Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents
To investigate associations between exposure to air pollution and child and adolescent mental health.
Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5.
The entire population under 18 years of age in 4 major counties. We excluded cohort members whose parents had dispensed a medication in the same medication group since the start date of the register. The cohort size was 552 221.
Main outcome measures
Cox proportional hazards models to estimate HRs and their 95% CIs for the outcomes, adjusted for individual-level and group-level characteristics.
The average length of follow-up was 3.5 years, with an average number of events per 1000 cohort members of ∼21. The mean annual level of NO2 was 9.8 µg/m3. Children and adolescents living in areas with higher air pollution concentrations were more likely to have a dispensed medication for a psychiatric disorder during follow-up (HR=1.09, 95% CI 1.06 to 1.12, associated with a 10 µg/m3 increase in NO2). The association with NO2 was clearly present in 3 out of 4 counties in the study area; however, no statistically significant heterogeneity was detected.
There may be a link between exposure to air pollution and dispensed medications for certain psychiatric disorders in children and adolescents even at the relatively low levels of air pollution in the study regions. The findings should be corroborated by others.
The Guardian press releases : here, here, here, here, here, here.
Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover study
2019 Study Abstract
To investigate the relationship between acute exposure to air pollutants and spontaneous pregnancy loss.
Case-crossover study from 2007 to 2015.
An academic emergency department in the Wasatch Front area of Utah.
A total of 1,398 women who experienced spontaneous pregnancy loss events.
Main Outcome Measure(s)
Odds of spontaneous pregnancy loss.
We found that a 10-ppb increase in 7-day average levels of nitrogen dioxide was associated with a 16% increase in the odds of spontaneous pregnancy loss (odds ratio [OR] = 1.16; 95% confidence interval [CI] 1.01–1.33; P=.04). A 10-μg/m3 increase in 3-day and 7-day averages of fine particulate matter were associated with increased risk of spontaneous pregnancy loss, but the associations did not reach statistical significance (OR3-day average = 1.09; 95% CI 0.99–1.20; P=.05) (OR7-day average = 1.11; 95% CI 0.99–1.24; P=.06). We found no evidence of increased risk for any other metrics of nitrogen dioxide or fine particulate matter or any metric for ozone.
We found that short-term exposure to elevated levels of air pollutants was associated with higher risk for spontaneous pregnancy loss.
Exploration of NO2 and PM2.5 air pollution and mental health problems using high-resolution data in London-based children from a UK longitudinal cohort study
In the first analysis of how common air pollutants affect teenage mental health, researchers found young people were three to four times more likely to have depression at 18 if they had been exposed to dirtier air at age 12. Comparison with earlier work indicates that air pollution is a greater risk factor than physical abuse in raising the risk of teenage depression.
- High-resolution pollution estimates were successfully combined with cohort data.
- Age-12 pollution exposure was not associated with age-12 mental health problems.
- But age-12 pollution exposure was significantly associated with age-18 depression.
- Associations with depression held even after controlling for common risk factors.
- Elevated odds of age-18 conduct disorder among children exposed to air pollution.
Abstract, Feb 2019
Air pollution is a worldwide environmental health issue. Increasingly, reports suggest that poor air quality may be associated with mental health problems, but these studies often use global measures and rarely focus on early development when psychopathology commonly emerges. To address this, we combined high-resolution air pollution exposure estimates and prospectively-collected phenotypic data to explore concurrent and longitudinal associations between air pollutants of major concern in urban areas and mental health problems in childhood and adolescence. Exploratory analyses were conducted on 284 London-based children from the Environmental Risk (E-Risk) Longitudinal Twin Study. Exposure to annualized PM2.5 and NO2 concentrations was estimated at address-level when children were aged 12. Symptoms of anxiety, depression, conduct disorder, and attention-deficit hyperactivity disorder were assessed at ages 12 and 18. Psychiatric diagnoses were ascertained from interviews with the participants at age 18. We found no associations between age-12 pollution exposure and concurrent mental health problems. However, age-12 pollution estimates were significantly associated with increased odds of major depressive disorder at age 18, even after controlling for common risk factors. This study demonstrates the potential utility of incorporating high-resolution pollution estimates into large epidemiological cohorts to robustly investigate associations between air pollution and youth mental health.
The Guardian press releases : here, here, here, here, here, here.
Unconventional oil and gas development is rapidly encroaching on heavily populated neighborhoods, posing potential risks to human health
Dr. Lisa McKenzie presents results from a human health risk assessment that characterized prenatal through adult health risks from exposure to non-methane hydrocarbons in Colorado populations living near oil and gas development. The study found that both air pollutant concentrations and health risks increased with proximity to oil and gas facilities.
Lisa McKenzie, PhD MPH,is an Assistant Research Professor at the Colorado School of Public Health on the University of Colorado Denver’s Anschutz Medical Campus. Her expertise is in exposure assessment and environmental epidemiology, and human health risk assessment. Dr. McKenzie’s research has contributed to the understanding of how air pollutants and other exposures resulting from the unconventional development of petroleum resources may affect the public’s health.
Reference. Image blogs.sierraclub.
Are noise and air pollution related to the incidence of dementia ?
A cohort study in London, England, 2018
Air pollution may increase the chance of developing dementia, a study has suggested, in fresh evidence that the health of people of all ages is at risk from breathing dirty air, TheGuardian reports.
To investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.
Retrospective cohort study using primary care data.
75 Greater London practices.
130 978 adults aged 50–79 years registered with their general practices on 1 January 2005, with no recorded history of dementia or care home residence.
Primary and secondary outcome measures
A first recorded diagnosis of dementia and, where specified, subgroups of Alzheimer’s disease and vascular dementia during 2005–2013. The average annual concentrations during 2004 of nitrogen dioxide (NO2), particulate matter with a median aerodynamic diameter ≤2.5 µm (PM2.5) and ozone (O3) were estimated at 20×20 m resolution from dispersion models. Traffic intensity, distance from major road and night-time noise levels (Lnight) were estimated at the postcode level. All exposure measures were linked anonymously to clinical data via residential postcode. HRs from Cox models were adjusted for age, sex, ethnicity, smoking and body mass index, with further adjustments explored for area deprivation and comorbidity.
2181 subjects (1.7%) received an incident diagnosis of dementia (39% mentioning Alzheimer’s disease, 29% vascular dementia). There was a positive exposure response relationship between dementia and all measures of air pollution except O3, which was not readily explained by further adjustment. Adults living in areas with the highest fifth of NO2 concentration (>41.5 µg/m3) versus the lowest fifth (<31.9 µg/m3) were at a higher risk of dementia (HR=1.40, 95% CI 1.12 to 1.74). Increases in dementia risk were also observed with PM2.5, PM2.5 specifically from primary traffic sources only and Lnight, but only NO2 and PM2.5 remained statistically significant in multipollutant models. Associations were more consistent for Alzheimer’s disease than vascular dementia.
We have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors.
A review of factors surrounding the air pollution exposure to in-pram babies and mitigation strategies
New study say infants are exposed to dirtier air in prams because they are lower to the ground and closer to exhaust pipes. Covering your pram will help protect your baby from air pollution, NHS News reports, August 15 2018.
- Exposure quantification of in-pram babies and potential mitigation efforts reviewed.
- Pollutant exposure to in-pram babies can exceeds adult’s exposure by up to 60%.
- First 1 m above road level important for exposure in breathing zone (~0.85 m) sitting babies
- Breathing height of in-pram babies lies where concentrations are usually the greatest.
- Both technology and community-driven measures are needed for exposure mitigation.
Air pollution exposure to in-pram babies poses a serious threat to their early childhood development, necessitating a need for effective mitigation measures. We reviewed the scientific and grey literature on in-pram babies and their personal exposure to traffic generated air pollutants such as particulate matter ≤10 μm (PM10), ≤2.5 μm (PM2.5), ≤0.10 μm (ultrafine particles) in size, black carbon and nitrogen oxides and potential mitigation pathways. In-pram babies can be exposed up to ~60% higher average concentrations depending on the pollutant types compared with adults. The air within the first few meters above the road level is usually most polluted. Therefore, we classified various pram types based on criteria such as height, width and the seating capacity (single versus twin) and assessed the breathing heights of sitting babies in various pram types available in the market. This classification revealed the pram widths between 0.56 and 0.82 m and top handle heights up to ~1.25 m as opposed to breathing height between 0.55 and 0.85 m, suggesting that the concentration within the first meter above the road level is critical for exposure to in-pram babies. The assessment of flow features around the prams suggests that meteorological conditions (e.g., wind speed and direction) and traffic-produced turbulence affect the pollution dispersion around them. A survey of the physicochemical properties of particles from roadside environment demonstrated the dominance of toxic metals that have been shown to damage their frontal lobe as well as cognition and brain development when inhaled by in-pram babies. We then assessed a wide range of active and passive exposure mitigation strategies, including a passive control at the receptor such as the enhanced filtration around the breathing zone and protection of prams via covers. Technological solutions such as creating a clean air zone around the breathing area can provide instant solutions. However, a holistic approach involving a mix of innovative technological solutions, community empowerment and exposure-centric policies are needed to help limit personal exposure of in-pram babies.
Air pollution reduces global life expectancy by more than one year, study finds
Air pollution shortens human lives by more than a year, according to a new study from a team of leading environmental engineers and public health researchers. Better air quality could lead to a significant extension of lifespans around the world, Phys.Org reports.
2018 Study Abstract
Exposure to ambient fine particulate matter (PM2.5) air pollution is a major risk for premature death. Here, we systematically quantify the global impact of PM2.5 on life expectancy. Using data from the Global Burden of Disease project and actuarial standard life table methods, we estimate global and national decrements in life expectancy that can be attributed to ambient PM2.5 for 185 countries. In 2016, PM2.5 exposure reduced average global life expectancy at birth by ∼1 year with reductions of ∼1.2–1.9 years in polluted countries of Asia and Africa. If PM2.5 in all countries met the World Health Organization Air Quality Guideline (10 μg m–3), we estimate life expectancy could increase by a population-weighted median of 0.6 year (interquartile range of 0.2–1.0 year), a benefit of a magnitude similar to that of eradicating lung and breast cancer. Because background disease rates modulate the effect of air pollution on life expectancy, high age-specific rates of cardiovascular disease in many polluted low- and middle-income countries amplify the impact of PM2.5 on survival. Our analysis adds to prior research by illustrating how mortality from air pollution substantially reduces human longevity.
The Lancet Countdown on health benefits from the UK Climate Change Act: a modelling study for Great Britain
New analysis published in The Lancet Planetary Health, May 2018, shows that meeting the UK’s Climate Change Act commitments could cut nitrogen dioxide (NO2) air pollution by 50-60%, contributing to improved public health and longer life expectancy. The Act requires the UK to reduce greenhouse gas emissions by at least 80% on 1990 levels by 2050.
Climate change poses a dangerous and immediate threat to the health of populations in the UK and worldwide. We aimed to model different scenarios to assess the health co-benefits that result from mitigation actions.
In this modelling study, we combined a detailed techno-economic energy systems model (UK TIMES), air pollutant emission inventories, a sophisticated air pollution model (Community Multi-scale Air Quality), and previously published associations between concentrations and health outcomes. We used four scenarios and focused on the air pollution implications from fine particulate matter (PM2·5), nitrogen dioxide (NO2) and ozone. The four scenarios were baseline, which assumed no further climate actions beyond those already achieved and did not meet the UK’s Climate Change Act (at least an 80% reduction in carbon dioxide equivalent emissions by 2050 compared with 1990) target; nuclear power, which met the Climate Change Act target with a limited increase in nuclear power; low-greenhouse gas, which met the Climate Change Act target without any policy constraint on nuclear build; and a constant scenario that held 2011 air pollutant concentrations constant until 2050. We predicted the health and economic impacts from air pollution for the scenarios until 2050, and the inequalities in exposure across different socioeconomic groups.
NO2 concentrations declined leading to 4 892 000 life-years saved for the nuclear power scenario and 7 178 000 life-years saved for the low-greenhouse gas scenario from 2011 to 2154. However, the associations that we used might overestimate the effects of NO2 itself. PM2·5 concentrations in Great Britain are predicted to decrease between 42% and 44% by 2050 compared with 2011 in the scenarios that met the Climate Change Act targets, especially those from road traffic and off-road machinery. These reductions in PM2·5 are tempered by a 2035 peak (and subsequent decline) in biomass (wood burning), and by a large, projected increase in future demand for transport leading to potential increases in non-exhaust particulate matter emissions. The potential use of biomass in poorly controlled technologies to meet the Climate Change Act commitments would represent an important missed opportunity (resulting in 472 000 more life-years lost from PM2·5 in the low-greenhouse gas scenario and 1 122 000 more life-years lost in the nuclear power scenario from PM2·5 than the baseline scenario). Although substantial overall improvements in absolute amounts of exposure are seen compared with 2011, these outcomes mask the fact that health inequalities seen (in which socioeconomically disadvantaged populations are among the most exposed) are projected to be maintained up to 2050.
The modelling infrastructure created will help future researchers explore a wider range of climate policy scenarios, including local, European, and global scenarios. The need to strengthen the links between climate change policy objectives and public health imperatives, and the benefits to societal wellbeing that might result is urgent.
Reference. Briefing for Policymakers. Infographic.
Over 95% of world’s population breathe dangerous air, study finds
More than 95% of the world’s population breathe unsafe air and the burden is falling hardest on the poorest communities, with the gap between the most polluted and least polluted countries rising rapidly, a comprehensive study of global air pollution has found.
- State of global air 2018, stateofglobalair.
- Over 95% of world’s population breathe dangerous air, study finds, euractiv, 17 Apr 2018.
Severe Urban Outdoor Air Pollution and Children’s Structural and Functional Brain Development, From Evidence to Precautionary Strategic Action
According to the latest estimates, about 2 billion children around the world are exposed to severe urban outdoor air pollution. Transdisciplinary, multi-method findings from epidemiology, developmental neuroscience, psychology, and pediatrics, show detrimental outcomes associated with pre- and postnatal exposure are found at all ages. Affected brain-related functions include perceptual and sensory information processing, intellectual and cognitive development, memory and executive functions, emotion and self-regulation, and academic achievement. Correspondingly, with the breakdown of natural barriers against entry and translocation of toxic particles in the brain, the most common structural changes are responses promoting neuroinflammation and indicating early neurodegenerative processes. In spite of the gaps in current scientific knowledge and the challenges posed by non-scientific issues that influence policy, the evidence invites the conclusion that urban outdoor air pollution is a serious threat to healthy brain development which may set the conditions for neurodegenerative diseases. Such evidence supports the perspective that urgent strategic precautionary actions, minimizing exposure and attenuating its effects, are needed to protect children and their brain development.
… continue reading Severe Urban Outdoor Air Pollution and Children’s Structural and Functional Brain Development, From Evidence to Precautionary Strategic Action on Frontiers in Public Health, April 2018.
Featured image credit Bon Bahar.