohort. We applied the same design to an Australian cohort to investigate associations with PTB and pre-labor rupture of membranes (PROM).MethodsFrom 287,680 births, we selected 39,189 women who had singleton births at least twice in Western Australia in 1997–2007 (n = 86,844 births). Analyses matched pregnancies to the same women with conditional logistic regression.ResultsFor PROM adjusted odds ratios (ORs) for a 1 μg/m³ increase in PM_2.5 in the first trimester, second trimester, third trimester, and whole pregnancy were 1.00 (95% confidence interval (CI): 0.97, 1.03), 1.03 (95% CI: 1.00, 1.06), 1.02 (95% CI: 1.00, 1.05), and 1.02 (95% CI: 0.99, 1.05) respectively. For PTB, corresponding ORs were 1.00 (95% CI: 0.96, 1.04), 1.00 (95% CI: 0.96, 1.04), 0.98 (95% CI: 0.94, 1.02), and 0.99 (95% CI: 0.95, 1.04) respectively.ConclusionRisk of PROM was greater for pregnancies with elevated PM_2.5 exposure in the second trimester than were other pregnancies to the same Australian women at lower exposure. There was insufficient evidence for an association with PTB, indicating that a longer time period might be needed to observe an association if a causal effect exists.     

Novel exposure biomarkers of N,N-diethyl-m-toluamide (DEET): Data from the 2007–2010 National Health and Nutrition Examination Survey

BackgroundN,N-diethyl-m-toluamide (DEET) is a widely used insect repellent in the United States.ObjectivesTo assess exposure to DEET in a representative sample of persons 6 years and older in the U.S. general population from the 2007–2010 National Health and Nutrition Examination Survey.MethodsWe analyzed 5348 urine samples by using online solid-phase extraction coupled to isotope dilution-high-performance liquid chromatography-tandem mass spectrometry. We used regression models to examine associations of various demographic parameters with urinary concentrations of DEET biomarkers.ResultsWe detected DEET in ~ 3% of samples and at concentration ranges (> 0.08 μg/L–45.1 μg/L) much lower than those of 3-(diethylcarbamoyl)benzoic acid (DCBA) (> 0.48 μg/L–30,400 μg/L) and N,N-diethyl-3-hydroxymethylbenzamide (DHMB) (> 0.09 μg/L–332 μg/L). DCBA was the most frequently detected metabolite (~ 84%). Regardless of survey cycle and the person's race/ethnicity or income, adjusted geometric mean concentrations of DCBA were higher in May–Sep than in Oct–Apr. Furthermore, non-Hispanic whites in the warm season were more likely than in the colder months [adjusted odds ratio (OR) = 10.83; 95% confidence interval (CI), 3.28–35.79] and more likely than non-Hispanic blacks (OR = 3.45; 95% CI, 1.51–7.87) to have DCBA concentrations above the 95th percentile.ConclusionsThe general U.S. population, including school-age children, is exposed to DEET. However, reliance on DEET as the sole urinary biomarker would likely underestimate the prevalence of exposure. Instead, oxidative metabolites of DEET are the most adequate exposure biomarkers. Differences by season of the year based on demographic variables including race/ethnicity likely reflect different lifestyle uses of DEET-containing products.     

Arsenic exposure,hyperuricemia, and gout in US adults

BackgroundThere is very limited information on the association between arsenic and serum uric acid levels or gout. The aim of this study was to investigate the association of arsenic with hyperuricemia and gout in US adults.MethodsA cross-sectional study was conducted in 5632 adults aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) 2003–2010 with determinations of serum uric acid and urine total arsenic and dimethylarsinate (DMA). Hyperuricemia was defined as serum uric acid higher than 7.0 mg/dL for men and 6.0 mg/dL for women. Gout was defined based on self-reported physician diagnosis and medication use.ResultsAfter adjustment for sociodemographic factors, comorbidities and arsenobetaine levels, the increase in the geometric means of serum uric acid associated with one interquartile range increase in total arsenic and DMA levels was 3% (95% CI 2–5) and 3% (2–5), respectively, in men and 1% (0–3) and 2% (0–4), respectively, in women. In men, the adjusted odds ratio for hyperuricemia comparing the highest to lowest quartiles of total arsenic was 1.84 (95% CI, 1.26–2.68) and for DMA it was 1.41 (95% CI, 1.01–1.96). The corresponding odds ratios in women were 1.26 (0.77, 2.07) and 1.49 (0.96, 2.31), respectively. The odds ratio for gout comparing the highest to lowest tertiles was 5.46 (95% CI, 1.70–17.6) for total arsenic and 1.98 (0.64–6.15) for DMA among women older than 40 years old. Urine arsenic was not associated with gout in men.ConclusionLow level arsenic exposures may be associated with the risk of hyperuricemia in men and with the prevalence of gout in women. Prospective research focusing on establishing the direction of the relationship among arsenic, hyperuricemia, and gout is needed.     

Association of modeled long-term personal exposure to ultrafine particles with inflammatory and coagulation biomarkers

BackgroundLong-term exposure to fine particulate matter has been linked to cardiovascular disease and systemic inflammatory responses; however, evidence is limited regarding the effects of long-term exposure to ultrafine particulate matter (UFP, < 100 nm). We used a cross-sectional study design to examine the association of long-term exposure to near-highway UFP with measures of systemic inflammation and coagulation.MethodsWe analyzed blood samples from 408 individuals aged 40–91 years living in three near-highway and three urban background areas in and near Boston, Massachusetts. We conducted mobile monitoring of particle number concentration (PNC) in each area, and used the data to develop and validate highly resolved spatiotemporal (hourly, 20 m) PNC regression models. These models were linked with participant time-activity data to determine individual time-activity adjusted (TAA) annual average PNC exposures. Multivariable regression modeling and stratification were used to assess the association between TAA-PNC and single peripheral blood measures of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor-necrosis factor alpha receptor II (TNFRII) and fibrinogen.ResultsAfter adjusting for age, sex, education, body mass index, smoking and race/ethnicity, an interquartile-range (10,000 particles/cm³) increase in TAA-PNC had a positive non-significant association with a 14.0% (95% CI: − 4.6%, 36.2%) positive difference in hsCRP, an 8.9% (95% CI: − 0.4%, 10.9%) positive difference in IL-6, and a 5.1% (95% CI: − 0.4%, 10.9%) positive difference in TNFRII. Stratification by race/ethnicity revealed that TAA-PNC had larger effect estimates for all three inflammatory markers and was significantly associated with hsCRP and TNFRII in white non-Hispanic, but not East Asian participants. Fibrinogen had a negative non-significant association with TAA-PNC.ConclusionsOur findings suggest an association between annual average near-highway TAA-PNC and subclinical inflammatory markers of CVD risk.     

Health effects for the population living near a cement plant: An epidemiological assessment

Epidemiological studies have shown the association between the exposure to air pollution and several adverse health effects. To evaluate the possible acute health effects of air pollution due to the emissions of a cement plant in two small municipalities in Italy (Mazzano and Rezzato), a case–control study design was used. The risks of hospital admission for cardiovascular or respiratory diseases for increasing levels of exposure to cement plant emissions were estimated, separately for adults (age > 34 years) and children (0–14 years). Odds ratios (OR) were estimated using unconditional regression models. Attributable risks were also calculated.Statistically significant risks were found mainly for respiratory diseases among children: OR 1.67 (95% CI 1.08–2.58) for the moderately exposed category (E1), OR 1.88 (95% CI 1.19–2.97) for the highly exposed category (E2), with an attributable risk of 38% of hospital admissions due to the exposure to cement plant exhausts. Adults had a weaker risk: OR 1.38 (95% CI 1.18–1.61) for group E1, OR 1.31 (95% CI 1.10–1.56) for group E2; the attributable risk was 23%. Risks were higher for females and for the age group 35–64. These results showed an association between the exposure to plant emissions and the risk of hospital admission for cardiovascular or respiratory causes; this association was particularly strong for children.     

Umbilical cord blood PBDEs concentrations are associated with placental DNA methylation

BackgroundIn utero polybrominated diphenyl ethers (PBDEs) exposure has been associated with adverse fetal growth. Alterations in placental DNA methylation might mediate those adverse effects.ObjectivesTo examine the associations between in utero PBDEs exposure and DNA methylation in human placenta.MethodsEighty apparently healthy mother-newborn pairs delivering at the Second Affiliated Hospital of Wenzhou Medical College were enrolled in this study. Placental DNA methylation of LINE1, NR3C1 and IGF2 was measured by quantitative polymerase chain reaction-pyrosequencing. In utero PBDEs exposure was assessed by measuring umbilical cord blood PBDEs concentrations.ResultsFor LINE-1, higher levels of BDE-66 exposure were associated with decreased DNA methylation (β = − 0.9, 95% CI, − 1.8 to − 0.1); For NR3C1, BDE-153 concentrations was significantly inversely associated with DNA methylation (β = − 2.0, 95% CI, − 3.7 to − 0.2); For IGF2, elevated concentrations of both BDE-153 (β = − 1.7; 95% CI, − 3.0 to − 0.4) and BDE-209 (β = − 1.0; 95% CI, − 1. 9 to − 0.1) were significantly associated with decreased DNA methylation.ConclusionsWe found that placental DNA methylation is associated with in utero PBDEs exposure. Changes in placental DNA methylation might be part of the underlying biological pathway between in utero PBDEs exposure and adverse fetal growth.