Residential Exposure Research Articles

Residential exposure to microbial emissions from livestock farms: Implementation and evaluation of land use regression and random forest spatial models

Adverse health effects have been linked with exposure to livestock farms, likely due to airborne microbial agents. Accurate exposure assessment is crucial in epidemiological studies, however limited studies have modelled bioaerosols. This study used measured concentrations in air of livestock commensals (Escherichia coli (E. coli) and Staphylococcus species (spp.)), and antimicrobial resistance genes (tetW and mecA) at 61 residential sites in a livestock-dense region in the Netherlands. For each microbial agent, land use regression (LUR) and random forest (RF) models were developed using Geographic Information System (GIS)-derived livestock-related characteristics as predictors. The mean and standard deviation of annual average concentrations (gene copies/m3) of E. coli, Staphylococcus spp., tetW and mecA were as follows: 38.9 (±1.98), 2574 (±3.29), 20991 (±2.11), and 15.9 (±2.58). Validated through 10-fold cross-validation (CV), the models moderately explained spatial variation of all microbial agents. The best performing model per agent explained respectively 38.4%, 20.9%, 33.3% and 27.4% of the spatial variation of E. coli, Staphylococcus spp., tetW and mecA. RF models had somewhat better performance than LUR models. Livestock predictors related to poultry and pig farms dominated all models. To conclude, the models developed enable enhanced estimates of airborne livestock-related microbial exposure in future epidemiological studies. Consequently, this will provide valuable insights into the public health implications of exposure to specific microbial agents.

Residential greenspace exposure, particularly green window-views, is associated with improved sleep quality among older adults: Evidence from a high-density city

Preliminary evidence suggests a potential link between greenspace exposure and better sleep quality. Here we aimed to investigate the specific associations between residential greenspace exposure, green-window views, and sleep quality among older adults and determine whether these associations were mediated through mitigation (i.e., perceived noise annoyance, air pollution, and artificial light pollution) and restoration (i.e., psychological stress) pathways. A total of 1007 older adults with an average age >70 years were recruited from 40 residential communities in the Old City District of Nanjing, China. We developed a set of fine-grained greenspace exposure indices based on 3D point cloud data derived from unmanned aerial vehicle photogrammetry, incorporating vegetation coverage and green volume ratio at the community level and green window ratio at the individual level. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. We examined the complex interrelationships between residential greenspace exposure, environmental stressors (air pollution, artificial light pollution, and noise), perceived mental stress, and sleep quality using multilevel linear regression models. The results suggested the following: (1) Vegetation coverage, green volume ratio, and green window ratio were significantly associated with sleep quality in older adults. (2) The green window ratio was more strongly associated with improved sleep quality than other greenspace exposure metrics. (3) These associations may be partially explained by noise mitigation and mental stress reduction. In conclusion, it seems advantageous to consider immediate residential greenspace, particularly through green-window views, as part of the interventions aimed at supporting sleep quality improvement among older adults.

Outdoor air pollution exposure and uterine cancer incidence in the sister study.

Outdoor air pollution is a ubiquitous exposure that includes endocrine-disrupting and carcinogenic compounds that may contribute to the risk of hormone-sensitive outcomes such as uterine cancer. However, there is limited evidence about the relationship between outdoor air pollution and uterine cancer incidence. We investigated the associations of residential exposure to particulate matter less than 2.5 µm in diameter (PM2.5) and nitrogen dioxide (NO2) with uterine cancer among 33,417 Sister Study participants with an intact uterus at baseline (2003-2009). Annual average air pollutant concentrations were estimated at participants' geocoded primary residential address(es) using validated spatiotemporal models. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between time-varying 12-month PM2.5 (µg/m3) and NO2 (ppb) averages and uterine cancer incidence. Over a median follow-up period of 9.8 years, 319 incident uterine cancer cases were identified. A 5-ppb increase in NO2 was associated with a 23% higher incidence of uterine cancer (HR = 1.23, 95% CI 1.04-1.46), especially among participants living in urban areas (HR = 1.53, 95% CI: 1.13-2.07). However, PM2.5 was not associated with increased uterine cancer incidence. In this large U.S. cohort, NO2, a marker of vehicular traffic exposure, was associated with a higher incidence of uterine cancer. These findings expand the scope of health effects associated with air pollution, supporting the need for policy and other interventions designed to reduce air pollutant exposure.

Long-term exposure to air pollution and incidence of gastric and the upper aerodigestive tract cancers in a pooled European cohort: The ELAPSE project.

Air pollution has been shown to significantly impact human health including cancer. Gastric and upper aerodigestive tract (UADT) cancers are common and increased risk has been associated with smoking and occupational exposures. However, the association with air pollution remains unclear. We pooled European subcohorts (N = 287,576 participants for gastric and N = 297,406 for UADT analyses) and investigated the association between residential exposure to fine particles (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone in the warm season (O3w) with gastric and UADT cancer. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. During 5,305,133 and 5,434,843 person-years, 872 gastric and 1139 UADT incident cancer cases were observed, respectively. For gastric cancer, we found no association with PM2.5, NO2 and BC while for UADT the hazard ratios (95% confidence interval) were 1.15 (95% CI: 1.00-1.33) per 5 μg/m3 increase in PM2.5, 1.19 (1.08-1.30) per 10 μg/m3 increase in NO2, 1.14 (1.04-1.26) per 0.5 × 10-5 m-1 increase in BC and 0.81 (0.72-0.92) per 10 μg/m3 increase in O3w. We found no association between long-term ambient air pollution exposure and incidence of gastric cancer, while for long-term exposure to PM2.5, NO2 and BC increased incidence of UADT cancer was observed.

Trends in orthoplastic operative exposure for plastic surgery residents in the United States

Recent trials have demonstrated clinical benefits to a combined orthoplastic approach for complex reconstructive surgery of the hand, upper and lower extremity. We sought to assess recent trends in exposure to orthoplastic-type procedures among plastic surgery residents training in the United States. Independent plastic surgery residents' case logs were extracted from the Accreditation Council for Graduate Medical Education (2011-2022). Select reconstructive procedure were taken as proxies for orthoplastic-type cases and analyzed by descriptive statistical analysis. The average number of orthoplastic-type cases completed per resident per year increased from 168.2 to 189.2 (12.5% increase) between 2011-2022. The greatest increase was in exposure to peripheral nerve injury repair of the hand and upper extremity (22.6 to 39.1, 73% increase). As a proportion of total procedures during the study period, orthoplastic-type procedures remained relatively unchanged (range 9.5-10.4%). Our findings suggest that plastic surgery residents may be increasingly well-prepared to contribute to orthoplastic care during and following their training. The steady proportion of cases that orthoplastic-type procedures represented over the study period suggests the increase in relevant orthoplastic case volume may be incidental and secondary to an overall rise among all procedures. Given evidence of the benefits of an orthoplastic approach, we recommend consideration of explicit benchmarks for orthoplastic training among plastic surgery residents.

Associations of residential green space with internalizing and externalizing behavior in early childhood

BackgroundGreen space exposures may promote child mental health and well-being across multiple domains and stages of development. The aim of this study was to investigate associations between residential green space exposures and child mental and behavioral health at age 4–6 years.MethodsChildren’s internalizing and externalizing behaviors in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort in Shelby County, Tennessee, were parent-reported on the Child Behavior Checklist (CBCL). We examined three exposures—residential surrounding greenness calculated as the Normalized Difference Vegetation Index (NDVI), tree cover, and park proximity—averaged across the residential history for the year prior to outcome assessment. Linear regression models were adjusted for individual, household, and neighborhood-level confounders across multiple domains. Effect modification by neighborhood socioeconomic conditions was explored using multiplicative interaction terms.ResultsChildren were on average 4.2 years (range 3.8-6.0) at outcome assessment. Among CANDLE mothers, 65% self-identified as Black, 29% as White, and 6% as another or multiple races; 41% had at least a college degree. Higher residential surrounding greenness was associated with lower internalizing behavior scores (-0.66 per 0.1 unit higher NDVI; 95% CI: -1.26, -0.07) in fully-adjusted models. The association between tree cover and internalizing behavior was in the hypothesized direction but confidence intervals included the null (-0.29 per 10% higher tree cover; 95% CI: -0.62, 0.04). No associations were observed between park proximity and internalizing behavior. We did not find any associations with externalizing behaviors or the attention problems subscale. Estimates were larger in neighborhoods with lower socioeconomic opportunity, but interaction terms were not statistically significant.ConclusionsOur findings add to the accumulating evidence of the importance of residential green space for the prevention of internalizing problems among young children. This research suggests the prioritization of urban green spaces as a resource for child mental health.

(120) A Survey of Exposure to the Use of Xiaflex for the Treatment of Peyronie’s Disease Among United States Urology Residency Programs

Abstract Introduction Xiaflex (Collagenase Clostridium Histolyticum) is an FDA-approved treatment for patients with Peyronie’s Disease. However, despite its approval and widespread implementation in clinical practice, there is concern that urologists in training are offered minimal exposure to its use. Objective Thus, the purpose of this study was to evaluate the exposure of urology residents to Peyronie’s Disease and its management, particularly Xiaflex. Methods A six-question Google Forms survey regarding exposure of residents to Peyronie’s Disease and the Use of Xiaflex was created. The survey was disseminated through email to urology residency program directors, chief residents, or andrology-focused faculty. Results Overall, 47 institutional responses were received, eliciting a response rate of approximately 34%. At 45 institutions (96%), residents receive training in directly evaluating and caring for patients with Peyronie’s disease. Of these, in 36 institutions the training is led by an academic faculty who is fellowship trained in sexual medicine. At 46 institutions (98%), residents receive training in observing and/or performing surgical procedures such as plication, grafting, and penile implants for Peyronie’s disease. With regards to surgical treatment, residents are trained by an academic faculty who is fellowship trained in sexual medicine at 35 programs. Conversely, residents at only 31 institutions (66%) receive observational or procedural training for non-surgical management of Peyronie’s disease, specifically Xiaflex. Residents receive non-surgical training by an academic faculty who is fellowship trained in sexual medicine at 25 institutions and an academic faculty who is not trained in sexual medicine at 6 institutions. When categorizing based on AUA section: 3 out of 4 Mid-Atlantic programs (75%), 3 out of 4 New England programs (75%), 2 out of 8 New York programs (25%), the 1 Northeastern program (100%), all 11 North Central programs (100%), 5 out of 6 South Central programs (83.33%), 5 out of 6 Southeastern programs (83.33%), and 3 out of 6 Western programs (50%) reported residency exposure to the use of Xiaflex. Conclusions Urology residents receive broad exposure to the management of Peyronie’s Disease, particularly its surgical treatment. However, there exists a glaring disparity in residency exposure to Xiaflex, which represents the sole FDA-approved medical management for Peyronie’s Disease. To our knowledge, we present the first study evaluating resident exposure to Xiaflex in the treatment of PD. We believe it is important for United States residency programs to ensure that their trainees are educated on the use of this treatment option. A broader incorporation of training of Xiaflex among urology residents may increase the number of providers who are comfortable and competent with providing this level of care to a potentially vulnerable patient population. Further research is warranted to elucidate why this discrepancy exists and how programs can provide residents with further exposure to the use of Xiaflex in patients with Peyronie’s Disease. Disclosure No.

Residential greenness and lower breast and prostate cancer incidence: Evidence from a retrospective cohort study of 977,644 participants from Israel

BackgroundThere is limited evidence on the associations between residential greenness and cancer incidence in longitudinal studies. ObjectivesThe aim of the study was to evaluate the associations between weighted mean residential greenness exposure and cancer incidence. MethodsThis is a registry based retrospective cohort study of 977,644 participants. The residential greenness exposure was estimated for every participant, as the weighted mean residential greenness exposure. This was based on the mean Normalized Difference Vegetation Index (NDVI) in the residential small geographic area and the duration of the residence in this area. Cancer incidence cases included consecutive newly diagnosed cases of primary cancer. Analyses were conducted for all cancer sites, lung cancer, bladder cancer, breast cancer, prostate cancer and melanoma-skin cancer. Cox regression models were used to evaluate the crude and adjusted associations (hazards ratios (HR) and its 95 % confidence intervals (CIs)) between tertiles of residential greenness and cancer incidence. Further adjusted models to nitrogen oxides (NOx) were estimated. ResultsAfter adjustment to covariates, exposure to the highest tertile of residential greenness, compared to the lowest, were associated with lower risk for all cancer sites (HR = 0.88, 95 % CI: 0.86–0.90), breast cancer (HR = 0.85, 95 % CI: 0.80–0.89) and prostate cancer (HR = 0.85, 95 % CI: 0.79–0.91). In addition, lower risk were observed for the middle tertile of exposure and all cancer sites (HR = 0.88, 95 % CI: 0.86–0.90), breast cancer (HR = 0.88, 95 % CI: 0.84–0.92) and prostate cancer (HR = 0.83, 95 % CI: 0.79–0.89). There was no evidence for mediation by air pollution (NOx). DiscussionResidential greenness demonstrated beneficial associations with lower risk for all cancers, breast and prostate cancers. If our observations will be replicated, it may present a useful avenue for public-health intervention to reduce cancer burden through the provision of greenness exposure.

Assessing Long-Term Thermal Environment Change with Landsat Time-Series Data in a Rapidly Urbanizing City in China

The studies of urban heat islands or urban thermal environments have attracted extensive attention, although there is still a lack of research focused on the analysis of long-term urban thermal environment change with fine spatial resolution and actual exposure of urban residents. Taking the rapidly urbanizing city of Nanjing, China as an example, this study utilizes the Landsat-derived daytime time-series land surface temperature data to comprehensively assess the city’s long-term (30-year) urban thermal environment change. The results showed that: (1) The overall surface urban heat island intensity showed a noticeable trend of first increasing and then decreasing from 1990 to 2020. (2) It exhibited the detailed spatial distribution of urban heat/cold islands within the urban center boundary. The percentage of surface urban heat islands was 77.01% in 1990, and it increased to 85.79% in 2010 and then decreased to 80.53% in 2020. (3) More than 65% of the urban residents have lived in areas with a surface urban heat island intensity greater than 3.0 °C, which also showed a trend of first increasing and then decreasing from 1990 to 2020. The methods and findings of this study can provide a reference for other studies on urban thermal environment changes and urban sustainable development.

Quantification of Radiation Exposure in Canadian Orthopaedic Surgery Residents.

Natural radiation exposure in the general population averages 3 milliSieverts (mSv) annually; however, radiation exposure in orthopaedic residents is not well defined. Despite protective measures, evidence of radiation-related diseases in orthopaedic surgeons is increasing. The purpose of this study was to quantify radiation exposure in orthopaedic residents and to determine the variability of exposure among post graduate year (PGY) of residency. Monthly radiation exposure was measured prospectively over a 12-month period in orthopaedic surgery residents from a single program. Participants wore dosimeters above ("exposed") and beneath ("shielded") protective lead. The primary outcome measure was the absolute value of radiation exposure in mSv. Repeated measures analysis was used to assess exposure with age, sex, year of training, operating room (OR) days, and height. Mean annual occupational radiation exposure was 3.30 ± 0.64 mSv over an average of 107 ± 38 OR days. Mean exposure per OR day was 0.033 ± 0.008 mSv. PGY-2 and PGY-3 residents had the highest cumulative exposure, and PGY-5 residents had the highest mean exposure per OR day (0.044 ± 0.009 mSv/d). Number of OR days per month and PGY level were significant predictors of radiation exposure (p < 0.05). Sex, age, and height were not significant in predicting radiation of the exposed dosimeter. Orthopaedic residents' exposure to radiation is nearly twice the general population's exposure. Given that yearly radiation exposure was highest during early residency years, but exposure based on number of OR days was highest in the final year of training, it is essential for resident education regarding radiation safety and safe clinical practices throughout their training.

Exposure to residential traffic and trajectories of unhealthy ageing: results from a nationally-representative cohort of older adults

BackgroundTraffic exposure has been associated with biomarkers of increased biological ageing, age-related chronic morbidities, and increased respiratory, cardiovascular, and all-cause mortality. Whether it is associated with functional impairments and unhealthy ageing trajectories is unknown.MethodsNationally representative population-based cohort with 3,126 community-dwelling individuals aged ≥60 years who contributed 8,291 biannual visits over a 10 year period. Unhealthy ageing was estimated with a deficit accumulation index (DAI) based on the number and severity of 52 health deficits, including 22 objectively-measured impairments in physical and cognitive functioning. Differences in DAI at each follow-up across quintiles of residential traffic density (RTD) at 50 and 100 meters, and closest distance to a petrol station, were estimated using flexible marginal structural models with inverse probability of censoring weights. Models were adjusted for sociodemographic and time-varying lifestyle factors, social deprivation index at the census tract and residential exposure to natural spaces.ResultsAt baseline, the mean (SD) age and DAI score of the participants were 69.0 (6.6) years and 17.02 (11.0) %, and 54.0% were women. The median (IQR) RTD at 50 and 100 meters were 77 (31-467) and 509 (182-1802) vehicles/day, and the mean (SD) distance to the nearest petrol station of 962 (1317) meters. The average increase in DAI (95%CI) for participants in quintiles Q2-Q5 (vs Q1) of RTD at 50 meters was of 1.51 (0.50, 2.53), 0.98 (-0.05, 2.01), 2.20 (1.18, 3.21) and 1.98 (0.90, 3.05), respectively. Consistent findings were observed at 100 meters. By domains, most of the deficits accumulated with increased RTD were of a functional nature, although RTD at 50 meters was also associated with worse self-reported health, increased vitality problems and higher incidence of chronic morbidities. Living closer to a petrol station was associated with a higher incidence of functional impairments and chronic morbidities.ConclusionsExposure to nearby residential traffic is associated with accelerated trajectories of unhealthy ageing. Diminishing traffic pollution should become a priority intervention for adding healthy years to life in the old age.

P450 Influence of radon levels at home in the clinical course of inflammatory bowel disease incident patients

Abstract Background Inflammatory Bowel Diseases (IBD) are a group of pathologies of unknown etiology associated with some environmental factors, only partially identified. The role of indoor radon, a radioactive gas, has not been formally studied and it might play a role on the evolution of the disease. The aim of this study is to analyze if residential radon exposure is associated with the evolution and development of flares or hospitalizations of IBD new diagnosed patients in a radon-prone area. Methods An observational prospective study was developed between June 2020 and September 2023, including incident cases with IBD that had been living at least 5 years in the same dwelling, those with a change of address in the last 5 years prior to diagnosis were excluded. All patients were followed-up through one year to assess the evolution of the disease. Hospitalizations related with the disease during the period, and number and severity of flares (measured by Partial Mayo Score and Harvey- Bradshaw) were collected. Radon levels were measured over three months in the participants’ home. Each individual was provided with a residential radon meter (a RSKS trace detector), given and read by the Galician Radon Laboratory, a certified radon laboratory. Radon concentrations were categorized into three groups, 0-99 Bq/m3, 100-299 Bq/m3 and &amp;gt;299 Bq/m3. Results are expressed as Odds Ratios with their 95%CI obtained through logistic regression. Results 136 patients with IBD (78 ulcerative colitis, 52 Crohn’s disease and 6 unclassified colitis) were included and prospectively followed, with a median age of 52 years old (IQR 40 – 59). 50% were females. There were no statistically significant differences in radon levels, taking levels of 0-99 Bq/m3 as reference, between patients hospitalized compared with non-hospitalized (OR 0.8 95%CI 0.3-2.1 for 100-299 Bq/m3, OR 1.7 95%CI 0.6-5.0 for &amp;gt;299 Bq/m3) nor in patients with a flare compared with patients without flares during the follow-up year (OR 0.4 95%CI 0.0-4.5 for 100-299 Bq/m3, OR 5.4 95%CI 0.8-34.3 for &amp;gt;299 Bq/m3). Radon levels were not associated with the number of flares either (OR 0.6 95%CI 0.3-1.7 for 100-299 Bq/m3, OR 1.5 95%CI 0.5-4.5 for &amp;gt;299 Bq/m3). Results are shown in table 1. Stratifying by type of IBD, results do not vary. For Crohn’s disease, OR for flare are 2.5 (95%CI 0.4-16.1) and 4.1 (95%CI 0.6-27.9), and for hospitalization 1 and 6.5 (OR95% (0.2-205-2). For ulcerative colitis, OR for flare are 0.6 (95%CI 0.2-1.8) and 1.8 (95%CI 0.4-7.8) and for hospitalization 0.9 (95%CI 0.1-17.1) and 9.3 (95%CI 0.6-134.0). Conclusion Indoor radon concentration seems to be not associated with an initial worst evolution of IBD patients in terms of hospitalizations or flares.

P1106 Is indoor radon associated with new diagnosis of inflammatory bowel disease patients?

Abstract Background Inflammatory Bowel Diseases (IBD) are a group of pathologies of unknown etiology associated with some environmental factors, only partially identified. The role of indoor radon, a radioactive gas, has not been formally studied and it might play a role on the onset of the disease. The aim of this study is to analyze the role of individual residential radon exposure on the incidence of IBD in a radon-prone area also characterized as a high incidence IBD region. Methods A case-control study was developed in the health area of Santiago de Compostela (Galicia, Spain) between June 2020 and September 2023, including incident cases with IBD. Controls were selected trough a frequency matching based on sex and age and without IBD. All participants had to be living at least 5 years in the same dwelling, those with a change of address in the last 5 years prior to diagnosis were excluded. Endoscopic index, imaging techniques and analytic parameters were collected. Radon levels measured over three months in the participants’ home were compared between cases and controls, and between the different types of IBD. Each individual was provided with a residential radon meter (a RSKS trace detector), given and read by the Galician Radon Laboratory, a certified radon laboratory. Procedure is summarized in Figure 1. Radon concentrations were categorized into three groups, 0-99 Bq/m3, 100-299 Bq/m3 and &amp;gt;299 Bq/m3. Results are expressed as Odds Ratios with their 95%CI obtained through logistic regression. Results 178 incident cases and 178 controls (102 ulcerative colitis, 70 Crohn’s disease and 6 unclassified colitis) were included, with a median age of 51 years old (IQR 40 – 59.5). 51.7% were females. Median radon levels of IBD patients´ homes were 144.5 (IQR 83 – 260) and median radon levels of controls´ homes were 189.5 (IQR 112 – 292.5) (figure 1). Adjusting by age and sex, high radon levels showed a negative association for the development of IBD (taking levels of 0-99 Bq/m3 as reference, OR 100-299 Bq/m3 is 0.5 (95%CI 0.3-0.8), and OR &amp;gt;299 Bq/m3 is 0.5 (95%CI 0.3-0.9). Results are shown in table 1. Analyzing women and men separately, there are no statistically significant differences (p&amp;gt;0.05 in each group). Taking into account the different types of IBD, radon levels show the same negative association but without statistical association. Conclusion High radon levels might be a protective factor for developing IBD overall and its most common types, Crohn’s disease and ulcerative colitis. Further studies in other areas with lower radon concentrations will be necessary to corroborate whether it influences the incidence of IBD.

Associations between air pollutants and acute exacerbation of drug-resistant tuberculosis: evidence from a prospective cohort study

BackgroundShort-term exposure to air pollution may trigger symptoms of drug-resistant tuberculosis (DR-TB) through stimulating lung tissue, damaging tracheobronchial mucosa, the key anti-mycobacterium T cell immune function, and production and release of inflammatory cytokines.ObjectiveTo investigate the association between acute exacerbations of DR-TB and short-term residential exposure to air pollutants (PM10, PM2.5, SO2, NO2, CO and O3) based on a large prospective cohort in Anhui Province, China.MethodPatients were derived from a prospective cohort study of DR-TB in Anhui Province. All DR-TB patients underwent drug-susceptibility testing and prefecture-level reference laboratories confirmed their microbiologies. The case-crossover design was performed to evaluate the association between the risk of acute exacerbations of DR-TB and short-term residential exposure to air pollution.ResultsShort-term NO2 exposure was significantly related to an elevated risk of first-time outpatient visit due to acute exacerbations of DR-TB(relative risk:1.159, 95% confidence interval:1.011 ~ 1.329). Stratification analyses revealed that the relationship between the risk of acute exacerbations and NO2 exposure was stronger in the elderly (age ≥ 65) DR-TB patients, and in individuals with a history of TB treatment.ConclusionsNO2 Exposure was significantly associated with an elevated risk of acute exacerbation of DR-TB in Anhui Province, China.

Association of residential greenness with obstructive sleep apnea among Chinese old adults and the mediation role of PM2.5 and leisure-time physical activity

Few studies have investigated the association of residential greenness with obstructive sleep apnea (OSA). This study was to comprehensively examine the association of residential greenness exposure with OSA and explore the mediating effect of leisure-time physical activity (LTPA) and PM2.5 on the association among Chinese old adults. A prospective cohort study that enrolled 2027 adults aged ≥65 was conducted between 1st July 2015 and 30th September 2019 in Southern China. OSA was ascertained by Berlin Questionnaire. Greenness exposure was measured by contemporaneous and cumulative average normalized difference vegetation index (NDVI) in the 1000 m radius around each participant's residential address. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated by Cox proportional hazards model to assess the impact of greenness exposure on the incidence of OSA after adjusting for confounders. LTPA and PM2.5 were examined as potential mediators in the aforementioned models. A total of 293, nearly 14.5 %, participants developed OSA within 59,251 person-months of follow-up. When comparing the highest with lowest tertiles, both contemporaneous NDVI (>0.351 vs. ≤0.325: HR = 0.20, 95 % CI = 0.13–0.31) and cumulative NDVI (> 0.346 vs. ≤ 0.317: HR = 0.32, 95 % CI = 0.21–0.47) were associated with a reduced risk of OSA after adjusting for confounders. LTPA and PM2.5 significantly mediated the association between greenness and OSA. In conclusion, this study indicated that exposure to higher residential greenness could decrease OSA risk, and this benefit may be achieved by promoting physical activity and decreasing PM2.5 concentration. The findings suggest to formulate targeted interventional strategies by expanding residential greenness to prevent OSA and reduce disease burden.

Intrauterine and early postnatal exposures to submicron particulate matter and childhood allergic rhinitis: A multicity cross-sectional study in China

BackgroundAirborne particulate matter pollution has been linked to occurrence of childhood allergic rhinitis (AR). However, the relationships between exposure to particulate matter with an aerodynamic diameter ≤1 μm (PM1) during early life (in utero and first year of life) and the onset of childhood AR remain largely unknown. This study aims to investigate potential associations of in utero and first-year exposures to size-segregated PMs, including PM1, PM1–2.5, PM2.5, PM2.5–10, and PM10, with childhood AR. MethodsWe investigated 29286 preschool children aged 3–6 years in 7 Chinese major cities during 2019–2020 as the Phase II of the China Children, Families, Health Study. Machine learning-based space-time models were utilized to estimate early-life residential exposure to PM1, PM2.5, and PM10 at 1 × 1-km resolutions. The concentrations of PM1–2.5 and PM2.5–10 were calculated by subtracting PM1 from PM2.5 and PM2.5 from PM10, respectively. Multiple mixed-effects logistic models were used to assess the odds ratios (ORs) and 95% confidence intervals (CIs) of childhood AR associated with per 10-μg/m3 increase in exposure to particulate air pollution during in utero period and the first year of life. ResultsAmong the 29286 children surveyed (mean ± standard deviation, 4.9 ± 0.9 years), 3652 (12.5%) were reported to be diagnosed with AR. Average PM1 concentrations during in utero period and the first year since birth were 36.3 ± 8.6 μg/m3 and 33.1 ± 6.9 μg/m3, respectively. Exposure to PM1 and PM2.5 during pregnancy and the first year of life was associated with an increased risk of AR in children, and the OR estimates were higher for each 10-μg/m3 increase in PM1 than for PM2.5 (e.g., 1.132 [95% CI: 1.022–1.254] vs. 1.079 [95% CI: 1.014–1.149] in pregnancy; 1.151 [95% CI: 1.014–1.306] vs. 1.095 [95% CI: 1.008–1.189] in the first year of life). No associations were observed between AR and both pre- and post-natal exposure to PM1–2.5, indicating that PM1 rather than PM1–2.5 contributed to the association between PM2.5 and childhood AR. In trimester-stratified analysis, childhood AR was only found to be associated with exposure to PM1 (OR = 1.077, 95% CI: 1.027–1.128), PM2.5 (OR = 1.048, 95% CI: 1.018–1.078), and PM10 (OR = 1.032, 95% CI: 1.007–1.058) during the third trimester of pregnancy. Subgroup analysis suggested stronger PM-AR associations among younger (<5 years old) and winter-born children. ConclusionsPrenatal and postnatal exposures to ambient PM1 and PM2.5 were associated with an increased risk of childhood AR, and PM2.5-related hazards could be predominantly attributed to PM1. These findings highlighted public health significance of formulating air quality guideline for ambient PM1 in mitigating children's AR burden caused by particulate air pollution.

Reconstructing individual-level exposures in cohort analyses of environmental risks: an example with the UK Biobank.

Recent developments in linkage procedures and exposure modelling offer great prospects for cohort analyses on the health risks of environmental factors. However, assigning individual-level exposures to large population-based cohorts poses methodological and practical problems. In this contribution, we illustrate a linkage framework to reconstruct environmental exposures for individual-level epidemiological analyses, discussing methodological and practical issues such as residential mobility and privacy concerns. The framework outlined here requires the availability of individual residential histories with related time periods, as well as high-resolution spatio-temporal maps of environmental exposures. The linkage process is carried out in three steps: (1) spatial alignment of the exposure maps and residential locations to extract address-specific exposure series; (2) reconstruction of individual-level exposure histories accounting for residential changes during the follow-up; (3) flexible definition of exposure summaries consistent with alternative research questions and epidemiological designs. The procedure is exemplified by the linkage and processing of daily averages of air pollution for the UK Biobank cohort using gridded spatio-temporal maps across Great Britain. This results in the extraction of exposure summaries suitable for epidemiological analyses of both short and long-term risk associations and, in general, for the investigation of temporal dependencies. The linkage framework presented here is generally applicable to multiple environmental stressors and can be extended beyond the reconstruction of residential exposures. IMPACT: This contribution describes a linkage framework to assign individual-level environmental exposures to population-based cohorts using high-resolution spatio-temporal exposure. The framework can be used to address current limitations of exposure assessment for the analysis of health risks associated with environmental stressors. The linkage of detailed exposure information at the individual level offers the opportunity to define flexible exposure summaries tailored to specific study designs and research questions. The application of the framework is exemplified by the linkage of fine particulate matter (PM2.5) exposures to the UK Biobank cohort.

Exposure to Residential Green Space and Bone Mineral Density in Young Children

Bone mass accrual is influenced by environmental and lifestyle factors. Targeted interventions at the early stages of life might decrease fracture and/or osteoporosis risk later in life. To investigate whether early-life exposure to residential surrounding green space is associated with a change in bone mineral density in young children. In this prospective birth cohort study (ENVIRONAGE [Environmental Influence on Aging in Early Life]), mother-child pairs from Flanders, Belgium, were recruited at birth and followed up for 4 to 6 years, between October 1, 2014, and July 31, 2021. Data analysis was conducted between January and February 2022. Green space was estimated for high green (>3 m vegetation height), low green (≤3 m vegetation height ), and total green (sum of high and low) within several radii (100-3000 m) around the residence after geocoding of the addresses. Radial bone mineral density was assessed using quantitative ultrasound measurement at follow-up, measured as the mean of the axially transmitted speed of sound in meters per second. Multiple linear and logistic regression models were used while accounting for relevant covariates and potential confounders. The study population comprised 327 children (180 [55.0%] female; mean [SD] age, 4.6 [0.4] years at the follow-up evaluation). Early-life exposure to residential green space was associated with increased childhood bone health. An IQR increment in total green (21.2%) and high green (19.9%) space within 500 m was associated with an increase of 27.38 m/s (95% CI, 9.63-45.13 m/s) and 25.30 m/s (95% CI, 7.93-42.68 m/s) in bone mineral density, respectively. Additionally, an IQR increase in total (25.2%) and high (23.2%) green space within 1000 m was associated with a 67% (odds ratio, 0.33; 95% CI, 0.17-0.61) and 61% (odds ratio, 0.39; 95% CI, 0.18-0.75) lower risk of having a bone density lower than the sex-specific 10th percentile (3567.6 m/s for girls and 3522.8 m/s for boys). In this study of children aged 4 to 6 years, higher bone mineral density and a lower risk of having low bone density were associated with higher residential green space exposure during childhood. These findings highlight the importance of early-life exposure to residential green space on bone health during critical periods of growth and development, with long-term implications.

Exposure to per- and polyfluoroalkyl substances (PFAS) in North Carolina homes: results from the indoor PFAS assessment (IPA) campaign.

Per and polyfluoroalkyl substances (PFAS) are ubiquitous in the indoor environment, resulting in indoor exposure. However, a dearth of concurrent indoor multi-compartment PFAS measurements, including air, has limited our understanding of the contributions of each exposure pathway to residential PFAS exposure. As part of the Indoor PFAS Assessment (IPA) Campaign, we measured 35 neutral and ionic PFAS in air, settled dust, drinking water, clothing, and on surfaces in 11 North Carolina homes. Ionic and neutral PFAS measurements reported previously and ionic PFAS measurements reported herein for drinking water (1.4-34.1 ng L-1), dust (202-1036 ng g-1), and surfaces (4.1 × 10-4-1.7 × 10-2 ng cm-2) were used to conduct a residential indoor PFAS exposure assessment. We considered inhalation of air, ingestion of drinking water and dust, mouthing of clothing (children only), and transdermal uptake from contact with dust, air, and surfaces. Average intake rates were estimated to be 3.6 ng kg-1 per day (adults) and 12.4 ng kg-1 per day (2 year-old), with neutral PFAS contributing over 80% total PFAS intake. Excluding dietary ingestion, which was not measured, inhalation contributed over 65% of PFAS intake and was dominated by neutral PFAS because fluorotelomer alcohol (FTOH) concentrations in air were several orders of magnitude greater than ionic PFAS concentrations. Perfluorooctanoic acid (PFOA) intake was 6.1 × 10-2 ng kg-1 per day (adults) and 1.5 × 10-1 ng kg-1 per day (2 year-old), and biotransformation of 8 : 2 FTOH to PFOA increased this PFOA body burden by 14% (adults) and 17% (2 year-old), suggesting inhalation may also be a meaningful contributor to ionic PFAS exposure through biotransformation.

An Integrated Approach for Conducting long-term PM2.5 Exposure and Health Impact Assessments for Residents of a City-scale

An Integrated Approach for Conducting long-term PM2.5 Exposure and Health Impact Assessments for Residents of a City-scale