P-1006 - Impact of traffic origin particulate matter and its chemical constituents on oxidative potential
Abstract Control Number
3304
Abstract Body
Currently high particulate matter (PM) levels are observed in most of the urban cities of India and one of the major sources of emissions are vehicle plying on roads. Exposure to PM and its components have been linked with various disorders and has been associated with the ability to produce free radicals and reactive oxygen species, known as “oxidative potential” of PM and is proposed to be one of the most relevant indicators of PM toxicity. In the present study we examined the oxidative potential of PM collected at roadside (RS) and urban background (BG) site using dithiothreitol (DTT) assay. PM measurements were carried out simultaneously at both the sites in Mumbai on seven consecutive days, covering both morning (7:00-11:00 AM) and afternoon (12:00-4:00 PM) hours in May 2018 using low volume sampler (Mini vol, Airmetrics, USA flow rate of 5 l min-1). The collected samples was analysed for carbonaceous aerosols (OC, EC, and WSOC) and trace elemental components of PM. The average mass concentration at RS and BG during morning rush hours was 80±23 µgm-3 and 43±10 µgm-3 while in the afternoon it was 84±14.8 µgm-3 and 53±13 µgm-3, respectively. The average OC, EC levels at RS were 19.8±8.8 µgm-3, 16.5±5.1 µgm-3 (morning), 21.8±9.4, 19.1±13.5 µgm-3 (afternoon), whereas at BG site it was 16.5±9.9 µgm-3, 2.5±2.1 µgm-3 (morning), 16±13 µgm-3, 3.5±3.4 µgm-3 (afternoon) respectively. The corresponding WSOC levels at RS and BG were 11% and 19% during morning period while during afternoon it was 15% and 27% of OC, respectively. The volume normalised DTT activity (DTTv) was higher at the roadside (1.12±0.54 nmol min-1 m-3) during morning period than at background (0.75±0.6 nmol min-1 m-3). Thus, our first results suggest that exposure to PM from traffic related emissions may pose substantial risk to a large population in urban areas.
P-0897 - Short-term PM2.5 exposure and acute incidence of myocardial infarction a time-stratified case-crossover study in China
Abstract Control Number
1997
Abstract Body
Background Myocardial infarction (MI) and ambient fine particulate matter (PM2.5) pollution are two global public health concerns. Evidence investigating the association between PM2.5 and acute incidence of MI in developing countries is limited. Methods A multicenter study based on a time-stratified case-crossover design including 36,679 cases from MI incidence registry data and PM2.5 site monitoring data was conducted. Results With a 10 μg/m3 increase in PM2.5 concentration, there was an increase of 0.98% (0.40%, 1.57%) in acute incidence risk of MI on day lag02. The corresponding values for males and individuals aged over 74 years were 1.58% (95% CI: 0.82%, 2.35%) and 1.19% (95% CI: 0.35%, 2.05%) respectively, indicating higher risks than other groups. The non-linear concentration-response curve indicated a steeper slope under daily PM2.5 below 50μg/m3 and the marginal avoided premature morbidity attributed to per 10μg/m3 reduction became larger under the current air quality standard.Conclusion This study is the first multicenter study to examine the association between the acute incidence of MI and short-term exposure to PM2.5 in China. We provide solid evidence that PM2.5 is a risk factor for accelerating MI incidence. A susceptible population was identified. The robust findings from this study may suggest the necessity for a continuous reduction of PM2.5 concentration from the perspectives of public health.
P-0309 - Arsenic health risk studies in Uruguay with a Medical Geology approach: advantages and difficulties
Abstract Control Number
2962
Abstract Body
In Uruguay safe drinking water is supplied to 94% of the population by a state company (OSE) and 28% is provided from groundwater sources. Geogenic Arsenic. Health risks through groundwater is a very recent issue of concern, regarding all international scientific evidence of several adverse effects associated with low levels (As>20 ug/L).We discuss the advantages of our research studies with a Medical Geology approach, to evaluate the influence of geological factors in the geographical distribution of health problems associated with arsenic exposure, and to highlight the main difficulties found in the process. This approach provides the tools for overlaying local geochemical data and arsenic water levels with disease registry data retrospectively, to potentially identify the possibility that the water consuming population, will develop a particular type of disease over time.We assess available geochemical data and As levels, provided by OSE and epidemiological data available from the National Atlas of Cancer prevalence that were geo-referred in the areas where arsenic data in water were available. We carried out a cross -over treatment data, to evaluate possible failures or deficiencies for their further analysis and correlation, finding several lacking records regarding environmental factors and/or drinking water sources. However, we could get distribution maps with refined data of arsenic levels, contrasted with the incidence data of cancer types associated with arsenic (lung cancer, bladder, melanoma, nonmelanoma skin, liver and kidney), for men and women respectively, finding some interesting correlations.Overlapping the Uruguayan cancer atlas data with As levels in wells can be a potential tool to estimate the contribution of As, to the incidence of cancer, though the retrospective data provided presented several difficulties and inconsistencies. We highlight the relevance of developing an interinstitutional and multidisciplinary common framework.
P-0171 - Neighborhood Socioeconomic Status, Long-Term Exposure to Particulate Matter, and Risk of Cardiovascular Disease and Mortality in the Nurses’ Health Study
Abstract Control Number
1878
Abstract Body
Background: Although associations between particulate matter <2.5 microns (PM2.5) and cardiovascular disease (CVD) and mortality are well-established, less is known regarding the joint impact of PM2.5 and neighborhood socioeconomic status (nSES). Our objective was to investigate this interaction in a nationwide cohort of U.S. women. Methods: We used time-varying Cox proportional hazards models, conditioned on age and calendar time, to assess main and interaction effects of PM2.5 and nSES on risk of CVD (stroke, myocardial infarction) and mortality among 100,257 women in the Nurses’ Health Study between 1986 and 2008. Incident CVD (n=6,445) and mortality (n=10,186) cases were ascertained from medical or death record reviews. We created Census tract-level nSES scores by summing z-scores (where increasing scores were associated with affluence) of selected nSES metrics (e.g., race, education, income, home value, nativity, unemployment), and calculated time-varying 24-month average PM2.5 exposure using residential address history. Models were adjusted for time-varying demographic, lifestyle (e.g., diet, physical activity, smoking), and individual-level SES factors. Results: In multivariable adjusted models, increases in nSES (Hazard Ratio [HR]CVD: 0.98, 95% Confidence Interval [CI]: 0.97, 0.99; HRmortality: 0.99, 95% CI: 0.99, 1.00, per 1 unit increase) and PM2.5 (HRCVD: 1.03, 95% CI: 0.95, 1.12; HRmortality: 1.04, 95% CI: 0.97, 1.11, per 10 µg/m3 increase) were associated with incident CVD and mortality rates, although the associations with PM2.5 did not reach statistical significance. The interaction between PM2.5 and nSES was statistically significant for CVD risk (p<0.001) and mortality (p<0.013); associations with mortality were strongest among the least affluent neighborhoods, while associations with CVD were weakest in areas of least and greatest affluence. Conclusions: Our results suggest that PM2.5 and nSES exposures are associated with small changes in rates of mortality and CVD incidence. These exposures interact in a complex fashion, even within a relatively demographically homogeneous cohort of women.
P-0301 - Denver Developmental Screening Test II (DDST-R) adaptation for a birth cohort research - PIPA Project
Abstract Control Number
2853
Abstract Body
Background/Aims: The Denver Developmental Screening Test II (DDST-R) was used to evaluate the neuropsychomotor development of babies during the birth cohort pilot of the Pipa Project. In the pilot, data and samples of prenatal exposure to metals, plasticizers and pesticides were colected from pregnant women and babies who were evaluated in their first, third and sixth months of age. It was noticed that the standard form of the DDST-R contains many open fields that represents a hindering factor for research. We aim to present a new proposal for the application of the test. Methods: The DDST-R form was adapted to a table with closed fields to be marked with diferent options, according to ages and questions about the development milestone in different fields. The options were: pass (P), fail (F), refuse (R), no opportunity (NO). The table had hatched areas that highlighted the responses that the baby should present at each age and milestone, highlighting the 75% and 90% percentiles. There was also a field for caution and delay quantification, to be applied in the interpretation of normal, suspect and non-testable situations. Results: We obtained a total of 18.5% of fail in the first evaluation, 24.1% in the second and 31.7% in the third. In the first one, we did not find any children with an interpretation of the suspected DDST-R, and 6.2% of the children were untestable. In the second one, 6.35% of the children presented a suspected result, none of which was not testable; and in the third, 5.15% of the children had a suspected interpretation and 1.32% was not testable Conclusions: The ease of marking in closed fields enabled a better evaluation and consequent interpretation of the results of the DDST-R, proving to be a good instrument for research in the field of health and birth cohorts.
P-0911 - Changes in lipid profiles and blood pressure in response to acute exposure to ambient PM2.5 and its carbonaceous compositions - results from the AIRLESS Study
Abstract Control Number
2743
Abstract Body
Background Increasing evidence has shown ambient fine particles (PM2.5) as a key risk factor to cardiovascular and metabolic diseases. However, few human studies examined if the adverse effects were associated carbonaceous particles, the potential toxic species in PM2.5. Methods Based on AIRLESS project, we examined the changes in lipid profiles and blood pressure (BP) in response to acute exposure to ambient PM2.5 and its carbonaceous compositions, namely elemental carbon (EC) and organic carbon (OC). 251 nonsmoking participants from urban (N=123) and peri-urban (N=128) Beijing, China, have completed 2 times clinical visits in winter, and another 2 in summer. During each visit, serum samples were collected for the lipid profile analysis of total cholesterol (TC), High-density lipoprotein cholesterol (HDL), Low-density lipoprotein cholesterol (LDL) and Triglycerides (TG), and BP were measured. Daily ambient PM2.5, EC and OC were measured in the monitoring station nearby the participants’ communities. Associations between exposure and health outcomes were examined with linear mixed-effects model adjusted for demographic, socioeconomic and lifestyle parameters. Results Exposure to EC was significantly associated with all the cholesterol parameters, while PM2.5 and OC were only associated with HDL. For example, an IQR increase in previous 1-day exposure to EC (3.9 μg/m3) was significantly associated with an elevation of HDL [1.4%(95% confidence interval (CI): 0.7-2.1%)], LDL [1.5%(CI: 0.3-2.7%)] and TC [1.3%(CI: 0.4-2.2%)] (p<0.05). All the three pollutants were significantly associated with the increase in systolic and diastolic BP, but not the changes in TG. A clear modified effect between sites were observed that may be partly attributed to the difference in the local emission sources given the significantly differed ratio of OC to EC between the two sites. Conclusions Elemental carbon may play an important role in the adverse cardiovascular and metabolic effect of PM2.5.
P-0671 - Evaluation of Mental Health and Welfare Aspects of Workers in an Environmental Sanitation Company. Use of a Questionnaire
Abstract Control Number
1375
Abstract Body
Aspects related to work organization can cause mental wear, mental disorders and illnesses to workers. According PAHO, an environment that respects and protects basic civil, political, socioeconomic and cultural rights is fundamental for the promotion of mental health. Brazil (2016) registered 199 thousand workers, and in 2017 mental and behavioral disorders were responsible for the leave of 178.268 workers.According to legislation, part of workers' illness is linked to the environment and work methodologies adopted by the company. In this context, there is a marked growth of methods aimed at evaluating aspects related to work organization and their repercussions on workers' health. Therefore, addressing workers' quality of life in today's world context becomes important, the assessment of the psychosocial work environment through a voluntary questionnaire is an important determinant of the mental health status of workers. To present the predominant aspects of the mental health of the employees of a sanitation company through a worker health and welfare evaluation questionnaire. Application of the Brazilian version of the Self-Reporting Questionnaire (SRQ-20), anonymous, volunteer, completed by employees before consultation with the occupational physician from May to December/2019 at the medical ambulatory of an environmental sanitation company in the SP Brasil. Evaluated data: Job sector, sex, function (operational and administrative positions) and the answers. Excel 2013 and SPSS were used.100 questionnaires completed. 39 women, 61 men (33 administrative and 28 operational positions). 24% of the answers presented cutoff score for psycho-emotional disorders (equal to or greater than 7). Of these, 42% (10) were men (2 administrative and 8 operational positions) and 58% (14) were women, all in administrative positions. 67% were adminstrative. Discussions about the profile were held and used to adapt preventive measures.The use of SRQ-20 contributed to the tracking of mental health in the occupational context enabling specific health actions.
P-0854 - Human exposure pathways to poly- and perfluoroalkyl substances (PFAS) from indoor media: A systematic review
Abstract Control Number
1860
Abstract Body
Human exposure to per- and polyfluoroalkyl substances (PFAS) has been primarily attributed to contaminated food and drinking water. However, PFAS exposure has also been linked to use of products. Few studies report relationships between these exposure media and human biomonitoring measurements. A systematic review (SR) is a transparent and rigorous method to evaluate a body of scientific evidence to answer a specific research or policy question. Although widely used in clinical medicine and epidemiology, the development of SR methods that are applicable to exposure science studies is ongoing. This study adapted SR methodologies to identify important PFAS exposure pathways from indoor environment media, including consumer products, household articles, cleaning products, personal care products, and indoor air and dust. Included studies present exposure measures from indoor media paired with occupant PFAS concentrations in blood serum, focusing specifically on perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS). Searches were conducted of Web of Science, PubMed, and ToxNet databases, where approximately 6,000 studies were identified. Machine learning approaches were used during the literature scoping and title/abstract screening to prioritize pathways by automated tagging and to select studies for inclusion using an iterative predictive screening model. Studies were screened against inclusion criteria by two independent reviewers. The extraction and summarization of study characteristics were performed in DistillerSR software, visualized in Tableau, and will be available for download. The exposure assessment methods used in included studies were evaluated using an approach modified from the EPA’s Systematic Review Protocol for IRIS Assessments and the Navigation Guide. This study presents innovative SR methodologies for exposure science studies, including the development of exposure pathway-specific search strings for use in artificial intelligence software. The evidence generated will increase our understanding of exposure to PFAS from indoor environment sources, identify key data gaps, and inform future research priorities.
P-0092 - Neighborhood social cohesion and sleep health among White, Black, and Hispanic/Latino men and women in United States: Findings from the National Health Interview Survey
Abstract Control Number
2675
Abstract Body
Background: Social environmental factors such as unfavorable neighborhood cohesion may contribute to poor sleep by, for example, activating stress pathways. Methods: Using pooled cross-sectional data from 144,776 participants of the 2013-2017 National Health Interview Survey (NHIS), we examined overall and race/ethnicity-specific associations between neighborhood social cohesion and sleep health among White, Black, Hispanic/Latino, and Asian adults. Neighborhood social cohesion score (NSC) was measured based on self-reported responses to four questions related to trust and support, which were categorized into low, medium, and high groups. Very short sleep duration was defined as <6 hours; short sleep <7 hours, recommended sleep 7-8 hours, and long sleep ≥9 hours. Sleep difficulties were assessed based on “trouble falling asleep 3+ days,” “trouble staying asleep 3+ days,” “waking up feeling rested 4+ days,” and “took sleep medication ≥1 times” all in the previous week. Adjusting for sociodemographics, health behaviors, and health indicators, Poisson regression with robust variance was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for sleep duration and difficulty by low vs. high NSC and medium vs. high NSC. Results: Among 144,776 adults, mean age was 47±0.1 years, 48% were men, and 69% white. Overall, low vs. high NSC was associated with a higher prevalence of very short (PR=1.32; 95% CI: 1.25-1.40) and short (PR=1.19; 95% CI: 1.16-1.22) sleep duration. Low vs. high NSC was positively associated with very short sleep duration among Whites (PR=1.37; 95% CI: 1.28-1.47), Blacks (PR=1.13; 95% CI: 1.01-1.28), and Hispanics/Latinos (PR=1.30; 95% CI: 1.11-1.53). Among Asians, low NSC was associated with short sleep duration (PR=1.19; 95% CI: 1.06-1.32). Conclusions: Sleep difficulties were more prevalent among all racial/ethnic groups with less than high NSC. Low neighborhood social cohesion was associated with shorter sleep duration and sleep difficulty across racial/ethnic groups, and more research is warranted.
P-0090 - Association of trees and other vegetation near homes with asthma exacerbation in children
Abstract Control Number
2565
Abstract Body
Background. Vegetated landscapes (i.e., greenspace) may increase or decrease risk of asthma exacerbation through effects on pollen levels, localized climates (e.g., heat islands), air pollution, or child’s behaviors.
Methods. We investigated the association between neighborhood greenspace and pediatric asthma exacerbation (age <18 years) in the City of Philadelphia, by conducting a case-control study based on electronic health records (EHR) from the Children’s Hospital of Philadelphia (CHOP) Care Network. Our study included cases from 8017 outpatient clinic visits, 5953 emergency department (ED) visits, and 4401 inpatient encounters, with controls selected from non-exacerbation clinical encounters for asthma. We studied various greenspace measures, including overall greenness (i.e., vegetation density), tree canopy, grass/shrub coverage, and impervious landcover, within various buffer sizes surrounding the child’s residence. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusting for child- and neighborhood level sociodemographic factors.
Results. Lower odds of asthma exacerbation were observed in association with high levels of greenspace near the home (>75th percentile vs. ≤25th percentile) for ED cases, such as reduced odds of ED visits by 29% with high tree canopy coverage (OR=0.71, 95% CI= 0.61, 0.83), and 16% with high grass/shrub coverage (OR=0.84, 95% CI: 0.74, 0.97). Impervious surface landcover near the home was associated with greater odds of asthma exacerbation for ED (high vs. low: OR=1.50, 95% CI: 1.28, 1.75) and inpatient cases (OR=1.20, 95% CI: 1.02, 1.42). Small reductions in risk of outpatient clinic cases or inpatient cases in association with greater amounts of vegetation near the home were not statistically significant in the best-fitting models.
Conclusions. Our findings suggest a protective effect of residential neighborhood greenspace against asthma exacerbation; however, differing results among treatment settings requires further assessment of confounding by indication and effect modification.
Methods. We investigated the association between neighborhood greenspace and pediatric asthma exacerbation (age <18 years) in the City of Philadelphia, by conducting a case-control study based on electronic health records (EHR) from the Children’s Hospital of Philadelphia (CHOP) Care Network. Our study included cases from 8017 outpatient clinic visits, 5953 emergency department (ED) visits, and 4401 inpatient encounters, with controls selected from non-exacerbation clinical encounters for asthma. We studied various greenspace measures, including overall greenness (i.e., vegetation density), tree canopy, grass/shrub coverage, and impervious landcover, within various buffer sizes surrounding the child’s residence. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusting for child- and neighborhood level sociodemographic factors.
Results. Lower odds of asthma exacerbation were observed in association with high levels of greenspace near the home (>75th percentile vs. ≤25th percentile) for ED cases, such as reduced odds of ED visits by 29% with high tree canopy coverage (OR=0.71, 95% CI= 0.61, 0.83), and 16% with high grass/shrub coverage (OR=0.84, 95% CI: 0.74, 0.97). Impervious surface landcover near the home was associated with greater odds of asthma exacerbation for ED (high vs. low: OR=1.50, 95% CI: 1.28, 1.75) and inpatient cases (OR=1.20, 95% CI: 1.02, 1.42). Small reductions in risk of outpatient clinic cases or inpatient cases in association with greater amounts of vegetation near the home were not statistically significant in the best-fitting models.
Conclusions. Our findings suggest a protective effect of residential neighborhood greenspace against asthma exacerbation; however, differing results among treatment settings requires further assessment of confounding by indication and effect modification.
P-1223 - Impact of traffic-related air pollutants emission reduction policies on hospitalization by asthma, in Seoul and Incheon, Korea
Abstract Control Number
2437
Abstract Body
Although the goals of most air-quality policies is to reduce direct emissions from the source points, it also aims to reduce health burden due to exacerbated environmental pollution. Therefore, assessing the impact of environmental policies on related health outcomes is important. In Korea, especially in Seoul and Incheon, interventions for reducing traffic-related air pollutants (TRAP) were aggressively implemented since 2007. TRAP is a known risk factor for asthma. In this study, we aimed to investigate whether the interventions had a beneficial impact on hospitalization by asthma.Hospital records for hospitalization by asthma in the study (Seoul and Incheon) and the reference population (Daejeon, Daegu, Busan, and Ulsan) were abstracted from the database in National Health Insurance Service during 2003 to 2011. A controlled interrupted time series design (C-ITS) was adopted to assess the impact of air pollutants emission reduction policies on hospitalization by asthma. Long-term background trends were adjusted using the trends of reference cities. Various sensitivity analyses, including simple-ITS, and C-ITS with false-intervention and with simulated PM10 concentration when there was no intervention, were conducted to give a robustness of our study result.Emissions from traffic-related air pollutants were significantly reduced after 2007. Estimated numbers of prevented hospitalization for asthma in Seoul were 10,377 (14.1%) and 6,011 (8.7%) depending on the reference population (Daejeon and Daegu). For Incheon, estimated numbers of prevented hospitalization for asthma were 3,207 (11.7%) and 2,470 (9.2%) depending on the reference population (Busan and Ulsan). Potential beneficial effects of the interventions on asthma were also found in the sensitivity analysis. Our study provides supportive evidence for potential beneficial effects of interventions for reducing TRAP on hospitalization for asthma in Seoul and Incheon. More studies are needed to determine the impact of such environmental policy implementation on other diseases associated with air pollutants in Korea.
P-0868 - Profile of the Per- and Polyfluoroalkyl Substances (PFAS) Health Study: Exposure to and health risks of environmental PFAS contamination in Australian communities
Abstract Control Number
2333
Abstract Body
The extensive distribution of per- and polyfluoroalkyl substances (PFAS) has led to concerns about environmental and human health impacts. Risk assessments of contaminated areas in Australia have evaluated PFAS exposure pathways but have not quantified PFAS exposure levels in affected communities or the associated health risks. The PFAS Health Study aims to investigate multiple aspects of the PFAS exposure pathway, including the environmental and behavioural factors that influence PFAS body burdens, as well as health outcomes and concerns associated with PFAS exposure. We conducted a cross-sectional study of current and former residents and workers of three Australian communities affected by environmental PFAS contamination−Williamtown in New South Wales, Oakey in Queensland and Katherine in the Northern Territory−and three comparison communities. This Study included biomonitoring and a self-administered survey. The findings will guide our understanding of the determinants of PFAS exposure, associations with self-reported psychosocial or physical health outcomes and concerns, and actions that residents have taken in PFAS affected communities to reduce their exposure. The study design was informed by a systematic review of the health effects of PFAS exposure and a qualitative study of the health and social concerns of people living in Australian communities affected by environmental PFAS contamination. This study will produce knowledge to assist affected communities in understating the impact, if any, of PFAS exposure on their health and to aid policy makers in responding to PFAS contamination issues. The PFAS Health Study is the first of its kind in Australia and will add to the body of international literature around the effects of environmental PFAS exposure on human health.