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Short-term exposure to air pollution has previously been studied in relation to certain neurological disorders, but there is still a lack of convincing data linking air pollution to epileptic seizures. The study's goal was to investigate how exposure to ambient nitrogen dioxide (NO 2 ) affected the number of patients seeking assistance at the Wuhan Emergency Medical Center due to epileptic seizures. We gathered data on medical emergency calls (MECs), daily ambient air pollution concentrations (SO 2 , NO 2 , PM 2.5 , PM 10 , CO, and O 3 ), and meteorological variables in Wuhan, China, spanning from January 1, 2017, to November 30, 2019. To investigate the potential influence of ambient nitrogen dioxide on MECs for epileptic seizures, we carried out a time-series investigation using the general additive model (GAM). Additionally, analyses stratified by season, age, and gender were performed. A total of 8989 records of MECs for epileptic seizures were enrolled in our study during the period. Statistical analysis indicates that a rise of 10 μg/m3 in NO 2 concentration is linked to a 0.17% increase in daily MECs for epileptic seizures (95% confidence interval [CI]: 0.02%, 0.32%). Furthermore, people aged 14-59 years were more susceptible(2.25%, P < 0.05). The short-term effects of NO 2 exposure on daily MECs for epileptic seizures were stronger in warm seasons than in cool seasons (0.55% vs. -0.10%, P < 0.0001). Our findings suggests that short-term exposure to ambient NO 2 was positively correlated with daily MECs for epileptic seizures in Wuhan, China. Additionally, we observed that these associations were stronger in patients aged above 14 but under 60 years and the warmer seasons (from April to September)., (© 2024. The Author(s) under exclusive licence to International Society of Biometeorology.)

Previous studies demonstrated that short-term exposure to gaseous pollutants (nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3)) had a greater adverse effect on cardiovascular disease. However, little evidence exists regarding the synergy between gaseous pollutants and cardiovascular disease (CVD). Therefore, we aimed to estimate the effect of individual gaseous pollutants on hospital admissions for CVD and to explore the possible synergistic effects between gaseous pollutants. Daily hospitalization counts for CVD were collected from January 1, 2014, to December 31, 2015. We also collected daily time series on gaseous pollutants from the Environment of the People's Republic of China, including NO2, SO2, and O3. We used distributed lag nonlinear models (DLNMs) to assess the association of individual gaseous pollutants on CVD hospitalization, after controlling for seasonality, day of the week, public holidays, and weather variables. Then, we explored the variability across age and sex groups. In addition, we analyzed the synergistic effects between gaseous pollutants on CVD. Extremely low NO2 and SO2 increase the risk of CVD in all subgroup at lag 7 days. The greatest effect of high concentration of SO2 was observed in male and the elderly (≥ 65 years) at lag 3 days. Greater effects of high concentration of O3 were more pronounced in the young (< 65 years) and female at lag 3 days, while the effect of low concentration of O3 was greater in male and the young (< 65 years) at lag 0 day. We found a synergistic effect between NO2 and SO2 for CVD, as well as between SO2 and O3. The synergistic effects of NO2 and SO2 on CVD were stronger in the elderly (≥ 65) and female. The female was sensitive to synergistic effects of SO2-O3 and NO2-O3. Interestingly, we found that there was a risk of CVD in the susceptible population even for gaseous pollutant concentrations below the National Environmental Quality Standard. The synergy between NO2 and SO2 was significantly associated with cardiovascular disease hospitalization in the elderly (≥ 65). This study provides evidence for the synergistic effect of gaseous pollutants on hospital admissions for cardiovascular disease. [ABSTRACT FROM AUTHOR]

Short-term exposure to PM 2.5 or O 3 can increase mortality risk; however, limited studies have evaluated their interaction. A multicity time series study was conducted to investigate the synergistic effect of PM 2.5 and O 3 on mortality in China, using mortality data and high-resolution pollutant predictions from 272 cities in 2013-2015. Generalized additive models were applied to estimate associations of PM 2.5 and O 3 with mortality. Modification and interaction effects were explored by stratified analyses and synergistic indexes. Deaths attributable to PM 2.5 and O 3 were evaluated with or without modification of the other pollutant. The risk of total nonaccidental mortality increased by 0.70% for each 10 μg/m 3 increase in PM 2.5 when O 3 levels were high, compared to 0.12% at low O 3 levels. The effect of O 3 on total nonaccidental mortality at high PM 2.5 levels (1.26%) was also significantly higher than that at low PM 2.5 levels (0.59%). Similar patterns were observed for cardiovascular or respiratory diseases. The relative excess risk of interaction and synergy index of PM 2.5 and O 3 on nonaccidental mortality were 0.69% and 1.31 with statistical significance, respectively. Nonaccidental deaths attributable to short-term exposure of PM 2.5 or O 3 when considering modification of the other pollutant were 28% and 31% higher than those without considering modification, respectively. Our results found synergistic effects of short-term coexposure to PM 2.5 and O 3 on mortality and suggested underestimations of attributable risks without considering their synergistic effects.

Some studies suggested that 24-h temperature change (TC24) was one of the potential risk factors for human health. However, evidence of the short-term effect of TC24 on outpatient and emergency department (O&ED) visits and hospitalizations for cause-specific cardiovascular diseases (CVDs) is still limited. The aim of this study is to explore the short-term effects of TC24 on O&ED visits and hospitalizations for CVDs in northwest China which is an area with large temperature variation. The O&ED visits records for CVDs of 3 general hospitals and the inpatient records for CVDs of 4 general hospitals were collected from January 1, 2013, to December 31, 2016, in Jinchang City, northwest China. Meteorological and air pollution data were also obtained during the same study period from local meteorological monitoring station and environmental monitoring station, respectively. A generalized additive model (GAM) with Poisson regression was employed to analyze the effects of TC24 on O&ED visits and hospitalizations for CVDs. V-shaped relationship were found between TC24 and O&ED visits and hospitalizations for CVDs, including total CVD, hypertension, coronary heart disease (CHD) and stroke. Stratified analysis showed that men and patients over 65 years old were more susceptible to temperature changes. The estimates in non-heating months were higher than in full year. TC24 can affect the O&ED visits and hospitalizations for CVDs in this study. This study provides useful data for policy makers to better prepare local responses to the impact of changes in temperature on population health. [ABSTRACT FROM AUTHOR]

Accumulating evidence witnesses the negative influence of air pollution on human health, but the relationship between air pollution and premature babies has been inconsistent. In this study, the association between weekly average concentration of air pollutants and preterm birth (PTB) was conducted in Xuzhou, a heavy industry city, in China. We constructed a distributed lag non-linear model (DLNM), an ecological study, to access the associations between ambient air pollutants and PTB in this study. Totally, 5408 premature babies were included, and the weekly average levels of PM2.5, PM10, SO2, NO2, O3, and CO were 61.24, 110.21, 22.55, 40.55, 104.45, and 1.04 mg/m3, respectively. We found that PM2.5, PM10, SO2, and NO2 significantly increased the risk of PTB, and the susceptibility windows of these contaminants were the second trimester and third trimester (from 12 to 29 weeks). Every 10 μg/m3 increase of PM2.5, PM10, SO2, and NO2, the greatest relative risk (RR) values and 95% confidence interval (CI) on PTB were 1.0075 [95% CI, 1.0019–1.0131], 1.0053 [95% CI, 1.0014–1.0092], 1.0203 [95% CI, 1.0030–1.0379], and 1.0170 [95% CI, 1.0052–1.0289] in lag 16th, 18th, 19th, and 20th gestational weeks, respectively. No significant influence of O3 and CO were found on preterm birth. Subgroup analysis showed that the risk of premature delivery was higher for younger pregnant women and in warm season. This finding shows that prenatal exposure to ambient air pollutants is associated with preterm birth, and there existed an exposure window period. [ABSTRACT FROM AUTHOR]

Background: It is still unclear about the association between ambient air pollution and attack risk of acute myocardial infarction (AMI) in South China. This study assessed the effects of short-term exposure to ambient air pollutants on hospital admission of AMI in Guangzhou, South China. Materials and methods: We obtained the information on 19,622 hospital admissions of AMI from the Guangzhou Cardiovascular and Cerebrovascular Disease Event Surveillance System during the years from 2014 to 2017. Daily concentrations of air pollution data on particulate matter < 2.5 μm in diameter (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) were available from the Daily Quality Report of the Guangzhou Environmental Protection Bureau during the study period. The effects of air pollution exposure on the risk of AMI hospital admission were assessed using Poisson generalized additive models. Risk estimates were reported as the percent increase in daily hospital admissions of AMI for an interquartile range (IQR) increment in air pollution concentrations. Results: On average, there were 13 hospital admissions of AMI each day. After controlling for the pollutants, including PM2.5, SO2, and O3, and other time-varying factors, a 21.26-μg/m3 increment in the 2-day moving average of same-day and previous-day NO2 concentrations was statistically linked to an increase of 6.38% [95% confidence interval (CI): 1.33%, 11.67%] of AMI hospital admissions. Additionally, per IQR increment in the 2-day moving average exposure of same-day and previous-day NO2 pollutant levels was linked to a 7.85% (95% CI: 1.19%, 14.95%) increase of AMI hospital admissions among people aged above 65 years old. An effect modification of risk by gender was found, suggesting that females were more susceptible to the exposure to NO2 pollutant. Conclusions: A statistical association between NO2 exposure and AMI attack risk is identified, which can provide insight into the planning of clinical services for AMI. [ABSTRACT FROM AUTHOR]

Background Chronic obstructive pulmonary disease (COPD) has become the fourth-leading cause of death. The association between air pollution and years of life lost (YLL) caused by COPD is currently a hot topic; however, few studies have been published regarding COPD YLL around the world, especially in China, a highly polluted area. Aim We investigated the exposure-response association between ambient particulate matter with an aerodynamic diameter of less than 10 μm (PM 10 ) and COPD YLL. Methods We applied a generalized additive model (GAM) to estimate the short-term effects of PM 10 on COPD YLL and mortality from 2002 to 2010 in Tianjin. Results The annual mean concentration of PM 10 was 111.6 μg/m 3 . An increase in PM 10 was significantly associated with daily YLL and mortality in a single pollutant model. A 10 μg/m 3 increase in the two-day moving average of PM 10 was associated with the maximum YLL increment of 0.30 (95% confidence interval: 0.06, 0.54) person-years and an excess risk (ER) of mortality of 0.60% (0.20%, 1.01%). For YLL increases, the association is stronger in elderly (0.27 (0.06, 0.48), the cumulative effect) populations than in younger populations. Conclusions An increment of COPD YLL is associated with an increased PM 10 concentration. Elderly groups are more susceptible to air pollution. Strict air pollutant emission control is needed to protect public health. [ABSTRACT FROM AUTHOR]

Evidence suggests a possible association between ambient air pollutants and oral diseases. Nevertheless, information regarding the relationship between air pollutants and pulpitis is scarce and inconclusive. In view of this, the present study aimed to investigate the relationship between short-term exposure to air pollution and outpatient visits for pulpitis. Daily data on outpatient visits for pulpitis, air pollutants, and meteorological data in Hefei, China, was collected from January 1, 2015 to December 31, 2021. The association between exposure to air pollutants and pulpitis outpatient visits was evaluated using distributed lag non-linear model (DLNM) and a generalized linear model (GLM). Furthermore, stratified analyses were performed by gender, age and season. A total of 93,324 records of outpatient visits for pulpitis were included in this study. The results showed that exposure to NO 2 , PM 2.5 , and CO were positively correlated with an increased risk of pulpitis outpatient visits. Each 10 μg/m 3 increase in NO 2 and PM 2.5 concentration, at lag 0-2 day, was associated with a 2.4% (relative risk (RR) = 1.024, 95% confidence interval (CI): 1.014-1.035) and 0.5% (RR = 1.005, 95% CI: 1.000-1.010) increase in pulpitis outpatient visits, respectively. With a 1 mg/m 3 increase in CO concentration, the risk of pulpitis outpatient visits increased by 9.1% (RR = 1.091, 95% CI: 1.031-1.154, lag 0-1 day). Intriguingly, exposure to O 3 was associated with a decreased risk of pulpitis outpatient visits (RR = 0.990, 95% CI: 0.984-0.995, lag 0-5 day). Subgroup analysis revealed that in the warm season, exposure to PM 2.5 , O 3 , and CO was related with a significantly higher outpatient risk of pulpitis than in the cold season. Additionally, the influence of PM 2.5 and CO exposure at age < 65 years was significantly stronger than at age ≥ 65 years. In conclusion, exposure to ambient NO 2 , PM 2.5 , and CO is associated with an increase in pulpitis outpatient visits in Hefei, China. Conversely, exposure to O 3 reduces the risk of outpatient visits for pulpitis. Age and season are effect modifiers of these associations., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: Previous epidemiological studies have shown that both long-term and short-term exposure to fine particulate matters (PM 2.5 ) were associated with the morbidity and mortality of circulatory system diseases (CSD). However, the impact of PM 2.5 on CSD remains inconclusive. This study aimed to investigate the associations between PM 2.5 and circulatory system diseases in Ganzhou., Methods: We conducted this time series study to explore the association between ambient PM 2.5 exposure and daily hospital admissions for CSD from 2016 to 2020 in Ganzhou by using generalized additive models (GAMs). Stratified analyses were also performed by gender, age, and season., Results: Based on 201,799 hospitalized cases, significant and positive associations were found between short-term PM2.5 exposure and hospital admissions for CSD, including total CSD, hypertension, coronary heart disease (CHD), cerebrovascular disease (CEVD), heart failure (HF), and arrhythmia. Each 10 μg/m 3 increase in PM 2.5 concentrations was associated with a 2.588% (95% confidence interval [CI], 1.161%-4.035%), 2.773% (95% CI, 1.246%-4.324%), 2.865% (95% CI, 0.786%-4.893%), 1.691% (95% CI, 0.239%-3.165%), 4.173% (95% CI, 1.988%-6.404%) and 1.496% (95% CI, 0.030%-2.983%) increment in hospitalizations for total CSD, hypertension, CHD, CEVD, HF, and arrhythmia, respectively. As PM 2.5 concentrations rise, the hospitalizations for arrhythmia showed a slow upward trend, while other CSD increased sharply at high PM 2.5 levels. In subgroup analyses, the impacts of PM 2.5 on hospitalizations for CSD were not materially changed, although the females had higher risks of hypertension, HF, and arrhythmia. The relationships between PM 2.5 exposure and hospitalizations for CSD were more significant among individuals aged ≤65 years, except for arrhythmia. PM 2.5 had stronger effects on total CSD, hypertension, CEVD, HF, and arrhythmia during cold seasons., Conclusion: PM 2.5 exposure was positively associated with daily hospital admissions for CSD, which might provide informative insight on adverse effects of PM 2.5 ., 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 You, Cao, Guo, Wang, Qiu, Zhou, Zhou, Chen and Zhang.)

Background: Ambient carbon monoxide (CO) exposure is associated with increased mortality and hospitalization risk for total respiratory diseases. However, evidence on the risk of hospitalization for specific respiratory diseases from ambient CO exposure is limited., Methods: Data on daily hospitalizations for respiratory diseases, air pollutants, and meteorological factors from January 2016 to December 2020 were collected in Ganzhou, China. A generalized additive model with the quasi-Poisson link and lag structures was used to estimate the associations between ambient CO concentration and hospitalizations of total respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), and influenza-pneumonia. Possible confounding co-pollutants and effect modification by gender, age, and season were considered., Results: A total of 72,430 hospitalized cases of respiratory diseases were recorded. Significant positive exposure-response relationships were observed between ambient CO exposure and hospitalization risk from respiratory diseases. For each 1 mg/m 3 increase in CO concentration (lag0-2), hospitalizations for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia increased by 13.56 (95% CI: 6.76%, 20.79%), 17.74 (95% CI: 1.34%, 36.8%), 12.45 (95% CI: 2.91%, 22.87%), 41.25 (95% CI: 18.19%, 68.81%), and 13.5% (95% CI: 3.41%, 24.56%), respectively. In addition, the associations of ambient CO with hospitalizations for total respiratory diseases and influenza-pneumonia were stronger during the warm season, while women were more susceptible to ambient CO exposure-associated hospitalizations for asthma and LRTI (all P < 0.05)., Conclusion: In brief, significant positive exposure-response relationships were found between ambient CO exposure and hospitalization risk for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia. Effect modification by season and gender was found in ambient CO exposure-associated respiratory hospitalizations., 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 Song, Qiu, Huang, Guo, Chen, Wang and Zhang.)

The associations of air pollution and meteorological factors with the outpatient visits of urticaria remain poorly studied. This study aimed to assess the association between air pollution, meteorological factors, and daily outpatient visits for urticaria in Shijiazhuang, China, during 2014-2019. Daily recordings of air pollutant concentrations, meteorological data, and outpatient visits data for urticaria were collected during the 6 years. Descriptive research methods were used to describe the distribution characteristics and demographic features of urticaria. A combination of the generalized linear regression model (GLM) and distribution lag nonlinear model (DLNM) was used to evaluate the lag association between environmental factors and daily outpatient visits for urticaria. Stratified analyses by gender (male; female) and age (< 18 years; 18-39 years; > 39 years) were further conducted. The dose-response relationship between daily urticaria visits and CO, NO 2 , O 3 , temperature, and relative humidity was nonlinear. High concentrations of CO, NO 2 , O 3 , and high temperatures increased the risk of urticaria outpatient visits. The maximum cumulative association of high concentrations of CO, NO 2 , and O 3 was lag 0-14 days (CO: RR = 1.10, 95%CI: 1.06, 1.31; NO 2 : RR = 1.09, 95%CI: 1.01, 1.08; O 3 : RR = 1.16, 95%CI: 1.08, 1.25), and high temperatures was lag 0-7 days (RR = 1.27, 95%CI: 1.14, 1.41). Low concentrations of NO 2 , O 3 , and high humidity, on the other hand, act as protective factors for urticaria outpatient. The maximum cumulative association of low concentrations of NO 2 was the 0-day lag (RR = 0.97, 95%CI: 0.95, 0.99), O 3 was lag 0-5 days (RR = 0.94, 95%CI: 0.88, 0.99), and high humidity was lag 0-10 days (RR = 0.93, 95%CI: 0.89, 0.98). Stratified analyses showed that the risk of urticaria outpatient visits was higher for the males and in the < 18 years age group. In conclusion, we found that the development of urticaria in Shijiazhuang has a distinct seasonal and cyclical nature. Air pollutants and meteorological factors had varying degrees of influence on the risk of urticaria outpatient visits. This study provides indirect evidence for a link between air pollution, meteorological factors, and urticaria outpatient visits., (© 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Abstract: Few studies have investigated the relationship of hospital admissions for cardiovascular diseases with fine (PM2.5: particles with an aerodynamic diameter less than 2.5 μm) and coarse particles (PMc: particles with an aerodynamic diameter between 2.5 and 10 μm) simultaneously. We aimed to estimate the differential effects of PM2.5 and PMc on emergency hospital admissions for cardiovascular diseases, after controlling for the gaseous pollutants. We conducted a time series analysis in Hong Kong using daily emergency hospital admissions for cardiovascular diseases, PM2.5 and PMc concentrations from January 2000 to December 2005. PMc concentrations were estimated by subtracting PM2.5 from PM10 measurements. Generalized additive Poisson models allowing overdispersion and autocorrelation were used to examine the effects of PM2.5 and PMc simultaneously, adjusting for time trends, weather conditions, influenza outbreaks, and gaseous pollutants. In two-pollutant model, an interquartile range (IQR) increase in the 2-day moving average (lag01) concentration of PM2.5 and PMc corresponded to 1.86% (95% CI: 0.85%, 2.88%) and −0.16% (95% CI: −1.07%, 0.76%) change of emergency hospital admissions for total circulatory diseases respectively. Results were sensitive to further inclusion of nitrogen dioxide but not of ozone and sulfur dioxide. We did not find any effects of PMc on circulatory hospitalizations independent of PM2.5. In conclusion, we confirmed the stronger and significant adverse effects of PM2.5, but no independent effect of PMc on emergency cardiovascular hospitalizations. The biological mechanisms underlying the differential effects of PM2.5 and PMc on cardiovascular diseases were discussed. [Copyright &y& Elsevier]

Background: Varicella accounts for significant morbidities and remains a public health issue worldwide. Climatic factors have been shown to associate with the incidence and transmission of various infectious diseases. We describe the epidemiology of varicella in paediatric patients hospitalized at a tertiary referral hospital in Hong Kong from 2004 to 2008, and to explore the possible association between the occurrence of varicella infection and various climatic factors. Methods: The hospital discharge database of Princess Margaret Hospital was retrospectively analyzed for admissions associated with varicella from 2004 to 2008. Meteorological data were obtained from the monthly meteorological reports from the Hong Kong Observatory website. Time series analysis was performed with Poisson regression using a Generalized Estimating Equation (GEE) approach. Results: During the study period, 598 children were hospitalized for varicella. The mean age on admission was 57.6 months, and the mean duration of hospitalization was 3.7 days. The overall complication rate was 47%. The mean monthly relative humidity, especially in cool seasons, was inversely correlated with the monthly varicella cases of the same month. Conclusions: Varicella can lead to serious complications and prolonged hospitalization, even in previously healthy children. Lower relative humidity in cool seasons is associated with higher number of paediatric varicella hospital admissions. These findings are useful for a better understanding of the pattern of paediatric varicella hospitalization in Hong Kong. [ABSTRACT FROM AUTHOR]

The topic of inflammatory bowel disease (IBD) has attracted more and more attention. Accumulating evidence suggests that exposure to air pollutants is associated with IBD, yet the results are inconsistent and study about daily exposure is few. This study evaluated the association between daily air pollution and IBD in Hefei, China. Daily IBD admission data were obtained from two hospitals in Hefei from January 1, 2019, to December 31, 2019. Daily concentrations of major air pollutants were provided by the Hefei Environmental Protection Bureau. Meteorological data were collected from China Meteorological Data Network. Distributed lag nonlinear model (DLNM) considering both the lag effects of exposure factors and nonlinear relationship of exposure-reaction was used to assess the effect of daily air pollutants exposure on IBD admission. During the study period, totally 886 cases of IBD were recruited, including 313 cases of ulcerative colitis (UC) and 573 cases of Crohn's disease (CD). The findings showed PM 2.5 , O 3 , and CO exposure significantly increased the risk of IBD. Mean concentrations of PM 2.5 , O 3 , and CO in Hefei were 43.85ug/m 3 , 100.78ug/m 3 , and 0.76 mg/m 3 , respectively. Each increase of 10 mg/m 3 in PM 2.5 /O 3 and 0.1 mg/m 3 in CO increased the risk of IBD. The strongest effects of these three pollutants on IBD were observed in lag2-lag3 (RR = 1.037, 95% CI: 1.005-1.070%), lag3 (RR = 1.020, 95% CI: 1.002-1.038%), and lag2 (RR = 1.036, 95% CI: 1.003-1.071%), respectively. In warm seasons, PM 2.5 , O 3 , and CO had a stronger effect increased the risk of IBD, which were observed in lag2 (RR = 1.104, 95% CI: 1.032-1.181%), lag2 and lag5 (RR = 1.023, 95% CI: 1.002-1.044%; RR = 1.036, 95% CI: 1.004-1.069%), and lag2 (RR = 1.071, 95% CI: 1.012-1.133%), respectively. Air pollutant (PM2.5, O 3 , and CO) exposure could increase the risk of IBD, while the most susceptibility seasons for the exposure were mainly in warm seasons. The results of this study suggest that air pollutants increase the risk of IBD patients in Hefei, China, providing a basis for developing countries to improve effective prevention of IBD, and a potential opportunity to avoid part of the risk of the onset or recurrence of IBD. This study contributes to the knowledge of the association between air pollution and IBD, but the associations need to be verified by further studies., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The seasonal variation of oral diseases has been observed in life, but the influences of oral diseases associated with non-optimal ambient temperature were unknown., Objective: To examine whether non-optimum ambient temperature is associated with increased risks of oral diseases., Methods: We conducted a time series study based on outpatient data from the Shanghai Health Information Center, containing all public hospitals in Shanghai from 2016 to 2019. Generalized additive models with distributed lagged nonlinear models were applied to fit the data., Result: A total of 3,882,636 outpatient cases of oral diseases were collected. Low temperature (<7 °C) posed increased risks for oral diseases. Daily temperature above 7 °C had no effect on oral diseases. The excess risks were present on the lag 1 day and lasted till lag 7 day. Relative to referent temperatures, the cumulative risks of total oral diseases, pulpitis, periodontitis, gum pain, stomatitis, and glossitis at extreme low temperature (-3 °C, 1st percentile) over lag 0-7 day were 1.92 (95% confidence interval, CI: 1.40, 2.63), 2.40 (95% CI: 1.78, 3.25), 1.62 (95% CI: 1.15, 2.29), 1.75 (95% CI: 1.08, 2.83), 1.81 (95% CI: 1.30, 2.53), and 2.22 (95% CI: 1.23, 3.99). These associations were larger in patients who were above age 60., Conclusion: This study provided novel epidemiological evidence that low ambient temperature may increase the risks of oral diseases. The temperature thresholds for eight oral diseases range from 3 to 7 °C. The excess risks could last for 7 days and were larger in older patients., 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 © 2021 Elsevier B.V. All rights reserved.)

Background: The topic of congenital heart diseases (CHDs) has attracted more and more attentions. Accumulating evidence suggests that exposure to air pollutants during pregnancy is associated with CHDs, yet the results are inconsistent and study about weekly exposure is few. Our study evaluated the association between weekly air pollution and CHDs in Hefei, China., Materials and Methods: Daily CHDs admission data were obtained from eight hospitals in Hefei from October 2015 to September 2017. Meteorological data and air quality were collected from China Meteorological Data Network. Distributed lag nonlinear model (DLNM) considering both the lag effect of exposure factors and the nonlinear relationship of exposure-reaction was used to assess the effect of weekly air pollutants exposure on CHDs admission., Results: During the study period, totally 47,046 cases of perinatal infants were recruited, and the incidence of CHDs was 9.71 per thousand. The findings showed PM 2.5 , PM 10 , SO 2 and NO 2 significantly increased the risk of CHDs. Each 10 μg/m 3 increase in PM 2.5 during gestational weeks 20-26 increased the risk of CHDs. The susceptibility windows of PM 10 (weeks 0-2 and weeks 25-29 of pregnancy), SO 2 (weeks 8-16 and weeks 29-38) and NO 2 (week 40), while the strongest effects of these 4 pollutants on CHDs were observed in week 22 (RR = 1.034, 95% CI: 1.007-1.062), week 0 (RR = 1.081, 95% CI: 1.02-1.146), week 37 (RR = 1.528, 95% CI: 1.085-2.153) and week 40 (RR = 1.171, 95% CI: 1.006-1.364), respectively., Conclusions: Air pollutants (SO 2 , NO 2 , PM 10 , and PM 2.5 ) exposure could increase the risk of CHDs, while the most crucial susceptibility windows for the exposure were mainly in the second and third trimesters. Boys seemed to be more sensitive to air pollution. Our study contributes to the knowledge of the association between maternal exposure to air pollution and CHDs, but the associations need to be verified by further studies., 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 B.V. All rights reserved.)

Background: Previous studies have mainly focused on the associations between particulate matters and infant mortality. However, evidence regarding the associations between gaseous pollutants and mortality among children aged <5 years remains sparse., Objectives: The aim of this study was to investigate the associations between ambient air pollution and death among children aged <5 years in Beijing, China, and explore the impact of age, gender and specific causes of death on these associations., Methods: Concentrations of ambient air pollution and the number of deaths among children aged <5 years in Beijing from January 2014 to September 2016 were extracted from authoritative electronic databases. The associations were estimated for a single-month lag from the current month up to the previous 5 months (lag0-lag5) and moving averages of the current and previous months (lag01-lag05) using generalized additive Poisson regression (adjusted for time trends, season, meteorological variables and holidays). Subgroup analyses related to age, gender and specific diseases were performed. Two-pollutant models were used to evaluate the possible role of single pollutants., Results: Sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ) and carbon monoxide (CO) demonstrated the strongest associations with death among children aged <5 years at lag0, and the estimates decreased or even turned negative with the increasing lag periods. For an interquartile range increase in SO 2 , NO 2 and CO at lag0, the odds ratios (OR) were 1.332 (95% CI 1.152-1.539), 1.383 (95% CI 1.113-1.718) and 1.273 (95% CI 1.028-1.575). However, CO lost significance after adjusting for SO 2 and NO 2 , and PM 2.5 gained significance (OR 1.548, 95% CI 1.061-2.258) after adjusting for PM 10 . The ORs for SO 2 and NO 2 remained the most stable across all two-pollutant models. The associations for children aged 1-5 years were stronger than those reported for infants at lag0 but lower at the other lag months. The pollutant associations were stronger for congenital heart disease-related death than overall and pneumonia-related death. We did not find significant differences in terms of gender., Conclusion: Exposure to air pollution may increase the incidence of death among children aged <5 years. SO 2 and NO 2 may be the most stable pollutants reflecting associations between air pollution and death, deserving further attention. Children with congenital heart diseases are more susceptible to air pollution. Therefore, it is urgent to implement the clean air targets established by WHO and reduce the exposure of children to air pollution., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objectives: Schizophrenia is a chronic and severe mental disorder affecting more than 21 million people worldwide. Short-term exposure to nitrogen dioxide (NO 2 ) has been associated with hospital admissions (HAs) for mental disorders, but no study has evaluated the specific association of NO 2 and schizophrenia. Additionally, the shape of the concentration-response (C-R) curve has not yet been assessed at present. This study aims to investigate the relationship between short-term exposure to NO 2 and HAs for schizophrenia in Hefei, from 2014 to 2016. We also attempt to explore the C-R and the underlying effect modifiers of the association., Methods: Daily number of HAs for schizophrenia was derived from the computerised medical record system of Anhui Mental Health Center. We used a time-series Poisson generalised linear regression combined with distributed lag non-linear models to model the NO 2 -schizophrenia relationship., Results: A total of 11 373 HAs were identified during the study period. An increase in levels of NO 2 was significantly associated with elevated schizophrenia HAs. The estimated relative risk per IQR increase in NO 2 at lag 01 was 1.10 (95% CI 1.01 to 1.18). Greater association was observed in young patients (relative risk: 1.11, 95% CI 1.02 to 1.19). The modelled C-R curves of the NO 2 -schizophrenia relationship suggested possible threshold effects of NO 2 for all ages combined, young patients, men and both seasons., Conclusions: Short-term exposure to NO 2 may be associated with increased schizophrenia HAs. Findings indicated potential threshold effects of NO 2 , which has important implications for health-based risk assessments., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)