Ambient PM2.5 and Daily Hospital Admissions for Acute Respiratory Infections: Effect Modification by Weight Status of Child

The high level of ambient particulate matter in many developing countries constitutes a major health burden, but evidence on its impact on children’s health is still limited in these regions. We conducted a time-stratified case-crossover analysis to quantify the short-term association between fine particulate matter (PM2.5) and hospital admissions due to acute respiratory infections (ARI) among children in Bhaktapur district, Nepal, and to investigate the potential modification of the effect by nutritional characteristic. We analyzed 258 children admitted to the pediatric hospital for ARI between February 2014 to February 2015. We observed evidence of increased risk on the same (lag 0) and preceding day (lag 1). The cumulative estimate of their average (lag 01) suggested each 10 μg/m3 increase in PM2.5 was associated with a relative risk (RR) of 1.16 (95% confidence interval [CI]: 1.02–1.31). The strongest evidence from a stratified analysis of three categories of weights was observed in the overweight group (RR: 1.77; 95% CI: 1.17–2.69) at lag 01, while the estimates for the normal weight and underweight groups were closer to the non-stratified estimates for all-ARI cases. The findings suggests that pediatric ARI is an important morbidity associated with inhalable PM2.5 and that more research is needed to elucidate and validate the observed dissimilarity by weight.

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Association of Acute Respiratory Infections with Indoor Air Pollution from Biomass Fuel Exposure among Under-Five Children in Jimma Town, Southwestern Ethiopia

Journal of Environmental and Public Health ◽

10.1155/2021/7112548 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Abebaw Addisu ◽

Tesfalem Getahun ◽

Mulunesh Deti ◽

Yilkal Negesse ◽

Besufekad Mekonnen

Keyword(s):

Particulate Matter ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Indoor Air Pollution ◽

Respiratory Infections ◽

Biomass Fuel ◽

Acute Respiratory Infections ◽

Under Five ◽

Under Five Children ◽

Increased Risk

Background. Most of the households in developing countries burn biomass fuel in traditional stoves with incomplete combustion that leads to high indoor air pollution and acute respiratory infections. Acute respiratory infection is the most common cause of under-five morbidity and mortality accounting for 2 million deaths worldwide and responsible for 18% of deaths among under-five children in Ethiopia. Although studies were done on acute respiratory infections, the majority of studies neither clinically diagnose respiratory infections nor use instant measurement of particulate matter. Methods. The community-based cross-sectional study design was employed among under-five children in Jimma town from May 21 to June 7, 2020. A total of 265 children through systematic random sampling were included in the study. The data were collected using a pretested semistructured questionnaire and laser pm 2.5 meter for indoor particulate matter concentration. Associations among factors were assessed through correlation analysis, and binary logistic regression was done to predict childhood acute respiratory infections. Variables with p -value less than 0.25 in bivariate regression were the candidate for the final multivariate logistic regression. Two independent sample t-tests were done to compare significant mean difference between concentrations of particulate matter. Results. Among 265 under-five children who were involved in the study, 179 (67.5%) were living in households that predominantly use biomass fuel. Prevalence of acute respiratory infections in the study area was 16%. Children living in households that use biomass fuel were four times more likely to develop acute respiratory infections than their counterparts (AOR: 4.348; 95% CI: 1.632, 11.580). The size of household was significantly associated with the prevalence of acute respiratory infections. Under-five children living in households that have a family size of six and greater had odds of 1.7 increased risk of developing acute respiratory infections than their counterparts (AOR: 1.7; 95% CI: 1.299, 2.212). The other factor associated with acute respiratory infection was separate kitchen; children living in households in which there were no separate kitchen were four times at increased risk of developing acute respiratory infection than children living in households which have separate kitchen (AOR: 4.591; 95% CI: 1.849, 11.402). The concentration of indoor particulate matter was higher in households using biomass fuel than clean fuel. There was statistically higher particulate matter concentration in the kitchen than living rooms (t = 4.509, p ≤ 0.001 ). Particulate matter 2.5 concentrations (μg/m3) of the households that had parental smoking were significantly higher than their counterparts (AOR: 20.224; 95% CI: 1.72, 12.58). Conclusion. There is an association between acute respiratory infections and biomass fuel usage among under-five children. Focusing on improved energy sources is essential to reduce the burden and assure the safety of children.

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Emotional Eating in Adolescence: Effects of Emotion Regulation, Weight Status and Negative Body Image

Nutrients ◽

10.3390/nu13010079 ◽

2020 ◽

Vol 13 (1) ◽

pp. 79

Author(s):

Lenka H. Shriver ◽

Jessica M. Dollar ◽

Susan D. Calkins ◽

Susan P. Keane ◽

Lilly Shanahan ◽

...

Keyword(s):

Body Image ◽

Emotion Regulation ◽

Emotional Regulation ◽

Emotional Eating ◽

Weight Status ◽

Normal Weight ◽

Linear Regression Models ◽

Obesity Risk ◽

Negative Body Image ◽

Increased Risk

Emotional eating is associated with an increased risk of binge eating, eating in the absence of hunger and obesity risk. While previous studies with children and adolescents suggest that emotion regulation may be a key predictor of this dysregulated eating behavior, little is known about what other factors may be influencing the link between emotional regulation and emotional eating in adolescence. This multi-method longitudinal study (n = 138) utilized linear regression models to examine associations between childhood emotion regulation, adolescent weight status and negative body image, and emotional eating at age 17. Emotion regulation predicted adolescent emotional eating and this link was moderated by weight status (β = 1.19, p < 0.01) and negative body image (β = −0.34, p < 0.01). Higher engagement in emotional eating was predicted by lower emotional regulation scores among normal-weight teens (β = −0.46, p < 0.001) but not among overweight/obese teens (β = 0.32, p > 0.10). Higher scores on emotion regulation were significantly associated with lower emotional eating at high (β = −1.59, p < 0.001) and low (β = −1.00, p < 0.01) levels of negative body image. Engagement in emotional eating was predicted by higher negative body image among overweight/obese teens only (β = 0.70, p < 0.001). Our findings show that while better childhood emotion regulation skills are associated with lower emotional eating, weight status and negative body image influence this link and should be considered as important foci in future interventions that aim to reduce emotional eating in adolescence.

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Is overweight/obesity a risk factor for atopic allergic disease in prepubertal children? A case–control study

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0051 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Aysel Vehapoglu ◽

Zeynep Ebru Cakın ◽

Feyza Ustabas Kahraman ◽

Mustafa Atilla Nursoy ◽

Ali Toprak

Keyword(s):

Body Weight ◽

Allergic Disease ◽

Weight Status ◽

Normal Weight ◽

Overweight And Obesity ◽

University Hospital ◽

Healthy Children ◽

Prepubertal Children ◽

Body Weight Status ◽

Increased Risk

Abstract Objectives It is unclear whether body weight status (underweight/normal weight/overweight/obese) is associated with allergic disease. Our objective was to investigate the relationship between body weight status (body mass index; BMI) and atopic allergic disease in prepubertal children, and to compare children with atopic allergic diseases with non atopic healthy children. Methods A prospective cross sectional study of 707 prepubertal children aged 3–10 years was performed; the participants were 278 atopic children with physician-diagnosed allergic disease (allergic rhinitis and asthma) (serum total IgE level >100 kU/l and eosinophilia >4%, or positivity to at least one allergen in skin test) and 429 non atopic healthy age- and sex-matched controls. Data were collected between December 2019 and November 2020 at the Pediatric General and Pediatric Allergy Outpatient Clinics of Bezmialem Vakıf University Hospital. Results Underweight was observed in 11.6% of all participants (10.8% of atopic children, 12.2% of healthy controls), and obesity in 14.9% of all participants (18.0% of atopic children, 12.8% of controls). Obese (OR 1.71; 95% CI: 1.08–2.71, p=0.021), and overweight status (OR 1.62; 95% CI: 1.06–2.50, p=0.026) were associated with an increased risk of atopic allergic disease compared to normal weight in pre-pubertal children. This association did not differ by gender. There was no relationship between underweight status and atopic allergic disease (OR 1.03; 95% CI: 0.63–1.68, p=0.894). Conclusions Overweight and obesity were associated with an increased risk of atopic allergic disease compared to normal weight among middle-income and high-income pre pubertal children living in Istanbul.

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FRI0458 EFFICACY AND SAFETY OF PCV13 VACCINATION IN JIA PATIENTS WITH SYSTEMIC MANIFESTATIONS ON TOCILIZUMAB AND CANAKINUMAB TREATMENT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5749 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 826.1-827

Author(s):

D. Vankova ◽

E. Alexeeva ◽

T. Dvoryakovskaya ◽

K. Isaeva ◽

A. Chomakhidze ◽

...

Keyword(s):

Respiratory Infections ◽

Clinical Effectiveness ◽

Immunosuppressive Drugs ◽

Acute Stage ◽

Acute Respiratory Infections ◽

Efficacy And Safety ◽

Vaccine Response ◽

Protection Level ◽

Acute Group ◽

Increased Risk

Background:The need for continuous use of immunosuppressive drugs leads to increased risk of developing infectious diseases in children with juvenile idiopathic arthritis with systemic manifestation (sJIA). Questions about choosing the optimal vaccination time and the effect of different classes of therapy on vaccination effectiveness are still open.Objectives:To study clinical and laboratory effectiveness of PCV13-vaccination in children with sJIA on tocilizumab (TOC) and canakinumab (CAN) treatment depending on disease activity stage.Methods:Prospective cohort study included 2 groups of sJIA patients: in stable remission (Remission group, n=53) receiving CAN (n=10) or TOC (n=43) treatment, and in acute stage of disease (Acute group, n=25) which started to received CAN (n=7) or TOC (n=18) either before vaccination (Acute Treated Before subgroup, n=17) or after vaccination (Acute Treated After subgroup, n=8). 0.5 ml of the 13-valent PCV was administered once subcutaneously. Efficacy was evaluated by achieving of protection level of anti-pneumococcal antibodies after 4 weeks and by clinical indicators after 6 month follow-up: frequency of acute respiratory infections, frequency of antibiotics treatment courses, frequency of temporary withdrawal of biologics treatment due to severe infections. Frequency of events were counted per patients-years.Results:Four weeks after vaccination, protection level of anti-pneumococcal antibodies was achieved by for 36 (67.9%) patients in Remission group, 16 (64%) patients in Acute group (intergroup p=0.932), and in 8 (47.06%) patients in Acute Treated Before subgroup and in 8 (100%) patients in Acute Treated After subgroup (intersubgroup p=0.022). PCV13 have shown high clinical effectiveness in both Remission group and Acute group. Reducing of acute respiratory infections frequency was as follows: from 4.57 to 2.15 episodes per patient-year in Remission group (p<0.001) and from 4.32 to 1.28 per patient-year in Acute group (p<0.001).Duration of antibiotics treatment reduced from 2.31 to 0.81 weeks per 1 patient-year in Remission group (p<0.001) from 1.97 to 0.74 in Acute group (p<0.001). Among patients who were previously treated with biologics, frequency of therapy withdrawal reduced from 4.34 to 2.42 per patient-year in Remission group (p<0.001) and from 3.53 to 1.18 in Acute Treated Before subgroup (p=0.002). The incidence of reactions to vaccination of PCV13 (local hyperemia, pain, subfebrile temperature) was similar in groups (22 (41.5%) for Remission group and 7 (28%) for Acute group, p= 0.319).Conclusion:Vaccination with the 13-valent PCV has demonstrated high clinical efficacy and safety in children with sJIA both in the acute stage of the disease and during remission. Vaccination of patients in acute stage of sJIA before treatment has advantages over vaccination during remission or after prolonged immunosuppressive therapy in terms of achieving an adequate vaccine response.Disclosure of Interests:Dariya Vankova: None declared, Ekaterina Alexeeva Grant/research support from: Roche, Pfizer, Centocor, Novartis, Speakers bureau: Roche, Novartis, Pfizer., Tatyana Dvoryakovskaya: None declared, Ksenia Isaeva: None declared, Aleksandra Chomakhidze: None declared, Rina Denisova: None declared, Anna Mamutova: None declared, Anna Fetisova: None declared, Marina Gautier: None declared, Elizaveta Krekhova: None declared, Meyri Shingarova: None declared, Ivan Kriulin: None declared, Anastasiya Kontorovich: None declared, Olga Galkina: None declared, Tatyana Radygina: None declared, Irina Zubkova: None declared, Natalia Tkachenko: None declared, Yanina Orlova: None declared, Mariya Kurdup: None declared, Anna Ismailova: None declared, Alina Alshevskaya: None declared, Andrey Moskalev: None declared, Olga Lomakina: None declared

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Association of Short-term Particulate Matter Exposure with Suicide Death Among Major Depressive Disorder Patients: A Time-Stratified Case-Crossover Analysis

10.21203/rs.3.rs-290077/v1 ◽

2021 ◽

Author(s):

In Young Hwang ◽

Daein Choi ◽

Jihoon Andrew Kim ◽

Seulggie Choi ◽

Jooyoung Chang ◽

...

Keyword(s):

Major Depressive Disorder ◽

Particulate Matter ◽

Depressive Disorder ◽

Short Term ◽

Major Depressive ◽

Suicide Death ◽

Case Crossover ◽

Crossover Analysis ◽

High Level ◽

Particulate Matter Exposure

Abstract Objective: There is growing evidence that suggests a potential association between particulate matter (PM) and suicide. However, it is unclear that PM exposure and suicide death among major depressive disorder (MDD) patients, a high-risk group for suicide.Methods: We investigated the risk of suicide among 1,046,169 newly-diagnosed MDD patients from 2004 to 2015 within the Korean National Health Insurance Service (NHIS) database. We identified 3,372 suicide cases from January 1, 2015, to December 31, 2017, within the death statistics database of the Korean National Statistical Office. PMs with diameter less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 2.5 μm to 10 μm (PM2.5-10) were considered, which were provided from the National Ambient Air Monitoring System in South Korea. Time-stratified case-crossover analysis was performed to investigate the association of particulate matter exposure to suicide events.Results: The risk of suicide was significantly high upon the high level of exposure to PM2.5-10, PM10 on lag 1 (p for trend = 0.044, 0.035, respectively). A similar association was observed in the multi-day lag model (lag 0-3). Increasing exposure to PM 2.5 was not associated with increased suicide risk.Conclusions: Short-term exposure to a high level of PM2.5-10 and PM10 was associated with an elevated risk for suicide among MDD patients, while PM2.5 did not. There is a clear dose-response relationship between short-term coarse particle exposures with suicide death among Major Depressive Disorder patients. This result will be used as an essential basis for consideration when establishing an air pollution alarm system and implementing a suicide prevention program for reducing adverse health outcomes by PM.

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Ambient fine particulate matter and hospital admissions for ischemic and hemorrhagic strokes and transient ischemic attack in 248 Chinese cities

The Science of The Total Environment ◽

10.1016/j.scitotenv.2020.136896 ◽

2020 ◽

Vol 715 ◽

pp. 136896 ◽

Cited By ~ 4

Author(s):

Jiangshao Gu ◽

Ying Shi ◽

Ning Chen ◽

Haibo Wang ◽

Ting Chen

Keyword(s):

Particulate Matter ◽

Transient Ischemic Attack ◽

Hospital Admissions ◽

Fine Particulate Matter ◽

Chinese Cities ◽

Fine Particulate ◽

Ischemic Attack

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Exercise During the First Trimester and Infant Size at Birth: Targeted Maximum Likelihood Estimation of the Causal Risk Difference

American Journal of Epidemiology ◽

10.1093/aje/kwz213 ◽

2019 ◽

Vol 189 (2) ◽

pp. 133-145 ◽

Cited By ~ 1

Author(s):

Samantha F Ehrlich ◽

Romain S Neugebauer ◽

Juanran Feng ◽

Monique M Hedderson ◽

Assiamira Ferrara

Keyword(s):

Maximum Likelihood ◽

Maximum Likelihood Estimation ◽

Gestational Age ◽

Weight Status ◽

Likelihood Estimation ◽

First Trimester ◽

Normal Weight ◽

Targeted Maximum Likelihood Estimation ◽

Increased Risk ◽

Targeted Maximum Likelihood

Abstract This cohort study sought to estimate the differences in risk of delivering infants who were small or large for gestational age (SGA or LGA, respectively) according to exercise during the first trimester of pregnancy (vs. no exercise) among 2,286 women receiving care at Kaiser Permanente Northern California in 2013–2017. Exercise was assessed by questionnaire. SGA and LGA were determined by the sex- and gestational-age-specific birthweight distributions of the 2017 US Natality file. Risk differences were estimated by targeted maximum likelihood estimation, with and without data-adaptive prediction (machine learning). Analyses were also stratified by prepregnancy weight status. Overall, exercise at the cohort-specific 75th percentile was associated with an increased risk of SGA of 4.5 (95% CI: 2.1, 6.8) per 100 births, and decreased risk of LGA of 2.8 (95% CI: 0.5, 5.1) per 100 births; similar findings were observed among the underweight and normal-weight women, but no associations were found among those with overweight or obesity. Meeting Physical Activity Guidelines was associated with increased risk of SGA and decreased risk of LGA but only among underweight and normal-weight women. Any vigorous exercise reduced the risk of LGA in underweight and normal-weight women only and was not associated with SGA risk.

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725. Clinical Outcomes of Elderly Individuals Presenting with Acute Respiratory Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.732 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S260-S260

Author(s):

Allison Bloom ◽

Sunil Suchindran ◽

Micah T Mcclain

Keyword(s):

Clinical Outcomes ◽

Bacterial Infections ◽

Respiratory Infections ◽

Point Of Care ◽

Predictive Ability ◽

Elderly Subjects ◽

Acute Respiratory Infections ◽

Elderly Individuals ◽

Increased Risk ◽

Scoring Tool

Abstract Background Elderly individuals experience increased morbidity and mortality from acute respiratory infections (ARI), which are complicated by difficulties defining etiologies of ARI and risk-stratifying patients in order to guide care. A number of scoring tools have been developed to predict illness severity and patient outcome for proven pneumonia, however less is known about the use of such metrics for all causes of ARIs. Methods We analyzed risk factors, clinical course and major outcomes of individuals ≥60 years of age presenting to the emergency department with a clinical diagnosis of ARI over a 5-year period. Results Of the enrolled individuals 40 had proven viral infection and 52 proven bacterial infections, but 184 patients with clinically adjudicated ARI (67%) remained without a proven microbial etiology despite extensive workup. Age (71.5 vs. 65.9 years, P < 0.001) and presence of cancer and heart failure were strongly predictive of illness severe enough to require hospital admission as compared with treatment in the outpatient setting. Of those with proven etiology, individuals with bacterial infection were more likely to require hospital and ICU admission (P < 0.001). When applied to this study, a modified PORT score was found to correlate more closely with clinical outcome measures than a modified CURB-65 (r, 0.54 vs. 0.39). Jackson symptom scores, historically used for viral illness, were found to inversely correlate with outcomes (r, −0.34) and show potential for differentiating viral and bacterial etiologies (P = 0.02). Interestingly, a multivariate analysis showed that a novel scoring tool utilizing sex, heart rate, respiratory rate, blood pressure, BUN, glucose and presence of chronic lung disease and cancer was highly predictive of poor outcome in elderly subjects with all-cause ARI. Conclusion Elderly subjects are at increased risk for poor clinical outcomes from ARI and their clinical management remains challenging. However, modified PORT, CURB-65, Jackson symptom score, and a novel scoring tool presented herein all offer some predictive ability for all-cause ARI in elderly subjects. Such broadly applicable scoring metrics have the potential to assist in treatment and triage decisions at the point of care. Disclosures All authors: No reported disclosures.

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