Environmental Health Risk Factor Research Articles

Effect of Seasonal Variation on the Relationship of Indoor Air Particulate Matter with Measures of Obesity and Blood Pressure in Children.

Background.Particulate matter (PM) air pollution is an important environmental health risk factor. Although some studies have shown PM to be associated with obesity and hypertension, very few studies have assessed the association of indoor PM specifically with obesity and blood pressure measures in children with respect to seasonal variation.Objectives.The present study investigated the relationship of PM with obesity and blood pressure variables in children across the winter and summer seasons.Methods.A comparative descriptive approach was adopted and school children from 10–14 years of age from selected rural and urban localities of the Eastern Cape Province of South Africa were assessed in winter and summer. Anthropometric measurements were taken, including height, weight, waist circumference, body mass index (BMI), and total fat mass (TFM), while blood pressure variables including systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured. Indoor air PM concentrations were measured in the classrooms in the presence of children.Results.The prevalence of obesity and hypertension in children were 13.4% and 5.1% in winter and 12.9% and 1.0% in summer, respectively. High blood pressure was more prevalent in children in rural areas, while the prevalence of obesity in children was higher in urban areas. Particulate matter was significantly (p<0.05) higher in rural areas compared to urban areas. Obese children in summer had a greater than 3-fold association (AOR: 3.681, p=0.005) with 4th interquartile range (IQR) of PM5 and a greater than 3- and 4-fold association (AOR: 3.08; 4.407; p<0.05) with 2nd and 4th IQR of PM10, respectively, than their overweight, normal weight or underweight counterparts. High blood pressure was not associated (p< 0.05) with PM.Conclusions.High concentrations of indoor PM were positively associated with obesity in children in summer, particularly among rural children. This association could be accounted for by location and seasonal differences.Participant Consent.ObtainedEthics Approval.Ethics approval was obtained from the Health Sciences Ethics Committee of Walter Sisulu University, South Africa (Ref No: CHI011SCHU01).Competing Interests.The authors declare no competing financial interests.

Heterogeneous Urban Exposures and Prevalent Hypertension in the Helsinki Capital Region, Finland.

Urban dwellers are simultaneously exposed to several environmental health risk factors. This study aimed to examine the relationship between long-term exposure to fine particulate matter (PM2.5, diameter < 2.5 µm) of residential-wood-burning and road-traffic origin, road-traffic noise, green space around participants’ homes, and hypertension. In 2015 and 2016, we conducted a survey of residents of the Helsinki Capital Region to determine their perceptions of environmental quality and safety, lifestyles, and health statuses. Recent antihypertensive medication was used as an indicator of current hypertensive illness. Individual-level exposure was estimated by linking residential coordinates with modelled outdoor levels of wood-smoke- and traffic-related PM2.5, road-traffic noise, and coverage of natural spaces. Relationships between exposure and hypertension were modelled using multi-exposure and single-exposure binary logistic regression while taking smooth functions into account. Twenty-eight percent of the participants were current users of antihypertensive medication. The odds ratios (95% confidence interval) for antihypertensive use were 1.12 (0.78–1.57); 0.97 (0.76–1.26); 0.98 (0.93–1.04) and 0.99 (0.94–1.04) for wood-smoke PM2.5, road-traffic PM2.5, road-traffic noise, and coverage of green space, respectively. We found no evidence of an effect of the investigated urban exposures on prevalent hypertension in the Helsinki Capital Region.

High Level of Real Urban Air Pollution Promotes Cardiac Arrhythmia in Healthy Mice.

Background and ObjectivesAmbient particulate matter (PM) in real urban air pollution (RUA) is an environmental health risk factor associated with increased cardiac events. This study investigated the threshold level to induce arrhythmia, as well as arrhythmogenic mechanism of RUA that mainly consisted of PM <2.5 μm in aerodynamic diameter close to ultrafine particles.MethodsRUA was artificially produced by a lately developed pyrolysis based RUA generator. C57BL/6 mice were divided into 4 groups: a control group (control, n=12) and three groups with exposure to RUA with the concentration of 200 µg/m3 (n=12), 400 µg/m3 (n=12), and 800 µg/m3 (n=12). Mice were exposed to RUA at each concentration for 8 hr/day and 5 day/week to mimic ordinary human activity during 3 weeks.ResultsThe QRS and QTc intervals, as well as intracellular Ca2+ duration, apicobasal action potential duration (APD) gradient, fibrosis, and inflammation of left ventricle of mouse hearts were increased dose-dependently with the increase of RUA concentration, and significantly increased at RUA concentration of 400 µg/m3 compared to control (all p<0.001). In mice exposed to RUA concentration of 800 µg/m3, spontaneous ventricular arrhythmia was observed in 42%, with significant increase of inflammatory markers, phosphorylated Ca2+/calmodulin-dependent protein kinase II (CaMKII), and phospholamban (PLB) compared to control.ConclusionsRUA could induce electrophysiological changes such as APD and QT prolongation, fibrosis, and inflammation dose-dependently, with significant increase of ventricular arrhythmia at the concentration of 400 µg/m3. RUA concentration of 800 µg/m3 increased phosphorylation of CaMKII and PLB.

Air Pollution and the Dynamic Association Between Depressive Symptoms and Memory in Oldest-Old Women.

Exposure to air pollution may contribute to both increasing depressive symptoms and decreasing episodic memory in older adulthood, but few studies have examined this hypothesis in a longitudinal context. Accordingly, we examined the association between air pollution and changes in depressive symptoms (DS) and episodic memory (EM) and their interrelationship in oldest-old (aged 80 and older) women. Prospective cohort data from the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes. Geographically diverse community-dwelling population. A total of 1,583 dementia-free women aged 80 and older. Women completed up to six annual memory assessments (latent composite of East Boston Memory Test and Telephone Interview for Cognitive Status) and the 15-item Geriatric Depression Scale (GDS-15). We estimated 3-year average exposures to regional particulate matter with aerodynamic diameter below 2.5 μm (PM2.5 ) (interquartile range [IQR] = 3.35 μg/m3 ) and gaseous nitrogen dioxide (NO2 ) (IQR = 9.55 ppb) at baseline and during a remote period 10 years earlier, using regionalized national universal kriging. Latent change structural equation models examined whether residing in areas with higher pollutant levels was associated with annual changes in standardized EM and DS while adjusting for potential confounders. Remote NO2 (β = .287 per IQR; P = .002) and PM2.5 (β = .170 per IQR; P = .019) exposure was significantly associated with larger increases in standardized DS, although the magnitude of the difference, less than 1 point on the GDS-15, is of questionable clinical significance. Higher DS were associated with accelerated EM declines (β = -.372; P = .001), with a significant indirect effect of remote NO2 and PM2.5 exposure on EM declines mediated by DS. There were no other significant indirect exposure effects. These findings in oldest-old women point to potential adverse effects of late-life exposure to air pollution on subsequent interplay between DS and EM, highlighting air pollution as an environmental health risk factor for older women.

Faktor Risiko Kesehatan Lingkungan Di Sekolah Dasar Kabupaten Padang Pariaman

School conditions that do not meet environmental health requirements are a threat to students and school members to be affected by health problems and infectious diseases. The purpose of this study was to analyze risk factors for environmental health at SDN 13 Batang Gasan and the potential health problems that would arise. This research is descriptive, with the population is the facilities and infrastructure and all students of SD Negeri 13 Batang Gasan, totaling 82 people. Data analysis was performed using environmental health risk factor analysis, namely providing answers about the risks that will arise, by dividing 6 risk criteria, namely very high (&gt; 80%), high (60% -79%), moderate (40% -59%), low (20% -39%), very low (1% -19%) and safe / not risky (0%). The results of the study prove that the level of environmental health risk in Public Elementary School 13 is high (65%). It is suggested that schools need to make efforts to control risk factors.

Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors

The Global Burden of Disease (GBD) study, coordinated by the Institute for Health Metrics and Evaluation (IHME), produces influential, data-driven estimates of the burden of disease and premature death due to major risk factors. Expanded quantification of disease due to environmental health (EH) risk factors, including climate change, will enhance accuracy of GBD estimates, which will contribute to developing cost-effective policies that promote prevention and achieving Sustainable Development Goals. We review key aspects of the GBD and introduce the Global Burden of Disease–Pollution and Health Initiative (GBD-PHI), which aims to work with IHME and the GBD study to improve estimates of disease burden attributable to EH risk factors and to develop an innovative approach to estimating climate-related disease burden—both current and projected. We discuss strategies for improving GBD quantification of specific EH risk factors, including air pollution, lead, and climate change. We highlight key methodological challenges, including new EH risk factors, notably evidence rating and global exposure assessment. A number of issues present challenges to the scope and accuracy of current GBD estimates for EH risk factors. For air pollution, minimal data exist on the exposure–risk relationships associated with high levels of pollution; epidemiological studies in high pollution regions should be a research priority. For lead, the GBD’s current methods do not fully account for lead’s impact on neurodevelopment; innovative methods to account for subclinical effects are needed. Decisions on inclusion of additional EH risk–outcome pairs need to be guided by findings of systematic reviews, the size of exposed populations, feasibility of global exposure estimates, and predicted trends in exposures and diseases. Neurotoxicants, endocrine-disrupting chemicals, and climate-related factors should be high priorities for incorporation into upcoming iterations of the GBD study. Enhancing the scope and methods will improve the GBD’s estimates and better guide prevention policy.

Policy options for India to minimize air pollution exposure and its health burden

Background:Air pollution has been identified as the largest environmental health risk factor in India. Objective:This work explores policy options for India which are feasible and sustainable. Results:India has already implemented Pradhan Mantri Ujjwala Yojana welfare scheme where clean fuel is being supplied to millions of poor households to curb household emissions. Estimates suggest that complete mitigation of household emissions (from cooking, lighting and heating) would reduce the ambient PM2.5 exposure by 30% (in addition to complete reduction of household exposure) that translates into almost 13% reduction in mortality burden. In near future, India needs to turn attention to key outdoor sources. If India follows current legislative emission pathway, ambient PM2.5 exposure is expected to rise by 40.6% and 47.5% in 2030 under RCP4.5 and RCP8.5 scenarios, respectively. On the contrary, short-lived climate pollutant (SLCP) mitigation emission pathway would contain ambient PM2.5 exposure in 2030 similar to the 2010 level. The mortality burden attributable to ambient PM2.5 is expected to increase by 88.7% (5-95 UI 62%-118%) in 2030 from 2010 for the current legislative emission pathway. Switching to SLCP mitigation emission would save 380,000 (270,000-510,000) lives in 2030. This benefit would come at the expense of an additional 0.3-0.5 degree C temperature rise, but is also expected to enhance precipitation. Discussion:Though this is not enough to meet United Nations sustainable development goal targets, achieving this by successfully implementing National Clean Air Program would be a big step forward for India. Further aggressive measures are required if it were to reduce the staggering health burden attributable to air pollution.

Jointly modeling the adoption and use of clean cooking fuels in rural India

Solid fuel combustion is a major cause of household air pollution, a leading environmental health risk factor globally. In India, over 750 million people continue to rely on firewood and other solid fuels for daily cooking. We explore the drivers of adoption and use of liquefied petroleum gas (LPG), India’s dominant clean cooking fuel. We document strides in LPG ownership using a panel dataset of over 8,500 rural households from six Indian states surveyed in 2015 and 2018 (ACCESS), partially due to India’s flagship clean cooking policy Pradhan Mantri Ujjwala Yojana (PMUY). We further demonstrate that the drivers of initial LPG adoption also apply to use. While fuel stacking—using solid fuels and LPG jointly—is pervasive, improved rural incomes and education result in the increased use of clean cooking fuels. After adoption, general LPG customers are predicted to consume on average 93 kilograms of LPG yearly (95% confidence interval (CI): 91–95 kg/year). However, PMUY beneficiaries are predicted to consume 27 kilograms of LPG (95% CI: 24–30 kg/year) less on average than general customers each year, even after controlling for socio-economic differences and years of using LPG. Our findings suggest that additional strategies to accelerate the transition to exclusive LPG use among the 80 million households acquiring LPG through PMUY should aim to improve affordability and increase awareness to realize the full benefits of the Government of India’s investments in cleaner cooking.

National and international experience of hygienic regulation of aircraft noise (literature review)

In the modern world, in the era of global industrialization, urbanization, and digitalization, providing safe living conditions is getting increasingly important. At the same time, the balance between providing comfort, economic expedience, and safety is an extremely important aspect. Development of technologies in the aviation industry, expansion of cities and their approaching to airports, as well as increased migration and tourist flows are the main challenges to ensuring a safe human environment. Currently, noise pollution, which is one of the main environmental health risk factors, is a serious public health problem. According to WHO Guidelines, air transport noise takes the first place for its annoying effect on the population. According to the European Guidelines, a cause-effect relationship between night noise exposure and health status change has been identified. This paper analyzes national and foreign procedural and technical approaches to the regulation and assessment of aircraft noise in residential areas in the vicinity of airports. The sanitary rules СП 2.1.8.3565-193 currently in force on the territory of the Russian Federation regulate the assessment of aircraft noise for compliance with allowable levels by the equivalent sound level standard for daytime and nighttime established for residential areas. This approach is harmonized with international legislation; however, regulatory values presented in the new sanitary rules are both the same for all residential areas and the most stringent in comparison with the standards in countries with highly developed aviation worldwide.

Perception of Environmental, Climatic and Anthropogenic Health Risk Factors by the Urban Population of the Russian Far North

Introduction: The objective of the study was to characterize subjective perception of environmental, climatic and anthropogenic health risk factors by indigenous and non-indigenous urban population of the Far North. Materials and methods: In summer–autumn 2019, we conducted a questionnaire-based survey (n=446) in two cities of the Russian Far North to establish the main features of public perception of environmental, climatic and anthropogenic health risk factors. Results: We established that one third of the respondents described northern climatic conditions as “severe” or “rather severe” without any marked differences in opinion between groups of respondents formed by criteria of age, sex, and nativity. The specific local features perceived as having the most adverse health effects included the polar night, atmospheric pressure and temperature fluctuations, and strong winds. A significantly more negative perception and harder adaptation to the climate of the Far North were typical of all women and non-indigenous people. They were also more persevering in self-preservation to minimize adverse health effects of the local factors and practiced compliance with daily living routines, diet control, vitamin intake, etc. Conclusions: We found that adverse climatic conditions, high levels of anthropogenic contamination in the northern urban areas, and the resulting worries about children’s health were the leading “push-out” factors of migration. Pronounced migration intentions were noted among both the locally born and bred people and the migrants. We also observed no significant differences between those groups in ranking the importance of climatic and anthropogenic factors in decision to leave.

Explaining the impact of environmental risk factors on cardiovascular health by the “exposome” concept

There is growing evidence that environmental risk factors (pollution and non‐chemical stressors) contribute to the global burden of cardiovascular, metabolic and mental disease. Clinical and epidemiological studies support that traffic‐associated environmental risk factors, air pollution and noise exposure, are associated with a higher risk for cardiovascular disease and significantly contribute to overall mortality. According to the results of the Lancet Commission on pollution and health, up to 9 Mio global annual deaths can be attributed to environmental pollution [Landrigan et al., Lancet 2018]. The numbers will rather increase in the future, because of increasing urbanization and continuous refinement of global exposure‐mortality models, which is supported by the recently reported global all‐cause mortality rate attributable to ambient air pollution by PM2.5 and O3 of 8.79 Mio [Lelieveld et al. and Münzel, Eur Heart J 2019]. Air pollution is obviously the leading health risk factor in the physical environment, followed by water and soil pollution with heavy metals, pesticides, other chemicals and occupational exposures. However, non‐chemical environmental health risk factors such as mental stress, light exposure, climatic changes and traffic noise are so far ignored by global health action plans. Especially for traffic noise‐related health effects there are numerous clinical and epidemiological studies reporting significant impact on cardiovascular disease. In this respect, the “exposome” concept represents a comprehensive description of lifelong exposure history and a rather novel scientific field that is now investigated more systematically. We here provide an in‐depth overview on the health effects of the external exposome, with emphasis on air pollution and traffic noise, and briefly present the actual studies on this topic. In addition, we summarize our previously published experimental research investigating effects of aircraft noise exposure in mice and men providing mechanistic insights on how noise contributes to non‐communicable disease.Support or Funding InformationThe present work was supported by the Boehringer Ingelheim Foundation “Novel and neglected risk factors” (to A.D. and T.M.).The exposome concept. The external exposome represents the sum of all environmental exposures including behavioral/ lifestyle factors. The external exposome (e.g. mental stress and environmental pollution) confer changes of the internal exposome (e.g. altered circadian clock by forward/backward shift, stress hormones, inflammation and oxidative stress) leading to health risks and disease conditions (e.g. atherosclerosis, vascular stenosis and myocardial infarction). BJP, submitted.Figure 1

Influence of mental stress and environmental toxins on circadian clocks: Implications for redox regulation of the heart and cardioprotection.

Risk factors in the environment such as air pollution and mental stress contribute to the development of chronic non‐communicable disease. Air pollution was identified as the leading health risk factor in the physical environment, followed by water pollution, soil pollution/heavy metals/chemicals and occupational exposures, however neglecting the non‐chemical environmental health risk factors (e.g. mental stress and noise). Epidemiological data suggest that environmental risk factors are associated with higher risk for cardiovascular, metabolic and mental diseases, including hypertension, heart failure, myocardial infarction, diabetes, arrhythmia, stroke, depression and anxiety disorders. We provide an overview on the impact of the external exposome comprising risk factors/exposures on cardiovascular health with a focus on dysregulation of stress hormones, mitochondrial function, redox balance and inflammation with special emphasis on the circadian clock. Finally, we assess the impact of circadian clock dysregulation on cardiovascular health and the potential of environment‐specific preventive strategies or “chrono” therapy for cardioprotection.LINKED ARTICLESThis article is part of a themed issue on Risk factors, comorbidities, and comedications in cardioprotection. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.23/issuetoc

Геоинформационные системы в популяционном анализе распространения депрессивных расстройств в Хабаровске

The research is devoted to the use of modern geoinformation technologies for the analysis of spatial medical and demographic data. On the example of the medical and ecological geoinformation system (MEGIS) of Khabarovsk the possibilities of geoinformation technologies in the study of the spread of depressive disorders in a large city and the analysis of cause-and-effect relationships between this disease and some socio-economic factors are shown. The features of mathematical support of MEGIS necessary for population epidemiological analysis are considered. The possibilities of using correlation-regression and cluster-discriminant analysis for these purposes are shown. At the stage of the initial manifestation of symptoms of depression, statistically significant binary risk factors for depressive disorders were established, which were used in the diagnostic questionnaire. Developed complex recognition, classification and predictive models on the individual level, to assess the risk of developing depressive disorders and to predict the potential severity of the disease. At the population level, risk groups for depressive disorders in patients who have suffered depressive episodes in childhood should be formed. Based on the results of multi-level GIS and classification and predictive modeling based on individual clinical dynamically, socio-psychological, transcultural and environmental health risk factors formulated practical recommendations to improve the prevention of depressive disorders. The study of clinical and pathodynamic, socio-psychological, transcultural and medico-ecological aspects of non-psychotic depressive disorders with the use of geoinformation systems was carried out for the prevention of depression and mental health stabilization of the region population. The results of this research can be used by specialists in geoinformation systems, medical demography, medical psychology and social psychiatry, sociology, psychiatry, psychology and family medicine, conflictology, information modeling and system analysis in health care.

TOPICALITY OF MONITORING OF INDUSTRIAL FREQUENCY MAGNETIC FIELDS OF 50 HZ IN RESIDENTIAL AND PUBLIC BUILDINGS

The problem of ensuring safety of electric and magnetic fields (EMF) of extremely low frequencies (ELF) is resulted from the development of the first low-frequency generators producing penetrating effect and causing negative biological outcomes. World power resources are doubling every 10 years, and ELF EMF are generated around by such sources. The number of sources on the scale of application, power and design diversity significantly exceeds those generating EMF in other frequency ranges. The population is exposed to 50 Hz ELF at work, in electric transport, in residential and public buildings, in residential areas. ELF EMF was found both to “pollute” the environment, be an environmental health risk factor, and affect negatively the health with potential long-term outcomes. Development of various methods and means of protection against the effect of ELF EMF remains relevant today. Limitation (regulation) of the effect of the factor both in terms of intensity and exposure is the most effective protection. Epidemiological studies to identify the relationship between exposure to ELF magnetic fields (MF) and carcinogenesis are on-going. A task panel group of research experts, established by WHO in 2005, conducted a routine procedure to assess health risks resulting from exposure to ELF MFs and, in particular, cancer and considered them to lack evidence. However, the significance of the data obtained was noted to be reduced due to procedural problems, potential systematic error of assessment. The problem remains unsolved. Research using various types of monitoring: social and hygienic, sanitary and epidemiological, is going on. Spatio-temporal monitoring of 50 Hz ELF MF in enclosed spaces of residential and public buildings, where a variety of equipment, devices, power supply systems, generating different MF levels, is an important area. The population is exposed to these conditions most of the day. Monitoring will allow assessing electromagnetic load at short-term and long-term exposures.

Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors.

Background:The Global Burden of Disease (GBD) study, coordinated by the Institute for Health Metrics and Evaluation (IHME), produces influential, data-driven estimates of the burden of disease and premature death due to major risk factors. Expanded quantification of disease due to environmental health (EH) risk factors, including climate change, will enhance accuracy of GBD estimates, which will contribute to developing cost-effective policies that promote prevention and achieving Sustainable Development Goals.Objectives:We review key aspects of the GBD for the EH community and introduce the Global Burden of Disease–Pollution and Health Initiative (GBD-PHI), which aims to work with IHME and the GBD study to improve estimates of disease burden attributable to EH risk factors and to develop an innovative approach to estimating climate-related disease burden—both current and projected.Methods:We discuss strategies for improving GBD quantification of specific EH risk factors, including air pollution, lead, and climate change. We highlight key methodological challenges, including new EH risk factors, notably evidence rating and global exposure assessment.Discussion:A number of issues present challenges to the scope and accuracy of current GBD estimates for EH risk factors. For air pollution, minimal data exist on the exposure–risk relationships associated with high levels of pollution; epidemiological studies in high pollution regions should be a research priority. For lead, the GBD’s current methods do not fully account for lead’s impact on neurodevelopment; innovative methods to account for subclinical effects are needed. Decisions on inclusion of additional EH risk–outcome pairs need to be guided by findings of systematic reviews, the size of exposed populations, feasibility of global exposure estimates, and predicted trends in exposures and diseases. Neurotoxicants, endocrine-disrupting chemicals, and climate-related factors should be high priorities for incorporation into upcoming iterations of the GBD study. Enhancing the scope and methods will improve the GBD’s estimates and better guide prevention policy. https://doi.org/10.1289/EHP5496

The "exposome" concept - how environmental risk factors influence cardiovascular health.

There is general consensus that environmental pollution and non-chemical stressors contribute to the incidence and prevalence of chronic noncommunicable disease (e.g. cardiovascular, metabolic and mental). Clinical and epidemiological studies support that air pollution and traffic noise are associated with a higher risk for cardiovascular disease and significantly contribute to overall mortality. In this respect, the "exposome" provides a comprehensive description of lifelong exposure history. A recent publication using an updated global exposure-mortality model found that the global all-cause mortality rate attributable to ambient air pollution by PM2.5 and O3 was 8.79 (95% CI 7.11-10.41) million in 2015 - much higher than previously calculated. For Europe this corresponds to 790,000 premature deaths due to ambient air pollution. Various large scale studies and expert commissions have identified air pollution as the leading health risk factor in the physical environment, followed by water and soil pollution with heavy metals, pesticides, other chemicals and occupational exposures, however neglecting the non-chemical environmental health risk factors: mental stress, light exposure, climatic changes and traffic noise. Especially for traffic noise-related health effects there are numerous clinical and epidemiological studies reporting significant impact on cardiovascular disease. We here provide an in-depth review on the health effects of the external exposome, with emphasis on air pollution and traffic noise and to a lesser degree mental stress and other environmental pollutants. In addition, we summarize our previously published experimental research investigating effects of aircraft noise exposure in mice and provide mechanistic insights on how noise contributes to noncommunicable disease.

The global burden of transportation tailpipe emissions on air pollution-related mortality in 2010 and 2015

Emissions from the transportation sector are a major contributor to ambient air pollution, the leading environmental health risk factor globally. This study aims to quantify the contribution of tailpipe emissions from global transportation, disaggregated by four sub-sectors, to the global disease burden associated with ambient fine particulate matter (PM2.5) and ground-level ozone in 2010 and 2015. We use the GEOS-Chem global chemical transport model to simulate transportation-attributable PM2.5 and ozone concentrations, combined with epidemiological health impact assessment methods consistent with the Global Burden of Disease 2017 study to estimate the associated burden of disease. We estimate that emissions from the transportation sector were associated with 361 000 (95% CI, 258 000–462 000) PM2.5 and ozone deaths in 2010 and 385 000 (95% CI, 274 000–493 000) in 2015. These results translate into 11.7% of total global ambient PM2.5 and ozone deaths in 2010 and 11.4% in 2015. Together, PM2.5 and ozone concentrations from transportation tailpipe emissions resulted in an estimated 7.8 million years of life lost and approximately $1 trillion (2015 US$) in health damages globally in 2015. Among transportation sub-sectors, on-road diesels contributed most to the health burden from transportation tailpipe emissions in nearly all trade blocs, for both PM2.5 and ozone, though other sub-sectors also contributed substantially (particularly on-road non-diesel vehicles for ozone mortality, and shipping and non-road mobile sources for PM2.5 mortality). These results indicate that despite recent adoption of more stringent vehicle emission regulations in many countries, the transportation sector remains a major contributor to the air pollution disease burden globally. Future work may explore the degree to which currently adopted policies, as well as expected growth in the transportation sector in India, Africa, and other rapidly developing locations, will influence future transportation-attributable public health burdens.

Study Design, Rationale and Procedures for Human Biomonitoring of Hazardous Chemicals from Foods and Cooking in Korea.

Objectives: A nationwide biomonitoring program identified the long-term trends of environmental exposures to hazardous chemicals in the general population and found geographical locations where body burdens of an exposed group significantly differed from those of the general population. The purpose of this study is to analyze the hazardous compounds associated with foods and cooking in the nationwide general population for evaluation of the environmental exposures and health risk factors and for the establishment of the reference levels at the national level. Methods: During 2009–2010, the National Institute of Food and Drug Safety Evaluation (NIFDS) conducted a nationwide human biomonitoring study, including a questionnaire survey and environmental exposure assessments for specific hazardous compounds from foods and cooking among the general population in South Korea. Results: A total of 2139 individuals voluntarily participated in 98 survey units in South Korea, including 889 (41.6%) men and 1250 women (58.4%). Bio-specimens (serum and urine) and questionnaires were collected from the study population. Acrylamides, heterocyclic amines (HCAs), phenols, and phthalates were analyzed from urine, and perfluorinated compounds (PFCs) and organic chloride pesticides (OCPs) were analyzed from serum samples. The information on exposure pathway and geographical locations for all participants was collected by questionnaire interviews, which included demographic characteristics, socioeconomic status, history of family diseases, conditions of the indoor and outdoor environment, lifestyles, occupational history, and food and dietary information. Conclusion: We describe the design of the study and sampling of human biospecimen procedures including bio-sample repository systems. The resources produced from this nationwide human biomonitoring study and survey will be valuable for use in future biomarkers studies and for the assessment of exposure to hazardous compounds associated with foods and cooking.

Translating Nutrition Research into Healthy Building Standards (P16-059-19)

ObjectivesTo codify scientific, medical and industry research and best practices into design, policy and performance interventions that may improve the nutritional health of individuals in buildings around the world. MethodsThe WELL Building Standard™ (WELL™) is the first global rating system to holistically focus on promoting health and well-being through building design, construction and operations. WELL was developed by integrating scientific and medical research on environmental health, behavioral factors, health outcomes and demographic risk factors with leading practices in building design, construction and management. WELL launched in 2014 after six years of research and development and a comprehensive expert peer review process. WELL Certification is third-party administered and involves on-site performance testing to ensure buildings perform as designed. ResultsWELL is administered by the International WELL Building Institute™ and builds upon green and sustainable building practices. WELL addresses 10 topic areas (concepts) of the built environment: Air, Water, Nourishment, Light, Movement, Thermal Comfort, Sound, Materials, Mind and Community. Each concept is comprised of features that are either preconditions (mandatory) or optimizations (optional). The Nourishment concept includes design interventions and nutrition policies that focus on increasing access to fruits and vegetables and promoting nutritional transparency. Projects may also choose to voluntarily pursue features that target food advertising, portion sizes, nutrition education, food allergies and alternatives, responsible food sourcing and local food production, among other topics that may influence dietary health.There are currently over 1200 projects across 265 million square feet in 43 countries applying WELL. Post-occupancy survey data from certified projects can help elucidate the impact of the built environment on human health and inform the continuous evolution of the standard. ConclusionsGiven that individuals spend 90% of their time indoors, integrating nutrition research and dietary recommendations into healthy building standards can help improve nutritional health through enhanced food environments. Funding SourcesNone.

Future impacts of environmental factors on achieving the SDG target on child mortality—A synergistic assessment

An estimated 26% of current global child deaths can be attributed to various and modifiable environmental factors, which are addressed under multiple Sustainable Development Goals (SDGs). This study assesses future reductions in child mortality in relation to the achievement of environment-related SDG targets. It uses projections of health risk factors from the IMAGE 3.0 Integrated Assessment Model, based on the Shared Socioeconomic Pathways (SSPs), linked to a standard multi-state health model (GISMO), distinguishing risk factors, disease occurrence and cause-specific death. The study concludes that, on a global level, the SDG target on child mortality will not be achieved in any of the three SSP scenarios analysed, mainly due to persistent high mortality rates in Sub-Saharan Africa and South Asia. By 2030, environmental health risk factors – including childhood undernutrition, no access to improved drinking water and sanitation, no access to modern fuels and exposure to malaria – will still be responsible for 14% to 16% of total global child deaths (8% to 10% when excluding nutrition-related mortality). Under the middle-of-the-road SSP2 baseline scenario, achievement of the SDG targets on hunger, drinking water and sanitation and modern energy services, would avoid 433 thousand child deaths by 2030. If, in addition, also higher standards would be achieved for access to water and energy, as well as universal secondary female education and advanced malaria control, a total of 733 thousand child deaths is projected to be avoided by 2030 (444 thousand child deaths, when excluding nutrition-related mortality), which would reduce projected global child mortality by 13%. Overall, more than 25% of the child mortality reduction that is needed to achieve the SDG target in Sub-Saharan Africa can be achieved through SDG-related policies on food, water and energy. This requires integrated and intersectoral approaches to environmental health.