The Relationship between Traffic-Related Air Pollution Exposures and Allostatic Load Score among Youth with Type 1 Diabetes in the SEARCH Cohort

OBJECTIVE: We investigated the effects of chronic exposures to particulate and traffic-related air pollution on allostatic load (AL) score, a marker of cumulative biological risk, among youth with type 1 diabetes. RESEARCH DESIGN AND METHODS: Participants were drawn from five clinical sites of the SEARCH for Diabetes in Youth (SEARCH) study (n=2,338). Baseline questionnaires, anthropometric measures, and a fasting blood test were taken at a clinic visit between 2001 and 2005. AL was operationalized using 10 biomarkers reflecting cardiovascular, metabolic, and inflammatory risk. Annual residential exposures to PM(2.5) and proximity to heavily-trafficked major roadways were estimated for each participant. Poisson regression models adjusted for sociodemographic and lifestyle factors were conducted for each exposure. RESULTS: No significant associations were observed between exposures to PM(2.5) or proximity to traffic and AL score, however analyses were suggestive of effect modification by race for residential distance to heavily-trafficked major roadways (p=0.02). In stratified analyses, residing <100, 100-<200 and 200-<400 m compared to 400 m or more from heavily-trafficked major roadways was associated with 11%, 26% and 14% increases in AL score, respectively (95% CIs: −4, 29; 9, 45.0; −1, 30) for non-white participants compared to 6%, −2%, and −2% changes (95% CIs: −2, 15; −10, 7; −8, 6) for white participants. CONCLUSIONS: Among this population of youth with type 1 diabetes, we did not observe consistent relationships between chronic exposures to particulate and traffic-related air pollution and changes in AL score, however associations for traffic-related pollution exposures may differ by race/ethnicity and warrant further examination

sj-docx-1-new-10.1177_10482911241235380 - Supplemental material for Using Evidence-based Scientific Research to Influence Dietary Behavioral Change: Taking a Look in the Mirror

Supplemental material, sj-docx-1-new-10.1177_10482911241235380 for Using Evidence-based Scientific Research to Influence Dietary Behavioral Change: Taking a Look in the Mirror by Clifton P. Bueno de Mesquita, Ylenia Vimercati Molano, Lara Vimercati and P. Jacob Bueno de Mesquita in NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy</p

Quantifying the Potential Health Impacts of Unvented Combustion in Homes – A Meta-Analysis

While a growing body of scientific literature describes the population health impacts of fossil fuel production and burning via climate and air pollution pathways, less is known about the health impacts of indoor combustion. This paper summarizes the results of studies from the last two decades that investigated the association between exposure to sources of unvented combustion pollutants in homes and a range of health outcomes. We found gas combustion to be associated with 6-28% (95% confidence intervals) increased odds of asthma symptoms, 4-51% increased odds of systemic symptoms, 7-81% increased odds of asthma medication use, and 3-12% increased risk of mortality. These findings can be used to improve public health, for example, by informing requirements for improved ventilation and source control, justifying switching to vented appliances, better regulation of device emissions and quantifying the benefits of electrification of end-uses. Dose-response relationships between human health, NO2 exposure, and other by- products of combustion are not characterized with a high degree of precision. However, there is clear evidence of a wide range of health effects, even at low levels of exposure. Despite the various designs, geographic sites, length of follow-up, and study dates, we noted a level of consistency between the studies within the current meta-analysis, and with previous ones, which strengthens the level of confidence in our findings

Control of airborne infectious disease in buildings: Evidence and research priorities.

The evolution of SARS-CoV-2 virus has resulted in variants likely to be more readily transmitted through respiratory aerosols, underscoring the increased potential for indoor environmental controls to mitigate risk. Use of tight-fitting face masks to trap infectious aerosol in exhaled breath and reduce inhalation exposure to contaminated air is of critical importance for disease control. Administrative controls including the regulation of occupancy and interpersonal spacing are also important, while presenting social and economic challenges. Indoor engineering controls including ventilation, exhaust, air flow control, filtration, and disinfection by germicidal ultraviolet irradiation can reduce reliance on stringent occupancy restrictions. However, the effects of controls-individually and in combination-on reducing infectious aerosol transfer indoors remain to be clearly characterized to the extent needed to support widespread implementation by building operators. We review aerobiologic and epidemiologic evidence of indoor environmental controls against transmission and present a quantitative aerosol transfer scenario illustrating relative differences in exposure at close-interactive, room, and building scales. We identify an overarching need for investment to implement building controls and evaluate their effectiveness on infection in well-characterized and real-world settings, supported by specific, methodological advances. Improved understanding of engineering control effectiveness guides implementation at scale while considering occupant comfort, operational challenges, and energy costs

Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community.

Little is known about the amount and infectiousness of influenza virus shed into exhaled breath. This contributes to uncertainty about the importance of airborne influenza transmission. We screened 355 symptomatic volunteers with acute respiratory illness and report 142 cases with confirmed influenza infection who provided 218 paired nasopharyngeal (NP) and 30-minute breath samples (coarse &gt;5-µm and fine ≤5-µm fractions) on days 1-3 after symptom onset. We assessed viral RNA copy number for all samples and cultured NP swabs and fine aerosols. We recovered infectious virus from 52 (39%) of the fine aerosols and 150 (89%) of the NP swabs with valid cultures. The geometric mean RNA copy numbers were 3.8 × 104/30-minutes fine-, 1.2 × 104/30-minutes coarse-aerosol sample, and 8.2 × 108 per NP swab. Fine- and coarse-aerosol viral RNA were positively associated with body mass index and number of coughs and negatively associated with increasing days since symptom onset in adjusted models. Fine-aerosol viral RNA was also positively associated with having influenza vaccination for both the current and prior season. NP swab viral RNA was positively associated with upper respiratory symptoms and negatively associated with age but was not significantly associated with fine- or coarse-aerosol viral RNA or their predictors. Sneezing was rare, and sneezing and coughing were not necessary for infectious aerosol generation. Our observations suggest that influenza infection in the upper and lower airways are compartmentalized and independent

Outcomes of Collective Decisions With Externalities Predicted

In collective decision making bilateral deals can increase or decrease the likelihood of finding compromises, depending on whether such deals have externalities. Positive externalities mean third actors profit from bilateral deals, whereas negative externalities mean bilateral deals hurt third actors. We develop the first model of collective decision making that takes externalities into account. The model computes the expected outcomes of the issues to be decided and construes four coalitions of actors on each pair of issues. Then it searches for a set of alternative expected outcomes, such that no coalition can further increase the payoffs of one of its members, either (i) without decreasing the payoffs of one of its members, or (ii) without decreasing the payoffs of any actor. The Generalized Nash Bargaining Solution is used to pick a single outcome. The model is tested on data from decisions in the European Union.

Minimal transmission in an influenza A (H3N2) human challenge-transmission model within a controlled exposure environment

Uncertainty about the importance of influenza transmission by airborne droplet nuclei generates controversy for infection control. Human challenge-transmission studies have been supported as the most promising approach to fill this knowledge gap. Healthy, seronegative volunteer ‘Donors’ (n = 52) were randomly selected for intranasal challenge with influenza A/Wisconsin/67/2005 (H3N2). ‘Recipients’ randomized to Intervention (IR, n = 40) or Control (CR, n = 35) groups were exposed to Donors for four days. IRs wore face shields and hand sanitized frequently to limit large droplet and contact transmission. One transmitted infection was confirmed by serology in a CR, yielding a secondary attack rate of 2.9% among CR, 0% in IR (p = 0.47 for group difference), and 1.3% overall, significantly less than 16% (p<0.001) expected based on a proof-of-concept study secondary attack rate and considering that there were twice as many Donors and days of exposure. The main difference between these studies was mechanical building ventilation in the follow-on study, suggesting a possible role for aerosols