A review of progress in research of relationship between air pollution and perinatal depression / 环境与职业医学

In recent years, the increasing incidence of perinatal depression has become an important public health problem. In addition to the traditional social demographic factors, biological factors, obstetric factors, etc., the association between air pollution and perinatal depression (PND) has also attracted more and more attention. In this paper, studies on the association between air pollution and PND were reviewed, especially the associations of PND with ambient air pollutants such as PM2.5, PM10, NO2, and O3 as well as indoor air pollutants such as tobacco smoke, and the characteristics and possible biological mechanisms of the influence of different pollutants on PND were summarized. Based on the available studies, various outdoor air pollutants are associated with PND, and some pollutants may exhibit a dose-response relationship with it. As for indoor air pollution, studies only have focused on the impact of tobacco exposure on PND, and as yet, no study has explored the association between other indoor pollutants (e.g. cooking oil smoke and solid fuel) and PND. Current studies indicate that air pollution may act on PND through oxidative stress and neuroendocrine mechanisms, but the exact biological mechanism remains to be further studied. In the future, further studies should be encouraged on the epidemiological associations of other indoor air pollutants with PND and the interactions between other factors and air pollution on PND, and the underlying biological mechanisms, to provide new insights for the prevention of PND from the perspective of environmental health.

Progress on associations between intrauterine cigarette smoke exposure and cognitive and behavioral development / 国际儿科学杂志

Intrauterine cigarette smoke exposure(ICSE)refers to a condition under which pregnant women actively inhale and/or passively inhale cigarettes and smogs mostly consisting of nicotine, tar and carbon monoxide during the first, second and third trimesters of pregnancies.As an adverse environmental factor in early life, ICSE is associated with increased risks of various diseases at childhood and adulthood.ICSE is closely related with children′s cognitive and behavioral developmental disorders.It has been reported that ICSE led to elevated risks of cognitive impairments including disorders in fine motor skills, language and vocabulary, reading comprehension, matrix reasoning, working memory, learning skills, orientation and other capabilities.Additionally, it is associated with increased risks of attention deficit hyperactivity disorder and sleep disorder, but the association with autism spectrum disorder is still controversial.The review focuses on the effects of ICSE on cognitive and behavioral development, and summarizes the underlying mechanisms, providing more clinical ideas for etiological studies of cognitive and behavioral developmental disorders in children.

Analysis of second-hand smoke exposure and lung cancer death trend among population in Huizhou area / 公共卫生与预防医学

Objective To investigate the relationship between second-hand smoke exposure and lung cancer death trend in Huizhou area. Methods The corresponding records of lung cancer in the tumor registration system in Huizhou area from January 2019 to December 2019 were collected to investigate the subjects' second-hand smoke exposure. Linear regression model was used to analyze the correlation between the mortality of lung cancer patients and the second-hand smoke exposure rate. Logistic regression model was used to analyze the correlation between second-hand smoke exposure and death of lung cancer patients. Results In 2019, the mortality rate of lung cancer patients in Huizhou was the highest in the third quarter, and the second-hand smoke exposure rate of lung cancer patients was also the highest in the third quarter. The mortality rate of lung cancer patients in Huizhou was significantly positively correlated with the second-hand smoke exposure rate (r2 = 0.985 9, P<0.05). The second-hand smoke exposure rate, second-hand smoke exposure concentration, and the extent of second-hand smoke environmental enclosure of dead cancer patients were significantly higher than those of lung cancer patients in the survival group, and the difference was statistically significant (P<0.05). The second-hand smoke exposure, second-hand smoke concentration and the extent of the enclosure of second-hand smoke environment were independent risk factors influencing the death of lung cancer patients (P<0.05). Conclusion The trend of lung cancer deaths in Huizhou in 2019 was consistent with the prevalence of second-hand smoke exposure. The second-hand smoke exposure is an important factor for lung cancer deaths.

Second hand smoke exposure in workplace by job status and occupations

BACKGROUND: The objective of this study is to evaluate the risk of exposure to second hand smoke (SHS) during working hours by job status and occupation. METHODS: Using the 4th Korean Working Conditions Survey (KWCS), 49,674 respondents who answered the question about SHS were studied. A chi-square test was carried out to determine whether there is a significant different in SHS exposure frequency by general and occupational characteristics and experience of discrimination at work and logistic regression analysis was carried out to identify the risk level of SHS exposure by variables. RESULTS: In this study, we found that male workers in their 40s and 50s, workers employed in workplaces with fewer than 50 employees, daily workers, and people working outdoors had a higher rate of exposure to SHS than the others. The top five occupations with the highest SHS exposure were construction and mining-related occupations, metal core-makers-related trade occupations, wood and furniture, musical instrument, and signboard-related trade occupations, transport and machine-related trade occupations, transport and leisure services occupations. The least five exposed occupations were public and enterprise senior officers, legal and administrative professions, education professionals, and health, social welfare, and religion-related occupations. CONCLUSION: Tobacco smoke is a significant occupational hazard. Smoking ban policy in the workplace can be a very effective way to reduce the SHS exposure rate in the workplace and can be more effective if specifically designed by the job status and various occupations.

Environmental Tobacco Smoke Exposure at Home and Attributable Problem Behaviors in Korean Children and Adolescents for 2012–2014 in a Nationally Representative Survey

BACKGROUND: This study aimed to examine the environmental tobacco smoke (ETS) exposure at home and associated problem behaviors in Korean children and adolescents. METHODS: Approximately 2,167 children aged 3–18 years were included in the study after excluding 163 active smokers from the Korean Environmental Health Survey in Children and Adolescents (2012–2014). ETS data were obtained using a questionnaire; problem behaviors were measured using the Child Behavior Checklist administered to parents. The relationship between ETS exposure and problem behavior was evaluated using a survey regression model adjusted for region, age, sex, income, and father's education. The population-attributable fraction (PAF%) was calculated based on problem behaviors related to ETS exposure at home. RESULTS: The rates of ETS exposure at home were 20%, 28%, and 39% in children aged 3–5, 6–11, and 12–18 years, respectively; ETS exposure at home was associated with behavioral problems: the exposed group having higher total behavioral problem score (95% confidence interval [CI]) than the non-exposed by 2.46 (0.60–4.32) and 2.74 (0.74–4.74) in children aged 6–11 and 12–18 years, respectively, with no significant association in those aged 3–5 years. The PAF% (95% CI) of total problem behaviors for ETS exposure at home were 2.68 (−10.11–17.78), 10.66 (3.25–17.55), and 11.62 (3.03–18.96) in children aged 3–5, 6–11, and 12–18 years, respectively. Children with externalizing problems had higher PAF% than those with internalizing problems. CONCLUSION: In Korea, ETS exposure at home is associated with problem behaviors in children and adolescents with about more than 10% population attributable fraction.

Effect of clarithromycin on expressions of HDAC2and GR in smoke-exposed asthmatic mice / 西安交通大学学报(医学版)

Objective To explore the effects of clarithromycin on the expressions of histone deacetylase-2 (HDAC2) and glucocorticoid receptor (GR) of cigarette smoke-exposed asthmatic mice.Methods BALB/c mice were chosen to be the subjects of this study.They were raised to establish asthma model (OVA group);and mice in one asthma group were exposed to smoke (SEA group), one asthma group were treated with clarithromycin (CAM group) after smoke exposure.Control group mice were used as parallel comparison.The histopathological changes were studied to assess lung tissue inflammation.Cell counts in bronchoalveolar lavage fluid were also tested for airway inflammation.Histone deacelytase2 (HDAC2) activity of lung tissues was measured by qRT-PCR.HDAC2 and GR expressions in the lung tissue were detected by Western blot.Results Histopathologic observation showed massive infiltration of inflammatory cells in both OVA group and SEA group, while inflammation infiltration attenuated in CAM group.Compared with those in CAM group, the levels of IL-4 and IL-8 in bronchoalveolar lavage fluid of SEA group increased significantly (104.36±14.39 vs.65.49±10.82, 681.35±66.18 vs.321.49±90.37;P=0.031, 0.017).The expression of HDAC2 mRNA in CAM group was significantly higher than that in SEA group (0.062±0.013 vs.0.031±0.015, P=0.032).The expressions of HDAC2 protein (0.23±0.017 vs.0.49±0.022, P=0.033) and GR protein (0.19±0.014 vs.0.64±0.023, P=0.011) were significantly lower in SEA group than in CAM group.Conclusion Clarithromycin could attenuate airway inflammation in smoke-exposed asthmatic mice.The mechanism of action may be related to the expression of HDAC2 gene in the lower reaches by combining with GR.

Study on the epidemiological status of tobacco use among teenagers in Zhejiang province,China / 中华流行病学杂志

Objective To describe the prevalence of tobacco use among teenagers in different populations by sex and grades at school,and to provide evidence for the development of smoking control and health promotion programs.Methods A total of 4 797 teenagers selected from 36 schools through stratified multi-stage cluster sampling in Zhejiang province and were surveyed by using a questionnaire with 3 886 eligible ones for analysis.Indicators as tried smoking,current smoking,and secondhand smoke exposure,etc.,were calculated by weight on age proportions from the numbers of juniors in Zhejiang province.Results Prevalence rates of tried smoking and current smoking among teenagers were 10.91％ and 2.07％,respectively.7.72％ of the juniors were susceptible to future tobacco use.The prevalence rates of tried smoking were 15.65％ for boys and 5.58％ for girls,12.13％ in rural and 9.24％ in urban areas.Students from the 9th grade showed the highest rate (15.15％) while the 7th graders appeared the lowest level of susceptibility to future tobacco use (5.22％).The highest level of current smoking was seen in the group of "weekly allowance more than 30 Yuan,from parents"(4.07％).The prevalence of secondhand exposure to smoke in outdoor and indoor places,public transport,or at home were 57.60％,54.45％,46.97％,and 43.16％,respectively,among the teenagers.3 071 juniors (77.33％) saw the smoking scenes in the past 30 days but only 1 367 juniors (28.30％) were aware of the basic knowledge on tobaccos in class,in the past 12 months.Conclusions There were juniors who tried to smoke or were current smokers.The rate of secondhand exposure to smoking was high.A large number of the juniors were lack of education on knowledge related to tobacco control,in the classroom.It was important to promote and publicize the knowledge on tobacco so as to reduce the number of teenagers who were susceptible to future tobacco use.

Study on the epidemiological status of tobacco use among teenagers in Zhejiang province,China / 中华流行病学杂志

Objective To describe the prevalence of tobacco use among teenagers in different populations by sex and grades at school,and to provide evidence for the development of smoking control and health promotion programs.Methods A total of 4 797 teenagers selected from 36 schools through stratified multi-stage cluster sampling in Zhejiang province and were surveyed by using a questionnaire with 3 886 eligible ones for analysis.Indicators as tried smoking,current smoking,and secondhand smoke exposure,etc.,were calculated by weight on age proportions from the numbers of juniors in Zhejiang province.Results Prevalence rates of tried smoking and current smoking among teenagers were 10.91％ and 2.07％,respectively.7.72％ of the juniors were susceptible to future tobacco use.The prevalence rates of tried smoking were 15.65％ for boys and 5.58％ for girls,12.13％ in rural and 9.24％ in urban areas.Students from the 9th grade showed the highest rate (15.15％) while the 7th graders appeared the lowest level of susceptibility to future tobacco use (5.22％).The highest level of current smoking was seen in the group of "weekly allowance more than 30 Yuan,from parents"(4.07％).The prevalence of secondhand exposure to smoke in outdoor and indoor places,public transport,or at home were 57.60％,54.45％,46.97％,and 43.16％,respectively,among the teenagers.3 071 juniors (77.33％) saw the smoking scenes in the past 30 days but only 1 367 juniors (28.30％) were aware of the basic knowledge on tobaccos in class,in the past 12 months.Conclusions There were juniors who tried to smoke or were current smokers.The rate of secondhand exposure to smoking was high.A large number of the juniors were lack of education on knowledge related to tobacco control,in the classroom.It was important to promote and publicize the knowledge on tobacco so as to reduce the number of teenagers who were susceptible to future tobacco use.

Changes in and Factors Affecting Second-hand Smoke Exposure in Nonsmoking Korean Americans in California: A Panel Study

PURPOSE: We evaluated changes in and factors affecting second-hand smoke (SHS) exposure in a panel study of nonsmokers. METHODS: This study was based on data from a larger study of tobacco use among a representative sample of adults of Korean descent residing in California. Participants included 846 males and 1,399 females who were nonsmokers at baseline (2005-2006) and at follow-up (2007-2009). Participants were selected by probability sampling and were interviewed by telephone. RESULTS: At baseline, 50.0% were exposed to any SHS, and at follow-up 2 years later, 60.4% were exposed to any SHS (p < .001). SHS exposure at baseline was associated with acculturation, employment, spousal smoking, and having a friend who smoked (p < .001). Employment, spousal smoking, and other family members smoking were associated with SHS at follow-up (p < .001). The odds ratio of SHS in the employed group declined from 2.01 at baseline to 1.53 at follow-up, that of the group having a smoking spouse increased from 1.88 to 2.36, and that of the group having other family members smoking increased from 1.20 to 1.69. CONCLUSIONS: We showed that SHS exposure increased among Korean American nonsmokers in California, and the most important variables explaining the change in SHS exposure involved smoking among others with whom the subject is associated. These findings could be used as objective evidence for developing public health policies to reduce SHS exposure.

The expression of HDAC2 in lung of smoke cessation and smoking cessation rats / 中国医师杂志

Objective To study the expression of HDAC2 in lung of smoke cessation and smoking cessation rats,Methods Forty SD rats were divided into five groups randomly:normal control group (group A),1-month smoking group (group B,),2-month smoking group (group C),1-month smokingcessation group(group D),2-month smoking-cessation group(group E).Group B rats were exposured to cigarettes for 1 month,C,D,E were exposured to cigarettes for 2 months.At 1 month,group B were sacrificed,at 2 month,group C were sacrificed,group D was smoking cessation for 1 month and group E for 2 months.Pathomorphological changes of the small airway were analyzed,and then study the HDAC2 in rats'lung tissue.Results Compared with group A,the levels of HDAC2 in group B,group C,group D,group E were decreased (P ＜ 0.01),but smoking groups levels were lower than smoking-cessation groups.In smoking groups,group C was lower than group B.In smoking-cessation groups,group D was lower than group E.Conclusion It shows that the levels of HDAC2 in rats' lung tissue decrease after smoking exposure.It can recrease after quitting,but still cant back to normal.

Second-hand Smoke: A neglected public health challenge.

Exposure to secondhand smoke (SHS) causes an estimated 5% of the global burden of disease, slightly higher than the burden from direct use of tobacco. This review highlights the urgent need to address this ignored public health issue by presenting the evidence and impact of SHS on those exposed using global studies including those from the South-East Asia Region. The burden of morbidity from SHS exposure is higher in low-income countries in Southeast Asia region compared to the rest of the world. SHS exposure affects those most vulnerable, especially women and children. While several countries in the region have enacted legislation which offer protection to those exposed to SHS, most measures are partial and inadequate. As a result, implementation and compliance at national and sub-national level within the countries of the Southeast Asia region is variable. Governments must ensure that legislation mandates comprehensive smoke-free environments in order to provide public health benefit which offers universal protection to everyone and everywhere. Where comprehensive legislation exists, stringent implementation and enforcement, along with awareness building, education and monitoring through regular compliance studies must be done to sustain smokefree status of public places within jurisdictions.

Second-hand Smoke Exposure and Urine Cotinine Levels by Occupation in the Busan, Ulsan, Kyeongnam Provinces / 대한산업의학회지

OBJECTIVES: Exposure to second-hand smoke varied by smoking rate in the workplace and no-smoking policies. The purpose of this study was to estimate the status of second-hand smoke exposure by occupation through urine cotinine analysis in Busan, Ulsan, and Kyeongnam provinces. METHODS: Data was obtained from the National Institute of Environmental Research of Korea as 'The 2008 Korea National Survey for Environmental Pollutants in Human Body'. We selected 629 non-smokers who lived in Busan, Ulsan and Gyeongnam provinces. General and occupational characteristics were gathered using a structured questionnaire. Urine cotinine concentrations were analyzed by a gas chromatograph-mass selective detector. Statistical analysis was carried out using the Chi-square test, Student t-test and ANOVA. RESULTS: The geometric mean (geometric standard deviation) of urine cotinine concentration was 17.11 (2.74) ng/ml. The urine cotinine concentration of the middle school graduate group (18.47 (2.86) ng/ml) was higher than the college graduate group (15.64 (2.60) ng/ml, p=0.212). Also, the cotinine concentration of current drinkers (18.98 (2.47) ng/ml) was higher than non-drinkers (16.15 (2.88) ng/ml, p=0.054). The proportion who smelled smoke was higher in workers (38.5%) than in non-workers (29.7%, p=0.02). Therefore, urine cotinine concentration was higher in workers (17.29 (2.66) ng/ml) than in non-workers (16.97 (2.81) ng/ml) but not at a statistically significant amount (p=0.826). In addition, cotinine concentration between the group who smelled smoke (20.45 (2.42) ng/ml) and the group who did not smelled smoke (15.53 (2.78) ng/ml) was significantly different (p=0.016) in workers but not in non-workers (17.08 (2.42) ng/ml vs 16.92 (2.98) ng/ml, p=0.942). According to the National Center for Health Statistics occupational categories in the US and the Korea Standard Classification of Occupations, the urine cotinine concentration of white collar workers such as technical workers and administrators, professional specialists, and managers was higher (18.01 (2.55) ng/ml) than that of blue collar workers such as plant and machine operators and assemblers, elementary occupations, and craft and related trades workers (15.36 (3.48) ng/ml). CONCLUSIONS: The workplace is an important contributor to second-hand smoke exposure in Busan, Ulsan and Kyeongnam provinces. Unlike in advanced countries, where anti-smoking policies have been implemented, urine cotinine concentration in people in Busan, Ulsan and Kyeongnam provinces was higher in the white collar group than in the blue collar group. This result might be due to a higher indoor second-hand smoking rate of workplaces in these areas. Further studies are needed to evaluate the correlation between regional characteristics of industries, anti-smoking policies in the workplace, smoking rates and urine cotinine concentrations of workers.

Effect of cigarette smoke exposure on the interleukin-17-producing CD4+T helper lymphocyte in mice with emphysema / 中华微生物学和免疫学杂志

Objective To investigate the effect of cigarette smoke exposure on the interleukin-17-producing CD4+T helper lymphocyte( Th17 ) in peripheral blood and lungs of cigarette smoke-induced emphysema mice. MethodsForty male BALB/c mice were randomly divided into 4 groups, including a control group C12, a control group C24, a smoke-exposure group S12 and a smoke-exposure group S24, 10 mice each group. Morphological changes were evaluated by mean linear intercepts (Lm) and destructive index (DI). The concentration of IL-17, IFN-γ and TNF-α in bronchoalveolar lavage fluid(BALF) and the concentration of IFN-γ and TNF-α in lung homogenates were measured by enzyme-linked immunosorbent assay (ELISA). The proportion of CD4+IL-17+ Th17 cells in peripheral blood and lungs of mice was determined by flow cytometry. The mRNA expressions of RORγt and IL-17 in peripheral blood and lungs were evaluated by real-time PCR. ResultsLm and DI were significantly higher in S12 and S24 groups [(39.19±3.51)μm vs (46.87±7.16) μm, 39.13±1.57 vs 45.16±3.13]than that in C12 and C24 groups [(32.60± 3.21 ) μm vs (32.38±3.73) μm, 28.23± 1.62 vs 28.86±2.07], all P＜0.05. IL-17, IFN-γand TNF-α in BALF of S12 and S24 groups [(119.72±10.72) ng/L vs (296.40±14.00) ng/L,(129.7±22.2) ng/L vs(251. 1±62.4) ng/L, (17.35±1.60) ng/L, (36.35±1.43) ng/L]were higher than those in C12 and C24 groups [(52.06±4.70) ng/L vs (51.89 ±6.82) ng/L, ( 85.8 ±26.8) ng/L vs ( 88.9 ± 11.5 ) ng/L,(6.41 ±0.90) ng/L vs (5.85±0.92) ng/L], IFN-γ and TNF-α in lungs of S12 and S24 groups [( 1124.3±174.4) ng/L vs (1342.7±206.1) ng/L, (77.2±13.7) ng/L vs (101.7±19.0) ng/L, (129.7±22.2)ng/L vs (251.1 ±62.4) ng/L]were higher than those in C12 and C24 groups[(946.2±81.9) ng/L vs (1027.2±188.3) ng/L, (62.1±16.1) ng/L vs(64.4±15. 1) ng/L], all P＜0.05. The percentage of Th17 cells in lungs of S12 and S24 groups [(3.27±1.12)％ vs (7.19±2.24)％, ( 1.96±0.61 )％ vs (3.82±1.26)％]was significantly increased as compared with that of C12 and C24 groups [(1.80± 0.75)％ vs (1.99±0.59)％], all P＜0.05. And the percentage of Th17 cells in peripheral blood of S12 and S24 groups [(1.96±0.61)％ vs ( 3.82± 1.26)％]was also significantly higher than those in C12 and C24 groups [(0.90±0.37)％ vs (0.97±0.32)％], all P＜0.05. In peripheral blood and lungs,the mRNA levels of RORγt and IL-17 in S12 and S24 groups were higher than in C12 and C24 groups, all P＜0.05.Moreover, the frequency of Th17 cells in peripheral blood and lungs had a positive correlation with Lm and DI( r=0.706-0.772 ,all P＜0.05 ). ConclusionAn up-regulation of proportions Th17 in peripheral blood and lungs of cigarette smoke-inducsed emphysema mice were detected. It may be involved in the amplified and persistent inflammation.

Dynamic Expression of Tumor Necrosis Factor-α and Vascular Endothelial Growth Factor in Rat Model of Pulmonary Emphysema Induced by Smoke Exposure / 华中科技大学学报（医学）（英德文版）

In order to explore the roles of tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) in the pathogenesis of pulmonary emphysema, male Wistar rats were random-ized into group A<,1>, group A<,2.5> and group A<,4>, each with smoke exposure for 1 month, 2.5 months or 4 months, respectively. Group B<,1>, group B<,2.5> and group B<,4> were used as non smoking controls at corre-sponding time points. TNF-α in bronchoalveolar lavage fluid (BALF) and expression of VEGF in lung tissue was determined by ELISA or by SABC immunohistochemistry assay either. Lung slices were stained with hematoxylin and eosin (HE). Results showed that in animal with smoke exposure the mean linear interceptor (Lm), an index of pulmonary emphysema and the content of TNF-α in BALF increased gradually, on contrary, the expression of VEGF in lung tissue decreased (P<0.05).This phenomenon was not obvious in animals without smoke exposure. Lm was negatively correlated to the VEGF expression (γ=-0.81, P<0.01) and positively correlated to TNF-α concentration (γ=0.52, P<0.004), which implies that smoke exposure decreased the expression of VEGF and increased the expression of TNF-α. It is plausible to speculate that the imbalance of TNF-α and VEGF may play an important role in the pathogenesis of smoke-induced pulmonary emphysema.