March 30 | 2020

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Air pollution and stunting: a missing link?

Sheela S Sinharoy, Thomas Clasen, Reynaldo Martorell.

 

The Lancet Global Health Comment Volume 8, Issue 4, April 2020, Pages e472-e475

https://doi.org/10.1016/S2214-109X(20)30063-2

 

Child linear growth impairment, particularly stunting, remains a global health challenge. Stunting is defined as a height-for-age Z-score more than two SDs below the WHO child growth standards reference median for age and sex. The number of children younger than 5 years who are stunted was 59 million (34%) in south Asia and 58 million (33%) in sub-Saharan Africa in 2018.1 Stunting is associated with poor child development, lower productivity and earnings in adulthood, and increased risk of chronic diseases later in life.2, 3 In this Comment, we argue that air pollution has been largely ignored as a potentially important cause of stunting, we outline a conceptual framework for how air pollution might lead to impaired linear growth in children, and we call for additional research into these mechanisms.

March 23 | 2020

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Projected local rain events due to climate change and the impacts on waterborne diseases in Vancouver, British Columbia, Canada.

Bimal K. Chhetri, Eleni Galanis, Stephen Sobie, Jordan Brubacher, Robert Balshaw, Michael Otterstatter, Sunny Mak, Marcus Lem, Mark Lysyshyn, Trevor Murdock, Manon Fleury, Kirsten Zickfeld, Mark Zubel, Len Clarkson, Tim K. Takaro

Environmental Health volume 18, Article number: 116 (2019) https://dx.doi.org/10.14288/1.0387512

 

Abstract

Background

Climate change is increasing the number and intensity of extreme weather events in many parts of the world. Precipitation extremes have been linked to both outbreaks and sporadic cases of waterborne illness. We have previously shown a link between heavy rain and turbidity to population-level risk of sporadic cryptosporidiosis and giardiasis in a major Canadian urban population. The risk increased with 30 or more dry days in the 60 days preceding the week of extreme rain. The goal of this study was to investigate the change in cryptosporidiosis and giardiasis risk due to climate change, primarily change in extreme precipitation.

Methods

Cases of cryptosporidiosis and giardiasis were extracted from a reportable disease system (1997–2009). We used distributed lag non-linear Poisson regression models and projections of the exposure-outcome relationship to estimate future illness (2020–2099). The climate projections are derived from twelve statistically downscaled regional climate models. Relative Concentration Pathway 8.5 was used to project precipitation derived from daily gridded weather observation data (~ 6 × 10 km resolution) covering the central of three adjacent watersheds serving metropolitan Vancouver for the 2020s, 2040s, 2060s and 2080s.

Results

Precipitation is predicted to steadily increase in these watersheds during the wet season (Oct. -Mar.) and decrease in other parts of the year up through the 2080s. More weeks with extreme rain (>90th percentile) are expected. These weeks are predicted to increase the annual rates of cryptosporidiosis and giardiasis by approximately 16% by the 2080s corresponding to an increase of 55–136 additional cases per year depending upon the climate model used. The predicted increase in the number of waterborne illness cases are during the wet months. The range in future projections compared to historical monthly case counts typically differed by 10–20% across climate models but the direction of change was consistent for all models.

Discussion

If new water filtration measures had not been implemented in our study area in 2010–2015, the risk of cryptosporidiosis and giardiasis would have been expected to increase with climate change, particularly precipitation changes. In addition to the predicted increase in the frequency and intensity of extreme precipitation events, the frequency and length of wet and dry spells could also affect the risk of waterborne diseases as we observed in the historical period. These findings add to the growing evidence regarding the need to prepare water systems to manage and become resilient to climate change-related health risks.

Linked CANUE and administrative health databases: PopDataBC, MCHP and NB_IRDT | March 27th | 2020

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Linked CANUE and administrative health databases: PopDataBC and MCHP

March 27th (9 am pacific | 12 noon eastern)

 

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Linkage of CANUE exposure data with provincially managed administrative health databases offers new and exciting opportunities for environmental health research. To date, CANUE data has been linked to data held by Population Data BC (PopData), Manitoba Centre for Health Policy (MCHP), and the New Brunswick Institute for Research, Data and Training (NB-IRDT).

Speakers:

Kelly Sanderson is the Lead of Business and Initiatives Development at Population Data BC. She works closely with BC government and BC SUPPORT Unit partners on joint data initiatives funded by the Strategy for Patient-Oriented Research (SPOR). She joined the organization in 2009 and was previously the Data Access Unit Lead where she enjoyed working with and guiding many researchers through the Data Access Request process. Her educational background and related professional experience was in Urban Planning and Geographical Information systems so she readily appreciates the value CANUE data brings as a new PopData holding.

Charles Burchill has been an Associate Director at the Manitoba Centre for Health Policy, University of Manitoba, since 2006.  Prior to this role, he worked as a research analyst at MCHP starting in 1992.  He is actively involved with Health and Social policy-related research using Manitoba administrative health and social data.  The repository of data represents over 80 distinct programs and databases with linkable data in the areas of health, family services, justice, and education.  His graduate work was in field ecology, with the CANUE data providing an opportunity to bring his interests full circle. The CANUE data represents an important source of built environment and environmental data that can be linked through small area geographies to the overall repository.

Dr. Ted McDonald is a Professor of Economics at the University of New Brunswick in Fredericton, Academic Director of the NB Research Data Centre, Director of the NB Institute for Research, Data and Training and the New Brunswick lead for the Maritime SPOR SUPPORT Unit. He holds a Ph.D. and a Master of Commerce in Economics from the University of Melbourne. Dr. McDonald’s main areas of research include health status and labour market issues of immigrants, rural residents, minority groups and other subpopulations, as well as an ongoing program of research on the socioeconomic and demographic determinants of cancer.

Dany Doiron is a research associate in the Respiratory Epidemiology and Clinical Research Unit at the Research Institute of the McGill University Health Centre (RI-MUHC) and is CANUE’s data linkage lead. Dany holds a Masters degree in Public Policy (Simon Fraser University) and PhD in Epidemiology (University of Basel). His research explores the effects of environmental exposures on health.

 

March 8 | 2020

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Ambient air pollution and incidence of early-onset paediatric type 1 diabetes: A retrospective population-based cohort study.

Elten M, Donelle J, Lima I, Burnett RT, Weichenthal S, Stieb DM, Hystad P, van Donkelaar A, Chen H, Paul LA, Crighton E, Martin RV, Decou ML, Luo W, Lavigne É.

Environ Res. 2020 Feb 22;184:109291.[Epub ahead of print] DOI:10.1016/j.envres.2020.109291

 

Abstract

BACKGROUND:

Studies have reported increasing incidence rates of paediatric diabetes, especially among those aged 0-5 years. Epidemiological evidence linking ambient air pollution to paediatric diabetes remains mixed.

OBJECTIVE:

This study investigated the association between maternal and early-life exposures to common air pollutants (NO2, PM2.5, O3, and oxidant capacity [Ox; the redox-weighted average of O3 and NO2]) and the incidence of paediatric diabetes in children up to 6 years of age.

METHODS:

All registered singleton births in Ontario, Ca nada occurring between April 1st, 2006 and March 31st, 2012 were included through linkage from health administrative data. Monthly exposures to NO2, PM2.5, O3, and Ox were estimated across trimesters, the entire pregnancy period and during childhood. Random effects Cox proportional hazards models were used to assess the relationships with paediatric diabetes incidence while controlling for important covariates. We also modelled the shape of concentration-response (CR) relationships.

RESULTS:

There were 1094 children out of a cohort of 754,698 diagnosed with diabetes before the age of six. O3 exposures during the first trimester of pregnancy were associated with paediatric diabetes incidence (hazard ratio (HR) per interquartile (IQR) increase = 2.00, 95% CI: 1.04-3.86). The CR relationship between O3 during the first trimester and paediatric diabetes incidence appeared to have a risk threshold, in which there was little-to-no risk below 25 ppb of O3, while above this level risk increased sigmoidally. No other associations were observed.

CONCLUSION:

O3 exposures during a critical period of development were associated with an increased risk of paediatric diabetes incidence.