Long-term exposure to ambient air pollution and measures of central hemodynamics and arterial stiffness among multiethnic Chicago residents.

OBJECTIVES: To examine whether long-term air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters. METHODS: We assessed central hemodynamic parameters including central blood pressure, cardiac parameters, systemic vascular compliance and resistance, and brachial artery stiffness measures [including brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR)] using waveform analysis of the arterial pressure signals obtained from a standard cuff sphygmomanometer (DynaPulse2000A, San Diego, CA). The long-term exposures to particles with an aerodynamic diameter < 2.5 µm (PM2.5) and nitrogen dioxide (NO2) for the 3-year periods prior to enrollment were estimated at residential addresses using fine-scale intra-urban spatiotemporal models. Linear mixed models adjusted for potential confounders were used to examine associations between air pollution exposures and health outcomes. RESULTS: The cross-sectional study included 2,387 Chicago residents (76% African Americans) enrolled in the ChicagO Multiethnic Prevention And Surveillance Study (COMPASS) during 2013-2018 with validated address information, PM2.5 or NO2, key covariates, and hemodynamics measurements. We observed long-term concentrations of PM2.5 and NO2 to be positively associated with central systolic, pulse pressure and BAR, and negatively associated with BAD, and BAC after adjusting for relevant covariates. A 1-µg/m3 increment in preceding 3-year exposures to PM2.5 was associated with 1.8 mmHg higher central systolic (95% CI: 0.98, 4.16), 1.0 mmHg higher central pulse pressure (95% CI: 0.42, 2.87), a 0.56%mmHg lower BAD (95% CI: -0.81, -0.30), and a 0.009 mL/mmHg lower BAC (95% CI: -0.01, -0.01). CONCLUSION: This population-based study provides evidence that long-term exposures to PM2.5 and NO2 is related to central BP and arterial stiffness parameters, especially among African Americans.

Long-term exposure to ambient air pollution and measures of central hemodynamics and arterial stiffness among multiethnic Chicago residents.

Objectives: To examine whether air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters. Methods: We assessed central hemodynamic parameters, brachial artery stiffness measures [including brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR)] using waveform analysis of the arterial pressure signals obtained from a standard cuff sphygmomanometer (DynaPulse2000A, San Diego, CA). The long-term exposures to particles with an aerodynamic diameter < 2.5µm (PM2.5) and nitrogen dioxide (NO2) for the 3-year periods prior to enrollment were estimated at residential addresses using fine-scale intra-urban spatiotemporal models. Linear mixed models adjusted for potential confounders were used to examine associations between air pollution exposures and health outcomes. Results: The cross-sectional study included 2,387 Chicago residents (76% African Americans) enrolled in the ChicagO Multiethnic Prevention And Surveillance Study (COMPASS) during 2013-2018 with validated address information, PM2.5 or NO2, key covariates, and hemodynamics measurements. We observed long-term concentrations of PM2.5 and NO2 to be positively associated with central systolic, pulse pressure and BAR, and negatively associated with BAD, and BAC after adjusting for relevant covariates. A 1-µg/m3 increment in preceding 3-year exposures to PM2.5 was associated with 1.8 mmHg higher central systolic (95% CI: 0.98, 4.16), 1.0 mmHg higher central pulse pressure (95% CI: 0.42, 2.87), a 0.56%mmHg lower BAD (95% CI: -0.81, -0.30), and a 0.009 mL/mmHg lower BAC (95% CI: -0.01, -0.01). Conclusion: This population-based study provides evidence that long-term exposures to PM2.5 and NO2 is related to central BP and arterial stiffness parameters, especially among African Americans.

Urban Spatial Accessibility of Primary Care and Hypertension Control and Awareness on Chicago's South Side: A Study From the COMPASS Cohort.

BACKGROUND: Understanding the relationship between hypertension and spatial accessibility of primary care can inform interventions to improve hypertension control and awareness, especially among disadvantaged populations. This study aims to investigate the association between spatial accessibility of primary care and hypertension control and awareness. METHODS: Participant data from the COMPASS (Chicago Multiethnic Prevention and Surveillance Study) between 2013 and 2019 were analyzed. All participants were geocoded. Locations of primary care providers in Chicago were obtained from MAPSCorps. A score was generated for spatial accessibility of primary care using an enhanced 2-step floating catchment area method. A higher score indicates greater accessibility. Measured hypertension was defined as systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg. Logistic regression was used to estimate odds ratio and 95% CI for hypertension status in relation to accessibility score quartiles. RESULTS: Five thousand ninety-six participants (mean age, 53.4±10.8) were included. The study population was predominantly non-Hispanic black (84.0%), over 53% reported an annual household income <$15 000, and 37.3% were obese. Measured hypertension prevalence was 78.7% in this population, among which 37.7% were uncontrolled and 41.0% were unaware. A higher accessibility score was associated with lower measured hypertension prevalence. In fully adjusted models, compared with the first (lowest) quartile of accessibility score, the odds ratio strengthened from 0.82 (95% CI, 0.67-1.01) for the second quartile to 0.75 (95% CI, 0.62-0.91) for the third quartile, and further to 0.73 (95% CI, 0.60-0.89) for the fourth (highest) quartile. The increasing trend had a P<0.01. Similar associations were observed for both uncontrolled and unaware hypertensions. When stratified by neighborhood socioeconomic status, a higher accessibility score was associated with lower rates of unaware hypertension in both disadvantaged and nondisadvantaged neighborhoods. CONCLUSIONS: Better spatial accessibility of primary care is associated with improved hypertension awareness and control.

Acute effects of ambient temperature on lung function of a panel of school children living in Dhaka, Bangladesh.

INTRODUCTION: Short-term exposure to ambient temperature plays a significant role in human health. However, studies examining ambient temperature and lung function are scarce in locations with a tropical environment. To address this research gap, the current study investigated the effects of short-term ambient temperature on lung function in children and seasonal variation in this association in Dhaka, Bangladesh. METHODS: The study was conducted in three schools located in three cities inside and around Dhaka. Repeated lung function measurements were obtained from a panel of 315 school children (including 86 asthmatic children) aged 9-16 years in 2013. Linear mixed-effects models adjusted for potential confounders were used to examine the effect of ambient temperature on lung function. RESULTS: Short-term exposure to low ambient temperature was associated with a significant decrement in children's lung function. For each 1 °C decrease in daily mean temperature at cumulative lag of the current and previous day, lung function parameter values were -3.02% (95% CI, -1.69 to -4.35) for peak expiratory flow (PEF), and -1.48% (95% CI, -0.75 to -2.22) for forced expiratory volume within 1 s (FEV1). A significant seasonal variation was also observed in these associations, as the estimated adverse effects of decrease in daily mean temperature on lung function measures were primarily evident in winter. DISCUSSION: This study suggests that short-term ambient exposure to decrease in temperature adversely affect lung function. A significant seasonal modification in the association between temperature and lung function was also observed for these children living in an environment with a tropical climatic condition as the adverse effect of decrease in ambient temperature was primarily observed in winter than in summer.

Cohort profile: the ChicagO Multiethnic Prevention and Surveillance Study (COMPASS).

PURPOSE: The ChicagO Multiethnic Prevention and Surveillance Study or 'COMPASS' is a population-based cohort study with a goal to examine the risk and determinants of cancer and chronic disease. COMPASS aims to address factors causing and/or exacerbating health disparities using a precision health approach by recruiting diverse participants in Chicago, with an emphasis on those historically underrepresented in biomedical research. PARTICIPANTS: Nearly 8000 participants have been recruited from 72 of the 77 Chicago community areas. Enrolment entails the completion of a 1-hour long survey, consenting for past and future medical records from all sources, the collection of clinical and physical measurement data and the on-site collection of biological samples including blood, urine and saliva. Indoor air monitoring data and stool samples are being collected from a subset of participants. On collection, all biological samples are processed and aliquoted within 24 hours before long-term storage and subsequent analysis. FINDINGS TO DATE: The cohort reported an average age of 53.7 years, while 80.5% identified as African-American, 5.7% as Hispanic and 47.8% as men. Over 50% reported earning less than US$15 000 yearly, 35% were obese and 47.8% were current smokers. Moreover, 38% self-reported having had a diagnosis of hypertension, while 66.4% were measured as hypertensive at enrolment. FUTURE PLANS: We plan to expand recruitment up to 100 000 participants from the Chicago metropolitan area in the next decade using a hybrid community and clinic-based recruitment framework that incorporates data collection through mobile medical units. Follow-up data collection from current cohort members will include serial samples, as well as longitudinal health, lifestyle and behavioural assessment. We will supplement self-reported data with electronic medical records, expand the collection of biometrics and biosamples to facilitate increasing digital epidemiological study designs and link to state and/or national level databases to ascertain outcomes. The results and findings will inform potential opportunities for precision disease prevention and mitigation in Chicago and other urban areas with a diverse population. REGISTRATION: NA.

Effects of Short-term Exposure to Ambient Particulate Matter on the Lung Function of School Children in Dhaka, Bangladesh.

BACKGROUND: Ambient particulate pollution may adversely affect children's lung function. However, evidence on this association remains scarce in Asia despite this region having the greatest burden of disease due to air pollution. OBJECTIVES: To investigate the effect of short-term exposure to ambient particulate matter (PM) on the lung function of school children in Dhaka city, Bangladesh. The possible seasonal modification of this association was also examined. METHODS: A panel of 315 school children who were 9-16 years of age were recruited from three schools in and around Dhaka. Lung function was assessed using a spirometry test during the cool and warm seasons in 2013, yielding six measurements per child. Daily PM data were retrieved from nearby air monitoring stations. Linear mixed effects models were used to examine associations. Seasonal modification was examined by stratification. RESULTS: An inverse association was observed for the lung function parameters with PM2.5; peak expiratory flow (PEF) and forced expiratory volume within 1 second (FEV1) decreased with increasing PM2.5. The percent deviation from the personal median was -4.19% [95% confidence interval (CI): -5.72, -2.66] for PEF and -2.05% (95% CI: -2.92, -1.18) for FEV1 for a 20 µg/m increase in PM2.5 on the previous day. Results for PM10 were less consistent. The estimated effects of PM on lung functions were generally greater in the warm season. CONCLUSIONS: Short-term exposure to PM is associated with worse lung function in children living in highly polluted settings, with the strength of these adverse PM effects varying by season.

Association between short-term exposure to fine particulate matter and daily emergency room visits at a cardiovascular hospital in Dhaka, Bangladesh.

BACKGROUND: It has been suggested that exposure to fine particulate matter (PM2.5) adversely affects cardiovascular health. However, the effect modifications by individual characteristics and season have been less studied in developing countries where PM2.5 levels are high. OBJECTIVES: To estimate the risks of cardiovascular emergency room visits in relation to daily concentrations of PM2.5 and to assess how these associations can be modified by age, sex, and nutritional status of patients and by season. METHODS: The analytic sample was 6774 adults who visited the emergency room at a cardiovascular disease (CVD) hospital in Dhaka throughout one year (n = 364 days). A time-stratified case-crossover design with conditional Poisson regression analysis was used to estimate the relative risks (RRs) and 95% confidence intervals (CIs) of visits while adjusting for temperature. Stratification was performed by gender, age (<65 and ≥65 years), BMI (underweight, normal weight, overweight), and season (dry summer: February to April; wet summer: May to October; dry winter: November to January). RESULTS: The mean concentration of PM2.5 was 86.1 µg/m3. An IQR increase (103 µg/m3) in PM2.5 at lag 3 was significantly associated with a 12% (RR: 1.12; 95% CI: 1.01-1.23) increase in CVD emergency room visits. No evidence of association was found for the other lags. Underweight and overweight patients showed evidence of increased risk at lag 2 (RR: 1.31; 95% CI: 1.02-1.67) and lag 4 (RR: 1.20; 95% CI: 1.04-1.39), respectively. CONCLUSION: Increases in the daily concentrations of PM2.5 may lead to more cardiovascular emergency room visits in Dhaka, Bangladesh. Response times from ambient exposure to CVD emergency visits may differ by season and the nutritional status of susceptible individuals, necessitating further research.

Acute Effects of Ambient PM2.5 on All-Cause and Cause-Specific Emergency Ambulance Dispatches in Japan.

Short-term health effects of ambient PM2.5 have been established with numerous studies, but evidence in Asian countries is limited. This study aimed to investigate the short-term effects of PM2.5 on acute health outcomes, particularly all-cause, cardiovascular, respiratory, cerebrovascular and neuropsychological outcomes. We utilized daily emergency ambulance dispatches (EAD) data from eight Japanese cities (2007-2011). Statistical analyses included two stages: (1) City-level generalized linear model with Poisson distribution; (2) Random-effects meta-analysis in pooling city-specific effect estimates. Lag patterns were explored using (1) unconstrained-distributed lags (lag 0 to lag 7) and (2) average lags (lag: 0-1, 0-3, 0-5, 0-7). In all-cause EAD, significant increases were observed in both shorter lag (lag 0: 1.24% (95% CI: 0.92, 1.56)) and average lag 0-1 (0.64% (95% CI: 0.23, 1.06)). Increases of 1.88% and 1.48% in respiratory and neuropsychological EAD outcomes, respectively, were observed at lag 0 per 10 µg/m³ increase in PM2.5. While respiratory outcomes demonstrated significant average effects, no significant effect was observed for cardiovascular outcomes. Meanwhile, an inverse association was observed in cerebrovascular outcomes. In this study, we observed that effects of PM2.5 on all-cause, respiratory and neuropsychological EAD were acute, with average effects not exceeding 3 days prior to EAD onset.

Interactive effects of specific fine particulate matter compositions and airborne pollen on frequency of clinic visits for pollinosis in Fukuoka, Japan.

BACKGROUND: Previous studies have revealed the interactive effects of airborne pollen and particulate matter on the daily consultations for pollinosis, but it is uncertain which compositions are responsible. This study aimed to investigate the interactive effects of specific PM2.5 compositions and airborne pollen on the daily number of clinic visits for pollinosis in Fukuoka. METHODS: We obtained daily data on pollen concentrations, PM2.5 compositions, PM2.5 mass, gaseous pollutants (SO2, NO2, CO, and O3), and weather variables monitored in Fukuoka between February and April, 2002-2012. In total, 73,995 clinic visits for pollinosis were made at 10 clinics in Fukuoka Prefecture during the study period. A time-stratified case-crossover design was applied to examine the interactive effects. The concentrations of PM2.5 and its compositions were stratified into low (<15th percentile), moderate (15th-85th percentile), and high (>85th percentile) levels, and the association between airborne pollen and daily clinic visits for pollinosis was analyzed within each level. RESULTS: We found a significant interaction between specific PM2.5 compositions and airborne pollen. Specifically, the odds ratio of daily clinic visits for pollinosis per interquartile increase in pollen concentration (39.8 grains/cm2) at the average cumulative lag of 0 and 2 days during high levels of non-sea-salt Ca2+ was 1.446 (95% CI: 1.323-1.581), compared to 1.075 (95% CI: 1.067-1.083) when only moderate levels were observed. This result remained significant when other air pollutants were incorporated into the model and was fairly persistent even when different percentile cut-off points were used. A similar interaction was found when we stratified the data according to non-sea-salt SO42- levels. This finding differed from estimates made according to PM2.5 and NO3- levels, which predicted that the effects of pollen were strongest in the lower levels. CONCLUSIONS: Associations between airborne pollen and daily clinic visits for pollinosis could be enhanced by high levels of specific PM2.5 compositions, especially non-sea-salt Ca2+.

Short-term exposure to ambient particulate matter and emergency ambulance dispatch for acute illness in Japan.

Short-term exposure to air pollution may be linked to negative health outcomes that require an emergency medical response. However, few studies have been undertaken on this phenomenon to date. The aim of this study therefore was to examine the association between short-term exposure to ambient suspended particulate matter (SPM) and emergency ambulance dispatches (EADs) for acute illness in Japan. Daily EAD data, daily mean SPM and meteorological data were obtained for four prefectures in the Kanto region of Japan for the period from 2007 to 2011. The area-specific association between daily EAD for acute illness and SPM was explored using generalized linear models while controlling for ambient temperature, relative humidity, seasonality, long-term trends, day of the week and public holidays. Stratified analyses were conducted to evaluate the modifying effects of age, sex and medical conditions. Area-specific estimates were combined using meta-analyses. For the total study period the mean level of SPM was 23.7µg/m(3). In general, higher SPM was associated with a significant increase in EAD for acute illness [estimated pooled relative risk (RR): 1.008, 95% CI: 1.007 to 1.010 per 10µg/m(3) increase in SPM at lag 0-1]. The effects of SPM on EAD for acute illness were significantly greater for moderate/mild medical conditions (e.g. cases that resulted in <3weeks hospitalization or no hospitalization) when compared to severe medical conditions (e.g. critical cases, and cases that led to >3weeks hospitalization or which resulted in death). Using EAD data, this study has shown the adverse health effects of ambient air pollution. This highlights the importance of reducing the level of air pollution in order to maintain population health and well-being.

Delta-aminolevulinic acid dehydratase (ALAD) polymorphism in lead exposed Bangladeshi children and its effect on urinary aminolevulinic acid (ALA).

BACKGROUND AND OBJECTIVE: Lead has long been recognized as a harmful environmental pollutant. People in developing countries like Bangladesh still have a higher risk of lead exposure. Previous research has suggested that the delta-aminolevulinic acid dehydratase (ALAD) genotype can modify lead toxicity and individual susceptibility. As children are more susceptible to lead-induced toxicity, this study investigated whether the ALAD genotype influenced urinary excretion of delta-aminolevulinic acid (U-ALA) among children exposed to environmental lead in Bangladesh. METHODS: Subjects were elementary schoolchildren from a semi-urban industrialized area in Bangladesh. A total of 222 children were studied. Blood and urine were collected to determine ALAD genotypes, blood lead levels and urinary aminolevulinic acid (U-ALA). RESULTS: The mean BPb level was 9.7 µg/dl for the study children. BPb was significantly positively correlated with hemoglobin (p<0.01). In total, allele frequency for ALAD 1 and 2 was 0.83 and 0.17 respectively. The mean U-ALA concentration was lower in ALAD1-2/2-2 carriers than ALAD1-1 carriers for boys (p=0.001). But for girls, U-ALA did not differ significantly by genotype (p=0.26). When U-ALA was compared by genotype at the same exposure level in a multiple linear regression analysis, boys who were ALAD1-2/2-2 carriers still had a lower level of U-ALA compared to ALAD1-1 carriers. CONCLUSION: This study provides information about the influence of ALAD polymorphism and its association with U-ALA in Bangladeshi children. Our results indicate that the ALAD1-2/2-2 genotype may have a protective effect in terms of U-ALA for environmentally lead exposed boys.

Arsenic contamination in groundwater and its effects on adolescent intelligence and social competence in Bangladesh with special reference to daily drinking/cooking water intake.

OBJECTIVE: The present study aims to investigate the relationship between arsenic (As) exposure and intelligence quotient (IQ) or social competence (SC) of Bangladeshi adolescents (aged 14 or 15 years) in Sonargaon thana. METHODS: Information about socioeconomic status (SES) was collected as confounding factors. To evaluate the relative contribution of As sources to total As intake, the As concentrations in urine and drinking/cooking water, and the amount of water added in cooking, were assessed on site using a food frequency questionnaire (FFQ). RESULTS: The results confirmed that As exposure was essential to lower adolescent IQ or SC because they were negatively associated with As exposure after controlling for SES (particularly household income). Except for cooking water, the amount of drinking water varied with season and appeared to be the major As source because the As concentration in water was generally correlated with the As concentration in urine, and they were related to lower IQ or SC (even after controlling for SES). The FFQ survey revealed that rice was consumed the most frequently (more than once daily), followed by daal (bean) soup and nonleafy vegetables, but fish, meat, and eggs were consumed approximately once a week. Water intake per meal from cooked rice was estimated to be 616 mL/person, followed by bean soup (258 mL/person) and cooked vegetables (82 mL/person). CONCLUSIONS: Our results suggest that water used for cooking might be an important source of As, and the cooking process can affect the amount of As in cooked food.