Abstracts • Environmental Epidemiology (XXX) XXX
Environmental Epidemiology
Conclusion: further study is needed to confirm these results.
This study suggested that Organochlorine pesticides exposures may
increase breast cancer risk among Sudanese women. Regulation and
controlling the wild used of pesticides must be active special in rural
community.
Chronic Kidney Disease of undetermined cause (CKDu),
an emerging disease in developing nations: a Malawian
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geographical study with focus on potable water sources
Hamilton S1,2, Pearce N2, Fecht D1, Vineis P1
hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2023
1
Imperial College London, 2The London School of Hygiene and Tropical
Medicine
OPS 25: Drinking water contamination and adult health, Room 411,
Floor 4, August 26, 2019, 10:30 AM - 12:00 PM
Background: There is increasing recognition of epidemics of pri-
marily tubular-interstitial chronic kidney disease (CKD) clustering
amongst working-age populations in agricultural communities in low-
and-middle-income countries. These conditions have been termed CKD
of undetermined cause (CKDu) due to unidentified underlying aetiol-
ogy. Hypothesised causes include heat stress and heavy metal exposure
through potable water. Our aim was to investigate CKDu presence in
Malawi, and identify potential risk factors including nephrotoxic heavy
metals in potable drinking water.
Methods: Blood and urine samples (n=770) taken from an urban
and rural study site (January-August 2018) were used to estimate kidney
function across the sample population. We applied linear and logistic
regression models with postulated risk factors including age, sex, educa-
tion, residence, vegetarianism, and body mass index to estimate risk of
low glomerular filtration rate (eGFR) (<90 ml/min/1.73m2).
We collected potable water samples which were tested for trace met-
als by Nottingham University. We analysed the spatial distribution of
trace metals across the study area using inverse distance weighting with
standardised z-scores.
Results: Mean eGFR was 117.1±15.83ml/min/1.73m2. Prevalence of
low eGFR was 5% (95%CI = 3.0, 6.2), and did not vary substantially
between sites. Factors associated with low eGFR included low income
(<10,000 Malawian Kwacha) [OR (95%CI) = 0.16 (0.02, 1.07)]; and
age [4.87 (0.39, 6.00)] per 10-year increase. Mean trace metal concen-
trations did not exceed permissible limits. However, some sites con-
tained nephrotoxic metal concentrations which neared limits, including
Cadmium (2.66µg/L, World Health Organisation limit 3.00µg/L).
Conclusions: Reduced kidney function in the absence of known risk
factors (eGFR <90 ml/min/1.73m2) was observed across our study area,
however little difference in risk between sites was observed. No known
nephrotoxic trace metals exceeded permissible limits, however, analyses
of heavy metals concentrations in bio samples will be conducted to rule
these out as risk factors for reduced kidney function in Malawi.
A nation-wide study shows increasing hypotension
hospital visits with higher ambient temperature
Han C1, Lim Y2,3, Lee K2,3, Hong Y1,2,3
1
Department of Preventive Medicine, Seoul National University College
of Medicine, 2Institute of Environmental Medicine, Seoul National
University Medical Research Center, 3Environmental Health Center,
Seoul National University College of Medicine
OPS 12: Morbidity effects of high and low temperatures, Room 315,
Floor 3, August 28, 2019, 10:30 AM - 12:00 PM
Background
Although blood pressure decreases in response to high ambient tem-
perature, little is known whether the ambient temperature can induce
clinical hypotension events. Therefore, we conducted a time-series anal-
ysis to evaluate the association between hypotension hospital visits and
ambient temperature in seven metropolitan cities of Korea.
150
Methods
We used the National Health Insurance Database, which contains
the complete hospital visit data of entire Korean population. We col-
lected hospital visit data of seven metropolitan cities and linked the
number of daily hypotension hospital visits to city-level ambient tem-
perature, relative humidity, and air pollution levels from 2011 to 2015.
Time-series analysis using the Poisson generalized additive model was
conducted for each metropolitan city and we meta-analyzed the time-se-
ries results using the random effect model.
Results
There was a total of 132,097 hospital visits for hypotension during
our study period. A 1 degree Celsius (°C) increase in ambient tempera-
ture was associated with 1.1% increase in hospital visits for hypoten-
sion on lag day 0. Effects of ambient temperature lasted for 7 days,
showing greater effects in shorter lag days. Subgroup analysis by sex and
income groups showed similar results, but effects of ambient tempera-
ture on hypotension hospital visits was higher in the younger age group
compared to older age group (aged over 65 years old). The results were
unchanged when we applied cumulative lags, different case definitions,
degrees of freedom per year, and multi-pollutant model adjusting for air
pollutants.
Conclusions
Hospital visits for hypotension were positively associated with ambi-
ent temperature. Increased hypotension events in response to increased
ambient temperature might explain the high cardiovascular mortality
on hot days.
Exposure assesment of indoor PM2.5 monitoring among
local residents near coal-fired power plants in Korea
Han X1, Choi K1, Lee Y1, Yang H1, Bae S2, Kwon H1
1
Department of Preventive Medicine, Dankook University, 2Department
of Preventive Medicine, The Catholic University of Korea
TPS 901: Indoor air pollution, Exhibition Hall, Ground floor, August
28, 2019, 3:00 PM - 4:30 PM
Background:
Epidemiological studies of fine particulate matter (PM2.5) typically
use ambient measurements as exposure proxies among local people
near coal-fired power plants. There might be an error in defining the
measurement as personal exposure due to far distance between ambient
measurement point and indoor environment among local residents. We
aimed to measure the indoor PM2.5 exposure level and to evaluate how
it relates to the outdoor air quality of residents near coal-fired power
plants.
Methods:
We measured PM2.5 data at home among 6 residents near coal-fired
power plants in 3 different regions, Korea. Each participant underwent
24-hour sampling for 28 days (June 8 to July 5 in 2018). We collected
the data on nearest national ambient measurement station, weather
data, and total suspended particles (TSP) data from real-time telemon-
itoring system (TMS) of chimney at coal-fired power plants during the
same period.
Results:
Median(Min-Max) of indoor PM2.5 concentration(µg/m3) were
12.6(2.3-38.2) in region A, 13.4(3.1-32.8), 14.3(3.1-41.2) in region
B, 11.9(2.8-78.3), 16.6(3.2-83.6), 9.8(2.5-33.4) in region C.And
18.0(1.0-64.0), 15.0(1.0-63.0), 18.0(1.0-59.0) in outdoor region A,
region B, region C, respectively, The correlation coefficient(p-value)
of indoor and outdoor PM2.5 concentration were 0.537(<0.001) in
region A; 0.571(<0.001), 0.724(<0.001)in region B; 0.435(<0.001),
0.656(<0.001), 0.685(<0.001)in region C. Those of indoor PM2.5
concentration and tsp concentration were 0.024(0.212) in region A;
0.021(0.001), 0.053(0.402) in region B; 0.366(0.002), 0.533(0.095),
0.408(0.047) in region C.
 Abstracts • Environmental Epidemiology (XXX) XXX www.environmentalepidemiology.com
Conclusion:
The correlation between PM2.5 concentration of indoor and out-
door showed moderate, but low with tsp from TMS. Further study is
needed to consider other indicators related to indoor air pollutants con-
centration using indoor exposure meter reflect real life environment.
Personal exposure to PM2.5 and its inflammatory effect
on local residents in urban and rural Beijing, China:
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results of the AIRLESS project
Han Y1,3, Chatzidiakou L2, Yan L1,4, Chen W3, Cai Y4, Wu Y5, Liu J6,
hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 05/01/2023
Chan Q4, Kelly F1, Zhu T3
1
King’s College London, 2University of Cambridge, 3Peking University,
4
Imperial College London, 5Peking University Clinical Research
Institute, 6Beijing Anzhen Hospital
TPS 911: Air pollution, epigenetics, biomarkers, Exhibition Hall,
Ground floor, August 26, 2019, 3:00 PM - 4:30 PM
Introduction Owing to diverse air pollution sources, socio-economic
and personal activity patterns, residents in urban and rural areas may
be exposed to varying concentrations of fine particulate matter (PM2.5),
resulting in distinct health responses. Here, we compare personal expo-
sure of PM2.5 from urban and rural setting using data from AIRLESS
project and investigate the associations between PM2.5 and respiratory
and systemic inflammatory biomarkers.
Methods In total, 123 urban and 128 rural non-smoking subjects
aged 40-70 years were recruited from two well-established cohorts in
Beijing to allow a panel-study design. During Nov-Dec 2016 and May-
Jun 2017, each subject was instructed to carry a validated personal air
monitor (PAM) to measure PM2.5 concentration at high spatiotempo-
ral resolution for consecutive seven days in each campaign. During the
participated week, each subject completed two clinical measurements of
exhaled NO (FeNO) and blood monocytes counts on Day3 and Day7.
The associations between personal exposure to PM2.5 and health out-
comes were examined with linear mixed-effect models with adjustment
for demographic, socio-economic, lifestyle and meteorological variables.
Results The weekly mean concentrations (standard deviation [SD])
of personal exposure to PM2.5 during the winter and summer campaign
were 64.1(35.4) and 34.3(12.3) μg/m3 in rural subjects, higher than
those of 33.8(18.9) and 28.7(9.9) μg/m3 experienced by the urban sub-
jects. An IQR increase in previous 1-day personal exposure to PM2.5
(26.1 μg/m3) was significantly associated with elevated FeNO [7.8%
(95% confidence interval (CI): 5.0-10.8%)] and monocyte counts
[0.6%(CI: 0.3-0.9%)] (p<0.05). The PM2.5-associated changes in
FeNO and monocyte counts were 6.0% and 0.2% in rural subjects,
lower than those of 9.3% and 0.7% in urban subjects, respectively.
Conclusions Compared with urban residents, rural residents in
Beijing have a higher personal exposure to PM2.5 in both winter and
summer, but lower PM2.5-associated respiratory and systemic inflam-
matory responses.
Global estimation of effect on life expectancy at age of
60 by particulate air pollution
Han C1, Lim Y2,3, Hong Y1,2,3
1
Department of Preventive Medicine, Seoul National University College
of Medicine, 2Institute of Environmental Medicine, Seoul National
University Medical Research Center, 3Environmental Health Center,
Seoul National University College of Medicine
TPS 682: Long-term health effects of air pollutants 2, Exhibition
Hall, Ground floor, August 27, 2019, 3:00 PM - 4:30 PM
Background
Previous studies evaluating the association between particulate
matter less than 2.5μm in diameter (PM2.5) and life expectancy were
conducted in single country assuming linear relationship. In our study,
we evaluated the association using global country level data accounting
151
for non-linear relationship between PM2.5 concentration and life
expectancy.
Methods
A total of 17 years (from 2000 to 2016) of country level popula-
tion weighted PM2.5 concentration and life expectancy at age of 60
were archived from Global Burden of Disease Study 2017 database and
World Health Organization Global Health Observatory. A generalized
estimating equation with a compound symmetry covariance structure
was used to evaluate the linear association between reduction in annual
PM2.5 concentration and increase of life expectancy. Non-parametric
analysis using generalized additive mixed model and piecewise linear
regression was conducted for repeatedly measured data analysis with
non-linear assumption.
Results
A 17 years of data from 176 countries were used in our analysis.
With a linear assumption, 10μg/m3 reduction in annual PM2.5 concen-
tration was associated with 0.34 years (95%CI, 0.20, 0.49) of increase
in life expectancy. By assuming non-linear relationship, life expectancy
increased by 0.72 years (95%CI: 0.49, 0.96) per 10μg/m3 reduction on
0-24.0μg/m3 PM2.5 concentration range. Life expectancy increased by
0.01 years (95%CI: -0.06, 0.08) per 10μg/m3 reduction on PM2.5 range
above 24.0μg/m3.
Conclusion
There was non-linear relationship between country level population
weighted annual PM2.5 concentration and life expectancy at age of 60.
Life expectancy gain are expected with decrease of PM2.5 exposure
even in very low PM2.5 concentration ranges. Future individual and
multi-level studies are needed to confirm our ecologic study findings.
High spatial resolution health risk assessment of road
traffic noise on ischemic heart disease deaths for
Melbourne, Australia in 2011
Hanigan I1,2,6,7, Chaston T1,2, Hinze B3, Dennekamp M4,6, Jalaludin B5,6,
Kinfu Y7, Morgan G1,2,6
1
The University of Sydney School Of Public Health, 2The University of
Sydney University Centre for Rural Health, 3Ambient Maps, 4Victoria
Environmental Protection Authority, 5Ingham Institute for Medical
Research, University of New South Wales, 6Centre for Air pollution,
energy and health Research (CAR), Woolcock Institute of Medical
Research, 7Centre for Research and Action in Public Health, University
of Canberra
TPS 781: Health effects of noise, Exhibition Hall, Ground floor,
August 27, 2019, 3:00 PM - 4:30 PM
Introduction: Road traffic noise pollution increases risk of mortality
from ischemic heart disease (IHD). Noise pollution is highly localized,
so high resolution mapping of the exposure surface is a key concern.
For health impact assessments optimally the data on exposure and
health outcomes would both be available at small-area level. However,
in Australia IHD deaths data are only easily accessed at low resolution,
aggregated to local government areas (LGA, mean ~130,000 people).
Our method utilizes low-resolution health data with high spatial reso-
lution noise mapping for producing health risk maps at the mesh-block
level (MB, ~75 people).
Methods: We used a noise contour map for Melbourne, Australia
from 2011 based on a spatial predictive model to estimate population
exposures at the MB level. We used the non-linear exposure–response
function for traffic noise and IHD as recommended by the World Health
Organization to calculate attributable fractions of deaths for MBs. LGA-
level IHD rates were then downscaled to MBs using publicly available
data to estimate attributable numbers.
Results: Average noise exposures for MBs was 35 dB and peaked
at 72 dB. Approximately 5% of the population was exposed to traffic
noise above the threshold of 55 dB. Attributable rates of IHD deaths due