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Background Limited studies have examined the effect of prenatal exposure to particulate matter with diameter of <2.5 µm (PM2.5) and <1 μm (PM1) on fetal growth using ultrasound measurements with inconsistent results. No study has evaluated the joint effect of the indoor air pollution index and ambient particulate matter on fetal growth. Methods We conducted a prospective birth cohort study in Beijing, China in 2018, including 4319 pregnant women. We estimated prenatal PM2.5 and PM1 exposure using a machine-learning method and calculated the indoor air pollution index based on individual interviews. Gender- and gestational age-adjusted Z-score of the abdominal circumference (AC), head circumference (HC), femur length (FL) and estimated fetal weight (EFW) was calculated and then undergrowth was defined. A generalized estimating equation was used to evaluate the individual and joint effect of indoor air pollution index, PM2.5 and PM1 on fetal Z-score and undergrowth parameters. Results One unit increase in the indoor air pollution index was associated with −0.044 (95% CI: −0.087, −0.001) and −0.050 (95% CI: −0.094, −0.006) decrease in the AC and HC Z-scores, respectively. PM1 and PM2.5 were associated with decreased AC, HC, FL and EFW Z-scores, and higher risk of undergrowth. Compared with exposure to lower PM1 (≤ median) and no indoor air pollution, those exposed to higher PM1 (> median) and indoor air pollution had decreased EFW Z-scores (β = −0.152, 95% CI: −0.230, −0.073) and higher risk of EFW undergrowth (RR = 1.651, 95% CI: 1.106, 2.464). Indoor air pollution and ambient PM2.5 exposure had a similar joint effect on the Z-scores and undergrowth parameters of fetal growth. Conclusions This study suggested that indoor air pollution and ambient PM exposure had individual and joint negative effects on fetal growth. [ABSTRACT FROM AUTHOR]

Limited studies examined the associations of prenatal exposure to particulate matter (PM) and children's growth with inconsistent results, and no study focused on PM 1. We matched a birth cohort (10,547 children) with daily PM 1 and PM 2.5 concentrations by maternal home addresses. Air pollution concentrations were predicted by satellite remote sensing data, meteorological factors, and land use information. The weight and length of children in the birth cohort were measured at approximately one year old. We calculated the Z-score of weight for length (WFL) and body mass index (BMI) and then defined overweight and obesity (OWOB) based on WHO Standards. Generalized linear regression and modified Poisson regression were used to identify the association of prenatal exposure to PM 1 or PM 2.5 with anthropometric measurements and risk of OWOB. We also determined the mediation effect of preterm birth on the associations. Results showed that a 10 μg/m3 increase in prenatal exposure to PM 1 and PM 2.5 was significantly associated with a 0.105 [95% confidence interval (CI): 0.067, 0.144] and 0.063 (95% CI: 0.029, 0.097) increase in WFL Z-score for one-year-old children. Similar associations were found for BMI Z-score. A 10 μg/m3 increase in prenatal PM 1 and PM 2.5 exposure was significantly associated with 1.012 (95% CI : 1.003, 1.021) and 1.010 (95% CI : 1.002, 1.018) times higher risk of OWOB.. Preterm birth mediated 7.5% [direct effect (DE) = 0.106, P < 0.001; indirect effect (IE) = 0.009, P < 0.001)] and 9.9% (DE = 0.064, P < 0.001; IE = 0.007, P < 0.001) of the association between prenatal PM 1 and PM 2.5 exposure and WFL Z-score of the children. The association of prenatal PM 1 and PM 2.5 exposure with BMI Z-score of children was also mediated by preterm birth by 6.6% (DE = 0.111, P < 0.001; IE = 0.008, P < 0.001) and 9.1% (DE = 0.064, P < 0.001; IE = 0.006, P < 0.001). These results remained robust in the sensitivity analyses. In conclusion, prenatal exposure to PM 1 and PM 2.5 increased WFL, BMI Z-scores and higher risk of OWOB for one-year-old children. The associations were partially mediated by preterm birth. These findings call for the urgent action on air pollution regulation to protect early-life health among children. [Display omitted] • We first studied the association of PM 1 with the early onset of childhood obesity and the mediation effect of preterm birth. • Prenatal exposure to PM 1 and PM 2.5 increased WFL, BMI Z-scores and risk of overweight and obesity for one-year-old children. • The associations of prenatal PM exposure with WFL and BMI Z-scores of children were partially mediated by preterm birth. [ABSTRACT FROM AUTHOR]

Skin diseases have become a global concern. This study aims to evaluate the associations between ambient air pollution and emergency room visits for skin diseases under the background of improving air quality in China. Based on 45,094 cases from a general hospital and fixed-site monitoring environmental data from 2014–2019 in Beijing, China, this study used generalized additive models with quasi-Poisson regression to estimate the exposure–health associations at lag 0–1 to lag 0–7. PM2.5 and NO2 exposure were associated with increased emergency room visits for total skin diseases (ICD10: L00-L99). Positive associations of PM2.5, PM10, O3 and NO2 with dermatitis/eczema (ICD-10: L20–30), as well as SO2 and NO2 with urticaria (ICD-10: L50) visits were also found. For instance, a 10 μg/m3 increase in PM2.5 was associated with increases of 0.7% (95%CI: 0.2%, 1.2%) in total skin diseases visits at lag 0–5 and 1.1% (95%CI: 0.6%, 1.7%) in dermatitis/eczema visits at lag 0–1, respectively. For PM2.5, PM10 and CO, stronger annual associations were typically observed in the high-pollution (2014) and low-pollution (2018/2019) years. For instance, a 10 μg/m3 increase in PM2.5 at lag 0–5 was associated with increases of 1.8% (95%CI: 1.0%, 2.6%) and 2.3% (95%CI: 0.4%, 4.3%) in total skin disease visits in 2014 and 2018, respectively. Our study emphasizes the necessity of controlling the potential health hazard of air pollutants on skin, although significant achievements in air quality control have been made in China. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is widely known with a high incidence rate worldwide, but the correlation between exposure to per- and polyfluoroalkyl substances (PFAS) and the number of lymph nodes in CRC patients remains unclear. In the present study, we enrolled 305 CRC patients (122 females and 183 males) at Beijing Hospital in China. A total of 17 PFAS were detected in serum samples of these patients, and 5 PFAS with detection rates >75% were selected in this study. The CRC patients' number of metastatic lymph nodes (MLNs) and total lymph nodes (TLNs) were chosen as outcomes. Poisson regression models were used to analyze the associations between single PFAS and number of MLNs and TLNs. Quantile g-Computation models were performed to examine the joint effect of PFAS mixtures on number of MLNs and TLNs. A positive correlation between serum PFAS levels and number of MLNs was identified. For instance, the numbers of MLNs in patients with serum PFOA, PFNA, 6:2 Cl-PFESA concentrations at the 95th percentile were 27% (95% CI: 1%, 60%), 35% (95% CI: 1%, 82%), 87% (95% CI: 4%, 238%) higher compared with the threshold level. The results of Quantile g-Computation models also showed that every quantile increase in PFAS mixtures was associated with a 4.67%, (95% CI: 0.07%, 9.48%) increase in the numbers of MLNs, and PFOS dominated the effects of the mixtures. Moreover, a negative correlation between PFAS mixtures and number of TLNs in patients with no MLNs was also observed. The present study suggested that exposure to PFAS may worsen the prognosis of CRC patients. These findings could help guide future research and public health policies aimed at reducing exposure to PFAS and mitigating their potential impacts on human health. [Display omitted] • Five of the 17 PFAS were frequently detected in serum of 305 colorectal cancer patients. • Higher PFAS mixtures were associated with elevated number of metastatic lymph nodes. • PFOS dominated the effects of the PFAS mixtures on number of metastatic lymph nodes. [ABSTRACT FROM AUTHOR]

Limited studies investigated the association of prenatal exposure to PM 2.5 and fetal growth measured by ultrasound with inconsistent results. No study evaluated the effect of PM 2.5 constituents on fetal growth in utero. We aimed to investigated whether prenatal exposure to PM 2.5 and its constituents was associated with fetal growth measured by ultrasound. A total of 4319 eligible pregnant women in Peking University Birth Cohort in Tongzhou (PKUBC-T) were included in the study. Based on mothers' residential addresses, we estimated prenatal PM 2.5 concentrations with a satellite-based spatiotemporal model and PM 2.5 constituents concentrations with a modified Community Multiscale Air Quality model. Fetal growth parameters of abdominal circumference (AC), head circumference (HC), and femur length (FL) were measured by ultrasound and then estimated fetal weight (EFW) was calculated. We calculated sex and gestational age-specific fetal growth Z-score and then defined the corresponding fetal undergrowth. Generalized estimating equation was used to investigate the association of PM 2.5 and its constituents with fetal growth Z-score and fetal undergrowth. Prenatal exposure to PM 2.5 , OC, EC, SO 4 2−, NH 4 +, or NO 3 − was consistently associated with decreased Z-scores of fetal growth parameters (AC, HC, FL, EFW). One IQR increase of PM 2.5 , OC, EC, SO 4 2−, NH 4 +, or NO 3 − was associated with −0.183 [95% confident interval (CI): −0.225, −0.141], −0.144 (95%CI: −0.181, −0.107), −0.123 (95%CI: −0.160, −0.085), −0.035 (95%CI: −0.055, −0.015), −0.095 (95%CI: −0.126, −0.064), and −0.124 (95%CI: −0.159, −0.088) decrease in EFW Z-score, respectively. Prenatal exposure to PM 2.5 , OC, EC, SO 4 2−, NH 4 +, or NO 3 − was also associated with higher risk of fetal AC, HC, FL or EFW undergrowth. The study identified that prenatal exposure to PM 2.5 or its constituents was associated with impaired fetal growth. The findings provided evidence that control measures for PM 2.5 constituents should be implemented for further promoting fetal growth. • This is the first study on the effect of PM 2.5 constituents on fetal growth in utero. • PM 2.5 constituents had adverse effects on fetal growth Z-scores. • PM 2.5 constituents were associated with increased risk of fetal undergrowth. [ABSTRACT FROM AUTHOR]

Few studies examined the association of prenatal exposure to green spaces with children's body mass index (BMI) Z-score, and no study evaluated the joint effect of prenatal green spaces and PM 2.5 or PM 1 exposure on children's BMI Z-score. We aimed to assess the individual and joint effects of prenatal green spaces, PM 2.5 , and PM 1 exposure on BMI Z-score of children aged two years. The study was based on a birth cohort in Beijing, China, in which 13,253 mothers (LMP from 2014 to 2017) and their children were included. We estimated prenatal green spaces exposure by calculating average normalized difference vegetation index with 500 m buffers (NDVI-500), prenatal PM 2.5 and PM 1 exposure based on maternal residential addresses. Weight and height of children were measured at 2 years old. We calculated children's BMI Z-score based on the WHO Standards. Generalized linear regression was used to examine the individual and joint effects of prenatal NDVI-500, PM 2.5 and PM 1 exposure on children's BMI Z-score. A 0.1 increase in prenatal NDVI-500 exposure, a 10 μg/m3 decrease in PM 2.5 , a 10 μg/m3 decrease in PM 1 were associated with 0.185 [95% confidence interval (95% CI): 0.155, 0.216], 0.034 (95% CI : 0.015, 0.052) and 0.041 (95% CI : 0.020, 0.061) increase of children's BMI Z-score, respectively. Compared with those exposed to low-level NDVI-500 (not greater than median) and high-level PM 2.5 (greater than median), the BMI Z-score was higher in children whose mother exposed to high-level of NDVI-500 and low-level PM 2.5 [β:0.172 (95% CI : 0.131, 0.214), P interaction = 0.003]. Compared with those exposed to low-level NDVI-500 and high-level PM 1 , the BMI Z-score was higher in children whose mother exposed to high-level of NDVI-500 and low-level PM 1 [β:0.169 (95% CI : 0.127, 0.210), P interaction <0.001]. In the trimester-specific analysis, NDVI-500 and PM exposure during the second trimester have a consistent individual effect, together with a joint effect, on child growth. The study suggested the beneficial effect of prenatal exposure to green spaces on child growth and its interaction with PM 2.5 and PM 1 , especially in the second trimester. The findings call for developing public health policy to improve green infrastructure and control PM 2.5 and PM 1 concentrations, in order to promote child growth. • No study evaluated the joint effect of prenatal green spaces and PM 2.5 or PM 1 exposure on children's BMI Z-score. • It is the first study to explore the joint effect of prenatal NDVI-500, PM 2.5 and PM 1 exposure on children's BMI Z-score. • We found that NDVI-500 during pregnancy was associated with increased BMI Z-score of children aged two years. • Prenatal NDVI-500 exposure had an interaction effect with PM 2.5 and PM 1 on child growth in the first two years. [ABSTRACT FROM AUTHOR]

The association of airborne particulate matter of 1 μm or less (PM 1) with fetal growth hasn't been studied. We aimed to investigate the association of PM 1 with fetal growth parameters measured via ultrasonography and birth weight. The birth cohort included 18,669 pregnant women who were pregnant between 2014 and 2017 in Tongzhou Maternal and Child Health Hospital of Beijing, China. The predicted PM 1 concentration was matched with the residential addresses of each woman. The fetal abdominal circumference (AC), head circumference (HC), femur length (FL) and estimated fetal weight (EFW) were evaluated via ultrasonography, while birth weight was measured at birth. The fetal parameters and birth weight were standardized as gestational-age- and gender-adjusted Z-score. We defined undergrowth of fetal parameters, low birth weight (LBW) and small-for-gestational-age (SGA) as categorized outcomes. Generalized estimating equations and generalized linear regression were used to examine the associations of PM 1 with quantitative and categorized outcomes, respectively. A 10 μg/m3 increase in PM 1 was associated with decrement in the Z-scores of AC [-0.027, 95% confidence intervals (CI): -0.047~ -0.07]EFW (-0.055, 95%CI: -0.075~-0.035). These results remained robust after adjusting nitrogen dioxide and sulphur dioxide. We didn't observe significant results regarding the analyses of undergrowth of all fetal parameters and the analyses of birth weight outcomes. This study identified the negative associations between PM 1 and fetal parameters in utero. The findings provided robust evidence that strategies for reducing PM 1 exposure can prevent early-life health. • PM 1 was negatively associated with fetal growth in utero. • PM 1 was not associated with birth weight outcomes. • The findings provided robust evidence that strategies of reducing PM1 exposure can prevent early-life health problem. [ABSTRACT FROM AUTHOR]

• Evidence on residential greenness and fetal growth in utero is scarce in China. • Residential greenness were beneficially associated with fetal growth in utero. • The associations were stronger in women exposed to lower levels of PM 2.5. Although studies have examined the association between residential greenness and birth weight, there is no evidence regarding the association between residential greenness and fetal growth in utero. We aimed to investigate the associations of residential greenness with both fetal growth in utero and birth weight. A birth cohort (2014–2017) with 18,665 singleton pregnancies was established in Tongzhou Maternal and Child hospital of Beijing, China. Residential greenness was matched with maternal residential address and estimated from remote satellite data using normalized difference vegetation index with 200 m and 500 m buffers (NDVI-200 and NDVI-500). Fetal parameters including estimated fetal weight (EFW), abdominal circumference (AC), head circumference (HC) and femur length (FL) were assessed by ultrasound measurements during pregnancy. Fetal parameters were standardized as gestational-age- and gender-adjusted Z-score and undergrowth was defined as Z-score < −1.88. Birth weight Z-score, low birth weight (LBW) and small for gestational age (SGA) were assessed as birth outcomes. Generalized estimating equations with the autoregressive working correlation structure and generalized linear regression were used to examine the associations of residential greenness with quantitative and categorized outcomes. We found an increase Z-score of EFW [0.054, 95% confidence interval (CI): 0.020–0.087], AC (0.045, 95%CI: 0.011–0.080) and HC (0.054, 95%CI: 0.020–0.089) associated with residential greenness above NDVI-500 median compared to less than and equal to NDVI-500 median. Stratified analyses indicated that the associations might be stronger in women exposed to lower levels of particles with aerodynamic diameters ≤2.5 µm. No associations were found in the analyses of NDVI-250 with fetal growth in utero. We didn't observe significant associations of NDVI with birth weight Z-score, LBW and SGA. This study identified a positive association of NDVI-500 and fetal growth in utero, but we didn't observe its association with birth weight measures. Our results suggest that building sufficient green infrastructure might potentially promote early life health. [ABSTRACT FROM AUTHOR]