Air pollution and human cognition: A systematic review and meta-analysis.

BACKGROUND: This systematic review summarises and evaluates the literature investigating associations between exposure to air pollution and general population cognition, which has important implications for health, social and economic inequalities, and human productivity. METHODS: The engines MEDLINE, Embase Classic+Embase, APA PsycInfo, and SCOPUS were searched up to May 2022. Our inclusion criteria focus on the following pollutants: particulate matter, NOx, and ozone. The cognitive abilities of interest are: general/global cognition, executive function, attention, working memory, learning, memory, intelligence and IQ, reasoning, reaction times, and processing speed. The collective evidence was assessed using the NTP-OHAT framework and random-effects meta-analyses. RESULTS: Eighty-six studies were identified, the results of which were generally supportive of associations between exposures and worsened cognition, but the literature was varied and sometimes contradictory. There was moderate certainty support for detrimental associations between PM2.5 and general cognition in adults 40+, and PM2.5, NOx, and PM10 and executive function (especially working memory) in children. There was moderate certainty evidence against associations between ozone and general cognition in adults age 40+, and NOx and reasoning/IQ in children. Some associations were also supported by meta-analysis (N = 14 studies, all in adults aged 40+). A 1 µg/m3 increase in NO2 was associated with reduced performance on general cognitive batteries (ß = -0.02, p < 0.05) as was a 1 µg/m3 increase in PM2.5 exposure (ß = -0.02, p < 0.05). A 1µgm3 increase in PM2.5 was significantly associated with lower verbal fluency by -0.05 words (p = 0.01) and a decrease in executive function task performance of -0.02 points (p < 0.001). DISCUSSION: Evidence was found in support of some exposure-outcome associations, however more good quality research is required, particularly with older teenagers and young adults (14-40 years), using multi-exposure modelling, incorporating mechanistic investigation, and in South America, Africa, South Asia and Australasia.

Perpetuation of gender discrimination in Pakistani society: results from a scoping review and qualitative study conducted in three provinces of Pakistan.

BACKGROUND: Gender discrimination is any unequal treatment of a person based on their sex. Women and girls are most likely to experience the negative impact of gender discrimination. The aim of this study is to assess the factors that influence gender discrimination in Pakistan, and its impact on women's life. METHODS: A mixed method approach was used in the study in which a systematic review was done in phase one to explore the themes on gender discrimination, and qualitative interviews were conducted in phase two to explore the perception of people regarding gender discrimination. The qualitative interviews (in-depth interviews and focus group discussions) were conducted from married men and women, adolescent boys and girls, Healthcare Professionals (HCPs), Lady Health Visitors (LHVs) and Community Midwives (CMWs). The qualitative interviews were analyzed both manually and electronically through QSR NVivo 10. The triangulation of data from the systematic review and qualitative interviews were done to explore the gender discrimination related issues in Pakistan. RESULTS: The six major themes have emerged from the systematic review and qualitative interviews. It includes (1) Status of a woman in the society (2) Gender inequality in health (3) Gender inequality in education (4) Gender inequality in employment (5) Gender biased social norms and cultural practices and (6) Micro and macro level recommendations. In addition, a woman is often viewed as a sexual object and dependent being who lacks self identity unless being married. Furthermore, women are restricted to household and child rearing responsibilities and are often neglected and forced to suppress self-expression. Likewise, men are viewed as dominant figures in lives of women who usually makes all family decisions. They are considered as financial providers and source of protection. Moreover, women face gender discrimination in many aspects of life including education and access to health care. CONCLUSION: Gender discrimination is deeply rooted in the Pakistani society. To prevent gender discrimination, the entire society, especially women should be educated and gendered sensitized to improve the status of women in Pakistan.

Personal radiofrequency electromagnetic field exposure of adolescents in the Greater London area in the SCAMP cohort and the association with restrictions on permitted use of mobile communication technologies at school and at home.

Personal measurements of radiofrequency electromagnetic fields (RF-EMF) have been used in several studies to characterise personal exposure in daily life, but such data are limitedly available for adolescents, and not yet for the United Kingdom (UK). In this study, we aimed to characterise personal exposure to RF-EMF in adolescents and to study the association between exposure and rules applied at school and at home to restrict wireless communication use, likely implemented to reduce other effects of mobile technology (e.g. distraction). We measured exposure to RF-EMF for 16 common frequency bands (87.5 MHz-3.5 GHz), using portable measurement devices (ExpoM-RF), in a subsample of adolescents participating in the cohort Study of Cognition, Adolescents and Mobile Phones (SCAMP) from Greater London (UK) (n = 188). School and home rules were assessed by questionnaire and concerned the school's availability of WiFi and mobile phone policy, and parental restrictions on permitted mobile phone use. Adolescents recorded their activities in real time using a diary app on a study smartphone, while characterizing their personal RF-EMF exposure in daily life, during different activities and times of the day. Data analysis was done for 148 adolescents from 29 schools who recorded RF-EMF data for a median duration of 47 h. The majority (74%) of adolescents spent part of their time at school during the measurement period. Median total RF-EMF exposure was 40 µW/m2 at home, 94 µW/m2 at school, and 100 µW/m2 overall. In general, restrictions at school or at home made little difference for adolescents' measured exposure to RF-EMF, except for uplink exposure from mobile phones while at school, which was found to be significantly lower for adolescents attending schools not permitting phone use at all, compared to adolescents attending schools allowing mobile phone use during breaks. This difference was not statistically significant for total personal exposure. Total exposure to RF-EMF in adolescents living in Greater London tended to be higher compared to exposure levels reported in other European countries. This study suggests that school policies and parental restrictions are not associated with a lower RF-EMF exposure in adolescents.

COVID-19 & informal settlements: is 'Stay Home' safe?

The disproportional burden of coronavirus (COVID-19) and vulnerability to containment measures in informal settlements have been recognised; however, the role of poor housing conditions in propagating these remains neglected. Poor housing conditions makes it difficult to effectively implement social distancing measures. With increased time spent in cramped, dark and uncomfortable indoor environments, water and sanitation outside the home, and no outdoor space, higher exposure to existing health hazards and high levels of stress, with women and children being most vulnerable, are anticipated. Through this commentary paper, we reflect on these interconnections and recommend immediate measures and the long-term need for adequate housing for health and well-being.

Noise pollution and human cognition: An updated systematic review and meta-analysis of recent evidence.

BACKGROUND: This systematic review provides a comprehensive synthesis of recent epidemiological evidence that environmental noise negatively impacts human cognition. METHODS: We update a prior review with recent publications (PROSPERO CRD42019151923). The strength of evidence for associations was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework. We also conducted random-effects meta-analyses where suitable. RESULTS: 16 studies were identified and reviewed in tandem with 32 studies previously reviewed by Clark & Paunovic (2018). A meta-analysis from 3 studies found that reading comprehension scores in quiet classrooms were 0.80 (95% confidence interval: 0.40; 1.20) points higher than children in noisier classrooms. Meta-analysis of the impact of 1 dB (dB) increase in environmental noise on reading and language abilities gave a pooled beta coefficient of -0.11(95% confidence interval: -0.32; 0.10). A meta-analysis of Odds Ratios (OR) from 3 studies found higher odds of cognitive impairment in people aged 45 + with higher residential noise exposure (OR 1.40, 95% CI: 1.18;1.61). After qualitative synthesis of remaining studies, there was high quality evidence for an association between environmental noise and cognitive impairment in middle-to-older adults, moderate quality evidence for an association between aircraft noise and reading and language in children, and moderate quality evidence against an association between aircraft noise and executive functioning in children. Generally the literature was supportive for other cognitive outcomes, but with low or very low-quality evidence. DISCUSSION: The evidence so far suggests that noise exposure is associated with cognition, but more good quality research using standardised methodology is required to corroborate these results and to allow for precise risk estimation by larger meta-analyses. There is also a need for more research with older teenagers and young-to-middle aged adults, on the synergistic effects of noise and air pollution, and in Africa, Central and South America, South Asia and Australasia.

Operationalising a One Health approach to reduce the infection and antimicrobial resistance (AMR) burden in under-5 year old urban slum dwellers: The Childhood Infections and Pollution (CHIP) Consortium.

The WHO advocates the use of a One Health approach to address antimicrobial resistance (AMR), focusing on integrating human, animal and environmental health factors. Nevertheless, there is a dearth of AMR research investigating the complexity of down and upstream factors across the One Health spectrum, especially in resource-deprived settings. The Childhood Infections and Pollution Consortium (CHIP) was designed to reduce the burden of childhood infections and AMR in urban slums, particularly in low-and middle-income countries, using One Health and technology-enabled Citizen Science approaches. Currently operationalized in three countries; India, Indonesia and Chile; CHIP is composed of interdisciplinary academics, healthcare professionals, veterinarians, international and local non-governmental organisations, current and former policymakers, local artists and community champions, amongst others. The CHIP Consortium invites collaborations for evidence-driven research, targeted investment and co-development of interventions in slums. We will host our third annual consortium workshop in Hong Kong in 2021 to build on our current work and explore new avenues to tackle childhood infections and AMR.

COVID-19 and informal settlements - implications for water, sanitation and health in India and Indonesia.

Informal settlements are home to over 1 billion people worldwide and are characterised by high population densities and poor environmental conditions. The authors identify the impact of COVID-19 on existing water and sanitation practices and potential pathways for the transmission of COVID-19 in informal settlements in India and Indonesia. In the short term, there is an urgent need for mobile and contactless hand washing, washing/bathing facilities and toilets. In the long term, COVID-19 provides an opportunity to invest in centralised water and sanitation networked solutions appropriate for high-density settings to integrate those settlements into cities and improve environmental conditions and health in these cities.