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The short-term adverse effects of ambient fine particulate matter (PM 2.5) and ozone (O 3) on anxiety disorders (ADs) remained inconclusive. We applied an individual-level time-stratified case-crossover study, which including 126,112 outpatient visits for ADs during 2019–2021 in Guangdong province, China, to investigate the association of short-term exposure to PM 2.5 and O 3 with outpatient visits for ADs, and estimate excess outpatient visits in South China. Daily residential air pollutant exposure assessments were performed by extracting grid data (spatial resolution: 1 km × 1 km) from validated datasets. We employed the conditional logistic regression model to quantify the associations and excess outpatient visits. The results of the single-pollutant models showed that each 10 μg/m3 increase of PM 2.5 and O 3 exposures was significantly associated with a 3.14 % (95 % confidence interval: 2.47 %, 3.81 %) and 0.88 % (0.49 %, 1.26 %) increase in odds of outpatient visits for ADs, respectively. These associations remained robust in 2-pollutant models. The proportion of outpatient visits attributable to PM 2.5 and O 3 exposures was up to 7.20 % and 8.93 %, respectively. Older adults appeared to be more susceptible to PM 2.5 exposure, especially in cool season, and subjects with recurrent outpatient visits were more susceptible to O 3 exposure. As our study subjects were from one single hospital in China, it should be cautious when generalizing our findings to other regions. Short-term exposure to ambient PM 2.5 and O 3 was significantly associated with a higher odds of outpatient visits for ADs, which can contribute to considerable excess outpatient visits. • Exposure to ambient PM 2.5 and O 3 was associated with an increased odds of outpatient visits for anxiety disorders. • PM 2.5 and O 3 exposures were attributable to considerable excess outpatient visits. • Older adults were more susceptible to PM 2.5 exposure, especially in cool season. • Subjects with recurrent outpatient visits were more susceptible to O 3 exposure. [ABSTRACT FROM AUTHOR]

Accumulating animal studies have demonstrated associations between ambient air pollution (AP) and metabolic dysfunction-associated fatty liver disease (MAFLD), but relevant epidemiological evidence is limited. We evaluated the association of long-term exposure to AP with the risk of incident MAFLD in Northwest China. The average AP concentration between baseline and follow-up was used to assess individual exposure levels. Cox proportional hazard models and restricted cubic spline functions (RCS) were used to estimate the association of PM2.5 and its constituents with the risk of MAFLD and the dose–response relationship. Quantile g-computation was used to assess the joint effects of mixed exposure to air pollutants on MAFLD and the weights of the various pollutants. We observed 1516 cases of new-onset MAFLD, with an incidence of 10.89%. Increased exposure to pollutants was significantly associated with increased odds of MAFLD, with hazard ratios (HRs) of 2.93 (95% CI: 1.22, 7.00), 2.86 (1.44, 5.66), 7.55 (3.39, 16.84), 4.83 (1.89, 12.38), 3.35 (1.35, 8.34), 1.89 (1.02, 1.62) for each interquartile range increase in PM2.5, SO42−, NO3−, NH4+, OM, and BC, respectively. Stratified analyses suggested that females, frequent exercisers and never-drinkers were more susceptible to MAFLD associated with ambient PM2.5 and its constituents. Mixed exposure to SO42−, NO3−, NH4+, OM and BC was associated with an increased risk of MAFLD, and the weight of BC had the strongest effect on MAFLD. Exposure to ambient PM2.5 and its constituents increased the risk of MAFLD. [ABSTRACT FROM AUTHOR]

Aim: The rising prevalence of periodontitis imposes substantial burdens on individuals and society. Identifying environmental risk factors for periodontitis may contribute to tackling the global public health burden of it. This study aimed to assess the association between long‐term exposure to PM2.5 and periodontitis in a nationally representative population from China. Materials and Methods: In this multi‐centre cross‐sectional study of 372 communities in 31 provinces of Mainland China, we used data from the Fourth National Oral Health Survey of China in 2015–2016, in combination with high‐resolution gridded concentrations of fine particulate matter (PM2.5). Logistic regression was applied to assess the relationship between long‐term PM2.5 exposure and the risk of periodontitis. In addition, we examined whether the association varied by individual characteristics, and estimated the exposure–response relationship and the risk of damaged tooth in each tooth quadrant. Results: A total of 8391 participants from 96 cities were diagnosed with periodontitis, accounting for 60.04% (8391/13,459) of the participants. For each 10 μg/m3 increment in 1‐, 3‐ and 5‐year average concentrations of PM2.5, the risk of total periodontitis increased by 9.0% (95% confidence interval: 6.0%, 12.0%), 8.0% (6.0, 11·0) and 7.0% (5.0, 10.0), respectively. Mild periodontitis was more strongly associated with PM2.5 exposure than moderate and severe periodontitis. The teeth in the lower anterior, lower posterior or upper anterior are more susceptible to the effect of PM2.5 on the periodontal pocket, calculus and bleeding gums. Conclusions: Long‐term exposure to PM2.5 is significantly associated with an increased risk of periodontitis in the nationally representative Chinese population. Considering the rising prevalence of periodontitis, considerable costs of treatment, and substantially adverse effects on individuals and society, these findings suggest that stricter air quality regulations may help ease the burden of periodontal disease. [ABSTRACT FROM AUTHOR]

Clean air actions (CAAs) in China have been linked to considerable benefits in public health. However, whether the beneficial effects of CAAs are equally distributed geographically is unknown. Using high-resolution maps of the distributions of major air pollutants (fine particulate matter [PM2.5] and ozone [O3]) and population, we aimed to track spatiotemporal changes in health impacts from, and geographic inequality embedded in, the reduced exposures to PM2.5 and O3 from 2013 to 2020. We used a method established by the Global Burden of Diseases Study. By analyzing the changes in loss of life expectancy (LLE) attributable to PM2.5 and O3, we calculated the gain of life expectancy (GLE) to quantify the health benefits of the air-quality improvement. Finally, we assessed the geographic inequality embedded in the GLE using the Gini index (GI). Based on risk assessments of PM2.5 and O3, during the first stage of CAAs (2013 to 2017), the mean GLE was 1.87 months. Half of the sum of the GLE was disproportionally distributed in about one quarter of the population exposed (GI 0.44). During the second stage of CAAs (2017 to 2020), the mean GLE increased to 3.94 months and geographic inequality decreased (GI 0.18). According to our assessments, CAAs were enhanced, from the first to second stages, in terms of not only preventing premature mortality but also ameliorating health inequalities. The enhancements were related to increased sensitivity to the health effects of air pollution and synergic control of PM2.5 and O3 levels. Our findings will contribute to optimizing future CAAs. [ABSTRACT FROM AUTHOR]

Outdoor air pollution has been considered as a severe environmental health issue that almost affecting everyone in the world, and intensive actions were launched. However, little is known about the association between dynamic changes in ambient fine particulate matter (PM2.5) exposure and body mass index (BMI) among old adults. To investigate the dynamic changes in ambient PM2.5 and body mass index among the elderly, we included a total of 7204 participants from 28 provinces of China during 2011–2015 in the China Health and Retirement Longitudinal Study (CHARLS). Ambient fine particle matter (PM2.5) was estimated using a well-validated space–time extremely randomized trees model. Change in PM2.5 and BMI (ΔPM2.5 and ΔBMI) were calculated as the value at a follow-up visit minus value at baseline. Linear mixed-effects models were applied to quantify the associations, controlling for sociodemographic factors. We found that per 1 μg/m3 increase in PM2.5 exposure was associated with a 0.031–0.044 kg/m2 increase in BMI among the elderly. We observed an approximate linear concentration-response relationship of PM2.5 and BMI in each visit. Each 1 μg/m3 increase in ΔPM2.5 exposure was associated with an increase in ΔBMI (β = 0.040, 95% CI 0.030, 0.049), while per 1 μg/m3 decrease in the ΔPM2.5 exposure level was associated with a decrease in ΔBMI (β = −0.016, 95% CI −0.027, −0.004). Our findings suggest that dynamic changes in ambient PM2.5 was positively associated with changes in BMI among old Chinese population. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the correlation between environmental PM2.5 and heart failure (HF) hospitalization in Lanzhou. China. Method: The correlation between atmospheric PM, 5 and HF hospitalization was evaluated using a distributed lag nonlinear model. Result: During the study period, 16,122 HF patients were hospitalized. The average concentration of PM2.5 is 45.24 µg/m³. PM2.5 was positively correlated with HIT hospitalization with single lag (lagO) and cumulative lag (lagO], lag02, lag03). The maximum lag effect is estimated to occur in lag03, and with the PM2.5 concentration increasing by 10 µg/m³, HF hospitalization risk increased by 1.023 (95% confidence interval. 1.006-1.039). The risk of hospitalization for HF in the male group, the age group 65 years or older, and the cold season was statistically significant and more positively correlated. Conclusion: PM2.5 exposure increases the risk of HF admission in Lanzhou. [ABSTRACT FROM AUTHOR]

We investigated the association of long-term exposure to atmospheric PM2.5 with non-accidental and cause-specific mortality in Yinzhou, China. From July 2015 to January 2018, a total of 29,564 individuals aged ≥ 40 years in Yinzhou were recruited for a prospective cohort study. We used the Cox proportional-hazards model to analyze the relationship of the 2-year average concentration of PM2.5 prior to the baseline with non-accidental and cause-specific mortality. The median PM2.5 concentration was 36.51 μg/m3 (range: 25.57–45.40 μg/m3). In model 4, the hazard ratios per 10 μg/m3 increment in PM2.5 were 1.25 (95%CI: 1.04–1.50) for non-accidental mortality and 1.38 (95%CI:1.02–1.86) for cardiovascular disease mortality. We observed no associations between PM2.5 and deaths from respiratory disease or cancer. In the subgroup analysis, interactions were observed between PM2.5 and age, as well as preventive measures on hazy days. The observed association between long-term exposure to atmospheric PM2.5 at a relatively moderate concentration and the risk of non-accidental and cardiovascular disease mortality among middle-aged and elderly Chinese adults could provide evidence for government decision-makers to revise environmental policies towards a more stringent standard. [ABSTRACT FROM AUTHOR]

Globally, air pollution is the fourth leading risk factor for death, while lung cancer (LC) is the leading cause of cancer-related death. The aim of this study was to explore the prognostic factors of LC and the influence of high fine particulate matter (PM2.5) on LC survival. Data on LC patients were collected from 133 hospitals across 11 cities in Hebei Province from 2010 to 2015, and survival status was followed up until 2019. The personal PM2.5 exposure concentration (μg/m3) was matched according to the patient's registered address, calculated from a 5-year average for every patient, and stratified into quartiles. The Kaplan–Meier method was used to estimate overall survival (OS), and Cox's proportional hazard regression model was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). The 1-, 3-, and 5-year OS rates of the 6429 patients were 62.9%, 33.2%, and 15.2%, respectively. Advanced age (75 years or older: HR = 2.34, 95% CI: 1.25–4.38), subsite at overlapping (HR = 4.35, 95% CI: 1.70–11.1), poor/undifferentiated differentiation (HR = 1.71, 95% CI: 1.13–2.58), and advanced stages (stage III: HR = 2.53, 95% CI: 1.60–4.00; stage IV: HR = 4.00, 95% CI: 2.63–6.09) were risk factors for survival, while receiving surgical treatment was a protective factor (HR = 0.60, 95% CI: 0.44–0.83). Patients exposed to light pollution had the lowest risk of death with a 26-month median survival time. The risk of death in LC patients was greatest at PM2.5 concentrations of 98.7–108.9 μg/m3, especially for patients at advanced stage (HR = 1.43, 95% CI: 1.29–1.60). Our study indicates that the survival of LC is severely affected by relatively high levels of PM2.5 pollution, especially in those with advanced-stage cancer. [ABSTRACT FROM AUTHOR]

This paper investigates the impact of air pollution on students' cognitive performance in a high-stakes exam: China's College English Test (CET). We match exams taken from 2013 to 2017 at 22 universities across China with hourly air pollution measures from the nearest monitoring stations. Identification leverages a student fixed effects model, which alleviates the concern of omitted variables, such as students' ability. Our estimates indicate a statistically significant negative impact of fine particulate matters (PM 2.5 ) exposure during exam windows on cognitive performance. By focusing on a single language exam, instead of comparing performance across different test subjects, we are able to paint a more accurate picture of the cognitive impact of air pollution. We highlight the importance of short-term air pollution exposure for high-stakes cognitive performance. Our results suggest that temporary defensive measures could be important in mitigating the negative consequences of air pollution. [ABSTRACT FROM AUTHOR]

This review aimed to systematically summarize the epidemiological literature on the cardiorespiratory effects of PM 2.5 published during the 13th Five-Year Plan period (2016–2020) in China. Original articles published between January 1, 2016 and June 30, 2021 were searched in PubMed, Web of Science, the China National Knowledge Internet Database and Wanfang Database. Random- or fixed-effects models were used to pool effect estimates where appropriate. Of 8558 records identified, 145 met the full eligibility criteria. A 10 µg/m³ increase in short-term PM 2.5 exposure was significantly associated with increases of 0.70%, 0.86%, 0.38% and 0.96% in cardiovascular mortality, respiratory mortality, cardiovascular morbidity, and respiratory morbidity, respectively. The specific diseases with significant associations included stroke, ischemic heart disease, heart failure, arrhythmia, chronic obstructive pulmonary disease, pneumonia and allergic rhinitis. The pooled estimates per 10 µg/m³ increase in long-term PM 2.5 exposure were 15.1%, 11.9% and 21.0% increases in cardiovascular, stroke and lung cancer mortality, and 17.4%, 11.0% and 4.88% increases in cardiovascular, hypertension and lung cancer incidence respectively. Adverse changes in blood pressure, heart rate variability, systemic inflammation, blood lipids, lung function and airway inflammation were observed for either short-term or long-term PM 2.5 exposure, or both. Collectively, we summarized representative exposure-response relationships between short- and long-term PM 2.5 exposure and a wide range of cardiorespiratory outcomes applicable to China. The magnitudes of estimates were generally smaller in short-term associations and comparable in long-term associations compared with those in developed countries. Our findings are helpful for future standard revisions and policy formulation. There are still some notable gaps that merit further investigation in China. [Display omitted] [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association of ambient PM2.5 exposure with blood pressure (BP) at the population level in China. A total of 14,080 participants who had at least two valid blood pressure records were selected from the China Health and Retirement Longitudinal Survey during 2011–2015. Their long-term PM 2.5 exposure was assessed at the geographical level, on the basis of a regular 0.1° × 0.1° grid over China. A mixed-effects regression model was used to assess associations. Each decrease of 10 μg/m3 in the 1 year-mean PM 2.5 concentration (FPM 1Y) was associated with a decrease of 1.24 [95% confidence interval (CI): 0.84–1.64] mmHg systolic BP (SBP) and 0.50 (95% CI : 0.25–0.75) mmHg diastolic BP (DBP), respectively. A robust association was observed between the long-term decrease in PM 2.5 and decreased BP in the middle-aged and older population. Using a generalized additive mixed model, we further found that SBP increased nonlinearly overall with FPM 1Y but in an approximately linear range when the FPM 1Y concentration was < 70 μg/m3; In contrast, DBP increased approximately linearly without a clear threshold. Efficient control of PM 2.5 air pollution may promote vascular health in China. Our study provides robust scientific support for making the related air pollution control policies. [ABSTRACT FROM AUTHOR]

Summary: We hypothesized that air pollution could cause oxidative damage and inflammation in the human body, which was linked to bone loss. Our result showed that long-term exposure to air pollution might decrease bone mineral density (BMD) T-score and increase the prevalence of osteoporosis in Hubei province. Introduction: Osteoporosis is becoming an increasingly serious public health problem with the advent of global aging. Long-term exposure to air pollution has been linked to multitudinous adverse health outcomes, but evidence is still relatively limited and inconsistent for BMD T-score and osteoporosis. This study aimed at exploring the associations between long-term exposure to air pollution and BMD T-score and osteoporosis. Methods: The Hubei part of the China Osteoporosis Prevalence Study was extracted. Data on air pollutants were collected by the national air quality real-time release platform of China Environmental Monitoring Station. Linear mixed models and multilevel logistic regression analyses were performed to assess the associations between air pollution and BMD T-score and osteoporosis, respectively. Subgroup analyses were conducted to identify vulnerable populations. Results: A total of 1845 participants were included in this cross-section study. Per 10 ug/m3 increase in PM2.5 and SO2 were associated with 0.20 (95% CI: 0.04, 0.36) and 0.31 (95% CI: 0.11, 0.51) decrease in BMD T-score of the neck of femur, respectively. Per 10 ug/m3 increase in CO was linked with 0.03 (95% CI: 0.02, 0.05) decrease in BMD T-score of the total hip. Per 1 ug/m3 increase in PM2.5 was associated with 5% increase in the prevalence of osteoporosis in all participants. In general, the higher concentrations of PM2.5 with the more adverse effect on osteoporosis (P for trend = 0.01). The impact of PM2.5 on osteoporosis in males was higher than that in females [1.29, 95% CI (1.11, 1.50) vs 1.01, 95% CI (0.95, 1.07)]. Per 1 ug/m3 increase in PM10 corresponded with 4% elevation in the risks of osteoporosis in rural population. The ORs (95% CI) for the association of osteoporosis and NO2 in ever/current smoking and drinking population were 1.07 (1.01, 1.13) and 1.05 (1.00, 1.09), respectively. SO2 had a statistically significant positive effect on people with comorbidity [OR = 1.10, (95% CI: 1.00 to 1.21)], while none in people without comorbidity [OR = 0.96, (95% CI: 0.88 to 1.05)]. Conclusion: Our study provided evidence that long-term exposure to PM2.5 was linked with the decreased BMD T-score and increased risk of osteoporosis among all participants. The adverse impacts of PM2.5, PM10, and NO2 were larger in males than in females. People having comorbidity, living in rural areas, and current/ever smoking or drinking were more vulnerable to air pollution. Public health departments should consider air pollution to formulate better preventive measures for osteoporosis. [ABSTRACT FROM AUTHOR]

Background: Dietary fish-oil supplementation might attenuate the associations between fine particulate matter (PM2.5) and subclinical biomarkers. However, the molecular mechanisms remain to be elucidated. This study aimed to explore the molecular mechanisms of fish-oil supplementation against the PM2.5-induced health effects.Methods: We conducted a randomized, double-blinded, and placebo-controlled trial among healthy college students in Shanghai, China, from September 2017 to January 2018. A total of 70 participants from the Fenglin campus of Fudan University were included. We randomly assigned participants to either supplementation of 2.5-gram fish oil (n = 35) or sunflower-seed oil (placebo) (n = 35) per day and conducted four rounds of health measurements in the last two months of the trial. As a post hoc exploratory study, the present untargeted metabolomics analysis used remaining blood samples collected in the previous trial and applied a Metabolome-Wide Association Study framework to compare the effects of PM2.5 on the metabolic profile between the sunflower-seed oil and fish oil groups.Results: A total of 65 participants completed the trial (34 of the fish oil group and 31 of the sunflower-seed oil group). On average, ambient PM2.5 concentration on the day of health measurements was 34.9 µg/m3 in the sunflower-seed oil group and 34.5 µg/m3 in the fish oil group, respectively. A total of 3833 metabolites were significantly associated with PM2.5 in the sunflower-seed oil group and 1757 in the fish oil group. Of these, 1752 metabolites showed significant between-group differences. The identified differential metabolites included arachidonic acid derivatives, omega-3 fatty acids, omega-6 fatty acids, and omega-9 fatty acids that were related to unsaturated fatty acid metabolism, which plays a role in the inflammatory responses.Conclusion: This trial suggests fish-oil supplementation could mitigate the PM2.5-induced inflammatory responses via modulating fatty acid metabolism, providing biological plausibility for the health benefits of fish-oil supplementation against PM2.5 exposure.Trial Registration: This study is registered at ClinicalTrails.gov (NCT03255187). [ABSTRACT FROM AUTHOR]

Ambient exposure to fine particulate matter (PM2.5) in eastern China, a densely populated region with very high-level PM2.5 pollution, has attracted great concern from the public, government, and scientific community. By taking advantage of advanced statistical methods and a high-resolution PM2.5 dataset, this study explicitly investigated the spatiotemporal changes in PM2.5 in eastern China from 2001 to 2018 at multiple spatial and temporal scales and examined its links with natural and socioeconomic factors to explore their effects on PM2.5 changes. This study found that the PM2.5 concentration in most of eastern China declined recently, while most of the discernable decreasing trends occurred in the southern and western areas of the study domain, and the statistically significant increasing trends were primarily in the North China Plain. The influencing factors analysis found that, among the selected four natural and five anthropogenic factors, temperature, and population density exerted more potent effects than the other influencing factors, and all the influencing factors were found to impose complex effects on the PM2.5 concentration over space and time. Our study draws a complete picture of the changes in PM2.5 and its possible influences, which could guide future actions to mitigate PM2.5 pollution in eastern China. [ABSTRACT FROM AUTHOR]

Exposure to fine particulate matter (PM 2.5 ) poses numerous health risks, with oxidative potential (OP) serving as a critical marker of its toxicity. Synthetic phenolic antioxidants (SPAs) and bisphenols (BPs) influence reactive oxygen species (ROS) levels in PM 2.5 , and exposure to these compounds induces oxidative stress in organisms, thereby potentially affecting the OP of PM 2.5 . We detected 26 phenols (including 12 SPAs, 5 transformation products (TPs), and 9 BPs) in PM 2.5 sample collected from October 2018 to September 2021 in Wuhan, China. Among them, 19 substances were detected at a detection frequency greater than 50 % in PM 2.5 sample. AO 2246 and BHT were the main components of SPAs, and BHT-Q and BPA had the highest concentrations in TPs and BPs, respectively. PM 2.5 mass concentrations and phenolic levels were higher in winter and autumn. Substances within groups were strongly correlated, suggesting the same or similar source of exposure. This finding aid in more precise pollution source identification and is crucial for comprehensively evaluating their combined health effects. Furthermore, we determined the OP of PM 2.5 and found that BPs were related to increased OP and ROS. This suggests that the toxicity of PM 2.5 is influenced not only by its concentration but also by its chemical composition, with BPs potentially enhancing its toxic effects. These factors should be fully considered when assessing the health impacts of PM 2.5 ., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

There is a lack of evidence from cohort studies on the causal association of long-term exposure to ambient fine particulate matter (PM 2.5 ) and its chemical components with the risk of nasopharyngeal carcinoma (NPC) recurrence. Based on a 10-year prospective cohort of 1184 newly diagnosed NPC patients, we comprehensively evaluated the potential causal links of ambient PM 2.5 and its chemical components including black carbon (BC), organic matter (OM), sulfate (SO 4 2- ), nitrate (NO 3 - ), and ammonium (NH 4 + ) with the recurrence risk of NPC using a marginal structural Cox model adjusted with inverse probability weighting. We observed 291 NPC patients experiencing recurrence during the 10-year follow-up and estimated a 33% increased risk of NPC recurrence (hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 1.02-1.74) following each interquartile range (IQR) increase in PM 2.5 exposure. Each IQR increment in BC, NH 4 + , OM, NO 3 - , and SO 4 2- was associated with HRs of 1.36 (95%CI: 1.13-1.65), 1.35 (95%CI: 1.07-1.70), 1.33 (95%CI: 1.11-1.59), 1.32 (95%CI: 1.06-1.64), 1.31 (95%CI: 1.08-1.57). The elderly, patients with no family history of cancer, no smoking history, no drinking history, and those with severe conditions may exhibit a greater likelihood of NPC recurrence following exposure to PM 2.5 and its chemical components. Additionally, the effect estimates of the five components are greater among patients who were exposed to high concentration than in the full cohort of patients. Our study provides solid evidence for a potential relationship between long-term exposure to PM 2.5 and its components and the risk of NPC recurrence., (© 2024 UICC.)

China's swift socioeconomic development has led to extremely severe ambient PM 2.5 levels, the associated negative health outcomes of which include premature death. However, a comprehensive explanation of the socioeconomic mechanism contributing to PM 2.5 -related premature deaths has not yet to be fully elucidated through long-term spatial panel data. Here, we employed a global exposure mortality model (GEMM) and the system generalized method of moments (Sys-GMM) to examine the primary determinants contributing to premature deaths in Chinese provinces from 2000 to 2021. We found that in the research period, premature deaths in China increased by 46 %, reaching 1.87 million, a figure that decreased somewhat after the COVID-19 outbreak. 62 thousand premature deaths were avoided in 2020 and 2021 compared to 2019, primarily due to the decline in PM 2.5 concentrations. Premature deaths have increased across all provinces, particularly in North China, and a discernible spatial agglomeration effect was observed, highlighting effects on nearby provinces. The findings also underscored the significance of determinants such as urbanization, import and export trade, and energy consumption in exacerbating premature deaths, while energy intensity exerted a mitigating influence. Importantly, a U-shaped relationship between premature deaths and economic development was unveiled for the first time, implying the need for vigilance regarding potential health impact deterioration and the implementation of countermeasures as the per capita GDP increases in China. Our findings deserve attention from policymakers as they shed fresh insights into atmospheric control and Health China action., Competing Interests: Declaration of competing interest No conflict of interest exits in the submission of this manuscript, and manuscript is approved by all authors for publication. I would like to declare on behalf of my co-authors that the work described is original research that has not been published previously. The manuscript has also not been submitted to another journal for the consideration of publication. All the authors listed have approved the enclosed manuscript., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Previous studies have primarily focused on the links between fine particulate matter (PM 2.5 ) and bone health among the general population instead of PM 2.5 components and the specific population. We aimed to investigate the associations between PM 2.5 components and bone health among middle-aged and elderly women., Methods: A total of 748 middle-aged and elderly women were randomly sampled from 32 streets/villages in Hubei Province. The concentrations of ambient PM 2.5 and its components were extracted across various residential areas from the Tracking Air Pollution in China (TAP) dataset. Bone mineral density measurements were obtained from dual-energy X-ray absorptiometry scans of study participants. Multivariable logistic and linear models were employed to assess the relationship between PM 2.5 and its components and bone loss., Results: Per interquartile range (IQR) increase in nitrate (NO 3 - ) and ammonium (NH 4 + ) concentrations were associated with 1.65 [95% confidence intervals (CI): 1.13, 2.30] and 1.77 (95% CI: 1.26, 2.49) times higher odds of osteoporosis, respectively. Long-term exposure to sulfate (SO 4 2- ), NO 3 - , and NH 4 + was negatively associated with T-scores and bone mineral density in L1-L4 lumbar vertebrae. In addition, the elderly, women who have experienced menarche after the age of 14, and postmenopausal women were more susceptible to the water-soluble inorganic salts of PM 2.5 ., Conclusion: The study emphasizes the need for comprehensive policies addressing air quality, with a specific focus on vulnerable populations such as middle-aged and elderly women. Public health interventions aimed at reducing ambient PM 2.5 concentrations and minimizing exposure to its harmful components are crucial in mitigating the adverse impact on skeletal health and improving the overall well-being of communities., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Climate change and air pollution are major challenges facing the world today. Cold waves and air pollution significantly impact ischemic heart disease (IHD), but the extent of these effects at different altitudes remains unclear, especially their interactions. We collected daily meteorological, pollutant, and IHD hospitalization data from Xining and Xinxiang from 2016 to 2021. Using a time-stratified case-crossover approach, we fitted conditional Poisson regression models to assess the association between cold waves, PM 2.5 , and IHD hospitalizations and quantified their interactions. Additionally, we calculated the attributable fraction (AF) and attributable number (AN) of hospitalizations due to exposure to cold waves and medium to high-level PM 2.5 . We also performed stratified analyses by altitude, gender, and age. Both cold waves and PM 2.5 were positively associated with IHD hospitalization rates in Xining and Xinxiang, but the differences between the two regions were not significant. The relative risk of cold waves was 1.15 (1.07, 1.24) in Xining and 1.16 (1.11, 1.21) in Xinxiang. In Xining, there was an interaction between cold waves and different levels of PM 2.5 . We estimated the attributable fraction due to the joint exposure of cold waves and PM 2.5 to be 0.14-0.49 in Xining and 0.26-0.36 in Xinxiang. Older adults and males faced higher risks. This study highlights the importance of reducing PM 2.5 exposure and optimizing extreme weather warning systems and suggests further exploration of the impacts of individual behaviors and regional characteristics on IHD., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: There are a few reports on the associations between fine particulate matter (PM 2.5 )-bound heavy metals and lung function., Objectives: To evaluate the associations of single and mixed PM 2.5 -bound heavy metals with lung function., Methods: This study included 316 observations of 224 Chinese adults from the Wuhan-Zhuhai cohort over two study periods, and measured participants' personal PM 2.5 -bound heavy metals and lung function. Three linear mixed models, including the single constituent model, the PM 2.5 -adjusted constituent model, and the constituent residual model were used to evaluate the association between single metal and lung function. Mixed exposure models including Bayesian kernel machine regression (BKMR) model, weighted quantile sum (WQS) model, and Explainable Machine Learning model were used to assess the relationship between PM 2.5 -bound heavy metal mixtures and lung function., Results: In the single exposure analyses, significant negative associations of PM 2.5 -bound lead, antimony, and cadmium with peak expiratory flow (PEF) were observed. In the mixed exposure analyses, significant decreases in forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), maximal mid-expiratory flow (MMF), and forced expiratory flow at 75% of the pulmonary volume (FEF75) were associated with the increased PM 2.5 -bound heavy metal mixture. The BKMR models suggested negative associations of PM 2.5 -bound lead and antimony with lung function. In addition, PM 2.5 -bound copper was positively associated with FEV1/FVC, MMF, and FEF75. The Explainable Machine Learning models suggested that FEV1/FVC, MMF, and FEF75 decreased with the elevated PM 2.5 -bound lead, manganese, and vanadium, and increased with the elevated PM 2.5 -bound copper., Conclusions: The negative relationships were detected between PM 2.5 -bound heavy metal mixture and FEV1/FVC, MMF, as well as FEF75. Among the PM 2.5 -bound heavy metal mixture, PM 2.5 -bound lead, antimony, manganese, and vanadium were negatively associated with FEV1/FVC, MMF, and FEF75, while PM 2.5 -bound copper was positively associated with FEV1/FVC, MMF, and FEF75., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Enhanced cardiovascular health (CVH) is linked to reduced mortality risks, whereas long-term exposure to fine particulate matter (PM 2.5 ), elevates these risks. Whether long-term exposure to PM 2.5 counteracts the health benefits of high CVH is unknown. The study aims to evaluate whether the association of CVH assessed by Life's Essential 8 (LE8) with death was consistent between participants with different PM 2.5 exposures., Methods: We included 134,727 participants in the field survey of China Chronic Disease and Risk Factor Surveillance which was conducted from August 2013 to June 2014. The deaths of participants were obtained by linking to the National Mortality Surveillance System (2013-2018). The environmental data is obtained by satellite inversion. The participants' CVH scores were calculated using the LE8 method. Hazard ratio (HR) and 95% confidence intervals (95%CI) for mortality were calculated using Cox regression models., Results: A total of 2,936 all-cause deaths and 1,158 cardiovascular disease (CVD) deaths were recorded. Compared to those with low CVH, adults with high CVH demonstrated a reduced risk of all-cause mortality, irrespective of their PM 2.5 exposure levels (P < 0.05, all P for interaction >0.05). Furthermore, in comparison to those with low CVH and highest PM 2.5 exposure, adults with high CVH and lowest PM 2.5 exposure exhibited HR of 0.18 (95%CI, 0.12-0.25) for all-cause mortality and 0.13 (95%CI, 0.08-0.22) for CVD mortality., Conclusions: High CVH is associated with reduced all-cause mortality risk, regardless of PM 2.5 exposure levels. For Chinese adults, sustaining high CVH is advisable, irrespective of their residential location., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Prenatal exposure to fine particulate matter (PM 2.5 ) has been linked with increased neurodevelopmental disorders. However, the most detrimental component of PM 2.5 and the most vulnerable exposure time windows remain undetermined, especially in areas with high PM 2.5 levels. In a prospective cohort study involving 4494 mother-child dyads, we examined the associations of prenatal exposure to PM 2.5 and its four main components with children's neurodevelopmental and behavioral problems (NBPs), separately in three pregnancy trimesters. Poisson regression and generalized additive models were used to depict the linear and nonlinear associations, respectively. Weighted quantile sum and Bayesian kernel machine regression models were applied to examine the effects of exposure to both mixed and individual components. Results showed that exposure to PM 2.5 and its components throughout the three trimesters increased the risk of children's NBPs (Risk ratio for PM 2.5 : 1.16, 95 % confidence interval 1.14-1.18 per μg/m 3 in the first trimester; 1.15, 1.12-1.17 in the second trimester; 1.06, 1.04-1.08 in the third trimester), with associations gradually diminishing as pregnancy progressed (P values for trends < 0.05). Among the four main components of PM 2.5 , exposure to SO 4 2- posed the highest risks on children's NBPs, while organic matter contributed the largest proportion to the overall impacts of PM 2.5 exposure. These results underscore the significance of mitigating PM 2.5 exposure in pregnant women to reduce the risk of neurodevelopmental disorders in offspring. Our findings would inform risk assessment of PM 2.5 exposure and facilitate the development of precision preventive strategies targeting specific components of PM 2.5 in similar areas with high levels of exposure., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Short-term exposure to particulate matter air pollution has been associated with the exacerbations of COPD, but its association with COPD mortality was not fully elucidated. We aimed to assess the association between short-term particulate matter exposure and the risk of COPD mortality in China using individual-level data., Methods: We derived 2.26 million COPD deaths from a national death registry database in Chinese mainland between 2013 and 2019. Exposures to fine particulate matter (PM 2.5 ) and coarse particulate matter (PM 2.5-10 ) were assessed by satellite-based models of a 1 × 1 km resolution and assigned to each individual based on residential address. The associations of PM 2.5 and PM 2.5-10 with COPD mortality were examined using a time-stratified case-crossover design and conditional logistic regressions with distributed lag models. We further conducted stratified analyses by age, sex, education level, and season., Findings: Short-term exposures to both PM 2.5 and PM 2.5-10 were associated with increased risks of COPD mortality. These associations appeared and peaked on the concurrent day, attenuated and became nonsignificant after 5 or 7 days, respectively. The exposure-response curves were approximately linear without discernible thresholds. An interquartile range increase in PM 2.5 and PM 2.5-10 concentrations was associated with 4.23% (95% CI: 3.75%, 4.72%) and 2.67% (95% CI: 2.18%, 3.16%) higher risks of COPD mortality over lag 0-7 d, respectively. The associations of PM 2.5 and PM 2.5-10 attenuated slightly but were still significant in the mutual-adjustment models. A larger association of PM 2.5-10 was observed in the warm season., Interpretation: This individual-level, nationwide, case-crossover study suggests that short-term exposure to PM 2.5 and PM 2.5-10 might act as one of the environmental risk factors for COPD mortality., Funding: This study is supported by the National Key Research and Development Program of China (2023YFC3708304 and 2022YFC3702701), the National Natural Science Foundation of China (82304090 and 82030103), the 3-year Action Plan for Strengthening the Construction of the Public Health System in Shanghai (GWVI-11.2-YQ31), and the Science and Technology Commission of Shanghai Municipality (21TQ015)., Competing Interests: Declaration of interests All authors declare no potential conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Up until now, evidence pertaining to the short-term effects of fine particulate matter (PM2.5) in cardiovascular diseases (CVD) is scarce in China. In this study, we aim to estimate the association between short-term exposure to PM2.5 and hospitalizations for total and cause-specific CVD in Lanzhou of China. Methods: Daily counts of cardiovascular admissions were obtained from three large general hospitals in Lanzhou, China between 2014 and 2019. Air quality and meteorological data were obtained from the monitoring stations nearest to the admitting hospitals. We utilized Quasi-Poisson time-series regressions with distributed lag nonlinear models (DLNM) to assess the association between PM2.5 and CVD admitted in the three general hospitals. A stratified analysis was also conducted for age, sex, and disease subcategories. Results: PM2.5 was positively correlated with daily admissions for total or other cause-specific CVD under different lag patterns. For every 10 μg/m3 increase in the PM2.5 concentration, the relative risk of daily admissions for total CVD, ischemic heart disease (IHD), heart rhythm disturbances (HRD), heart failure (HF), and cerebrovascular disease (CD) was: 1.011 [95% confidence interval (CI), 1.001–1.020] in lag01; 1.020 (95% CI 1.004–1.036) in lag07; 1.013 (95% CI 1.001–1.026) in lag7; 1.018 (95% CI 1.005–1.038) in lag1; and 1.007 (95% CI 1.001–1.018) in lag1. Both low and high temperatures increased the risk of cardiovascular hospitalization. No differences were found after stratification by gender and age. We found an almost linear relationship between the exposure to PM2.5 and cause-specific CVD admissions with no threshold effect. Males as well as the elderly, aged ≥ 65 years, were more vulnerable to PM 2.5 exposure. Conclusions: Our results have demonstrated that PM2.5 has adverse impacts on cardiovascular hospitalizations in Lanzhou, especially on IHD. [ABSTRACT FROM AUTHOR]

Limited studies in China have explored the association between gravidae exposure to PM 2.5 and small for gestational age infants (SGA), yielding inconsistent results. This study in Wuhan utilized daily excessive concentration hours (DECH) as a novel measure to assess PM 2.5 's impact on SGA. Data on air pollutants and pregnant women were collected from the Wuhan Municipal Ecology and Environmental Bureau and Wuhan Children's Hospital, respectively. Logistic regression models were employed to evaluate the contribution of PM 2.5 -DECH and PM 2.5 -mean to SGA. Significant correlations were observed between PM 2.5 -mean and SGA during the second trimester [OR = 1.23 (95% CI: 1.14-1.32)] and the entire pregnancy [OR = 1.15 (95% CI: 1.07-1.24)]. Similar correlations were found between PM 2.5 -DECH and SGA. These findings suggest that increased PM 2.5 exposure is associated with a higher risk of SGA, and DECH may be used as a prospective substitute indicator for daily average concentration in similar studies.

Association between fine particulate matter (PM2.5) and respiratory health has attracted great concern in China. Substantial epidemiological evidences confirm the correlational relationship between PM2.5 and respiratory disease in many Chinese cities. However, the causative impact of PM2.5 on respiratory disease remains uncertain and comparative analysis is limited. This study aims to explore and compare the correlational relationship as well as the causal connection between PM2.5 and upper respiratory tract infection (URTI) in two typical cities (Beijing, Shenzhen) with rather different ambient air environment conditions. The distributed lag nonlinear model (DLNM) was used to detect the correlational relationship between PM2.5 and URTI by revealing the lag effect pattern of PM2.5 on URTI. The convergent cross mapping (CCM) method was applied to explore the causal connection between PM2.5 and URTI. The results from DLNM indicate that an increase of 10 μg/m3 in PM2.5 concentration is associated with an increase of 1.86% (95% confidence interval: 0.74%-2.99%) in URTI at a lag of 13 days in Beijing, compared with 2.68% (95% confidence interval: 0.99–4.39%) at a lag of 1 day in Shenzhen. The causality detection with CCM quantitatively demonstrates the significant causative influence of PM2.5 on URTI in both two cities. Findings from the two methods consistently show that people living in low-concentration areas (Shenzhen) are less tolerant to PM2.5 exposure than those in high-concentration areas (Beijing). In general, our study highlights the adverse health effects of PM2.5 pollution on the general public in cities with various PM2.5 levels and emphasizes the needs for the government to provide appropriate solutions to control PM2.5 pollution, even in cities with low PM2.5 concentration. [ABSTRACT FROM AUTHOR]

Background Limited data suggest that household air pollution from cooking and heating with solid fuel (i.e. coal and biomass) stoves may contribute to the development of hypertension and vascular damage. Methods Using mixed-effects regression models, we investigated the associations of household air pollution with blood pressure (BP) and vascular function in 753 adults (ages 40–79 years) from 3 diverse provinces in China. We conducted repeated measures of participants' household fuel use, personal exposure to fine particulate air pollution (PM2.5), BP, brachial–femoral pulse wave velocity (bfPWV), and augmentation index. Ultrasound images of the carotid arteries were obtained to assess intima–media thickness (CIMT) and plaques. Covariate information on sociodemographics, health behaviors, 24-h urinary sodium, and blood lipids was also obtained. Results Average estimated yearly personal exposure to PM2.5 was 97.5 µg/m3 (SD: 79.2; range: 3.5–1241), and 65% of participants cooked with solid fuel. In multivariable models, current solid fuel use was associated with higher systolic (2.4 mm Hg, 95% CI: −0.4, 4.9) and diastolic BP (1.4 mm Hg, 95% CI: −0.1, 3.0) and greater total area of plaques (1.7 mm2, 95% CI: −6.5, 9.8) compared with exclusive use of electricity or gas stoves. A 1 − ln(µg/m3) increase in PM2.5 exposure was associated with higher systolic (1.5 mm Hg, 95% CI: 0.2, 2.7) and diastolic BP (1.0 mm Hg, 95% CI: 0.4, 1.7) and with greater CIMT (0.02 mm, 95% CI: 0.00, 0.04) and total area of plaques (4.7 mm2, 95% CI: −2.0, 11.5). We did not find associations with arterial stiffness, except for a lower bfPWV (−1.5 m/s, 95% CI: −3.0, −0.0) among users of solid fuel heaters. Conclusions These findings add to limited evidence that household air pollution is associated with higher BP and with greater CIMT and total plaque area. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence that exposure to PM 2.5 and its constituents is associated with an increased risk of gestational diabetes mellitus (GDM), but studies on the relationship between exposure to PM 2.5 constituents and the risk of GDM are still limited., Methods: A total of 17,855 pregnant women in Guangzhou were recruited for this retrospective cohort study, and the time-varying average concentration method was used to estimate individual exposure to PM 2.5 and its constituents during pregnancy. Logistic regression was used to assess the relationship between exposure to PM 2.5 and its constituents and the risk of GDM, and the expected inflection point between exposure to PM 2.5 and its constituents and the risk of GDM was estimated using logistic regression combined with restricted cubic spline curves. Stratified analyses and interaction tests were performed., Results: After adjustment for confounders, exposure to PM 2.5 and its constituents (NO 3 - , NH 4 + , and OM) was positively associated with the risk of GDM during pregnancy, especially when exposure to NO 3 - and NH 4 + occurred in the first to second trimester, with each interquartile range increase the risk of GDM by 20.2% (95% CI: 1.118-1.293) and 18.2% (95% CI. 1.107-1.263), respectively. The lowest inflection points between PM 2.5 , SO 4 2- , NO 3 - , NH 4 + , OM, and BC concentrations and GDM risk throughout the gestation period were 18.96, 5.80, 3.22, 2.67, 4.77 and 0.97 µg/m 3 , respectively. In the first trimester, an age interaction effect between exposure to SO 4 2- , OM, and BC and the risk of GDM was observed., Conclusions: This study demonstrates a positive association between exposure to PM 2.5 and its constituents and the risk of GDM. Specifically, exposure to NO 3 - , NH 4 + , and OM was particularly associated with an increased risk of GDM. The present study contributes to a better understanding of the effects of exposure to PM 2.5 and its constituents on the risk of GDM., (© 2024. The Author(s).)

Short-term exposure to PM 2.5 or O 3 can increase mortality risk; however, limited studies have evaluated their interaction. A multicity time series study was conducted to investigate the synergistic effect of PM 2.5 and O 3 on mortality in China, using mortality data and high-resolution pollutant predictions from 272 cities in 2013-2015. Generalized additive models were applied to estimate associations of PM 2.5 and O 3 with mortality. Modification and interaction effects were explored by stratified analyses and synergistic indexes. Deaths attributable to PM 2.5 and O 3 were evaluated with or without modification of the other pollutant. The risk of total nonaccidental mortality increased by 0.70% for each 10 μg/m 3 increase in PM 2.5 when O 3 levels were high, compared to 0.12% at low O 3 levels. The effect of O 3 on total nonaccidental mortality at high PM 2.5 levels (1.26%) was also significantly higher than that at low PM 2.5 levels (0.59%). Similar patterns were observed for cardiovascular or respiratory diseases. The relative excess risk of interaction and synergy index of PM 2.5 and O 3 on nonaccidental mortality were 0.69% and 1.31 with statistical significance, respectively. Nonaccidental deaths attributable to short-term exposure of PM 2.5 or O 3 when considering modification of the other pollutant were 28% and 31% higher than those without considering modification, respectively. Our results found synergistic effects of short-term coexposure to PM 2.5 and O 3 on mortality and suggested underestimations of attributable risks without considering their synergistic effects.

Accumulating animal studies have demonstrated associations between ambient air pollution (AP) and metabolic dysfunction-associated fatty liver disease (MAFLD), but relevant epidemiological evidence is limited. We evaluated the association of long-term exposure to AP with the risk of incident MAFLD in Northwest China. The average AP concentration between baseline and follow-up was used to assess individual exposure levels. Cox proportional hazard models and restricted cubic spline functions (RCS) were used to estimate the association of PM 2.5 and its constituents with the risk of MAFLD and the dose-response relationship. Quantile g-computation was used to assess the joint effects of mixed exposure to air pollutants on MAFLD and the weights of the various pollutants. We observed 1516 cases of new-onset MAFLD, with an incidence of 10.89%. Increased exposure to pollutants was significantly associated with increased odds of MAFLD, with hazard ratios (HRs) of 2.93 (95% CI: 1.22, 7.00), 2.86 (1.44, 5.66), 7.55 (3.39, 16.84), 4.83 (1.89, 12.38), 3.35 (1.35, 8.34), 1.89 (1.02, 1.62) for each interquartile range increase in PM 2.5 , SO 4 2- , NO 3 - , NH 4 + , OM, and BC, respectively. Stratified analyses suggested that females, frequent exercisers and never-drinkers were more susceptible to MAFLD associated with ambient PM 2.5 and its constituents. Mixed exposure to SO 4 2- , NO 3 - , NH 4 + , OM and BC was associated with an increased risk of MAFLD, and the weight of BC had the strongest effect on MAFLD. Exposure to ambient PM 2.5 and its constituents increased the risk of MAFLD., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Fine particulate matter (PM 2.5 ) is a risk factor of cardiovascular disease. Associations between PM 2.5 compositions and cardiovascular disease are a point of special interest but inconsistent. This study aimed to explore the cardiovascular effects of heavy metal(loid) compositions in PM 2.5 . Data for mortality, air pollutants and meteorological factors in Anyang, China from 2017 to 2021 were collected. Heavy metal(loid) in PM 2.5 were monitored and examined monthly. A Case-crossover design was applied to the estimated data set. The interquartile range increase in cadmium (Cd), antimony (Sb) and arsenic (As) at lag 1 was associated with increment of 8.1% (95% CI: 3.3, 13.2), 4.8% (95% CI: 0.2, 9.5) and 3.5% (95% CI: 1.1, 6.0) cardiovascular mortality. Selenium in lag 2 was inversely associated with cerebrovascular mortality (RR = 0.920 95% CI: 0.862, 0.983). Current-day exposure of aluminum was positively associated with mortality from ischemic heart disease (RR = 1.083 95% CI: 1.001, 1.172). Stratified analysis indicated sex, age and season modified the cardiovascular effects of As (P < 0.05). Our study reveals that heavy metal(loid) play key roles in adverse effects of PM 2.5 . Cd, Sb and As were significant risk factors of cardiovascular mortality. These findings have potential implications for accurate air pollutants control and management to improve public health benefits., (© 2024. The Author(s) under exclusive licence to International Society of Biometeorology.)

Distinguishing the effects of different fine particulate matter components (PMCs) is crucial for mitigating their effects on human health. However, the sparse distribution of locations where PM is collected for component analysis makes it challenging to investigate the relevant health effects. This study aimed to investigate the agreement between data-fusion-enhanced exposure assessment and site monitoring data in estimating the effects of PMCs on gestational diabetes mellitus (GDM). We first improved the spatial resolution and accuracy of exposure assessment for five major PMCs (EC, OM, NO 3 - , NH 4 + , and SO 4 ). Next, we compared the associations between exposures to PMCs during pregnancy and GDM in a hospital-based cohort of 1148 pregnant women in Heshan, China, using both site monitoring data and data-fusion model estimates. The comparative analysis showed that the data-fusion-based exposure generated stronger estimates of identifying statistical disparities. This study suggests that data-fusion-enhanced estimates can improve exposure assessment and potentially mitigate the misclassification of population exposure arising from the utilization of site monitoring data.2- ) in the Pearl River Delta region by a data fusion model that combined inputs from multiple sources using a random forest model (10-fold cross-validation R 2 : 0.52 to 0.61; root mean square error: 0.55 to 2.26 μg/m 3 ). Next, we compared the associations between exposures to PMCs during pregnancy and GDM in a hospital-based cohort of 1148 pregnant women in Heshan, China, using both site monitoring data and data-fusion model estimates. The comparative analysis showed that the data-fusion-based exposure generated stronger estimates of identifying statistical disparities. This study suggests that data-fusion-enhanced estimates can improve exposure assessment and potentially mitigate the misclassification of population exposure arising from the utilization of site monitoring data.

Since 2000, China has faced severe air pollution challenges，prompting the initiation of comprehensive emission control measures post-2013. The subsequent implementation of these measures has led to remarkable enhancements in air quality. This study aims to enhance our understanding of the long-term trends in fine particulate matter (PM 2.5 ) and gaseous pollutants of ozone (O 3 ) and nitrogen dioxide (NO 2 ) across China from 2000 to 2020. Utilizing the Community Multiscale Air Quality (CMAQ) model, we conducted a nationwide analysis of air quality, systematically quantifying model predictions against observations for pollutants. The CMAQ model effectively captured the trends of air pollutants, meeting recommended performance benchmarks. The findings reveal variations in pollutant concentrations, with initial increases in PM 2.5 followed by a decline after 2013. The proportion of the population living in high PM 2.5 concentrations (>75 μg/m 3 ) decreased to <5 % after 2015. However, during the period from 2017 to 2020, around 40 % of the population continued to live in regions that did not meet the criteria for Chinese air quality standards (35 μg/m 3 ). From 2000 to 2019, fewer than 20 % of the population met the WHO standard (100 μg/m 3 ) for MDA8 O 3 . In 2000, 77 % of the population met the NO 2 standard (<20 μg/m 3 ), a figure that declined to 60 % between 2005 and 2014, nearly reaching 70 % in 2020. This study offers a comprehensive analysis of the changes in pollutants and public exposure in 2000-2020. It serves as a foundational resource for future efforts in air pollution control and health research., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Due to the rapid economic development and acceleration of industrialization, most cities in China are experiencing severe air pollution. Exposure to fine particulate matter (PM2.5) has been associated with acute lower respiratory tract infection (ALRI). To estimate associations between short-term exposure to PM2.5 and ALRI hospitalization in Yancheng City, China. This was a 6-year time-series study from 2014 to 2019. Data on hospitalization were collected from four high-ranked general hospitals, including for community-acquired pneumonia (CAP), acute exacerbation of chronic bronchitis (AECB), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and acute exacerbation of bronchiectasis (AEB), and the sum was termed total ALRIs. We obtained pollutant exposure data from five fixed monitoring stations. The association between PM2.5 and ALRI hospitalization was estimated using the generalized linear model with quasi-Poisson regression. Two-pollutant models were applied to test the robustness of the observed correlations. Subgroup analyses included sex, age, and season. During the study period, a total of 43,283 cases of total ALRIs were recorded. The average annual mean PM2.5 concentration was 45.4 ± 32.3 μg/m3. A 10-μg/m3 increase in PM2.5 concentration (lag 0) was significantly associated with increases in hospitalizations for total ALRIs (at 0.73%; 95% CI: 0.40%, 1.06%), in CAP (at 0.80%; 95% CI: 0.02%, 1.57%), in for AECOPD (1.08%; 95% CI: 0.38%, 1.78%), and AECB (0.67%; 95% CI: 0.23%, 1.11%). The estimated effects for total ALRIs and AECB were relatively robust with adjustment for other air pollutants. Associations between PM2.5 and total ALRIs were stronger in females, in the elderly, and in the cold season. PM2.5 exposure was significantly associated with ALRI morbidity, and females and older people were more susceptible to PM2.5 air pollution, especially in the cold season. [ABSTRACT FROM AUTHOR]

Household fine particulate matter (PM2.5) pollution greatly impacts residents' health. To explore the current national situation of household PM2.5 pollution in China, a study was conducted based on literature published from 1998 to 2018. After extracting data from the literature in conformity with the requirements, the nationwide household‐weighted mean concentration of household PM2.5 (HPL) was calculated. Subgroup analyses of spatial, geographic, and temporal differences were also done. The estimated overall HPL in China was 132.2 ± 117.7 μg/m3. HPL in the rural area (164.3 ± 104.5 μg/m3) was higher than that in the urban area (123.9 ± 122.3 μg/m3). For HPLs of indoor sampling sites, the kitchen was the highest, followed by the bedroom and living room. There were significant differences of geographic distributions. The HPLs in the South were higher than the North in four seasons. The inhaled dose of household PM2.5 among school‐age children differed from provinces with the highest dose up to 5.9 μg/(kg·d). Countermeasures should be carried out to reduce indoor pollution and safeguard health urgently. [ABSTRACT FROM AUTHOR]

Ambient fine particulate matter (PM2.5), as one of the predominant air pollutants, has achieved effective control in recent years in China. Whether the use of indoor air purifiers is still necessary needs further exploration. A randomized crossover trial was conducted in 54 healthy students in Beijing, China. Participants were randomized assigned to the use of real or sham high‐efficiency particulate air filter (HEPA) for a week and changed the status after a washout period. Health measurements of cardiorespiratory biomarkers were performed at the end of each period. Linear mixed‐effects models were used to evaluate the association between PM2.5 exposure and cardiorespiratory biomarkers. Compared with sham air purification, average diastolic blood pressure (DBP), fractional exhaled nitric oxide (FeNO), and 8‐isoprostane (8‐isoPGF2α) levels decreased significantly in the real purification. The effects of indoor air purification on lung function indicators including forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and forced expiratory flow between the 25th and 75th percentile of forced vital capacity (FEF25%–75%) were also significant. Our findings showed a protective effect of indoor HEPA air purifiers on cardiorespiratory health of young healthy adults reflected by the decreased blood pressure, respiratory inflammation, and systematic oxidative stress and improved lung function. [ABSTRACT FROM AUTHOR]

Existing PM2.5-morbidity studies using daily mean concentration as exposure metric may fail to capture intra-day variations of PM2.5 concentrations, resulting in underestimated health impacts to some extent. This study introduced a novel indicator, daily excessive concentration hours (DECH), defined as sums of per-hourly excessive concentrations of PM2.5 against a specific threshold within a day. PM2.5 DECHs were separately calculated as daily concentration-hours >8, 10, 15, 20, and 25 μg/m3 (abbreviations: DECH-8, DECH-10, DECH-15, DECH-20, and DECH-25). We adopted a time-stratified case-crossover design with conditional logistic regression models to compare risks of hospitalizations for chronic obstructive pulmonary disease (COPD) associated with PM2.5 mean and DECHs in Shenzhen, China. We observed highly comparable PM2.5-COPD associations using exposure metrics of daily mean and DECHs with above-defined thresholds. For instance, PM2.5 mean and DECHs showed similar increases in risks of COPD hospitalization for an interquartile range rise in exposure, with odds ratio estimates of 1.26 (95% confidence interval: 1.06–1.50) for PM2.5 mean, 1.24 (1.05–1.46) for DECH-10 and 1.21 (1.06–1.39) for DECH-25, respectively. Findings remained robust after further adjusting for gaseous pollutants (e.g., SO2, NO2, CO, and O3) and meteorologic factors (e.g., wind speed and air pressure). Our study strengthened the evidence that DECHs could come be as a novel exposure metric in health risk assessments associated with short-term exposure to ambient PM2.5. [ABSTRACT FROM AUTHOR]

• PM 2.5 is associated with the increased surrogate indices of insulin resistance (IR). • Healthy diet could reduce the harm of long-term PM 2.5 exposure on surrogate indices. • IR is also attenuated by rational diet components despite challenge of PM 2.5 control. The relationship of fine particulate matter (PM 2.5) exposure and insulin resistance remains inclusive. Our study aimed to investigate this association in the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR). Specifically, we examined the associations between long-term PM 2.5 exposure and three surrogate indicators of insulin resistance: the triglyceride-glucose index (TyG), TyG with waist circumference (TyG-WC) and metabolic score for insulin resistance (METS-IR). Additionally, we explored potential effect modification of dietary intake and components. Generalized estimating equations were used to evaluate the associations between PM 2.5 and the indicators with an unbalanced repeated measurement design. Our analysis incorporated a total of 162,060 observations from 99,329 participants. Each 10 μg/m3 increment of PM 2.5 was associated with an increase of 0.22 % [95 % confidence interval (CI): 0.20 %, 0.25 %], 1.60 % (95 % CI: 1.53 %, 1.67 %), and 2.05 % (95 % CI: 1.96 %, 2.14 %) in TyG, TyG-WC, and METS-IR, respectively. These associations were attenuated among participants with a healthy diet, particularly those with sufficient intake of fruit and vegetable, fish or tea (p interaction < 0.0028). For instance, among participants with a healthy diet, TyG increased by 0.11 % (95 % CI: 0.08 %, 0.15 %) per 10 μg/m3 PM 2.5 increment, significantly lower than the association observed in those with an unhealthy diet. The findings of this study emphasize the potential of a healthy diet to mitigate these associations, highlighting the urgency for improving air quality and implementing dietary interventions among susceptible populations in China. [ABSTRACT FROM AUTHOR]

Analyzing the influencing factors of fine particulate matter and ozone formation and identifying the coupling relationship between the two are the basis for implementing the synergistic pollutants control. However, the current research on the synergistic relationship between the two still needs to be further explored. Using the Geodetector model, we analyzed the effects of meteorology and emissions on fine particulate matter and ozone concentrations over the "2 + 26" cities at multiple timescales, and also explored the coupling relationship between the two pollutants. Fine particulate matter concentrations showed overall decreasing trends on inter-season and inter-annual scale from 2015 to 2021, whereas ozone concentrations showed overall increasing trends. While ozone concentrations displayed an inverted U-shaped distribution from month to month, fine particulate matter concentrations displayed a U-shaped fluctuation. On inter-annual scale, climatic factors, with planet boundary layer height as the main determinant, have higher effects for both pollutants than human precursors. In summer and autumn, sunshine duration had the most influence on fine particulate matter, while planet boundary layer height was the greatest factor in winter. Fine particulate matter is the leading impacting factor on ozone concentrations in summer, and there were positive associations between them on both annual and seasonal scale. The impact of nitrogen oxides and volatile organic compounds for both pollutants concentrations varied significantly between seasons. The two pollutants concentration were enhanced by the interactions between the various components. On inter-annual scale, interactions between the planet boundary layer height and other factors dominated the concentrations of the two pollutants, whereas in summer, interactions between fine particulate matter and other factors dominated the concentrations of ozone. The study has implications for the treatment of atmospheric pollution in China and other nations and can serve as an important reference for the creation of integrated atmospheric pollution regulation policies over the "2 + 26" cities. [Display omitted] • Meteorology have stronger effects than emissions on inter-annual scale. • PM 2.5 plays the dominant role on O 3 formation in summer. • There is positive correlations between PM 2.5 and O 3 on inter-annual and inter-season scale. • Interactions between the factors exerted enhanced effects on the PM 2.5 and O 3 concentrations. [ABSTRACT FROM AUTHOR]

Hypertension, a major risk factor of many severe chronic diseases and leading cause of global disease burden, is reported to be associated with long-term exposure to PM2.5. China's high PM2.5 pollution level has become a major public health issue. However, existing studies from China have got inconsistent results with very limited investigation into the multi-ethnic peoples. This study adds multi-ethnic evidence from Sichuan Province, southwestern China, and assesses ethnic differences of PM2.5 exposure effect on hypertension. We pooled large cross-sectional data from two surveys conducted in 2013 and 2018 to examine the association of long-term exposure to PM2.5 on prevalence of hypertension in adults aged 30 years old and above. Community-specified annual PM2.5 concentration was estimated using satellite data. Thirty-one thousand four hundred sixty-two participants with average exposure concentration of 32.8 μg/m3 were included. The proportions of the Han, the Tibetan, the Yi, and other ethnic people were 89.2%, 7.3%, 3.2%, and 0.3%, respectively. The adjusted odds ratio (OR) was 1.08 (95% CI, 1.04–1.12) for a 10 μg/m3 PM2.5 concentration increment. The adjusted ORs for the Han, the Tibetan, and the Yi were 1.08 (95% CI, 1.04–1.12), 0.03 (95% CI, 0.00–0.27), and 1.75 (95% CI, 1.28–2.38) for a 10 μg/m3 PM2.5 concentration increment, respectively. Stratification analysis found stronger associations in participants with chronic diseases and Yi minority population. The results showed that long-term exposure to PM2.5 may increase the risk of hypertension prevalence in Chinese multi-ethnic adults. The associations were different among ethnicities. [ABSTRACT FROM AUTHOR]

Negative ion air purifiers (NIAPs), as a less costly alternative to the HEPA filtration, have been increasingly deployed in China and potentially elsewhere. While reducing indoor concentrations of fine particulate matter (PM2.5), NIAPs generate massive amounts of negative ions that may be of health concern. We performed week‐long interventions with NIAPs in the dormitories of 56 healthy college students living in Beijing. In a randomized order, each student underwent a true and a sham NIAP session. Cardiorespiratory outcomes were measured before and after each session. The use of true NIAPs reduced indoor PM2.5 concentrations significantly, while notably increased negative ion levels. Increases in PM2.5 and negative ion (NI) exposure were independently associated with increased urinary concentration of malondialdehyde, a biomarker of systemic oxidative stress, resulting in a null net effect of NIAP on malondialdehyde. Likewise, no significant net effects of NIAPs were observed for other outcomes indicative of lung function, vascular tone, arterial stiffness, and inflammation. Our findings suggest that negative ions, possibly along with their reaction products with the room air constituents, adversely affect health. The downsides do not support the use of NIAPs as a health‐based mitigation strategy to reduce PM2.5 exposure, especially in residences with PM2.5 concentrations that are not extremely high. [ABSTRACT FROM AUTHOR]

Background: Extreme weather events like heatwaves and fine particulate matter (PM 2.5 ) have a synergistic effect on mortality, but research on the synergistic effect of cold waves and PM 2.5 on outpatient visits for respiratory disease, especially at high altitudes in climate change-sensitive areas, is lacking., Methods: we collected time-series data on meteorological, air pollution, and outpatient visits for respiratory disease in Xining. We examined the associations between cold waves, PM 2.5 , and outpatient visits for respiratory disease using a time-stratified case-crossover approach and distributional lag nonlinear modeling. Our analysis also calculated the relative excess odds due to interaction (REOI), proportion attributable to interaction (AP), and synergy index (S). We additionally analyzed cold waves over time to verify climate change., Results: Under different definitions of cold waves, the odds ratio for the correlation between cold waves and outpatient visits for respiratory disease ranged from 0.95 (95% CI: 0.86, 1.05) to 1.58 (1.47, 1.70). Exposure to PM 2.5 was significantly associated with an increase in outpatient visits for respiratory disease. We found that cold waves can synergize with PM 2.5 to increase outpatient visits for respiratory disease (REOI > 0, AP > 0, S > 1), decreasing with stricter definitions of cold waves and longer durations. Cold waves' independent effect decreased over time, but their interaction effect persisted. From 8.1 to 21.8% of outpatient visits were due to cold waves and high-level PM 2.5 . People aged 0-14 and ≥ 65 were more susceptible to cold waves and PM 2.5 , with a significant interaction for those aged 15-64 and ≥ 65., Conclusion: Our study fills the gap on how extreme weather and PM 2.5 synergistically affect respiratory disease outpatient visits in high-altitude regions. The synergy of cold waves and PM2.5 increases outpatient visits for respiratory disease, especially in the elderly. Cold wave warnings and PM 2.5 reduction have major public health benefits., (© 2024. The Author(s).)

Background: With global climate change, the health impacts of cold spells and air pollution caused by PM 2.5 are increasingly aggravated, especially in high-altitude areas, which are particularly sensitive. Exploring their interactions is crucial for public health., Methods: We collected time-series data on meteorology, air pollution, and various causes of death in Xining. This study employed a time-stratified case-crossover design and conditional logistic regression models to explore the association between cold spells, PM 2.5 exposure, and various causes of death, and to assess their interaction. We quantitatively analyzed the interaction using the relative excess odds due to interaction (REOI), attributable proportion due to interaction (AP), and synergy index (S). Moreover, we conducted stratified analyses by average altitude, sex, age, and educational level to identify potential vulnerable groups., Results: We found significant associations between cold spells, PM 2.5 , and various causes of death, with noticeable effects on respiratory disease mortality and COPD mortality. We identified significant synergistic effects (REOI>0, AP > 0, S > 1) between cold spells and PM 2.5 on various causes of death, which generally weakened with a stricter definition of cold spells and longer duration. It was estimated that up to 9.56% of non-accidental deaths could be attributed to concurrent exposure to cold spells and high-level PM 2.5 . High-altitude areas, males, the older adults, and individuals with lower educational levels were more sensitive. The interaction mainly varied among age groups, indicating significant impacts and a synergistic action that increased mortality risk., Conclusion: Our study found that in high-altitude areas, exposure to cold spells and PM 2.5 significantly increased the mortality risk from specific diseases among the older adults, males, and those with lower educational levels, and there was an interaction between cold spells and PM 2.5 . The results underscore the importance of reducing these exposures to protect public health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ning, He, Liu, Ma, Ma, Wu, Ma and Zhang.)

Alveolar nitric oxide is a non-invasive indicator of small-airway inflammation, a key pathophysiologic mechanism underlying lower respiratory diseases. However, no epidemiological studies have investigated the impact of fine particulate matter (PM 2.5 ) exposure on the concentration of alveolar nitric oxide (CANO). To explore the associations between PM 2.5 exposure in multiple periods and CANO, we conducted a nationwide cross-sectional study in 122 Chinese cities between 2019 and 2021. Utilizing a satellite-based model with a spatial resolution of 1 × 1 km, we matched long-term, mid-term, and short-term PM 2.5 exposure for 28,399 individuals based on their home addresses. Multivariable linear regression models were applied to estimate the associations between PM 2.5 at multiple exposure windows and CANO. Stratified analyses were also performed to identify potentially vulnerable subgroups. We found that per interquartile range (IQR) unit higher in 1-year average, 1-month average, and 7-day average PM 2.5 concentration was significantly associated with increments of 17.78% [95% confidence interval (95%CI): 12.54%, 23.26%], 8.76% (95%CI: 7.35%, 10.19%), and 4.00% (95%CI: 2.81%, 5.20%) increment in CANO, respectively. The exposure-response relationship curves consistently increased with the slope becoming statistically significant beyond 20 μg/m 3 . Males, children, smokers, individuals with respiratory symptoms or using inhaled corticosteroids, and those living in Southern China were more vulnerable to PM 2.5 exposure. In conclusion, our study provided novel evidence that PM 2.5 exposure in long-term, mid-term, and short-term periods could significantly elevate small-airway inflammation represented by CANO. Our results highlight the significance of CANO measurement as a non-invasive tool for early screening in the management of PM 2.5 -related inflammatory respiratory diseases., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Vehicle electrification has been recognized for its potential to reduce emissions of air pollutants and greenhouse gases in China. Several studies have estimated how national-level policies of electric vehicle (EV) adoption might bring very large environmental and public health benefits from improved air quality to China. However, large-scale adoption is very costly, some regions derive more benefits from large-scale EV adoption than others, and the benefits of replacing internal combustion engines in specific cities are less known. Therefore, it is important for policymakers to design incentives based on regional characteristics - especially for megacities like Shanghai - which typically suffer from worse air quality and where a larger population is exposed to emissions from vehicles. Over the past five years, Shanghai has offered substantial personal subsidies for passenger EVs to accelerate its electrification efforts. Still, it remains uncertain whether EV benefits justify the strength of incentives. The purpose of our study is to evaluate the health and climate benefits of replacing light-duty gasoline vehicles (ICEVs) with battery EVs in the city of Shanghai. We assess health impacts due to ICEV emissions of primary fine particulate matter, NO x , and volatile organic compounds, and to powerplant emissions of NO x and SO 2 due to EV charging. We incorporate climate benefits from reduced greenhouse gas emissions based on existing research. We find that the benefit of replacing the average ICEV with an EV in Shanghai is US$6400 (2400-14,700), with health impacts of EVs about 20 times lower than the average ICEV. Larger benefits ensue if older ICEVs are replaced, but replacing newer China ICEVs also achieves positive health benefits. As Shanghai plans to stop providing personal subsidies for EV purchases in 2024, our results show that EVs achieve public health and climate benefits and can help inform policymaking strategies in Shanghai and other megacities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Rationale: Limited cohort studies have evaluated chronic effects of high fine particulate matter (particulate matter with an aerodynamic diameter ≤2.5 μm [PM2.5]) exposure on lung cancer.Objectives: To investigate the response pattern of lung cancer associated with high PM2.5 exposure.Methods: A Chinese cohort of 118,551 participants was followed up from 1992 to 2015. By incorporating PM2.5 exposure at 1 km spatial resolution generated using the satellite-based model during 2000-2015, we estimated the association between lung cancer and time-weighted average PM2.5 concentration using Cox proportional hazard models.Measurements and Main Results: A total of 844 incident lung cancer cases were identified during 915,053 person-years of follow-up. Among them, 701 lung cancer deaths occurred later. The exposure-response curves for lung cancer associated with PM2.5 exposure were nonlinear, with steeper slopes at the higher concentrations. Adjusted for age, sex, geographical region, urbanization, education level, smoking status, alcohol consumption, work-related physical activity, and body mass index, participants exposed to the second-fifth quintiles of PM2.5 had higher risk for lung cancer incidence than those exposed to the first quintile, with hazard ratios of 1.44 (95% confidence interval [CI], 1.10-1.88), 1.49 (95% CI, 1.12-1.99), 2.08 (95% CI, 1.42-3.04), and 2.45 (95% CI, 1.83-3.29), respectively. The corresponding hazard ratios for lung cancer mortality were 1.83 (95% CI, 1.33-2.50), 1.80 (95% CI, 1.29-2.53), 2.50 (95% CI, 1.62-3.86), and 2.95 (95% CI, 2.09-4.17), respectively.Conclusions: We provide strong evidence that high PM2.5 exposure leads to an elevated risk of lung cancer incidence and mortality, highlighting that remarkable public health benefits could be obtained from the improvement of air quality in highly polluted regions. [ABSTRACT FROM AUTHOR]

Investigators in previous studies have drawn inconsistent conclusions regarding the relationship between relatively low exposure to fine particulate matter (particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5)) and risk of gestational diabetes mellitus (GDM), while the association between high PM2.5 exposure and GDM risk has not been well studied. We investigated the association of high PM2.5 exposure during pregnancy with blood glucose levels and GDM risk in Chinese women. The present study was conducted from August 2013 to May 2016 among 3,967 pregnant women in the Tongji Maternal and Child Health Cohort in Wuhan, China. PM2.5 exposure during pregnancy for each participant was estimated by means of land-use regression models. An interquartile-range increase in PM2.5 exposure (33.84 μg/m3 for trimester 1 and 33.23 μg/m3 for trimester 2) was associated with 36% (95% confidence interval (CI): 1.15, 1.61) and 23% (95% CI: 1.01, 1.50) increased odds of GDM during trimester 1 and trimester 2, respectively. An interquartile-range increment of PM2.5 exposure during trimester 1 increased 1-hour and 2-hour blood glucose levels by 1.40% (95% CI: 0.42, 2.37) and 1.82% (95% CI: 0.98, 2.66), respectively. The same increment of PM2.5 exposure during trimester 2 increased fasting glucose level by 0.85% (95% CI: 0.41, 1.29). Our findings suggest that high PM2.5 exposure during pregnancy increases blood glucose levels and GDM risk in Chinese women. [ABSTRACT FROM AUTHOR]

Fine particulate matter has been a major concern in China as it is closely linked to issues such as haze, health and climate impacts. Since China released its new national air quality standard for fine particulate matter (PM2.5) in 2012, great efforts have been put into reducing its concentration and meeting the standard. Significant improvement has been seen in recent years, especially in Beijing, the capital city of China. This paper reviews how China understands its sources of fine particulate matter, the major contributor to haze, and the most recent findings by researchers. It covers the characteristics of PM2.5 in China, the major methods to understand its sources such as emission inventory and measurement networks, the major research programmes in air quality research, and the major measures that lead to successful control of fine particulate matter pollution. A great example of linking scientific findings to policy is the control of coal combustion from the residential sector in northern China. This review not only provides an overview of the fine particulate matter pollution problem in China, but also its experience of air quality management, which may benefit other countries facing similar issues. This article is part of a discussion meeting issue 'Air quality, past present and future'. [ABSTRACT FROM AUTHOR]

This study aims to investigate whether sources of metal elements in fine particulate matter and their distribution in high-rise buildings vary with floor levels. Inductively coupled plasma emission spectrometry (ICP-AES) was used to determine the contents of 11 common heavy metals in PM2.5 samples collected from different floors of a high-rise residential building in Northeast China during the heating season. The sources of metal elements in PM2.5 samples on different floors were analysed by the enrichment factor method and the principal component analysis method. The concentration of metal elements is higher in lower floors (<7th floor) and lower in higher floors (>7th floor). The enrichment factor method shows that the enrichment factors of As, Cd, Cu and Pb may be seriously affected by human sources, while the enrichment factors of the other seven metals are less than 10, indicating that their sources may be natural sources. The principal component analysis shows that the main sources of indoor metal elements in high-rise residential buildings are divided into four main components, including coal combustion (31.44%), automobile emissions and transportation (21.60%), soil dust, particulate matter discharged from agricultural production and atmospheric dust (13.43%), metallurgical, chemical and ore mining (12.61%). [ABSTRACT FROM AUTHOR]

Background: The effect of short-term exposure to fine particulate matter (PM2.5) on the incidence of acute noncardiovascular critical illnesses (ANCIs) and clinical outcomes is unknown in patients with acute cardiovascular diseases.Methods: We conducted a retrospective study in 2337 admissions to an intensive cardiac care unit (ICCU) from June 2016 to May 2017. We used the 2-day average PM2.5 concentration before ICCU admission to estimate the individual exposure level, and patients were divided into 3 groups according to the concentration tertiles. Major ANCI was defined as the composite of acute respiratory failure, acute kidney injury, gastrointestinal hemorrhage, or sepsis. The primary endpoint was all-cause death or discharge against medical advice in extremely critical condition.Results: During the 12-month study period, the annual median concentration of PM2.5 in Chengdu, China was 48 μg/m3 (IQR, 33-77 μg/m3). More than 20% of admissions were complicated by major ANCI, and the primary endpoints occurred in 7.6% of patients during their hospitalization. The association of short-term PM2.5 exposure levels with the incidence of acute respiratory failure (adjusted OR [odds ratio] =1.31, 95% CI [confidence interval]1.12-1.54) and acute kidney injury (adjusted OR = 1.20, 95% CI 1.02-1.41) showed a significant trend. Additionally, there were numerically more cases of sepsis (adjusted OR = 1.21, 95% CI 0.92-1.60) and gastrointestinal hemorrhage (adjusted OR = 1.29, 95% CI 0.94-1.77) in patients with higher exposure levels. After further multivariable adjustment, short-term PM2.5 exposure levels were still significantly associated with incident major ANCI (adjusted OR = 1.32, 95% CI 1.12-1.56), as well as a higher incidence of the primary endpoint (adjusted OR = 1.52, 95% CI 1.09-2.12).Conclusion: Short-term PM2.5 exposure before ICCU admission was associated with an increased risk of incident major ANCI and worse in-hospital outcomes in patients receiving intensive cardiac care. [ABSTRACT FROM AUTHOR]