Hong Xian

Mortality burden of ambient fine particulate air pollution in six Chinese cities: Results from the Pearl River Delta study.

BACKGROUNDnEpidemiological studies have reported significant association between ambient fine particulate matter air pollution (PM2.5) and mortality, however, few studies have investigated the relationship of mortality with PM2.5 and associated mortality burden in China, especially in a multicity setting.nnnMETHODSnWe investigated the PM2.5-mortality association in six cities of the Pearl River Delta region from 2013 to 2015. We used generalized additive Poisson models incorporating penalized smoothing splines to control for temporal trend, temperature, and relative humidity. We applied meta-analyses using random-effects models to pool the effect estimates in the six cities. We also examined these associations in stratified analyses by sex, age group, education level and location of death. We further estimated the mortality burden (attributable fraction and attributable mortality) due to ambient PM2.5 exposures.nnnRESULTSnDuring the study period, a total of 316,305 deaths were recorded in the study area. The analysis revealed a significant association between PM2.5 and mortality. Specifically, a 10μg/m3 increase in 4-day averaged (lag03) PM2.5 concentration corresponded to a 1.76% (95% confidence interval (CI): 1.47%, 2.06%) increase in total mortality, 2.19% (95% CI: 1.80%, 2.59%) in cardiovascular mortality, and 1.68% (95% CI: 1.00%, 2.37%) in respiratory mortality. The results were generally robust to model specifications and adjustment of gaseous air pollutants. We estimated that 0.56% (95% CI: 0.47%, 0.66%) and 3.79% (95% CI: 3.14%, 4.45%) of all-cause mortalities were attributable to PM2.5 using Chinas and WHOs air quality standards as the reference, corresponding to 1661 (95% CI: 1379, 1946) and 11,176 (95% CI: 9261, 13,120) attributable premature mortalities, respectively.nnnCONCLUSIONnThis analysis adds to the growing body of evidence linking PM2.5 with daily mortality, and mortality burdens, particularly in one Chinese region with high levels of air pollution.

Human serum levels of perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) in Uyghurs from Sinkiang-Uighur Autonomous Region, China: background levels study

Perfluorinated compounds (PFCs), such as perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA), are a family of commonly used industrial chemicals whose persistence and ubiquity in blood samples of humans and wildlife have become a growing concern. Despite PFOS and PFOA having been found in human blood and tissue samples from occupationally exposed workers and the general worldwide population, little systematic knowledge has accrued with respect to exposure levels in Uyghurs in the Sinkiang-Uighur Autonomous Region of China, which is predominantly agricultural and pastoral. Our goal was to provide background data for biological monitoring in the general population of this region. In this study, 110 self-reported healthy human serum samples were collected from nonoccupationally exposed Uyghurs volunteers and analyzed by microbore HPLC-electrospray tandem mass spectrometry. Among the 110 blood specimens, PFOS was detected in 102 samples (93xa0%) and ranged from the lower limit of quantification of 0.01 to 22.63xa0μg/L with a median of 1.93xa0μg/L (interquartile range 1.00–3.43xa0μg/L). The median was higher among males (2.39xa0μg/L; interquartile range 1.23–4.40xa0μg/L) than that among females (1.20xa0μg/L; interquartile range 0.83–2.77xa0μg/L). No significant difference was observed with respect to age. The concentration of PFOA was lower than that of PFOS and was found only in seven samples (6xa0%) at concentrations above the limit of quantification. This study is the first investigation to reveal serum PFOS and PFOA levels in the general population of Uyghurs. PFOS and PFOA concentrations found in the present investigation were lower than those found in recent studies consisting of subjects from different geographic locations (PFOS 5.0–44.7xa0μg/L, PFOA 1.5–10xa0μg/L).

Exposure to ambient PM2.5 associated with overall and domain-specific disability among adults in six low- and middle-income countries

BACKGROUNDnExposure to particulate matter pollution is associated with various cardiopulmonary diseases, which are closely related with disability. The direct relationship between air pollution and disability, however, has not been fully explored.nnnMETHODSnWe used data from 45,625 participants in the Study on global AGEing and adult health in six low- and middle-income countries. The 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) was used to measure the disability with six domains (cognition, mobility, self-care, getting along, life activities, and participation in society). Participants community addresses were used to estimate annual concentration of PM2.5 using satellite data. We used linear mixed models to examine the effects of PM2.5 on overall and domain-specific WHODAS scores.nnnRESULTSnExposure to PM2.5 was significantly associated with greater disability score (a higher score implies a greater disability); each 10μg/m3 increase corresponded to 0.72 (95% CI: 0.22, 1.22) increase in overall disability score. Compared with low PM2.5 level (<14.33μg/m3), moderate (14.33-27.83μg/m3) and high exposure levels (>27.83μg/m3) were associated with 3.43 (95% CI: 1.43, 5.43) and 3.72 (95% CI: 1.59, 5.86) increase in disability scores. Among the six domains, cognition, mobility and getting along were found to be associated with PM2.5. Stratified analyses found that women and older subjects were more sensitive to this effect.nnnCONCLUSIONnExposure to ambient PM2.5 might be one risk factor of disability in the low- and middle-income countries, women and older adults are the vulnerable population; and among the six domains, cognition, mobility and getting along are more relevant to this effect.

Maternal Prepregnancy Body Mass Index and Small for Gestational Age Births in Chinese Women.

BACKGROUNDnBoth high and low prepregnancy body mass index (BMI) has been associated with small for gestational age births (SGA; birthweight below the population specific 10th centile for the gestational age), but results remain inconsistent. We examined the association between maternal BMI and SGA, and evaluated if the associations were modified by preterm birth (being born prior to 37 weeks) status.nnnMETHODSnA population-based cohort study was conducted in Wuhan, China from June 2011, to June 2013. Women who delivered a non-malformed livebirth (n = 76 695) were included using the Wuhan Maternal and Child Health Management Information System. Log-binomial regression models were used to analyse the associations between prepregnancy BMI, categorized using thresholds adapted to the Chinese population, and SGA. Stratified analyses were used to examine the relationship of prepregnancy BMI to preterm-SGA and term-SGA.nnnRESULTSnOf the 76 695 live births, 3058 (4.0%) were delivered preterm. For babies born at term, prepregnancy underweight (<18.5 kg/m2 ) was associated with an increased risk of SGA, the adjusted risk ratio (RR) was 1.41 (95% confidence interval (CI) 1.33, 1.49), whereas, being overweight (24.0-27.9 kg/m2 ) was associated with a decreased risk (RR 0.84, 95% CI 0.74, 0.94). For babies born preterm, prepregnancy underweight was not associated with risk of SGA, but being overweight was associated with an increased risk (RR 1.57, 95% CI 1.04, 2.35).nnnCONCLUSIONSnThese data suggest that the association of overweight and underweight prepregnancy BMI and SGA differs depending on whether the baby is full term or preterm.

Long-term exposure to ambient air pollution (including PM 1 ) and metabolic syndrome: The 33 Communities Chinese Health Study (33CCHS)

&NA; Little evidence exists about the effects of long‐term exposure to ambient air pollution on metabolic syndrome (MetS). This study aimed to determine the association between long‐term ambient air pollution and MetS in China. A total of 15,477 adults who participated in the 33 Communities Chinese Health Study (33CCHS) in 2009 were evaluated. MetS was defined based on the recommendation by the Joint Interim Societies. Exposure to air pollutants was assessed using data from monitoring stations and a spatial statistical model (including particles with diameters ≤ 1.0 &mgr;m (PM1), ≤ 2.5 &mgr;m (PM2.5), and ≤ 10 &mgr;m (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3)). Two‐level logistic regression analyses were utilized to assess the associations between air pollutants and MetS. The prevalence of MetS was 30.37%. The adjusted odds ratio of MetS per 10 &mgr;g/m3 increase in PM1, PM2.5, PM10, SO2, NO2, and O3 were 1.12 (95% CI = 1.00–1.24), 1.09 (95% CI = 1.00–1.18), 1.13 (95% CI = 1.08–1.19), 1.10 (95% CI = 1.02–1.18), 1.33 (95% CI = 1.12–1.57), and 1.10 (95% CI = 1.01–1.18), respectively. Stratified analyses indicated that the above associations were stronger in participants with the demographic variables of males, < 50 years of age, and higher income, as well as with the behavioral characteristics of smoking, drinking, and consuming sugar‐sweetened soft drinks frequently. This study indicates that long‐term exposure to ambient air pollutants may increase the risk of MetS, especially among males, the young to middle aged, those of low income, and those with unhealthy lifestyles. HighlightsAssociations of ambient air pollution with metabolic syndrome were scarcely studied.Data from 15,477 Chinese adults were analyzed.Long‐term exposure to air pollution was associated with metabolic syndrome.Demographic and lifestyle factors modified the association between metabolic syndrome and air pollution.

Consumption of fruit and vegetables might mitigate the adverse effects of ambient PM2.5 on lung function among adults

Background Evidence on the effects of ambient PM2.5 on lung function is limited among adults and the effect modification by dietary fruit and vegetables remains largely unknown. Methods We interviewed 29,032 participants aged 50 years and older from the WHO Study on global AGEing and adult health. Annual average PM2.5 levels were estimated for each community using satellite data. We applied multi‐level linear regressions to examine the association between ambient PM2.5 and lung function (forced vital capacity (FVC), forced expiratory volume in 1‐sec (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), and forced expiratory flow between 25th and 75th percentiles of FVC (FEF25–75)). Results We found that ambient PM2.5 was associated with lower lung functions. Each 10 &mgr;g/m3 increase in PM2.5 corresponded to reductions of 123.58 ml in FVC (95% CI: −185.21, −61.95), 126.64 ml in FEV1 (95% CI: −186.04, −67.23) and 178.93 ml/s FEV25–75 (95% CI: −249.20, −108.66). Lower effect estimates were observed among those with higher consumption of fruit and vegetables. Conclusion Our study suggests that exposure to ambient PM2.5 might be one risk factor of reduced lung function in adults and that higher consumption of fruit and vegetables may mitigate this effect. HighlightsWe examined the effects of PM2.5 on lung function among adults.PM2.5 was associated with lower levels of FVC, FEV1 and FEV25‐75.Fruit and vegetables could mitigate these effects.

Sex-specific difference in the association between poor sleep quality and abdominal obesity in rural Chinese: a large population-based study

STUDY OBJECTIVESnExisting studies on sleep quality and associated obesity are inconsistent, and few studies have prospectively evaluated the association between sleep quality and abdominal obesity among Chinese individuals. To fill this void, the current study aimed to assess the association between sleep quality and abdominal obesity in a rural Chinese population.nnnMETHODSnA representative sample of 9,404 adults aged 20-93 years in northeastern China was selected between 2012 and 2013 by a multistage cluster and random sampling method. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), where a score of 6 or higher indicated sleep disorder. Abdominal obesity was measured by waist circumference (WC), with abdominal obesity defined as WC > 90 cm for men and WC > 80 cm for women.nnnRESULTSnMale participants with abdominal obesity had higher global PSQI scores in addition to higher subscores in almost all of the elements compared to normal values. The odds ratios of abdominal obesity among participants with sleep disorders were 1.64 (95% confidence interval [CI]: 1.39-1.95) and 1.14 (95% CI: 0.98-1.32) for males and females compared to the reference group. The risk in all sleep elements was significantly increased, with odds ratios ranging from 1.28 (95% CI: 1.08-1.51) to 5.81 (95% CI: 3.54-9.53) for males. The risk only in four elements was significantly increased, from 1.28 (95% CI: 1.12-1.47) to 2.27 (95% CI: 1.36-3.80) for females.nnnCONCLUSIONSnPoor sleep quality was associated with abdominal obesity in Chinese. Furthermore, effects in males were larger than those in females.

The attributable risk of chronic obstructive pulmonary disease due to ambient fine particulate pollution among older adults

BACKGROUNDnThe linkage between ambient fine particle pollution (PM2.5) and chronic obstructive pulmonary disease (COPD) and the attributable risk remained largely unknown. This study determined the cross-sectional association between ambient PM2.5 and prevalence of COPD among adults ≥50u202fyears of age.nnnMETHODSnWe surveyed 29,290 participants aged 50u202fyears and above in this study. The annual average concentrations of PM2.5 derived from satellite data were used as the exposure indicator. A mixed effect model was applied to determine the associations and the burden of COPD attributable to PM2.5. RESULTS: Among the participants, 1872 (6.39%) were classified as COPD cases. Our analysis observed a threshold concentration of 30u202fμg/m3 in the PM2.5-COPD association, above which we found a linear positive exposure-response association between ambient PM2.5 and COPD. The odds ratio (OR) for each 10u202fμg/m3 increase in ambient PM2.5 was 1.21(95% CI: 1.13, 1.30). Stratified analyses suggested that males, older subjects (65u202fyears and older) and those with lower education attainment might be the vulnerable subpopulations. We further estimated that about 13.79% (95% CI: 7.82%, 21.62%) of the COPD cases could be attributable to PM2.5 levels higher than 30u202fμg/m3 in the study population.nnnCONCLUSIONnOur analysis indicates that ambient PM2.5 exposure could increase the risk of COPD and accounts for a substantial fraction of COPD among the study population.

Gestational Weight Gain per Pre-Pregnancy Body Mass Index and Birth Weight in Twin Pregnancies: A Cohort Study in Wuhan, China

To assess the relationship between gestational weight gain (GWG) of twin-pregnancy women and twin birth weights, as well as to evaluate whether pre-pregnancy body mass index (BMI) influences this relationship. A cohort study was conducted in Wuhan, China, between 1/01/2011 and 8/31/2017. Women with twin pregnancies who delivered live and non-malformed twins were included (6,925 women and 13,850 infants), based on the Wuhan Maternal and Child Health Management Information System. Logistic regression models were employed to examine the association between GWG and paired small for gestational age (SGA, defined as birth weight <10th percentile for gestational age and sex)/SGA and linear regression models were utilized to explore the relationship between GWG and sum of birth weights. The associations of GWG based on both the IOM and Chinese recommendations and SGA/SGA pairs were obtained, as well as the stratified analyses by pre-pregnancy BMI. Additionally, the sum birth weight of one twin pair increased by 15.88u2009g when the GWG increased by 1u2009kg. GWG below the IOM and Chinese recommendations was associated with an increased risk of SGA/SGA pairs in all pre-pregnancy BMI categories. However, in underweight, overweight, and obese women, the association between GWG above the IOM and Chinese recommendations and SGA/SGA pairs changed with adjustment.

Examining the relationships between life satisfaction and alcohol, tobacco and marijuana use among school-aged children

BackgroundnThere are many known risk factors associated with youth substance use. Nonetheless, the impact of life satisfaction (LS) on the use of alcohol, tobacco and marijuana by adolescents still remains largely unknown.nnnMethodsnThe present analysis utilized data from the Health Behavior in School-Aged Children 2009-10 US study. Multilevel logistic regression models were used to assess the relationship between LS and individual substance use. Multilevel multinomial regression models examined the relationship with total number of substances used.nnnResultsnAfter controlling for numerous variables associated with substance use, individuals reporting low LS were significantly more likely to ever use tobacco (OR = 1.34, 95% CI = [1.01, 1.78]), alcohol (OR = 1.45, 95% CI = [1.10, 1.92]) and marijuana (OR = 1.98, 95% CI = [1.39, 2.82]). Additionally, students with low LS were significantly more likely to use two substances (OR = 1.90, 95% CI = [1.15, 3.14]) and three substances concurrently (OR = 2.00, 95% CI = [1.27, 3.16]).nnnConclusionsnThe present study identified strong associations between LS and individual, as well as concurrent, substance use among adolescents. Interventions aiming to reduce adolescent substance use may benefit from incorporating components to improve LS.