Publications
194 results found
Guyatt AL, Cai YS, Doiron D, et al., 2024, Air pollution, lung function and mortality: survival and mediation analyses in UK Biobank, ERJ Open Research, Pages: 00093-2024
<jats:sec><jats:title>Background</jats:title><jats:p>Air pollution is associated with lower lung function, and both are associated with premature mortality and cardiovascular disease (CVD). Evidence remains scarce on the potential mediating effect of impaired lung function on the association between air pollution and mortality or CVD.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We used data from UK Biobank (N∼200 000) with 8-year follow-up to mortality and incident CVD. Exposures to PM<jats:sub>10</jats:sub>, PM<jats:sub>2.5</jats:sub>, and NO<jats:sub>2</jats:sub>were assessed by land-use regression modelling. Lung function [forced expiratory volume in 1-second (FEV<jats:sub>1</jats:sub>), Forced Vital Capacity (FVC), and their ratio] was measured between 2006–2010 and transformed to Global Lung Function Initiative z-scores. Adjusted Cox proportional hazards and causal proportional hazards mediation analysis models were fitted, stratified by smoking status.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Lower FEV<jats:sub>1</jats:sub>and FVC were associated with all-cause and CVD mortality, and incident CVD, with larger estimates in ever- than never-smokers: (all-cause mortality Hazard Ratio (HR) per decrease FEV<jats:sub>1</jats:sub>GLI z-score, ever-smokers: 1.29 [95%CI:1.24–1.34], never-smokers: HR 1.16 [95%CI:1.12–1.21]). Long-term exposure to PM<jats:sub>2.5</jats:sub>or NO<jats:sub>2</jats:sub>was associated with incident CVD, with similar effect sizes for ever and never-smokers. Mediated proportions of the air pollution—all-cause mortality estimates driven by FEV<jats:sub>1</jats:sub>were 18% [95%CI:2%-33%] for PM<jats:sub>2.5</jats:sub>, and 27% [95%CI:3%-51%] for
Allen NE, Lacey B, Lawlor DA, et al., 2024, Prospective study design and data analysis in UK Biobank., Sci Transl Med, Vol: 16
Population-based prospective studies, such as UK Biobank, are valuable for generating and testing hypotheses about the potential causes of human disease. We describe how UK Biobank's study design, data access policies, and approaches to statistical analysis can help to minimize error and improve the interpretability of research findings, with implications for other population-based prospective studies being established worldwide.
Williams AT, Chen J, Coley K, et al., 2023, Genome-wide association study of thyroid-stimulating hormone highlights new genes, pathways and associations with thyroid disease., Nat Commun, Vol: 14
Thyroid hormones play a critical role in regulation of multiple physiological functions and thyroid dysfunction is associated with substantial morbidity. Here, we use electronic health records to undertake a genome-wide association study of thyroid-stimulating hormone (TSH) levels, with a total sample size of 247,107. We identify 158 novel genetic associations, more than doubling the number of known associations with TSH, and implicate 112 putative causal genes, of which 76 are not previously implicated. A polygenic score for TSH is associated with TSH levels in African, South Asian, East Asian, Middle Eastern and admixed American ancestries, and associated with hypothyroidism and other thyroid disease in South Asians. In Europeans, the TSH polygenic score is associated with thyroid disease, including thyroid cancer and age-of-onset of hypothyroidism and hyperthyroidism. We develop pathway-specific genetic risk scores for TSH levels and use these in phenome-wide association studies to identify potential consequences of pathway perturbation. Together, these findings demonstrate the potential utility of genetic associations to inform future therapeutics and risk prediction for thyroid diseases.
Eminson K, Cai YS, Chen Y, et al., 2023, Does air pollution confound associations between environmental noise and cardiovascular outcomes?-A systematic review, ENVIRONMENTAL RESEARCH, Vol: 232, ISSN: 0013-9351
Riveron TP, Wilde MJ, Ibrahim W, et al., 2023, Characterisation of volatile organic compounds in hospital indoor air and exposure health risk determination, BUILDING AND ENVIRONMENT, Vol: 242, ISSN: 0360-1323
Itzkowitz N, Gong X, Atilola G, et al., 2023, Aircraft noise and cardiovascular morbidity and mortality near Heathrow Airport: a case-crossover study, Environment International, Vol: 177, Pages: 1-9, ISSN: 0160-4120
Aircraft noise causes annoyance and sleep disturbance and there is some evidence of associations between long-term exposures and cardiovascular disease (CVD). We investigated short-term associations between previous day aircraft noise and cardiovascular events in a population of 6.3 million residing near Heathrow Airport using a case-crossover design and exposure data for different times of day and night. We included all recorded hospitalisations (n=442,442) and deaths (n=49,443) in 2014-2018 due to CVD. Conditional logistic regression was used to estimate the ORs and adjusted for NO2 concentration, temperature, and holidays. We estimated an increase in risk for 10dB increment in noise during the previous evening (Leve OR = 1.007, 95% CI 0.999-1.015), particularly from 22:00-23:00h (OR= 1.007, 95% CI 1.000-1.013), and the early morning hours 04:30-06:00h (OR= 1.012, 95% CI 1.002-1.021) for all CVD admissions, but no significant associations with day-time noise. There was effect modification by age-sex, ethnicity, deprivation, and season, and some suggestion that high noise variability at night was associated with higher risks. Our findings are consistent with proposed mechanisms for short-term impacts of aircraft noise at night on CVD from experimental studies, including sleep disturbance, increases in blood pressure and stress hormone levels and impaired endothelial function.
Chen Y, Hansell AL, Clark SN, et al., 2023, Environmental noise and health in low-middle-income-countries: A systematic review of epidemiological evidence, ENVIRONMENTAL POLLUTION, Vol: 316, ISSN: 0269-7491
Khan MS, Douglas P, Hansell A, et al., 2022, Assessing the health risk of living near composting facilities on lung health, fungal and bacterial disease in cystic fibrosis: a UK CF Registry study, Environmental Health, Vol: 21, Pages: 1-13, ISSN: 1476-069X
AimTo explore the health risk of living near permitted composting sites (PCSs) on disease severity in children and adults with cystic fibrosis (CF) across the UK. MethodsA semi-individual cross-sectional study was used to examine the risk of disease severity in people with CF (pwCF) within and beyond 4 km of PCSs in the UK in 2016. All pwCF registered in the UK CF Registry were eligible for this study. Linear and Poisson regressions, adjusted for age, gender, genotype, BMI, Pseudomonas aeruginosa and deprivation, were used to quantify associations between distance to a PCS and percent predicted forced expiratory volume in one second (ppFEV1), pulmonary exacerbations (#IVdays), and fungal and bacterial infections.ResultsThe mean age of the 9,361 pwCF (3,931 children and 5,430 adults) studied was 20.1 (SD = 14.1) years; 53.3% were male; and 49.2% were homozygous F508del. Over 10% of pwCF (n = 1,015) lived within 4 km of a PCS. We found no statistically significant difference in ppFEV1 and #IVdays/year in children. However, in adults, ppFEV1 was -1.07% lower (95% confidence interval (CI): -2.29%, 0.16%) and #IVdays/year were 1.02 day higher (95%CI: 1.01, 1.04) within 4 km of a PCS. Furthermore, there were statistically significant differences in mean ppFEV1 in CF adults with Aspergillus fumigatus (58.2.% vs 62.0%, p = 0.005) and Candida spp. (56.9% vs 59.9%, p = 0.029) residing within 4 km of a PCS. No associations were identified for allergic bronchopulmonary aspergillosis, P. aeruginosa or Staphylococcus aureus.ConclusionsThis novel national study provides evidence that adults with CF living near a PCS may experience small reductions in lung function, an increased risk of pulmonary exacerbations, and more frequent fungal infections. If confirmed by studies using refined exposure assessment methods accounting for bioaerosol dispersion, these results could have important implications for the living environment of
Ronaldson A, Arias de la Torre J, Ashworth M, et al., 2022, Associations between air pollution and multimorbidity in the UK Biobank: A cross-sectional study, FRONTIERS IN PUBLIC HEALTH, Vol: 10
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- Citations: 5
Tremper A, Jephcote C, Gulliver J, et al., 2022, Sources of particle number concentration and noise near London Gatwick Airport, Environment International, Vol: 161, ISSN: 0160-4120
There is increasing evidence of potential health impacts from both aircraft noise and aircraft-associated ultrafine particles (UFP). Measurements of noise and UFP are however scarce near airports and so their variability and relationship are not well understood. Particle number size distributions and noise levels were measured at two locations near Gatwick airport (UK) in 2018–19 with the aim to characterize particle number concentrations (PNC) and link PNC sources, especially UFP, with noise. Positive Matrix Factorization was used on particle number size distribution to identify these sources. Mean PNC (7500–12,000 p cm−3) were similar to those measured close to a highly trafficked road in central London. Peak PNC (94,000 p cm−3) were highest at the site closer to the runway. The airport source factor contributed 17% to the PNC at both sites and the concentrations were greatest when the respective sites were downwind of the runway. However, the main source of PNC was associated with traffic emissions. At both sites noise levels were above the recommendations by the WHO (World Health Organisation). Regression models of identified UFP sources and noise suggested that the largest source of noise (LAeq-1hr) above background was associated with sources of fresh traffic and urban UFP depending on the site. Noise and UFP correlations were moderate to low suggesting that UFP are unlikely to be an important confounder in epidemiological studies of aircraft noise and health. Correlations between UFP and noise were affected by meteorological factors, which need to be considered in studies of short-term associations between aircraft noise and health.
Gong X, Fenech B, Blackmore C, et al., 2022, Association between Noise Annoyance and Mental Health Outcomes: A Systematic Review and Meta-Analysis, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 19
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- Citations: 7
Wright CY, Kapwata T, Abdelatif N, et al., 2022, Household Air Pollution and Respiratory Symptoms a Month Before and During the Stringent COVID-19 Lockdown Levels 5 and 4 in South Africa, ANNALS OF GLOBAL HEALTH, Vol: 88, ISSN: 2214-9996
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- Citations: 3
Hansell AL, Villeneuve PJ, 2021, Invited Perspective: Ambient Air Pollution and SARS-CoV-2: Research Challenges and Public Health Implications., Environ Health Perspect, Vol: 129
Doiron D, Bourbeau J, de Hoogh K, et al., 2021, Ambient air pollution exposure and chronic bronchitis in the Lifelines cohort, THORAX, Vol: 76, Pages: 772-779, ISSN: 0040-6376
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- Citations: 16
Roca Barcelo A, Nardocci A, Souza de Aguilar B, et al., 2021, Risk of cardiovascular mortality, stroke and coronary heart mortality associated with aircraft noise around Congonhas airport, São Paulo, Brazil, Environmental Health, Vol: 20, Pages: 1-14, ISSN: 1832-3367
BackgroundNoise pollution is increasingly recognised as a public health hazard, yet limited evidence is available from low- and middle-income countries (LMIC), particularly for specific sources. Here, we investigated the association between day-night average (Ldn) aircraft noise and the risk of death due to cardiovascular disease (CVD), stroke and coronary heart disease (CHD) at small-area level around São Paulo‘s Congonhas airport, Brazil during the period 2011–2016.MethodsWe selected 3259 census tracts across 16 districts partially or entirely exposed to ≥50 dB aircraft noise levels around the Congonhas airport, using pre-modelled 5 dB Ldn noise bands (≤50 dB to > 65 dB). We estimated the average noise exposure per census tract using area-weighting. Age, sex and calendar year-specific death counts for CVD, stroke and CHD were calculated by census tract, according to the residential address at time of death. We fitted Poisson regression models to quantify the risk associated with aircraft noise exposure, adjusting for age, sex, calendar year and area-level covariates including socioeconomic development, ethnicity, smoking and road traffic related noise and air pollution.ResultsAfter accounting for all covariates, areas exposed to the highest levels of noise (> 65 dB) showed a relative risk (RR) for CVD and CHD of 1.06 (95% CI: 0.94; 1.20) and 1.11 (95%CI: 0.96; 1.27), respectively, compared to those exposed to reference noise levels (≤50 dB). The RR for stroke ranged between 1.05 (95%CI: 0.95;1.16) and 0.91 (95%CI: 0.78;1.11) for all the noise levels assessed. We found a statistically significant positive trend for CVD and CHD mortality risk with increasing levels of noise (p = 0.043 and p = 0.005, respectively). No significant linear trend was found for stroke. Risk estimates were generally higher after excluding road traffic density, suggesting t
Jephcote C, Hansell AL, Adams K, et al., 2021, Changes in air quality during COVID-19 'lockdown' in the United Kingdom, ENVIRONMENTAL POLLUTION, Vol: 272, ISSN: 0269-7491
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- Citations: 90
Baudin C, Lefevre M, Babisch W, et al., 2021, The role of aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and medication use: results of a pooled-analysis from seven European countries, BMC PUBLIC HEALTH, Vol: 21
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- Citations: 4
Chen Y, Hodgson S, Gulliver J, et al., 2021, Trimester effects of source-specific PM10 on birth weight outcomes in the Avon Longitudinal Study of Parents and Children (ALSPAC), Environmental Health, Vol: 1, ISSN: 1476-069X
BackgroundEvidence suggests that exposure to particulate matter with aerodynamic diameter less than 10 μm (PM10) is associated with reduced birth weight, but information is limited on the sources of PM10 and exposure misclassification from assigning exposures to place of residence at birth.MethodsTrimester and source-specific PM10 exposures (PM10 from road source, local non-road source, and total source) in pregnancy were estimated using dispersion models and a full maternal residential history for 12,020 births from the Avon longitudinal study of parents and children (ALSPAC) cohort in 1990–1992 in the Bristol area. Information on birth outcomes were obtained from birth records. Maternal sociodemographic and lifestyle factors were obtained from questionnaires. We used linear regression models for continuous outcomes (birth weight, head circumference (HC), and birth length (BL) and logistic regression models for binary outcomes (preterm birth (PTB), term low birth weight (TLBW) and small for gestational age (SGA)). Sensitivity analysis was performed using multiple imputation for missing covariate data.ResultsAfter adjustment, interquartile range increases in source specific PM10 from traffic were associated with 17 to 18% increased odds of TLBW in all pregnancy periods. We also found odds of TLBW increased by 40% (OR: 1.40, 95%CI: 1.12, 1.75) and odds of SGA increased by 18% (OR: 1.18, 95%CI: 1.05, 1.32) per IQR (6.54 μg/m3) increase of total PM10 exposure in the third trimester.ConclusionThis study adds to evidence that maternal PM10 exposures affect birth weight, with particular concern in relation to exposures to PM10 from road transport sources; results for total PM10 suggest greatest effect in the third trimester. Effect size estimates relate to exposures in the 1990s and are higher than those for recent studies – this may relate to reduced exposure misclassification through use of full residential history information, changes in
Cai Y, Zijlema WL, Sorgjerd EP, et al., 2020, Impact of road traffic noise on obesity measures: Observational study of three European cohorts, ENVIRONMENTAL RESEARCH, Vol: 191, ISSN: 0013-9351
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- Citations: 17
Baudin C, Lefevre M, Babisch W, et al., 2020, The role of aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and hypertension risk: Results of a pooled analysis from seven European countries, ENVIRONMENTAL RESEARCH, Vol: 191, ISSN: 0013-9351
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- Citations: 23
Pirani M, Mason A, Hansell A, et al., 2020, A flexible hierarchical framework for improving inference in area-referenced environmental health studies, Biometrical Journal: journal of mathematical methods in biosciences, Vol: 62, Pages: 1650-1669, ISSN: 0323-3847
Study designs where data have been aggregated by geographical areas are popular in environmental epi-demiology. These studies are commonly based on administrative databases and, providing a completespatial coverage, are particularly appealing to make inference on the entire population. However, the re-sulting estimates are often biased and difficult to interpret due to unmeasured confounders, which typicallyare not available from routinely collected data. We propose a framework to improve inference drawn fromsuch studies exploiting information derived from individual-level survey data. The latter are summarized inan area-level scalar score by mimicking at ecological-level the well-known propensity score methodology.The literature on propensity score for confounding adjustment is mainly based on individual-level studiesand assumes a binary exposure variable. Here we generalize its use to cope with area-referenced stud-ies characterized by a continuous exposure. Our approach is based upon Bayesian hierarchical structuresspecified into a two-stage design: (i) geolocated individual-level data from survey samples are up-scaled atecological-level, then the latter are used to estimate a generalizedecological propensity score(EPS) in thein-sample areas; (ii) the generalized EPS is imputed in the out-of-sample areas under different assumptionsabout the missingness mechanisms, then it is included into the ecological regression, linking the exposureof interest to the health outcome. This delivers area-level risk estimates which allow a fuller adjustment forconfounding than traditional areal studies. The methodology is illustrated by using simulations and a casestudy investigating the risk of lung cancer mortality associated with nitrogen dioxide in England (UK).
Lavigne A, Freni Sterrantino A, Fecht D, et al., 2020, A spatial joint analysis of metal constituents of ambient particulate matter and mortality in England, Environmental Epidemiology, Vol: 4, Pages: e098-e098, ISSN: 2474-7882
Background Few studies have investigated associations between metal components of particulate matter on mortality due to well-known issues of multicollinearity. Here, we analyze these exposures jointly to evaluate their associations with mortality on small area data.Methods We fit a Bayesian Profile Regression (BPR) to account for the multicollinearity in the elemental components (iron, copper and zinc) of PM10 and PM2.5. The models are developed in relation to mortality from cardiovascular and respiratory disease and lung cancer incidence in 2008-11 at small area level, for a population of 13.6 million in the London-Oxford area of England.Results From the BPR, we identified higher risks in the PM10 fraction cluster likely to represent the study area, excluding London, for cardiovascular mortality RR 1.07 (95%CI 1.02, 1.12) and for respiratory mortality RR 1.06 (95%CI 0.99, 1.31), compared to the study mean. For PM2.5 fraction, higher risks were seen for cardiovascular mortality RR 1.55 (CI 95% 1.38, 1.71) and respiratory mortality RR 1.51 (CI 95% 1.33, 1.72), likely to represent the 'highways' cluster. We did not find relevant associations for lung cancer incidence.Conclusion Our analysis showed small but not fully consistent adverse associations between health outcomes and particulate metal exposures. The BPR approach identified subpopulations with unique exposure profiles and provided information about the geographical location of these to help interpret findings.
Cai Y, Hansell AL, Granell R, et al., 2020, Prenatal, early-life and childhood exposure to air pollution and lung function: the ALSPAC cohort, American Journal of Respiratory and Critical Care Medicine, Vol: 202, Pages: 112-123, ISSN: 1073-449X
RATIONALE: Exposure to air pollution during intrauterine development and through childhood may have lasting effects on respiratory health. OBJECTIVES: To investigate lung function at ages 8 and 15 years in relation to air pollution exposures during pregnancy, infancy and childhood in a UK population-based birth cohort. METHODS: Individual exposures to source-specific particulate matter with diameter ≤10µm (PM10) during each trimester, 0-6 months, 7-12 months (1990-1993) and up to age 15 years (1991-2008) were examined in relation to %predicted Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) at ages 8(N=5,276) and 15(N=3,446) years, usinglinear regression models adjusted for potential confounders. A profile regression model was used to identify sensitive time periods. MEASUREMENTS AND MAIN RESULTS: We did not find clear evidence for a sensitive exposure period for PM10 from road-traffic: at age 8 years, 1µg/m3 higher exposure during the first trimester was associated with lower %predicted of FEV1(-0.826, 95%CI:-1.357 to -0.296) and FVC(-0.817, 95%CI:-1.357 to -0.276), but similar associations were seen for exposures for other trimesters, 0-6 months, 7-12 months, and 0-7 years. Associations were stronger among boys, children whose mother had a lower education level or smoked during pregnancy. For PM10 from all sources, the third trimester was associated with lower %predicted of FVC (-1.312, 95%CI: -2.100 to -0.525). At age 15 years, no adverse associations were seen with lung function. CONCLUSIONS: Exposure to road-traffic PM10 during pregnancy may result in small but significant reductions in lung function at age 8 years.
Roca-Barceló A, Crabbe H, Ghosh R, et al., 2020, Temporal trends and demographic risk factors for hospital admissions due to carbon monoxide poisoning in England, Preventive Medicine, Vol: 136, ISSN: 0091-7435
Unintentional non-fire related (UNFR) carbon monoxide (CO) poisoning is a preventable cause of morbidity and mortality. Epidemiological data on UNFR CO poisoning can help monitor changes in the magnitude of this burden, particularly through comparisons of multiple countries, and to identify vulnerable sub-groups of the population which may be more at risk. Here, we collected data on age- and sex- specific number of hospital admissions with a primary diagnosis of UNFR CO poisoning in England (2002–2016), aggregated to small areas, alongside area-level characteristics (i.e. deprivation, rurality and ethnicity). We analysed temporal trends using piecewise log-linear models and compared them to analogous data obtained for Canada, France, Spain and the US. We estimated age-standardized rates per 100,000 inhabitants by area-level characteristics using the WHO standard population (2000–2025). We then fitted the Besag York Mollie (BYM) model, a Bayesian hierarchical spatial model, to assess the independent effect of each area-level characteristic on the standardized risk of hospitalization. Temporal trends showed significant decreases after 2010. Decreasing trends were also observed across all countries studied, yet France had a 5-fold higher risk. Based on 3399 UNFR CO poisoning hospitalizations, we found an increased risk in areas classified as rural (0.69, 95% CrI: 0.67; 0.80), highly deprived (1.77, 95% CrI: 1.66; 2.10) or with the largest proportion of Asian (1.15, 95% CrI: 1.03; 1.49) or Black population (1.35, 95% CrI: 1.20; 1.80). Our multivariate approach provides strong evidence for the identification of vulnerable populations which can inform prevention policies and targeted interventions.
Fecht D, Garwood K, Butters O, et al., 2020, Automation of cleaning and reconstructing residential address histories to assign environmental exposures in longitudinal studies, International Journal of Epidemiology, Vol: 49, Pages: i49-i56, ISSN: 1464-3685
Background: We have developed an open-source ALgorithm for Generating Address Exposures (ALGAE) that cleans residential address records to construct address histories and assign spatially-determined exposuresto cohort participants. The first application of this algorithm was to construct prenatal and early-life air pollution exposure for individuals of the Avon Longitudinal Study of Parents and Children (ALSPAC)in the South West of Englandusingpreviously estimated particulate matter ≤10 μm (PM10) concentrations. Methods: ALSPAC recruited 14,541 pregnant women between 1991and 1992. We assignedtrimester-specific estimated PM10exposures for 12,752 pregnancies,and first year of life exposures for 12,525births, based on maternal residence and residential mobility. Results: Average PM10exposure was32.6 μg/m3(StDev. 3.0 μg/m3) during pregnancy and 31.4 μg/m3(StDev. 2.6 μg/m3) during the first year of life. 6.7% ofwomen changedaddress during pregnancy, and 18.0% moved during first year of lifeof their infant. Exposure differences ranged from -5.3 μg/m3 to 12.4 μg/m3(up to 26% difference) during pregnancy and -7.22 μg/m3to 7.64 μg/m3(up to 27% difference) in the first year of life,when comparing estimated exposure using the address at birth and that assessedusing the complete cleaned address history. For the majority of individualsexposure changed by <5% but some relatively large changes were seen both in pregnancy and infancy.Conclusion: ALGAE provides a generic andadaptable, open-source solution to clean addresses stored in acohort contact database and assign life-stage specific exposureestimates with the potential to reduce exposure misclassification.
Hodgson S, Fecht D, Gulliver J, et al., 2020, Availability, access, analysis and dissemination of small area data, International Journal of Epidemiology, Vol: 49, Pages: i4-i14, ISSN: 1464-3685
In this era of ‘big data’, there is growing recognition of the value of environmental, health, social and demographic data for research. Open government data initiatives are growing in number and in terms of content. Remote sensing data are finding widespread use in environmental research, including in low- and middle-income settings. While our ability to study environment and health associations across countries and continents grows, data protection rules and greater patient control over the use of their data present new challenges to using health data in research. Innovative tools that circumvent the need for the physical sharing of data by supporting non-disclosive sharing of information, or that permit spatial analysis without researchers needing access to underlying patient data can be used to support analyses while protecting data confidentiality. User-friendly visualisations, allowing small area data to be seen and understood by non-expert audiences are revolutionising public and researcher interactions with data. The UK Small Area Health Statistics Unit’s Environment and Health Atlas for England and Wales, and the US National Environmental Public Health Tracking Network offer good examples. Open data facilitates user-generated outputs, and ‘mash-ups’, and user generated inputs from social media, mobile devices, and wearable tech are new data streams which will find utility in future studies, and bring novel dimensions with respect to ethical use of small area data.
Piel FB, Parkes B, Hambly P, et al., 2020, Software application profile: the Rapid Inquiry Facility 4.0: an open access tool for environmental public health tracking, International Journal of Epidemiology, Vol: 49, Pages: i38-i48, ISSN: 0300-5771
The Rapid Inquiry Facility 4.0 (RIF) is a new user-friendly and open-access tool, developed by the UK Small Area Health Statistics Unit (SAHSU), to facilitate environment public health tracking (EPHT) or surveillance (EPHS). The RIF is designed to help public health professionals and academics to rapidly perform exploratory investigations of health and environmental data at the small-area level (e.g. postcode or detailed census areas) in order to identify unusual signals, such as disease clusters and potential environmental hazards, whether localized (e.g. industrial site) or widespread (e.g. air and noise pollution). The RIF allows the use of advanced disease mapping methods, including Bayesian small-area smoothing and complex risk analysis functionalities, while accounting for confounders. The RIF could be particularly useful to monitor spatio-temporal trends in mortality and morbidity associated with cardiovascular diseases, cancers, diabetes and chronic lung diseases, or to conduct local or national studies on air pollution, flooding, low-magnetic fields or nuclear power plants.
Piel F, Fecht D, Hodgson S, et al., 2020, Small-area methods for investigation of environment and health, International Journal of Epidemiology, Vol: 49, Pages: 686-699, ISSN: 1464-3685
Small-area studies offer a powerful epidemiological approach to study disease patterns at the population level and assess health risks posed by environmental pollutants. They involve a public health investigation on a geographic scale (e.g. neighbourhood) with overlay of health, environmental, demographic and potential confounder data. Recent methodological advances, including Bayesian approaches, combined with fast growing computational capabilities permit more informative analyses than previously possible, including the incorporation of data at different scales, from satellites to individual-level survey information. Better data availability has widened the scope and utility of small-area studies, but also led to greater complexity, including choice of optimal study area size and extent, duration of study periods, range of covariates and confounders to be considered, and dealing with uncertainty. The availability of data from large, well-phenotyped cohorts such as UK Biobank enables the use of mixed-level study designs and the triangulation of evidence on environmental risks from small-area and individual-level studies, therefore improving causal inference, including use of linked biomarker and -omics data. As a result, there are now improved opportunities to investigate the impacts of environmental risk factors on human health, particularly for the surveillance and prevention of non-communicable diseases.
Roca Barcelo A, Douglas P, Fecht D, et al., 2020, Risk of respiratory hospital admission associated with modelled concentrations of Aspergillus fumigatus from composting facilities in England, Environmental Research, Vol: 183, Pages: 1-10, ISSN: 0013-9351
Bioaerosols have been associated with adverse respiratory-related health effects and are emitted in elevated concentrations from composting facilities. We usedmodelledAspergillus fumigatusconcentrations, a good indicator for bioaerosol emissions,to assess associations with respiratory-related hospital admissions. Mean dailyAspergillus fumigatusconcentrationswere estimated for each composting site for first full year of permit issuefrom2005 onwardsto 2014 for Census Output Areas (COAs) within 4km of 76 composting facilities in England, as previously described (Williams et al. 2019). We fitted ahierarchicalgeneralized mixed modelto examine therisk of hospital admission witha primary diagnosis of(i) any respiratory condition,(ii) respiratory infections,(iii) asthma,(iv) COPD,(v)diseases due to organic dust,and (vi)Cystic Fibrosis,inrelation to quartilesof Aspergillus fumigatusconcentrations. Models included a random intercept for each COAto account for over-dispersion,nested within composting facility, on whicha random intercept was fitted to account for clusteringof the data, with adjustmentsfor age, sex, ethnicity, deprivation, tobacco sales (smoking proxy) and traffic load (as a proxy for traffic-related air pollution). Weincluded 249,748 respiratory-related and 3,163 Cystic Fibrosis hospital admissions in 9,606 COAswith a population-weighted centroid within 4 km of the 76 included composting facilities. After adjustment for confounders, no statistically significant effect was observed for any respiratory-related (Relative Risk (RR)=0.99; 95% Confidence Interval (CI)0.96–1.01)or for Cystic Fibrosis (RR=1.01; 95% CI 0.56-1.83)hospital admissions for COAs in the highest quartile of exposure. Similar results were observed across all respiratory disease sub-groups.This study does not provide evidence for increased risks of respiratory-related hospitalisationsfor those livingnearcomposting facilities.However, given the limitations in the dispersion modelling, risks
Smith RB, Beevers SD, Gulliver J, et al., 2020, Impacts of air pollution and noise on risk of preterm birth and stillbirth in London, Environment International, Vol: 134, ISSN: 0160-4120
BackgroundEvidence for associations between ambient air pollution and preterm birth and stillbirth is inconsistent. Road traffic produces both air pollutants and noise, but few studies have examined these co-exposures together and none to date with all-cause or cause-specific stillbirths.ObjectivesTo analyse the relationship between long-term exposure to air pollution and noise at address level during pregnancy and risk of preterm birth and stillbirth.MethodsThe study population comprised 581,774 live and still births in the Greater London area, 2006–2010. Outcomes were preterm birth (<37 completed weeks gestation), all-cause stillbirth and cause-specific stillbirth. Exposures during pregnancy to particulate matter with diameter <2.5 μm (PM2.5) and <10 μm (PM10), ozone (O3), primary traffic air pollutants (nitrogen dioxide, nitrogen oxides, PM2.5 from traffic exhaust and traffic non-exhaust), and road traffic noise were estimated based on maternal address at birth.ResultsAn interquartile range increase in O3 exposure was associated with elevated risk of preterm birth (OR 1.15 95% CI: 1.11, 1.18, for both Trimester 1 and 2), all-cause stillbirth (Trimester 1 OR 1.17 95% CI: 1.07, 1.27; Trimester 2 OR 1.20 95% CI: 1.09, 1.32) and asphyxia-related stillbirth (Trimester 1 OR 1.22 95% CI: 1.01, 1.49). Odds ratios with the other air pollutant exposures examined were null or <1, except for primary traffic non-exhaust related PM2.5, which was associated with 3% increased odds of preterm birth (Trimester 1) and 7% increased odds stillbirth (Trimester 1 and 2) when adjusted for O3. Elevated risk of preterm birth was associated with increasing road traffic noise, but only after adjustment for certain air pollutant exposures.DiscussionOur findings suggest that exposure to higher levels of O3 and primary traffic non-exhaust related PM2.5 during pregnancy may increase risk of preterm birth and stillbirth; and a possible relationship between long-term traff
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