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Several epidemiological studies have demonstrated that particulate matter (PM) in air pollution can be involved in the genesis or aggravation of different cardiovascular, respiratory, perinatal, and cancer diseases. This study assessed the in vitro effects of PM10 on the secretion of cytokines by a human monocytic cell line (THP-1). We compared the chemotactic, pro-inflammatory, and anti-inflammatory cytokines induced by PM10 collected for two years during three different seasons in five different Mexico City locations. MIP-1α, IP-10, MCP-1, TNF-α, and VEGF were the main secretion products after stimulation with 80 µg/mL of PM10 for 24 h. The THP-1 cells showed a differential response to PM10 obtained in the different sites of Mexico City. The PM10 from the north and the central city areas induced a higher pro-inflammatory cytokine response than those from the south. Seasonal pro-inflammatory cytokine secretion always exceeded anti-inflammatory secretion. The rainy-season-derived particles caused the lowest pro-inflammatory effects. We concluded that toxicological assessment of airborne particles provides evidence supporting their potential role in the chronic exacerbation of local or systemic inflammatory responses that may worsen the evolution of some chronic diseases.
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BACKGROUND/OBJECTIVE: Changes in metabolism and extensive hemodynamic adjustments occur during normal pregnancy. The presence of maternal obesity imposes an overload to these physiological adaptations that may result in increased risk for the development of cardiometabolic complications during and after pregnancy. The aim of this study is to describe total cholesterol (TC), triglycerides (TG), glucose, and arterial blood pressure (BP) trajectories and to analyze the association of these cardiometabolic risk indicators during pregnancy with pre-pregnancy body mass index (pBMI) and monthly gestational weight gain (MGWG). SUBJECTS/METHODS: A prospective cohort study of pregnant women was conducted in Mexico City. Monthly samples of blood were taken during clinical follow-up and biochemical and blood pressure were measured during each visit. Adjusted linear mixed-effect regression models were fit to describe the trajectories of these biomarkers during pregnancy and to analyze the association with pBMI and MGWG. RESULTS: Seven hundred and twenty women were included of which 16.6% had pre-gestational obesity, 33.2% had pre-gestational overweight, 45.8% had normal pBMI and 4.4% had pre-gestational underweight. Women with pre-gestational obesity had higher lipids concentrations in the beginning of pregnancy (TC: [Formula: see text] = 33.08, p = 0.010; TG: [Formula: see text] = 31.29, p = <0.001) but the concentrations increased less than in women with normal pBMI (TC: [Formula: see text] = -14.18, p = 0.001; TG: [Formula: see text] = -5.42, p < 0.001). By the end of pregnancy, women with pre-gestational obesity had lower concentrations of lipids than women with normal pBMI. By contrast, women with pre-gestational obesity had higher glucose concentrations and higher BP levels than women with normal pBMI over pregnancy. CONCLUSIONS: pBMI is differentially associated with longitudinal trajectories of maternal biochemical markers of cardiometabolic risk. MGWG did not significantly affect the biochemical indicators or BP trajectories. Our results suggest that pBMI is more relevant to predicting adverse cardiometabolic markers trajectories during pregnancy than MGWG.
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Índice de Massa Corporal , Aumento de Peso , Fatores de Risco Cardiometabólico , Feminino , Humanos , Gravidez , Estudos ProspectivosRESUMO
Background: Early delivery remains a significant public health problem that has long-lasting impacts on mother and child. Understanding biological mechanisms underlying timing of labor, including endocrine disruption, can inform prevention efforts. Methods: Gestational hormones were measured among 976 women in PROTECT, a longitudinal birth cohort in Puerto Rico. We evaluated associations between hormone concentrations at 18 and 26 weeks gestation and gestational age at birth, while assessing effect modification by fetal sex. Exploratory analyses assessed binary outcomes of overall preterm birth (PTB, <37 weeks gestation) and the spontaneous PTB subtype, defined as preterm premature rupture of membranes, spontaneous preterm labor, or both. Multivariable logistic and linear regressions were fit using visit-specific hormone concentrations, and fetal sex-specific effects were estimated using interaction terms. Main outcome models were adjusted for maternal age, education, marital status, alcohol consumption, environmental tobacco smoke exposure, and pre-pregnancy body mass index (BMI). Exploratory models adjusted for maternal age and education. Results: We observed reduced gestational age at birth with higher circulating CRH (ß: -2.73 days, 95% CI: -4.97, -0.42), progesterone (ß: -4.90 days, 95% CI: -7.07, -2.73), and fT4 concentrations (ß: -2.73 days, 95% CI: -4.76, -0.70) at 18 weeks specifically among male fetuses. Greater odds of overall and spontaneous PTB were observed among males with higher CRH, estriol, progesterone, total triiodothyronine (T3), and free thyroxine (fT4) concentrations. Greater odds of PTB among females was observed with higher testosterone concentrations. Conclusions: Various associations between hormones and timing of delivery were modified by fetal sex and timing of hormone measurement. Future studies are needed to understand differential mechanisms involved with timing of labor between fetal sexes.
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Parto Obstétrico , Feto/metabolismo , Hormônios/sangue , Fatores Etários , Índice de Massa Corporal , Escolaridade , Disruptores Endócrinos , Feminino , Idade Gestacional , Humanos , Recém-Nascido Prematuro , Estudos Longitudinais , Masculino , Gravidez , Resultado da Gravidez , Nascimento Prematuro , Porto Rico , Caracteres Sexuais , Fatores SocioeconômicosRESUMO
BACKGROUND: Particulate matter ≤10 µm in aerodynamic diameter (PM10) and diet quality are risk factors for systemic inflammation, which is associated with preterm birth (PTB). PM10 and a pro-inflammatory diet (assessed by the Dietary Inflammatory Index [DII®]) have been individually evaluated as causes of PTB and differences by offspring sex have been reported for the DII. However, additional studies are needed to evaluate joint effects of these associations to inform intervention efforts. OBJECTIVES: To evaluate the independent and joint effects of PM10 and energy-adjusted DII (E-DII) on PTB risks. METHODS: PM10 estimates were generated from daily citywide averages for 1216 pregnant women from three subcohorts of the Early Life Exposures in Mexico to Environmental Toxicants study using data from the Mexico City Outdoor Air Monitoring Network. Among a subset of participants (N = 620), E-DII scores were calculated using a validated food frequency questionnaire. Cox Proportional Hazards models were run for select periods during pregnancy and entire pregnancy averages for E-DII and PM10. We assessed for potential non-linear associations using natural splines. RESULTS: In adjusted models, PM10 exposure was associated with increased risks of PTB for a range of values (58-72 µg/m3) during the second trimester, while negative associations were seen during the second (≥74 µg/m3) and third trimesters (55-65 µg/m3). Analyses conducted using distributed lag models for periods closer to delivery (max lag = 90) did not show negative associations between PM10 exposure and preterm birth, and indeed positive significant associations were observed (estimates and figures). E-DII was not associated with PTB and there was no evidence of effect modification by infant sex. There was no evidence of interaction between PM10 and E-DII and the risk of preterm birth. DISCUSSION: Associations between PM10 and PTB in Mexico City varied over time and across levels of PM10. Our findings of negative associations in the second and third trimesters, which are contrary to the hypothesized relationship between PM10 and PTB, may be due to a number of factors, including live birth bias and the exposure period evaluated. Differences in results for the periods evaluated suggest that PM10 from shorter exposure windows may play a more proximal role in initiating preterm labor.
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Poluentes Atmosféricos , Poluição do Ar , Nascimento Prematuro , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Dieta/efeitos adversos , Exposição Dietética , Feminino , Humanos , Lactente , Recém-Nascido , Exposição Materna/efeitos adversos , México/epidemiologia , Material Particulado/análise , Material Particulado/toxicidade , Gravidez , Nascimento Prematuro/induzido quimicamente , Nascimento Prematuro/epidemiologiaRESUMO
Although the isolated effects of several specific nutrients have been examined, little is known about the relationship between overall maternal diet during pregnancy and fetal development and growth. This study evaluates the association between maternal diet and low birthweight (LBW) in 660 pregnant women from the Pregnancy Research on Inflammation, Nutrition,& City Environment: Systematic Analyses (PRINCESA) cohort in Mexico City. Using prior day dietary intake reported at multiple prenatal visits, diet was assessed prospectively using a priori (Maternal Diet Quality Score [MDQS]) and a posteriori (dietary patterns extracted by factor analysis) approaches. The association between maternal diet and LBW was investigated by logistic regression, controlling for confounders. Adherence to recommended guidelines (higher MDQS) was associated with a reduced risk of LBW (OR, 0.22; 95% confidence interval [0.06, 0.75], P < .05, N = 49) compared with the lowest adherence category (reference group), controlling for maternal age, education, height, marital status, pre-pregnancy body mass index, parity, energy intake, gestational weight gain, and preterm versus term birth; a posteriori dietary patterns were not associated with LBW risk. Higher adherence to MDQS was associated with a lower risk of having an LBW baby in this sample. Our results support the role of advocating a healthy overall diet, versus individual foods or nutrients, in preventing LBW.
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Dieta/métodos , Desenvolvimento Fetal , Recém-Nascido de Baixo Peso , Fenômenos Fisiológicos da Nutrição Materna , Política Nutricional , Adulto , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , México , Gravidez , Estudos Prospectivos , Adulto JovemRESUMO
OBJECTIVE: The aims of this study were to characterize, among pregnant Mexican women, gestational weight gain (GWG) trajectories; assess associations of maternal dietary quality score (MDQS) with GWG during early-mid pregnancy, middle pregnancy, late pregnancy, and prolonged pregnancy; and evaluate the association between MDQS and adequacy of GWG, throughout pregnancy. We hypothesized that higher MDQS adherence is protective against insufficient or excessive GWG across pregnancy and that the association between MDQS adherence and GWG would vary by prepregnancy body mass index (BMI) category. METHODS: We analyzed data from 660 pregnant women participating in the PRINCESA (Pregnancy Research on Inflammation, Nutrition and City Environments: Systematic Analyses) cohort in Mexico City, 2009 to 2014. Repeated measures of dietary intake and mother's weight were obtained during pregnancy. Individual GWG trajectories were modeled in a multilevel regression framework. Associations between MDQS (low, medium, and high adherence) and GWG were investigated using mixed-effect regression models with linear splines. RESULTS: Women with prepregnancy BMI of ≥30 kg/m2 had a slower rate of GWG (RGWG) compared with other categories. A higher adherence to MDQS was protective against an insufficient (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.42-0.95; Pâ¯=â¯0.03) and an excessive RGWG (OR, 0.62; 95% CI, 0.41-0.94; Pâ¯=â¯0.03) throughout pregnancy, adjusting for prepregnancy BMI, energy intake, maternal age, educational level, parity, fetal sex, marital status, and physical activity. Associations between diet and RGWG differed by gestational period. CONCLUSION: A better quality diet, as measured by MDQS, was associated with appropriate GWG during pregnancy in the PRINCESA cohort.
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Trajetória do Peso do Corpo , Dieta Saudável/estatística & dados numéricos , Ganho de Peso na Gestação , Adulto , Índice de Massa Corporal , Estudos de Coortes , Dieta/efeitos adversos , Feminino , Humanos , México , Razão de Chances , Sobrepeso/etiologia , Gravidez , Complicações na Gravidez/etiologia , Adulto JovemRESUMO
BACKGROUND: Environmental exposures are associated with a number of outcomes including adverse pregnancy outcomes. Although inflammation is hypothesized to play a role, the mechanistic pathways between environmental exposures and adverse health outcomes, including associations between exposures and longitudinal measures of systemic and reproductive tract inflammation, need elucidation. OBJECTIVES: This study was conducted to evaluate whether exposure to air pollution is associated with immunologic responses in the systemic circulation and lower reproductive tract, and to evaluate whether systemic and reproductive tract immunologic responses are similar. METHODS: We quantified repeated measures of cytokines from cervico-vaginal exudates and serum obtained concurrently among 104 women with term pregnancies and estimated PM10 and CO exposure using the monitor nearest each participant's residence. Serum and cervico-vaginal cytokines were compared using Wilcoxon signed-ranks test and Spearman rank correlations for select gestational months. We used intraclass correlation coefficients (ICCs) to quantify reproducibility of cytokine measurements, and Tobit regression to estimate associations between air pollution and cytokines. RESULTS: Median cervico-vaginal levels of IL-6, Eotaxin, IP-10, MCP-1, MIP-1α, MIP-1ß, and TNFα were higher than corresponding serum cytokines, significantly so for IL-6 and IP-10. Cervico-vaginal and serum cytokines were not correlated, but cytokines from the same fluid were correlated. ICCs for most serum cytokines were ≤0.40, while ICCs were higher in cervico-vaginal cytokines (range 0.52-0.83). IP-10 and Eotaxin had the highest ICCs for both cytokine sources. In adjusted models, PM10 was positively associated with serum cytokines IL-6, IP-10, MIP-1ß and Eotaxin but inversely associated with cervico-vaginal cytokine TNFα, IP-10, MIP-1ß, MCP-1 and Eotaxin, controlling for false discovery rate. CO was inversely associated with cervico-vaginal TNFα, IL-6, MIP-1ß, MCP-1 and Eotaxin. CONCLUSIONS: Inflammatory processes are compartment-specific. Systemic inflammatory markers may provide information on immunologic processes and response to environmental exposures, but are not proxies for lower reproductive tract inflammation.
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Poluição do Ar/estatística & dados numéricos , Citocinas/metabolismo , Monitoramento Ambiental , Exposição Materna/estatística & dados numéricos , Adulto , Biomarcadores/metabolismo , Exposição Ambiental , Feminino , Humanos , Inflamação , México , Gravidez , Adulto JovemRESUMO
Air pollution has been linked to adverse cardiovascular outcomes; however, susceptibility may vary by population. Puerto Rican adults living in the US may be a susceptible group due to a high rate of adverse cardiovascular events. We evaluated the effect of changes in ambient particle number concentration (PNC, a measure of ultrafine particles) and effects on biomarkers of cardiovascular risk in the Boston Puerto Rican Health Study (BPRHS), a longitudinal cohort (nâ¯=â¯1499). Ambient PNC was measured at a fixed site between 2004 and 2013 and daily mean concentrations were used to construct PNC metrics, including lags of 0, 1 and 2 days and moving averages (MAs) of 3, 7 and 28 days. We examined the association of each metric with C-reactive protein (CRP) and blood pressure. Each model included subject-specific random intercepts to account for multiple measurements. An interquartile range (IQR) increase in PNC was associated with CRP for all metrics, notably a 3-day increase in PNC was associated with a 7.1% (95% CI: 2.0%, 12.2%) increase in CRP. Significant associations with CRP were seen in women, but not men; with current and former (but not non-) smokers; participants younger (but not older) than 65â¯y; those without diabetes (but not with), and those with (but not without), hypertension. Our study extends knowledge about the health effects of air pollution to a vulnerable population that has been understudied.
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Poluição do Ar/análise , Biomarcadores/sangue , Sistema Cardiovascular , Adulto , Pressão Sanguínea , Boston/epidemiologia , Proteína C-Reativa/análise , Feminino , Hispânico ou Latino , Humanos , Estudos Longitudinais , Masculino , Material Particulado , Porto Rico/etnologiaRESUMO
The Mexico City Metropolitan Area (MCMA) is one of the largest and most populated urban environments in the world and experiences high air pollution levels. To develop models that estimate pollutant concentrations at fine spatiotemporal scales and provide improved air pollution exposure assessments for health studies in Mexico City. We developed finer spatiotemporal land use regression (LUR) models for PM2.5, PM10, O3, NO2, CO and SO2 using mixed effect models with the Least Absolute Shrinkage and Selection Operator (LASSO). Hourly traffic density was included as a temporal variable besides meteorological and holiday variables. Models of hourly, daily, monthly, 6-monthly and annual averages were developed and evaluated using traditional and novel indices. The developed spatiotemporal LUR models yielded predicted concentrations with good spatial and temporal agreements with measured pollutant levels except for the hourly PM2.5, PM10 and SO2. Most of the LUR models met performance goals based on the standardized indices. LUR models with temporal scales greater than one hour were successfully developed using mixed effect models with LASSO and showed superior model performance compared to earlier LUR models, especially for time scales of a day or longer. The newly developed LUR models will be further refined with ongoing Mexico City air pollution sampling campaigns to improve personal exposure assessments.
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Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Monitoramento Ambiental/métodos , Cidades , México , Material ParticuladoRESUMO
BACKGROUND: Observed seasonal differences in particulate matter (PM) associations with human health may be due to their composition and to toxicity-related seasonal interactions. OBJECTIVES: We assessed seasonality in PM composition and in vitro PM pro-inflammatory potential using multiple PM samples. METHODS: We collected 90 weekly PM10 and PM2.5 samples during the rainy-warm and dry-cold seasons in five urban areas with different pollution sources. The elements, polycyclic aromatic hydrocarbons (PAHs), and endotoxins identified in the samples were subjected to principal component analysis (PCA). We tested the potential of the PM to induce tumor necrosis factor alpha (TNFα) and interleukin 6 (IL-6) secretion in cultured human monocytes (THP-1), and we modeled pro-inflammatory responses using the component scores. RESULTS: PM composition varied by size and by season. PCA identified two main components that varied by season. Combustion-related constituents (e.g., vanadium, benzo[a]pyrene, benzo[a]anthracene) mainly comprised component 1 (C1). Soil-related constituents (e.g., endotoxins, silicon, aluminum) mainly comprised component 2 (C2). PM from the rainy-warm season was high in C2. PM (particularly PM2.5) from the dry-cold season was rich in C1. Elevated levels of cytokine production were associated with PM10 and C2 (rainy-warm season), whereas reduced levels of cytokine production were associated with PM2.5 and C1 (dry-cold season). TNFα secretion was increased following exposure to PM with high (vs. low) C2 content, but TNFα secretion in response to PM was decreased following exposure to samples containing ≥ 0.1% of C1-related PAHs, regardless of C2 content. The results of the IL-6 assays suggested more complex interactions between PM components and particle size. CONCLUSIONS: Variations in PM soil and PAH content underlie seasonal and PM size-related patterns in TNFα secretion. These results suggest that the mixture of components in PM explains some seasonal differences in associations between health outcomes and PM in epidemiologic studies. CITATION: Manzano-León N, Serrano-Lomelin J, Sánchez BN, Quintana-Belmares R, Vega E, Vázquez-López I, Rojas-Bracho L, López-Villegas MT, Vadillo-Ortega F, De Vizcaya-Ruiz A, Rosas Perez I, O'Neill MS, Osornio-Vargas AR. 2016. TNFα and IL-6 responses to particulate matter in vitro: variation according to PM size, season, and polycyclic aromatic hydrocarbon and soil content. Environ Health Perspect 124:406-412; http://dx.doi.org/10.1289/ehp.1409287.
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Poluentes Atmosféricos/toxicidade , Interleucina-6/metabolismo , Material Particulado/toxicidade , Hidrocarbonetos Policíclicos Aromáticos/toxicidade , Estações do Ano , Poluentes do Solo/toxicidade , Solo/química , Fator de Necrose Tumoral alfa/metabolismo , Poluentes Atmosféricos/química , Linhagem Celular Tumoral , Cidades , Endotoxinas/toxicidade , Monitoramento Ambiental , Humanos , Metais/química , México , Tamanho da Partícula , Material Particulado/química , Hidrocarbonetos Policíclicos Aromáticos/química , Poluentes do Solo/químicaRESUMO
UNLABELLED: Geostatistical interpolation methods to estimate individual exposure to outdoor air pollutants can be used in pregnancy cohorts where personal exposure data are not collected. Our objectives were to a) develop four assessment methods (citywide average (CWA); nearest monitor (NM); inverse distance weighting (IDW); and ordinary Kriging (OK)), and b) compare daily metrics and cross-validations of interpolation models. We obtained 2008 hourly data from Mexico City's outdoor air monitoring network for PM10, PM2.5, O3, CO, NO2, and SO2 and constructed daily exposure metrics for 1,000 simulated individual locations across five populated geographic zones. Descriptive statistics from all methods were calculated for dry and wet seasons, and by zone. We also evaluated IDW and OK methods' ability to predict measured concentrations at monitors using cross validation and a coefficient of variation (COV). All methods were performed using SAS 9.3, except ordinary Kriging which was modeled using R's gstat package. Overall, mean concentrations and standard deviations were similar among the different methods for each pollutant. Correlations between methods were generally high (r=0.77 to 0.99). However, ranges of estimated concentrations determined by NM, IDW, and OK were wider than the ranges for CWA. Root mean square errors for OK were consistently equal to or lower than for the IDW method. OK standard errors varied considerably between pollutants and the computed COVs ranged from 0.46 (least error) for SO2 and PM10 to 3.91 (most error) for PM2.5. OK predicted concentrations measured at the monitors better than IDW and NM. Given the similarity in results for the exposure methods, OK is preferred because this method alone provides predicted standard errors which can be incorporated in statistical models. The daily estimated exposures calculated using these different exposure methods provide flexibility to evaluate multiple windows of exposure during pregnancy, not just trimester or pregnancy-long exposures. IMPLICATIONS: Many studies evaluating associations between outdoor air pollution and adverse pregnancy outcomes rely on outdoor air pollution monitoring data linked to information gathered from large birth registries, and often lack residence location information needed to estimate individual exposure. This study simulated 1,000 residential locations to evaluate four air pollution exposure assessment methods, and describes possible exposure misclassification from using spatial averaging versus geostatistical interpolation models. An implication of this work is that policies to reduce air pollution and exposure among pregnant women based on epidemiologic literature should take into account possible error in estimates of effect when spatial averages alone are evaluated.
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Poluentes Atmosféricos/análise , Poluição do Ar/análise , Exposição Ambiental , Monitoramento Ambiental/métodos , Modelos Estatísticos , Feminino , Humanos , México , Gravidez , Estações do AnoRESUMO
Preterm birth is a public health issue of global significance, which may result in mortality during the perinatal period or may lead to major health and financial consequences due to lifelong impacts. Even though several risk factors for preterm birth have been identified, prevention efforts have failed to halt the increasing rates of preterm birth. Epidemiological studies have identified air pollution as an emerging potential risk factor for preterm birth. However, many studies were limited by study design and inadequate exposure assessment. Due to the ubiquitous nature of ambient air pollution and the potential public health significance of any role in causing preterm birth, a novel focus investigating possible causal mechanisms influenced by air pollution is therefore a global health priority. We hypothesize that air pollution may act together with other biological factors to induce systemic inflammation and influence the duration of pregnancy. Evaluation and testing of this hypothesis is currently being conducted in a prospective cohort study in Mexico City and will provide an understanding of the pathways that mediate the effects of air pollution on preterm birth. The important public health implication is that crucial steps in this mechanistic pathway can potentially be acted on early in pregnancy to reduce the risk of preterm birth.
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Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Exposição Materna/efeitos adversos , Complicações na Gravidez/diagnóstico , Citocinas/metabolismo , Dieta , Feminino , Humanos , Inflamação/complicações , México , Modelos Teóricos , Obesidade/complicações , Trabalho de Parto Prematuro/etiologia , Estresse Oxidativo , Material Particulado , Gravidez , Nascimento Prematuro , Fatores de RiscoRESUMO
Spatial variation in particulate matter-related health and toxicological outcomes is partly due to its composition. We studied spatial variability in particle composition and induced cellular responses in Mexico City to complement an ongoing epidemiologic study. We measured elements, endotoxins, and polycyclic aromatic hydrocarbons in two particle size fractions collected in five sites. We compared the in vitro proinflammatory response of J774A.1 and THP-1 cells after exposure to particles, measuring subsequent TNFα and IL-6 secretion. Particle composition varied by site and size. Particle constituents were subjected to principal component analysis, identifying three components: C(1) (Si, Sr, Mg, Ca, Al, Fe, Mn, endotoxin), C(2) (polycyclic aromatic hydrocarbons), and C(3) (Zn, S, Sb, Ni, Cu, Pb). Induced TNFα levels were higher and more heterogeneous than IL-6 levels. Cytokines produced by both cell lines only correlated with C(1) , suggesting that constituents associated with soil induced the inflammatory response and explain observed spatial differences.
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Poluentes Atmosféricos/análise , Material Particulado/análise , Material Particulado/toxicidade , Poluentes Atmosféricos/química , Poluentes Atmosféricos/toxicidade , Animais , Linhagem Celular/efeitos dos fármacos , Linhagem Celular/metabolismo , Cidades , Endotoxinas/análise , Monitoramento Ambiental , Humanos , Interleucina-6/metabolismo , México , Camundongos , Tamanho da Partícula , Material Particulado/química , Hidrocarbonetos Policíclicos Aromáticos/análise , Análise de Componente Principal , Testes de Toxicidade , Fator de Necrose Tumoral alfa/metabolismoRESUMO
Preterm birth is one of the leading causes of perinatal mortality and is associated with long-term adverse health consequences for surviving infants. Preterm birth rates are rising worldwide, and no effective means for prevention currently exists. Air pollution exposure may be a significant cause of prematurity, but many published studies lack the individual, clinical data needed to elucidate possible biological mechanisms mediating these epidemiological associations. This paper presents the design of a prospective study now underway to evaluate those mechanisms in a cohort of pregnant women residing in Mexico City. We address how air quality may act together with other factors to induce systemic inflammation and influence the duration of pregnancy. Data collection includes: biomarkers relevant to inflammation in cervico-vaginal exudate and peripheral blood, along with full clinical information, pro-inflammatory cytokine gene polymorphisms and air pollution data to evaluate spatial and temporal variability in air pollution exposure. Samples are collected on a monthly basis and participants are followed for the duration of pregnancy. The data will be used to evaluate whether ambient air pollution is associated with preterm birth, controlling for other risk factors. We will evaluate which time windows during pregnancy are most influential in the air pollution and preterm birth association. In addition, the epidemiological study will be complemented with a parallel toxicology invitro study, in which monocytic cells will be exposed to air particle samples to evaluate the expression of biomarkers of inflammation.
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Poluição do Ar , Monitoramento Ambiental , Inflamação/epidemiologia , Nascimento Prematuro/epidemiologia , Adulto , Biomarcadores/metabolismo , Citocinas/genética , Citocinas/metabolismo , Feminino , Humanos , México/epidemiologia , Polimorfismo Genético , Gravidez , Estudos Prospectivos , Fatores de Risco , Fatores de TempoRESUMO
BACKGROUND: People with less education in Europe, Asia, and the United States are at higher risk of mortality associated with daily and longer-term air pollution exposure. We examined whether educational level modified associations between mortality and ambient particulate pollution (PM10) in Latin America, using several timescales. METHODS: The study population included people who died during 1998-2002 in Mexico City, Mexico; Santiago, Chile; and São Paulo, Brazil. We fit city-specific robust Poisson regressions to daily deaths for nonexternal-cause mortality, and then stratified by age, sex, and educational attainment among adults older than age 21 years (none, some primary, some secondary, and high school degree or more). Predictor variables included a natural spline for temporal trend, linear PM10 and apparent temperature at matching lags, and day-of-week indicators. We evaluated PM10 for lags 0 and 1 day, and fit an unconstrained distributed lag model for cumulative 6-day effects. RESULTS: The effects of a 10-microg/m increment in lag 1 PM10 on all nonexternal-cause adult mortality were for Mexico City 0.39% (95% confidence interval = 0.13%-0.65%); São Paulo 1.04% (0.71%-1.38%); and for Santiago 0.61% (0.40%-0.83%). We found cumulative 6-day effects for adult mortality in Santiago (0.86% [0.48%-1.23%]) and São Paulo (1.38% [0.85%-1.91%]), but no consistent gradients by educational status. CONCLUSIONS: PM10 had important short- and intermediate-term effects on mortality in these Latin American cities, but associations did not differ consistently by educational level.
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Poluição do Ar/efeitos adversos , Escolaridade , Mortalidade , Material Particulado/efeitos adversos , Adulto , Idoso , Brasil/epidemiologia , Chile/epidemiologia , Cidades , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Modelos Biológicos , Material Particulado/análise , Risco , Tempo (Meteorologia) , Adulto JovemRESUMO
BACKGROUND: Factors affecting vulnerability to heat-related mortality are not well understood. Identifying susceptible populations is of particular importance given anticipated rising temperatures from climatic change. METHODS: We investigated heat-related mortality for three Latin American cities (Mexico City, Mexico; São Paulo, Brazil; Santiago, Chile) using a case-crossover approach for 754 291 deaths from 1998 to 2002. We considered lagged exposures, confounding by air pollution, cause of death and susceptibilities by educational attainment, age and sex. RESULTS: Same and previous day apparent temperature were most strongly associated with mortality risk. Effect estimates remained positive though lowered after adjustment for ozone or PM(10). Susceptibility increased with age in all cities. The increase in mortality risk for those >or=65 comparing the 95th and 75th percentiles of same-day apparent temperature was 2.69% (95% CI: -2.06 to 7.88%) for Santiago, 6.51% (95% CI: 3.57-9.52%) for São Paulo and 3.22% (95% CI: 0.93-5.57%) for Mexico City. Patterns of vulnerability by education and sex differed across communities. Effect estimates were higher for women than men in Mexico City, and higher for men elsewhere, although results by sex were not appreciably different for any city. In São Paulo, those with less education were more susceptible, whereas no distinct patterns by education were observed in the other cities. CONCLUSIONS: Elevated temperatures are associated with mortality risk in these Latin American cities, with the strongest associations in São Paulo, the hottest city. The elderly are an important population for targeted prevention measures, but vulnerability by sex and education differed by city.
Assuntos
Cidades , Temperatura Alta/efeitos adversos , Mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Poluentes Atmosféricos/toxicidade , Brasil , Criança , Pré-Escolar , Chile , Estudos Cross-Over , Escolaridade , Feminino , Análise de Fourier , Humanos , Lactente , Recém-Nascido , Masculino , México , Pessoa de Meia-Idade , Ozônio/toxicidade , Material Particulado , Fatores Sexuais , Adulto JovemRESUMO
We assessed the influence of control for air pollution and respiratory epidemics on associations between apparent temperature (AT) and daily mortality in Mexico City and Monterrey. Poisson regressions were fit to mortality among all ages, children (ages 0-14 years) and the elderly (ages >or=65 years). Predictors included mean daily AT, season, day of week and public holidays for the base model. Respiratory epidemics and air pollution (particulate matter <10 microm in aerodynamic diameter and O3) were added singly and then jointly for a fully adjusted model. Percent changes in mortality were calculated for days of relatively extreme temperatures [cold (10-11 degrees C) for both cities and heat (35-36 degrees C) for Monterrey], compared to days at the overall mean temperature in each city (15 degrees C in Mexico City, 25 degrees C in Monterrey). In Mexico City, total mortality increased 12.4% [95% confidence interval (CI) 10.5%, 14.5%] on cold days (fully adjusted). Among children, the adjusted association was similar [10.9% (95% CI: 5.4%, 16.7%)], but without control for pollution and epidemics, was nearly twice as large [19.7% (95% CI: 13.9%, 25.9)]. In Monterrey, the fully adjusted heat effect for all deaths was 18.7% (95% CI: 11.7%, 26.1%), a third lower than the unadjusted estimate; the heat effect was lower among children [5.5% (95% CI: -10.1%, 23.8%)]. Cold had a similar effect on all-age mortality as in Mexico City [11.7% (95% CI: 3.7%, 20.3%)]. Responses of the elderly differed little from all-ages responses in both cities. Associations between weather and health persisted even with control for air pollution and respiratory epidemics in two Mexican cities, but risk assessments and climate change adaptation programs are best informed by analyses that account for these potential confounders.
Assuntos
Temperatura Baixa/efeitos adversos , Temperatura Alta/efeitos adversos , Mortalidade , Adolescente , Idoso , Idoso de 80 Anos ou mais , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Criança , Pré-Escolar , Cidades , Monitoramento Ambiental , Efeito Estufa , Humanos , Umidade , Lactente , Recém-Nascido , México , Ozônio/análise , Doenças RespiratóriasRESUMO
We evaluated whether associations between PM10 and daily mortality in Mexico City differ by the PM10 measurement device or by regional differences in particle composition. Additionally, we reanalyzed previously collected data in light of recent insights about flaws in commonly used time series analysis techniques. We examined daily associations between mortality and four indicators of ambient PM10 using Poisson regression, controlling for temperature and time trends with cubic natural splines. Associations were calculated for five subregions corresponding to five monitoring sites and pooled for the entire metropolitan area. PM10 was measured with three methods: Tapered Element Oscillating Microbalance (TEOM), Sierra-Anderson High Volume (Hi-Vol) and Harvard Impactor (HI), the latter only at one site. In addition, predicted values of daily PM10 were developed using the Hi-Vol measurements, which were taken every sixth day, and weather, visibility and other pollutant data. We assigned deaths to the exposure from the monitor nearest to their residence. We also re-evaluated the HI PM2.5 and mortality association in southwest Mexico City, which was estimated previously using nonparametric statistical models. Slight decreases in effect estimates were observed (a 1.45% increase (95% CI: 0.09%, 2.83%) in total mortality per 10 microg/m(3) increment of PM2.5 at lag 0) compared to a 1.68% change (95% CI: 0.45%, 2.93%) using the previously employed nonparametric approach. Using data pooled over all the regions, PM10 measured by the TEOM and the predicted PM10 values showed little association with mortality at any of the lags examined. The pooled estimates for Hi-Vol PM10 (using one sixth of the data) were positive across all lags examined and significant for lags 3 and 5. No consistent patterns of differing associations were seen across regions that would correspond with particle toxicity or composition. Particulate air pollution, measured with gravimetric methods, is associated with daily mortality and presents a risk to health in Mexico City. The reanalysis suggests that previous research is robust to statistical method and likely to yield the same overall conclusions about the short-term effects of airborne particles on mortality.
Assuntos
Poluentes Atmosféricos/intoxicação , Mortalidade/tendências , Humanos , México/epidemiologia , Tamanho da Partícula , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Tempo , População UrbanaRESUMO
We investigated whether the association of daily mortality and ambient ozone differs by age and area social conditions of the region of residence using a time-series analysis. The study setting was metropolitan Mexico City, a high altitude city situated in a valley, with an estimated 20 million inhabitants, large socioeconomic gradients, and ozone levels frequently exceeding international standards. We stratified daily deaths by six census-derived socioeconomic indicators, based on characteristics of the county where decedents lived. We used Poisson regression to model the association between daily mortality and ozone levels (on the day of death and the previous day) in separate models, stratified by area socioeconomic level and age, and controlling for time trends and temperature. Ozone was positively associated with total mortality [0.65% increase per 10 ppb increment, 95% confidence interval (CI): 0.02%, 1.28%] and for mortality among those over age 65 [1.39% increase per 10 ppb increment, 95% CI: 0.51%, 2.28%]. Associations between ozone and all-age mortality did not show any consistent patterns according to socioeconomic gradients. We conclude that elderly people are at higher risk for ozone-associated mortality. Though county-level social indicators in Mexico City were not strong markers of vulnerability to ozone-associated acute mortality in this analysis, complex associations between individual and area-level factors may exist that would require additional data and further analyses to elucidate.
Assuntos
Poluentes Atmosféricos/toxicidade , Mortalidade , Ozônio/toxicidade , Condições Sociais/estatística & dados numéricos , Saúde da População Urbana/estatística & dados numéricos , Fatores Etários , Humanos , México , Modelos Estatísticos , Análise de Regressão , TemperaturaRESUMO
In researching health effects of air pollution, pollutant levels from fixed-site monitors are commonly assigned to the subjects. However, these concentrations may not reflect the exposure these individuals actually experience. A previous study of ozone (O3) exposure and lung function among shoe-cleaners working in central Mexico City used fixed-site measurements from a monitoring station near the outdoor work sites as surrogates for personal exposure. The present study assesses the degree to which these estimates represented individual exposures. In 1996, personal O3 exposures of 39 shoe-cleaners working outdoors were measured using an active integrated personal sampler. Using mixed models, we assessed the relationship between measured personal O3 exposure and ambient O3 measurements from the fixed-site monitoring station. Ambient concentrations were approximately 50 parts per billion higher, on average, than personal exposures. The association between personal and ambient O3 was highly significant (mixed model slope p < 0.0001). The personal/ambient ratio was not constant, so use of the outdoor monitor would not be appropriate to rank O3 exposure and evaluate health effects between workers. However, the strong within-worker longitudinal association validates previous findings associating day-to-day changes in fixed-site O3 levels with adverse health effects among these shoe-cleaners and suggests fixed-site O3 monitors may adequately estimate exposure for other repeated-measure health studies of outdoor workers.