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BACKGROUND: The few studies that have examined associations between greenspace and lung function in adulthood have yielded conflicting results and none have examined whether the rate of lung function decline is affected. OBJECTIVE: We explored the association between residential greenspace and change in lung function over 20 years in 5559 adults from 22 centers in 11 countries participating in the population-based, international European Community Respiratory Health Survey. METHODS: Forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC) were measured by spirometry when participants were approximately 35 (1990-1994), 44 (1999-2003), and 55 (2010-2014) years old. Greenness was assessed as the mean Normalized Difference Vegetation Index (NDVI) in 500 m, 300 m, and 100 m circular buffers around the residential addresses at the time of lung function measurement. Green spaces were defined as the presence of agricultural, natural, or urban green spaces in a circular 300 m buffer. Associations of these greenspace parameters with the rate of lung function change were assessed using adjusted linear mixed effects regression models with random intercepts for subjects nested within centers. Sensitivity analyses considered air pollution exposures. RESULTS: A 0.2-increase (average interquartile range) in NDVI in the 500 m buffer was consistently associated with a faster decline in FVC (-1.25 mL/year [95% confidence interval: -2.18 to -0.33]). These associations were especially pronounced in females and those living in areas with low PM(10) levels. We found no consistent associations with FEV(1) and the FEV(1)/FVC ratio. Residing near forests or urban green spaces was associated with a faster decline in FEV(1), while agricultural land and forests were related to a greater decline in FVC. CONCLUSIONS: More residential greenspace was not associated with better lung function in middle-aged European adults. Instead, we observed slight but consistent declines in lung function parameters. The potentially detrimental association requires verification in future studies.

BACKGROUND: During the 2020/2021 winter, the labour market was under the impact of the COVID-19 pandemic. Changes in socioeconomic resources during this period could have influenced individual mental health. This association may have been mitigated or exacerbated by subjective risk perceptions, such as perceived risk of getting infected with SARS-CoV-2 or perception of the national economic situation. Therefore, we aimed to determine if changes in financial resources and employment situation during and after the second COVID-19 wave were prospectively associated with depression, anxiety and stress, and whether perceptions of the national economic situation and of the risk of getting infected modified this association. METHODS: One thousand seven hundred fifty nine participants from a nation-wide population-based eCohort in Switzerland were followed between November 2020 and September 2021. Financial resources and employment status were assessed twice (Nov2020-Mar2021, May-Jul 2021). Mental health was assessed after the second measurement of financial resources and employment status, using the Depression, Anxiety and Stress Scale (DASS-21). We modelled DASS-21 scores with linear regression, adjusting for demographics, health status, social relationships and changes in workload, and tested interactions with subjective risk perceptions. RESULTS: We observed scores above thresholds for normal levels for 16% (95%CI = 15-18) of participants for depression, 8% (95%CI = 7-10) for anxiety, and 10% (95%CI = 9-12) for stress. Compared to continuously comfortable or sufficient financial resources, continuously precarious or insufficient resources were associated with worse scores for all outcomes. Increased financial resources were associated with higher anxiety. In the working-age group, shifting from full to part-time employment was associated with higher stress and anxiety. Perceiving the Swiss economic situation as worrisome was associated with higher anxiety in participants who lost financial resources or had continuously precarious or insufficient resources. CONCLUSION: This study confirms the association of economic stressors and mental health during the COVID-19 pandemic and highlights the exacerbating role of subjective risk perception on this association.

BACKGROUND: Adolescents have special sexual and reproductive health (ASRH) needs and are susceptible to poor health outcomes. The global burden of ill sexual health includes a significant proportion of Adolescents. The existing ASRH services in Ethiopia and particularly in the Afar region are currently not well suited to meet the needs of pastoralist adolescents. This study assesses the level of ASRH service utilization among pastoralists in Afar regional state, Ethiopia. METHOD: A community based cross-sectional study was conducted from January to March 2021 in four randomly chosen pastoralist villages or kebeles of Afar, Ethiopia. A multistage cluster sampling procedure was used to select 766 volunteer adolescents aged 10-19. SRH services uptake was measured asking whether they had used any SRH service components during the last year. Data was collected through face-to-face interviews with a structured questionnaire; data entry was done with Epi info 3.5.1. Logistic regression analyses was used to assess associations with SRH service uptake. SPSS version 23 statistical software package was used for advanced logistic regression analyses to assess the associations between dependent and predictor variables. RESULTS: The study revealed that two-thirds or 513 (67%) of the respondents are aware of ASRH services. However, only one-fourth (24.5%) of the enrolled adolescents used at least one ASRH service in the past twelve months. ASRH services utilization was significantly associated with gender (being female [AOR = 1.87 (CI 1.29-2.70)], being in school [AOR = 2.38(CI: 1.05-5.41), better family income [AOR = 10.92 (CI; 7.10-16.80)], prior discussions of ASRH issues [AOR = 4.53(CI: 2.52, 8.16)], prior sexual exposure [AOR = 4.75(CI: 1.35-16.70)], and being aware of ASRH services [AOR = 1.96 (CI: 1.02-3.822)]. Being pastoralist, religious and cultural restrictions, fear of it becoming known by parents, services not being available, income, and lack of knowledge were found to deter ASRH service uptake. CONCLUSION: Addressing ASRH needs of pastoralist adolescents is more urgent than ever, sexual health problems are increasing where these groups face broad hurdles to SRH service uptake. Although Ethiopian national policy has created an enabling environment for ASRH, multiple implementation issues require special attention to such neglected groups. "Gender-culture-context-appropriate" interventions are favorable to identify and meet the diverse needs of Afar pastoralist adolescents. Afar regional education bureau and concerned stakeholders need to improve adolescent education to overcome social barriers (e.g. humiliation, disgrace, and deterring gender norms) against ASRH services through community outreach programs. In addition, economic empowerment, peer education, adolescent counseling, and parent-youth communication will help address sensitive ASRH issues.

Air pollution, for example from particulate matter, nitrogen oxides or ozone, is harmful to health. Short-term increases in air pollution can lead to exacerbation of existing lung diseases. Long-term air pollution contributes to the development of cardiorespiratory diseases. According to the European Environment Agency, 53,000 people prematurely died in Germany in 2019 due to particulate matter pollution. Air pollution control is a political task with great public health potential. In recent years, it has significantly contributed to improving air quality and thus health. In view of the new more stringent World Health Organization (WHO) air quality guidelines, the authorities and policy makers worldwide are now confronted with the question of adjusting air quality targets and setting standards. In Europe, the EU Directive on air quality standards is passed by the EU Parliament and the Council of the EU and is binding for air quality targets of member states. Member states can be brought to court for failure to achieve the targets. Therefore, there is a risk that achievable and less ambitious air pollution targets will be set. Even now, the EU guideline values are significantly higher than those in the USA or Switzerland. While "only" 11% of the EU population were exposed to levels above the current EU limit for PM10 in 2020, 71% of the population were exposed to hazardous levels of PM10 following the new recommendation by the WHO. Among the most important and successful air pollution control measures is the reduction of air pollutants at the source: emission control. Despite the energy crisis goals regarding air pollution control and climate protection must not be ignored. Importantly, health protection cannot be left to individuals. Health professionals have an important clinical role in advising sensitive patients on how to deal with short-term elevated levels of air pollutants but beyond that their advisory role in policy is very significant.

Previous studies have explored relationships of air pollution and metabolic profiles with lung function. However, the metabolites linking air pollution and lung function and associated mechanisms have not been reviewed from a life-course perspective. Here we provide a narrative review summarizing recent evidence on the associations of metabolic profiles with both air pollution exposure and lung function in both children and adults. Twenty-six studies identified through a systematic PubMed search were included with 10 studies analyzing air pollution-related metabolic profiles, and 16 analyzing lung function-related metabolic profiles. A wide range of metabolites were identified being associated with short- and long-term exposure, partly overlapping with those linked to lung function in the general population and respiratory diseases such as asthma and COPD. The existing studies show that metabolomics offers potential to identify biomarkers linked to both environmental exposures and respiratory outcomes, but many suffer from small sample size, cross-sectional designs, preponderance on adult lung function, heterogeneity in exposure assessment, lack of confounding control and omics integration. The ongoing EXposome Powered tools for healthy living in urbAN Settings (EXPANSE) project aims at addressing some of these shortcomings by combining biospecimens from large European cohorts, and harmonized air pollution exposure and exposome data.

By 2030, more than 80% of Europe's population will live in an urban environment. The urban exposome, consisting of factors such as where we live and work, where and what we eat, our social network, and what chemical and physical hazards we are exposed to, provides important targets to improve population health. The EXPANSE (EXposome Powered tools for healthy living in urbAN SEttings) project will study the impact of the urban exposome on the major contributors to Europe's burden of disease: Cardio-Metabolic and Pulmonary Disease. EXPANSE will address one of the most pertinent questions for urban planners, policy makers, and European citizens: "How to maximize one's health in a modern urban environment?" EXPANSE will take the next step in exposome research by (1) bringing together exposome and health data of more than 55 million adult Europeans and OMICS information for more than 2 million Europeans; (2) perform personalized exposome assessment for 5,000 individuals in five urban regions; (3) applying ultra-high-resolution mass-spectrometry to screen for chemicals in 10,000 blood samples; (4) evaluating the evolution of the exposome and health through the life course; and (5) evaluating the impact of changes in the urban exposome on the burden of cardiometabolic and pulmonary disease. EXPANSE will translate its insights and innovations into research and dissemination tools that will be openly accessible via the EXPANSE toolbox. By applying innovative ethics-by-design throughout the project, the social and ethical acceptability of these tools will be safeguarded. EXPANSE is part of the European Human Exposome Network. © 2021 Georg Thieme Verlag. All rights reserved.

Studies reporting on associations between short-term exposure to outdoor fine (PM2.5), and ultrafine particles (UFP) and blood pressure and lung function have been inconsistent. Few studies have characterized exposure by personal monitoring, which especially for UFP may have resulted in substantial exposure measurement error. We investigated the association between 24-h average personal UFP, PM2.5, and soot exposure and dose and the health parameters blood pressure and lung function. We further assessed the short-term associations between outdoor concentrations measured at a central monitoring site and near the residences and these health outcomes. We performed three 24-h personal exposure measurements for UFP, PM2.5, and soot in 132 healthy adults from Basel (Switzerland), Amsterdam and Utrecht (the Netherlands), and Turin (Italy). Monitoring of each subject was conducted in different seasons in a one-year study period. Subject's activity levels and associated ventilation rates were measured using actigraphy to calculate the inhaled dose. After each 24-h monitoring session, blood pressure and lung function were measured. Contemporaneously with personal measurements, UFP, PM2.5 and soot were measured outdoor at the subject's residential address and at a central site in the research area. Associations between short-term personal and outdoor exposure and dose to UFP, PM2.5, and soot and health outcomes were tested using linear mixed effect models. The 24-h mean personal, residential and central site outdoor UFP exposures were not associated with blood pressure or lung function. UFP mean exposures in the 2-h prior to the health test was also not associated with blood pressure and lung function. Personal, central site and residential PM2.5 exposure were positively associated with systolic blood pressure (about 1.4 mmHg increase per Interquartile range). Personal soot exposure and dose were positively associated with diastolic blood pressure (1.2 and 0.9 mmHg increase per Interquartile range). No consistent associations between PM2.5 or soot exposure and lung function were observed. Short-term personal, residential outdoor or central site exposure to UFP was not associated with blood pressure or lung function. Short-term personal PM2.5 and soot exposures were associated with blood pressure, but not lung function.

Background: Lung function is highly heritable and differs between the sexes throughout life. However, little is known about sex-differential genetic effects on lung function. We aimed to conduct the first genome-wide genotype-by-sex interaction study on lung function to identify genetic effects that differ between males and females. Methods: We tested for interactions between 7,745,864 variants and sex on spirometry-based measures of lung function in UK Biobank (N=303,612), and sought replication in 75,696 independent individuals from the SpiroMeta consortium. Results: Five independent single-nucleotide polymorphisms (SNPs) showed genome-wide significant (P

An increasing number of findings from epidemiological studies support associations between exposure to air pollution and the onset of several diseases, including pulmonary, cardiovascular and neurodegenerative diseases, and malignancies. However, intermediate, and potentially mediating, biological mechanisms associated with exposure to air pollutants are largely unknown. Previous studies on the human exposome have shown that the expression of certain circulating microRNAs (miRNAs), regulators of gene expression, are altered upon exposure to traffic-related air pollutants. In the present study, we investigated the relationship between particulate matter (PM) smaller than 2.5 mm (PM2.5), PM2.5 absorbance (as a proxy of black carbon and soot), and ultrafine-particles (UFP, smaller than 0.1 mm), measured in healthy volunteers by 24 h personal monitoring (PEM) sessions and global expression levels of peripheral blood miRNAs. The PEM sessions were conducted in four European countries, namely Switzerland (Basel), United Kingdom (Norwich), Italy (Turin), and The Netherlands (Utrecht). miRNAs expression levels were analysed using microarray technology on blood samples from 143 participants. Seven miRNAs, hsa-miR-24-3p, hsa-miR-4454, hsa-miR-4763-3p, hsa-miR-425-5p, hsa-let-7d-5p, hsa-miR502-5p, and hsa-miR-505-3p were significantly (FDR corrected) expressed in association with PM2.5 personal exposure, while no significant association was found between miRNA expression and the other pollutants. The results obtained from this investigation suggest that personal exposure to PM2.5 is associated with miRNA expression levels, showing the potential for these circulating miRNAs as novel biomarkers for air pollution health risk assessment. (C) 2020 Elsevier Ltd. All rights reserved.

Background: Low lung function has been associated with increased body mass index (BMI). The aim of this study was to investigate whether the effect of BMI on lung function is mediated by DNA methylation. Methods: We used individual data from 285,495 participants in four population-based cohorts: the European Community Respiratory Health Survey, the Northern Finland Birth Cohort 1966, the Swiss Study on Air Pollution and Lung Disease in Adults, and the UK Biobank. We carried out Mendelian randomisation (MR) analyses in two steps using a two-sample approach with SNPs as instrumental variables (IVs) in each step. In step 1 MR, we estimated the causal effect of BMI on peripheral blood DNA methylation (measured at genome-wide level) using 95 BMI-associated SNPs as IVs. In step 2 MR, we estimated the causal effect of DNA methylation on FEV₁, FVC, and FEV₁/FVC using two SNPs acting as methQTLs occurring close (in cis) to CpGs identified in the first step. These analyses were conducted after exclusion of weak IVs (F statistic