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Objectives: We assessed the relationship between heat and emergency hospital admissions (EHAs) in Switzerland using clinically relevant metrics. Methods: Applying distributed lag non-linear models, we investigated temperatureadmission associations between May and September 1998--2019 for various disease groups, by age class and gender. We estimated the relative risk (RR) for moderate (29°C) and extreme (34°C) daily maximum temperatures relative to disease-specific optimum temperature, and calculated attributable fractions (AFs) for hot days and the following week. We also calculated the total number of heat-related EHAs. Results: We attributed 31,387 (95% confidence interval: 21,567--40,408) EHAs to aboveoptimal temperatures, 1.1% (0.7%--1.4%) of the total. Extreme temperatures increased the EHA risk for mental, infectious and neurological diseases. We observed particularly high AFs due to extreme heat for dehydration (85.9%, 95% CI: 82.4%--88.8%) and acute kidney injury (AKI, 56.1%, 95% CI: 45.3%--64.7%). While EHA risk generally increased with age, we also found high RRs for infectious diseases in children (0--15 years) and AKI in young adults (15--64 years). Conclusion: Hot weather increases the EHA risk in Switzerland. Therefore a comprehensive clinical and public health response is needed. [ABSTRACT FROM AUTHOR]

Background: Long-term exposure to transportation noise is related to cardio-metabolic diseases, with more recent evidence also showing associations with diabetes mellitus (DM) incidence. This study aimed to evaluate the association between transportation noise and DM mortality within the Swiss National Cohort. Methods: During 15 years of follow-up (2001–2015; 4.14 million adults), over 72,000 DM deaths were accrued. Source-specific noise was calculated at residential locations, considering moving history. Multi-exposure, time-varying Cox regression was used to derive hazard ratios (HR, and 95%-confidence intervals). Models included road traffic, railway and aircraft noise, air pollution, and individual and area-level covariates including socio-economic position. Analyses included exposure-response modelling, effect modification, and a subset analysis around airports. The main findings were integrated into meta-analyses with published studies on mortality and incidence (separately and combined). Results: HRs were 1.06 (1.05, 1.07), 1.02 (1.01, 1.03) and 1.01 (0.99, 1.02) per 10 dB day evening-night level (Lden) road traffic, railway and aircraft noise, respectively (adjusted model, including NO2). Splines suggested a threshold for road traffic noise (~ 46 dB Lden, well below the 53 dB Lden WHO guideline level), but not railway noise. Substituting for PM2.5, or including deaths with type 1 DM hardly changed the associations. HRs were higher for males compared to females, and in younger compared to older adults. Focusing only on type 1 DM showed an independent association with road traffic noise. Meta-analysis was only possible for road traffic noise in relation to mortality (1.08 [0.99, 1.18] per 10 dB, n = 4), with the point estimate broadly similar to that for incidence (1.07 [1.05, 1.09] per 10 dB, n = 10). Combining incidence and mortality studies indicated positive associations for each source, strongest for road traffic noise (1.07 [1.05, 1.08], 1.02 [1.01, 1.03], and 1.02 [1.00, 1.03] per 10 dB road traffic [n = 14], railway [n = 5] and aircraft noise [n = 5], respectively). Conclusions: This study provides new evidence that transportation noise is associated with diabetes mortality. With the growing evidence and large disease burden, DM should be viewed as an important outcome in the noise and health discussion. [ABSTRACT FROM AUTHOR]

Background: The climate of southern Africa is expected to become hotter and drier with more frequent severe droughts and the incidence of diarrhoea to increase. From 2015 to 2018, Cape Town, South Africa, experienced a severe drought which resulted in extreme water conservation efforts. We aimed to gain a more holistic understanding of the relationship between diarrhoea in young children and climate variability in a system stressed by water scarcity. Methods: Using a mixed-methods approach, we explored diarrhoeal disease incidence in children under 5 years between 2010 to 2019 in Cape Town, primarily in the public health system through routinely collected diarrhoeal incidence and weather station data. We developed a negative binomial regression model to understand the relationship between temperature, precipitation, and relative humidity on incidence of diarrhoea with dehydration. We conducted in-depth interviews with stakeholders in the fields of health, environment, and human development on perceptions around diarrhoea and health-related interventions both prior to and over the drought, and analysed them through the framework method. Results: From diarrhoeal incidence data, the diarrhoea with dehydration incidence decreased over the decade studied, e.g. reduction of 64.7% in 2019 [95% confidence interval (CI): 5.5–7.2%] compared to 2010, with no increase during the severe drought period. Over the hot dry diarrhoeal season (November to May), the monthly diarrhoea with dehydration incidence increased by 7.4% (95% CI: 4.5–10.3%) per 1 °C increase in temperature and 2.6% (95% CI: 1.7–3.5%) per 1% increase in relative humidity in the unlagged model. Stakeholder interviews found that extensive and sustained diarrhoeal interventions were perceived to be responsible for the overall reduction in diarrhoeal incidence and mortality over the prior decade. During the drought, as diarrhoeal interventions were maintained, the expected increase in incidence in the public health sector did not occur. Conclusions: We found that that diarrhoeal incidence has decreased over the last decade and that incidence is strongly influenced by local temperature and humidity, particularly over the hot dry season. While climate change and extreme weather events especially stress systems supporting vulnerable populations such as young children, maintaining strong and consistent public health interventions helps to reduce negative health impacts. [ABSTRACT FROM AUTHOR]

Background: Long-term exposure to air pollution and noise is detrimental to health; but studies that evaluated both remain limited. This study explores associations with natural and cause-specific mortality for a range of air pollutants and transportation noise. Methods: Over 4 million adults in Switzerland were followed from 2000 to 2014. Exposure to PM2.5, PM2.5 components (Cu, Fe, S and Zn), NO2, black carbon (BC) and ozone (O3) from European models, and transportation noise from source-specific Swiss models, were assigned at baseline home addresses. Cox proportional hazards models, adjusted for individual and area-level covariates, were used to evaluate associations with each exposure and death from natural, cardiovascular (CVD) or non-malignant respiratory disease. Analyses included single and two exposure models, and subset analysis to study lower exposure ranges. Results: During follow-up, 661,534 individuals died of natural causes (36.6% CVD, 6.6% respiratory). All exposures including the PM2.5 components were associated with natural mortality, with hazard ratios (95% confidence intervals) of 1.026 (1.015, 1.038) per 5 µg/m3 PM2.5, 1.050 (1.041, 1.059) per 10 µg/m3 NO2, 1.057 (1.048, 1.067) per 0.5 × 10–5/m BC and 1.045 (1.040, 1.049) per 10 dB Lden total transportation noise. NO2, BC, Cu, Fe and noise were consistently associated with CVD and respiratory mortality, whereas PM2.5 was only associated with CVD mortality. Natural mortality associations persisted < 20 µg/m3 for PM2.5 and NO2, < 1.5 10–5/m BC and < 53 dB Lden total transportation noise. The O3 association was inverse for all outcomes. Including noise attenuated all outcome associations, though many remained significant. Across outcomes, noise was robust to adjustment to air pollutants (e.g. natural mortality 1.037 (1.033, 1.042) per 10 dB Lden total transportation noise, after including BC). Conclusion: Long-term exposure to air pollution and transportation noise in Switzerland contribute to premature mortality. Considering co-exposures revealed the importance of local traffic-related pollutants such as NO2, BC and transportation noise. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although plausible from a pathophysiological point of view, robust evidence for effects of transportation noise on mental health remains scarce. Meanwhile, psychiatric diseases are among the most prevalent noncommunicable diseases worldwide, and suicide as a mortality outcome highly connected to mental disorders presents a pressing public health issue. The aim of this study was to investigate the association between source-specific transportation noise, particulate matter (PM) air pollution, residential greenness, and suicide by means of a nationwide cohort study. METHODS: Road traffic, railway and aircraft noise exposure as well as exposure to air pollution [PM with aerodynamic diameter ≤2.5 μm (PM2.5)] and greenness [normalized difference vegetation index (NDVI)] were linked to 5.1 million adults (age 15 y and older) in the Swiss National Cohort, accounting for their address history. Mean noise exposure in 5-y periods was calculated. Individuals were followed for up to 15 y (2001-2015). Time-varying Cox regression models were applied to deaths by suicide (excluding assisted suicide). Models included all three noise sources, PM2.5, and NDVI plus individual and spatial covariates, including socioeconomic status. Effect modification by sex, age, socioeconomic indicators, and degree of urbanization was explored. RESULTS: During the follow-up, there were 11,265 suicide deaths (10.4% poisoning, 33.3% hanging, 28.7% firearms, 14.7% falls). Road traffic and railway noise were associated with total suicides [hazard ratios. 1.040; 95% confidence interval (CI): 1.015, 1.065; and 1.022 (95% CI: 1.004, 1.041) per 10 dB day-evening-night level (Lden)], whereas for aircraft noise, a risk increase starting from 50 dB was masked by an inverse association in the very low exposure range (30-40 dB). Associations were stronger for females than males. The results were robust to adjustment for residential greenness and air pollution. CONCLUSION: In this longitudinal, nationwide cohort study, we report a robust association between exposure to road traffic and railway noise and risk of death by suicide after adjusting for exposure to air pollution and greenness. These findings add to the growing body of evidence that mental health disorders may be related to chronic transportation noise exposure. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs), the leading cause of death worldwide, are sensitive to temperature. In light of the reported climate change trends, it is important to understand the burden of CVDs attributable to temperature, both hot and cold. The association between CVDs and temperature is region-specific, with relatively few studies focusing on low-and middle-income countries. This study investigates this association in Puducherry, a district in southern India lying on the Bay of Bengal, for the first time. Methods: Using in-hospital CVD mortality data and climate data from the Indian Meteorological Department, we analyzed the association between apparent temperature (Tapp) and in-hospital CVD mortalities in Puducherry between 2011 and 2020. We used a case-crossover model with a binomial likelihood distribution combined with a distributed lag non-linear model to capture the delayed and non-linear trends over a 21-day lag period to identify the optimal temperature range for Puducherry. The results are expressed as the fraction of CVD mortalities attributable to heat and cold, defined relative to the optimal temperature. We also performed stratified analyses to explore the associations between Tapp and age-and-sex, grouped and considered together, and different types of CVDs. Sensitivity analyses were performed, including using a quasi-Poisson time-series approach. Results: We found that the optimal temperature range for Puducherry is between 30°C and 36°C with respect to CVDs. Both cold and hot non-optimal Tapp were associated with an increased risk of overall in-hospital CVD mortalities, resulting in a U-shaped association curve. Cumulatively, up to 17% of the CVD deaths could be attributable to non-optimal temperatures, with a slightly higher burden attributable to heat (9.1%) than cold (8.3%). We also found that males were more vulnerable to colder temperature; females above 60 years were more vulnerable to heat while females below 60 years were affected by both heat and cold. Mortality with cerebrovascular accidents was associated more with heat compared to cold, while ischemic heart diseases did not seem to be affected by temperature. Conclusion: Both heat and cold contribute to the burden of CVDs attributable to non-optimal temperatures in the tropical Puducherry. Our study also identified the age-and-sex and CVD type differences in temperature attributable CVD mortalities. Further studies from India could identify regional associations, inform our understanding of the health implications of climate change in India and enhance the development of regional and contextual climate-health action-plans. [ABSTRACT FROM AUTHOR]

Epidemiological studies have shown that prenatal exposure to air pollution such as particulate matter (PM) and nitrogen dioxide (NO SB 2 sb ) is associated with impaired lung function after birth[1] and the development of childhood asthma and wheeze, for example.[2] Biological mechanisms linking prenatal air pollution exposure to respiratory morbidity are not completely understood. Some epidemiological studies have reported that air pollution exposure increases the serum levels of IL-17a in asthmatic children.[4] However, the effect of prenatal air pollution on IL-17a levels in humans is still unknown. Ambient prenatal air pollution exposure is associated with low cord blood IL-17a in infants. [Extracted from the article]

Epidemiological studies investigating the relationship between air temperature or heat and health, still, by and large, rely on either information from the nearest weather station or on coarse gridded temperature predictions, thereby ignoring small‐scale intra‐urban variations. Recent methodological advances show promise in achieving high spatiotemporal temperature predictions, thus improving the characterization of spatial variations in temperature and decreasing bias in health studies. Here, we applied a two‐stage approach using random forest to (a) impute missing moderate resolution imaging spectroradiometer (MODIS) land surface temperature at a 1 × 1 km resolution and (b) to use the gap‐filled MODIS data to explain spatiotemporal variation in the measured ground‐based air temperature data at a 100 × 100 m resolution across Switzerland using a range of predictor variables, including meteorological parameters, normalized difference vegetation index, impervious surface and altitude. Models presented here managed to capture temporal and spatial variations in air temperature in Switzerland from 2003 to 2018 at a fine spatial resolution of 100 × 100 m. Stage 1 models achieved an overall R2 of 0.98 and a root mean squared error (RMSE) of 1.49°C (independent validation), and the stage 2 model performed well for all years with R2 and RMSE ranging from 0.94 to 0.99 and 1.05 to 1.86°C, respectively. We were also able to capture the urban heat island effect and some typical weather phenomena caused by Switzerland's complex topography, like the foehn effect and inversion conditions. The resulting daily temperature surfaces for 2003–2018 will facilitate ongoing epidemiological research investigating the health effects of heat. [ABSTRACT FROM AUTHOR]

Over the last decades, concern has arisen worldwide about the negative impacts of pesticides on the environment and human health. Exposure via dust ingestion is important for many chemicals but poorly characterized for pesticides, particularly in Africa. We investigated the spatial and temporal variations of 30 pesticides in dust and estimated the human exposure via dust ingestion, which was compared to inhalation and soil ingestion. Indoor dust samples were collected from thirty-eight households and two schools located in two agricultural regions in South Africa and were analyzed using high-performance liquid chromatography coupled to tandem mass spectrometry. We found 10 pesticides in dust, with chlorpyrifos, terbuthylazine, carbaryl, diazinon, carbendazim, and tebuconazole quantified in >50% of the samples. Over seven days, no significant temporal variations in the dust levels of individual pesticides were found. Significant spatial variations were observed for some pesticides, highlighting the importance of proximity to agricultural fields or of indoor pesticide use. For five out of the nineteen pesticides quantified in dust, air, or soil (i.e., carbendazim, chlorpyrifos, diazinon, diuron and propiconazole), human intake via dust ingestion was important (>10%) compared to inhalation or soil ingestion. Dust ingestion should therefore be considered in future human exposure assessment to pesticides. [ABSTRACT FROM AUTHOR]

Although WiFi contributes little to total radiofrequency electromagnetic field (RF-EMF) exposure in our everyday environment, concern has raised whether this specific type of modulated RF-EMF causes health problems. The aim of this review is to evaluate all types of studies that investigated biological and health effects of WiFi exposure and fulfilled basic quality criteria. Eligible for inclusion were epidemiological, human experimental, in vivo and in vitro studies using realistic WiFi exposure settings. We conducted a systematic literature search for all papers published between January 1997 and August 2020 followed by a quality review addressing blinding and dosimetry in experimental studies and various types of biases in epidemiological studies. All studies fulfilling the quality criteria were descriptively summarized in terms of observation or absence of associations. From 1385 articles identified by the literature search, 23 fulfilled basic quality criteria: 6 epidemiological papers, 6 human experimental articles, 9 in vivo articles, and 2 in vitro articles. Whereas in vivo and in vitro studies applied exposure levels up to 4 W/kg, human studies dealt with exposure levels several orders of magnitude below the ICNIRP guidelines, which are typical for WiFi exposure situations in the everyday environment. Numerous outcomes ranging from biological markers to symptoms were mostly found not to be associated with WiFi exposure. Sporadic findings were not consistent in terms of outcomes or exposure-response associations. This review based on a systematic literature search and quality evaluation does not suggest detrimental health effects from WiFi exposure below regulatory limits. [ABSTRACT FROM AUTHOR]

Extreme temperatures have reached unprecedented levels in many regions of the globe due to climate change, and a further increase is expected. Besides other consequences, high temperatures increase the mortality risk and severely affect the labour productivity of workers. We perform a high-resolution spatial analysis to assess the impacts of heat on mortality and labour productivity in Switzerland and project their development under different Representative Concentration Pathway (RCP) scenarios, considering that no socio-economic changes take place. The model is based on the risk framework of the Intergovernmental Panel on Climate Change (IPCC), which combines the three risk components: hazard, exposure, and vulnerability. We model the two impact categories in the same spatially explicit framework, and we integrate uncertainties into the analysis by a Monte Carlo simulation. We model first that about 658 deaths are associated with heat exposure currently each year in Switzerland. Second, the economic costs caused by losses in labour productivity amount to around CHF 665 million (approx. USD 700 million) per year. Should we remain on an RCP8.5 emissions pathway, these values may double (for mortality) or even triple (for labour productivity) by the end of the century. Under an RCP2.6 scenario impacts are expected to slightly increase and peak around mid-century, when climate is assumed to stop warming. Even though uncertainties in the model are large, the underlying trend in impacts is unequivocal. The results of the study are valuable information for political discussions and allow for a better understanding of the cost of inaction. [ABSTRACT FROM AUTHOR]

Various epidemiological studies have reported on air pollution exposure-related lung function decline and respiratory health effects in children. Children have increased susceptibility to ambient air pollutants as physiological and structural changes of the lung are still occurring within the first five years of life after birth. This review examines applications in air pollution exposure assessment methods when evaluating lung function and respiratory health concentration–response effects in young children, while considering the effects of critical windows of exposure. We identified 13 studies that used various methods of exposure assessment in assessing respiratory health outcomes (presence of lower respiratory tract infections, respiratory symptoms, wheezing and asthma) in children under five. The methods applied included personal monitoring (n = 1), proximity-based methods (n = 3), inverse distance weighting (n = 2), geographic weighted regression (n = 1), dispersion modeling (n = 1), satellite-based methods (n = 2) and land use regression modeling (n = 5). These studies assessed exposure and outcomes at different "windows of susceptibility": antenatally/specific trimesters (n = 8), infancy (n = 5) and early childhood (n = 6). In most studies, the reported measures of air pollutants were noted to be below the prescribed limits, though for some, a cause–effect association was observed. It was also noted that there was very little variation in estimates between time points or trimesters of exposure, likely attributed to limitations in the selected exposure assessment method. Moderate to high correlations between trimesters were reported for most studies. [ABSTRACT FROM AUTHOR]

Background: Outdoor air pollution is increasingly recognised as a key threat to population health globally, with particularly high risks for urban residents. In this study, we assessed the association between residential nitrogen dioxide (NO2) exposure and children's cognitive and behavioural development using data from São Paulo Brazil, one of the largest urban agglomerations in the world. Methods: We used data from the São Paulo Western Region Birth Cohort, a longitudinal cohort study aiming to examine determinants as well as long-term implications of early childhood development. Cross-sectional data from the 72-month follow-up was analysed. Data on NO2 concentration in the study area was collected at 80 locations in 2019, and land use regression modelling was used to estimate annual NO2 concentration at children's homes. Associations between predicted NO2 exposure and children's cognitive development as well as children's behavioural problems were estimated using linear regression models adjusted for an extensive set of confounders. All results were expressed per 10 μg/m3 increase in NO2. Results: 1143 children were included in the analysis. We found no association between NO2 and children's cognitive development (beta -0.05, 95% CI [-0.20; 0.10]) or behavioural problems (beta 0.02, 95% CI [-0.80; 0.12]). Conclusion: No association between child cognition or child behaviour and NO2 was found in this cross-sectional analysis. Further research will be necessary to understand the extent to which these null results reflect a true absence of association or other statistical, biological or adaptive factors not addressed in this paper. [ABSTRACT FROM AUTHOR]

Rationale: Infants born prematurely have impaired capacity to deal with oxidative stress shortly after birth. Objectives: We hypothesize that the relative impact of exposure to air pollution on lung function is higher in preterm than in term infants. Methods: In the prospective BILD (Basel-Bern Infant Lung Development) birth cohort of 254 preterm and 517 term infants, we investigated associations of particulate matter ⩽10 μm in aerodynamic diameter (PM10) and nitrogen dioxide with lung function at 44 weeks' postconceptional age and exhaled markers of inflammation and oxidative stress response (fractional exhaled nitric oxide [FeNO]) in an explorative hypothesis-driven study design. Multilevel mixed-effects models were used and adjusted for known confounders. Measurements and Main Results: Significant associations of PM10 during the second trimester of pregnancy with lung function and FeNO were found in term and preterm infants. Importantly, we observed stronger positive associations in preterm infants (born 32-36 wk), with an increase of 184.9 (95% confidence interval [CI], 79.1-290.7) ml/min [Formula: see text]e per 10-μg/m3 increase in PM10, than in term infants (75.3; 95% CI, 19.7-130.8 ml/min) (pprematurity × PM10 interaction = 0.04, after multiple comparison adjustment padj = 0.09). Associations of PM10 and FeNO differed between moderate to late preterm (3.4; 95% CI, -0.1 to 6.8 ppb) and term (-0.3; 95% CI, -1.5 to 0.9 ppb) infants, and the interaction with prematurity was significant (pprematurity × PM10 interaction = 0.006, padj = 0.036). Conclusions: Preterm infants showed significantly higher susceptibility even to low to moderate prenatal air pollution exposure than term infants, leading to increased impairment of postnatal lung function. FeNO results further elucidate differences in inflammatory/oxidative stress response when comparing preterm infants with term infants. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to describe the factors associated with mortality by suicide among working women focusing on work-related factors. Methods: The study population consisted in all Swiss residents recorded in the 1990 and/or the 2000 compulsory national censuses and were linked to emigration and mortality registers. We selected all women aged 18–65 and at work at the official census dates. Following work-related variables were available: socio-economic status, weekly hours of work, the sector of activity and the job title coded according to the International Standard Classification of Occupations (ISCO). The risk of suicide was modelled using negative binomial regression. Results: The cohort comprised 1,771,940 women and 2526 deaths by suicide corresponding to 24.9 million person-years. The most significant non-occupational predictors of suicide were age, period, civil status, religion, nationality and geographical regions. Adjusted on these factors, part-time work was associated with increased suicide rates. According to job codes, health and social activities, in particular care-worker had the highest suicide risks. Conclusion: Suicide among working women depended on work-related factors even taking into account other socio-demographic factors. [ABSTRACT FROM AUTHOR]

Introduction: We modeled suicidal rate among Swiss working‐age males, considering three groups of factors at socio‐demographic, occupational, and societal levels jointly. Our goal was twofold: to verify the effect of occupation after adjustment for non‐occupational factors and to identify protective and risk factors relevant for suicide prevention in working male adults. Methods: The study population included all men aged [18–65] years at the 2000 population census and followed up within the Swiss National Cohort (SNC). The risk of suicide was modeled using Poisson regression. Results: The cohort comprised 1,534,564 men and 4371 deaths by suicide. Suicide rate varied significantly according to age, civil status, nationality, highest education achieved, and socio‐professional category at socio‐demographic level; occupation, occupational activity branch, weekly working hours, and home‐to‐work commute time at occupational level; calendar period of death, region, religious affiliation, and volunteering activity at societal level. After adjustment for non‐occupational factors, agricultural and fishery laborers, military and civil security workers, and health and social workers were identified as high‐risk groups with respect to suicide. Conclusion: This study evidenced a complex web of factors at socio‐demographic, occupational, and societal levels behind the suicide in Swiss male workers and identified the most at‐risk groups, deserving targeted prevention efforts. [ABSTRACT FROM AUTHOR]

Exposure to extremely low frequency magnetic fields (ELF-MF) and electric shocks occurs in many workplaces and occupations but it is unclear whether any of these exposures cause Amyotrophic lateral sclerosis (ALS). The aim of this systematic review and meta-analysis is to explore whether occupational exposure to ELF-MF and/or electric shocks are risk factor for ALS. We searched PubMed, Embase, and Web of Science databases up to the end of 2019. Pooled risk estimates were calculated using random-effects meta-analysis including exploration of the sources of heterogeneity between studies and publication bias. Twenty-seven publications fulfilled the inclusion criteria. We found a weak, significant, association between occupational exposure to ELF-MF and the risk of ALS (RRPooled estimate: 1.20; 95%CI: 1.05, 1.38) with moderate to high heterogeneity (I2=66.3%) and indication of publication bias (PEgger's test=0.03). No association was observed between occupational exposure to electric shocks and risk of ALS (RRPooled estimate: 0.97; 95%CI: 0.80, 1.17) with high heterogeneity (I2=80.5%), and little indication for publication bias (PEgger's test=0.24). The findings indicate that occupational exposure to ELF-MF, but not electric shocks, might be a risk factor for ALS. However, given the moderate to high heterogeneity and potential publication bias, the results should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Aims It is unclear whether night-time noise events, including from aeroplanes, could trigger a cardiovascular death. In this study, we investigate the potential acute effects of aircraft noise on mortality and the specific role of different night-time exposure windows by means of a case-crossover study design. Methods and results We selected 24 886 cases of death from cardiovascular disease (CVD) from the Swiss National Cohort around Zürich Airport between 2000 and 2015. For night-time deaths, exposure levels 2 h preceding death were significantly associated with mortality for all causes of CVD [OR = 1.44 (1.03–2.04) for the highest exposure group (LAeq > 50 dB vs. <20 dB)]. Most consistent associations were observed for ischaemic heart diseases, myocardial infarction, heart failure, and arrhythmia. Association were more pronounced for females (P  = 0.02) and for people living in areas with low road and railway background noise (P  = 0.01) and in buildings constructed before 1970 (P  = 0.36). We calculated a population attributable fraction of 3% in our study population. Conclusion Our findings suggest that night-time aircraft noise can trigger acute cardiovascular mortality. The association was similar to that previously observed for long-term aircraft noise exposure. [ABSTRACT FROM AUTHOR]

BACKGROUND: The impact of nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter of less than or equal to 2.5. microns (PM2.5) exposures on lung function has been investigated mainly in children and less in adults. Furthermore, it is unclear whether short-term deviations of air pollutant concentration need to be considered in long-term exposure models. OBJECTIVES: The aims of this study were to investigate the association between short-term air pollution exposure and lung function and to assess whether short-term deviations of air pollutant concentration should be integrated into long-term exposure models. METHODS: Short-term (daily averages 0–7 d prior) and long-term (1- and 4-y means) NO2 and PM2.5 concentrations were modeled using satellite, land use, and meteorological data calibrated on ground measurements. Forced expiratory volume within the first second (FEV1) of forced exhalation and forced vital capacity (FVC) were measured during a LuftiBus assessment (2003–2012) and linked to exposure information from the Swiss National Cohort for 36,085 adults (ages 18–95 y). We used multiple linear regression to estimate adjusted associations, and additionally adjusted models of long-term exposures for short-term deviations in air pollutant concentrations. RESULTS: A 10 µg/m³ increase in NO2 and PM2.5 on the day of the pulmonary function test was associated with lower FEV1 and FVC (NO2: FEV1 -8.0 ml [95% confidence interval: -13.4, -2.7], FVC -16.7 ml [-23.4, -10.0]; PM2.5: FEV1 -15.3 ml [-21.9, -8.7], FVC -18.5 ml [-26.5, -10.5]). A 10 µg/m³ increase in 1-y mean NO2 was also associated with lower FEV1 (-7:7 ml; -15.9, 0.5) and FVC (-21.6 ml; -31.9, -11.4), as was a 10 µg/m³ increase in 1-y mean PM2.5 (FEV1: -42.2 ml; -56.9, -27.5; FVC: -82.0 ml; -100.1, -63.9). These associations were robust to adjustment for short-term deviations in the concentration of each air pollutant. CONCLUSIONS: Short- and long-term air pollution exposures were negatively associated with lung function, in particular long-term PM2.5 exposure with FVC. Our findings contribute substantially to the evidence of adverse associations between air pollution and lung function in adults. [ABSTRACT FROM AUTHOR]

Background: Suicide is a major and complex public health problem. In Switzerland, suicide accounts for about 1000 deaths yearly and is the fourth leading cause of mortality. The first nationwide Swiss study of suicides identified eight male and four female occupations with statistically significant excess of suicide compared to the general Swiss population. Working time, self-employer status, low socio-economic status and low skill level required for occupation were associated with increase in suicide risk. Presently, we aim to compare the distribution of suicide risk across occupations with the prevalence of somatic and psychiatric morbidity in Swiss working-aged adults. We hypothesized that some diseases would cluster in particular occupations, indicating potential work-relatedness of suicides found in these occupations. Methods: We used the Swiss National Cohort (SNC) and included 10575 males and 2756 females deceased by suicide between 1990 and 2014. We estimated the prevalence of 16 categories of concomitant diseases in each occupation, using national mortality records, and assessed the homogeneity of diseases distribution across occupations. For diseases, which prevalence varied significantly across occupations, we analyzed the correlation with the distribution of suicide risk, estimated as the standardized mortality ratio (SMR) of suicide. Results: Mental and behavioral disorders were the most commonly reported concomitant diseases in our population. In men, the prevalence of these disorders and more specifically, the prevalence of substance-related and addictive disorders, and of psychotic disorders varied significantly across occupations and was correlated with the SMR of suicide. The prevalence of malignant neoplasms and the prevalence of diseases of the musculoskeletal system and connective tissue also varied significantly across male occupations, while in women, such a variation was observed for neoplasms of uncertain or unknown behavior and diseases of the nervous system and sense organs, without being correlated with the SMR of suicide. Conclusion: Some of the identified morbidities can be occupation-related and could negatively affect the working capacity and the employability, which in turn could be related to the suicide. Disentangling concomitant diseases according to their work-relatedness and relationship with the suicide risk is important for identifying occupation-related suicides, understanding their characteristics, and developing appropriated interventions for their prevention. [ABSTRACT FROM AUTHOR]

BACKGROUND: Few epigenome-wide association studies (EWAS) on air pollutants exist, and none have been done on transportation noise exposures, which also contribute to environmental burden of disease. OBJECTIVE: We performed mutually independent EWAS on transportation noise and air pollution exposures. METHODS: We used data from two time points of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA) from 1,389 participants contributing 2,542 observations. We applied multiexposure linear mixed-effects regressions with participant-level random intercept to identify significant Cytosine-phosphate-Guanine (CpG) sites and differentially methylated regions (DMRs) in relation to 1-y average aircraft, railway, and road traffic day-evening-night noise (Lden); nitrogen dioxide (NO2); and particulate matter (PM) with aerodynamic diameter <2.5 lm (PM2.5). We performed candidate (CpG-based; cross-systemic phenotypes, combined into “allostatic load”) and agnostic (DMR-based) pathway enrichment tests, and replicated previously reported air pollution EWAS signals. RESULTS: We found no statistically significant CpGs at false discovery rate <0.05. However, 14, 48, 183, 8, and 71 DMRs independently associated with aircraft, railway, and road traffic Lden; NO2; and PM2.5, respectively, with minimally overlapping signals. Transportation Lden and air pollutants tendentially associated with decreased and increased methylation, respectively. We observed significant enrichment of candidate DNA methylation related to C-reactive protein and body mass index (aircraft, road traffic Lden, and PM2.5), renal function and “allostatic load” (all exposures). Agnostic functional networks related to cellular immunity, gene expression, cell growth/proliferation, cardiovascular, auditory, embryonic, and neurological systems development were enriched. We replicated increased methylation in cg08500171 (NO2) and decreased methylation in cg17629796 (PM2.5). CONCLUSIONS: Mutually independent DNA methylation was associated with source-specific transportation noise and air pollution exposures, with distinct and shared enrichments for pathways related to inflammation, cellular development, and immune responses. These findings contribute in clarifying the pathways linking these exposures and age-related diseases but need further confirmation in the context of mediation analyses. [ABSTRACT FROM AUTHOR]

Introduction: Medulloblastoma is a malignant embryonal tumor of the cerebellum that occurs predominantly in children. To find germline genetic variants associated with medulloblastoma risk, we conducted a genome-wide association study (GWAS) including 244 medulloblastoma cases and 247 control subjects from Sweden and Denmark. Methods: Genotyping was performed using Illumina BeadChips, and untyped variants were imputed using IMPUTE2. Results: Fifty-nine variants in 11 loci were associated with increased medulloblastoma risk (p < 1 × 10–5), but none were statistically significant after adjusting for multiple testing (p < 5 × 10–8). Thirteen of these variants were genotyped, whereas 46 were imputed. Genotyped variants were further investigated in a validation study comprising 249 medulloblastoma cases and 629 control subjects. In the validation study, rs78021424 (18p11.23, PTPRM) was associated with medulloblastoma risk with OR in the same direction as in the discovery cohort (ORT = 1.59, pvalidation = 0.02). We also selected seven medulloblastoma predisposition genes for investigation using a candidate gene approach: APC, BRCA2, PALB2, PTCH1, SUFU, TP53, and GPR161. The strongest evidence for association was found for rs201458864 (PALB2, ORT = 3.76, p = 3.2 × 10–4) and rs79036813 (PTCH1, ORA = 0.42, p = 2.6 × 10–3). Conclusion: The results of this study, including a novel potential medulloblastoma risk loci at 18p11.23, are suggestive but need further validation in independent cohorts. [ABSTRACT FROM AUTHOR]

Rationale: Most studies determining the prevalence of airway obstruction are limited to short time periods.Objectives: Because temporal trends of obstruction in populations are largely unknown, we determined the prevalence of airway obstruction over 20 years in yearly general population samples in Switzerland between 1993 and 2012.Methods: We analyzed data of 85,789 participants aged 35 years and older who provided spirometric measurements as part of the LuftiBus lung function campaign. We linked data from the 2003-2012 period to the Swiss National Cohort to adjust for annual population differences. Spirometry was performed without bronchodilation, according to American Thoracic Society guidelines. We used Global Lung Initiative (GLI) and Hankinson reference equations to identify obstruction.Results: Obstruction prevalence increased between 1993 and 2012 from 6.1% (95% confidence interval [CI], 5.5 to 6.7) to 15.6% (95% CI, 13.8 to 17.3) based on GLI estimates and from 5.3% (95% CI, 4.7 to 5.9) to 15.4% (95% CI, 13.6 to 17.1) based on Hankinson estimates. When adjusted for participant demographics, air pollutant and occupational exposures, altitude, and season, the prevalence ratios of obstruction were 1.54 (95% CI, 1.22 to 1.93) and 1.65 (95% CI, 1.33 to 2.04) for GLI- and Hankinson-defined airway obstruction, respectively, for 2012 compared with 2003.Conclusions: Though prebronchodilator measurements likely overestimate the prevalence of airway obstruction in absolute terms compared with post-bronchodilator measurements, we found an increase in airway obstruction prevalence. Even with adjustment for several well-known risk factors for obstruction to make the populations across the years more comparable, we still saw a statistically significant increase in prevalence over this time period. [ABSTRACT FROM AUTHOR]

Exposure to traffic noise is associated with stress and sleep disturbances. The World Health Organization (WHO) recently concluded that road traffic noise increases the risk for ischemic heart disease and potentially other cardiometabolic diseases, including stroke, obesity, and diabetes. The WHO report focused on whole-day noise exposure, but new epidemiological and translational field noise studies indicate that nighttime noise, in particular,is an important risk factor for cardiovascular disease (CVD) through increased levels of stress hormones and vascular oxidative stress, leading to endothelial dysfunction and subsequent development of various CVDs. Novel experimental studies found noise to be associated with oxidative stress-induced vascular and brain damage, mediated by activation of the NADPH oxidase, uncoupling of endothelial and neuronal nitric oxide synthase, and vascular/brain infiltration with inflammatory cells. Noise-induced pathophysiology was more pronounced in response to nighttime as compared with daytime noise. This review focuses on the consequences of nighttime noise. [ABSTRACT FROM AUTHOR]

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Mobile phones (MPs) are the most relevant source of radiofrequency electromagnetic field (RF-EMF) exposure to the brain and the salivary gland. Whether this exposure implies a cancer risk has been addressed in several case-control and few cohort studies. A meta-analysis of these studies does not show increased risks for meningioma, pituitary, and salivary gland tumors. For glioma and acoustic neuroma, the results are heterogeneous, with few case-control studies reporting substantially increased risks. However, these elevated risks are not coherent with observed incidence time trends, which are considered informative for this specific topic owing to the steep increase in MP use, the availability of virtually complete cancer registry data from many countries, and the limited number of known competing environmental risk factors. In conclusion, epidemiological studies do not suggest increased brain or salivary gland tumor risk with MP use, although some uncertainty remains regarding long latency periods (>15 years), rare brain tumor subtypes, and MP usage during childhood. [ABSTRACT FROM AUTHOR]

Aims The present study aimed to disentangle the risk of the three major transportation noise sources—road, railway, and aircraft traffic—and the air pollutants NO2 and PM2.5 on myocardial infarction (MI) mortality in Switzerland based on high quality/fine resolution exposure modelling. Methods and results We modelled long-term exposure to outdoor road traffic, railway, and aircraft noise levels, as well as NO2 and PM2.5 concentration for each address of the 4.40 million adults (>30 years) in the Swiss National Cohort (SNC). We investigated the association between transportation noise/air pollution exposure and death due to MI during the follow-up period 2000–08, by adjusting noise [Lden(Road), Lden(Railway), and Lden(Air)] estimates for NO2 and/or PM2.5 and vice versa by multipollutant Cox regression models considering potential confounders. Adjusting noise risk estimates of MI for NO2 and/or PM2.5 did not change the hazard ratios (HRs) per 10 dB increase in road traffic (without air pollution: 1.032, 95% CI: 1.014–1.051, adjusted for NO2 and PM2.5: 1.034, 95% CI: 1.014–1.055), railway traffic (1.020, 95% CI: 1.007–1.033 vs. 1.020, 95% CI: 1.007–1.033), and aircraft traffic noise (1.025, 95% CI: 1.006–1.045 vs. 1.025, 95% CI: 1.005–1.046). Conversely, noise adjusted HRs for air pollutants were lower than corresponding estimates without noise adjustment. Hazard ratio per 10 μg/m³ increase with and without noise adjustment were 1.024 (1.005–1.043) vs. 0.990 (0.965–1.016) for NO2 and 1.054 (1.013–1.093) vs. 1.019 (0.971–1.071) for PM2.5. Conclusion Our study suggests that transportation noise is associated with MI mortality, independent from air pollution. Air pollution studies not adequately adjusting for transportation noise exposure may overestimate the cardiovascular disease burden of air pollution. [ABSTRACT FROM AUTHOR]

This paper studies the effect of antenna polarization on measurement uncertainty of a multi-band body-worn distributed exposure meter (BWDM). The BWDM is a device for assessing electromagnetic fields in real environments accurately. The BWDM consists of 8 nodes and is calibrated on the body for simultaneous measurement of the incident power density in four frequency bands. Each node contains an antenna that can have two potential antenna polarizations.The BWDM is calibrated on four human subjects in an anechoic chamber to determine its measurement uncertainty in terms of 68% confidence interval (CI68) of the on-body antenna aperture. The results show that using a fixed polarization of the antennas on body can lead to a different CI68 up to maximum 4.9 dB when worn by another person which is still 9.6 dB lower than the measurement uncertainty of commercial exposure meters. [ABSTRACT FROM AUTHOR]

The health impact of indoor air pollution in informal settlement households has not been extensively studied in South Africa. This cross‐sectional study investigated the association between asthma and common indoor exposures among schoolchildren from four informal settlements located in two municipalities in the Western Cape Province. A total of 590 children, aged 9‐11 years, were recruited. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was administered to caregivers. Pulmonary function assessment included spirometry and fractional exhaled nitric oxide (FeNO). Phadiatop test for atopy was done. The prevalence of doctor‐diagnosed asthma was 3.4% (n = 20) among whom only 50% were on treatment. The prevalence of current wheeze was 12.9%, and 17.6% had airway obstruction (FEV1 < lower limit of normal), while 10.2% had airway inflammation (FeNO > 35 ppb). In adjusted logistic regression models, dampness, visible mold growth, paraffin use for cooking, and passive smoking were associated with a twofold to threefold increased risk in upper and lower airway outcomes. The strongest association was that of visible mold growth with rhinitis (adjusted odds ratio—aOR 3.37, 95% CI: 1.69‐6.71). Thus, there is a need for improved diagnosis of childhood asthma and Indoor Air Quality in informal settlement households. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS) is caused by the gradual degeneration and death of motor neurons, with mostly unknown etiology. Some risk factors have been suggested for this disease including extremely low frequency magnetic fields (ELF-MF) exposure. This meta-analysis assesses the association of residential exposure to ELF-MF with the risk of ALS. Five studies have addressed the risk of ALS in relation to overhead power lines. A pooled relative risk (RR) of 0.71 [95% confidence interval (CI): 0.48, 1.07] for the most exposed population group (either <200 m distance from high voltage power lines or >0.1 μT) was found. Little heterogeneity (I2=0.00%, p=0.67) and indication for publication bias (PBegg's test=0.22; PEgger's test=0.19) was seen. Overall, we found no evidence for an association between residential exposure to ELF-MF and the risk of ALS, although the number of exposed cases is low. [ABSTRACT FROM AUTHOR]

Background: Although studies have consistently found an association between childhood leukaemia risk and magnetic fields, the associations between childhood leukaemia and distance to overhead power lines have been inconsistent. We pooled data from multiple studies to assess the association with distance and evaluate whether it is due to magnetic fields or other factors associated with distance from lines.Methods: We present a pooled analysis combining individual-level data (29,049 cases and 68,231 controls) from 11 record-based studies.Results: There was no material association between childhood leukaemia and distance to nearest overhead power line of any voltage. Among children living < 50 m from 200 + kV power lines, the adjusted odds ratio for childhood leukaemia was 1.33 (95% CI: 0.92-1.93). The odds ratio was higher among children diagnosed before age 5 years. There was no association with calculated magnetic fields. Odds ratios remained unchanged with adjustment for potential confounders.Conclusions: In this first comprehensive pooled analysis of childhood leukaemia and distance to power lines, we found a small and imprecise risk for residences < 50 m of 200 + kV lines that was not explained by high magnetic fields. Reasons for the increased risk, found in this and many other studies, remains to be elucidated. [ABSTRACT FROM AUTHOR]