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Bile acids (BAs) play a crucial role in lipid metabolism of children. However, the association between per- and polyfluoroalkyl substance (PFAS) exposure and BAs in children is scarce. To address this need, we selected 252 children from the Maoming Birth Cohort and measured 32 PFAS, encompassing short- and long-chain perfluorocarboxylic acids (PFCAs) and perfluorosulfonic acids (PFSAs) in the cord blood. Additionally, we analyzed nine primary and eight secondary BAs in the serum of three-year-old children. Generalized linear models with FDR-adjusted and Bayesian kernel machine regression (BKMR) were used to explore the associations of individual and mixture effects of PFAS and BAs. We found negative associations between cord blood long-chain PFCAs exposure and serum primary BAs in three-year-old children. For example, one ln-unit (ng/mL) increase of perfluoro-n-tridecanoic acid (PFTrDA), perfluoro-n-undecanoic acid (PFUnDA) and perfluoro-n-decanoic acid (PFDA) were associated with decreased taurochenodeoxycholic acid, with estimated percentage change of -24.28% [95% confidence interval (CI): -36.75%, -9.35%], -25.84% (95% CI: -39.67%, -8.83%), and -22.97% (95% CI: -34.45%, -9.47%) respectively. Notably, the observed associations were more pronounced in children with lower vegetable intake. Additionally, the BKMR model also demonstrated a monotonical decline in primary BAs as the PFAS mixture increased. We provided the first evidence of the association between intrauterine exposure to PFAS and its mixture with BAs in children. Further large-sample-size studies are needed to verify this finding., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Per- and polyfluoroalkyl substances (PFAS) have attracted worldwide attention as one of persistent organic pollutants; however, there is limited knowledge about the exposure concentrations of PFAS-contained ambient particulate matter and the related health risks. This study investigated the abundance and distribution of 32 PFAS in fine particulate matter (PM 2.5 ) collected from 93 primary or secondary schools across the Pearl River Delta region (PRD), China. These chemicals comprise four PFAS categories which includes perfluoroalkyl carboxylic acids (PFCAs), perfluoroalkyl sulfonic acids (PFSAs), perfluoroalkyl acid (PFAA) precursors and PFAS alternatives. In general, concentrations of target PFAS ranged from 11.52 to 419.72 pg/m 3 (median: 57.29 pg/m 3 ) across sites. By categories, concentrations of PFSAs (median: 26.05 pg/m 3 ) were the dominant PFAS categories, followed by PFCAs (14.25 pg/m 3 ), PFAS alternatives (2.75 pg/m 3 ) and PFAA precursors (1.10 pg/m 3 ). By individual PFAS, PFOS and PFOA were the dominant PFAS, which average concentration were 24.18 pg/m 3 and 6.05 pg/m 3 , respectively. Seasonal variation showed that the concentrations of PFCAs and PFSAs were higher in winter than in summer, whereas opposite seasonal trends were observed in PFAA precursors and PFAS alternatives. Estimated daily intake (EDI) and hazard quotient (HQ) were used to assess human inhalation-based exposure risks to PFAS. Although the health risks of PFAS via inhalation were insignificant (HQ far less than one), sufficient attention should be levied to ascertain the human exposure risks through inhalation, given that exposure to PFAS through air inhalation is a long term and cumulative process., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Particulate matter (PM) exposure is associated to the adverse change in blood lipids. Vitamin D is beneficial to lipid metabolism, but whether vitamin D levels modifies the impact of air pollutants on lipids is unclear. The purpose of the study was to investigate if vitamin D modifies the associations of PM and serum lipids in young healthy people. From December 2017 to January 2018, a panel study with five once weekly follow-ups was conducted on 88 healthy adults aged 21.09 (1.08) (mean (SD)) years on average in Guangzhou, China. We measured serum lipids, serum 25-hydroxyvitamin D (25(OH)D) concentrations (440 blood samples in total), mass concentrations of particulate matter with diameters ≤2.5 μm (PM 2.5 ), ≤1.0 μm (PM 1.0 ), and ≤0.5 μm (PM 0.5 ), and number concentrations of particulate matter with diameters ≤0.2 μm (PN 0.2 ) and ≤0.1 μm (PN 0.1 ) at each follow-up. Linear mixed-effect models were applied to assess the interaction of vitamin D and size-fractionated PM short-term exposure on four lipid metrics. We found the interactions between 25(OH)D and size-fractionated PM exposure on blood lipids in different lags (lag 3 days and 4 days). An interquartile range increase in PM 2.5 , PM 1.0 , PM 0.5 were significantly associated with increments of 12.30%, 12.99%, and 13.66% in triglycerides (TGs) at lag 4 days at vitamin D levels <15 ng/mL group, respectively. Similar results were found for PN 0.2 , PN 0.1 and low-density lipoprotein cholesterol (LDL-C). All the associations between size-fractionated PM and blood lipids were found null statistically significant in vitamin D levels ≥15 ng/mL group., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Little evidence exists concerning the associations of greenspace with childhood lipid profiles and dyslipidemias, especially in developing countries and regions. We aimed to investigate the associations of greenspace surrounding schools with lipid levels and dyslipidemia prevalence among Chinese children and teenagers. We obtained baseline information and health data of 10,408 children and teenagers (aged 6-18 years) who studied from 94 schools in China. We measured levels of four blood lipids: triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Dyslipidemias were defined using standard recommendations. Greenness surrounding schools were assessed using two satellite-based greenness indices, Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI) at 300-, 500-, and 1000-m circular buffers based on each school's latitude and longitude. We used random forest model combined with meteorological and remote sensing data to estimate air pollution levels surrounding each school. We used generalized linear mixed models to estimate the associations of greenness with lipid levels and dyslipidemias prevalence. We also performed sub-group and mediation analyses. An interquartile range (IQR) increase in NDVI 500m was significantly associated with a 0.064 mmol/L (95% confidence interval [CI]: 0.083, -0.045) and 0.049 mmol/L (95% CI: 0.065, -0.033) decreased TC and LDL-C levels, respectively, as well as a 0.13-fold (95% CI: 0.01, 0.23) and 0.17-fold (95% CI: 0.01, 0.30) decreased odds of hypercholesterolemia and hyperbetalipoproteinemia, respectively. Associations were stronger in students aged ≤12 years and born to parents having lower education levels compared to their counterparts. Particle with aerodynamic diameter ≤2.5 μm (PM 2.5 ) mediated 61.5% and 16.7% of the association of greenness with TG and LDL-C levels, respectively. In summary, higher school-based greenness exposure was beneficially associated with lipid levels among Chinese children and adolescents, and part of the association can be explained by lowed PM 2.5 levels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Previous studies have indicated that outdoor light at night (LAN) is associated with a higher prevalence of overweight or obesity in adults. However, the association of LAN levels with overweight or obesity in children is still unknown. This study utilized data from the Seven Northeastern Cities study, which included 47,990 school-aged children and adolescents (ages 6-18 years). Outdoor LAN levels were measured using satellite imaging data. Weight and height were used to calculate age-sex-specific body mass index (BMI) Z-scores based on the World Health Organization (WHO) growth standards. Overweight status and obesity were defined using the Chinese standard. Information regarding socioeconomic status, sleep-related characteristics, and obesogenic factors were obtained using a questionnaire. A generalized linear mixed model examined the associations of outdoor LAN levels (in quartiles) with the outcomes of interest. Compared to children in the lowest quartile of outdoor LAN levels, children exposed to higher outdoor LAN levels had larger BMI Z-scores and higher odds of being overweight (including obesity) or obese, with the largest estimates in the third quartile [BMI Z-score: β = 0.26, 95% CI: 0.18-0.33; overweight (including obesity): OR = 1.40, 95% CI: 1.25-1.56; obesity: OR = 1.46, 95% CI: 1.29-1.65]. There was a significant sex difference (P interaction <0.001) in the association of outdoor LAN levels with BMI Z-scores, and the association was stronger in males. Results remained robust following multiple sensitivity analyses and the adjustment of sleep-related characteristics, obesogenic factors, and environmental exposures. Our findings suggest that higher outdoor LAN levels are associated with larger BMI Z-scores and greater odds of overweight (including obesity) and obesity in school-aged children and adolescents. Further, the association between outdoor LAN levels and BMI Z-scores is stronger in males. Future studies with exposure assessments that consider both outdoor and indoor LAN exposures are needed., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Ambient particles with aerodynamic diameter <0.1 μm (PM 0.1 ) have been suggested to have significant health impact. However, studies on the association between long-term PM 0.1 exposure and human blood lipid metabolism are still limited. This study was aimed to evaluate such association based on multiple lipid biomarkers and dyslipidemia indicators. We matched the 2006-2009 average PM 0.1 concentration simulated using the neural-network model following the WRF-Chem model with the clinical and questionnaire data of 15,477 adults randomly recruited from 33 communities in Northeast China in 2009. After controlling for social demographic and behavior confounders, we assessed the association of PM 0.1 concentration with multiple lipid biomarkers and dyslipidemia indicators using generalized linear mixed-effect models. Effect modification by various social demographic and behavior factors was examined. We found that each interquartile range increase in PM 0.1 concentration was associated with a 5.75 (95% Confidence interval, 3.24-8.25) mg/dl and a 6.05 (2.85-9.25) mg/dl increase in the serum level of total cholesterol and LDL-C, respectively. This increment was also associated with an odds ratio of 1.25 (1.10-1.42) for overall dyslipidemias, 1.41 (1.16, 1.73) for hypercholesterolemia, and 1.90 (1.39, 2.61) for hyperbetalipoproteinemia. Additionally, we found generally greater effect estimates among the younger participants and those with lower income or with certain behaviors such as high-fat diet. The deleterious effect of long-term PM 0.1 exposure on lipid metabolism may make it an important toxic chemical to be targeted by future preventive strategies., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Limitations of Normalized Difference Vegetation Index (NDVI) potentially contributed to the inconsistent findings of greenspace exposure and childhood asthma. The aim of this study was to use a novel greenness exposure assessment method, capable of overcoming the limitation of NDVI to determine the extent to which it was associated with asthma prevalence in Chinese children. During 2009-2013, a cross-sectional study of 59,754 children aged 2-17 years was conducted in northeast China. Tencent street view images surrounding participants' schools were segmented by a deep learning model, and streetscape greenness was extracted. The green view index (GVI) was used to assign exposure and higher value indicates more green coverage. Mixed-effects logistic regression models were used to calculate the adjusted odds of asthma per interquartile range (IQR) increase of GVI for trees and grass. Participants were further stratified to investigate whether particulate matter with an aerodynamic diameter <2.5 μm (PM 2.5 ) was a modifier. An IQR increase in GVI 800m for trees was associated with lower adjusted odds of doctor-diagnosed asthma (OR: 0.76; 95%CI: 0.72-0.80) and current asthma (OR: 0.82; 95%CI: 0.75-0.89). An IQR increase in GVI 800m for grass was associated with higher adjusted odds of doctor-diagnosed asthma (OR: 1.04; 95%CI: 1.00-1.08) and current asthma (OR: 1.08; 95%CI: 1.02-1.14). After stratification by PM 2.5 exposure level, the negative association between trees and asthma, and the positive association between grass and asthma were observed only in low PM 2.5 exposure levels (≤median: 56.23 μg/m 3 ). Our results suggest that types of vegetation may play a role in the association between greenness exposure and childhood asthma. Exposure to trees may reduce the odds of childhood asthma, whereas exposure to grass may increase the odds. Additionally, PM 2.5 may modify the associations of trees and grass with childhood asthma., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Chlorinated polyfluoroalkyl ether sulfonates (Cl-PFESAs), are ubiquitous alternatives to perfluorooctane sulfonate (PFOS), a widely used poly- and perfluoroalkyl substance (PFAS). Despite in vivo and in vitro evidence of metabolic toxicity, no study has explored associations of Cl-PFESAs concentrations with metabolic syndrome (MetS) in a human population. To help address this data gap, we quantified 32 PFAS, including 2 PFOS alternative Cl-PFESAs (6:2 and 8:2 Cl-PFESAs) in serum from 1228 adults participating in the cross-sectional Isomers of C8 Health Project in China study. The odds ratios (ORs) and 95% confidence intervals (CIs) of MetS and its various components were estimated using individual PFAS as a continuous or categorical predictor in multivariate regression models. The association between the overall mixture of PFAS and MetS was examined using probit Bayesian Kernel Machine Regression (BKMR-P). Greater serum PFAS concentrations were associated with higher odds of MetS and demonstrated a statistically significant dose-response trend (P for trend < 0.001). For example, each ln-unit (ng/mL) increase in serum 6:2 Cl-PFESA was associated with a higher prevalence of MetS (OR = 1.52, 95% CI: 1.25, 1.85). MetS was also 2.26 (95% CI: 1.59, 3.23) times more common in the highest quartile of serum 6:2 Cl-PFESA concentration than the lowest, and particularly high among women (OR = 6.41, 95% CI: 3.65, 11.24). The BKMR-P analysis showed a positive association between the overall mixture of measured PFAS and the odds of MetS, but was only limited to women. While our results suggest that exposure to Cl-PFESAs was associated with MetS, additional longitudinal studies are needed to more definitively address the potential health concerns of these PFOS alternatives., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Evidence concerning effects of ambient air pollution on homocysteine (HCY) metabolism is scarce. We aimed to explore the associations between ambient particulate matter (PM) exposure and the HCY metabolism markers and to evaluate effect modifications by folate, vitamin B 12 , and methylenetetrahyfrofolate reductase (MTHFR) C677T gene polymorphism. Between December 1, 2017 and January 5, 2018, we conducted a panel study in 88 young college students in Guangzhou, China, and received 5 rounds of health examinations. Real-time concentrations of PMs with aerodynamic diameter ≤2.5 (PM 2.5 ), ≤1.0 (PM 1.0 ), and ≤0.1 (PM 0.1 ) were monitored, and the serum HCY metabolism markers (i.e., HCY, S-Adenosylhomocysteine [SAH], and S-Adenosylmethionine [SAM]) were repeatedly measured. We applied linear mixed effect models combined with a distributed lag model to evaluate the associations of PMs with the HCY metabolism markers. We also explored effect modifications of folate, vitamin B 12 , and the MTHFR C677T polymorphism on the associations. We observed that higher concentrations of PM 2.5 and PM 1.0 were associated with higher serum levels of HCY, SAH, SAM, and SAM/SAH ratio (e.g., a 10 μg/m 3 increase in PM 2.5 during lag 0 day and lag 5 day was significantly associated with 1.3-19.4%, 1.3-28.2%, 6.2-64.4%, and 4.8-28.2% increase in HCY, SAH, SAM, and SAM/SAH ratio, respectively). In addition, we observed that the associations of PM 2.5 with the HCY metabolism markers were stronger in participants with lower B vitamins levels. This study demonstrated that short-term exposure to PM 2.5 and PM 1.0 was deleteriously associated with the HCY metabolism markers, especially in people with lower B vitamins levels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Previous epidemiological and experimental studies have shown that legacy perfluoroalkyl acids (PFAAs) are immunotoxic. However, whether the immunosuppressive effects in PFAA alternatives which recently have been widely detected in the environment are unknown. To address this knowledge gap, we investigated the relationship of serum legacy PFAAs and PFAA alternatives with the antibody of hepatitis B virus in adults. We recruited 605 participants from a cross-sectional study, the Isomer of C8 Health Project in China. We measured two representative legacy PFAAs (perfluorooctane sulfonate, PFOS and perfluorooctanoic acid, PFOA), and three PFAA alternatives (two chlorinated polyfluorinated ether sulfonic acids, Cl-PFESAs and perfluorobutanoic acid, PFBA) in serum using ultra-performance liquid chromatograph-tandem mass spectrometry (UPLC-MS/MS). We applied linear and logistic regression models to analyze associations between serum PFAAs and hepatitis B surface antibody (HBsAb) with multivariable adjustments. We found negative associations between serum PFAAs concentrations and HBsAb. Lower serum HBsAb levels (log mIU/mL) were observed for each log-unit increase in linear PFOS (β = -0.31, 95% confidential interval: 0.84, -0.18), 6:2 PFESA (β = -0.81, 95% CI: 1.20, -0.42), 8:2 PFESA (β = -0.29, 95% CI: 0.43, -0.14) and PFBA (β = -0.18, 95% CI: 0.28, -0.08). The association between PFAAs and HBsAb seronegative seemed to be higher for 6:2 PFESA (odds ratio = 3.32, 95% CI: 2.16, 5.10) than its predecessors, linear PFOS (OR = 1.96, 95% CI: 1.37, 2.81) and branched PFOS isomers (OR = 1.64, 95% CI: 1.05, 2.56). We report new evidence that exposure to PFAA alternatives are associated with lower HBsAb in adults. This association seems to be stronger in 6:2 PFESA than PFOS. Our results suggest that more studies are needed to clarify the potential toxicity of PFAA alternatives in human which will facilitate better chemical regulations for PFAAs., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Evidence suggests that residential greenness may be protective of high blood pressure, but there is scarcity of evidence on the associations between greenness around schools and blood pressure among children. We aimed to investigate this association in China. Our study included 9354 children from 62 schools in the Seven Northeastern Cities Study. Greenness around each child's school was measured by NDVI (Normalized Difference Vegetation Index) and SAVI (Soil-Adjusted Vegetation Index). Particulate matter ≤ 1 μm (PM 1 ) concentrations were estimated by spatiotemporal models and nitrogen dioxide (NO 2 ) concentrations were collected from air monitoring stations. Associations between greenness and blood pressure were determined by generalized linear and logistic mixed-effect models. Mediation by air pollution was assessed using mediation analysis. Higher greenness was consistently associated with lower blood pressure. An increase of 0.1 in NDVI corresponded to a reduction in SBP of 1.39 mmHg (95% CI: 1.86, -0.93) and lower odds of hypertension (OR = 0.76, 95% CI: 0.69, 0.82). Stronger associations were observed in children with higher BMI. Ambient PM 1 and NO 2 mediated 33.0% and 10.9% of the association between greenness and SBP, respectively. In summary, greater greenness near schools had a beneficial effect on blood pressure, particularly in overweight or obese children in China. The associations might be partially mediated by air pollution. These results might have implications for policy makers to incorporate more green space for both aesthetic and health benefits., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Little information exists on interaction effects between air pollution and influenza vaccination on allergic respiratory diseases. We conducted a large population-based study to evaluate the interaction effects between influenza vaccination and long-term exposure to ambient air pollution on allergic respiratory diseases in children and adolescents., Methods: A cross-sectional study was investigated during 2012-2013 in 94 schools from Seven Northeastern Cities (SNEC) in China. Questionnaires surveys were obtained from 56 137 children and adolescents aged 2-17 years. Influenza vaccination was defined as receipt of the influenza vaccine. We estimated air pollutants exposure [nitrogen dioxide (NO 2 ) and particulate matter with aerodynamic diameters ≤1 μm (PM 1 ), ≤2.5 μm (PM 2.5 ) and ≤10 μm (PM 10 )] using machine learning methods. We employed two-level generalized linear mix effects model to examine interactive effects between influenza vaccination and air pollution exposure on allergic respiratory diseases (asthma, asthma-related symptoms and allergic rhinitis), after controlling for important covariates., Results: We found statistically significant interactions between influenza vaccination and air pollutants on allergic respiratory diseases and related symptoms (doctor-diagnosed asthma, current wheeze, wheeze, persistent phlegm and allergic rhinitis). The adjusted ORs for doctor-diagnosed asthma, current wheeze and allergic rhinitis among the unvaccinated group per interquartile range (IQR) increase in PM 1 and PM 2.5 were significantly higher than the corresponding ORs among the vaccinated group [For PM 1 , doctor-diagnosed asthma: OR: 1.89 (95%CI: 1.57-2.27) vs 1.65 (95%CI: 1.36-2.00); current wheeze: OR: 1.50 (95%CI: 1.22-1.85) vs 1.10 (95%CI: 0.89-1.37); allergic rhinitis: OR: 1.38 (95%CI: 1.15-1.66) vs 1.21 (95%CI: 1.00-1.46). For PM 2.5 , doctor-diagnosed asthma: OR: 1.81 (95%CI: 1.52-2.14) vs 1.57 (95%CI: 1.32-1.88); current wheeze: OR: 1.46 (95%CI: 1.21-1.76) vs 1.11 (95%CI: 0.91-1.35); allergic rhinitis: OR: 1.35 (95%CI: 1.14-1.60) vs 1.19 (95%CI: 1.00-1.42)]. The similar patterns were observed for wheeze and persistent phlegm. The corresponding p values for interactions were less than 0.05, respectively. We assessed the risks of PM 1 -related and PM 2.5 -related current wheeze were decreased by 26.67% (95%CI: 1.04%-45.66%) and 23.97% (95%CI: 0.21%-42.08%) respectively, which was attributable to influenza vaccination (both p for efficiency <0.05)., Conclusions: Influenza vaccination may play an important role in mitigating the detrimental effects of long-term exposure to ambient air pollution on childhood allergic respiratory diseases. Policy targeted at increasing influenza vaccination may yield co-benefits in terms of reduced allergic respiratory diseases., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

While exposure to places with higher greenness shows health benefits, evidence is scarce on its lipidemic effects. We assessed the associations between residential greenness and blood lipids and effect mediations by air pollution, physical activity, and adiposity in China. Our study included 15,477 adults from the population-based 33 Communities Chinese Health Study, conducted between April and December 2009, in Northeastern China. We measured total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Residential greenness was estimated using two satellite-derived vegetation indices - the Normalized Difference Vegetation Index (NDVI) and the Soil Adjusted Vegetation Index (SAVI). We used both nitrogen dioxide (NO 2 ) and particles ≤2.5 μm in aerodynamic diameter (PM 2.5 ) as proxies of outdoor air pollution. Associations were assessed using linear mixed effects regression models and logistic mixed effects regression models, and mediation analyses were also performed. Living in higher greenness areas was consistently associated with lower TC, TG, and LDL-C levels and higher HDL-C levels (e.g., change in TC, TG, LDL-C, and HDL-C per 0.1-unit increase in NDVI 500-m was -1.52%, -3.05%, -1.91%, and 0.52%, respectively). Similar results were obtained for the corresponding dyslipidemias. These associations were generally stronger in women and older adults. While educational levels showed effect modifications, the effect pattern was inconsistent. Both outdoor air pollution and body mass index mediated 9.1-62.3% and 5.6-40.1% of the associations for greenness and blood lipids, respectively, however, physical activity did not. Our results suggest beneficial associations between residing in places with higher greenness and blood lipid levels, especially in women and the elder individuals. The associations were partly mediated by lower air pollution and adiposity., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The effect of ambient air pollution exposure on childhood hypertension has emerged as a concern in China, and previous studies suggested pet ownership is associated with lower blood pressure (BP). However, limited information exists on the interactive effects pet ownership and air pollution exposure has on hypertension. We investigated the interactions between exposure to pet ownership and air pollutants on hypertension in Chinese children. 9354 students in twenty-four elementary and middle schools (aged 5-17 years) in Northeastern China were evaluated during 2012-2013. Four-year average concentrations of particulate matter with aerodynamic diameter of ≤10 μm (PM 10 ), SO 2 , NO 2 , and O 3 , were collected in the 24 districts from 2009 to 2012. Hypertension was defined as average diastolic or systolic BP (three time measurements) in the 95th percentile or higher based on height, age, and sex. To examine effects, two-level regression analysis was used, controlling covariates. Consistent interactions between exposure to pet and air pollutants were observed. Compared to children exposed to pet, those not exposed exhibited consistently stronger effects of air pollution. The highest odds ratios (ORs) per 30.6 μg/m 3 increase in PM 10 were 1.79 (95%confidence interval [95%CI]: 1.29-2.50) in children without current pet exposure compared to 1.24 (95%CI: 0.85-1.82) in children with current pet exposure. As for BP, only O 3 had an interaction for all exposure to pet ownership types, and showed lower BP in children exposed to pet. The increases in mean diastolic BP per 46.3 μg/m 3 increase in O 3 were 0.60  mmHg (95%CI: 0.21, 0.48) in children without pet exposure in utero compared with 0.34  mmHg (95%CI: 0.21, 0.48) in their counterparts. When stratified by age, pet exposure was more protective among younger children. In conclusion, in this large population-based cohort, pet ownership is associated with smaller associations between air pollution and hypertension in children, suggesting pet ownership reduces susceptibility to the health effects of pollutants., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Numerous studies have evaluated the effects of long-term exposure to ambient air pollution on hypertension. However, little information exists regarding its effects on prehypertension, a very common, but understudied cardiovascular indicator. We evaluated data from 24,845 adults (ages 18-74 years) living in three Northeastern Chinese cities in 2009. Blood pressure (BP) was measured by trained observers using a standardized mercuric-column sphygmomanometer. Three-year (from 2006 to 2008) average concentrations of particles with an aerodynamic diameter ≤10 μm (PM 10 ), sulfur dioxide (SO 2 ), nitrogen dioxides (NO 2 ), and ozone (O 3 ) were calculated using data from monitoring stations. Effects were analyzed using generalized additive models and two-level regression analyses, controlling for covariates. We found positive associations of all pollutants with prehypertension (e.g. odds ratio (OR) was 1.17 (95% confidence interval (CI), 1.09-1.25) per interquartile range (IQR) of PM 10 ) in a fully adjusted model, as compared to normotensive participants. These associations were stronger than associations with hypertension (e.g. OR was 1.03 (95% CI, 1.00, 1.07) per IQR of PM 10 ). We have also found positive associations of all studied pollutants with systolic and diastolic BP: e.g., associations with PM 10 per IQR were 1.24 mmHg (95% CI, 1.03-1.45) for systolic BP and 0.47 mmHg (95% CI, 0.33-0.61) for diastolic BP. Further, we observed that associations with BP were stronger in women and in older participants (systolic BP only). In conclusion, long-term exposure to ambient air pollution was more strongly associated with prehypertension than with hypertension, especially among females and the elderly. Thus, interventions to reduce air pollution are of great significance for preventing future cardiovascular events, particularly among individuals with prehypertension., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The impact of ambient air pollution on health causes concerns in China. However, little is known about the association of short-term air pollution exposure with blood pressure (BP) in children. The goal of present study was to assess the association between short-term air pollution and BP in children from a highly polluted area in China. This study enrolled 9354 children in 24 elementary and middle schools (aged 5-17 years) from the Seven Northeast Cities (SNEC) study, respectively, during the period of 2012-2013. Ambient air pollutants, including particulate matter with an aerodynamic diameter of ≤10 μm (PM 10 ), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ) and ozone (O 3 ) on the days (1-5 days) preceding BP examination were collected from local air monitoring stations. Generalized additive models and two-level regression analyses were used to evaluate the relationship between air pollution and BP after adjusting for other covariates. Results showed that with an interquartile range (IQR) increase in PM 10 (50.0 μg/m 3 ) and O 3 (53.0 μg/m 3 ) level during the 5-day mean exposure, positive associations with elevated BP were observed, with an odds ratio of 2.17 (95% CI, 1.61-2.93) for PM 10 and 2.77 (95% CI, 1.94-3.95) for O 3 . Both systolic BP and diastolic BP levels were positively associated with an IQR increase of four air pollutants at different lag times. Specifically, an IQR increase in the 5-day mean of PM 10 and O 3 was associated with elevation of 2.07 mmHg (95% CI, 1.71-2.44) and 3.29 mmHg (95% CI, 2.86-3.72) in systolic BP, respectively. When stratified by sex, positive relationships were observed for elevated BP with NO 2 exposure only in males. This is the first report on the relationship between ambient short-term air pollution exposure and children BP in China. Findings indicate a need to control air pollutants and protect children from heavy air pollution exposure in China., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

To investigate the risk of hyperuricemia in relation to Perfluoroalkyl substances (PFASs) in children from Taiwan, 225 Taiwanese children aged 12-15 years were recruited from 2009 to 2010. Linear and logistic regression models were employed to examine the influence of PFASs on serum uric acid levels. Findings revealed that eight of ten PFASs analyses were detected in >94% of the participants' serum samples. Multivariate linear regression models revealed that perfluorooctanic acid (PFOA) was positively associated with serum uric acid levels (β = 0.1463, p < 0.05). Of all the PFASs analyses, only PFOA showed a significant effect on elevated levels of hyperuricemia (aOR = 2.16, 95%CI: 1.29-3.61). When stratified by gender, the association between serum PFOA and uric acid levels was only evident among boys (aOR = 2.76, 95%CI: 1.37-5.56). In conclusion, PFOA was found to be associated with elevated serum levels of uric acid in Taiwanese children, especially boys. Further research is needed to elucidate these links., (Copyright © 2016 Elsevier Ltd. All rights reserved.)