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Fertility and Sterility Aug 2022Climate change is a major risk factor for overall health, including reproductive health, and well-being. Increasing temperatures, due mostly to increased greenhouse... (Review)
Review
Climate change is a major risk factor for overall health, including reproductive health, and well-being. Increasing temperatures, due mostly to increased greenhouse gases trapping excess heat in the atmosphere, result in erratic weather patterns, wildfires, displacement of large communities, and stagnant water resulting in vector-borne diseases that, together, have set the stage for new and devastating health threats across the globe. These conditions disproportionately affect disadvantaged and vulnerable populations, including women, pregnant persons, young children, the elderly, and the disabled. This review reports on the evidence for the adverse impacts of air pollution, wildfires, heat stress, floods, toxic chemicals, and vector-borne diseases on male and female fertility, the developing fetus, and obstetric outcomes. Reproductive health care providers are uniquely positioned and have an unprecedented opportunity to educate patients and policy makers about mitigating the impact of climate change to assure reproductive health in this and future generations.
Topics: Air Pollution; Climate Change; Female; Humans; Male; Reproductive Health; Vulnerable Populations; Weather
PubMed: 35878942
DOI: 10.1016/j.fertnstert.2022.06.005 -
International Journal of Environmental... Jul 2022Air pollution affects health, but much of the focus to this point has been on outdoor air. Higher indoor pollution is anticipated due to increasingly energy-efficient... (Review)
Review
Indoor Air Pollution and the Health of Vulnerable Groups: A Systematic Review Focused on Particulate Matter (PM), Volatile Organic Compounds (VOCs) and Their Effects on Children and People with Pre-Existing Lung Disease.
Air pollution affects health, but much of the focus to this point has been on outdoor air. Higher indoor pollution is anticipated due to increasingly energy-efficient and less leaky buildings together with more indoor activities. Studies of indoor air pollution focusing on children and people with respiratory disease from the database Web of Science (1991-2021) were systemically reviewed according to the PRISMA guidelines, with 69 studies included in the final selection. Emissions from building materials affected indoor air quality, and ventilation also had an influence. The main indoor air pollutants are Volatile Organic Compounds (VOCs) and Particulate Matter (PM). PM sources included smoking, cooking, heating, candles, and insecticides, whereas sources of coarse particles were pets, housework and human movements. VOC sources included household products, cleaning agents, glue, personal care products, building materials and vehicle emissions. Formaldehyde levels were particularly high in new houses. Personal exposure related to both indoor and outdoor pollutant levels, highlighting home characteristics and air exchange rates as important factors. Temperature, humidity, educational level, air purifiers and time near sources were also related to personal exposure. There was an association between PM and Fractional exhaled Nitric Oxide (FeNO), lung function, oxygen saturation, childhood asthma and symptoms of chronic obstructive pulmonary disease (COPD) patients. High VOCs were associated with upper airways and asthma symptoms and cancer. Effective interventional studies for PM in the future might focus on human behavior together with air purifiers and increased ventilation, whereas VOC interventions might center more on building materials and household products, alongside purification and ventilation.
Topics: Air Pollutants; Air Pollution, Indoor; Asthma; Child; Environmental Monitoring; Humans; Lung; Lung Diseases; Particulate Matter; Volatile Organic Compounds
PubMed: 35886604
DOI: 10.3390/ijerph19148752 -
Environmental Pollution (Barking, Essex... Jan 2022We provide a comprehensive and updated systematic review and meta-analysis of the association between air pollution exposure and depression, searching PubMed, Embase,... (Meta-Analysis)
Meta-Analysis Review
We provide a comprehensive and updated systematic review and meta-analysis of the association between air pollution exposure and depression, searching PubMed, Embase, and Web of Sciences for relevant articles published up to May 2021, and eventually including 39 studies. Meta-analyses were performed separately according to pollutant type [particulate matter with diameter ≤10 μm (PM) and ≤2.5 μm (PM), nitrogen dioxide (NO), sulfur dioxide (SO), ozone (O), and carbon monoxide (CO)] and exposure duration [short- (<30 days) and long-term (≥30 days)]. Test for homogeneity based on Cochran's Q and I statistics were calculated and the restricted maximum likelihood (REML) random effect model was applied. We assessed overall quality of pooled estimates, influence of single studies on the meta-analytic estimates, sources of between-study heterogeneity, and publication bias. We observed an increased risk of depression associated with long-term exposure to PM (relative risk: 1.074, 95% confidence interval: 1.021-1.129) and NO (1.037, 1.011-1.064), and with short-term exposure to PM (1.009, 1.006-1.012), PM (1.009, 1.007-1.011), NO (1.022, 1.012-1.033), SO (1.024, 1.010-1.037), O (1.011, 0.997-1.026), and CO (1.062, 1.020-1.105). The publication bias affecting half of the investigated associations and the high heterogeneity characterizing most of the meta-analytic estimates partly prevent to draw very firm conclusions. On the other hand, the coherence of all the estimates after excluding single studies in the sensitivity analysis supports the soundness of our results. This especially applies to the association between PM and depression, strengthened by the absence of heterogeneity and of relevant publication bias in both long- and short-term exposure studies. Should further investigations be designed, they should involve large sample sizes, well-defined diagnostic criteria for depression, and thorough control of potential confounding factors. Finally, studies dedicated to the comprehension of the mechanisms underlying the association between air pollution and depression remain necessary.
Topics: Air Pollutants; Air Pollution; Depression; Environmental Exposure; Humans; Nitrogen Dioxide; Ozone; Particulate Matter
PubMed: 34600062
DOI: 10.1016/j.envpol.2021.118245 -
Neurotoxicology Dec 2022Accumulating data suggest that air pollution increases the risk of internalizing psychopathology, including anxiety and depressive disorders. Moreover, the link between... (Review)
Review
Accumulating data suggest that air pollution increases the risk of internalizing psychopathology, including anxiety and depressive disorders. Moreover, the link between air pollution and poor mental health may relate to neurostructural and neurofunctional changes. We systematically reviewed the MEDLINE database in September 2021 for original articles reporting effects of air pollution on 1) internalizing symptoms and behaviors (anxiety or depression) and 2) frontolimbic brain regions (i.e., hippocampus, amygdala, prefrontal cortex). One hundred and eleven articles on mental health (76% human, 24% animals) and 92 on brain structure and function (11% human, 86% animals) were identified. For literature search 1, the most common pollutants examined were PM (64.9%), NO (37.8%), and PM (33.3%). For literature search 2, the most common pollutants examined were PM (32.6%), O (26.1%) and Diesel Exhaust Particles (DEP) (26.1%). The majority of studies (73%) reported higher internalizing symptoms and behaviors with higher air pollution exposure. Air pollution was consistently associated (95% of articles reported significant findings) with neurostructural and neurofunctional effects (e.g., increased inflammation and oxidative stress, changes to neurotransmitters and neuromodulators and their metabolites) within multiple brain regions (24% of articles), or within the hippocampus (66%), PFC (7%), and amygdala (1%). For both literature searches, the most studied exposure time frames were adulthood (48% and 59% for literature searches 1 and 2, respectively) and the prenatal period (26% and 27% for literature searches 1 and 2, respectively). Forty-three percent and 29% of studies assessed more than one exposure window in literature search 1 and 2, respectively. The extant literature suggests that air pollution is associated with increased depressive and anxiety symptoms and behaviors, and alterations in brain regions implicated in risk of psychopathology. However, there are several gaps in the literature, including: limited studies examining the neural consequences of air pollution in humans. Further, a comprehensive developmental approach is needed to examine windows of susceptibility to exposure and track the emergence of psychopathology following air pollution exposure.
Topics: Pregnancy; Female; Humans; Adult; Air Pollutants; Environmental Exposure; Air Pollution; Anxiety Disorders; Brain; Particulate Matter
PubMed: 36280190
DOI: 10.1016/j.neuro.2022.10.011 -
Environmental Pollution (Barking, Essex... Dec 2020Exposure to outdoor air pollution has been linked to lung cancer, and suspicion arose regarding bladder, kidney, and urinary tract cancer (urological cancers). However,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Exposure to outdoor air pollution has been linked to lung cancer, and suspicion arose regarding bladder, kidney, and urinary tract cancer (urological cancers). However, most of evidence comes from occupational studies; therefore, little is known about the effect of exposure to air pollution on the risk of urological cancers in the general population.
METHOD
We systematically searched Medline, Scopus, and Web of Science for articles investigating the associations between long-term exposure to air pollution and the risk of urological cancer (incidence or mortality). We included articles using a specific air pollutant (PM, PM, …) or proxies (traffic, proximity index …). We assessed each study's quality with the Newcastle-Ottawa scale and rated the quality of the body of evidence for each pollutant-outcome with the GRADE approach. The different study methodologies regarding exposure or outcome prevented us to perform a meta-analysis.
RESULTS
twenty articles (four case-control, nine cohort, and seven ecologic) met our inclusion criteria and were included in this review: eighteen reported bladder, six kidney, and two urinary tract. Modeling air pollutants was the most common exposure assessment method. Most of the included studies reported positive associations between air pollution and urological cancer risk. However, only a few reached statistical significance (e.g. for bladder cancer mortality, adjusted odds-ratio of 1.13 (1.03-1.23) for an increase of 4.4 μg.m-3 of PM). Most studies inadequately addressed confounding, and cohort studies had an insufficient follow-up.
DISCUSSION
Overall, studies suggested positive (even though mostly non-significant) associations between air pollution exposure and bladder cancer mortality and kidney cancer incidence. We need more studies with better confounding control and longer follow-ups.
Topics: Air Pollutants; Air Pollution; Environmental Exposure; Humans; Particulate Matter; Urinary Bladder; Urologic Neoplasms
PubMed: 32871482
DOI: 10.1016/j.envpol.2020.115328 -
Environmental Health Perspectives Jul 2023Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent.
OBJECTIVES
We aimed to conduct a systematic review of the literature and meta-analysis to provide a more comprehensive and multiperspective assessment of the associations between short- and long-term air pollution exposure and HF from epidemiological evidences.
METHODS
Three databases were searched up to 31 August 2022 for studies investigating the association between air pollutants (, , , , CO, ) and HF hospitalization, incidence, or mortality. A random effects model was used to derive the risk estimations. Subgroup analysis was conducted by geographical location, age of participants, outcome, study design, covered area, the methods of exposure assessment, and the length of exposure window. Sensitivity analysis and adjustment for publication bias were performed to test the robustness of the results.
RESULTS
Of 100 studies covering 20 countries worldwide, 81 were for short-term and 19 were for long-term exposure. Almost all air pollutants were adversely associated with the risk of HF in both short- and long-term exposure studies. For short-term exposures, we found the risk of HF increased by 1.8% [relative risk , 95% confidence interval (CI): 1.011, 1.025] and 1.6% (, 95% CI: 1.011, 1.020) per increment of and , respectively. HF was also significantly associated with , , and CO, but not . Positive associations were stronger when exposure was considered over the previous 2 d (lag 0-1) rather than on the day of exposure only (lag 0). For long-term exposures, there were significant associations between several air pollutants and HF with RR (95% CI) of 1.748 (1.112, 2.747) per increment in , 1.212 (1.010, 1.454) per increment in , and 1.204 (1.069, 1.356) per increment in , respectively. The adverse associations of most pollutants with HF were greater in low- and middle-income countries than in high-income countries. Sensitivity analysis demonstrated the robustness of our results.
DISCUSSION
Available evidence highlighted adverse associations between air pollution and HF regardless of short- and long-term exposure. Air pollution is still a prevalent public health issue globally and sustained policies and actions are called for to reduce the burden of HF. https://doi.org/10.1289/EHP11506.
Topics: Humans; Particulate Matter; Environmental Exposure; Air Pollution; Air Pollutants; Heart Failure
PubMed: 37399145
DOI: 10.1289/EHP11506 -
Scientific Reports Nov 2021Skin aging has been defined to encompass both intrinsic and extrinsic aging, with extrinsic aging effected by environmental influences and overlaying the effects of... (Meta-Analysis)
Meta-Analysis
Skin aging has been defined to encompass both intrinsic and extrinsic aging, with extrinsic aging effected by environmental influences and overlaying the effects of chronological aging. The risk factors of skin aging have been studied previously, using methods of quantifying skin aging. However, these studies have yet to be reviewed. To better understand skin aging risk factors and collate the available data, we aimed to conduct a systematic review and meta-analysis. We conducted our systematic review in compliance with Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines. Embase, PubMed and Web of Science databases were searched in October 2020 using specific search strategies. Where odds ratios were reported, meta-analyses were conducted using the random effects model. Otherwise, significant factors were reported in this review. We identified seven notable risk factors for various skin aging phenotypes: age, gender, ethnicity, air pollution, nutrition, smoking, sun exposure. This review's results will guide future works, such as those aiming to examine the interaction between genetic and environmental influences.
Topics: Age Factors; Air Pollutants; Air Pollution; Humans; Risk Factors; Sex Factors; Skin; Skin Aging; Smoking; Ultraviolet Rays
PubMed: 34764376
DOI: 10.1038/s41598-021-01573-z -
The Cochrane Database of Systematic... Aug 2021Pressure ulcers (also known as pressure injuries, pressure sores and bed sores) are localised injuries to the skin or underlying soft tissue, or both, caused by... (Review)
Review
BACKGROUND
Pressure ulcers (also known as pressure injuries, pressure sores and bed sores) are localised injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction. Specific kinds of beds, overlays and mattresses are widely used with the aim of preventing and treating pressure ulcers.
OBJECTIVES
To summarise evidence from Cochrane Reviews that assess the effects of beds, overlays and mattresses on reducing the incidence of pressure ulcers and on increasing pressure ulcer healing in any setting and population. To assess the relative effects of different types of beds, overlays and mattresses for reducing the incidence of pressure ulcers and increasing pressure ulcer healing in any setting and population. To cumulatively rank the different treatment options of beds, overlays and mattresses in order of their effectiveness in pressure ulcer prevention and treatment.
METHODS
In July 2020, we searched the Cochrane Library. Cochrane Reviews reporting the effectiveness of beds, mattresses or overlays for preventing or treating pressure ulcers were eligible for inclusion in this overview. Two review authors independently screened search results and undertook data extraction and risk of bias assessment using the ROBIS tool. We summarised the reported evidence in an overview of reviews. Where possible, we included the randomised controlled trials from each included review in network meta-analyses. We assessed the relative effectiveness of beds, overlays and mattresses for preventing or treating pressure ulcers and their probabilities of being, comparably, the most effective treatment. We assessed the certainty of the evidence using the GRADE approach.
MAIN RESULTS
We include six Cochrane Reviews in this overview of reviews, all at low or unclear risk of bias. Pressure ulcer prevention: four reviews (of 68 studies with 18,174 participants) report direct evidence for 27 pairwise comparisons between 12 types of support surface on the following outcomes: pressure ulcer incidence, time to pressure ulcer incidence, patient comfort response, adverse event rates, health-related quality of life, and cost-effectiveness. Here we focus on outcomes with some evidence at a minimum of low certainty. (1) Pressure ulcer incidence: our overview includes direct evidence for 27 comparisons that mostly (19/27) have very low-certainty evidence concerning reduction of pressure ulcer risk. We included 40 studies (12,517 participants; 1298 participants with new ulcers) in a network meta-analysis involving 13 types of intervention. Data informing the network are sparse and this, together with the high risk of bias in most studies informing the network, means most network contrasts (64/78) yield evidence of very low certainty. There is low-certainty evidence that, compared with foam surfaces (reference treatment), reactive air surfaces (e.g. static air overlays) (risk ratio (RR) 0.46, 95% confidence interval (CI) 0.29 to 0.75), alternating pressure (active) air surfaces (e.g. alternating pressure air mattresses, large-celled ripple mattresses) (RR 0.63, 95% CI 0.42 to 0.93), and reactive gel surfaces (e.g. gel pads used on operating tables) (RR 0.47, 95% CI 0.22 to 1.01) may reduce pressure ulcer incidence. The ranking of treatments in terms of effectiveness is also of very low certainty for all interventions. It is unclear which treatment is best for preventing ulceration. (2) Time to pressure ulcer incidence: four reviews had direct evidence on this outcome for seven comparisons. We included 10 studies (7211 participants; 699 participants with new ulcers) evaluating six interventions in a network meta-analysis. Again, data from most network contrasts (13/15) are of very low certainty. There is low-certainty evidence that, compared with foam surfaces (reference treatment), reactive air surfaces may reduce the hazard of developing new pressure ulcers (hazard ratio (HR) 0.20, 95% CI 0.04 to 1.05). The ranking of all support surfaces for preventing pressure ulcers in terms of time to healing is uncertain. (3) Cost-effectiveness: this overview includes direct evidence for three comparisons. For preventing pressure ulcers, alternating pressure air surfaces are probably more cost-effective than foam surfaces (moderate-certainty evidence). Pressure ulcer treatment: two reviews (of 12 studies with 972 participants) report direct evidence for five comparisons on: complete pressure ulcer healing, time to complete pressure ulcer healing, patient comfort response, adverse event rates, and cost-effectiveness. Here we focus on outcomes with some evidence at a minimum of low certainty. (1) Complete pressure ulcer healing: our overview includes direct evidence for five comparisons. There is uncertainty about the relative effects of beds, overlays and mattresses on ulcer healing. The corresponding network meta-analysis (with four studies, 397 participants) had only three direct contrasts and a total of six network contrasts. Again, most network contrasts (5/6) have very low-certainty evidence. There was low-certainty evidence that more people with pressure ulcers may heal completely using reactive air surfaces than using foam surfaces (RR 1.32, 95% CI 0.96 to 1.80). We are uncertain which surfaces have the highest probability of being the most effective (all very low-certainty evidence). (2) Time to complete pressure ulcer healing: this overview includes direct evidence for one comparison: people using reactive air surfaces may be more likely to have healed pressure ulcers compared with those using foam surfaces in long-term care settings (HR 2.66, 95% CI 1.34 to 5.17; low-certainty evidence). (3) Cost-effectiveness: this overview includes direct evidence for one comparison: compared with foam surfaces, reactive air surfaces may cost an extra 26 US dollars for every ulcer-free day in the first year of use in long-term care settings (low-certainty evidence).
AUTHORS' CONCLUSIONS
Compared with foam surfaces, reactive air surfaces may reduce pressure ulcer risk and may increase complete ulcer healing. Compared with foam surfaces, alternating pressure air surfaces may reduce pressure ulcer risk and are probably more cost-effective in preventing pressure ulcers. Compared with foam surfaces, reactive gel surfaces may reduce pressure ulcer risk, particularly for people in operating rooms and long-term care settings. There are uncertainties for the relative effectiveness of other support surfaces for preventing and treating pressure ulcers, and their efficacy ranking. More high-quality research is required; for example, for the comparison of reactive air surfaces with alternating pressure air surfaces. Future studies should consider time-to-event outcomes and be designed to minimise any risk of bias.
Topics: Bedding and Linens; Beds; Humans; Incidence; Network Meta-Analysis; Pressure Ulcer; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 34398473
DOI: 10.1002/14651858.CD013761.pub2 -
JAMA Network Open Jun 2020Knowledge of whether serious adverse pregnancy outcomes are associated with increasingly widespread effects of climate change in the US would be crucial for the...
IMPORTANCE
Knowledge of whether serious adverse pregnancy outcomes are associated with increasingly widespread effects of climate change in the US would be crucial for the obstetrical medical community and for women and families across the country.
OBJECTIVE
To investigate prenatal exposure to fine particulate matter (PM2.5), ozone, and heat, and the association of these factors with preterm birth, low birth weight, and stillbirth.
EVIDENCE REVIEW
This systematic review involved a comprehensive search for primary literature in Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, PubMed, ClinicalTrials.gov website, and MEDLINE. Qualifying primary research studies included human participants in US populations that were published in English between January 1, 2007, and April 30, 2019. Included articles analyzed the associations between air pollutants or heat and obstetrical outcomes. Comparative observational cohort studies and cross-sectional studies with comparators were included, without minimum sample size. Additional articles found through reference review were also considered. Articles analyzing other obstetrical outcomes, non-US populations, and reviews were excluded. Two reviewers independently determined study eligibility. The Arskey and O'Malley scoping review framework was used. Data extraction was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.
FINDINGS
Of the 1851 articles identified, 68 met the inclusion criteria. Overall, 32 798 152 births were analyzed, with a mean (SD) of 565 485 (783 278) births per study. A total of 57 studies (48 of 58 [84%] on air pollutants; 9 of 10 [90%] on heat) showed a significant association of air pollutant and heat exposure with birth outcomes. Positive associations were found across all US geographic regions. Exposure to PM2.5 or ozone was associated with increased risk of preterm birth in 19 of 24 studies (79%) and low birth weight in 25 of 29 studies (86%). The subpopulations at highest risk were persons with asthma and minority groups, especially black mothers. Accurate comparisons of risk were limited by differences in study design, exposure measurement, population demographics, and seasonality.
CONCLUSIONS AND RELEVANCE
This review suggests that increasingly common environmental exposures exacerbated by climate change are significantly associated with serious adverse pregnancy outcomes across the US.
Topics: Air Pollution; Female; Hot Temperature; Humans; Infant, Low Birth Weight; Maternal Exposure; Observational Studies as Topic; Pregnancy; Premature Birth; Stillbirth; United States
PubMed: 32556259
DOI: 10.1001/jamanetworkopen.2020.8243 -
Environmental Research Apr 2022Allergic rhinitis (AR) is one of the most common allergic diseases in the world, and usually persists throughout the activity. Epidemiological studies have shown a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Allergic rhinitis (AR) is one of the most common allergic diseases in the world, and usually persists throughout the activity. Epidemiological studies have shown a positive association between air pollution and allergic rhinitis. However, we could not find any meta-analysis of the risk of air pollutants (PM, PM, NO, SO, O and CO) on the prevalence of AR in people of all ages.
OBJECTIVES
Carry out a meta-analysis on the results of recent studies (up to 2020) to present valid information about exposure to air pollution and risk of prevalence of AR.
METHODS
We systematically searched three databases for studies up to December 17, 2020, including air pollution and AR. Random effect models were conducted to estimate the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). Subgroup analysis, funnel plot, Egger's test, and the trim-and-fill method were also conducted.
RESULTS
Thirty-five studies across 12 countries, including a total of 453,470 participants, were included. The OR per 10 μg/m increase of pollutants was 1.13 (1.04-1.22) for PM and 1.12 (1.05-1.20) for PM. The OR per 10 μg/m increment of gaseous pollutants were 1.13 (1.07-1.20) for NO, 1.13 (1.04-1.22) for SO and 1.07 (1.01-1.12) for O. No significant association was observed between CO and AR. Children or adolescents are more sensitive to air pollution than adults. The effects of PM and SO were significantly stronger in Europe than Asia. The effects of air pollutants were more significant and higher in developing countries than in developed countries, except for PM. A significant difference of subgroup test was found between developed and developing countries of NO.
CONCLUSION
This meta-analysis showed a positive association between air pollution and the prevalence of allergic rhinitis, and identified geographic area and economic level as the potential modifiers for the association.
Topics: Adolescent; Adult; Air Pollutants; Air Pollution; Child; Environmental Exposure; Humans; Particulate Matter; Rhinitis, Allergic
PubMed: 34863689
DOI: 10.1016/j.envres.2021.112472