Lijun Pei

Field Measurement of Emission Factors of PM, EC, OC, Parent, Nitro-, and Oxy- Polycyclic Aromatic Hydrocarbons for Residential Briquette, Coal Cake, and Wood in Rural Shanxi, China

Air pollutants from residential solid fuel combustion are attracting growing public concern. Field measured emission factors (EFs) of various air pollutants for solid fuels are close to the reality and urgently needed for better emission estimations. In this study, emission factors of particulate matter (PM), organic carbon (OC), elemental carbon (EC), and various polycyclic aromatic hydrocarbons (PAHs) from residential combustions of coal briquette, coal cake, and wood were measured in rural Heshun County, China. The measured EFs of PM, OC, and EC were 8.1-8.5, 2.2-3.6, 0.91-1.6 g/kg for the wood burnt in a simple metal stove, 0.54-0.64, 0.13-0.14, 0.040-0.0041 g/kg for the briquette burned in an improved stove with a chimney, and 3.2-8.5, 0.38-0.58, 0.022-0.052 g/kg for the homemade coal cake combusted in a brick stove with a flue, respectively. EFs of 28 parent PAHs, 4 oxygenated PAHs, and 9 nitro-PAHs were 182-297, 7.8-10, 0.14-0.55 mg/kg for the wood, 14-16, 1.7-2.6, 0.64-0.83 mg/kg for the briquette, and 168-223, 4.7-9.5, 0.16-2.4 mg/kg for the coal cake, respectively. Emissions from the wood and coal cake combustions were much higher than those for the coal briquette, especially true for high molecular weight PAHs. Most EFs measured in the field were higher than those measured in stove combustions under laboratory conditions.

Maternal serum vitamin B12, folate and homocysteine and the risk of neural tube defects in the offspring in a high-risk area of China.

OBJECTIVE To examine the association between the risk of neural tube defects (NTD) and maternal serum vitamin B12, folate and homocysteine in a high-risk area of China. DESIGN A case-control study was carried out in Luliang mountain area of Shanxi Province. SUBJECTS/SETTING A total of eighty-four NTD pregnancies and 110 matched controls were included in the study; their serum vitamin B12 and folate concentrations were measured by chemiluminescent immunoenzyme assay and total homocysteine concentrations by fluorescent polarisation immunoassay. RESULTS Serum vitamin B12 and folate concentrations were lower in NTD-affected pregnant women than in controls (P < 0.01). Serum total homocysteine was higher in the NTD group than in controls at less than 21 weeks of gestation (P < 0.01). Adjusted odds ratios revealed that women with lower vitamin B12 (adjusted OR=4.96; 95 % CI 1.94, 12.67) and folate (adjusted OR=3.23; 95 % CI 1.33, 7.85) concentrations had a higher risk of NTD compared to controls. Based on dietary analysis, less consumption of meat, egg or milk, fresh vegetables and fruit intake would increase the risk of NTD. CONCLUSIONS Lower serum concentrations of folate and vitamin B12 are related to the increased risk of NTD in high-risk populations. Both folate and vitamin B12 intake insufficiency could contribute to the increased risk of NTD. A dietary supplement, combining folate and vitamin B12, might be an effective measure to decrease the NTD incidence in these areas.

Variable contribution of the MTHFR C677T polymorphism to non-syndromic cleft lip and palate risk in China

Non‐syndromic cleft lip with or without cleft palate (nsCL/P) is one of the most common craniofacial malformations among newborn infants. It has been demonstrated that periconceptional folic acid supplementation may reduce the occurrence of offspring with clefts, particularly in the North China; however, the mechanism remains unknown. Our study of a thermolabile polymorphism (C677T) of methylenetetrahydrofolate reductase (MTHFR) gene in 170 Chinese case‐parent triads revealed a moderate association between this MTHFR polymorphism and nsCL/P in a population from North China, but not in a population from South China. Moreover, the study revealed that the heterozygous parents in the North were about twice as likely to transmit the high‐risk T allele to affected cases, as that observed in the South (OR = 2.24, 95% CI: 1.08–4.65). Thus, the MTHFR polymorphism is a significant risk factor for nsCL/P in this Northern Chinese population. Our study suggested possible genetic heterogeneity in the development of nsCL/P among Northern and Southern populations in China.

Indoor Air Pollution From Coal Combustion and the Risk of Neural Tube Defects in a Rural Population in Shanxi Province, China

The authors evaluated indoor air pollution from coal combustion (IAPCC) as a potential risk factor for neural tube defects (NTDs) in a rural population in Shanxi Province, China. The studied rural population has both high IAPCC exposure and a high prevalence of NTDs. A population-based case-control study was used to identify 610 NTD cases and 837 normal controls between November 2002 and December 2007. Information was collected within 1 week following delivery or pregnancy termination due to prenatal NTD diagnosis. The authors derived an exposure index by integrating a series of IAPCC-related characteristics concerning dwelling and lifestyle. Compared with women with no IAPCC exposure, women with any exposure at all had a 60% increased risk of having a child with an NTD (adjusted odds ratio (OR) = 1.6, 95% confidence interval (CI): 1.1, 2.1). An increased NTD risk was linked to both residential heating (adjusted OR = 1.7, 95% CI: 1.1, 2.4) and cooking (adjusted OR = 1.5, 95% CI: 1.1, 2.1). The risk increased with increases in the exposure index, showing a dose-response trend (P < 0.001). This is the first known study to link IAPCC to NTDs. Additional studies are needed to confirm the link between IAPCC and NTDs.

Urinary tract abnormalities in Chinese rural children who consumed melamine-contaminated dairy products: a population-based screening and follow-up study

Background: Kidney damage related to consumption of melamine-contaminated dairy products by young children in China has been described. However, no studies have reported on the population-based prevalence of kidney damage among exposed children or on the condition of affected children after follow-up. Methods: We conducted an ultrasound-based screening in September 2008 of 7933 children younger than 36 months of age who lived in a rural area in China where the dairy products most highly contaminated with melamine were sold. We monitored children who had evidence of nephrolithiasis or hydronephrosis at screening using renal ultrasonography after one, three and six months. We also collected information from the mothers of affected children about consumption of melamine-contaminated products between June and August 2008. Results: The overall prevalence of urinary tract abnormalities among screened children was 0.61% (95% confidence interval [CI] 0.45%–0.80%). The mean exposure dose of melamine was estimated to be 116 (range 36–220) mg per day. Of the 48 affected children, 43 (89.6%) were asymptomatic, 2 had symptoms and were hospitalized, and 3 had symptoms but treatment had been not sought for them. Of the 46 children for whom six-month follow-up information was available, renal abnormalities persisted in 5 children and resolved in the remaining 41. Interpretation: Among children who underwent screening, 0.61% showed ultrasonographic evidence of nephrolithiasis or hydronephrosis. Most of the affected children were asymptomatic. The majority of the affected children recovered from the toxic effects of melamine over time without specific treatment. Renal abnormalities remained in 12% of the affected children.

Low Birth Weight and Lung Function in Adulthood: Retrospective Cohort Study in China, 1948–1996

OBJECTIVE: The goal was to determine whether the components of low lung function in adulthood were associated with low birth weight in a Chinese population. METHODS: A retrospective cohort study was conducted from December 1995 to August 1996. A total of 627 men and women who were born between 1948 and 1954 were recruited; lung function indices were tested and respiratory diseases were examined in the Peking Union Medical College Hospital. Information on variables was recorded, and multivariate analysis of variance was performed to evaluate associations. RESULTS: Significant associations were observed between birth weight and forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) in adulthood, after adjustment for maternal age, gestational week, offsprings gender, birth height, history of dyspnea and asthma, lung diseases before 16 years of age, lung diseases after measles and pneumonia before 16 years of age, cough with sputum within 2 years, current asthma, taking medicine for asthma, adult BMI, male alcohol consumption, and male smoking (P < .001). Linear trends between birth weight and FEV1, FVC, and PEF were noted (P < .001, 1-way analysis of variance); FEV1, FVC, and PEF values increased with increasing birth weight. Low birth weight was associated with the FEV1/FVC predictive value (P < .05), but there was no linear trend (P > .05). CONCLUSIONS: Low birth weight may increase the prevalence of and risk for low lung function in adulthood in the Chinese population. The development of lung function may be affected by hypogenesis in utero.

Association of reduced folate carrier gene polymorphism and maternal folic acid use with neural tube defects

This study was designed to investigate whether the risk for neural tube defects (NTDs) was associated with reduced folate carrier gene (RFC1 A80G) polymorphism and/or with the interaction between the RFC1 gene and maternal periconceptional use of folic acid. One hundred four nuclear families with NTDs and 100 non‐malformed control families were sampled to investigate the potential interaction between maternal or the offsprings RFC1 (A80G) genotypes and the maternal periconceptional use of folic acid through a population‐based case–control study. RFC1 (A80G) genotypes were detected using PCR‐restricted fragment length polymorphism (PCR‐RFLP). Mother who had the GG genotype and did not take folic acid had an elevated risk for NTDs (OR = 5.43, 95% CI = 1.68–18.28) as compared to the mother who had AA or GA genotype and took maternal periconceptional folic acid. The interactive coefficient was 1.12 between maternal GG genotype and the periconceptional folic acid non‐use. The risk for having an infant with NTDs was 8.80 (95% CI = 2.83–28.69) for offspring with the GG genotype, as compared to the offspring with AA or GA genotype among the mothers who did not take folic acid supplements. The interactive coefficient was 1.45 for offspring with the GG genotype and without maternal periconceptional supplementation of folic acid. Our findings suggest that there is a potential gene–environment interaction on the risk of NTDs between maternal or offspring RFC1 GG genotype and maternal periconceptional intake of folic acid. The RFC1 is likely to be an important candidate gene in folate transportation and RFC1 GG genotype (A80G) may be associated with an increased risk for NTDs in this Chinese population.

Prevention of NTDs with periconceptional multivitamin supplementation containing folic acid in China.

BACKGROUND Maternal nutritional factors seem to contribute substantially to the complex etiologies of NTDs. Foremost among these factors is the periconceptional use of supplementation containing folic acid, which is associated with a reduction in the risk of women having NTD-affected pregnancies. This study was designed to observe the effectiveness of multivitamin supplementation containing folic acid in preventing NTDs in a Chinese population and to detect factors that would impact the effectiveness. METHODS Through family planning networks, a population-based community intervention study was carried out in 18 counties of China. Participants were divided into an intervention (taking multivitamin) group and a control group, and were followed up according to periconceptional multivitamin supplementation (in general 6 mg) for 2 years. Women who had a pregnancy were followed up from 28 weeks gestation at least to pregnancy termination, and the outcome was recorded. The incidence rate of the two groups and the relative risks were calculated to evaluate the efficacy of the multivitamin supplement in preventing NTDs. RESULTS During 2000 and 2002, all of the women having pregnancies with birth defects and women whose pregnancies were without any birth defects were interviewed. Nine NTDs were recorded from 25,444 pregnancies (NTD birth prevalence = 0.35/1,000 pregnancies) in the intervention group and 48 NTDs among 26,599 pregnancies (NTD birth prevalence = 1.80/1,000 pregnancies) in the control group. The protective rate was 80.4%. CONCLUSIONS Periconceptional multivitamin supplementation containing folic acid can prevent the occurrence of NTDs with the beneficial effect dependent on the frequency and timing of the supplementation. Our study suggests that multivitamin supplement containing folic acid taken from a time point of 2 months before conception and continuing until completion of the second month after conception and taken more than five times per week can significantly reduce the risks of NTDs.

Birth weight, maternal body mass index, and early childhood growth: a prospective birth cohort study in China.

Background The relations of birth weight and maternal body mass index (BMI) to overweight remain unresolved. We prospectively examined the relations of birth weight with various anthropometric measures at age 3 to 6 years, the effect of maternal BMI, and the patterns of these relations in an analysis using 9 birth weight categories. Methods The subjects were 210 172 singleton infants born alive with a gestational age ≥28 weeks between October 1993 and December 1996; the subjects were followed up in 2000. Birth weight, maternal height and weight, and other relevant information were measured or collected prospectively. Overweight and underweight were defined by using National Center for Health Statistics/World Health Organization reference data. Logistic regression models were used to estimate relative risks. Analyses stratified by quartile of maternal BMI were performed to examine the effects of maternal BMI on the associations of birth weight with overweight and underweight. Results Birth weight was linearly associated with height, weight, and BMI at age 3–6 years. Adjustment for maternal BMI did not alter this association. Birth weight was positively associated with overweight and negatively associated with underweight. The relation curves for both overweight and underweight resembled half of a flat parabolic curve. The associations for overweight and underweight were slightly stronger for the highest and lowest quartiles of maternal BMI, respectively. Conclusions Higher birth weight is associated with an increased risk for childhood overweight, and lower birth weight with an increased risk for underweight. The associations between birth weight and early childhood anthropometric growth measures could not explained by maternal BMI.

Household air pollution and personal exposure to nitrated and oxygenated polycyclic aromatics (PAHs) in rural households: Influence of household cooking energies.

Residential solid fuels are widely consumed in rural China, contributing to severe household air pollution for many products of incomplete combustion, such as polycyclic aromatic hydrocarbons (PAHs) and their polar derivatives. In this study, concentrations of nitrated and oxygenated PAH derivatives (nPAHs and oPAHs) for household and personal air were measured and analyzed for influencing factors like smoking and cooking energy type. Concentrations of nPAHs and oPAHs in kitchens were higher than those in living rooms and in outdoor air. Exposure levels measured by personal samplers were lower than levels in indoor air, but higher than outdoor air levels. With increasing molecular weight, individual compounds tended to be more commonly partitioned to particulate matter (PM); moreover, higher molecular weight nPAHs and oPAHs were preferentially found in finer particles, suggesting a potential for increased health risks. Smoking behavior raised the concentrations of nPAHs and oPAHs in personal air significantly. People who cooked food also had higher personal exposures. Cooking and smoking have a significant interaction effect on personal exposure. Concentrations in kitchens and personal exposure to nPAHs and oPAHs for households using wood and peat were significantly higher than for those using electricity and liquid petroleum gas (LPG).