Spatial variability in mortality inequalities, socioeconomic deprivation, and air pollution in small areas of the Barcelona Metropolitan Region, Spain

Background

There is evidence that geographic variability of social health inequalities continues to exist even after individual risk factors have been taken into account. However, relatively few studies have examined the contribution of exposure to air pollutants to those inequalities.

Objectives

To study the geographic variability of inequalities in mortality and their associations with socioeconomic and environmental inequalities in small areas of the metropolitan of Barcelona during the period 1994 to 2003.

Methods

As in the MEDEA Project, the small area unit was the census tract. Study population consisted of the residents of the metropolitan area of Barcelona. Response variables were all-cause and specific-cause standardized mortality ratio (SMR). Explanatory variables were deprivation index, summarizing socioeconomic variables of the census tracts, and estimates of air pollutant exposures. Bayesian hierarchical models were used in order to reduce the extra variability when using SMR and to assess associations between mortality and deprivation and air pollution.

Results

Statistically significant associations with deprivation were found for the causes of death related to consumption of tobacco and alcohol for men and, besides lung cancer, diet-related causes for women. Statistically significant pollution coefficients were only found in the metropolitan area of Barcelona and in men. A positive interaction between pollutants and the deprivation index was statistically significant for respiratory mortality and PM₁₀, and ischemic disease mortality and NO₂, both for men.

Conclusions

We found deprivation to be associated in a statistically significant way with the geographical variation in mortality in the census tracts of the metropolitan area of Barcelona, in the period 1994 to 2003. Those air pollutants more directly related with traffic modify some of these associations.     

The relationship between particulate air pollution and emergency hospital visits for hypertension in Beijing, China

Background

A number of epidemiological studies have examined the adverse effect of air pollution on mortality and morbidity. Also, several studies have investigated the associations between air pollution and specific-cause diseases including arrhythmia, myocardial infarction, and heart failure. However, little is known about the relationship between air pollution and the onset of hypertension.

Objective

To explore the risk effect of particulate matter air pollution on the emergency hospital visits (EHVs) for hypertension in Beijing, China.

Methods

We gathered data on daily EHVs for hypertension, fine particulate matter less than 2.5 μm in aerodynamic diameter (PM_2.5), particulate matter less than 10 μm in aerodynamic diameter (PM₁₀), sulfur dioxide, and nitrogen dioxide in Beijing, China during 2007. A time-stratified case-crossover design with distributed lag model was used to evaluate associations between ambient air pollutants and hypertension. Daily mean temperature and relative humidity were controlled in all models.

Results

There were 1,491 EHVs for hypertension during the study period. In single pollutant models, an increase in 10 μg/m³ in PM_2.5 and PM₁₀ was associated with EHVs for hypertension with odds ratios (overall effect of five days) of 1.084 (95% confidence interval (CI): 1.028, 1.139) and 1.060% (95% CI: 1.020, 1.101), respectively.

Conclusion

Elevated levels of ambient particulate matters are associated with an increase in EHVs for hypertension in Beijing, China.     

Urinary 1-hydroxypyrene and PAH exposure in 4-year-old Spanish children

Aims:

Exposure to polycyclic aromatic hydrocarbons (PAH), among the main compounds present in polluted urban air, is of concern for children's health. Childhood exposure to PAH was assessed by urinary monitoring of 1-hydroxypyrene (1-OHP), a pyrene metabolite, investigating its association with exposure to air pollution and other factors related to PAH in air.

Methods:

A group of 174 4-year-old children were recruited and a questionnaire on their indoor and outdoor residential environment was completed by parents. At the same time, environmental measurements of traffic-related air pollution (NO₂) were carried out. A urine sample was collected from each child in order to analyze 1-OHP using HPLC with fluorescence detection, correcting for creatinine concentrations. Non-parametric tests and regression analyses were used to identify environmental factors that influence 1-OHP excretion.

Results:

Mean urinary 1-OHP concentration was 0.061 μmol/mol creatinine, ranging from 0.004 to 0.314 μmol/mol. Non-parametric tests and regression analysis showed positive and significant associations (P ≤ 0.05) between 1-OHP and predicted residential exposure to NO₂ (which was based on outdoor environmental measurements and geo-statistical analysis), self-reported residential vehicle traffic, passive smoking and cooking appliance. 1-OHP levels tended to be higher among children living in urban areas (0.062 μmol/mol vs. 0.058 μmol/mol for children living in rural areas) but differences were not significant (P = 0.20).

Conclusion:

In Southern Spain, concentrations of urinary 1-OHP were in the lower range of those generally reported for children living in non-polluted areas in Western Europe and the USA. Traffic-related air pollution, passive smoking and cooking appliance influenced urinary 1-OHP level in the children, which should be prevented due to the health consequences of the inadvertent exposure to PAH during development.     

Risk of limb birth defects and mother's home proximity to cornfields

Background

Although previous studies have linked proximity to crops and birth defects, they lacked individual-level exposure data and none was based on using planted area instead of linear proximity to crops as the exposure metric. We studied birth defects in relation to the area of corn or soybeans within 500 m of the mother's residence.

Methods

We selected all singleton births from rural areas conceived during the 2000-2004 spring-summer months (n = 48,216). We determined whether the area with corn or soybeans around the home was associated with birth defects using multiple unconditional logistic regression.

Results

We found that limb birth defects (ICD-9-CM 754.5, 755) increased in relation to cornfields (Adjusted OR = 1.22; 95 % CI = 1.01, 1.47 per additional 10 ha planted with corn within 500 m). None of the birth defect types studied was associated with soybeans.

Conclusions

In the Midwest, a significant and expanding proportion of the population is now living in close proximity to cornfields. Our results suggest that additional studies should be conducted to identify which factor(s) associated with cornfields are behind the observed increase in limb birth defects.     

Health impacts associated with the implementation of a national petrol-lead phase-out program (PLPOP): evidence from Taiwan between 1981 and 2007

Background and objective

In 1981, a petrol-lead phase-out program (PLPOP) was launched in Taiwan for the abatement of environmental lead emissions. The present study was set out to examine whether the reduction of environmental lead emissions would result in the decrease in mortality rates of various diseases based on national data between 1981 and 2007.

Method

The national mortality data were obtained from the Office of Statistics of the Taiwan Department of Health (Taiwan DOH). Standardized mortality ratios (SMRs) were calculated based on 2000 WHO world standard population. Gasoline consumptions were obtained from the Bureau of Energy.

Results

The mean blood lead levels (BLLs) had decreased dramatically from approximately 20.14 μg/dl in the leaded petrol phase to 3 μg/dl or lower in the unleaded petrol phase. From 1981 to 2007, the mortality (per 100,000 people) was decreased from 146.2 to 43.8 for cerebrovascular disease, from 85.3 to 44.4 for heart disease, from 35.4 to 6.6 for hypertensive disease, from 21.3 to 17.3 for nephrosis, and from 810.2 to 491.6 for all causes. By taking the confounders (including economic growth rate, per capita income, tobacco consumption, and medical resources) into account, the decreases in SMRs for all causes, cerebrovascular disease, and nephrosis were found to be highly correlated with the decrease in petrol lead emissions (p-values = 0.001, < 0.001, 0.020, respectively).

Conclusion

Our results clearly show that the implementation of the PLPOP was associated with a decline in mortality rates in several diseases that have been associated with lead exposure, even after adjustment for a number of relevant confounders.     

Blood total mercury and fish consumption in the Korean general population in KNHANES III, 2005

Objectives

The obejective of this study was to assess the association between the blood total mercury concentration and fish consumption in the Korean general adult population using a representative sample.

Methods

We studied the blood mercury concentration in a representative sample of 1,749 Koreans who were included in the Third Korean National Health and Nutritional Examination Survey (KNHANES III) performed in 2005, and compared it with the frequency of fish consumption collected during the nutrition survey of KNHANES III.

Results

The geometric means of the blood mercury levels in female subjects (n = 890), male subjects (n = 859), and all participants (n = 1,749) representing adult Koreans aged ≥ 20 years were 3.70 μg/L [95% confidence interval (CI), 3.46-3.94 μg/L], 4.70 μg/L (95% CI, 4.38-5.02 μg/L), and 4.15 μg/L (95% CI, 3.93-4.38 μg/L), respectively. The geometric mean of the blood mercury level was significantly higher in the high-fish-consumption group (4.38 μg/L; more than once a week) than in the low-consumption group (3.71 μg/L: less than once a week), but the intergroup difference of 18% was less than that in Western countries. Among the nine listed individual types of fish and shellfish, there was a general trend for the blood mercury level to increase with the consumption frequency of squid, clam, salted seafood, and mackerel. The proportion of Korean women aged 20-49 years having blood mercury levels of at least 5.8 μg/L was 27.7% (150/542) in our study.

Conclusions

The blood mercury level in a representative sample of the Korean adult population was found to be associated with fish consumption in both men and women. However, a high consumption of fish increased the blood mercury level by only 18%.     

Mortality due to lung, laryngeal and bladder cancer in towns lying in the vicinity of combustion installations

Background

Installations that burn fossil fuels to generate power may represent a health problem due to the toxic substances which they release into the environment.

Objectives

To investigate whether there might be excess mortality due to tumors of lung, larynx and bladder in the population residing near Spanish combustion installations included in the European Pollutant Emission Register.

Methods

Ecologic study designed to model sex-specific standardized mortality ratios for the above three tumors in Spanish towns, over the period 1994-2003. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Using mixed Poisson regression models, we analyzed: risk of dying from cancer in a 5-kilometer zone around installations that commenced operations before 1990; effect of type of fuel used; and risk gradient within a 50-kilometer radius of such installations.

Results

Excess mortality (relative risk, 95% confidence interval) was detected in the vicinity of pre-1990 installations for lung cancer (1.066, 1.041-1.091 in the overall population; 1.084, 1.057-1.111 in men), and laryngeal cancer among men (1.067, 0.992-1.148). Lung cancer displayed excess mortality for all types of fuel used, whereas in laryngeal and bladder cancer, the excess was associated with coal-fired industries. There was a risk gradient effect in the proximity of a number of installations.

Conclusions

Our results could support the hypothesis of an association between risk of lung, laryngeal and bladder cancer mortality and proximity to Spanish combustion installations.     

Is the association between temperature and mortality modified by age, gender and socio-economic status?

Background

A number of studies have examined the relationship between high ambient temperature and mortality. Recently, concern has arisen about whether this relationship is modified by socio-demographic factors. However, data for this type of study is relatively scarce in subtropical/tropical regions where people are well accustomed to warm temperatures.

Objective

To investigate whether the relationship between daily mean temperature and daily all-cause mortality is modified by age, gender and socio-economic status (SES) in Brisbane, Australia.

Methods

We obtained daily mean temperature and all-cause mortality data for Brisbane, Australia during 1996-2004. A generalised additive model was fitted to assess the percentage increase in all deaths with every one degree increment above the threshold temperature. Different age, gender and SES groups were included in the model as categorical variables and their modification effects were estimated separately.

Results

A total of 53,316 non-external deaths were included during the study period. There was a clear increasing trend in the harmful effect of high temperature on mortality with age. The effect estimate among women was more than 20 times that among men. We did not find an SES effect on the percent increase associated with temperature.

Conclusions

The effects of high temperature on all deaths were modified by age and gender but not by SES in Brisbane, Australia.     

Mercury exposure in female artisanal small-scale gold miners (ASGM) in Mongolia: An analysis of human biomonitoring (HBM) data from 2008

Background

Many poor in developing countries have turned to artisanal small-scale gold mining (ASGM) in an attempt to improve their situation. However, the mercury used to extract gold from ore is discharged in vaporized form into the environment, where it poses a hazard for human health.

Methods

As part of an environmental epidemiological study in Mongolia—to evaluate the burden of environmental mercury contamination—urine, blood and hair samples were collected from residents of areas with or without mercury contamination. A total of 200 blood, urine and hair samples were analyzed for mercury and divided into three subgroups according to mercury content: (1) occupational exposure (high/medium); (2) environmental exposure (low); and (3) no exposure. Internal mercury distributions of the subgroups were compared using the Kruskal-Wallis and Mann-Whitney U-test. The Chi-square test and likelihood ratio proportion were used to compare the findings with threshold limits.

Results

The highest values and greatest differences were seen in the urine samples (p < 0.001, Kruskal-Wallis). The occupational group showing the highest exposure with a median mercury level of 4.36 μg/l (control group: 0.10 μg/l, p < 0.001), 7.18 μg/g creatinine and 12 results above the threshold limit HBM I (Human Biomonitoring I). Even participants from the low-exposure subgroup showed elevated mercury levels (median 2.88 μg/l urine and 2.98 μg/g creatinine, p < 0.001), with 10 individuals above the HBM I threshold limits.

Discussion

The body burden resulting from the use of mercury in artisanal gold mining is high not only in the miners themselves, an increased mercury hazard was also found for inhabitants of mining areas who were not actively involved in mining. Public health support measures are urgently needed to alleviate the situation.     

Relative survival after exposure to polychlorinated biphenyls and dioxins: a follow-up of Japanese patients affected in the Yusho incident

Objectives

Little information is available on conditional survival among Yusho patients, who were accidentally exposed to PCBs and other dioxin-related compounds. In this study, we estimated relative survival among Yusho patients to quantify time trends in excess mortality compared to the general population.

Methods

A total of 1664 Yusho patients (860 males, and 804 females) were analyzed as Yusho cohort subjects. Relative survival ratio (RSR) was calculated as a measure of patient survival.

Results

Overall, 1-, 5-, 10-, and 15-year RSRs were 1.00 (95% confidence interval (CI): 0.99, 1.00), 1.00 (95% CI: 0.99, 1.01), 0.99 (95% CI: 0.98, 1.00), and 0.99 (95% CI: 0.98, 1.01), respectively. We did not observe meaningful increases or decreases in RSRs in either sex, which remained the same in all age groups for 1-, 5-, 10-, and 15-year RSRs.

Conclusions

This study provides quantitative evidence that Yusho patients have no significant difference in relative survival compared with the general Japanese population. Our results suggest that PCBs and dioxin exposure confers no excess mortality. This information may be important for both the clinical management of and patient coping with Yusho disease.     

Nickel release from inexpensive jewelry and hair clasps purchased in an EU country — Are consumers sufficiently protected from nickel exposure?

Background

Nickel allergic subjects are at risk factor of acquiring hand eczema. In 1990 and 1994, respectively, Denmark and member states in the EU regulated nickel release from selected consumer products. The intention was that the nickel epidemic could be controlled and prevented if the general population was protected from high cutaneous nickel concentrations. Despite a decrease, the prevalence of nickel allergy remains high as nearly 10% of young women are nickel allergic.

Objective

This study aimed to perform dimethylglyoxime (DMG) testing of inexpensive jewelry and hair clasps purchased from random stores in Copenhagen, Denmark to detect the proportion of items that may result in nickel allergy.

Methods

Inexpensive jewelry and hair clasps were purchased from 36 stores and street vendors in Copenhagen and were later tested for nickel release using the DMG test.

Results

The study showed that 19.3% hair clasps, 14.8% earrings, and 12.9% necklaces intended for adult women released an excessive amount of nickel. Of 25 stores visited, 36.0% sold DMG positive jewelry. For items designed for children, excessive nickel release was identified in hair clasps (79.4%) and in finger rings (20%). Four (50.0%) of 8 children clothing stores sold jewelry that released too much nickel.

Discussion

Excessive nickel release has been regulated since 1990 in Denmark. However, 1/5 of purchased items released nickel in concentrations that may lead to nickel allergy. Especially hair clasps intended for children released an excessive amount of nickel.     

Sub-micrometer particulate air pollution and cardiovascular mortality in Beijing, China

Background

While the link between particulate matter and cardiovascular mortality is well established, it is not fully investigated and understood which properties of the aerosol might be responsible for the health effects, especially in polluted mega-city areas.

Objectives

Our goal was to explore the association between daily cardiovascular mortality and different particle metrics in the sub-micrometer range in Beijing, China.

Methods

We obtained daily counts of cause-specific cardiovascular deaths in the Beijing urban area for the period March 2004 to August 2005. Concurrently, continuous measurements of particle number size distributions were performed. Particle number concentrations (NC) between 0.003 μm and 0.8 μm were converted to particle mass and surface area concentrations assuming spherical particles. Semi-parametric Poisson regression models adjusting for trend, seasonality, day of the week, and meteorology were used to estimate immediate, delayed and cumulative particle effects. Additionally, effect modification by air mass origin was investigated.

Results

We observed associations between daily cardiovascular mortality and particle NC for a 2-days delay. Moreover, nearly all particle metrics showed 2-days delayed associations with ischemic heart disease mortality. The strongest association was found for particle NC in the size range 0.03-0.1 μm (7.1% increase in daily mortality with a 95%-confidence interval of 2.9%-11.5%, per an increase of 6250 particles/cm³). Results for surface and mass concentrations with a lag of two days indicated effect modification by air mass origin, whereas effects of particle NC were not modified.

Conclusions

Results show an elevated risk of cardiovascular mortality in Beijing from short-term exposure to particulate air pollution in the sub-micrometer range. Results also indicate that locally produced smaller particles and regionally transported particles may exhibit different effects in Beijing.     

Changing blood lead levels and DNA damage (comet assay) among immigrant women in Taiwan

Background

International marriage has had a rapid growth in recent years in Taiwan. However, little is known about the blood lead levels and DNA damage levels among immigrant women from resource-limited countries.

Objective

This study (a) explored differences between immigrant women and native women in demographic characteristics, blood lead levels, and DNA damage levels, and (b) identified risk factors that are associated with blood lead concentrations and DNA damage levels after immigration.

Methods

We used a structured questionnaire to collect data on socio-demographic status from (a) 71 immigrant women who had resettled in 2006 in Taichung, Taiwan and (b) 83 native women who live in the same area. Each study participant provided blood samples for lead and metal measurements, complete blood count examination, and the comet assay to measure degree of DNA damage.

Results

Immigrant women had higher mean blood lead concentration (2.23 ± 1.63 vs. 1.63 ± 1.00 μg/dl; p = 0.04) and lower mean blood zinc level (6.22 ± 2.22 vs. 6.89 ± 2.44 mg/l; p = 0.07) than native women. Resettlement time was a determinant to decrease blood lead and DNA damage levels among immigrants in Taiwan. Multiple linear regression analysis confirmed a statistically significant association between blood lead level and DNA damage, while zinc had a protective effect.

Conclusions

Public health agencies should focus on primary prevention and providing screening programs for this vulnerable population. An immigrant women's cohort should been established to follow-up and improve for elevated lead exposure families.     

Feasibility of community food item collection for the National Children's Study

Background

The National Children's Study proposes to investigate biological, chemical, physical, and psychosocial environmental exposures and their role on health outcomes in pregnant women and children. One specific area of concern is contaminant exposure through the ingestion of solid foods. National food contaminant databases may miss dietary exposures unique to specific communities and sources of food.

Objective

The purpose of this study was to evaluate the feasibility of community food item collection for the assessment of pesticide exposure in pregnant women and young children.

Methods

A prospective observational design was used to test the food collection protocol in mothers (n = 45) of children aged 15-24 months in Salt Lake City, Utah. Foods for collection were based on: 1) frequency of different foods consumed by the target population as determined by the National Health and Nutrition Examination Survey data; 2) child food frequency questionnaire; and 3) likelihood of pesticide contamination in the foods. Assessment measures included: demographics, environmental health survey, quality assurance checklist, and participant evaluation form.

Results

An average of three food items were obtained from 44 households, yielding a collection rate of 97.8%. Overall, 100% of the food samples were rated as acceptable. Moreover, a vast majority of mothers reported that the study was not burdensome (95.5%) and that preparing the food sample was easy (93.2%).

Conclusions

This study suggests that the community food item collection methodology shows promise as a low-burden approach for capturing dietary exposures on a household level, and appears to be a feasible tool for large population studies to assess dietary exposures unique to specific communities.     

Lead exposure is associated with a delay in the onset of puberty in South African adolescent females: Findings from the Birth to Twenty cohort

Introduction

One of the suggested, yet under-researched, causes of pubertal delay is lead exposure. In South Africa blood lead levels are generally higher than in resource-rich countries. Thus the effects of lead exposure on pubertal development may be significant.

Objective

The objective of this study is to determine the association between lead exposure and pubertal development in adolescent females in the Birth to Twenty cohort (Bt20).

Methods

Bt20 is a Johannesburg based birth cohort study that commenced in 1990 and includes 1682 girls. At 13 years of age venous blood samples were collected from 725 adolescent female participants for lead content analyses; of these, 712 had menarche data. Pubertal measurement was based on age of menarche and self-reported Tanner staging for pubic hair (n = 684) and breast development (n = 682).

Results

The mean blood lead level for the sample was 4.9 μg/dl. Fifty percent had blood lead levels < 5.0 μg/dl, 49% were ≥ 5.0 μg/dl and 1% was > 10.0 μg/dl. The average age of menarche was 12.7 years. At 13 years, 4% and 7% had reached Tanner stage 5 for pubic hair and breast development, respectively. Analyses showed that higher blood lead levels were associated with significant delays in the onset of puberty (p < 0.001).

Conclusion

The study found that higher blood lead levels were associated with a delay in the onset of puberty, after adjustment for confounders. Lead exposure in resource-poor countries is generally higher compared to resource-rich countries and thus the effects of high blood levels have personal and public health significance.     

The effect of particle size on cardiovascular disorders--the smaller the worse

Background

Previous studies observed associations between airborne particles and cardio-vascular disease. Questions, however, remain as to which size of the inhalable particles (coarse, fine, or ultrafine) exerts the most significant impact on health.

Methods

For this retrospective study, data of the total number of 23,741 emergency service calls, registered between February 2002 and January 2003 in the City of Leipzig, were analysed, identifying 5326 as being related to cardiovascular incidences. Simultaneous particle exposure was determined for the particle sizes classes < 100 nm (UFP), < 2.5 μm (PM2.5) and < 10 μm (PM10). We used a time resolution of 1 day for both parameters, emergency calls and exposure.

Results

Within the group of cardiovascular diseases, the diagnostic category of hypertensive crisis showed a significant association with particle exposure. The significant effect on hypertensive crisis was found for particles with a size of < 100 nm in diameter and starting with a lag of 2 days after exposure. No consistent influence could be observed for PM2.5 and PM10. The Odds Ratios on hypertensive crisis were significant for the particle size < 100 nm in diameter from day 2 post exposure OR = 1.06 (95%CI: 1.02-1.10, p = 0.002) up to day 7 OR = 1.05 (95%CI 1.02-1.09, p = 0.005).

Conclusion

Ultrafine particles affect cardiovascular disease adversely, particularly hypertensive crises. Their effect is significant compared with PM2.5 and PM10. It appears necessary, from a public health point of view, to consider regulating this type of particles using appropriate measurands as particle number.     

Mortality due to tumours of the digestive system in towns lying in the vicinity of metal production and processing installations

Background

Releases to the environment of pollutants from industrial metal production and processing installations can pose a health problem to humans, owing to the toxic substances that such emissions contain.

Objectives

To investigate whether there might be excess mortality due to tumours of the digestive system among the population residing near Spanish metal production and processing installations included in the European Pollutant Emission Register.

Methods

Ecological study designed to examine mortality due to malignant tumours of the digestive system (oral cavity and pharynx, oesophagus, stomach, pancreas, liver, gallbladder, and colon-rectum) at the municipal level, over the period 1994-2003. Population exposure to pollution was estimated on the basis of distance from town of residence to the pollution source. Using mixed Poisson regression models, we analysed: risk of dying from cancer in a 5-kilometre zone around installations by year of commencement of operations; effect of pollution discharge route (air or water) and type of industrial activity; and risk gradient within a 50-kilometre radius of such installations.

Results

Excess mortality (relative risk, 95% confidence interval) was detected in the vicinity of pre-1990 installations for colorectal cancer (1.05, 1.02-1.08 in men; 1.04, 1.00-1.07 in women) and liver cancer (1.06, 1.00-1.12 in men), with this risk being concentrated in installations that released pollution to air. On stratifying by type of industrial activity, statistically significant associations were also observed between the remaining tumours and certain metal production and processing activities. There was also a gradient effect in the proximity to a number of installations.

Conclusions

The results support the existence of an association between risk of dying due to some tumours of the digestive system and residential proximity to the Spanish metal production and processing installations studied.     

Respiratory effects of indoor particles in young children are size dependent

Background

Extensive epidemiological studies have provided evidence of an association between elevated outdoor particulate air pollution and adverse health effects. However, while people typically spend majority of time indoors, there is limited knowledge on airborne indoor particles and on the correlation between the concentrations of indoor particles and health effects. Even insights into the influence of differently sized indoor particles on human health are still rare.

Objective

The association between differentially sized indoor air particles and the development of respiratory diseases was studied for three year aged children.

Methods

Short-term measurements of particle mass and number concentrations were carried out in children's rooms. Information on possible particle sources (smoking habits, type of heating, and traffic) and respiratory outcomes were obtained from questionnaires. Measured indoor particle concentrations were correlated with possible sources of indoor particles and with respiratory health impacts.

Results

Daily smoking, smoking more than 5 cigarettes per day at home and traffic density in front of the window of children's room were found to be related to indoor exposure by particles of different diameters. High indoor particle exposures were associated with an increased risk for the development of obstructive bronchitis and in some extent of non-obstructive bronchitis. The strongest impact was observed for the mass concentration of particles < 1 μm and the number concentration of particles > 0.5 μm. The risk increases still remain significant if tested for stability changing the number of adjustment variables or omitting randomly selected cases, respectively.

Conclusion

Our results show significant associations between indoor particle concentrations and the risks for respiratory diseases in young children. The applied short-term measurements can help to assess the health risks of indoor particles with different sizes within epidemiological studies.     

Exposures to PM₂.₅ components and heart rate variability in taxi drivers around the Beijing 2008 Olympic Games

Background

Carbonaceous and metallic components of particles have been shown to play a role in particles' effects on cardiac autonomic function as measured by heart rate variability (HRV). Previously we reported the association of HRV with marked changes in traffic-related particulate air pollution around the Beijing 2008 Olympic Games in a panel of taxi drivers.

Objective

We further investigated the relationship between exposures to the carbonaceous and metallic components of traffic-related particles and HRV in the same population.

Methods

Repeated measurements of in-car exposures to particulate matter ≤ 2.5 μm in aerodynamic diameter (PM_2.5), carbon monoxide and nitrogen oxides were conducted in a group of 14 taxi drivers for one work shift in four study periods around the Beijing 2008 Olympics. The quantities of organic/elemental carbons and 27 elements of the in-car PM_2.5 mass were determined laboratorially. Linear mixed-effects models were used to evaluate the impact of exposures to different PM_2.5 components on HRV while controlling for potential confounders.

Results

Taxi drivers' exposures to in-car PM_2.5 and its components showed dramatic changes across the four study periods around the Beijing 2008 Olympics. Differences in associations of in-car PM_2.5 components with HRV were found. An interquartile range (IQR: 917.9 ng/m³) increase in calcium was associated with a 5.48 millisecond [ms, 95% confidence interval (CI): 0.71, 10.24] increase in standard deviations of normal-to-normal (SDNN) intervals, while an IQR (4.1 ng/m³) increase in nickel was associated with a 1.53 ms (95% CI: 0.14, 2.92) increase in SDNN index. Additionally, a decline of 8.11 ms (95% CI: − 15.26, − 0.97) in SDNN per IQR (481.4 ng/m³) increase in iron was also found.

Conclusion

The results support associations of PM_2.5 metallic components with HRV in younger healthy individuals. Future studies are needed to clarify the interaction among different PM_2.5 components or the role of PM_2.5 mixtures.     

Total blood mercury, plasma homocysteine, methylmalonic acid and folate in US children aged 3-5 years, NHANES 1999-2004

Background

Mercury is a known neurotoxicant; however, the relationship between childhood exposures and neurodevelopmental outcomes is uncertain, and may be modified by nutrition-related susceptibilities. In vitro studies found that mercury inhibited methionine synthase, an enzyme that interacts with vitamin B-12 and folate to regenerate the amino acid methionine from homocysteine, and inhibition of methionine synthase diverted homocysteine to cysteine and glutathione synthesis. The relationships between mercury, homocysteine, B-12, and folate have not been examined in children.

Objective

This study aimed to evaluate associations between Hg and homocysteine in male and female children differentiated by higher and lower methylmalonic acid (MMA, an indicator of vitamin B-12 deficiency) and folate status.

Design

Cross-sectional data on total blood mercury (Hg), plasma homocysteine, MMA, and serum folate were obtained from the 1999-2004 National Health and Nutrition Examination Surveys for children aged 3-5 years (n = 1005). We used multiple linear regression to evaluate relationships between homocysteine and Hg quartiles, stratified by sex, MMA ≥ and folate < sample medians, adjusted for demographic, anthropometric, and environmental factors.

Results

In boys with higher MMA and lower folate (n = 135), but not in other children, we observed inverse associations between homocysteine and Hg. Children with Hg > 3.49 μmol/L showed 1.14 μmol/L lower homocysteine (p < 0.001) relative to the lowest quartile (≤ 0.70 μmol/L) {p-value for trend < 0.001}. Compared to other subsamples, this subsample had significantly higher homocysteine levels.

Conclusion

Hg was inversely correlated with plasma homocysteine in young boys, but not girls, with higher MMA and lower folate. Additional studies are merited to evaluate Hg and amino acid metabolism in susceptible children.