April 30 | 2018

Using electronic health record data for environmental and place based population health research: a systematic review.

Schinasi LH, Auchincloss AH, Forrest CB, Diez Roux AV.

Ann Epidemiol. 2018 Mar 21. pii: S1047-2797(18)30059-0. [Epub ahead of print] DOI:10.1016/j.annepidem.2018.03.008 

Abstract 

PURPOSE:

We conducted a systematic review of literature published on January 2000-May 2017 that spatially linked electronic health record (EHR) data with environmental information for population health research.

METHODS:

We abstracted information on the environmental and health outcome variables and the methods and data sources used.

RESULTS:

The automated search yielded 669 articles; 128 articles are included in the full review. The number of articles increased by publication year; the majority (80%) were from the United States, and the mean sample size was approximately 160,000. Most articles used cross-sectional (44%) or longitudinal (40%) designs. Common outcomes were health care utilization (32%), cardiometabolic conditions/obesity (23%), and asthma/respiratory conditions (10%). Common environmental variables were sociodemographic measures (42%), proximity to medical facilities (15%), and built environment and land use (13%). The most common spatial identifiers were administrative units (59%), such as census tracts. Residential addresses were also commonly used to assign point locations, or to calculate distances or buffer areas.

CONCLUSIONS:

Future research should include more detailed descriptions of methods used to geocode addresses, focus on a broader array of health outcomes, and describe linkage methods. Studies should also explore using longitudinal residential address histories to evaluate associations between time-varying environmental variables and health outcomes.

April 23 | 2018

Associations between Neighborhood Walkability and Incident and Ongoing Asthma in Children.

Elinor Simons , Sharon D Dell ; Rahim Moineddin , and Teresa To

Ann Am Thorac Soc. 2018 Apr 17. DOI:10.1513/AnnalsATS.201708-693OC

Abstract

RATIONALE:

Childhood asthma has shown variable associations with children’s physical activity. Neighborhood walkability captures community features that promote walking and is protective against some chronic conditions, such as obesity and diabetes.

OBJECTIVES:

We evaluated associations between home neighborhood walkability and incident and ongoing childhood asthma.

METHODS:

This population-based cohort study used prospectively-collected administrative healthcare data for the province of Ontario housed at the Institute for Clinical Evaluative Sciences. We followed an administrative data cohort of 326,383 Toronto children born between 1997 and 2003 until ages 8-15 years. Home neighborhood walkability quintile was measured using a validated Walkability Index with four dimensions: population density, dwelling density, access to retail and services, and street connectivity. Incident asthma was defined by time of entry into the validated Ontario Asthma Surveillance Information System (OASIS) database, which requires two outpatient visits for asthma within two consecutive years or any hospitalization for asthma, and follows children with asthma longitudinally starting at any age. Associations between walkability and incident asthma were examined using Cox proportional hazards models. Associations between ongoing asthma and walkability in each year of life were examined using generalized linear mixed models.

RESULTS:

Twenty-one percent of children (n = 69,628) developed incident asthma and were followed longitudinally in the OASIS asthma database. Low birth home neighborhood walkability was associated with an increased incidence of asthma (HR 1.11, 95% CI, 1.08-1.14). Among children with asthma, low walkability in a given year of a child`s life was associated with greater odds of ongoing asthma in the same year (OR 1.12, 95% CI, 1.09-1.14).

CONCLUSIONS:

Children living in neighborhoods with low walkability were at increased risk of incident and ongoing asthma. Neighborhood walkability improvement, for example by adding pedestrian paths to improve street connectivity, offers potential strategies to contribute to primary asthma prevention.

APRIL 16 | 2018

Roadside vegetation design characteristics that can improve local, near-road air quality.

Baldauf, R., V. Isakov, A. Venkatram, P. Deshmukh, B. Yang, K. Zhang, R. Logan.

Transportation Research Part D: Transport and Environment. Elsevier BV, AMSTERDAM, Netherlands, 52:354-361, (2017) https://doi.org/10.1016/j.trd.2017.03.013

  Abstract

As public health concerns have increased due to the rising number of studies linking adverse health effects with exposures to traffic-related air pollution near large roadways, interest in methods to mitigate these exposures have also increased. Several studies have investigated the use of roadside features in reducing near-road air pollution concentrations since this method is often one of the few short-term options available. Since roadside vegetation has other potential benefits, the impact of this feature has been of particular interest. The literature has been mixed on whether roadside vegetation reduces nearby pollutant concentrations or whether this feature has no effect or even potentially increases downwind air pollutant concentrations. However, these differences in study results highlight key characteristics of the vegetative barrier that can result in pollutant reductions or increase local pollutant levels. This paper describes the characteristics of roadside vegetation that previous research shows can result in improved local air quality, as well as identify characteristics that should be avoided in order to protect from unintended increases in nearby concentrations. These design conditions include height, thickness, coverage, porosity/density, and species characteristics that promote improved air quality. These design considerations can inform highway departments, urban and transportation planners, and developers in understanding how best to preserve existing roadside vegetation or plant vegetative barriers in order to reduce air pollution impacts near transportation facilities. These designs can also be used to mitigate impacts from other air pollution sources where emissions occur near ground-level.

April 9 | 2018

Socio-economic inequalities in exposure to industrial air pollution emissions in Quebec public schools

Emmanuelle Batisse, Sophie Goudreau, Jill Baumgartner, Audrey Smargiassi

Can J Public Health. 2018 Jan 22;108(5-6):e503-e509. http://dx.doi.org/10.17269/cjph.108.6166

Abstract

OBJECTIVES: We aimed to assess the relationships between deprivation at Quebec public schools, their proximity to polluting industries, and their exposure to industrial air emission sources including ambient fine particulate matter (PM2.5), sulphur dioxide (SO2) and nitrogen dioxide (NO2).

METHODS: We obtained four indicators of school deprivation using data from the 2006 Canadian census called the low-income threshold indicator, the neighbourhood SES indicator, and the social and material deprivation indicators of Pampalon. Using proximity spatial tools, we constructed three buffers of 2.5, 5 and 7.5 km around each school and summed up total emissions of PM2.5, SO2and NO2 for each school. Industrial air emissions were estimated using data from the 2006 Canadian National Pollutant Release Inventory. The Pearson correlations and LOESS regressions and natural log-transformed industrial air emissions were evaluated for Quebec public schools within the three buffers.

RESULTS: Of the 2189 public schools in Quebec, 608 (27.8%), 1108 (50.6%) and 1384 (63.2%) schools were located near at least one industry emitting one or more pollutants of interest in buffers of 2.5 km, 5 km and 7.5 km of schools respectively. Weak positive Pearson correlations (r) were found between log-transformed tons of industrial emissions of PM2.5, SO2 and NO2 and both the social deprivation (r = {0.23; 0.33}) and low-income threshold (r = {0.17; 0.29}) indicators in a buffer of 2.5 km. However, we found negative associations between emissions and the neighbourhood SES (r = {0.06; 0.16}) and material deprivation (r = {−0.04; 0.08}) indicators.

CONCLUSION: Our study suggests that schools in Quebec with higher rates of socio-economic deprivation among their students may be more likely to be exposed to higher emissions of industrial air pollutants.

 

April 2 | 2018

Childhood exposure to green space – A novel risk-decreasing mechanism for schizophrenia?

Engemann K, Pedersen CB, Arge L, Tsirogiannis C, Mortensen PB, Svenning JC.

Schizophr Res. 2018 Mar 21. pii: S0920-9964(18)30178-6. doi:10.1016/j.schres.2018.03.026. [Epub ahead of print] 

https://doi.org/10.1016/j.schres.2018.03.026

Abstract 

Schizophrenia risk has been linked to urbanization, but the underlying mechanism remains unknown. Green space is hypothesized to positively influence mental health and might mediate risk of schizophrenia by mitigating noise and particle pollution exposure, stress relief, or other unknown mechanisms. The objectives for this study were to determine if green space are associated with schizophrenia risk, and if different measures of green space associate differently with risk. We used satellite data from the Landsat program to quantify green space in a new data set for Denmark at 30 × 30 m resolution for the years 1985–2013. The effect of green space at different ages and within different distances from each person’s place of residence on schizophrenia risk was estimated using Cox regression on a very large longitudinal population-based sample of the Danish population (943,027 persons). Living at the lowest amount of green space was associated with a 1.52-fold increased risk of developing schizophrenia compared to persons living at the highest level of green space. This association remained after adjusting for known risk factors for schizophrenia: urbanization, age, sex, and socioeconomic status. The strongest protective association was observed during the earliest childhood years and closest to place of residence. This is the first nationwide population-based study to demonstrate a protective association between green space during childhood and schizophrenia risk; suggesting limited green space as a novel environmental risk factor for schizophrenia. This study supports findings from other studies highlighting positive effects of exposure to natural environments for human health.

March 26| 2018

The Association between Lifelong Greenspace Exposure and 3-Dimensional Brain Magnetic Resonance Imaging in Barcelona Schoolchildren

Payam Dadvand, Jesus Pujol, Dídac Macià, Gerard Martínez-Vilavella, Laura Blanco-Hinojo, Marion Mortamais, Mar Alvarez-Pedrerol, Raquel Fenoll, Mikel Esnaola, Albert Dalmau-Bueno, Mónica López-Vicente, Xavier Basagaña, Michael Jerrett, Mark J. Nieuwenhuijsen, and Jordi Sunyer

Environ Health Perspect; February 2018, Volume 126, Issue 2 https://doi.org/10.1289/EHP1876

ABSTRACT

BACKGROUND:

Proponents of the biophilia hypothesis believe that contact with nature, including green spaces, has a crucial role in brain development in children. Currently, however, we are not aware of evidence linking such exposure with potential effects on brain structure.

OBJECTIVE:

We determined whether lifelong exposure to residential surrounding greenness is associated with regional differences in brain volume based on 3-dimensional magnetic resonance imaging (3D MRI) among children attending primary school.

METHODS:

We performed a series of analyses using data from a subcohort of 253 Barcelona schoolchildren from the Brain Development and Air Pollution Ultrafine Particles in School Children (BREATHE) project. We averaged satellite-based normalized difference vegetation index (NDVI) across 100-m buffers around all residential addresses since birth to estimate each participant’s lifelong exposure to residential surrounding greenness, and we used high-resolution 3D MRIs of brain anatomy to identify regional differences in voxel-wise brain volume associated with greenness exposure. In addition, we performed a supporting substudy to identify regional differences in brain volume associated with measures of working memory (d′ from computerized n-back tests) and inattentiveness (hit reaction time standard error from the Attentional Network Task instrument) that were repeated four times over one year. We also performed a second supporting substudy to determine whether peak voxel tissue volumes in brain regions associated with residential greenness predicted cognitive function test scores.

RESULTS:

Lifelong exposure to greenness was positively associated with gray matter volume in the left and right prefrontal cortex and in the left premotor cortex and with white matter volume in the right prefrontal region, in the left premotor region, and in both cerebellar hemispheres. Some of these regions partly overlapped with regions associated with cognitive test scores (prefrontal cortex and cerebellar and premotor white matter), and peak volumes in these regions predicted better working memory and reduced inattentiveness.

CONCLUSION:

Our findings from a study population of urban schoolchildren in Barcelona require confirmation, but they suggest that being raised in greener neighborhoods may have beneficial effects on brain development and cognitive function.

March 19 | 2018

Associations Between the Built Environment and Objective Measures of Sleep: The Multi-Ethnic Study of Atherosclerosis.

Johnson DA, Hirsch JA, Moore KA, Redline S, Diez Roux AV.

Am J Epidemiol. 2018 Mar 14. doi: 10.1093/aje/kwx302. [Epub ahead of print] https://doi.org/10.1093/aje/kwx302

Abstract

Although dense neighborhood built environments support increased physical activity and lower obesity, these features may also disturb sleep. Therefore, we sought to understand the association between the built environment and objectively measured sleep. From 2010 to 2013, we analyzed data from examination 5 of the Multi-Ethnic Study of Atherosclerosis, a diverse population from 6 US cities. We fit multilevel models that assessed the association between the built environment (Street Smart Walk Score, social engagement destinations, street intersections, and population density) and sleep duration or efficiency from 1-week wrist actigraphy in 1,889 individuals. After adjustment for covariates, a 1-standard-deviation increase in Street Smart Walk Score was associated with 23% higher odds of short sleep duration (≤6 hours; odds ratio = 1.2, 95% confidence interval: 1.0, 1.4), as well as shorter average sleep duration (mean difference = -8.1 minutes, 95% confidence interval: -12.1, -4.2). Results were consistent across other built environment measures. Associations were attenuated after adjustment for survey-based measure of neighborhood noise. Dense neighborhood development may have multiple health consequence. In promoting denser neighborhoods to increase walkability, it is important to also implement strategies that reduce the adverse impacts of this development on sleep, such as noise reductions efforts.

March 12 | 2018

Gene-by-environment interactions in urban populations modulate risk phenotypes

Marie-Julie Favé, Fabien C. Lamaze, David Soave, Alan Hodgkinson, Héloïse Gauvin, Vanessa Bruat, Jean-Christophe Grenier, Elias Gbeha, Kimberly Skead, Audrey Smargiassi, Markey Johnson, Youssef Idaghdour & Philip Awadalla

Nature Communications volume 9, Article number: 827 (2018)  https://www.nature.com/articles/s41467-018-03202-2

 

ABSTRACT

Uncovering the interaction between genomes and the environment is a principal challenge of modern genomics and preventive medicine. While theoretical models are well defined, little is known of the G × E interactions in humans. We used an integrative approach to comprehensively assess the interactions between 1.6 million data points, encompassing a range of environmental exposures, health, and gene expression levels, coupled with whole-genome genetic variation. From ∼1000 individuals of a founder population in Quebec, we reveal a substantial impact of the environment on the transcriptome and clinical endophenotypes, overpowering that of genetic ancestry. Air pollution impacts gene expression and pathways affecting cardio-metabolic and respiratory traits, when controlling for genetic ancestry. Finally, we capture four expression quantitative trait loci that interact with the environment (air pollution). Our findings demonstrate how the local environment directly affects disease risk phenotypes and that genetic variation, including less common variants, can modulate individual’s response to environmental challenges.

March 5 | 2018

Assessing the Exposome with External Measures: Commentary on the State of the Science and Research Recommendations

Michelle C. Turner, Mark Nieuwenhuijsen, Kim Anderson, David Balshaw, Yuxia Cui, Genevieve Dunton, Jane A. Hoppin, Petros Koutrakis, and Michael Jerrett

Annual Review of Public Health Vol. 38:215-239 (Volume publication date March 2017) https://doi.org/10.1146/annurev-publhealth-082516-012802

Abstract

The exposome comprises all environmental exposures that a person experiences from conception throughout the life course. Here we review the state of the science for assessing external exposures within the exposome. This article reviews (a) categories of exposures that can be assessed externally, (b) the current state of the science in external exposure assessment, (c) current tools available for external exposure assessment, and (d) priority research needs. We describe major scientific and technological advances that inform external assessment of the exposome, including geographic information systems; remote sensing; global positioning system and geolocation technologies; portable and personal sensing, including smartphone-based sensors and assessments; and self-reported questionnaire assessments, which increasingly rely on Internet-based platforms. We also discuss priority research needs related to methodological and technological improvement, data analysis and interpretation, data sharing, and other practical considerations, including improved assessment of exposure variability as well as exposure in multiple, critical life stages.

February 27 | 2018

Six research priorities for cities and climate change

Xuemei Bai, Richard J. Dawson, Diana Ürge-Vorsatz, Gian C. Delgado, Aliyu Salisu Barau, Shobhakar Dhakal, David Dodman, Lykke Leonardsen, Valerie Masson-Delmotte, Debra Roberts, Seth Schultz.

Nature 555, 23-25 (2018) doi: 10.1038/d41586-018-02409-z www.nature.com/articles/d41586-018-02409-z

Xuemei Bai and colleagues call for long-term, cross-disciplinary studies to reduce carbon emissions and urban risks from global warming.