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.     

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.     

“Science is Everywhere,but No One Knows It”: Assessing the Cultural Distance to Science of Rural South African Publics

ABSTRACT

In science communication, a prerequisite for reaching different parts of a society is to find out how these publics experience and interpret science. Since rural South African publics are perceived to exhibit a large cultural distance to science, the present exploratory study aimed to know in more detail how rural South Africans perceive and understand science in their local and social contexts. Theoretical notions on cultural distance and the methodological approach of segmentation studies were considered. Semi-structured interviews with rural South Africans were carried out in four towns (n?=?52) that differ with respect to having a large scientific installation in their vicinity, or not. Sensitively comparing local and social contexts helped identifying three different publics who differed regarding their perceptions of science; however, the large scientific installations only made a difference in perceptions for those publics who were generally less exposed to and less knowledgeable about science.     

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.     

The short-term effect of heat waves on mortality and its modifiers in China: An analysis from 66 communities

BackgroundMany studies have reported increased mortality risk associated with heat waves. However, few have assessed the health impacts at a nation scale in a developing country. This study examines the mortality effects of heat waves in China and explores whether the effects are modified by individual-level and community-level characteristics.MethodsDaily mortality and meteorological variables from 66 Chinese communities were collected for the period 2006–2011. Heat waves were defined as ≥ 2 consecutive days with mean temperature ≥ 95th percentile of the year-round community-specific distribution. The community-specific mortality effects of heat waves were first estimated using a Distributed Lag Non-linear Model (DLNM), adjusting for potential confounders. To investigate effect modification by individual characteristics (age, gender, cause of death, education level or place of death), separate DLNM models were further fitted. Potential effect modification by community characteristics was examined using a meta-regression analysis.ResultsA total of 5.0% (95% confidence intervals (CI): 2.9%–7.2%) excess deaths were associated with heat waves in 66 Chinese communities, with the highest excess deaths in north China (6.0%, 95% CI: 1%–11.3%), followed by east China (5.2%, 95% CI: 0.4%–10.2%) and south China (4.5%, 95% CI: 1.4%–7.6%). Our results indicate that individual characteristics significantly modified heat waves effects in China, with greater effects on cardiovascular mortality, cerebrovascular mortality, respiratory mortality, the elderly, females, the population dying outside of a hospital and those with a higher education attainment. Heat wave mortality effects were also more pronounced for those living in urban cities or densely populated communities.ConclusionHeat waves significantly increased mortality risk in China with apparent spatial heterogeneity, which was modified by some individual-level and community-level factors. Our findings suggest adaptation plans that target vulnerable populations in susceptible communities during heat wave events should be developed to reduce health risks.     

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.     

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.     

Traffic-related air pollution and hyperactivity/inattention,dyslexia and dyscalculia in adolescents of the German GINIplus and LISAplus birth cohorts

BackgroundFew studies have examined the link between air pollution exposure and behavioural problems and learning disorders during late childhood and adolescence.ObjectivesTo determine whether traffic-related air pollution exposure is associated with hyperactivity/inattention, dyslexia and dyscalculia up to age 15 years using the German GINIplus and LISAplus birth cohorts (recruitment 1995–1999).MethodsHyperactivity/inattention was assessed using the German parent-completed (10 years) and self-completed (15 years) Strengths and Difficulties Questionnaire. Responses were categorized into normal versus borderline/abnormal. Parent-reported dyslexia and dyscalculia (yes/no) at age 10 and 15 years were defined using parent-completed questionnaires. Individual-level annual average estimates of nitrogen dioxide (NO₂), particulate matter (PM)₁₀ mass, PM_2.5 mass and PM_2.5 absorbance concentrations were assigned to each participant's birth, 10 year and 15 year home address. Longitudinal associations between the air pollutants and the neurodevelopmental outcomes were assessed using generalized estimation equations, separately for both study areas, and combined in a random-effects meta-analysis. Odds ratios and 95% confidence intervals are given per interquartile range increase in pollutant concentration.ResultsThe prevalence of abnormal/borderline hyperactivity/inattention scores and parental-reported dyslexia and dyscalculia at 15 years of age was 12.9%, 10.5% and 3.4%, respectively, in the combined population (N = 4745). In the meta- analysis, hyperactivity/inattention was associated with PM_2.5 mass estimated to the 10 and 15 year addresses (1.12 [1.01, 1.23] and 1.11 [1.01, 1.22]) and PM_2.5 absorbance estimated to the 10 and 15 year addresses (1.14 [1.05, 1.25] and 1.13 [1.04, 1.23], respectively).ConclusionsWe report associations suggesting a potential link between air pollution exposure and hyperactivity/inattention scores, although these findings require replication.     

Exposure to emissions from municipal solid waste incinerators and miscarriages: A multisite study of the MONITER Project

BackgroundMiscarriages are an important indicator of reproductive health but only few studies have analyzed their association with exposure to emissions from municipal solid waste incinerators.This study analyzed the occurrence of miscarriages in women aged 15–49 years residing near seven incinerators of the Emilia-Romagna Region (Northern Italy) in the period 2002–2006.MethodsWe considered all pregnancies occurring in women residing during the first trimester of pregnancy within a 4 km radius of each incinerator. Addresses were geocoded and exposures were characterized by a dispersion model (ADMS Urban model) producing pollution maps for incinerators based on PM₁₀ stack measurements and for other pollution sources based on NO_x ground measurements. Information on pregnancies and their outcomes was obtained from the Hospital Discharge Database. Simplified True Abortion Risks (STAR) × 100 estimated pregnancies were calculated. We ran logistic regressions adjusting for maternal characteristics, exposure to other sources of pollution, and sites, considering the whole population and stratifying by miscarriage history.ResultsThe study analyzed 11,875 pregnancies with 1375 miscarriages. After adjusting for confounders, an increase of PM₁₀ due to incinerator emissions was associated with an increased risk of miscarriage (test for trend, p = 0.042). The odds ratio for the highest quartile of exposed versus not exposed women was 1.29, 95% CI 0.97–1.72. The effect was present only for women without previous miscarriages (highest quartile of exposed versus not exposed women 1.44, 95% CI 1.06–1.96; test for trend, p = 0.009).ConclusionExposure to incinerator emissions is associated with an increased risk of miscarriage. This result should be interpreted with those of a previous study on reproductive health conducted in the same area that observed an association between incinerator exposure and preterm births.     

Residential exposure to traffic noise and risk of incident atrial fibrillation: A cohort study

BackgroundStudies have found long-term exposure to traffic noise to be associated with higher risk for hypertension, ischemic heart disease and stroke. We aimed to investigate the novel hypothesis that traffic noise increases the risk of atrial fibrillation (A-fib).MethodsIn a population-based cohort of 57,053 people aged 50–64 years at enrolment in 1993–1997, we identified 2692 cases of first-ever hospital admission of A-fib from enrolment to end of follow-up in 2011 using a nationwide registry. The mean follow-up time was 14.7 years. Present and historical residential addresses were identified for all cohort members from 1987 to 2011. For all addresses, exposure to road traffic and railway noise was estimated using the Nordic prediction method and exposure to air pollution was estimated using a validated dispersion model. We used Cox proportional hazard model for the analyses with adjustment for lifestyle, socioeconomic position and air pollution.ResultsA 10 dB higher 5-year time-weighted mean exposure to road traffic noise was associated with a 6% higher risk of A-fib (incidence rate ratio (IRR): 1.06; 95% confidence interval (95% CI): 1.00–1.12) in models adjusted for factors related to lifestyle and socioeconomic position. The association followed a monotonic exposure–response relationship. In analyses with adjustment for air pollution, NO_x or NO₂, there were no statistically significant associations between exposure to road traffic noise and risk of A-fib; IRR: 1.04; (95% CI: 0.96–1.11) and IRR: 1.01; (95% CI: 0.94–1.09), respectively. Exposure to railway noise was not associated with A-fib.ConclusionExposure to residential road traffic noise may be associated with higher risk of A-fib, though associations were difficult to separate from exposure to air pollution.     

Increased risk of non-Hodgkin lymphoma and serum organochlorine concentrations among neighbors of a municipal solid waste incinerator

Organochlorine chemicals may contribute to an increased risk of non-Hodgkin lymphoma (NHL) within non-occupationally exposed populations. Among these chemicals, dioxins and furans were mainly released by municipal solid waste incinerators (MSWIs) until a recent past in France, a source of exposure that is of public concern. We investigated organochlorines and the risk of NHL among neighbors of a French MSWI with high levels of dioxin emissions (Besan?on, France), using serum concentrations to assess exposure. The study area consisted of three electoral wards, containing or surrounding the MSWI. Pesticides, dioxins, furans, and polychlorinated biphenyls (PCBs) were measured in the serum of 34 newly diagnosed NHL cases (2003-2005) and 34 controls. Risks of NHL associated with each lipid-corrected serum concentration were estimated using exact logistic regression. The pesticides β-hexachlorocyclohexane (odds ratio [OR]=1.05, 95% confidence interval [CI]=1.00-1.12, per 10 ng/g lipid) and p,p' dichloro-diphenyl-trichloroethane (DDT) (OR=1.20, 95% CI=1.01-1.45, per 10 ng/g lipid) were associated with NHL risk. Evidence indicated an increased NHL risk associated with cumulative WHO(1998)-toxic equivalency factor (TEQ) concentrations (dioxins, OR=1.12, 95% CI=1.03-1.26; furans, OR=1.16, 95% CI=1.03-1.35; dioxin-like PCBs, OR=1.04, 95% CI=1.00-1.07; and total TEQ, OR=1.04, 95% CI=1.01-1.05), as well as with non dioxin-like PCBs (OR=1.02, 95% CI=1.01-1.05, per 10 ng/g lipid). Most congener-specific associations were statistically significant. This study provides strong and consistent support for an association between serum cumulative WHO(1998)-TEQ concentrations, at levels experienced by people residing in the vicinity of a polluting MSWI, and risk of NHL.     

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.     

National monitoring of PCDD/DFs in environmental media around incinerators in Korea

To examine the levels of PCDD/DFs pollution in environmental samples in the vicinity of various incinerators, the levels of PCDD/DFs in air and soil samples collected near 17 incinerators and stack emission gases were investigated between 2003 and 2006. A total of 434 soil, 28 stack emission gas, and 38 air samples were analyzed for their PCDD/DFs concentrations. The PCDD/DFs concentrations in the flue gas samples ranged from 0.02 to 16.41 ng I-TEQ/Sm(3), with an arithmetical mean value of 3.13 ng I-TEQ/Sm(3). The PCDD/DFs concentrations in the air samples ranged from 0.032 to 0.965 pg I-TEQ/Sm(3). The soil samples contained between N.D. and 153.23 pg I-TEQ/g-dry, with an average of 7.36 pg I-TEQ/g-dry. These levels were generally consistent with or lower than many previous studies. The average PCDD/DFs levels in the soil samples decrease with increasing distance from the incinerator. From the PCDD/DFs level gradient from each plant, a distance of 500 m is suggested as being under the influence of an incinerator.     

Short-term effects of particulate matter constituents on daily hospitalizations and mortality in five South-European cities: Results from the MED-PARTICLES project

BackgroundFew recent studies examined acute effects on health of individual chemical species in the particulate matter (PM) mixture, and most of them have been conducted in North America. Studies in Southern Europe are scarce. The aim of this study is to examine the relationship between particulate matter constituents and daily hospital admissions and mortality in five cities in Southern Europe.MethodsThe study included five cities in Southern Europe, three cities in Spain: Barcelona (2003–2010), Madrid (2007–2008) and Huelva (2003–2010); and two cities in Italy: Rome (2005–2007) and Bologna (2011–2013). A case-crossover design was used to link cardiovascular and respiratory hospital admissions and total, cardiovascular and respiratory mortality with a pre-defined list of 16 PM₁₀ and PM_2.5 constituents. Lags 0 to 2 were examined. City-specific results were combined by random-effects meta-analysis.ResultsMost of the elements studied, namely EC, SO₄^2 −, SiO_2, Ca, Fe, Zn, Cu, Ti, Mn, V and Ni, showed increased percent changes in cardiovascular and/or respiratory hospitalizations, mainly at lags 0 and 1. The percent increase by one interquartile range (IQR) change ranged from 0.69% to 3.29%. After adjustment for total PM levels, only associations for Mn, Zn and Ni remained significant. For mortality, although positive associations were identified (Fe and Ti for total mortality; EC and Mg for cardiovascular mortality; and NO₃⁻ for respiratory mortality) the patterns were less clear.ConclusionsThe associations found in this study reflect that several PM constituents, originating from different sources, may drive previously reported results between PM and hospital admissions in the Mediterranean area.     

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.     

Communicating air pollution-related health risks to the public: An application of the Air Quality Health Index in Shanghai,China

The Air Quality Health Index (AQHI) was originally developed in Canada. However, little is known about its validity in communicating morbidity risks. We aimed to establish the AQHI in Shanghai, China, and to compare the associations of AQHI and existing Air Pollution Index (API) with daily mortality and morbidity. We constructed the AQHI as the sum of excess total mortality associated with individual air pollutants, and then adjusted it to an arbitrary scale (0–10), according to a time-series analysis of air pollution and mortality in Shanghai from 2001 to 2008. We examined the associations of AQHI with daily mortality and morbidity, and compared these associations with API from 2005 to 2008. The coefficients of short-term associations of total mortality with particulate matter with an aerodynamic diameter less than 10 μm (PM₁₀), PM_2.5 and nitrogen dioxide (NO₂) were used in the establishment of AQHI. During 2005–2008, the AQHI showed linear non-threshold positive associations with daily mortality and morbidity. A unit increase of the PM₁₀-AQHI was associated with a 0.90% [95% (confidence interval, CI), 0.43 to 1.37], 1.04% (95%CI, 0.04 to 2.04), 1.62% (95%CI, 0.39 to 2.85) and 0.51% (95%CI, 0.09 to 0.93) increase of current-day total mortality, hospital admissions, outpatient visits and emergency room visits, respectively. The PM_2.5-AQHI showed quite similar effect estimates with the PM₁₀-AQHI. In contrast, the associations for API were much weaker and generally statistically insignificant. The AQHI, compared with the existing API, provided a more effective tool to communicate the air pollution-related health risks to the public.     

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.     

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.     

Outdoor air pollution and term low birth weight in Japan

IntroductionEvidence has accumulated on the association between ambient air pollution and adverse birth outcomes. However, most of the previous studies were conducted in geographically distinct areas and suffer from lack of important potential covariates. We examined the effect of ambient air pollution on term low birth weight (LBW) using data from a nationwide population-based longitudinal survey in Japan that began in 2001.MethodsWe restricted participants to term singletons (n = 44,109). Air pollution concentrations during the 9 months before birth were obtained at the municipality level and were assigned to the participants who were born in the corresponding municipality. We conducted multilevel logistic regression analyses adjusting for individual and municipality-level variables.ResultsWe found that air pollution exposure during pregnancy was positively associated with the risk of term LBW. In the fully adjusted models, odds ratios following one interquartile range increase in each pollutant were 1.09 (95% confidence interval: 1.00, 1.19) for suspended particulate matter (SPM), 1.11 (0.99, 1.26) for nitrogen dioxide (NO₂), and 1.71 (1.18, 2.46) for sulfur dioxide (SO₂). Specifically, effect estimates for SPM and NO₂ exposure at the first trimester were higher than those at other trimesters, while SO₂ was associated with the risk at all trimesters. Nonsmoking mothers were more susceptible to SPM and NO₂ exposure compared with smoking mothers.ConclusionsAmbient air pollution increases the risk of term LBW in a nationally representative sample in Japan.     

Exposure to traffic-related air pollution and the risk of developing breast cancer among women in eight Canadian provinces: A case–control study

A few recent studies have reported positive associations between long-term exposure to traffic-related air pollution and the incidence of breast cancer. We capitalized on an existing Canadian multi-site population-based case–control study to further investigate this association.We used the National Enhanced Cancer Surveillance System, a population-based case–control study conducted in eight of 10 Canadian provinces from 1994 to 1997. A total of 1569 breast cancer cases and 1872 population controls who reported at least 90% complete self-reported addresses over the 1975–1994 exposure period were examined. Mean exposure levels to nitrogen dioxide (NO₂) (an indicator of traffic-related air pollution) were estimated for this period using three different measures: (1) satellite-derived observations; (2) satellite-derived observations scaled with historical fixed-site measurements of NO₂; and (3) a national land-use regression (LUR) model. Proximity to major roads was also examined. Using unconditional logistic regression, stratified by menopausal status, we estimated odds ratios (ORs) adjusted for many individual-level and contextual breast cancer risk factors.We observed positive associations between incident breast cancer and all three measures of NO₂ exposure from 1975 to 1994. In fully adjusted models for premenopausal breast cancer, a 10 ppb increase in NO₂ exposure estimated from the satellite-derived observations, the scaled satellite-derived observations, and the national LUR model produced ORs of 1.26 (95% confidence intervals (CIs): 0.92–1.74), 1.32 (95% CI: 1.05–1.67) and 1.28 (95% CI: 0.92–1.79). For postmenopausal breast cancer, we found corresponding ORs of 1.10 (95% CI: 0.88–1.36), 1.10 (95% CI: 0.94–1.28) and 1.07 (95% CI: 0.86–1.32). Substantial heterogeneity in the ORs was observed across the eight Canadian provinces and reduced ORs were observed when models were restricted to women who had received routine mammography examinations. No associations were found for road proximity measures.This study provides some support for the hypothesis that traffic-related air pollution may be associated with the development of breast cancer, especially in premenopausal women. With the few studies available, further research is clearly needed.