Environmental Health Burden Research Articles

3.E. Scientific session: Environmental Health Tracking Systems: a tool for planetary health

Abstract Planetary health offers a good framework for better understanding the interconnection between human health and environmental changes, promoting effective cross-sector actions and partnerships, and ensuring policy coherence. Effective implementation of this conceptual framework requires monitoring and reporting on indicators relevant to planetary health that capture the scope, spatial and temporal scales of changes in natural systems that affect human health and well-being. An approach in that sense are the environmental public health tracking systems (EPHT), which imply the ongoing collection, integration, analysis, and interpretation of data at the same spatiotemporal scale about environmental hazards, and related human exposure and health effects, maintaining appropriate data protection measures. It aims to provide public-health decision makers with timely, accurate and systematic data for quantifying health impacts related to environmental factors. EPHT system are proposed as an essential tool for designing and monitoring policies and actions that prevent and reduce environmental health burdens (EHB) efficiently and cost-effectively, and as an alerting system against present and future climatic and health crisis. Pursuing such goals requires the use of health information systems that enable the monitoring and assessing of environmental health in multiple dimensions, considering specificities across different geographical and cultural settings. EPHT system requires defining a rationale on how to select the dimensions and indicators to be included. Common challenges for defining those indicators are related to the availability of data recording, data standardization, and the linkage, integration and sharing of databases. In parallel, it is also important to define a decision aiding tools in which evidence and data are understandable and inform about the extent to which specific policy goals are attained, tailoring such tools to the specific settings. Present session attends to answers to those challenges by sharing experiences from different contexts and countries Key messages • EPHT systems represent an effective tool for progressing in achieving planetary health goals and as a surveillance alerting system for future health crisis. • Adjusting EH data quality recording and analysis in EPHT systems is essential for improving resources assignment, and the effectiveness of healthy policies in reducing EHB.

Environment-related health risks, knowledge and awareness among people in precarious milieus: secondary data analysis from the German "Environmental Awareness Study".

Precarious milieus more frequently suffer from environmental risks and show lower environmental awareness and behavior than other milieus in the German population. This study investigates the factors that influence environmental awareness in precarious milieus and the roles of environmental knowledge and the perception of environment-related health burdens. A quantitative secondary data analysis of the German Environmental Awareness Study 2018 (N = 2017) was used to analyze the perception of environmental health burdens, environmental knowledge, and environmental awareness between precarious milieus (n = 190) and seven other milieus. One-way analysis of variance (ANOVA) and Bonferroni post hoc tests were used for this purpose. More in-depth analyses of the precarious milieus were carried out using multiple regression analyses. There were significant differences in the perceptions of environmental health burdens affected by rail-traffic noise and neighborhood noise. Furthermore, environmental knowledge in precarious milieus was significantly lower than in five out of the seven other milieus (all p < 0.001) and was significantly associated with environmental cognition and gender. Precarious milieus had higher environmental affect than established milieus but less than that of critical-creative milieus and young idealists (all p < 0.001). Environmental cognition and environmental behavior were significantly associated with environmental affect. Environmental cognition was significantly higher in precarious milieus than in established milieus and among young pragmatists but was lower than in critical-creative milieus and among young idealists (all p < 0.001). Environmental affect, environmental knowledge, and gender were significantly associated with environmental cognition. In precarious milieus, environmental behavior was significantly lower than in traditional milieus and critical-creative milieus and among young idealists (all p < 0.001) and was significantly associated with environmental affect. The differences in the perception of environmental health burdens, environmental knowledge, and environmental awareness among precarious milieus indicate that there is a need for specific education and support structures for these population groups. Further research is needed to determine what other factors within the precarious milieus influence environmental knowledge and awareness, as well as the skills needed to understand environmental information, which are included in the framework of environmental (health) literacy.

Queering Environmental Justice: Unequal Environmental Health Burden on the LGBTQIA+ Community

Queering Environmental Justice: Unequal Environmental Health Burden on the LGBTQIA+ Community

Real-time forecast of temperature-related excess mortality at small-area level: towards an operational framework

The development of innovative tools for real-time monitoring and forecasting of environmental health impacts is central to effective public health interventions and resource allocation strategies. Though a need for such generic tools has been previously echoed by public health planners and regional authorities responsible for issuing anticipatory alerts, a comprehensive, robust and scalable real-time system for predicting temperature-related excess deaths at a local scale has not been developed yet. Filling this gap, we propose a flexible operational framework for coupling publicly available weather forecasts with temperature-mortality risk functions specific to small census-based zones, the latter derived using state-of-the-art environmental epidemiological models. Utilising high-resolution temperature data forecast by a leading European meteorological centre, we demonstrate a real-time application to forecast the excess mortality during the July 2022 heatwave over England and Wales. The output, consisting of expected temperature-related excess deaths at small geographic areas on different lead times, can be automated to generate maps at various spatio-temporal scales, thus facilitating preventive action and allocation of public health resources in advance. While the real-case example discussed here demonstrates an application for predicting (expected) heat-related excess deaths, the framework can also be adapted to other weather-related health risks and to different geographical areas, provided data on both meteorological exposure and the underlying health outcomes are available to calibrate the associated risk functions. The proposed framework addresses an urgent need for predicting the short-term environmental health burden on public health systems globally, especially in low- and middle-income regions, where rapid response to mitigate adverse exposures and impacts to extreme temperatures are often constrained by available resources.

Impacts de la crise environnementale et climatique sur la santé de la femme : quelles spécificités ? Que peut-on faire ?

ObjectivePollution is one of the world's largest risk factors for disease and premature death. In Europe, it is responsible for approximately 20% of mortality. Chemicals exposure can occur by inhalation, ingestion or skin contact and begins in utero. Pollutants can be divided into three categories: endocrine disruptors (pesticides, PFAS, plastics, dioxins, etc.), heavy metals (cadmium, mercury and lead…) and nanomaterials. Climate change and air pollution are other main health threats. MethodsLiterature review using PubMed and ResearchGate databases and institutional websites. ResultsEndocrine disruptors are identified as significant risk factors for the reproductive health with negative documented impacts following prenatal or adult exposure. Climate change and air pollution can cause gender-based health disparities. Numerous scientific arguments show that chemical pollution and climate change disproportionately impact women, both on a social and biological level. Populations in precarious situations among which women are over-represented suffer the most severe social consequences including in France. There are several gender-specific domestic or occupational exposures to pollutants, most often to the disadvantage of women compared to men. Finally, although very few gendered data exist in environmental health, there are sexual-based physiological vulnerabilities concerning the metabolism of pollutants and the capacity to adapt to heat. ConclusionFacing this threat of gender inequity in sexual and reproductive health and rights’ width, women's health professionals have a major role to play in initiating new ways to assess and reduce the environmental health burden in women.

Quantifying China's iron and steel industry's CO2 emissions and environmental health burdens: A pathway to sustainable transformation

Assessing the iron and steel industry's (ISI) impact on climate change and environmental health is vital, particularly in China, where this sector significantly influences air quality and CO2 emissions. There is a lack of comprehensive analyses that consider the environmental and health burdens of manufacturing processes for ISI enterprises. Here, we present an integrated emission inventory that encompasses air pollutants and CO2 emissions from 811 ISI enterprises and five key manufacturing processes in 2020. Our analysis shows that sintering is the primary source of air pollution in the ISI. It contributes 71% of SO2, 73% of NOx, and 54% of PM2.5 emissions. On the other hand, 81% of total CO2 emissions come from blast furnaces. Significantly, the contributions of ISI have resulted in an increase of 3.6 μg m−3 in national population-weighted PM2.5 concentration, causing approximately 59,035 premature deaths in 2020. Emissions from Hebei, Jiangsu, Shandong, Shanxi, and Inner Mongolia provinces contributed to 48% of PM2.5-related deaths in China. Moreover, the transportation of air pollutants across provincial borders highlights a concerning trend of environmental health inequality. Based on the research findings, it is crucial for ISI manufacturers to prioritize the removal of outdated production capacities and adopt energy-efficient and advanced techniques, along with ultra-low emission technologies. This is particularly important for those manufacturers with substantial environmental footprints. These transformative actions are essential in mitigating the environmental and health impacts in the affected regions.

Experimental Investigation of the Derivative Cutting When Machining AISI 1045 with Micro-Textured Cutting Tools

In the context of satisfying sustainability requirements nowadays, dry machining is one of the ideal strategies to eliminate the environmental and human health burdens of machining processes. In addition, micro-textured cutting tools are used to improve the performance of dry machining processes. Micro-textures reduce the chip-tool contact length and thus reduce friction and heat, which results in fewer cutting forces and temperature. However, the action of micro-cutting of the bottom side of the chip, which is known as derivative cutting, cuts down the gains of using textured tools, where derivative cutting leads to higher cutting forces, heat, and tool wear. This study aimed to investigate the effects of significant texture design parameters (i.e., micro-groove width) when cutting AISI 1045 steel using different machining parameters (i.e., 75 m/min and 150 m/min of cutting velocity, 0.05 and 0.10 mm/rev of feed). Three different textured cutting tool designs were prepared using the laser texturing technique and then utilized in machining experiments. In addition, the measured machining outputs were forces, power consumption, flank wear, and surface roughness. There were no marks for the derivative cutting when using the textured cutting tool with the narrowest micro-grooves according to the obtained microscopical images after the machining tests. In addition, the textured cutting tool, which included the narrowest micro-grooves, showed better performance compared to the non-textured cutting tool and the other textured tool designs in terms of cutting and feed forces, power consumption, flank tool wear, and surface roughness at the used cutting conditions. This confirmed that the careful optimal design of the micro-textured tools can reduce or eliminate the severity of the derivative cutting, and thus improve the overall machining performance.

Environmental Sustainability, Electronics, and Ergonomics: A Tale of Two Continents

What does the overdependence on electronic and electrical appliances in the US have to do with migrant workers in West Africa? What is the relevance and role of Human Factors and Ergonomics (HF/E) research and practice in this context? This discussion panel will: (i) explore the nexus between electrical and electronic appliance waste (e-waste) – of which the US and other developed countries are a major contributor – and the disproportionate environmental and occupational health burden placed on emerging countries such as Ghana, and (ii) examine how corporations are responding by intentional paradigm shifts in sustainability, circularity, supply chain transparency, and product life-cycle management spanning raw material sourcing to recycling and reuse. This panel will be a social impact discussion hosted by the HFES Environmental Design Technical Group in collaboration with the HFES Sustainability Task Force and the IEA Technical Committee on Informal Work, with panelists from academia and industry.

Advancing Environmental Health and Justice: A Call for Assessment and Oversight of Health Care Waste. (APHA Policy Statement Number 20224, Adopted November 2022).

Health care waste adversely affects society in ways that have been overlooked for decades, an issue that the coronavirus disease 2019 (COVID-19) pandemic has accelerated significantly. This policy statement addresses the human impacts that occur as health care waste is processed, transported, landfilled, or incinerated. With limited federal tracking and lack of regulation, patterns of environmental racism persist. Communities of color and low-income communities most often experience the greatest environmental health burdens through the disposal of waste in their communities. Many communities have called for action for decades, as our massive health care industry contributes greatly to these harms. Centering these communities, public health professionals must advocate for (1) evidence-based federal policies with transparent, accessible data about health care waste generation, type, and fate; (2) leadership within the health care industry (e.g., from hospitals, accrediting bodies, and professional organizations) to address environmental health and justice issues related to waste; (3) health impact assessments, cost-benefit analyses, and circular economy research with health care systems and communities to identify cost-effective, feasible, and just solutions; and (4) federal initiatives to prioritize funding toward mitigation of cumulative exposures and impacts, reparation for harms, and investment in well-being for communities exposed to waste, health care or otherwise. Some public health experts anticipate that we may be entering a "pandemic age," which suggests that, without intervention, intersecting issues of infectious disease, climate change, waste, and environmental health and justice will remain and reoccur.

A Multimethodological Approach for the Valorization of “Senatore Cappelli” Wheat Milling By-Products as a Source of Bioactive Compounds and Nutraceutical Activity

Wheat is the third most cultivated cereal in the world and represents the major contributor to human nutrition. Milling wheat by-products such as husks (17-20% of the total processing output weight), even if still containing high-value-added bioactive compounds, are often left untreated or unused, thus resulting in environmental and human health burdens. In these regards, the present study is aimed at evaluating in a multimethodological approach the nutraceutical properties of durum wheat husks belonging to the ancient cultivar "Senatore Cappelli", thus assessing their potential as bioactive compound sources in terms of phytochemical, cytotoxic, and nutraceutical properties. By means of HPLC-FD analyses, wheat husk samples analyzed revealed a higher content of serotonin, amounting to 35% of the total BAs, and were confirmed to occur at biogenic amines quality index (BAQI) values <10 mg/100 g. In addition, spectrophotometric assays showed a significant variable content in the phenolic (189.71-351.14 mg GAE/100 g) and antioxidant compounds (31.23-37.84 mg TE/100 g) within the wheat husk samples analyzed, according to the different cultivar areas of origin. Considering wheat husk extracts' anti-inflammatory and antioxidant activity, in vitro analyses were performed on BV-2 murine microglia cells cultured in the presence or absence of LPS, thus evaluating their ability to promote microglia polarization towards an anti-inflammatory phenotype. Cytotoxicity assays showed that wheat extracts do not affect microglia viability. Wheat husks activity on microglial polarization was assessed by analyzing the expression of M1 and M2 markers' mRNA by RT-PCR. Wheat husk antioxidant activity was assessed by analysis of NRF2 and SOD1 mRNA expression. Moreover, the sustainability assessment for the recovery of bioactive components from wheat by-products was carried out by applying the life cycle assessment (LCA) methodology using SimaPro v9.2.2. software.

Environmental health impacts and inequalities in green space and air pollution exposures in six European cities

BACKGROUND The GoGreenRoutes project (Horizon 2020/869764) aims to introduce co-created nature-based solutions (NBS) as interventions to enhance access to green space in six medium-sized European cities (Burgas, Lahti, Limerick, Tallinn, Umea, and Versailles). We analyzed the spatial distribution and health impacts associated with unequal exposure to air pollution and green space prior to the implementation of these NBS interventions in each city. METHODS We retrieved air pollution (NO₂ and PM₂.₅) and green space (NDVI and % Green Area proxies) data at a 250m x 250m grid-cell level for each city, in addition to population and mortality data for 2015. We compared baseline exposures to WHO guidelines and calculated the exposure differences at the grid-cell level. We applied a comparative risk assessment methodology to estimate the mortality burden attributable to not achieving the WHO guidelines. We evaluated exposures and attributable mortality distributions and their associations to understand current urban environmental inequalities. RESULTS We found high variability in air pollution and green spaces levels between and within all six cities. Around 60% of the population lacked green space and 90% of the population were exposed to air pollution above WHO guidelines. Overall, we estimated a city range between 3-37 and 2-71 deaths/100,000 persons were attributable to exceedances in WHO NO₂ and PM₂.₅ limit values, respectively; 4-13 deaths/100,000 persons were associated with lack of Green Area; and 18-35 deaths/100,000 persons were linked to NDVI levels below the city target. Green space and air pollution were highly spatially correlated, likewise their attributable burdens. CONCLUSIONS Our results suggest that urban populations in the analyzed cities are affected simultaneously by lack of green space and increased air pollution. We expect NBS interventions will contribute to reducing the environmental health burden and inequalities in the GoGreenRoutes cities. KEYWORDS Health impact assessment; urban health; health equity; nature-based solutions.

Using Multisource Data to Assess PM2.5 Exposure and Spatial Analysis of Lung Cancer in Guangzhou, China.

Elevated air pollution, along with rapid urbanization, have imposed higher health risks and a higher disease burden on urban residents. To accurately assess the increasing exposure risk and the spatial association between PM2.5 and lung cancer incidence, this study integrated PM2.5 data from the National Air Quality Monitoring Platform and location-based service (LBS) data to introduce an improved PM2.5 exposure model for high-precision spatial assessment of Guangzhou, China. In this context, the spatial autocorrelation method was used to evaluate the spatial correlation between lung cancer incidence and PM2.5. The results showed that people in densely populated areas suffered from higher exposure risk, and the spatial distribution of population exposure risk was highly consistent with the dynamic distribution of the population. In addition, areas with PM2.5 roughly overlapped with areas with high lung cancer incidence, and the lung cancer incidence in different locations was not randomly distributed, confirming that lung cancer incidence was significantly associated with PM2.5 exposure. Therefore, dynamic population distribution has a great impact on the accurate assessment of environmental exposure and health burden, and it is necessary to use LBS data to improve the exposure assessment model. More mitigation controls are needed in highly populated and highly polluted areas.

Examining the status of forest fire emission in 2020 and its connection to COVID-19 incidents in West Coast regions of the United States

Forest fires impact on soil, water, and biota resources. The current forest fires in the West Coast of the United States (US) profoundly impacted the atmosphere and air quality across the ecosystems and have caused severe environmental and public health burdens. Forest fire led emissions could significantly exacerbate the air pollution level and, therefore, would play a critical role if the same occurs together with any epidemic and pandemic health crisis. Limited research is done so far to examine its impact in connection to the current pandemic. As of October 21, nearly 8.2 million acres of forest area were burned, with more than 25 casualties reported so far. In-situ air pollution data were utilized to examine the effects of the 2020 forest fire on atmosphere and coronavirus (COVID-19) casualties. The spatial-temporal concentrations of particulate matter (PM2.5 and PM10) and Nitrogen Dioxide (NO2) were collected from August 1 to October 30 for 2020 (the fire year) and 2019 (the reference year). Both spatial (Multiscale Geographically Weighted Regression) and non-spatial (Negative Binomial Regression) analyses were performed to assess the adverse effects of fire emission on human health. The in-situ data-led measurements showed that the maximum increases in PM2.5, PM10, and NO2 concentrations (μg/m3) were clustered in the West Coastal fire-prone states during August 1 – October 30, 2020. The average concentration (μg/m3) of particulate matter (PM2.5 and PM10) and NO2 was increased in all the fire states severely affected by forest fires. The average PM2.5 concentrations (μg/m3) over the period were recorded as 7.9, 6.3, 5.5, and 5.2 for California, Colorado, Oregon, and Washington in 2019, increasing up to 24.9, 13.4, 25.0, and 17.0 in 2020. Both spatial and non-spatial regression models exhibited a statistically significant association between fire emission and COVID-19 incidents. Such association has been demonstrated robust and stable by a total of 30 models developed for analyzing the spatial non-stationary and local association. More in-depth research is needed to better understand the complex relationship between forest fire emission and human health.

Advancing Environmental Health and Justice: A Call for Assessment and Oversight of Healthcare Waste

Healthcare waste adversely impacts society in ways that have been overlooked for decades, an issue that the COVID-19 pandemic has accelerated significantly. This policy statement addresses the human impacts that occur as healthcare waste is processed, transported, landfilled, or incinerated. With limited federal tracking and lack of regulation, patterns of environmental racism persist. Communities of color and low-income communities most often experience the greatest environmental health burdens through disposal of waste in their communities. Many communities have called for action for decades, as our massive healthcare industry contributes greatly to these harms. Centering these communities, public health professionals must advocate for: 1) Evidence-based federal policies with transparent, accessible data about healthcare waste generation, type, and fate, 2) Leadership within the healthcare industry, from hospitals, accrediting bodies, professional organizations, and medical, health professions, and healthcare administration training programs to address environmental health and justice issues related to waste, 3) Health impact assessments, cost-benefit analyses, and circular economy research with healthcare systems and communities to identify cost-effective, feasible, and just solutions, and 4) Federal initiatives to prioritize funding towards mitigation of cumulative exposures and impacts, reparation for harms, and investment in well-being for communities fenceline to waste—healthcare or otherwise. Some public health experts anticipate that we may be entering a ‘pandemic age,’ which suggests that without intervention, intersecting issues of infectious disease, climate change, waste, and environmental health and justice will remain and reoccur.

Queering Environmental Justice: Unequal Environmental Health Burden on the LGBTQ+ Community.

The LGBTQ+ (lesbian, gay, bisexual, transgender/-sexual, queer or questioning, intersex, asexual, and all subsects) population has been the target of federal and state discriminatory policies leading to high levels of institutional discrimination in the housing, employment, and health sectors. Social determinants of health such as housing conditions, economic opportunities, and access to health care may negatively and disproportionately affect the LGBTQ+ population and reduce their capacity to respond to environmental harm (e.g., obtaining necessary medical care). Social determinants of health have been shown to be associated with unequal harmful environmental exposure, primarily along lines of race/ethnicity and socioeconomic status. However, chronic diseases, such as respiratory diseases, cardiovascular disease, and cancer, associated with environmental exposure have been shown to occur in higher rates in the LGBTQ+ population than in the cisgender, heterosexual population. We explore how environmental exposures may disproportionately affect the LGBTQ+ population through examples of environmental exposures, health risks that have been linked to environmental exposures, and social institutions that could affect resilience to environmental stressors for this population. We provide recommendations for policymakers, public health officials, and researchers. (Am J Public Health. 2022;112(1):79-87. https://doi.org/10.2105/AJPH.2021.306406).

Surface structure regulation of wastewater flocculated sludge for hierarchical superhydrophobic ceramic coating

Numerous wastewater flocculated sludge (WFS) is a global problem due to the considerable global environmental and public health burden, but sustainable and effective strategies for the resource utilization of WFS are still insufficient. Here, a facile and sustainable strategy was developed to regulate the surface structure of WFS for the fabrication of superhydrophobic ceramic coating. The structural transformation from the amorphous structure of WFS to hierarchical porous micro/nanocomposite structures was realized. Moreover, the designed ceramic coating maintained excellent superhydrophobic and self-cleaning properties over the entire pH range (1−14) or when applied to four different substrates. This work not only provides a new procedure for effective management of WFS and facile fabrication of superhydrophobic ceramic coating with excellent acid- and alkali-resistance and substrate-independent property, but also has potential applications in separation, catalysis and construction.

Delivering on the Green Deal’s zero pollution ambition for health

Abstract As part of an integrated approach, the EU Green Deal also includes a zero pollution ambition for a toxic-free environment. This is a much needed and overdue commitment to address the significant environmental health burden from pollution in Europe. Air pollution alone leads to 400,000 premature deaths annually, and the extent of the health harm from chemicals pollution, or effects from combined exposures are still under investigation. The next months will show if the EU Commission can deliver on their ambition, with the launch of a zero pollution action plan for air, water and soil, and the speed of the process to revise the EU's ambient air quality standards. In addition, the World Health Organization (WHO) is expected to launch updated air quality guidelines, following a scientific review which showed greater health harm from poor air quality. The presentation will provide an overview of the policy opportunities for public health professionals to be engaged in, to make the health case for zero harm from pollution, and zero delay in stopping pollution. A particular emphasis will be placed on showcasing the need for zero financing of pollution, as major investments for transformation under Just Transition and green recovery schemes are underway.

Women’s empowerment as a pathway to sustainable and modern energy for all: evidence from the Demographic and Health Surveys

BACKGROUND AND AIM: Household air pollution (HAP) is a leading cause of environmental pollution and health burden. Many countries in Africa cook with polluting fuels (main cause of HAP). Women’s empowerment (WE) is known to improve healthcare service use, child nutrition and agricultural productivity. In Africa, however, little is known about the relationship between WE and household fuel use. We aimed to examine if WE is associated with cooking fuel use in Africa, and whether it varies between countries. METHODS: We used the Demographic and Health Surveys conducted between 2003 and 2018 (n= 264 269 [women-household pairs]). We used a novel, Africa-specific index (Survey-based Women’s emPowERment index), including three dimensions of empowerment: attitude to violence, social independence and decision-making. We used hierarchical logistic regression models to assess the relationship between WE dimensions and the type of fuel used in the household (‘clean’: electricity, liquefied petroleum gas, biogas or natural gas; ‘polluting’: solid fuels or kerosene). Results from binomial and multinomial regressions were expressed as odds ratios (OR). The country-specific estimates were combined using meta-analysis. RESULTS:Only 43 778 (14.5%) households used clean fuels. Overall, 12/31, 22/31 and 13/31 country-level estimates showed a significant association between a one standard deviation increase in attitude to violence, social independence and decision-making (higher scores indicate greater empowerment) dimensions, respectively, and higher odds of using clean fuel as primary energy source for cooking. The estimates from random-effect meta-analyses showed that increased empowerment was associated with higher odds of using clean fuel for attitude to violence (OR = 1.22; 95% CI: 1.12–1.33), social independence (OR = 1.34; 95% CI: 1.28–1.42), and decision-making (OR = 1.10; 95% CI: 1.05–1.15). CONCLUSIONS:These results suggest that empowering women in these dimensions has potential to mitigate global climate, and accelerate transitions to clean fuel in Africa. An integrated multi-sector effort could be crucial. KEYWORDS: Air pollution, Climate, Environmental disparities, Exposure, Female, Policy

Underestimated or overestimated? Dynamic assessment of hourly PM2.5 exposure in the metropolitan area based on heatmap and micro-air monitoring stations.

Spatio-temporal distributions of air pollution and population are two important factors influencing the patterns of mortality and diseases. Past studies have quantified the adverse effects of long-term exposure to air pollution. However, the dynamic changes of air pollution levels and population mobility within a day are rarely taken into consideration, especially in metropolitan areas. In this study, we use the high-resolution PM2.5 data from the micro-air monitoring stations, and hourly population mobility simulated by the heatmap based on Location Based Service (LBS) big data to evaluate the hourly active PM2.5 exposure in a typical Chinese metropolis. The dynamic "active population exposure" is compared spatiotemporally with the static "census population exposure" based on census data. The results show that over 12h on both study periods, 45.83% of suburbs' population-weighted exposure (PWE) is underestimated, while 100% of rural PWE and more than 34.78% of downtown's PWE are overestimated, with the relative difference reaching from -11μg/m3 to 7μg/m3. More notably, the total PWE of the active population at morning peak hours on weekdays is worse than previously realized, about 12.41% of people are exposed to PM2.5 over 60μg/m3, about twice as much as that in census scenario. The commuters who live in the suburbs and work in downtown may suffer more from PM2.5 exposure and uneven environmental resource distribution. This study proposes a new approach of calculating population exposure which can also be extended to quantify other environmental issues and related health burdens.

Effects of ambient air pollution on psychological stress and anxiety disorder: a systematic review and meta-analysis of epidemiological evidence.

Ambient air pollution (AAP) is an important risk factor for increased mental health morbidity. Studies have highlighted the effect of AAP on psychological stressand anxiety disorder. However, existing evidence regarding this is largely equivocal. This systematic review with meta-analysis aims to synthesize published evidence to calculate the pooled estimate of the effect of AAP on psychological stress and anxiety disorder. A systematic bibliographic search was undertaken using PubMed, JGateplus, Google Scholar, and Cochrane Library for observational human studies published in English till 31st March 2020 reporting the effect of AAP on psychological stress and anxiety disorder. Study quality was assessed using the Joanna Briggs Institute critical appraisal tools. Meta-analysis was performed adopting a random-effects model using Meta-XL. Of 412 articles retrieved, a total of 30 articles [AAP and anxiety disorders, (n=17, 57%); AAP and psychological stress, (n=9, 30%) and AAP and both psychological stress and anxiety disorders, (n=4, 13%)] fulfilled the inclusion criteria covering a total population of 973,725 individuals. The pooled estimate (OR) of the effects of PM10 on psychological stress was 1.03 [(95% CI: 1.00, 1.05) (p=0.17, I 2=41%)]. The pooled estimate of the effects of NO2 and PM10 on anxiety disorder was 0.93 [(95% CI: 0.89, 0.97) (p=0.91, I 2=0%)] and 0.88 [(95% CI: 0.78, 0.98) (p=0.01, I 2=59%)] respectively. The pooled estimate of the effects of PM2.5 on anxiety Disorder was 0.88 [(95% CI: 0.72, 1.06) (p=0.00, I 2=80%)]. The present study provides the most updated pooled estimate of the effect of AAP on psychological stress and anxiety disorder. Future studies should focus on longitudinal studies conducted in LIC and LMIC countries using uniform and standardized criteria for exposure and outcome assessment as well as robust adjustment for confounders to minimize methodological heterogeneity resulting in reliable and comparable estimation of environmental mental health burden.