Associations between ambient air pollution and bone turnover markers in 10-year old children: results from the GINIplus and LISAplus studies (original) (raw)
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JAMA Network Open, 2020
IMPORTANCE Air pollution is a major threat to global health. Osteoporosis is responsible for a substantial burden of disease globally and is expected to increase in prevalence because of population aging. Few studies have investigated the association between air pollution and bone health, and their findings were inconclusive. OBJECTIVE To quantify the association between ambient and household air pollution and bone mass in a sample of the general population in peri-urban India. DESIGN, SETTING, AND PARTICIPANTS This was a population-based cross-sectional analysis of the Andhra Pradesh Children and Parents Study cohort, which recruited participants from 28 villages near Hyderabad, South India, during 2009 to 2012. Separate linear mixed models were fitted with nested random intercepts (household within villages) for each exposure-outcome pair and were sequentially adjusted for potential confounders. Data analysis was conducted between April 2019 and July 2019. EXPOSURES Annual mean ambient particulate matter air pollution less than 2.5 μm in aerodynamic diameter (PM 2.5) and black carbon (BC) levels at the residence estimated by land-use regression and self-reported use of biomass cooking fuel. MAIN OUTCOMES AND MEASURES The primary outcome was bone mineral content (BMC) measured in grams, corrected by bone area at the lumbar spine and left hip, as measured by dualenergy x-ray absorptiometry. The secondary outcome was bone mineral density measured in grams per centimeters squared. RESULTS A total of 3717 participants were analyzed (mean [SD] age, 35.7 [14.0] years; 1711 [46.0%] women). The annual mean (SD) PM 2.5 exposure was 32.8 (2.5) μg/m 3 , and the annual mean (SD) BC exposure was 2.5 (0.2) μg/m 3 ; 57.8% of participants used biomass cooking fuels. In fully adjusted models, PM 2.5 was associated with lower BMC in the spine (mean difference, −0.57 g per 3 μg/m 3 increase in PM 2.5 ; 95% CI, −1.06 to −0.07 g per 3 μg/m 3 increase in PM 2.5) and hip (mean difference, −0.13 g per 3 μg/m 3 increase in PM 2.5 ; 95% CI, −0.3 to 0.03 g per 3 μg/m 3 increase in PM 2.5). After confounder adjustment, exposure to PM 2.5 was also associated with lower bone mineral density in the spine (mean difference, −0.011 g/cm 2 per 3 μg/m 3 increase in PM 2.5 ; 95% CI, −0.021 to 0 g/cm 2 per 3 μg/m 3 increase in PM 2.5) and hip (mean difference, −0.004 g/cm 2 per 3 μg/m 3 increase in PM 2.5 ; 95% CI, −0.008 to 0.001 g/cm 2 per 3 μg/m 3 increase in PM 2.5). Exposure to BC was associated with lower BMC in the spine (mean difference, −1.13 g per 1 μg/m 3 increase in BC; 95% CI, −2.81 to 0.54 g per 1 μg/m 3 increase in BC) and hip (mean difference, −0.35 g per 1 μg/m 3 increase in BC; 95% CI, −0.96 to 0.25 g per 1 μg/m 3 increase in BC), although the confidence intervals were wider. There was no association between biomass fuel use and spine BMC (mean difference, 0.12 g; 95% CI, −0.45 to 0.68 g).
The Lancet. Planetary health, 2017
Air particulate matter (PM) is a ubiquitous environmental exposure associated with oxidation, inflammation, and age-related chronic disease. Whether PM is associated with loss of bone mineral density (BMD) and risk of bone fractures is undetermined. We conducted two complementary studies of: (i) long-term PM <2.5 μm (PM) levels and osteoporosis-related fracture hospital admissions among 9.2 million Medicare enrollees of the Northeast/Mid-Atlantic United States between 2003-2010; (ii) long-term black carbon [BC] and PMlevels, serum calcium homeostasis biomarkers (parathyroid hormone, calcium, and 25-hydroxyvitamin D), and annualized BMD reduction over a 8-year follow-up of 692 middle-aged (46.7±12.3 yrs), low-income BACH/Bone cohort participants. In the Medicare analysis, risk of bone fracture admissions at osteoporosis-related sites was greater in areas with higher PMlevels (Risk ratio [RR] 1.041, 95% Confidence Interval [CI], 1.030, 1.051). This risk was particularly high among ...
Exposure to Air pollution Increases the Risk of Osteoporosis
Medicine, 2015
Several studies have indicated that air pollution induces systemic as well as tissue-specific inflammation. Chronic inflammatory diseases such as rheumatoid arthritis and chronic obstructive pulmonary disease reduce bone mineral density (BMD), leading to increased release of immune cells from the bone marrow. However, the association between air pollution and osteoporosis remains poorly defined. Therefore, we conducted this population-based retrospective cohort study to evaluate the risk of osteoporosis in Taiwanese residents exposed to air pollution.
Osteoporosis International
Long-term environmental air pollution exposure was associated with osteoporosis' risk in a cohort of women at high risk of fracture. Cortical sites seemed to be more susceptible to the exposure's effect. Introduction Environmental air pollution has been associated with disruption of bone health at a molecular level. Particulate matter (PM) exposure can simultaneously stimulate bone resorption and halt bone formation. The primary aim of the present study is to describe the association between long-term exposure to PM and osteoporosis in a large cohort of women at high risk of fracture. Methods Clinical, demographic, and densitometric data were extracted from the DeFRAcalc79 dataset, which gathers data on women at risk for osteoporosis. Data on the monitoring of PM10 and PM2.5 concentrations were retrieved from the Italian institute of environment protection and research (Istituto Superiore per la Protezione e la Ricerca Ambientale, ISPRA). Generalized linear models with robust estimators were employed to determine the relationship between BMD and PM longterm exposure. Results A total 59,950 women from 110 Italian provinces were included in the study. PM 2.5 exposure was negatively associated with T-score levels at the femoral neck (β −0.005, 95 CI −0.007 to −0.003) and lumbar spine (β −0.003, 95% CI −0.006 to −0.001). Chronic exposure to PM2.5 above 25 μg/m 3 was associated with a 16% higher risk of having osteoporotic T-score at any site (aOR 1.161, 95% CI 1.105 to 1.220), and exposure to PM10 above 30 μg/m 3 was associated with a 15% higher risk of having osteoporotic T-score at any site (aOR 1.148, 95% CI 1.098 to 1.200). Conclusion Long-term exposure to air pollution was associated with higher risk of osteoporosis. Femoral neck site seemed to be more susceptible to the detrimental effect of PM exposure than lumbar spine site. Key message Exposure to air pollution is associated with osteoporosis, mainly at femoral site.
Particulate Air Pollution and Osteoporosis: A Systematic Review
Risk Management and Healthcare Policy
Air pollution is associated with inflammation and oxidative stress, which predispose to several chronic diseases in human. Emerging evidence suggests that the severity and progression of osteoporosis are directly associated with inflammation induced by air pollutants like particulate matter (PM). This systematic review examined the relationship between PM and bone health or fractures. A comprehensive literature search was conducted from January until February 2021 using the PubMed, Scopus, Web of Science, Google Scholar and Cochrane Library databases. Human cross-sectional, cohort and case-control studies were considered. Of the 1500 papers identified, 14 articles were included based on the inclusion and exclusion criteria. The air pollution index investigated by most studies were PM 2.5 and PM 10. Current studies demonstrated inconsistent associations between PM and osteoporosis risk or fractures, which may partly due to the heterogeneity in subjects' characteristics, study design and analysis. In conclusion, there is an inconclusive relationship between osteoporosis risk and fracture and PM exposures which require further validation.
Lung Function Growth in Children with Long-Term Exposure to Air Pollutants in Mexico City
American Journal of Respiratory and Critical Care Medicine, 2007
This article has an online data supplement, which is accessible from this issue's table of content online at www.atsjournals.org Word count: 2,583 ABSTRACT Rationale: Although short-term exposure to air pollution has been associated with acute, reversible lung function decrements, the impact of long-term exposure has not been well established. Objective: To evaluate the association between long-term exposure to ozone (O 3 ), particulate matter <10 µm in diameter (PM 10 ) and nitrogen dioxide (NO 2 ) and lung function growth in Mexico City schoolchildren. Methods: A dynamic cohort of 3,170 children aged 8 years at baseline was followed from The children attended 39 randomly selected elementary schools located near 10 air quality monitoring stations and were visited every 6 months. Statistical analyses were performed using general linear mixed models. Results: After adjusting for acute exposure and other potential confounding factors, deficits in FVC and FEV 1 growth over the 3-year follow-up period were significantly associated with exposure to O 3 , PM 10 and NO 2 . In multi-pollutant models, an interquartile range (IQR=11.3 ppb) increase in mean O 3 concentration was associated with an annual deficit in FEV 1 of 12 ml in girls and 4 ml in boys, an interquartile range (IQR=36.4 µg/m 3 ) increase in PM 10 with an annual deficit in FEV 1 of 11 ml in girls and 15 ml in boys, and an interquartile range (IQR=12.0 ppb) increase in NO 2 with an annual deficit in FEV 1 of 30 ml in girls and 25 ml in boys. Conclusion: We conclude that long-term exposure to O 3 , PM 10 and NO 2 is associated with a deficit in FVC and FEV 1 growth among schoolchildren living in Mexico City.
Effects of air pollution on growth in schoolchildren
Collegium antropologicum, 2014
The growth is considered a very sensitive indicator of the impact of environment of the health status of children. The aim of the study was to investigate whether air pollution is related to children's growth. The subjects were 1059 pupils, aged 7-11 years, living for more than ten years in the same home in the city of Nis (Serbia). Exposed group of children (N = 545) were attending the school located in a city area with a high level of air pollution, while the children (N = 514), in the comparison group, designed as non-exposed group, were attending the school in the area with a lower level of air pollution. The air concentrations of black smoke, nitrogen dioxide, sulfur dioxide and lead in sediment matter were determined in ten-year period. Air pollution is associated with children's height and weight, specially before the age of 9 years. There was a significant difference in the prevalence of thinness in children exposed to higher concentrations of air pollutants (p = 0.0...
Effects of Air Polution on Growth in Schoolchildren
Collegium Antropologicum, 2014
The growth is considered a very sensitive indicator of the impact of environment of the health status of children. The aim of the study was to investigate whether air pollution is related to children's growth. The subjects were 1059 pupils, aged 7-11 years, living for more than ten years in the same home in the city of Ni{ (Serbia). Exposed group of children (N=545) were attending the school located in a city area with a high level of air pollution, while the children (N=514), in the comparison group, designed as non-exposed group, were attending the school in the area with a lower level of air pollution. The air concentrations of black smoke, nitrogen dioxide, sulfur dioxide and lead in sediment matter were determined in ten-year period. Air pollution is associated with children's height and weight, specially before the age of 9 years. There was a significant difference in the prevalence of thinness in children exposed to higher concentrations of air pollutants (p=0.038). It might be possible that air pollution negatively contributed to the growth rate in urban children.
Annals of the American Thoracic Society, 2021
Rationale: Epidemiological evidence indicates that ambient exposure to particulate matter <2.5 μm in aerodynamic diameter (PM 2.5) has adverse effects on lung function growth in children, but it is not actually clear whether exposure to low-level PM 2.5 results in long-term decrements in lung function growth in preto early-adolescent schoolchildren. Objectives: To examine long-term effects of PM 2.5 within the 4-year average concentration range of 10-19 μg/m 3 on lung function growth with repeated measurements of lung function tests. Methods: Longitudinal analysis of 6,233 lung function measurements in 1,466 participants aged 8-12 years from 16 school communities in 10 cities around Japan, covering a broad area of the country to represent concentration ranges of PM 2.5 , was done with a multilevel linear regression model. Forced expiratory volume in 1 second, forced vital capacity (FVC), and maximal expiratory flow at 50% of FVC were used as lung function indicators to examine the effects of 10-μg/m 3 increases in the PM 2.5 concentration on relative growth per each 10-cm increase in height. Results: The overall annual mean PM 2.5 level was 13.5 μg/m 3 (range, 10.4-19.0 μg/m 3). We found no association between any of the lung function growth indicators and increases in PM 2.5 levels in children of either sex, even after controlling for potential confounders. Analysis with two-pollutant models with O 3 or NO 2 did not change the null results. Conclusions: This nationwide longitudinal study suggests that concurrent, long-term exposure to PM 2.5 at concentrations ranging from 10.4 to 19.0 μg/m 3 has little effect on lung function growth in preadolescent boys or pre-to early-adolescent girls.