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Background: The evidence on the effects of extreme meteorological conditions and high air pollution levels on incidence of hand, foot and mouth disease (HFMD) is limited. Moreover, results of the available studies are inconsistent. Further investigations are imperative to elucidate the specific issue., Methods: Data on the daily cases of HFMD, meteorological factors and air pollution were obtained from 2017 to 2022 in Jining City. We employed distributed lag nonlinear model (DLNM) incorporated with Poisson regression to explore the impacts of extreme meteorological conditions and air pollution on HFMD incidence., Results: We found that there were nonlinear relationships between temperature, wind speed, PM 2.5 , SO 2 , O 3 and HFMD. The cumulative risk of extreme high temperature was higher at the 95th percentile ( P 95 th) than at the 90th percentile( P 90 th), and the RR values for both reached their maximum at 10-day lag ( P 95 th RR = 1.880 (1.261-2.804), P 90 th RR = 1.787 (1.244-2.569)), the hazardous effect of extreme low temperatures on HFMD is faster than that of extreme high temperatures. The cumulative effect of extreme low wind speeds reached its maximum at 14-day lag ( P 95 th RR = 1.702 (1.389-2.085), P 90 th RR = 1.498(1.283-1.750)). The cumulative effect of PM 2.5 concentration at the P 90 th was largest at 14-day lag ( RR = 1.637 (1.069-2.506)), and the cumulative effect at the P 95 th was largest at 10-day lag ( RR = 1.569 (1.021-2.411)). High SO 2 concentration at the P 95 th at 14-day lag was associated with higher risk for HFMD ( RR : 1.425 (1.001-2.030))., Conclusion: Our findings suggest that high temperature, low wind speed, and high concentrations of PM2.5 and SO2 are associated with an increased risk of HFMD. This study not only adds insights to the understanding of the impact of extreme meteorological conditions and high levels of air pollutants on HFMD incidence but also holds practical significance for the development and enhancement of an early warning system for HFMD., Competing Interests: The authors declare that they have no competing interests., (© 2024 Cao et al.)

Although accumulative studies have revealed the associations between air pollutants and elevated risk of gestational hypertension (GH), evidence from developing countries with relatively higher levels of air pollutants remains limited. In this retrospective study, a total of 45,439 birth records were collected in Beijing, China from 2013 to 2018. For PM 2.5 , SO 2 , NO 2 , and O 3 , exposure windows from the 3rd month of preconception to the 6th month of conception and the averages of 3 months of preconception, trimester 1 and trimester 2 periods were all calculated for assessment of GH risks. The correlations between air pollutants and the risk of GH were analyzed by logistic regression model. Our results showed that exposure to PM 2.5 and SO 2 in the preconceptional and early pregnancy periods was related to the elevated risk of GH. Furthermore, 3 months preconceptional exposure to PM 2.5 (PCPM 2.5 : OR = 1.134 (1.114, 1.155)) and SO 2 (PCSO 2 : OR = 1.158 (1.135, 1.181)) showed a higher risk of GH than the results of the trimester 1 (T1PM 2.5 : OR = 1.131 (1.104, 1.159); T1SO 2 : OR = 1.164 (1.141, 1.187)) and the trimester 2 (T2PM 2.5 : OR = 1.154 (1.126, 1.182); T2SO 2 : OR = 1.121 (1.098, 1.144)). The study also found significant and higher OR values for PCPM 2.5 , and PCSO 2 from 2013 to 2016 when air pollution was serious in Beijing compared with 2017 to 2018 when the air pollution was obviously improved. Subgroup analysis also found that during 3 months of preconception women with higher age and who exposure to higher temperatures showed higher GH risk from PM 2.5 and SO 2 than that of the younger group and who exposure to lower temperature, respectively. Collectively, our findings suggest that air pollution exposure was adversely associated with GH in pregnant women and the preconceptional period is a critical air pollution exposure window for GH. Improving air quality can benefit public health, especially for sensitive populations like pregnant women., Competing Interests: Declaration of competing interest The authors declared that they have no conflicts of interest to this work. We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Introduction: Ozone (O 3 ) is known to induce oxidative stress that influences various cells and tissues, which may further lead to diminished bone mineral density. Nevertheless, few studies have investigated the association between O 3 exposure and fractures. Considering the similar growing trends of O 3 concentrations and fracture morbidity in recent years, in the present study, we aimed to examine whether O 3 exposure is associated with the fracture morbidity., Methods: Using a retrospective cohort study design, we analyzed the records of 8,075 patients with fracture admitted in the warm season to Beijing Jishuitan Hospital from 2014 to 2019 and matched them to the corresponding exposure time and concentration of O 3 ., Results: The results showed that increased odds of fracture were associated with increased O 3 concentrations, presumably because O 3 induces oxidative stress (OS) that leads to bone mineral density (BMD) loss., Discussion: Our findings suggest that O 3 exposure is a risk factor for fractures, providing new evidence of the adverse health effect induced by air pollution. We can conclude that more intensive air pollution control is needed for the prevention of fracture occurrence., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Lu, Xu, Gong, Zha, Li, Chen, Liu and Jiang.)

Birth weight is an important indicator of future growth and development for newborns. Few studies investigated the potential effects of air pollutants on macrosomia and their susceptible windows. We included 38,971 singleton full-term births from Beijing HaiDian Maternal and Child Health Hospital between 2014 and 2018, and assessed the associations of air pollutants exposure during preconception and pregnancy with macrosomia as well as the corresponding susceptible windows. The concentrations of air pollutants (PM 2.5 , PM 10 , SO 2 , NO 2 , CO and O 3 ) for participants were calculated by the data from the nearest monitoring stations. Distributed lag models (DLM) incorporating logistic regression models were used to estimate the associations between air pollutants exposure during the 3 months before conception and pregnancy period and the risk of macrosomia, identifying susceptible windows of air pollutants. Weighted quantile sum (WQS) regression was applied to estimate the joint effect of air pollutants. A 10 μg/m 3 increase in PM 2.5 exposure from 3rd to 8th gestational month was positively associated with the risk of macrosomia, with the strongest effect in the 6th month (OR = 1.010, 95 % CI: 1.002-1.019). For a 10 μg/m 3 increase in SO 2 , the windows of significant exposure were from the 1st preconception month to the 3rd gestational month, with the strongest effect in the 2nd month (OR = 1.030, 95 % CI: 1.010-1.049). We also observed the significant positive associations were in the 5th-8th gestational months for PM 10 , the 8th-9th gestational months for NO 2 and the 3rd-7th gestational months for CO respectively. WQS regression also indicated a positive association between co-exposure to air pollutants and macrosomia. Our results suggest air pollution exposure is associated with increased risk of macrosomia. The windows of exposure for susceptibility to the risk of macrosomia vary between air pollutants. The susceptible exposure windows were middle and late pregnancy for PM, CO and NO 2 , while for SO 2 , early pregnancy is the window of vulnerability. Our findings provide the evidence that air pollution exposure is an independent risk factor for macrosomia and a basis for targeted environment policy., 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 B.V. All rights reserved.)

Numerous studies have shown that air pollution seems to be able to cause many diseases. Considering the possible mechanism of action and the same growth trend, the present study is designed to examine whether and how air pollutants, especially ozone (O 3 ) exposure, are associated with the incidence of gestational diabetes mellitus (GDM). By a retrospective cohort, we analyzed the records of 45439 pregnant women from 2013 to 2018 and matched them to maternal exposure to O 3 . We found that the increased odds of GDM is associated with increased O 3 concentrations from the 1st month before pregnancy to the 3rd month during pregnancy. Specially, the odds ratios (ORs) of these associations were largest in the 1st month before pregnancy, suggesting that the effect of O 3 pollution on GDM occurred in pre-pregnancy period. Moreover, the exposure-response plot in the 1st month before pregnancy showed that the odds of GDM increased with the increasing concentration of O 3 . Our findings provide the evidence that O 3 exposure in both pre-pregnancy and pregnancy period elevates the odds of GDM, suggesting that more intensive air pollution controls are needed to improve the health of pregnant women and their offspring., 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.)

Both fine particulate matter (PM 2.5 ) and ozone (O 3 ) may have adverse effects on human health. However, previous studies on the effects of air pollutants mainly have focused on susceptible population, and evidence on healthy young adults is limited. We aimed to examine the associations of the two main air pollutants (PM 2.5 and O 3 ) with lung function, inflammation and oxidative stress in healthy young adults. We recruited 30 healthy young adults for a longitudinal panel study in Beijing and implemented health examination seven times, including lung function (FEV 1 and PEF) and biomarkers of inflammation and oxidative stress (i.e. C-reactive protein, CRP; interleukin-6, IL-6; malondialdehyde, MDA) from December 2019 to May 2021. Hourly ambient air pollutants data were obtained from the closest air quality monitoring station. Linear mixed-effect model was applied to explore the associations between air pollutants and lung function, inflammation and oxidative stress. We observed higher PM 2.5 exposure was associated with decrement in lung function and increment in CRP and MDA. Each 10 μg/m 3 increase in PM 2.5 (lag 2 day) is associated with a 17.06 ml (95% CI: -31.53, -2.58) decrease in FEV 1 , 46.34 ml/s (95% CI: -76.41, -16.27) decrease in PEF and increments of 2.86% (95% CI: 1.47%, 4.27%) in CRP, 1.63% (95% CI: 0.14%, 3.14%) in MDA respectively. However, there is no significant association between ozone exposure and health indicators. The study suggested that short-term exposure to PM 2.5 may decrease lung function and induce inflammation and oxidative stress in healthy adults, but there is no association between O 3 and each outcome., 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 The Authors. Published by Elsevier Inc. All rights reserved.)