Publications by authors named "Haidong Kan"

356 Publications

The exposome in practice: an exploratory panel study of biomarkers of air pollutant exposure in Chinese people aged 60-69 years (China BAPE Study).

Environ Int 2021 Sep 12;157:106866. Epub 2021 Sep 12.

China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China. Electronic address:

The exposome overhauls conventional environmental health impact research paradigms and provides a novel methodological framework that comprehensively addresses the complex, highly dynamic interplays of exogenous exposures, endogenous exposures, and modifiable factors in humans. Holistic assessments of the adverse health effects and systematic elucidation of the mechanisms underlying environmental exposures are major scientific challenges with widespread societal implications. However, to date, few studies have comprehensively and simultaneously measured airborne pollutant exposures and explored the associated biomarkers in susceptible healthy elderly subjects, potentially resulting in the suboptimal assessment and management of health risks. To demonstrate the exposome paradigm, we describe the rationale and design of a comprehensive biomarker and biomonitoring panel study to systematically explore the association between individual airborne exposure and adverse health outcomes. We used a combination of personal monitoring for airborne pollutants, extensive human biomonitoring, advanced omics analysis, confounding information, and statistical methods. We established an exploratory panel study of Biomarkers of Air Pollutant Exposure in Chinese people aged 60-69 years (China BAPE), which included 76 healthy residents from a representative community in Jinan City, Shandong Province. During the period between September 2018 and January 2019, we conducted prospective longitudinal monitoring with a 3-day assessment every month. This project: (1) leveraged advanced tools for personal airborne exposure monitoring (external exposures); (2) comprehensively characterized biological samples for exogenous and endogenous compounds (e.g., targeted and untargeted monitoring) and multi-omics scale measurements to explore potential biomarkers and putative toxicity pathways; and (3) systematically evaluated the relationships between personal exposure to air pollutants, and novel biomarkers of exposures and effects using exposome-wide association study approaches. These findings will contribute to our understanding of the mechanisms underlying the adverse health impacts of air pollution exposures and identify potential adverse clinical outcomes that can facilitate the development of effective prevention and targeted intervention techniques.
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http://dx.doi.org/10.1016/j.envint.2021.106866DOI Listing
September 2021

The acute effects of particulate matter air pollution on ambulatory blood pressure: A multicenter analysis at the hourly level.

Environ Int 2021 Sep 9;157:106859. Epub 2021 Sep 9.

School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China. Electronic address:

Epidemiological evidence from ambulatory blood pressure monitoring is needed to clarify the associations of particulate air pollution with blood pressure and potential lag patterns. We examined the associations of fine and coarse particulate matter (PM, PM) with ambulatory blood pressure among 7108 non-hypertensive participants from 7 Chinese cities between April 2016 and November 2020. Hourly concentrations of PM and PM were obtained from the nearest monitoring stations. We measured four blood pressure indicators, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). Linear mixed-effect models combined with distributed lag models were applied to analyze the data. Generally, very short-term exposure to PM was significantly associated with elevated blood pressure. These effects occurred on the same hour of blood pressure measurement, attenuated gradually, and became insignificant approximately at lag 12 h. An interquartile range (IQR, 33 μg/m) increase of PM was significantly associated with cumulative increments of 0.58 mmHg for SBP, 0.31 mmHg for DBP, 0.38 mmHg for MAP, and 0.33 mmHg for PP over lag 0 to 12 h. The exposure-response relationship curves were almost linear without thresholds, but tended to be flat at very high concentrations. No significant associations were observed for PM. Our study provides independent and robust associations between transient PM exposure and elevated blood pressure within the first 12 h, and reinforces the evidence for a linear and non-threshold exposure-response relationship, which may have implications for blood pressure management and hypertension prevention in susceptible population.
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http://dx.doi.org/10.1016/j.envint.2021.106859DOI Listing
September 2021

Mortality risk attributable to wildfire-related PM pollution: a global time series study in 749 locations.

Lancet Planet Health 2021 Sep;5(9):e579-e587

Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

Background: Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM and mortality across various regions of the world.

Methods: For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000-16. Daily concentrations of wildfire-related PM were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0·25° × 0·25° resolution. The association between wildfire-related PM exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM exposure was calculated.

Findings: 65·6 million all-cause deaths, 15·1 million cardiovascular deaths, and 6·8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 μg/m increase in the 3-day moving average (lag 0-2 days) of wildfire-related PM exposure were 1·019 (95% CI 1·016-1·022) for all-cause mortality, 1·017 (1·012-1·021) for cardiovascular mortality, and 1·019 (1·013-1·025) for respiratory mortality. Overall, 0·62% (95% CI 0·48-0·75) of all-cause deaths, 0·55% (0·43-0·67) of cardiovascular deaths, and 0·64% (0·50-0·78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM exposure during the study period.

Interpretation: Short-term exposure to wildfire-related PM was associated with increased risk of mortality. Urgent action is needed to reduce health risks from the increasing wildfires.

Funding: Australian Research Council, Australian National Health & Medical Research Council.
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http://dx.doi.org/10.1016/S2542-5196(21)00200-XDOI Listing
September 2021

Indoor exposure levels of radon in dwellings, schools, and offices in China from 2000 to 2020: A systematic review.

Indoor Air 2021 Aug 25. Epub 2021 Aug 25.

School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China.

After decades of development, the indoor environment in China has changed. A systematic review was conducted from peer-reviewed scientific papers with field test data of indoor radon in China from 2000 to 2020 for three types of buildings. The mean concentrations of indoor radon for dwellings, school buildings, and office buildings are 54.6, 56.1, and 54.9 Bq/m . The indoor radon concentration was related to seasons, climate regions, ventilation, decoration, and other factors such as soil and outdoor air. Colder seasons, especially in severe colder areas of China, newer decorated buildings, closed windows, and doors were all associated with higher indoor radon concentrations. Variables like climate region and ventilation showed statistical significance in the correlation analysis. Regarding the increasing trend of indoor radon concentration in China during the last two decades, further study of indoor radon is necessary especially for school buildings and office buildings, and will help access its environmental burden of disease in China more accurately.
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http://dx.doi.org/10.1111/ina.12920DOI Listing
August 2021

The decay of airborne bacteria and fungi in a constant temperature and humidity test chamber.

Environ Int 2021 Aug 13;157:106816. Epub 2021 Aug 13.

Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Department of Environmental Science & Engineering, Fudan Tyndall Centre, Institute of Atmospheric Sciences, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Institute of Atmospheric Sciences, Fudan University, Shanghai 200438, China; Institute of Eco-Chongming (IEC), Shanghai 200062, China. Electronic address:

Despite substantial research to profile the microbial characteristics in the atmosphere, the changing metabolism underpinning microbial successional dynamics remains ambiguous. Herein, we applied qPCR, high-throughput sequencing of the genes encoding 16S and ITS rRNA to render the bacterial/fungal dynamics of ambient PM filters maintained at constant conditions of temperature (20 ± 2 °C) and humidity (50 ± 5%). The incubation experiments which lasted for 50 days aim to simulate a metabolic process of microbe in two types PM (polluted and non-polluted). The results show that microbial community species in polluted PM had faster decay rates, more bacterial diversity and less fungal community compared to the non-polluted ones. For bacteria, the proportion of anaerobic species is higher than aerobic ones, and their performance of contain mobile elements, form-biofilms, and pathogenic risks declined rapidly as times went by. Whereas for fungi, saprotroph species occupied about 70% of the population, resulting in a specified peak of abundance due to the adequacy nutrients supplied by the apoptosis cells. Combining the classified microbial species, we found stable community structure and the volatile ones related to the various metabolic survival strategies during different time. Without the input of peripheral environment, the health risks of airborne microbe descend to a healthy level after 20 days, implying their biologic effectiveness was about 20 days no matter the air is polluted or not. This study provided new insights into the different metabolic survival of airborne microorganisms in ideal and stable conditions.
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http://dx.doi.org/10.1016/j.envint.2021.106816DOI Listing
August 2021

Predicting the effect of confinement on the COVID-19 spread using machine learning enriched with satellite air pollution observations.

Proc Natl Acad Sci U S A 2021 08;118(33)

Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention, Department of Environmental Science and Engineering, Fudan University, Shanghai 200438, China.

The real-time monitoring of reductions of economic activity by containment measures and its effect on the transmission of the coronavirus (COVID-19) is a critical unanswered question. We inferred 5,642 weekly activity anomalies from the meteorology-adjusted differences in spaceborne tropospheric NO column concentrations after the 2020 COVID-19 outbreak relative to the baseline from 2016 to 2019. Two satellite observations reveal reincreasing economic activity associated with lifting control measures that comes together with accelerating COVID-19 cases before the winter of 2020/2021. Application of the near-real-time satellite NO observations produces a much better prediction of the deceleration of COVID-19 cases than applying the Oxford Government Response Tracker, the Public Health and Social Measures, or human mobility data as alternative predictors. A convergent cross-mapping suggests that economic activity reduction inferred from NO is a driver of case deceleration in most of the territories. This effect, however, is not linear, while further activity reductions were associated with weaker deceleration. Over the winter of 2020/2021, nearly 1 million daily COVID-19 cases could have been avoided by optimizing the timing and strength of activity reduction relative to a scenario based on the real distribution. Our study shows how satellite observations can provide surrogate data for activity reduction during the COVID-19 pandemic and monitor the effectiveness of containment to the pandemic before vaccines become widely available.
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http://dx.doi.org/10.1073/pnas.2109098118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379976PMC
August 2021

Impact of ozone exposure on heart rate variability and stress hormones: A randomized-crossover study.

J Hazard Mater 2021 Jul 26;421:126750. Epub 2021 Jul 26.

Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China. Electronic address:

The biological mechanisms underlying the associations between atmospheric ozone exposure and adverse cardiometabolic outcomes are yet to be identified. Imbalanced autonomic nervous system (ANS) as well as activations of the sympatho-adrenomedullary (SAM) and hypothalamic-pituitary-adrenal (HPA) axes are among possible early biological responses triggered by ozone, and may eventually lead to cardiometabolic abnormalities. To determine whether acute ozone exposure causes ANS imbalance and increases the secretion of neuroendocrine stress hormones, we conducted a randomized, double-blind, crossover trial, under controlled 2-hour exposure to either ozone (200 ppb) or clean air with intermittent exercise among 22 healthy young adults. Here we found that, compared to clean air exposure, acute ozone exposure significantly decreased the high-frequency band of heart rate variability, even after adjusting for heart rate and pre-exposure to ambient air pollutants and meteorological factors. Ozone exposure also significantly increased the serum levels of stress hormones, including corticotrophin-releasing factor, adrenocorticotropic hormone, adrenaline, and noradrenaline. Metabolomics analysis showed that acute ozone exposure led to alterations in stress hormones, systemic inflammation, oxidative stress, and energy metabolism. Our results suggest that acute ozone exposure may trigger ANS imbalance and activate the HPA and SAM axes, offering potential biological explanations for the adverse cardiometabolic effects following acute ozone exposure.
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http://dx.doi.org/10.1016/j.jhazmat.2021.126750DOI Listing
July 2021

Personal exposure to PM in five commuting modes under hazy and non-hazy conditions.

Environ Pollut 2021 Jul 23;289:117823. Epub 2021 Jul 23.

School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China. Electronic address:

Effective reducing exposure to fine particulate matter (PM) during commuting can help lower the risk of adverse health effects therefrom; however, few studies have examined the influence of different background levels of air pollution-particularly in China where PM concentrations are high globally. In this study, personal sampling was conducted to measure individual exposure during five different modes of commuting (bus, metro, car, bicycle and walking) in Shanghai, China. A total of 125 measurements were conducted for five days under haze and non-haze conditions, following which the corresponding doses of PM inhaled were estimated. The mean concentrations (±standard deviation, SD, 1-min averaging) of background PM were 155.9 (±98.7) μg/m during haze and 36.3 (±17.6) μg/m under the non-haze conditions. Under both conditions, active commuters were exposed to higher PM concentrations than those using motorized commuting modes (Wilcoxon test, p < 0.01). Moreover, driving with closed windows and air conditioning effectively reduces the PM concentrations in cars by 35 %-57 %. Cyclists inhaled the highest doses (539.8 ± 313.2 and 134.8 ± 71.3 μg/h under haze and non-haze conditions, respectively), whereas car drivers inhaled the lowest doses (28.8 ± 21.2 and 3.7 ± 2.6 μg/h under haze and non-haze conditions, respectively). Individual exposure to PM during commuting varied with the modes; the discrepancy between the latter depended largely on the ambient concentration. Our findings provided evidence that traffic-related air pollution contributed to daily pollutant exposure and highlighted the importance of taking personal protective measures while commuting, particularly during haze.
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http://dx.doi.org/10.1016/j.envpol.2021.117823DOI Listing
July 2021

Reducing the Influence of Environmental Factors on Performance of a Diffusion-Based Personal Exposure Kit.

Sensors (Basel) 2021 Jul 6;21(14). Epub 2021 Jul 6.

Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong, China.

Sensor technology has enabled the development of portable low-cost monitoring kits that might supplement many applications in conventional monitoring stations. Despite the sensitivity of electrochemical gas sensors to environmental change, they are increasingly important in monitoring polluted microenvironments. The performance of a compact diffusion-based Personal Exposure Kit (PEK) was assessed for real-time gaseous pollutant measurement (CO, O, and NO) under typical environmental conditions encountered in the subtropical city of Hong Kong. A dynamic baseline tracking method and a range of calibration protocols to address system performance were explored under practical scenarios to assess the performance of the PEK in reducing the impact of rapid changes in the ambient environment in personal exposure assessment applications. The results show that the accuracy and stability of the ppb level gas measurement is enhanced even in heterogeneous environments, thus avoiding the need for data post-processing with mathematical algorithms, such as multi-linear regression. This establishes the potential for use in personal exposure monitoring, which has been difficult in the past, and for reporting more accurate and reliable data in real-time to support personal exposure assessment and portable air quality monitoring applications.
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http://dx.doi.org/10.3390/s21144637DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8309635PMC
July 2021

Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019: a three-stage modelling study.

Lancet Planet Health 2021 07;5(7):e415-e425

Department of Earth Sciences, University of Turin, Turin, Italy.

Background: Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures.

Methods: In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature-mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature-mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division.

Findings: Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967-5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58-11·07) of all deaths (8·52% [6·19-10·47] were cold-related and 0·91% [0·56-1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60-87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000-03 to 2016-19, the global cold-related excess death ratio changed by -0·51 percentage points (95% eCI -0·61 to -0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13-0·31), leading to a net reduction in the overall ratio. The largest decline in overall excess death ratio occurred in South-eastern Asia, whereas excess death ratio fluctuated in Southern Asia and Europe.

Interpretation: Non-optimal temperatures are associated with a substantial mortality burden, which varies spatiotemporally. Our findings will benefit international, national, and local communities in developing preparedness and prevention strategies to reduce weather-related impacts immediately and under climate change scenarios.

Funding: Australian Research Council and the Australian National Health and Medical Research Council.
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http://dx.doi.org/10.1016/S2542-5196(21)00081-4DOI Listing
July 2021

Fine particulate matter constituents and infant mortality in Africa: A multicountry study.

Environ Int 2021 11 30;156:106739. Epub 2021 Jun 30.

School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai 200030, China. Electronic address:

Background: Few studies have investigated the association between exposure to fine particulate matter (PM) and infant mortality in developing countries, especially for the health effects of specific PM constituents.

Objective: We aimed to examine the association of long-term exposure to specific PM constituents with infant mortality in 15 African countries from 2005 to 2015.

Methods: Based on the Demographic and Health Surveys (DHS) dataset, we included birth history records from 15 countries in Africa and conducted a multicountry cross-sectional study to examine the associations between specific PM constituents and infant mortality. We estimated annual residential exposure using satellite-derived PM for mass and a chemical transport model (GEOS-Chem) for its six constituents, including organic matter (OM), black carbon (BC), sulfate (SO), nitrate (NO), ammonium (NH), and soil dust (DUST). Multivariable logistic regression analysis was employed by fitting single-constituent models, the constituent-PM models, and the constituent-residual models. We also conducted stratified analyses by potential effect modifiers and examined the specific associations for each country.

Results: We found positive and significant associations between PM total mass and most of its constituents with infant mortality. In the single-constituent model, for an IQR increase in pollutant concentrations, the odds ratio (OR) of infant mortality was 1.03 (95 %CI; 1.01, 1.06) for PM total mass, and was 1.04 (95 %CI: 1.02, 1.06), 1.04 (95 %CI: 1.02, 1.05), 1.02 (95 %CI: 1.00, 1.03), 1.04 (1.01, 1.06) for BC, OM, SO, and DUST, respectively. The associations of BC, OM, and SO remained significant in the other two models. We observed larger estimates in subgroups with older maternal age, living in urban areas, using unclean cooking energy, and with access to piped water. The associations varied among countries, and by different constituents.

Conclusions: The carbonaceous fractions and sulfate play a major important role among PM constituents on infant mortality. Our findings have certain policy implications for implementing effective measures for targeted reduction in specific sources (fossil fuel combustion and biomass burning) of PM constituents against the risk of infant mortality.
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http://dx.doi.org/10.1016/j.envint.2021.106739DOI Listing
November 2021

Ambient fine particulate matter air pollution and the risk of preterm birth: A multicenter birth cohort study in China.

Environ Pollut 2021 Oct 22;287:117629. Epub 2021 Jun 22.

Heart Center, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China. Electronic address:

Preterm birth (PTB), defined as live birth before the 37th week of gestation, is believed to have profound impacts on the infant's health in later life. Air pollution has been suggested to be a potential risk factor of PTB, but the evidence was inconsistent. In this multicenter birth cohort study, we aimed to examine the association between fine particulate matter (PM) exposure during pregnancy and PTB in China. A total of 5976 live births were identified between Jan. 2009 and Feb. 2011 from 8 provinces in China. Residential exposures to PM were assigned based on satellite remote sensing estimates. Cox proportional hazards regressions were employed to explore the correlation for each trimester as well as the entire pregnancy. A total of 443 (7.4%) preterm births were observed. The average PM during pregnancy was 57.2 ± 8.8 μg/m. We found exposure to PM during the whole pregnancy (hazard ratio, HR = 1.262; 95% CI: 1.087-1.465) and in the first trimester (HR = 1.114; 95% CI: 1.007-1.232) was associated with higher risk of PTB. The associations of PM were stronger for subjects with older maternal or paternal age, lower maternal pre-pregnancy BMI, and lower family income. This study adds supports to the cumulating evidence linking PM exposure and elevated PTB risk. Measures of air pollution reduction are needed during pregnancy, especially at early stage of pregnancy to prevent adverse birth outcomes.
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http://dx.doi.org/10.1016/j.envpol.2021.117629DOI Listing
October 2021

Association of fine particulate matter air pollution and its constituents with lung function: The China Pulmonary Health study.

Environ Int 2021 11 26;156:106707. Epub 2021 Jun 26.

Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, China; National Center of Gerontology, Beijing, China.

The associations of long-term exposure to various constituents of fine particulate matter (≤2.5 μm in aerodynamic diameter, PM) air pollution with lung function were not clearly elucidated in developing countries. The aim was to evaluate the associations of long-term exposure to main constituents of PM with lung function in China. This is a nationwide, cross-sectional analysis among 50,991 study participants from the China Pulmonary Health study. Multivariable linear regression models were used to obtain differences of forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), FEV/FVC, peak expiratory flow (PEF), and forced expiratory flow at 25-75% of exhaled FVC (FEF) associated with an interquartile range (IQR) change of PM or its constituents. Residential annual PM levels varied from 26 μg/m to 92 μg/m (average: 53 μg/m). An IQR increase of PM concentrations was associated with lower FEV (19.82 mL, 95% CI: 11.30-28.33), FVC (17.45 mL, 95% CI: 7.16-27.74), PEF (86.64 mL/s, 95% CI: 59.77-113.52), and FEF (31.93 mL/s, 95% CI: 16.64-47.22). Black carbon, organic matter, ammonium, sulfate, and nitrate were negatively associated with most lung function indicators, with organic matter and nitrate showing consistently larger magnitude of associations than PM mass. This large-scale study provides first-hand epidemiological evidence that long-term exposure to ambient PM and some constituents, especially organic matter and nitrate, were associated with lower large- and small- airway function.
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http://dx.doi.org/10.1016/j.envint.2021.106707DOI Listing
November 2021

Indoor exposure levels of ammonia in residences, schools, and offices in China from 1980 to 2019: A systematic review.

Indoor Air 2021 Jun 28. Epub 2021 Jun 28.

School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China.

Indoor ammonia (NH ) pollution has been paid more and more attention in view of its health risk. However, few studies have investigated the exposure level in the non-occupational environment in China. This study systematically reviewed the indoor ammonia exposure level in different regions, the equivalent exposure concentration of different populations, and the factors that influence indoor air ammonia in residences, offices, and schools in China. The literature published in 1980-2019 from main databases was searched and detailed screened, and finally, 56 related studies were selected. The results illustrated that the median concentration of indoor air ammonia in residences, offices, and school buildings was 0.21 mg/m , 0.26 mg/m , and 0.15 mg/m . There were 46.4%, 71.4%, and 40% of these samples exceeding the NH  standard, respectively. The national concentrations and the equivalent exposure levels of adults and children were calculated and found to be higher than 0.20 mg/m . The concentration of ammonia varied greatly in different climate zones and economic development regions. Higher concentrations were found in the severe cold zone and the regions with higher economic level. This review reveals a high exposure risk of indoor air ammonia and the crucial impact of human emission, indoor air temperature, new concrete, and economic level, suggesting further investigation on indoor air ammonia evaluation and health effects.
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http://dx.doi.org/10.1111/ina.12864DOI Listing
June 2021

The prospective effects of long-term exposure to ambient PM and constituents on mortality in rural East China.

Chemosphere 2021 Oct 4;280:130740. Epub 2021 May 4.

School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China. Electronic address:

Few cohort studies explored the associations of long-term exposure to ambient fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM) and its chemical constituents with mortality risk in rural China. We conducted a 12-year prospective study of 28,793 adults in rural Deqing, China from 2006 to 2018. Annual mean PM and its constituents, including black carbon (BC), organic carbon (OC), ammonium (NH), nitrate (NO), sulfate (SO), and soil dust were measured at participants' addresses at enrollment from a satellite-based exposure predicting model. Cox proportional hazard model was used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs) of long-term exposure to PM for mortality. A total of 1960 deaths were identified during the follow-up. We found PM, BC, OC, NH, NO, and SO were significantly associated with an increased risk of non-accidental mortality. The HR for non-accidental mortality was 1.17 (95%CI: 1.07, 1.28) for each 10 μg/m increase in PM. As for constituents, the strongest association was found for BC (HR = 1.21, 95%CI: 1.11, 1.33), followed by NO, NH, SO, and OC (HR = 1.14-1.17 per interquartile range). A non-linear relationship was found between PM and non-accidental mortality. Similar associations were found for cardio-cerebrovascular and cancer mortality. Associations were stronger among men and ever smokers. Conclusively, we found long-term exposure to ambient PM and its chemical constituents (especially BC and NO) increased mortality risk. Our results suggested the importance of adopting effective targeted emission control to improve air quality for health protection in rural East China.
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http://dx.doi.org/10.1016/j.chemosphere.2021.130740DOI Listing
October 2021

Personal exposure to fine particulate matter and blood pressure: Variations by particulate sources.

Chemosphere 2021 Oct 27;280:130602. Epub 2021 Apr 27.

School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Key Laboratory of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Research, Institute of Reproduction and Development, Fudan University, Shanghai, China. Electronic address:

Fine particulate matter (PM) is a complex mixture of components which has been associated with various cardiovascular effects, such as elevated blood pressure (BP). However, evidences on specific sources behind these effects remain uncertain. Based on 140 72-h personal measurements among a panel of 36 health college students in Shanghai, China, we assessed associations between source-apportioned PM exposure and BP changes. Based on personal filter samples, PM source apportionment was conducted using Positive Matrix Factorization (PMF) model. Linear mixed-effects models were applied to evaluate associations of source-specific PM exposure with BP changes. Seven sources were identified in PMF analysis. Among them, secondary sulfate (41%) and nitrate (24%) sources contributed most to personal PM, followed by industrial emissions (15%), traffic-related source (10%), coal combustion (6.2%), dust (2.4%) and aged sea salt (1.1%). We found nitrate, traffic-related source and coal combustion were significantly associated with increased BP. For example, an interquartile range increase in PM from traffic-related source was significantly associated with increase in systolic BP [1.5 (95% CI: 0.26, 2.7) mmHg], diastolic BP [1.2 (95% CI: 0.10, 2.2) mmHg] and mean arterial pressure [1.2 (95% CI: 0.15, 2.2) mmHg]. This is the first investigation linking personal PM source profile and BP changes. This study provides evidence that several anthropogenic emissions (especially traffic-related emission) may be particularly responsible for BP increases, and highlights that the importance of development of health-oriented PM source control strategies.
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http://dx.doi.org/10.1016/j.chemosphere.2021.130602DOI Listing
October 2021

Evaluating carbon content in airway macrophages as a biomarker of personal exposure to fine particulate matter and its acute respiratory effects.

Chemosphere 2021 Nov 14;283:131179. Epub 2021 Jun 14.

School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China. Electronic address:

It remains unclear whether carbon content in airway macrophages (AM) can predict personal short-term exposure to fine particulate matter (PM) air pollution and its respiratory health effects. We aimed to evaluate the pathway from personal PM exposure to adverse respiratory outcomes through AM carbon content. We designed a longitudinal panel study with 3 scheduled follow-ups among 113 non-smoking patients of chronic obstructive pulmonary disease in Shanghai, China, from April 2017 to January 2019. We quantified AM carbon content from induced sputum by image analysis, tested lung function and measured sputum levels of 4 pro-inflammatory cytokines and 2 anti-inflammatory cytokines. We applied the "meet in the middle" approach incorporating linear mixed-effect models to evaluate the associations from external PM exposure to respiratory outcomes through AM carbon content. Our results indicated that personal exposure to PM within 24 h was significantly associated with decreased forced expiratory volume in 1s and anti-inflammatory cytokines, as well as increased macrophages and pro-inflammatory cytokines. These changes were accompanied by increased areas of AM carbon and higher percentage of AM area occupied by carbon, both of which were associated with increased levels of pro-inflammatory cytokines and decreased levels of anti-inflammatory cytokines. Exposure to ambient black carbon and organic carbon in PM within 2 days was significantly associated with increased AM carbon area and percentage of AM area occupied by carbon. Our findings reinforced the causality in respiratory health effects of PM in which increased AM carbon content might serve as a valid exposure biomarker.
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http://dx.doi.org/10.1016/j.chemosphere.2021.131179DOI Listing
November 2021

Associations of residential greenness with peripheral and central obesity in China.

Sci Total Environ 2021 Oct 28;791:148084. Epub 2021 May 28.

China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.

Background: Obesity is a well-known risk factor for public health. Recent studies found that greenness exposure may protect against obesity. However, the accumulated evidence on associations of greenness-obesity is inconsistent and most of them are from developed countries.

Objectives: This study aimed to evaluate the associations of greenness exposure with indicators of peripheral and central obesity.

Methods: This cross-sectional study was based on a Chinese national Sub-Clinical Outcomes of Polluted Air (SCOPA) prospective cohort across 15 provinces, and 5849 participants with average age of 64.7 were included. Surrounding greenness was estimated with the Enhanced Vegetation Index (EVI), which was calculated at each participant's residential addresses within a 250 m buffer. Weight, height and waist circumference (WC) were measured, and body mass index (BMI) and the waist-to-height ratio% (WHtR%) were calculated based on those measurements. The relationships between EVI and obese outcomes were explored using multiple linear regression and logistic regression models.

Results: Non-linear associations were observed between EVI and obese indicators. Participants living in Quartile 3 benefited more than in Quartile 4 compared to the lowest quartile (Quartile 1) of greenness. For peripheral obesity, participants living in Quartile 3 of EVI had 0.86 kg/m (β -0.86, 95% CI: -1.10, -0.61) lower BMI, and 46% (OR 0.54, 95% CI: 0.44-0.66) lower odds of peripheral obesity than in Quartile 1. For central obesity, participants living in Quartile 3 of EVI had 1.85 cm (β -1.85, 95% CI: -2.54, -1.15) lower waist circumference, 1.12% (β -1.12, 95% CI: -1.56, -0.67) lower waist-to-height ratio% (WHtR%), and 33% (OR 0.67, 95% CI: 0.57-0.78) lower odds of central obesity than in Quartile 1 of EVI.

Conclusions: Higher levels of greenness were statistically significant associated with lower obesity risk.
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http://dx.doi.org/10.1016/j.scitotenv.2021.148084DOI Listing
October 2021

Population ageing and deaths attributable to ambient PM pollution: a global analysis of economic cost.

Lancet Planet Health 2021 06;5(6):e356-e367

Ministry of Education Key Laboratory for Earth System modeling, Department of Earth System Science, Tsinghua University, Beijing, China. Electronic address:

Background: The health impacts of ambient air pollution impose large costs on society. Although all people are exposed to air pollution, the older population (ie, those aged ≥60 years) tends to be disproportionally affected. As a result, there is growing concern about the health impacts of air pollution as many countries undergo rapid population ageing. We investigated the spatial and temporal variation in the economic cost of deaths attributable to ambient air pollution and its interaction with population ageing from 2000 to 2016 at global and regional levels.

Methods: In this global analysis, we developed an age-adjusted measure of the value of a statistical life-year (VSLY) to estimate the economic cost of deaths attributable to ambient PM pollution using Global Burden of Diseases, Injuries, and Risk Factors Study 2017 data and country-level socioeconomic information. First, we estimated the global age-specific and cause-specific mortality and years of life lost (YLLs) attributable to PM pollution using the global exposure mortality model and global estimates of exposure at 0·1° × 0·1° (about 11 km × 11 km at the equator) resolution. Second, for each year between 2000 and 2016, we translated the YLLs within each age group into a health-related cost using a country-specific, age-adjusted measure of VSLY. Third, we decomposed the major driving factors that contributed to the temporal change in health costs related to PM. Finally, we did a sensitivity test to analyse the variability of the estimated health costs to four alternative valuation measures. We identified the uncertainty intervals (UIs) from 1000 draws of the parameters and concentration-response functions by age, cause, country, and year. All economic values are reported in 2011 purchasing power parity-adjusted US dollars. All simulations were done with R, version 3.6.0.

Findings: Globally, in 2016, PM was estimated to have caused 8·42 million (95% UI 6·50-10·52) attributable deaths, which was associated with 163·68 million (116·03-219·44) YLLs. In 2016, the global economic cost of deaths attributable to ambient PM pollution for the older population was US$2·40 trillion (1·89-2·93) accounting for 59% (59-60) of the cost for the total population ($4·09 trillion [3·19-5·05]). The economic cost per capita for the older population was $2739 (2160-3345) in 2016, which was 10 times that of the younger population (ie, those aged <60 years). By assessing the factors that contributed to economic costs, we found that increases in these factors changed the total economic cost by 77% for gross domestic product (GDP) per capita, 21% for population ageing, 16% for population growth, -41% for age-specific mortality, and -0·4% for PM exposure.

Interpretation: The economic cost of ambient PM borne by the older population almost doubled between 2000 and 2016, driven primarily by GDP growth, population ageing, and population growth. Compared with younger people, air pollution leads to disproportionately higher health costs among older people, even after accounting for their relatively shorter life expectancy and increased disability. As the world's population is ageing, the disproportionate health cost attributable to ambient PM pollution potentially widens the health inequities for older people. Countries with severe air pollution and rapid ageing rates need to take immediate actions to improve air quality. In addition, strategies aimed at enhancing health-care services, especially targeting the older population, could be beneficial for reducing the health costs of ambient air pollution.

Funding: National Natural Science Foundation of China, China Postdoctoral Science Foundation, and Qiushi Foundation.
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http://dx.doi.org/10.1016/S2542-5196(21)00131-5DOI Listing
June 2021

Effects of using different exposure data to estimate changes in premature mortality attributable to PM and O in China.

Environ Pollut 2021 Sep 28;285:117242. Epub 2021 Apr 28.

Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, Nanjing University of Information Science & Technology, Nanjing, 210044, China. Electronic address:

The assessment of premature mortality associated with the dramatic changes in fine particulate matter (PM) and ozone (O) has important scientific significance and provides valuable information for future emission control strategies. Exposure data are particularly vital but may cause great uncertainty in health burden assessments. This study, for the first time, used six methods to generate the concentration data of PM and O in China between 2014 and 2018, and then quantified the changes in premature mortality due to PM and O using the Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) model. The results show that PM-related premature mortality in China decreases by 263 (95% confidence interval (CI95): 142-159) to 308 (CI95: 213-241) thousands from 2014 to 2018 by using different concentration data, while O-related premature mortality increases by 67 (CI95: 26-104) to 103 (CI95: 40-163) thousands. The estimated mean changes are up to 40% different for the PM-related mortality, and up to 30% for the O-related mortality if different exposure data are chosen. The most significant difference due to the exposure data is found in the areas with a population density of around 10 people/km, mostly located in Central China, for both PM and O. Our results demonstrate that the exposure data source significantly affects mortality estimations and should thus be carefully considered in health burden assessments.
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http://dx.doi.org/10.1016/j.envpol.2021.117242DOI Listing
September 2021

Associations of fine particulate matter and its constituents with airway inflammation, lung function, and buccal mucosa microbiota in children.

Sci Total Environ 2021 Jun 4;773:145619. Epub 2021 Feb 4.

School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China; Shanghai Typhoon Institute/CMA, Shanghai, Key Laboratory of Meteorology and Health, Shanghai, 200030, China. Electronic address:

Background: Previous studies have suggested acute effects of ambient fine particulate matter (PM) air pollution on respiratory health among children, but evidence for PM constituents and respiratory health were still limited.

Objectives: To investigate associations of short-term exposure to PM and its constituents with airway inflammation, lung function, and airway microbiota in children.

Methods: We conducted a longitudinal panel study with 3 repeated health measurements among 62 children in Shanghai, China from November 2018 to June 2019. Respiratory health was measured by fractional exhaled nitric oxide (FeNO), saliva tumor necrosis factor-α (TNF-α), lung function (forced vital capacity and forced exhaled volume in 1 s), and microbiota diversity in buccal mucosa samples. Based on the linear mixed-effect models, we applied the single-constituent models and the constituent-PM adjustment models to examine the associations between PM constituents and health outcomes.

Result: Short-term exposure to PM was associated with higher TNF-α, FeNO levels and reduced lung function. Among all constituents, organic carbon, elemental carbon, NO and NH had the consistent and strongest associations with airway inflammation biomarkers and lung function parameters, followed by metallic elements. We also found short-term PM exposure was associated with decreased diversity in buccal mucosa bacterial community and two bacterial phyla, Fusobacteria and Proteobacteria, were identified as differential microbes with PM exposure.

Conclusion: Short-term exposure to PM may impair children's respiratory health represented by higher airway inflammation, lower lung function and altered buccal mucosa microbial colonization. Organic carbon, elemental carbon, NO and NH may dominate these effects.
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http://dx.doi.org/10.1016/j.scitotenv.2021.145619DOI Listing
June 2021

The Acute Effect of Diesel Exhaust Particles and Different Fractions Exposure on Blood Coagulation Function in Mice.

Int J Environ Res Public Health 2021 04 14;18(8). Epub 2021 Apr 14.

Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

The toxicity and widespread exposure opportunity of diesel exhaust particles (DEP) has aroused public health concerns. This study aimed to investigate the acute effect of DEP and different fractions exposure on blood coagulation function in mice. In this study, nine- week-old C57BL/6J male mice were divided into four exposure groups (with 15 mice in each group). The water-soluble (WS) and water-insoluble (WIS) fractions of DEP were isolated, and intratracheal instillation was used for DEP, WS and WIS exposure. The phosphate buffer saline (PBS) exposure group was set as the control group. After 24 h exposure, the mice were sacrificed for blood routine, coagulation function and bleeding time examinations to estimate the acute effect of DEP, WS and WIS exposure on the blood coagulation function. In our results, no statistically significant difference in weight of body, brain and lung was observed in different exposure groups. While several core indexes in blood coagulation like bleeding time (BT), fibrinogen (FIB), activated partial thromboplastin time (APTT) and prothrombin time (PT) altered or showed a lower tendency after DEP, WS and WIS exposure. For example, BT was lower In WIS exposure group (211.00 s) compared with PBS exposure group (238.50 s) ( < 0.01), and FIB was lower in WS exposure group (233.00 g/L) compared with PBS exposure group (249.50 g/L) ( < 0.05). Additionally, systemic inflammation-related indexes like white blood cell count (WBC), neutrophil count (NEUT), lymphocyte count (LYMPH) altered after DEP, WS and WIS exposure. In conclusion, DEP, WS and WIS fractions exposure could result in the hypercoagulable state of blood in mice. The noteworthy effects of WS and WIS fractions exposure on blood coagulation function deserve further investigation of the potential mechanism.
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http://dx.doi.org/10.3390/ijerph18084136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070753PMC
April 2021

Prenatal exposure to residential PM and its chemical constituents and weight in preschool children: A longitudinal study from Shanghai, China.

Environ Int 2021 09 24;154:106580. Epub 2021 Apr 24.

NHC Key Lab. Of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Old Hu Min Road, Shanghai 200237, China.

Background: Studies have reported that prenatal exposure to fine particulate matter (PM) might be associated with adverse birth outcomes in offspring. However, evidence with regard to the effects of prenatal exposure to PM and, especially, its main chemical constituents on offspring's weight in childhood is limited and inconsistent.

Objectives: The present study aimed to examine associations of prenatal exposure to PM total mass and its chemical constituents in each trimester with children's weight from birth to 6 years of age using data from Shanghai-Minhang Birth Cohort Study.

Methods: A total of 1,084 mother-infant pairs were included with both PM exposure data and at least one measurement of weight and height. Weight-for-Length (WLZ), BMI-for-Age (BMIz), and Weight-for-Age (WAZ) z-scores were generated according to the World Health Organization guidelines. Exposure to PM total mass and its chemical constituents [organic carbon (OC), black carbon (BC), ammonium (NH), nitrate (NO), sulfate (SO), and soil dust (SOIL)] during pregnancy was estimated from a satellite based modelling framework. We used multiple informant model to estimate the associations of trimester-specific PM total mass and its specific constituents concentrations with WLZ/BMIz and WAZ of offspring at birth and 1, 4, and 6 years of age.

Results: In multiple informant model, we observed consistent patterns of associations between exposure to PM total mass, OC, BC, NH, NO, and SO during the 2 and 3 trimesters and decreased WLZ/BMIz and WAZ at 1, 4, and 6 years of age in boys. We observed associations between prenatal exposure to PM total mass, NH, and NO during the 1 and 2 trimesters and increased WLZ/BMIz and WAZ in girls at birth. However, there were null associations at 1 and 4 years of age and inverse associations at 6 years of age.

Conclusions: Prenatal exposure to PM total mass and its main chemical constituents was associated with decreased weight in boys from 1 to 6 years of age, with increased weight at birth and decreased weight at 6 years of age in girls. Our findings suggest that prenatal exposure to PM and its chemical constituents may have a lasting effect on offspring's weight in childhood.
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http://dx.doi.org/10.1016/j.envint.2021.106580DOI Listing
September 2021

Ambient carbon monoxide and daily mortality: a global time-series study in 337 cities.

Lancet Planet Health 2021 04;5(4):e191-e199

Environmental and Occupational Medicine, National Taiwan University and NTU Hospital, Taipei, Taiwan; National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan.

Background: Epidemiological evidence on short-term association between ambient carbon monoxide (CO) and mortality is inconclusive and limited to single cities, regions, or countries. Generalisation of results from previous studies is hindered by potential publication bias and different modelling approaches. We therefore assessed the association between short-term exposure to ambient CO and daily mortality in a multicity, multicountry setting.

Methods: We collected daily data on air pollution, meteorology, and total mortality from 337 cities in 18 countries or regions, covering various periods from 1979 to 2016. All included cities had at least 2 years of both CO and mortality data. We estimated city-specific associations using confounder-adjusted generalised additive models with a quasi-Poisson distribution, and then pooled the estimates, accounting for their statistical uncertainty, using a random-effects multilevel meta-analytical model. We also assessed the overall shape of the exposure-response curve and evaluated the possibility of a threshold below which health is not affected.

Findings: Overall, a 1 mg/m increase in the average CO concentration of the previous day was associated with a 0·91% (95% CI 0·32-1·50) increase in daily total mortality. The pooled exposure-response curve showed a continuously elevated mortality risk with increasing CO concentrations, suggesting no threshold. The exposure-response curve was steeper at daily CO levels lower than 1 mg/m, indicating greater risk of mortality per increment in CO exposure, and persisted at daily concentrations as low as 0·6 mg/m or less. The association remained similar after adjustment for ozone but was attenuated after adjustment for particulate matter or sulphur dioxide, or even reduced to null after adjustment for nitrogen dioxide.

Interpretation: This international study is by far the largest epidemiological investigation on short-term CO-related mortality. We found significant associations between ambient CO and daily mortality, even at levels well below current air quality guidelines. Further studies are warranted to disentangle its independent effect from other traffic-related pollutants.

Funding: EU Horizon 2020, UK Medical Research Council, and Natural Environment Research Council.
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http://dx.doi.org/10.1016/S2542-5196(21)00026-7DOI Listing
April 2021

Paternal Exposure to PM Programs Offspring's Energy Homeostasis.

Environ Sci Technol 2021 05 7;55(9):6097-6106. Epub 2021 Apr 7.

Department of Medicine Cardiology Division, University of Maryland School of Medicine, Baltimore, Maryland 21201, United States.

Considerable studies show that maternal exposure to ambient fine particulate matter (PM) programs offspring's susceptibility to obesity. However, few studies have investigated the effect of paternal PM exposure on offspring's energy homeostasis. This study thus tested whether paternal PM exposure programs offspring's energy homeostasis. Male C57Bl/6J mice were exposed to filtered air or concentrated ambient PM (CAP) for 12 weeks and then mated with normal female C57Bl/6J mice. The offspring were assessed for growth trajectories, food intakes, and body compositions, and the sperm miRNAs of those sires were profiled by microarray. Zygotic injection was used to test whether the miRNA identified by the microarray mediates the impact of paternal PM exposure on offspring's energy homeostasis. Paternal CAP exposure resulted in significant hypophagia and weight loss in male, but not female, offspring. The weight loss of male offspring was accompanied by decreases in the liver and kidney masses and paradoxically an increase in the adipose mass. Without further exposure to CAP, this programming was three-generationally transmitted along the paternal line. The sperm miRNA profiling revealed that mmu-mir6909-5p was the sole differentially expressed sperm miRNA due to PM exposure, and zygotic injection of mmu-mir6909-5p mimicked all the effects of paternal PM exposure on offspring's energy homeostasis. Paternal PM exposure programs offspring's energy homeostasis through increasing paternal sperm mmu-mir6909-5p.
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http://dx.doi.org/10.1021/acs.est.0c08161DOI Listing
May 2021

Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities.

BMJ 2021 03 24;372:n534. Epub 2021 Mar 24.

Department of Environmental Health, Portuguese National Institute of Health, Porto, Portugal.

Objective: To evaluate the short term associations between nitrogen dioxide (NO) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol.

Design: Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis.

Setting: 398 cities in 22 low to high income countries/regions.

Main Outcome Measures: Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018.

Results: On average, a 10 μg/m increase in NO concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter ≤10 μm or ≤2.5 μm (PM and PM, respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities.

Conclusions: This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO.
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http://dx.doi.org/10.1136/bmj.n534DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7988454PMC
March 2021

Ultrafine particulate air pollution and pediatric emergency-department visits for main respiratory diseases in Shanghai, China.

Sci Total Environ 2021 Jun 11;775:145777. Epub 2021 Feb 11.

Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai 201102, China. Electronic address:

Background: Few studies have explored the short-term effects of ultrafine particles (UFPs, particles < 0.1 μm) air pollution on the exacerbations of pediatric respiratory diseases.

Objectives: We aimed to evaluate short-term association between UFP and emergency-department visits (EDVs) for main pediatric respiratory diseases.

Methods: We collected daily data on UFP and pediatric EDVs for main respiratory diseases [asthma, pneumonia, bronchitis and upper respiratory tract infections (URTI)] from 66 hospitals in Shanghai, China from 2016 to 2018. Generalized additive models combined with polynomial distributed lag models were applied to explore the associations between UFP level and pediatric EDVs for respiratory diseases. We fitted two-pollutant models with criteria air pollutants and performed stratified analyses by gender and age.

Results: UFP was associated with increased EDVs for all respiratory diseases in cumulative lags up to 2 d and 3 d. The greatest risk was found at cumulative lags (0-2 d) for all respiratory diseases. At cumulative lags (0-2 d), an interquartile range increase in concentrations of UFP (1800 particles/cm) was associated with relative risks of EDVs due to asthma [1.35, 95% confidence interval (CI): 1.14-1.59], pneumonia (1.20, 95% CI: 1.04-1.38), bronchitis (1.17, 95% CI: 1.03-1.33) and URTI (1.14, 95% CI: 1.02-1.28). These associations were almost unchanged when controlling for criteria air pollutants, and there was no threshold below which the associations were not present. There were stronger associations in children aged 0-13 years.

Conclusions: Short-term exposure to UFP may independently increase the risks of EDVs for asthma, pneumonia, bronchitis and URTI exacerbations among children.
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http://dx.doi.org/10.1016/j.scitotenv.2021.145777DOI Listing
June 2021

Projection of ship emissions and their impact on air quality in 2030 in Yangtze River delta, China.

Environ Pollut 2020 Aug 24;263(Pt A):114643. Epub 2020 Apr 24.

Health Effects Institute, 75 Federal Street, Suite 1400, Boston, MA, 02110-1817, USA.

China has been in the implementation phase of Domestic Ship Emission Control Areas (DECAs) regulation to reduce emissions of air pollutants from ships near populated areas since 2016. The Yangtze River Delta (YRD) is one of the busiest port clusters in the world, accounting for 11% of global seaborne cargo throughput, so future improvements in shipping emission controls may still be important in this region. To assess the impact of future ship emissions on air quality of coastal areas, this study evaluates emissions reductions and air quality in 2030 for three scenarios (business as usual, stricter regulations, and aspirational policies) representing increasing levels of control compared with a base year of 2015. We projected ship emissions in the region using a bottom-up approach developed in this study and based on the historical ship automatic identification system (AIS) activity data. We then predicted air quality across the YRD region in 2030 using the Community Multiscale Air Quality (CMAQ) model. The annual average contributions of ship emissions to ambient PM would decrease by 70.9%, 80.4%, and 86.2% relative to 2015 under the three scenarios, with the largest reductions of more than 4.1 μg/m near Shanghai Port under the aspirational scenario. Reductions in ship emissions generally led to lower levels of PM, particularly in most of the coastal cities in the YRD. Compared with a business-as-usual approach the aspirational scenario reduced SO, NO and PM concentrations from shipping by 71.8%, 61.1% and 52.5%, respectively. It was also more effective than the stricter regulation scenario, suggesting that the requirement to use 0.1% sulfur fuel within a 100Nm DECA would have additional benefits to ambient PM concentrations beyond 12Nm DECA area. This study provides evidence to inform deliberations on the potential air quality benefits of future control policies for ship emissions in China.
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http://dx.doi.org/10.1016/j.envpol.2020.114643DOI Listing
August 2020

Parental PM exposure changes Th17/Treg cells in offspring, is associated with the elevation of blood pressure.

Environ Toxicol 2021 Jun 19;36(6):1152-1161. Epub 2021 Feb 19.

Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.

Epidemiological evidences have indicated that fine particulate matter (PM ) exposure is associated with the occurrence and development of hypertension. The present study aims to explore the effects of parental PM exposure on blood pressure in offspring and elucidate the potential mechanism. The parental male and female C57BL/6 mice were exposed to concentrated PM or filtered air (FA) using Shanghai Meteorological and Environmental Animal Exposure System (Shanghai-METAS) for 16 weeks. At week 12, the mice were assigned to breed offspring. The male offspring mice were further exposed to PM or FA as above method. During the parental exposure, the average PM concentration was 133.7 ± 53.32 μg/m in PM chamber, whereas the average concentration in FA chamber was 9.4 ± 0.23 μg/m . Similarly, during the offspring exposure, the average concentration in PM and FA chamber were 100.76 ± 26.97 μg/m and 9.15 ± 0.15 μg/m , respectively. The PM -exposed offspring mice displayed the elevation of blood pressure, the increase of angiotensin II (Ang II), the decrease of angiotensin converting enzyme 2 (ACE2) and Ang (1-7) in serum when compared with the FA-exposed offspring mice. The similar results displayed in the proteins expression of ACE2, AT1R, and Ang (1-7) in vessel and kidney. More importantly, parental PM exposure further induced the increase in serous Ang II and the protein expression of AT1R in vessel, but decrease in ACE2 and Ang (1-7). The serous Ang II was positively associated with splenic T helper type 17 (Th17) cell population and serous IL (interleukin)-17A, but negatively associated with T regular (Treg) cell population and serous IL-10. The results suggested that parental air pollution exposure might induce the elevation of offspring blood pressure via mediate Th17- and Treg-related immune microenvironment.
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http://dx.doi.org/10.1002/tox.23114DOI Listing
June 2021

Acute effects of personal exposure to fine particulate matter on salivary and urinary biomarkers of inflammation and oxidative stress in healthy adults.

Chemosphere 2021 Jun 8;272:129906. Epub 2021 Feb 8.

School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, 201102, China. Electronic address:

Non-invasive bio-samples, such as saliva and urine, are promising tools for assessment of inflammation and oxidative stress biomarkers. Few studies have investigated potential responses of those biomarkers towards short-term PM exposure. We conducted a longitudinal study with 4 repeated examinations among 40 healthy, nonsmoking adults in Shanghai, China. Personal samplings were performed for PM exposure assessment. Then, five biomarkers, including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), alpha-1 antitrypsin (A1AT) in saliva and 8-Iso-Prostaglanding F (8-iso-PGF), total antioxidant capacity (TAC) in urine, were measured. We fitted linear mixed-effect models to evaluate short-term effect of personal PM exposure on salivary and urinary biomarkers, adjusting for potential confounders of meteorology, sociodemographic characteristics and biomarker detection. We also explored sensitive time windows of exposure for different biomarkers. We found robust associations of salivary CRP, TNF-α, and urinary 8-iso-PGF with PM exposure, and responses of salivary inflammatory markers occurred more acutely than urinary oxidative stress markers. For instance, a 10 μg/m increase in PM was associated with an elevation of 5.49% (95% CI: 1.17%, 9.99%) in CRP and 7.05% (95% CI: 1.29%, 13.13%) in TNF-α both at lag 12 h, and 6.97% (95% CI: 1.33%, 12.92%) in 8-iso-PGF at lag 01 d. Based on non-invasive samples, this study provided evidence on effect of PM exposure on responses of systematic inflammation and oxidative stress. Sub-daily (6-12 h) and daily (≥24 h) period after PM exposure might be sensitive time window to detect the responses of salivary (i.e. CRP, TNF) and urinary biomarkers (i.e. 8-iso-PGF), respectively.
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http://dx.doi.org/10.1016/j.chemosphere.2021.129906DOI Listing
June 2021
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