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Adverse health effects of household air pollution, including acute lower respiratory infections (ALRIs), pose a major health burden around the world, particularly in settings where indoor combustion stoves are used for cooking. Individual studies have limited exposure ranges and sample sizes, while pooling studies together can improve statistical power.

We present hierarchical models for estimating long-term exposure concentrations and estimating a common exposure-response curve. The exposure concentration model combines temporally sparse, clustered longitudinal observations to estimate household-specific long-term average concentrations. The exposure-response model provides a flexible, semiparametric estimate of the exposure-response relationship while accommodating heterogeneous clustered data from multiple studies. We apply these models to three studies of fine particulate matter (PM

) and ALRIs in children in Nepal a case-control study in Bhaktapur, a stepped-wedge trial in Sarlahi, and a parallel trial in Sarlahi. For each study, we estimate household-level long-term PM

concentrations. We apply the exposure-response model separately to each study and jointly to the pooled data.

The estimated long-term PM

concentrations were lower for households using electric and gas fuel sources compared with households using biomass fuel. The exposure-response curve shows an estimated ALRI odds ratio of 3.39 (95% credible interval = 1.89, 6.10) comparing PM

concentrations of 50 and 150 μg/m

and a flattening of the curve for higher concentrations.

These flexible models can accommodate additional studies and be applied to other exposures and outcomes. The studies from Nepal provides evidence of a nonlinear exposure-response curve that flattens at higher concentrations.

These flexible models can accommodate additional studies and be applied to other exposures and outcomes. The studies from Nepal provides evidence of a nonlinear exposure-response curve that flattens at higher concentrations.Metal halide lights (MHLs) emit ultraviolet radiation (UVR) and should be used with enclosed fixtures. We investigated a cluster of blurred vision in a locality in South India reported among light music event attendees to identify risk factors.

We searched for attendees with any eye-related symptoms by door-to-door. We described cases by time, place, and person and inspected the environment to generate a hypothesis. We followed-up the cohort of the attendees to examine the hypothesis of exposure to MHL as the cause of the outbreak. We computed relative risk (RR) and 95% confidence interval (CI) by comparing attack rates among attendees by seating location and duration of exposure.

Of the total 500 attendees, we could interview 319 (64%) and 89% (284/319) attendees developed bilateral photokeratitis (median age = 24 years [range 2-80 years]). Attack rate was higher among female (92% [172/189]) than male (85% [110/130]). Attack rate among those seated within 12 meters from dais was higher (95% [241/253]) than the rest (65% [43/66]; RR = 1.5; 95% CI = 1.2, 1.7) and attack rate was higher among those continuously exposed to MHL (97% [268/277]) than others (38% [16/42]; RR = 2.5; 95% CI = 1.7, 3.7). The duration of exposure was associated with increased risk of bilateral photokeratitis (χ

test for linear trend = 74;

< 0.00001). During the environmental inspection, we identified the use of MHL with a broken outer envelope.

Photokeratitis was associated with exposure to UVR from MHL with a broken outer envelope. We recommended the usage of MHL along with enclosed fixtures.

Photokeratitis was associated with exposure to UVR from MHL with a broken outer envelope. We recommended the usage of MHL along with enclosed fixtures.Emerging evidence from animal and human studies indicates that exposure to traffic-related air pollution may adversely affect fertility.

Among 7,342 female pregnancy planners from the United States and 1,448 from Canada, we examined the association between residential proximity to major roads and fecundability, the per-cycle probability of conception. From 2013 to 2019, women 21-45 years old who were trying to conceive without fertility treatment completed an online baseline questionnaire and follow-up questionnaires every 8 weeks for up to 12 months or until pregnancy. We geocoded residential addresses reported at baseline and during follow-up, and calculated distance to nearest major roads and length of major roads within buffers of 50, 100, 300, and 400 meters around the residence as proxies for traffic-related air pollution. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for individual- and neighborhood-level characteristics.

In the United States, the FR comparing women who lived <50 meters with those who lived ≥400 meters from the closest major road was 0.88 (95% CI = 0.80, 0.98). The association among Canadian women was similar in magnitude, but less precise (FR = 0.93; 95% CI = 0.74, 1.16). Likewise, length of major roads within buffers of 50 and 100 meters was associated with lower fecundability in both countries; associations were attenuated within larger buffers.

These results are consistent with the hypothesis that traffic-related air pollution or other near-road exposures may adversely affect fecundability.

These results are consistent with the hypothesis that traffic-related air pollution or other near-road exposures may adversely affect fecundability.Wildfire smoke adversely impacts respiratory health as fine particles can penetrate deeply into the lungs. Epidemiological studies of differential impacts typically target population subgroups in terms of vulnerability to wildfire smoke. Such information is useful to customize smoke warnings and mitigation actions for specific groups of individuals. In addition to individual vulnerability, it is also important to assess spatial patterns of health impacts to identify vulnerable communities and tailor public health actions during wildfire smoke events.

We assess the spatiotemporal variation in respiratory hospitalizations in San Diego County during a set of major wildfires in 2007, which led to a substantial public health burden. We propose a spatial within-community matched design analysis, adapted to the study of wildfire impacts, coupled with a Bayesian Hierarchical Model, that explicitly considers the spatial variation of respiratory health associated with smoke exposure, compared to reference periods before and after wildfires. We estimate the signal-to-noise ratio to ultimately gauge the precision of the Bayesian model output.

We find the highest excess hospitalizations in areas covered by smoke, mainly ZIP codes contained by and immediately downwind of wildfire perimeters, and that excess hospitalizations tend to follow the distribution of smoke plumes across space (ZIP codes) and time (days).

Analyzing the spatiotemporal evolution of exposure to wildfire smoke is necessary due to variations in smoke plume extent, particularly in this region where the most damaging wildfires are associated with strong wind conditions.

Analyzing the spatiotemporal evolution of exposure to wildfire smoke is necessary due to variations in smoke plume extent, particularly in this region where the most damaging wildfires are associated with strong wind conditions.Cirrhosis is an advanced liver disease affecting millions of people worldwide, involving high healthcare costs. Despite experimental evidence suggesting a possible role of airborne pollutants in liver diseases, epidemiological studies are lacking. We aimed at investigating the association between exposure to air pollutants and incidence of cirrhosis in a large population-based cohort in Rome.

We used an administrative cohort established from the 2001 census. We included all adults of 30 years of age or older who were free of cirrhosis, resulting in a study population of over 1.2 million subjects. Follow-up of the subjects ended on 31 December 2015. We ascertained incident cases of cirrhosis from regional mortality and hospital discharge registries using a validated algorithm. We assessed exposure of the subjects to PM

, PM coarse, PM

, PM

absorbance, NO

, NOx, and PM metal components at their residential address using Land Use Regression models. We used Cox regression models, adjusted for relevant covariates, to estimate the association between air pollution exposure and cirrhosis incidence.

We observed 10,111 incident cases of cirrhosis, with a crude incidence rate of 67 × 100,000 person-years. Long-term exposure to all pollutants tested was significantly associated with cirrhosis, e.g., PM

(hazard ratios [HR], 1.05; 95% confidence interval [CI], 1.01-1.09, per 10 µg/m

increments), PM coarse (HR, 1.11; 95% CI, 1.05-1.17, per 10 µg/m

increments), PM

(HR, 1.08; 95% CI, 1.03-1.13, per 5 µg/m

increments), and NO

(HR, 1.03; 95% CI, 1.02-1.05, per 10 µg/m

increments). The associations were robust in secondary analyses.

Our findings suggest a possible contribution of air pollution to the development of cirrhosis.

Our findings suggest a possible contribution of air pollution to the development of cirrhosis.Perfluorooctane sulfonic acid (PFOS) is a ubiquitous environmental contaminant. Most people in developed countries have detectable serum concentrations. Lower birth weight has been associated with serum PFOS in studies world-wide, many of which have been published only recently.

To facilitate a causal assessment of the birth weight and PFOS association, we updated previous meta-analyses of the association and employed a method that facilitated inclusion of all available data in one analysis. Our analysis was based on observations from 29 studies.

The random effects summary was -3.22 g/ng/ml (95% confidence interval [CI] = -5.11, -1.33). In a subgroup analysis stratified by when in pregnancy the PFOS concentration was measured, the summary for the early group was -1.35 (95% CI = -2.33, -0.37) and for the later group was -7.17 (95% CI = -10.93, -3.41). In a meta-regression model including a term for timing of blood draw, the intercept was slightly positive but essentially zero (0.59 g/ng/ml, 95% CI = -1.94, 3.11). In other words, the model indicated that when blood was drawn at the very beginning of pregnancy, there was essentially no relation of birth weight to PFOS. The results from the subgroup analyses differed from those from the model because the average gestational age at blood draw in the early group was 14 weeks, when bias would still be expected. see more A stronger inverse association in Asian studies was not completely explained by their blood draws being from later in pregnancy.

The evidence was weakly or not supportive of a causal association.

The evidence was weakly or not supportive of a causal association.Male hunters in Swedish counties with high fallout of 137Cs after the Chernobyl Nuclear Power Plant (NPP) accident have higher radiation exposure due to higher consumption of game compared with the general population.

Cancer incidence in Sweden was studied in 9 counties with different

Cs fallout after the Chernobyl NPP accident in 1986. In total, 9,267 cancer cases occurred in hunters and 138,909 cancer cases in non-hunters to 31 December 2015. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were calculated using unexposed hunters, or non-hunters, as reference to study internal radiation exposure or hunter life style, respectively.

Directly age standardized total cancer incidence showed an increasing trend in non-hunters. For hunters, the total cancer incidence was significantly lower up to 2001 when the total cancer incidence crossed over the weaker non-hunter trend and remained higher for the following 15 years. IRRs for total cancer in hunters versus non-hunters for each county did not show any clear exposure response pattern.