TY  - JOUR
AB  - Polychlorinated biphenyls (PCBs) are industrial chemicals commonly found in food and building materials. PCBs are immunotoxic and may disturb the fetal programming of the immune and respiratory systems. We evaluated the association between maternal PCB exposure in indoor air and asthma, allergic rhinitis, atopic eczema, and respiratory infections in the offspring in the Health Effects of PCBs in Indoor Air (HESPAIR) cohort. This register-based study examined 7982 children born to mothers residing in two partially PCB contaminated residential areas in Greater Copenhagen before and/or during pregnancy. Children were included if their mothers at any point had lived in a contaminated or uncontaminated apartment in the period from 3.6 years prior to conception until the date of birth. PCB exposure was defined as mothers' number of years in an apartment prior to birth of the child multiplied with the PCB concentration in indoor air based on air measurements. Information on the outcomes was retrieved from the Danish health registers from 1977 to 2018. We estimated adjusted hazard ratios using Cox regression. Our main analyses revealed no association between maternal exposure to PCBs in indoor air and any of the studied allergic and respiratory outcomes. Findings of sensitivity analyses were consistent with main analyses. While these findings may appear reassuring for the considerable number of people living or working in PCB contaminated indoor environments, they should be interpreted with caution due to the indirect measure of exposure, incomplete registration of diagnoses, and lack of supporting evidence from comparable studies.
AU  - Deen, L.*
AU  - Hougaard, K.S.*
AU  - Meyer, H.W.*
AU  - Sejbæk, C.S.*
AU  - Petersen, K.U.*
AU  - Frederiksen, M.*
AU  - Bonde, J.P.*
AU  - Standl, M.
AU  - Flexeder, C.
AU  - Tøttenborg, S.S.*
C1  - 73803
C2  - 57007
CY  - Hackerbrucke 6, 80335 Munich, Germany
TI  - Maternal exposure to polychlorinated biphenyls in indoor air and asthma, allergic rhinitis, atopic eczema, and respiratory tract infections in childhood.
JO  - Int. J. Hyg. Environ. Health
VL  - 266
PB  - Elsevier Gmbh
PY  - 2025
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: Little is known about the association between air pollution and self-perceived health (including both health-related quality of life [HRQoL] and self-rated health [SRH]). The aim of this study was therefore to explore whether long-term air pollution exposure is associated with worse self-perceived health, as measured by different tools. METHODS: We used a land-use regression model to determine the annual average levels of particulate matter with a diameter <10 μm (PM10), coarse particles (PMcoarse), fine particles (PM2.5), fine particle absorbances (PM2.5abs), particle number concentration (PNC), ozone (O3), nitrogen dioxide (NO2), and nitrogen oxide (NOX) for geocoded residential addresses (2014-2015). Questionnaires and face-to-face interviews were used to collect HRQoL (measured using the European Quality of Life 5 Dimensions [EQ-5D] index and the European Quality of Life Visual Analogue Scale [EQ-VAS]) and SRH indicators (measured through two survey questions) (2018-2019) from participants of the Cooperative Health Research in the Region of Augsburg (KORA)-Fit study in Germany. We explored associations via generalized additive models, multinomial logistic regression, and logistic regression. RESULTS: We included 2610 participants with a mean age of 64.0 years in this cross-sectional study, of which 1428 (54.7%) were female. Each interquartile range (IQR) increase in O3 was associated with a reduced EQ-5D index value (% change of mean points and 95% confidence interval: -0.91% [-1.76; -0.06]). The average EQ-VAS score declined between -1.57% and -0.96% with each IQR increase in PM10, PMcoarse, PM2.5abs, PNC, NO2, and NOX. These pollutants were associated with increased occurrence of poor SRH, with odds ratios ranging from 1.24 to 2.67. PM2.5abs was linked to a higher likelihood of reporting a worse comparative SRH (2.59 [1.12; 5.99]). Body mass index and self-perceived stress modified these associations. CONCLUSIONS: Long-term air pollution exposure was associated with poor self-perceived health, presenting as lower HRQoL and higher odds of poor SRH. Single-item indicators measuring self-perceived health status may work better than multi-dimensional indicators.
AU  - Liao, M.
AU  - Zhang, S.
AU  - Wolf, K.
AU  - Bolte, G.*
AU  - Laxy, M.*
AU  - Schwettmann, L.
AU  - Peters, A.
AU  - Schneider, A.E.
AU  - Kraus, U.
C1  - 72893
C2  - 56757
CY  - Hackerbrucke 6, 80335 Munich, Germany
TI  - Long-term associations between ambient air pollution and self-perceived health status: Results from the population-based KORA-Fit study.
JO  - Int. J. Hyg. Environ. Health
VL  - 264
PB  - Elsevier Gmbh
PY  - 2025
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: Short-term exposure to low and high air temperatures can cause serious harmful effects on human health. Existing literature has mostly focused on associations of ambient air temperature with mortality and the need for health care in population-level studies. Studies that have considered self-perceived health status as an outcome when examining the effects of air temperature on health are scarce. In this study, we explored the short-term association of daily mean air temperature with various measures of self-perceived health status. METHODS: This cross-sectional analysis is based on the Cooperative Health Research in the Region of Augsburg (KORA) FIT study conducted in 2018/2019 and included participants from the Augsburg region of Southern Germany. Health-related quality of life (HRQOL) was evaluated by using the 5-level EuroQol Five Dimension (EQ-5D-5L) questionnaire, including the EuroQol visual analog scale (EQ-VAS). Self-rated health (SRH) and comparative self-rated health (CSRH) were each assessed using a single question. Daily mean air temperature data was estimated using a spatiotemporal model and assigned to participants' home addresses at a resolution of 1 × 1 km. Regression models with a Distributed Lag Non-linear Modeling (DLNM) approach were used to investigate the associations between daily mean air temperature and self-perceived health measures. RESULTS: We found no association of heat or cold with the HRQOL, SRH or CSRH. Nevertheless, there was a significant protective association of low air temperature with the EQ-5D-5L dimension "usual activities." CONCLUSION: There was no evidence of daily mean air temperature adversely affecting participants' self-perceived health status.
AU  - Sohail, H.*
AU  - Zhang, S.
AU  - Kraus, U.
AU  - Mikkonen, S.*
AU  - Breitner-Busch, S.
AU  - Wolf, K.
AU  - Nikolaou, N.
AU  - Peters, A.
AU  - Lanki, T.*
AU  - Schneider, A.E.
C1  - 71419
C2  - 56099
CY  - Hackerbrucke 6, 80335 Munich, Germany
TI  - Association between air temperature and self-perceived health status in Southern Germany: Results from KORA FIT study.
JO  - Int. J. Hyg. Environ. Health
VL  - 262
PB  - Elsevier Gmbh
PY  - 2024
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Geothermal energy is predicted to be one of the most important renewable energy sources in the near future. In geothermal energy plants, the secondary products such as the scale containing naturally occurring radioactive material (NORM) and adhering to the surface of equipment produce radiation fields. The workers who maintain and clean such equipment are at a risk to be exposed by the technically enhanced NORM (TENORM). To estimate the risks of radiation exposure to the workers, we assessed internal doses resulting from the cleaning activities on 150 heat exchanging boards used at a geothermal energy plant, focusing on 222Rn, 226Ra, 210Pb, 228Ra and 228Th. The experiment was performed with the subjects of workers and office workers as control, supplying prepared foods and drinks. Using the analytical results of 210Pb, 226Ra, 228Ra, and 228Th in the excretions of subjects, committed effect doses were determined. The annual internal dose for the workers with protective clothing due to the cleaning activities on removing scale, assuming the cleaning activities requires 170 h (standard monthly working time) a year, was obtained as 26 μSv/y and the total dose including 222Rn inhalation dose was calculated as 323 μSv/y. The additional dose for the cleaning workers was less than the dose limit of 20000 μSv/y for radiation workers, even less than for general population (1000 μSv/y) recommended by International Commission on Radiological Protection (ICRP). However, the elevated inhalation dose for workers conducting cleaning activities may present a health hazard to workers if they deal with excessive materials containing TENORM, work for excessive time or are under inappropriate safety measures.
AU  - Shinonaga, T.
AU  - Walther, D.*
AU  - Li, W.B.
AU  - Tschiersch, J.
C1  - 67182
C2  - 54232
CY  - Hackerbrucke 6, 80335 Munich, Germany
TI  - Internal radiation exposure from TENORM for workers conducting cleaning activities on equipment used at geothermal energy plant.
JO  - Int. J. Hyg. Environ. Health
VL  - 248
PB  - Elsevier Gmbh
PY  - 2023
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: A large multicentre European study reported later onset of menopause among women residing in greener areas. This influence on the timing of a reproductive event like menopause, raises the question whether similar associations can be observed with timing of menarche. We investigated whether exposure to residential green space was related to the age at menarche in German and Australian adolescent girls. METHODS: The analytic samples comprised of 1706 German and 1474 Australian adolescent girls. Percentage of green space was calculated in 1000 m buffers around a residential address or its surrogate at the previous follow-up. Mixed effects Cox proportional hazard models were used to explore the associations. The survival object was the occurrence of menarche at the time of follow-up (15-year follow-up of the German cohorts and the study wave at 14-15 years in the Australian cohort) and number of years since baseline (10-year follow-up in the German cohort and the study wave at 10-11 years in the Australian cohort). Participants who did not reach menarche were included as censored observations. RESULTS: A greener residence was not associated with the age at menarche. Null findings were consistent in the general population and in analyses stratified by socioeconomic status or urbanicity in both countries. Urban residents were more likely to have earlier menarche, and this association was consistent across Germany and Australia. CONCLUSION: The results of our analysis do not support the hypothesis that residing in places with more green space can influence timing of menarche. However, given the limitations of our study, researchers should not be discouraged to further explore environmental risk factors of early menarche.
AU  - Markevych, I.
AU  - Astell-Burt, T.*
AU  - Altug, H.*
AU  - Triebner, K.*
AU  - Standl, M.
AU  - Flexeder, C.
AU  - Heinrich, J.*
AU  - Schikowski, T.*
AU  - Koletzko, S.*
AU  - Herberth, G.*
AU  - Bauer, C.P.*
AU  - von Berg, A.*
AU  - Berdel, D.*
AU  - Feng, X.*
C1  - 63991
C2  - 52010
TI  - Residential green space and age at menarche in German and Australian adolescent girls: A longitudinal study.
JO  - Int. J. Hyg. Environ. Health
VL  - 240
PY  - 2022
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: Exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to acute and chronic health effects through the suggested pathways of oxidative stress and inflammation. However, evidence is still limited. We aimed to investigate jointly the relationship of PAHs, oxidative stress, and inflammation. METHODS: We measured 13 biomarkers of PAH exposure (n = 6: hydroxylated polycyclic aromatic hydrocarbons, [OH-PAHs]), oxidative stress (n = 6: malondialdehyde (MDA); 8-hydroxy-2'-deoxyguanosine (8-OHdG); and 4 representatives of the compound class of F2α-isoprostanes) in urine, and inflammation (n = 1: high-sensitivity C-reactive protein, [hs-CRP]) in serum from 400 participants at the second follow-up (2013/2014) of the German KORA survey S4. Multiple linear regression models were applied to investigate the interplay between biomarkers. RESULTS: Concentrations of biomarkers varied according to sex, age, smoking status, season, and a history of obesity, diabetes, or chronic kidney disease. All OH-PAHs were significantly and positively associated with oxidative stress biomarkers. An interquartile range (IQR) increase in sum OH-PAHs was associated with a 13.3% (95% CI: 9.9%, 16.9%) increase in MDA, a 6.5% (95% CI: 3.5%, 9.6%) increase in 8-OHdG, and an 8.4% (95% CI: 6.6%, 11.3%) increase in sum F2α-isoprostanes. Associations were more pronounced between OH-PAHs and F2α-isoprostanes but also between OH-PAHs and 8-OHdG for participants with potential underlying systemic inflammation (hs-CRP ≥ 3 mg/L). We observed no association between OH-PAHs and hs-CRP levels. While 8-OHdG was significantly positively associated with hs-CRP (13.7% [95% CI: 2.2%, 26.5%] per IQR increase in 8-OHdG), F2α-isoprostanes and MDA indicated only a positive or null association, respectively. CONCLUSION: The results of this cross-sectional study suggest, at a population level, that exposure to PAHs is associated with oxidative stress even in a low exposure setting. Oxidative stress markers, but not PAHs, were associated with inflammation. Individual risk factors were important contributors to these processes and should be considered in future studies. Further longitudinal studies are necessary to investigate the causal chain of the associations.
AU  - Wu, X.
AU  - Cao, X.
AU  - Lintelmann, J.
AU  - Peters, A.
AU  - Koenig, W.*
AU  - Zimmermann, R.
AU  - Schneider, A.E.
AU  - Wolf, K.
C1  - 65673
C2  - 52363
TI  - Assessment of the association of exposure to polycyclic aromatic hydrocarbons, oxidative stress, and inflammation: A cross-sectional study in Augsburg, Germany.
JO  - Int. J. Hyg. Environ. Health
VL  - 244
PY  - 2022
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: Concentrations of persistent organic pollutants (POPs) have been associated with an increased type 2 diabetes (T2D) risk. It remains unclear whether POPs are also associated with the risk of diabetes complications including neuropathy and evidence on this topic is scarce. We aimed to investigate the hypothesis that low-dose background concentrations of POPs were positively associated with distal sensorimotor polyneuropathy (DSPN). METHODS: This cross-sectional study was based on data from the second follow-up (FF4, 2013-2014, N = 2279) of the population-based KORA S4 study (Augsburg, Germany). The study sample consisted of 200 participants, including four groups of 50 persons each with known T2D, prediabetes, newly diagnosed diabetes, and normal glucose tolerance (NGT) based on an oral glucose tolerance test. We analyzed the association of six most abundant serum concentrations of POPs, including polychlorinated biphenyls (PCBs) as well as organochlorine (OC) pesticides, with DSPN by multivariable logistic regression adjusted for age, sex, glycaemic status, body mass index, physical activity, smoking and alcohol consumption. We assessed effect modification by age, sex, glycaemic status and obesity and conducted two-pollutant models to check the robustness of the estimates. RESULTS: For all pollutants, the main models indicated no significant association of having DSPN but pointed to rather decreased odds for DSPN. Two-pollutant models supported these findings, though only the association between the combination of PCB-138 and beta-hexachlorocyclohexane (β-HCH) (OR: 0.59; 95% CI: 0.35-0.99) with DSPN became significant. No effect modification was found by age, sex, glycaemic status and obesity. CONCLUSION: Low-dose concentrations of POPs were not associated with increased odds of having DSPN in T2D, prediabetes and NGT.
AU  - Schwarz, M.
AU  - Wolf, K.
AU  - Schneider, A.E.
AU  - Schramm, K.-W.
AU  - Bongaerts, B.*
AU  - Henkelmann, B.
AU  - Herder, C.*
AU  - Roden, M.*
AU  - Peters, A.
AU  - Ziegler, D.*
AU  - Rathmann, W.*
C1  - 62086
C2  - 50641
CY  - Hackerbrucke 6, 80335 Munich, Germany
TI  - Association of persistent organic pollutants with sensorimotor neuropathy in participants with and without diabetes or prediabetes: Results from the population-based KORA FF4 study.
JO  - Int. J. Hyg. Environ. Health
VL  - 235
PB  - Elsevier Gmbh
PY  - 2021
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Background: Depression and anxiety have complex etiologies and are associated with a significant burden of disease. Although air pollution has been hypothesized as a possible risk factor of these disorders, the associations are still under-investigated. We aimed to analyze associations between long-term exposure to ambient ozone and particulate matter with diameter< 10 mu m (PM10) and diagnoses of depression and anxiety in a general population.Methods: We utilized data from a large statutory health insurance company from Saxony, Germany. Information on outpatient clinical diagnoses of depression and anxiety was available for the years 2005-2014. We assigned ambient ozone and PM10 estimates to residential districts of 1.13 million individuals aged 16 and older. Depression and anxiety were defined as diagnoses counts. Associations with depression and anxiety were assessed using adjusted generalized estimating equations models.Results: In the ten-year study period, the observed prevalences of depression and anxiety were 7.40% and 3.82%, respectively. In the two-pollutant model, 10 more days with a maximum 8-h average ozone concentration exceeding 120 mu g/m(3) resulted in a relative risk (RR) of 1.010 with 95% confidence interval (CI) (1.005, 1.014) for depression and an RR of 1.007 (95% CI (1.000, 1.014)) for anxiety. The effect estimates of PM10 for depression and anxiety were 1.180 (95% CI (1.160, 1.201)) and 1.176 (95% CI (1.148, 1.205)) per 10 mu g/m(3) increase in PM10 concentration, respectively. Age, sex, and access to healthcare of the individual were also associated with the diagnosis of the disorders. The associations were consistent across one- and two-pollutant models.Conclusions: Our findings indicate that increased levels of ambient ozone and PM10 may elevate the risk of a depression or anxiety diagnosis in the general population. However, given the lack of data on individual air pollutant exposure and socioeconomic status, our results should be interpreted with caution. Further well-designed epidemiological studies should replicate our findings.
AU  - Zhao, T.
AU  - Tesch, F.*
AU  - Markevych, I.
AU  - Baumbach, C.*
AU  - Janßen, C.*
AU  - Schmitt, J.*
AU  - Romanos, M.*
AU  - Nowak, D.*
AU  - Heinrich, J.
C1  - 59229
C2  - 48738
CY  - Hackerbrucke 6, 80335 Munich, Germany
TI  - Depression and anxiety with exposure to ozone and particulate matter: An epidemiological claims data analysis.
JO  - Int. J. Hyg. Environ. Health
VL  - 228
PB  - Elsevier Gmbh
PY  - 2020
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Background: Residing in greener places may be protective against diabetes mellitus (DM) but evidence is scarce and comes mainly from developed countries.Objectives: To investigate associations of residential greenness with DM prevalence and glucose-homeostasis markers in Chinese adults and whether these associations were mediated by air pollution, physical activity, and body mass index.Methods: In 2009, a total of 15,477 adults from the cross-sectional 33 Communities Chinese Health Study provided blood samples and completed a questionnaire. We considered fasting and 2-h glucose and insulin concentrations, as well as the homoeostasis model assessment of insulin resistance and beta-cell function, as glucose-homeostasis markers. DM was defined according to the American Diabetes Association's recommendations. Residential greenness was estimated by two satellite-derived vegetation indexes - Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI). Nitrogen dioxide and particulate matter <= 2.5 mu m were used as air pollution proxies. Associations were assessed by two-level adjusted logistic and linear regression models.Results: A 0.1-unit increase in NDVI500 m and SAVI(500 m) was significantly associated with lower odds of DM by factors of 0.88 (95% Confidence Interval 0.82-0.94) and 0.80 (0.72-0.90), respectively. Higher greenness was also significantly associated with lower fasting and 2-h glucose levels, 2-h insulin level, as well as lower insulin resistance and higher beta-cell function. Air pollution and body mass index significantly mediated 6.9-51.1% and 8.6-78.7% these associations, respectively, while no mediation role was observed for physical activity.Conclusions: Higher residential greenness appears to be associated with a lower prevalence of DM. This association might be due to glucose and insulin metabolism and pancreatic beta-cell function. Lower levels of air pollution and body mass index can be pathways linking greenspace to diabetes.
AU  - Yang, B.-Y.*
AU  - Markevych, I.
AU  - Heinrich, J.*
AU  - Bowatte, G.*
AU  - Bloom, M.S.*
AU  - Guo, Y.*
AU  - Dharmage, S.C.*
AU  - Jalaludin, B.*
AU  - Knibbs, L.D.*
AU  - Morawska, L.*
AU  - Qian, Z.*
AU  - Chen, D.H.*
AU  - Ma, H.*
AU  - Chen, D.*
AU  - Lin, S.*
AU  - Yang, M.*
AU  - Liu, K.K.*
AU  - Zeng, X.W.*
AU  - Hu, L.W.*
AU  - Dong, G.H.*
C1  - 54962
C2  - 46015
CY  - Hackerbrucke 6, 80335 Munich, Germany
SP  - 283-290
TI  - Associations of greenness with diabetes mellitus and glucose-homeostasis markers: The 33 Communities Chinese Health Study.
JO  - Int. J. Hyg. Environ. Health
VL  - 222
IS  - 2
PB  - Elsevier Gmbh
PY  - 2019
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Background: Long-term exposure to ambient air pollution contributes to the global burden of disease by particularly affecting cardiovascular (CV) causes of death. We investigated the association between particle number concentration (PNC), a marker for ultrafine particles, and other air pollutants and high sensitivity C-reactive protein (hs-CRP) as a potential link between air pollution and CV disease.Methods: We cross-sectionally analysed data from the second follow up (2013 and 2014) of the German KORA baseline survey which was conducted in 1999-2001. Residential long-term exposure to PNC and various other size fractions of particulate matter (PM10 with size of < 10 mu m in aerodynamic diameter, PMcoarse, 2.5-10 mu m or PM2.5 < 2.5 mu m, respectively), soot (PM(2.5)abs: absorbance of PM2.5), nitrogen oxides (nitrogen dioxide NO2 or oxides NOx, respectively) and ozone (O-3) were estimated by land-use regression models. Associations between annual air pollution concentrations and hs-CRP were modeled in 2252 participants using linear regression models adjusted for several confounders. Potential effect-modifiers were examined by interaction terms and two pollutant models were calculated for pollutants with Spearman inter-correlation < 0.70.Results: Single pollutant models for PNC, PM10 PMcoarse, PM(2.5)abs, NO2 and NOx showed positive but nonsignificant associations with hs-CRP. For PNC, an interquartile range (2000 particles/cm(3)) increase was associated with a 3.6% (95% CI: -0.9%, 8.3%) increase in hs-CRP. A null association was found for PM2.5. Effect estimates were higher for women, non-obese participants, for participants without diabetes and without a history of cardiovascular disease whereas ex-smokers showed lower estimates compared to smokers or non-smokers. For O-3, the dose-response function suggested a non-linear relationship. In two-pollutant models, adjustment for PM2.5 strengthened the effect estimates for PNC and PM10 (6.3% increase per 2000 particles/cm(3) [95% CI: 0.4%; 12.5%] and 7.3% per 16.5 mu g/m(3) [95% CI: 0.4%; 14.8%], respectively).Conclusion: This study adds to a scarce but growing body of literature showing associations between long-term exposure to ultrafine particles and hs-CRP, one of the most intensely studied blood biomarkers for cardiovascular health. Our results highlight the role of ultrafine particles within the complex mixture of ambient air pollution and their inflammatory potential.
AU  - Pilz, V.
AU  - Wolf, K.
AU  - Breitner-Busch, S.
AU  - Rückerl, R.
AU  - Koenig, W.*
AU  - Rathmann, W.*
AU  - Cyrys, J.
AU  - Peters, A.
AU  - Schneider, A.E.
C1  - 52943
C2  - 44491
CY  - Office Jena, P O Box 100537, 07705 Jena, Germany
SP  - 510-518
TI  - C-reactive protein (CRP) and long-term air pollution with a focus on ultrafine particles.
JO  - Int. J. Hyg. Environ. Health
VL  - 221
IS  - 3
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2018
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Using data from two large, prospective German birth cohorts (GINIplus and LISAplus), we reported that early-life and current long-term air pollution exposures were not associated with lung function at the age of 15 years in the general study population (Fuertes et al. 2015). In response to our manuscript, Kawada et al. (2016) raised two points: 1) that our primary null findings are in contrast to some previous studies that reporte significant associations and 2) that air pollution cannot be excluded as a risk factor for respiratory symptoms. To these two points, we respond, that we completely agree. However, despite the numerous studies that have evaluated the potential adverse role of air pollution on respiratory health, the evidence for an association remains inconsistent for most outcomes. For example, although the meta-analysis conducted by Gehring et al. 2013, that was highlighted by Kawada et al. (2016), reported associations between levels of nitrogen dioxide, total nitrogen oxides, mass concentrations of particulate matter with diameters < 2.5  (PM2.5) and PM2.5 absorbance at the current address only and small decreases in lung function overall, the cohort-specific associations appeared consistent in certain areas (the Dutch PIAMA cohort) and null in others (the German GINIplus and LISAplus cohorts, in line with the results of Fuertes et al. (2015)). Such heterogeneity is evident throughout the literature and emphasizes the need for continued high quality research efforts in this field, including the publication of “negative results” to avoid publication bias.  We agree that the study presented in Fuertes et al. (2015) is only one piece of this complex problem. Nonetheless, it contributes to the development of a comprehensive understanding of the potential effects of air pollution on respiratory health.
AU  - Fuertes, E.
AU  - Heinrich, J.
AU  - Schulz, H.
C1  - 48511
C2  - 41121
CY  - Jena
SP  - 476
TI  - Re: The effect of air pollution on lung function in children.
JO  - Int. J. Hyg. Environ. Health
VL  - 219
IS  - 4-5
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2016
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: Global climate changes may influence the geographical spread of allergenic plants thus causing new allergen challenges. OBJECTIVE: Allergy patients from two German federal states were compared for their status quo sensitization to ragweed, an establishing allergen, olive, a non-established allergen, and the native allergens birch, mugwort, and ash. METHODS: Between 2011 and 2013, 476 adult allergy patients per region were recruited. Patients completed a questionnaire, participated in a medical interview, and underwent skin prick testing and blood withdrawal for analysis of specific IgE to allergen components (ISAC technology). Data on regional pollen load from 2006 to 2011 were acquired from the German Pollen Information Service Foundation. RESULTS: Prick test reactivity to ragweed and ash, respectively, was lower in Bavaria than in NRW (ragweed: p=0.001, aOR=0.54; ash: p=0.001, aOR=0.59), whereas prick test reactivity to olive was higher (p=0.000, aOR=3.09). Prick test reactivity to birch and mugwort, respectively, did not significantly differ. 1% (1/127) of patients with prick test reactivity to ragweed showed sIgE to Amb a 1, and 65% (86/132) of olive-but-not-ash reactive patients showed sIgE to Ole e 1 (NRW: 67%, Bavaria: 65%; p=0.823, OR=0.91). Regional differences in sensitization pattern were neither explainable by cross-reactivity to pollen pan-allergens nor non-exposure variables nor by reported plant population or pollen data. CONCLUSIONS: Spread of ragweed and particularly olive may result in prompt occurrence of allergic symptoms. Early identification of invasive allergens due to climate change does need time and spatial close meshed measurement of respective indicator allergens and sensitization pattern.
AU  - Höflich, C.*
AU  - Balakirski, G.*
AU  - Hajdu, Z.*
AU  - Baron, J.M.*
AU  - Kaiser, L.*
AU  - Czaja, K.*
AU  - Merk, H.F.*
AU  - Gerdsen, S.*
AU  - Strassen, U.*
AU  - Bas, M.*
AU  - Bier, H.*
AU  - Dott, W.*
AU  - Mücke, H.G.*
AU  - Straff, W.*
AU  - Chaker, A.
AU  - Röseler, S.*
C1  - 47976
C2  - 39805
CY  - Jena
SP  - 252-260
TI  - Potential health risk of allergenic pollen with climate change associated spreading capacity: Ragweed and olive sensitization in two German federal states.
JO  - Int. J. Hyg. Environ. Health
VL  - 219
IS  - 3
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2016
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: Exposure to ambient air pollution may be associated with impaired mental health, including depression. However, evidence originates mainly from animal studies and epidemiological studies in specific subgroups. We investigated the association between air pollution and depressed mood in four European general population cohorts. METHODS: Data were obtained from LifeLines (the Netherlands), KORA (Germany), HUNT (Norway), and FINRISK (Finland). Residential exposure to particles (PM2.5, PM2.5absorbance, PM10) and nitrogen dioxide (NO2) was estimated using land use regression (LUR) models developed for the European Study of Cohorts for Air Pollution Effects (ESCAPE) and using European wide LUR models. Depressed mood was assessed with interviews and questionnaires. Logistic regression analyses were used to investigate the cohort specific associations between air pollution and depressed mood. RESULTS: A total of 70,928 participants were included in our analyses. Depressed mood ranged from 1.6% (KORA) to 11.3% (FINRISK). Cohort specific associations of the air pollutants and depressed mood showed heterogeneous results. For example, positive associations were found for NO2 in LifeLines (odds ratio [OR]=1.34; 95% CI: 1.17, 1.53 per 10μg/m(3) increase in NO2), whereas negative associations were found in HUNT (OR=0.79; 95% CI: 0.66, 0.94 per 10μg/m(3) increase in NO2). CONCLUSIONS: Our analyses of four European general population cohorts found no consistent evidence for an association between ambient air pollution and depressed mood.
AU  - Zijlema, W.L.*
AU  - Wolf, K.
AU  - Emeny, R.T.
AU  - Ladwig, K.-H.
AU  - Peters, A.
AU  - Kongsgård, H.*
AU  - Hveem, K.*
AU  - Kvaløy, K.*
AU  - Yli-Tuomi, T.*
AU  - Partonen, T.*
AU  - Lanki, T.*
AU  - Eeftens, M.*
AU  - de Hoogh, K.*
AU  - Brunekreef, B.*
AU  - Stolk, R.P.*
AU  - Rosmalen, J.G.*
C1  - 47568
C2  - 40673
CY  - Jena
SP  - 212-219
TI  - The association of air pollution and depressed mood in 70,928 individuals from four European cohorts.
JO  - Int. J. Hyg. Environ. Health
VL  - 219
IS  - 2
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2016
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - INTRODUCTION: The impact of outdoor air pollution exposure on long-term lung development and potential periods of increased lung susceptibility remain unknown. This study assessed associations between early-life and current residential exposure to air pollution and lung function at 15-years of age in two German birth cohorts. METHODS: Fifteen year-old participants living in an urban and rural area in Germany underwent spirometry before and after bronchodilation (N=2266). Annual average (long-term) exposure to nitrogen dioxide (NO2), particles with aerodynamic diameters less than 2.5μg/m(3) (PM2.5) mass and less than 10μg/m(3) (PM10) mass, PM2.5 absorbance and ozone were estimated to each participant's birth-, 10- and 15-year home address using land-use regression and kriging (ozone only) modelling. Associations between lung function variables and long-term pollutant concentrations were assessed using linear regression models adjusted for host and environmental covariates and recent short-term air pollution exposures. RESULTS: Long-term air pollution concentrations assessed to the birth-, 10- and 15-year home addresses were not associated with lung function variables, before and after bronchodilation, in the complete or study area specific populations. However, several lung function variables were negatively associated with long-term NO2 concentrations among asthmatics. For example, NO2 estimated to the 15-year home address was associated with the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) and the mean flow rate between 25% and 75% of FVC (-3.5%, 95% confidence interval [-6.0, -1.0] and -297.4ml/s [-592.6, -2.1] per 5.9μg/m(3) increase in NO2, respectively). Nearly all effect estimates for the associations between the short-term PM2.5 mass, PM10 mass and ozone concentrations and the lung function variables were negative in the complete population. CONCLUSIONS: Early-life and current long-term air pollution exposures and lung function at the age of 15 years were not associated in the complete study population. Asthmatics may represent a vulnerable group.
AU  - Fuertes, E.
AU  - Bracher, J.
AU  - Flexeder, C.
AU  - Markevych, I.
AU  - Klümper, C.*
AU  - Hoffmann, B.*
AU  - Krämer, U.*
AU  - von Berg, A.*
AU  - Bauer, C.P.*
AU  - Koletzko, S.*
AU  - Berdel, D.*
AU  - Heinrich, J.
AU  - Schulz, H.
C1  - 46443
C2  - 37535
CY  - Jena
SP  - 656-665
TI  - Long-term air pollution exposure and lung function in 15 year-old adolescents living in an urban and rural area in Germany: The GINIplus and LISAplus cohorts.
JO  - Int. J. Hyg. Environ. Health
VL  - 218
IS  - 7
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2015
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - In order to assess the personal exposure to ultrafine particles (UFP) during individual day-time activities and to investigate the impact of different microenvironments on exposure, we measured personal exposure to particle number concentrations (PNC), a surrogate for UFP, among 112 non-smoking participants in Augsburg, Germany over a nearly two-year period from March 2007 to December 2008. We obtained 337 personal PNC measurements from 112 participants together with dairies of their activities and locations. The measurements lasted on average 5.5 h and contained on average 330 observations. In addition, ambient PNC were measured at an urban background stationary monitoring site. Personal PNC were highly variable between measurements (IQR of mean: 11 780–24 650 cm−3) and also within a single measurement. Outdoor personal PNC in traffic environments were about two times higher than in non-traffic environments. Higher indoor personal PNC were associated with activities like cooking, being in a bistro or exposure to passive smoking. Overall, personal and stationary PNC were weakly to moderately correlated (r < 0.41). Personal PNC were much higher than stationary PNC in traffic (ratio: 1.5), when shopping (ratio: 2.4), and indoors with water vapor (ratio: 2.5). Additive mixed models were applied to predict personal PNC by participants’ activities and locations. Traffic microenvironments were significant determinants for outdoor personal PNC. Being in a bistro, passive smoking, and cooking contributed significantly to an increased indoor personal PNC.
AU  - Gu, J.
AU  - Kraus, U.
AU  - Schneider, A.E.
AU  - Hampel, R.
AU  - Pitz, M.*
AU  - Breitner-Busch, S.
AU  - Wolf, K.
AU  - Hänninen, O.*
AU  - Peters, A.
AU  - Cyrys, J.
C1  - 42824
C2  - 35361
CY  - Jena
SP  - 188-195
TI  - Personal day-time exposure to ultrafine particles in different microenvironments.
JO  - Int. J. Hyg. Environ. Health
VL  - 218
IS  - 2
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2015
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Negative associations between bone turnover markers and bone mineral density have been reported. In order to study the association between ambient air pollution and bone turnover markers, as indicators of bone loss, we investigated associations between land-use regression modeled air pollution (NO2, PM2.5 mass, PM2.5 - 10 [coarse particles], PM10 mass and PM2.5 absorbance) and bone turnover markers in 2264 children aged 10 years. Serum osteocalcin and C-terminal telopeptide of type I collagen (CTx), measured by Modular-System (Roche), were the two bone turnover markers considered in this analysis. In total population, NO2, PM2.5 - 10 and PM10 mass exposure were positively and significantly associated with both osteocalcin and CTx. A 2.5 (95% CI: 0.6, 4.4) ng/ml increase in osteocalcin and a 24.0 (95% CI: 6.7, 41.3) ng/L increase in CTx were observed per IQR (6.7 μg/m3) increase in NO2, independent of socioeconomic status, sex, age, pubertal status, fasting status and total physical activity. The estimated coefficients were 3.0 (95% CI: 0.1, 5.8) for osteocalcin and 32.3 (95% CI: 6.1, 58.5) for CTx with PM2.5 - 10; 3.2 (95% CI: 0.0, 6.4) for osteocalcin and 30.7 (95% CI: 1.7, 59.7) for CTx with PM10. Children living close to a major road (≤ 350 m) had higher levels of both osteocalcin (1.4 [-1.2, 4.0] ng/ml) and CTx (16.2 [-7.4, 39.8] ng/L). The adverse impact of ambient air pollution on bone turnover rates observed in one of the study areas showed stimulation of more such studies.
AU  - Liu, C.
AU  - Fuertes, E.
AU  - Flexeder, C.
AU  - Hofbauer, L.C.*
AU  - Berdel, D.*
AU  - Hoffmann, B.H.*
AU  - Kratzsch, J.K.*
AU  - von Berg, A.*
AU  - Heinrich, J.
AU  - GINIplus Study Group (Chen, C.M.
AU  - Filipiak, B.
AU  - Franke, K.
AU  - Gehring, U.
AU  - Laubereau, B.
AU  - Popescu, M.
AU  - Sausenthaler, S.
AU  - Schoetzau, A.
AU  - Wichmann, H.-E.
AU  - Zutavern, A.)
AU  - LISAplus Study Group (Schnappinger, M.)
C1  - 31959
C2  - 34908
CY  - Jena
SP  - 58-65
TI  - Associations between ambient air pollution and bone turnover markers in 10-year old children: Results from the GINIplus and LISAplus studies.
JO  - Int. J. Hyg. Environ. Health
VL  - 218
IS  - 1
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2015
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: Short-term exposure to increased particulate matter (PM) concentration has been reported to trigger myocardial infarction (MI). However, the association with ultrafine particles remains unclear. OBJECTIVES: We aimed to assess the effects of short-term air pollution and especially ultrafine particles on registry-based MI events and coronary deaths in the area of Augsburg, Germany. METHODS: Between 1995 and 2009, the MONICA/KORA myocardial infarction registry recorded 15,417 cases of MI and coronary deaths. Concentrations of PM<10μm (PM10), PM<2.5μm (PM2.5), particle number concentration (PNC) as indicator for ultrafine particles, and meteorological parameters were measured in the study region. Quasi-Poisson regression adjusting for time trend, temperature, season, and weekday was used to estimate immediate, delayed and cumulative effects of air pollutants on the occurrence of MI. The daily numbers of total MI, nonfatal and fatal events as well as incident and recurrent events were analysed. RESULTS: We observed a 1.3% risk increase (95%-confidence interval: [-0.9%; 3.6%]) for all events and a 4.4% [-0.4%; 9.4%] risk increase for recurrent events per 24.3μg/m(3) increase in same day PM10 concentrations. Nonfatal events indicated a risk increase of 3.1% [-0.1%; 6.5%] with previous day PM10. No association was seen for PM2.5 which was only available from 1999 on. PNC showed a risk increase of 6.0% [0.6%; 11.7%] for recurrent events per 5529 particles/cm(3) increase in 5-day average PNC. CONCLUSIONS: Our results suggested an association between short-term PM10 concentration and numbers of MI, especially for nonfatal and recurrent events. For ultrafine particles, risk increases were notably high for recurrent events. Thus, persons who already suffered a MI seemed to be more susceptible to air pollution.
AU  - Wolf, K.
AU  - Schneider, A.E.
AU  - Breitner-Busch, S.
AU  - Meisinger, C.
AU  - Heier, M.
AU  - Cyrys, J.
AU  - Kuch, B.*
AU  - von Scheidt, W.*
AU  - Peters, A.
AU  - KORA Study Group (Gieger, C.
AU  - Grallert, H.
AU  - Heinrich, J.
AU  - Holle, R.
AU  - Leidl, R.
AU  - Strauch, K.)
C1  - 45036
C2  - 37145
CY  - Jena
SP  - 535-542
TI  - Associations between short-term exposure to particulate matter and ultrafine particles and myocardial infarction in Augsburg, Germany.
JO  - Int. J. Hyg. Environ. Health
VL  - 218
IS  - 6
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2015
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Evidence for a role of long-term particulate matter exposure on acute respiratory infections is growing. However, which components of particulate matter may be causative remains largely unknown. We assessed associations between eight particulate matter elements and early-life pneumonia in seven birth cohort studies (Ntotal=15,980): BAMSE (Sweden), GASPII (Italy), GINIplus and LISAplus (Germany), INMA (Spain), MAAS (United Kingdom) and PIAMA (The Netherlands). Annual average exposure to copper, iron, potassium, nickel, sulfur, silicon, vanadium and zinc, each respectively derived from particles with aerodynamic diameters≤10μm (PM10) and 2.5μm (PM2.5), were estimated using standardized land use regression models and assigned to birth addresses. Cohort-specific associations between these exposures and parental reports of physician-diagnosed pneumonia between birth and two years were assessed using logistic regression models adjusted for host and environmental covariates and total PM10 or PM2.5 mass. Combined estimates were calculated using random-effects meta-analysis. There was substantial within and between-cohort variability in element concentrations. In the adjusted meta-analysis, pneumonia was weakly associated with zinc derived from PM10 (OR: 1.47 (95% CI: 0.99, 2.18) per 20ng/m(3) increase). No other associations with the other elements were consistently observed. The independent effect of particulate matter mass remained after adjustment for element concentrations. In conclusion, associations between particulate matter mass exposure and pneumonia were not explained by the elements we investigated. Zinc from PM10 was the only element which appeared independently associated with a higher risk of early-life pneumonia. As zinc is primarily attributable to non-tailpipe traffic emissions, these results may suggest a potential adverse effect of non-tailpipe emissions on health.
AU  - Fuertes, E.
AU  - Macintyre, E.
AU  - Agius, R.M.*
AU  - Beelen, R.*
AU  - Brunekreef, B.*
AU  - Bucci, S.*
AU  - Cesaroni, G.*
AU  - Cirach, M.*
AU  - Cyrys, J.
AU  - Forastiere, F.*
AU  - Gehring, U.*
AU  - Gruzieva, O.*
AU  - Hoffmann, B.*
AU  - Jedynska, A.*
AU  - Keuken, M.*
AU  - Klümper, C.*
AU  - Kooter, I.M.*
AU  - Korek, M.*
AU  - Krämer, U.*
AU  - Mölter, A.*
AU  - Nieuwenhuijsen, M.*
AU  - Pershagen, G.*
AU  - Porta, D.*
AU  - Postma, D.S.*
AU  - Simpson, A.*
AU  - Smit, H.A.*
AU  - Sugiri, D.*
AU  - Sunyer, J.*
AU  - Wang, M.*
AU  - Heinrich, J.
C1  - 31643
C2  - 34607
CY  - Jena
SP  - 819-829
TI  - Associations between particulate matter elements and early-life pneumonia in seven birth cohorts: Results from the ESCAPE and TRANSPHORM projects.
JO  - Int. J. Hyg. Environ. Health
VL  - 217
IS  - 8
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2014
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: Only few epidemiological studies have investigated the association between air temperature and blood pressure (BP) or pulse pressure (PP), with inconsistent findings. We examined whether short-term changes in air temperature were associated with changes in BP or PP in three different populations. METHODS: Between March 2007 and December 2008, 371 systolic and diastolic BP measurements were collected in 30 individuals with type-2 diabetes mellitus (T2D), 30 persons with impaired glucose tolerance and 42 healthy individuals without a metabolic disorder from Augsburg, Germany. Hourly means of ambient meteorological data were obtained from a fixed measurement station. Personal temperature measurements were conducted using data loggers. Temperature effects were evaluated using additive mixed models adjusting for time trend and relative humidity. RESULTS: Decreases in air temperature were associated with an increase in systolic BP, diastolic BP and PP in individuals with T2D. For example, a 1°C decrease in ambient temperature was associated with an immediate increase in systolic BP of 1.0mmHg (95%-confidence interval: [0.5;1.4]mmHg). Effects of personally measured air temperature were similar. Temperature effects were modified by age, body mass index, gender, antihypertensive medication and whereabouts, such as being indoors. CONCLUSIONS: We observed associations between decreases in air temperature and increases in BP as well as PP in persons with T2D indicating that these people might be potentially more susceptible to changes in air temperature. Our findings may provide a hypothesis for a mechanism between air temperature decreases and short-term increases of cardiovascular events.
AU  - Lanzinger, S.
AU  - Hampel, R.
AU  - Breitner-Busch, S.
AU  - Rückerl, R.
AU  - Kraus, U.
AU  - Cyrys, J.
AU  - Geruschkat, U.
AU  - Peters, A.
AU  - Schneider, A.E.
C1  - 31523
C2  - 34520
CY  - Jena
SP  - 775-784
TI  - Short-term effects of air temperature on blood pressure and pulse pressure in potentially susceptible individuals.
JO  - Int. J. Hyg. Environ. Health
VL  - 217
IS  - 7
PB  - Elsevier Gmbh, Urban & Fischer Verlag
PY  - 2014
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Most previous studies which have investigated the short-term effects of air pollution on airway inflammation, assessed by an increase of exhaled nitric oxide (eNO), have been conducted among asthmatic children. Few studies have considered this potential association among non-asthmatics. Furthermore, although both short- and long-term effects of air pollution on eNO had been reported separately, studies which include both are scarce. We explored associations between 24 h NO2 and PM10 (particles with aerodynamic diameters below 10 μm) mass with eNO in 1985 children (192 asthmatics and 1793 non-asthmatics) aged 10 years and accounted for the long-term effects of air pollution by adjusting for annual averages of NO2, PM10 mass, PM2.5 mass (particles with aerodynamic diameters below 2.5 μm) and PM2.5 absorbance, using data from two German birth cohorts in Munich and Wesel. In total, robust associations between 24 h NO2 and eNO were observed in both single-pollutant (percentage change: 18.30%, 95% confidence interval: 11.63-25.37) and two-pollutant models (14.62%, 6.71-23.11). The association between 24 h PM10 mass and eNO was only significant in the single-pollutant model (9.59%, 4.80-14.61). The same significant associations were also observed in non-asthmatic children, while they did not reach significant levels in asthmatic children. Associations between annual averages of ambient air pollution (NO2, PM10 mass, PM2.5 mass and PM2.5 absorbance) and eNO were consistently null. In conclusion, significantly positive associations were observed between short-term ambient air pollution and eNO. No long-term effects of air pollution on eNO were found in this study.
AU  - Liu, C.
AU  - Flexeder, C.
AU  - Fuertes, E.
AU  - Cyrys, J.
AU  - Bauer, C.-P.*
AU  - Koletzko, S.*
AU  - Hoffmann, B.*
AU  - von Berg, A.*
AU  - Heinrich, J.
C1  - 28101
C2  - 32935
CY  - Jena
SP  - 483-491
TI  - Effects of air pollution on exhaled nitric oxide in children: Results from the GINIplus and LISAplus studies.
JO  - Int. J. Hyg. Environ. Health
VL  - 217
IS  - 4-5
PB  - Elsevier
PY  - 2014
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Indoor microbial agents exposure is associated to depressive symptoms in adults and persistent exposure to indoor mould is associated to poorer cognitive function in children. In our study, we aimed to assess the effects of the exposure to indoor factors associated with increased microbial exposure (mould, dampness and pets) on behavioural problems in children aged 10 years, participating in two German birth cohorts. A total of 4860 children were followed until the age of 10 years, and the strengths and difficulties questionnaire (SDQ) was administered to the parents. Indoor factors were assessed through parental reported questionnaires in periodical surveys. Logistic and multinomial regressions adjusting for potential confounders were performed. Prevalences of borderline/abnormal total scores in the SDQ at 10 years of age were higher in children exposed to mould (aOR = 1.23, 95%CI = 1.00-1.56), dampness (aOR = 1.51, 95%CI = 1.10-2.07), and pets (aOR = 1.48, 95%CI = 1.20-1.94). The dimension "emotional symptoms" showed statistically significant risk estimates for mould and pets, meanwhile "conduct problems" and "hyperactivity/inattention" dimensions only did for pets. No significant associations were found for the "peer relationship problems" dimension. We found a significant strong interaction between dampness and pet, the risk of borderline/abnormal scores in the "total difficulties" scale and the "emotional symptoms" dimension for pets' was at least twice the risk in children with reported dampness than in children without. Our findings point to a potential effect of microbial exposure on children's behavioural problems, especially on emotional disorders, probably mediated through neurotoxicity and immune system activation.
AU  - Casas, L.
AU  - Tiesler, C.M.
AU  - Thiering, E.
AU  - Brüske, I.
AU  - Koletzko, S.*
AU  - Bauer, C.-P.*
AU  - Wichmann, H.-E.
AU  - von Berg, A.*
AU  - Berdel, D.*
AU  - Krämer, U.*
AU  - Schaaf, B.
AU  - Lehmann, I.
AU  - Herbarth, O.*
AU  - Sunyer, J.*
AU  - Heinrich, J.
C1  - 23932
C2  - 31299
SP  - 146-154
TI  - Indoor factors and behavioural problems in children: The GINIplus and LISAplus birth cohort studies.
JO  - Int. J. Hyg. Environ. Health
VL  - 216
IS  - 2
PB  - Elsevier
PY  - 2013
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Exposure to biocontaminants is associated with behavioural problems and poorer cognitive function. Our study assesses the associations between early life exposure to home dampness, pets and farm animal contact and cognitive function and social competences in 4-year old children, and the associations between these indoor factors and microbial compounds (bacterial endotoxin and fungal extracellular polysaccharides). A Spanish population-based birth-cohort enrolled 482 children, and 424 of them underwent psychometric testing at 4 years of age, including the McCarthy Scales of Child Abilities (MSCA) and the California Preschool Social Competence Scale (CPSCS). Information on pet ownership, farm animal contact and home dampness was periodically reported by the parents through questionnaires. Microbial compounds were measured in living room sofa dust collected at the age of 3 months. Persistent home dampness during early life significantly decreased the general score of MSCA by 4.9 points (95% CI: -8.9; -0.8), and it decreased the CPSCS by 6.5 points (95% CI: -12.2; -0.9) in the child's bedroom. Cat or dog ownership were not associated with the outcomes, but occasional farm animal contact increased the general cognitive score of MSCA by 5.6 points (95% CI: 1.8; 9.3). Cat and dog ownership were associated with higher levels of endotoxins in home dust. None of the measured microbial compounds were related with the psychometric tests scores. In conclusion, damp housing in early life may have adverse effects on neuropsychological development at 4 years old. More research is needed to explore the possible involvement of mycotoxins in the observed results.
AU  - Casas, L.*
AU  - Torrent, M.*
AU  - Zock, J.P.*
AU  - Doekes, G.*
AU  - Forns, J.*
AU  - Guxens, M.*
AU  - Täubel, M.*
AU  - Heinrich, J.
AU  - Sunyer, J.*
C1  - 26098
C2  - 32068
SP  - 690-697
TI  - Early life exposures to home dampness, pet ownership and farm animal contact and neuropsychological development in 4 year old children: A prospective birth cohort study.
JO  - Int. J. Hyg. Environ. Health
VL  - 216
IS  - 6
PB  - Elsevier
PY  - 2013
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Epidemiological studies have shown associations between ambient air pollution and changes in heart rate variability (HRV). However, studies using personal air pollution measurements, especially with exposure averages <24h, are still rare. Between February and March 2008 HRV data as well as personal exposure to particulate matter <2.5μm (PM2.5), and particle number concentrations (PNC) were collected in five volunteers for up to 8.3h on a 5min resolution. Information about the participant's whereabouts was also collected. Mixed models were used to analyze concurrent and up to 30min delayed effects of air pollutants as well as being in traffic on 5min-averages of heart rate (HR), high and low frequency power (HF and LF), standard deviation of all normal-to-normal intervals (SDNN), and the root mean square of successive interval differences (RMSSD). Results are presented as %-change from the mean per increase in interquartile range of air pollutant. In total, 474 5-min segments were available for analysis. We observed concurrent and delayed reductions in SDNN of about 0.8-1.0% in association with a 5.4μg/m(3) increase in PM2.5. However, being in traffic by car led to an increase of about 20% 10-14min and 15-19min later. An increase in PM2.5 or PNC was associated with lagged decreases for RMSSD and HF. We detected concurrent reductions in RMSSD (-17.6% [95%-confidence interval: 29.1; -4.3]) when being in traffic by bike/foot. Being in traffic by car was associated with an immediate reduction in LF while more delayed increases in LF were observed when being in traffic by bike/foot. Air pollution and traffic effects on HR were less consistent. These rapid changes in HRV within 30min might be mediated by the autonomic nervous system in response to direct reflexes from receptors in the lungs.
AU  - Hampel, R.
AU  - Rückerl, R.
AU  - Yli-Tuomi, T.*
AU  - Breitner-Busch, S.
AU  - Lanki, T.*
AU  - Kraus, U.
AU  - Cyrys, J.
AU  - Belcredi, P.
AU  - Brüske, I.
AU  - Laitinen, T.M.*
AU  - Timonen, K.*
AU  - Wichmann, H.-E.
AU  - Peters, A.
AU  - Schneider, A.E.
C1  - 28286
C2  - 33062
CY  - Jena
SP  - 460-464
TI  - Impact of personally measured pollutants on cardiac function.
JO  - Int. J. Hyg. Environ. Health
VL  - 217
IS  - 4-5
PB  - Elsevier
PY  - 2013
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - BACKGROUND: Chronic noise is an environmental pollutant and well-known to cause annoyance and sleep disturbance. Its association with clinical and subclinical adverse health effects has been discussed. OBJECTIVES: This systematic review aimed to examine associations between chronic noise exposure during pregnancy or childhood and health outcomes in early and late childhood. METHODS: Following a systematic electronic literature search (MEDLINE, EMBASE), an additional hand search and a critical evaluation of potential articles by 2 independent reviewers, 29 studies were included: 12 on pregnancy/birth outcomes with samples ranging from 115 to 22,761 and 17 on cardiovascular and immune-mediated health outcomes in childhood with samples ranging from 43 to 1542. Evidence levels (3 to 2++) were rated according to the Scottish Intercollegiate Guidelines Network. RESULTS: Chronic noise exposure during pregnancy was not associated with birth weight, preterm birth, congenital anomalies, perinatal and neonatal death based on 6 cohort, 4 case-control, and 2 cross-sectional studies (highest evidence level 2+). There was some evidence supporting an association of chronic noise exposure with increased systolic blood pressure and stress hormone levels in urine and saliva in children evaluating 2 cohort and 15 cross-sectional studies (highest evidence level 2-). CONCLUSIONS: There seemed to be no associations between chronic noise and pregnancy outcomes based on studies with evidence levels up to 2+. Associations between chronic noise and health in children were based mainly on cross-sectional studies. However, the studies included in this comprehensive systematic review showed a high variation in study design, outcome, exposure and confounder assessments.
AU  - Hohmann, C.*
AU  - Grabenhenrich, L.*
AU  - de Kluizenaar, Y.*
AU  - Tischer, C.G.
AU  - Heinrich, J.
AU  - Chen, C.-M.
AU  - Thijs, C.*
AU  - Nieuwenhuijsen, M.*
AU  - Keil, T.*
C1  - 11860
C2  - 30885
SP  - 217-229
TI  - Health effects of chronic noise exposure in pregnancy and childhood: A systematic review initiated by ENRIECO.
JO  - Int. J. Hyg. Environ. Health
VL  - 216
IS  - 3
PB  - Elsevier
PY  - 2013
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Although traffic emits both air pollution and noise, studies jointly examining the effects of both of these exposures on blood pressure (BP) in children are scarce. We investigated associations between land-use regression modeled long-term traffic-related air pollution and BP in 2368 children aged 10 years from Germany (1454 from Munich and 914 from Wesel). We also studied this association with adjustment of long-term noise exposure (defined as day-evening-night noise indicator "Lden" and night noise indicator "Lnight") in a subgroup of 605 children from Munich inner city. In the overall analysis including 2368 children, NO2, PM2.5 mass (particles with aerodynamic diameters below 2.5μm), PM10 mass (particles with aerodynamic diameters below 10μm) and PM2.5 absorbance were not associated with BP. When restricting the analysis to the subgroup of children with noise information (N=605), a significant association between NO2 and diastolic BP was observed (-0.88 (95% confidence interval: -1.67, -0.08)). However, upon adjusting the models for noise exposure, only noise remained independently and significantly positively associated with diastolic BP. Diastolic BP increased by 0.50 (-0.03, 1.02), 0.59 (0.05, 1.13), 0.55 (0.03, 1.07), and 0.58 (0.05, 1.11)mmHg for every five decibel increase in Lden and by 0.59 (-0.05, 1.22), 0.69 (0.04, 1.33), 0.64 (0.02, 1.27), and 0.68 (0.05, 1.32)mmHg for every five decibel increase in Lnight, in different models of NO2, PM2.5 mass, PM10 mass and PM2.5 absorbance as the main exposure, respectively. In conclusion, air pollution was not consistently associated with BP with adjustment for noise, noise was independently and positively associated with BP in children.
AU  - Liu, C.
AU  - Fuertes, E.
AU  - Tiesler, C.M.
AU  - Birk, M.
AU  - Babisch, W.
AU  - Bauer, C.-P.*
AU  - Koletzko, S.*
AU  - von Berg, A.*
AU  - Hoffmann, B.*
AU  - Heinrich, J.
AU  - GINIplus Study Group (Heinrich, J.
AU  - Wichmann, H.-E.)
AU  - LISAplus Study Group (Heinrich, J.
AU  - Wichmann, H.-E.)
C1  - 28159
C2  - 32974
CY  - Jena
SP  - 499-505
TI  - The associations between traffic-related air pollution and noise with blood pressure in children: Results from the GINIplus and LISAplus studies.
JO  - Int. J. Hyg. Environ. Health
VL  - 217
IS  - 4-5
PB  - Elsevier
PY  - 2013
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Each day we are exposed to a complex mixture of microbial agents and components in indoor environments. A major part of this mixture derives from fungal and bacterial origin. The impact between those microbial agents in the home environment in relation to respiratory health in children is still a major issue in research. There is little known about the causal agents that provoke or arrest the development of allergic respiratory disorders in children. Identification is complicated by the biodiversity and variability of microbial components in indoor air as well as the lack of validated and standardized exposure assessment methods. In this review, we aim to consider all important aspects in terms of research which may encounter an epidemiological study. Apart from the need for standardized exposure assessment methods which consider cost, handling and effort, especially for the participants, we suggest that a combination of different analysis methods such as chemical and molecular methods may have the potential to best describe the microbial milieu in indoor environments at present. Further, the impact of mould and moisture remediation activities on health is still heavily under investigated, especially in larger prospective cohorts of children and should be a topic of future research. Moreover, the exposure to mould and microbial agents might be embedded in a broader spectrum of children's health such as behavior and cognitive development.
AU  - Tischer, C.G.
AU  - Heinrich, J.
C1  - 11881
C2  - 30883
SP  - 109-114
TI  - Exposure assessment of residential mould, fungi and microbial components in relation to children's health: Achievements and challenges.
JO  - Int. J. Hyg. Environ. Health
VL  - 216
IS  - 2
PB  - Elsevier
PY  - 2013
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - The objective of the present study was to investigate the principle relationships between concentrations in human and environmental matrices of polychlorinated biphenyls (PCBs) and hexachlorobenzene (HCB) in short distance comparable areas within Saxony, Germany by employing the data of the German Environmental Specimen Banking (ESB). Examples supporting this idea were presented by selecting data on blood plasma collected from students in University of Halle and pine shoots, egg matter of city pigeons, earthworm, and roe deer liver. Similar pattern for PCB 138 and PCB 180 was found for the human plasma and pine shoots samples during investigated years and the human data followed the corresponding environmental levels with some delay of approximately two years. However, PCB 153 that was the prevailing congener did not manifest this relationship. In addition, the correlation of the ratios of concentrations (human/environmental concentration) to some physicochemical constants such as molecular weight (MW), octanol-water partition coefficient (log K-ow), Henry's law constant (K-H), and sorption partition coefficient (log K-oc) of HCB, PCB 138, PCB 153, and PCB 180 were studied. The resulted negative slopes with all constants in case of blood plasma/city pigeons egg matter pairs suggested that the accumulation of lipophilic compounds is more pronounced in pigeon eggs than in human blood.
AU  - Pandelova, M.
AU  - Schramm, K.-W.
C1  - 7979
C2  - 29964
SP  - 220-223
TI  - Human and environmental biomonitoring of polychlorinated biphenyls and hexachlorobenzene in Saxony, Germany based on the German Environmental Specimen Bank.
JO  - Int. J. Hyg. Environ. Health
VL  - 215
IS  - 2
PB  - Elsevier 
PY  - 2012
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Asthma has become the most common, childhood chronic disease in the industrialized world, and it is also increasing in developing regions. There are huge differences in the prevalence of childhood asthma across countries and continents, and there is no doubt that the prevalence of asthma was strongly increasing during the past decades worldwide. Asthma, as a complex disease, has a broad spectrum of potential determinants ranging from genetics to life style and environmental factors. Environmental factors are likely to be important in explaining the regional differences and the overall increasing trend towards asthma's prevalence. Among the environmental conditions, indoor factors are of particular interest because people spend more than 80% of their time indoors globally. Increasing prices for oil, gas and other sources of primary energy will further lead to better insulation of homes, and ultimately to reduced energy costs. This will decrease air exchange rates and will lower the dilution of indoor air mass with ambient air. Indoor air quality and potential health effects will therefore be an area for future research and for gaining a better understanding of asthma epidemics. This strategic review will summarize the current knowledge of the effects of a broad spectrum of indoor factors on the development of asthma in childhood in Western countries based on epidemiological studies. In conclusion, several epidemiological studies point out, that indoor factors might cause asthma in childhood. Stronger and more consistent findings are seen when exposure to these indoor factors is assessed by surrogates for the source of the actual toxicants. Measurement-based exposure assessments for several indoor factors are less common than using surrogates of the exposure. These studies, however, mainly showed heterogeneous results. The most consistent finding for an induction of asthma in childhood is related to exposure to environmental tobacco smoke, to living in homes close to busy roads, and in damp homes where are visible moulds at home. The causing agents of the increased risk of living in damp homes remained uncertain and needs clarification. Exposure to pet-derived allergens and house dust mites are very commonly investigated and thought to be related to asthma onset. The epidemiological evidence is not sufficient to recommend avoidance measures against pet and dust mites as preventive activities against allergies. More research is also needed to clarify the potential risk for exposure to volatile and semi-volatile organic compounds due to renovation activities, phthalates and chlorine chemicals due to cleaning.
AU  - Heinrich, J.
C1  - 6320
C2  - 28502
CY  - Jena, Germany
SP  - 1-25
TI  - Influence of indoor factors in dwellings on the development of childhood asthma.
JO  - Int. J. Hyg. Environ. Health
VL  - 214
IS  - 1
PB  - Elsevier
PY  - 2011
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - The exposure to ambient particulate matter (PM) pollution is a major threat to public health. Chinese megacities are coined by high levels of PM. Our aims were to examine the concentration levels of PM in megacities (Guangzhou, Hong Kong, and Shenzhen) of the Pearl River Delta (PRD), South China; to compare the results with international and national air quality guidelines; and to assess the health impact in terms of possible reductions in premature deaths due to PM reduction. The Medline(®) data base was used to identify published studies (systematic literature search). Based on our appraisal criteria 13 studies remained in the analysis. Additionally, publicly available data were extracted from data sources provided by municipal authorities of the cities under study. PM data reported in μg/m(3) were abstracted from single studies and municipal reports. If possible, the PM data were stratified for season of data collection (summer/winter half-year) and simple means were calculated for cities, seasons and months. Based on the abstracted data, a health impact assessment (HIA) was done in order to estimate potential preventable premature deaths due to PM pollution in the cities. Almost all PM data exceeded national and international air quality guidelines. Our HIA showed that in Guangzhou ten thousands of premature deaths could be prevented if the PM burden was reduced to these air quality limit values. We identified no suitable epidemiological study reporting PM according to our study protocol. Further epidemiological studies should be carried out to more precisely determine the spatial distribution of PM-related health risks in PRD. Environmental protection measures and public health interventions are required to reduce burden of PM-related diseases in PRD.
AU  - Jahn, H.J.*
AU  - Schneider, A.E.
AU  - Breitner-Busch, S.
AU  - Eissner, R.*
AU  - Wendisch, M.*
AU  - Krämer, A.*
C1  - 6164
C2  - 28851
SP  - 281-295
TI  - Particulate matter pollution in the megacities of the Pearl River Delta, China - a systematic literature review and health risk assessment.
JO  - Int. J. Hyg. Environ. Health
VL  - 214
IS  - 4
PB  - Elsevier
PY  - 2011
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - In this study, we evaluated the association between prenatal and postnatal exposure to environmental tobacco smoke and the development of insulin resistance in 10 year old children. Fasting blood samples were collected from 470 children participating in two prospective birth cohorts. Of those 276 were selected population based and enriched with 194 children exceeding the 85th percentile of body mass index in this age group. Children already having diabetes type 1 or 2 at the age of 10 years were excluded. Fasting blood insulin and glucose levels and calculated HOMA index for insulin resistance assessment were analysed using generalised additive models. Potential confounders were adjusted for. Insulin resistance was increased by 24% in children frequently exposed to environmental tobacco smoke during childhood (MR(adj) = 1.24, p = 0.001), while glucose levels were not. Exclusion of prenatally exposed children did not attenuate the association (MR(adj) = 1.25, p = 0.006). After stratification, the effect sizes were identical within overweight children and the population based sample of children. Insulin resistance and fasting insulin levels were increasing with increasing numbers of cigarettes smoked in children's home. Maternal smoking during the third trimester of pregnancy increased children's insulin levels (MR(adj) = 1.19, p = 0.037), and even more so, if children were exclusively breastfed after birth (MR(adj) = 1.31, p = 0.016). Increased mean ratios were found for smoking of a third person in addition to maternal smoking. Positive dose-dependent associations and independent effects of postnatal exposure suggest involvement of environmental tobacco smoke in the risk for development of insulin resistance in children.
AU  - Thiering, E.
AU  - Brüske, I.
AU  - Kratzsch, J.*
AU  - Thiery, J.*
AU  - Sausenthaler, S.
AU  - Meisinger, C.
AU  - Koletzko, S.*
AU  - Bauer, C.P.*
AU  - Schaaf, B.*
AU  - von Berg, A.*
AU  - Berdel, D.*
AU  - Lehmann, I.*
AU  - Herbarth, O.*
AU  - Krämer, U.*
AU  - Wichmann, H.-E.
AU  - Heinrich, J.
AU  - GINIplus Study Group (Wichmann, H.-E.
AU  - Heinrich, J.
AU  - Schoetzau, A.
AU  - Popescu, M.
AU  - Mosetter, M.
AU  - Schindler, J.
AU  - Franke, K.
AU  - Laubereau, B.
AU  - Sausenthaler, S.
AU  - Thaqi, A.
AU  - Zutavern, A.
AU  - Zirngibl, A.)
AU  - LISAplus Study Group (Chen, C.-M.
AU  - Schnappinger, M.
AU  - Rzehak, P.
AU  - Wichmann, H.-E.
AU  - Heinrich, J.
AU  - Bolte, G.
AU  - Belcredi, P.
AU  - Jacob, B.
AU  - Schoetzau, A.
AU  - Mosetter, M.
AU  - Schindler, J.
AU  - Höhnke, A.
AU  - Franke, K.
AU  - Laubereau, B.
AU  - Sausenthaler, S.
AU  - Thaqi, A.
AU  - Zirngibl, A.)
C1  - 6777
C2  - 29265
SP  - 361-368
TI  - Prenatal and postnatal tobacco smoke exposure and development of insulin resistance in 10 year old children.
JO  - Int. J. Hyg. Environ. Health
VL  - 214
IS  - 5
PB  - Elsevier
PY  - 2011
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Studies have reported contradictory effects of cat and dog exposure on allergy, resulting in inconsistent recommendations on animal avoidance. We conducted a systematic review of observational studies published in English from 2000 to January 2009. It shows in this review that the reported exposure-response relationships are contradictory. A total of 17 and 13 birth cohort studies on cat and dog exposure, respectively, are included in the review. Most of the birth cohort studies found that cat or dog exposure in early life had no effect on the development of asthma or wheezing symptoms and dog exposure during infancy was found to protect children from developing sensitization against aeroallergens. A total of 7 and 6 prospective studies in school-age children or adults on cat and dog exposure, respectively, are included in this review and most of these studies suggested an inverse association between cat exposure and asthma and wheezing symptoms. As for cross-sectional studies, 26 and 21 studies on cat and dog exposure, respectively, are included in this review, which cover a broad range of age groups and geographical areas, and reported inconsistent results. The evidence summarised in this systematic review needs to be interpreted with caution, the inconsistent study results may be due to study design, exposure assessment, and avoidance measure. The exposure-response relationships may also alter in geographical areas where the community prevalence of cats and dogs are significantly different. However, as the evidence of the effects of pet keeping on subsequent development of asthma or allergic diseases presented in this review are not overwhelmingly strong, the decision of whether to keep a cat or a dog in the family should be based on arguments other than the concern of developing asthma and allergy.
AU  - Chen, C.M.
AU  - Tischer, C.G.
AU  - Schnappinger, M.
AU  - Heinrich, J.
C1  - 247
C2  - 27311
SP  - 1-31
TI  - The role of cats and dogs in asthma and allergy: A systematic review.
JO  - Int. J. Hyg. Environ. Health
VL  - 213
IS  - 1
PB  - Elsevier
PY  - 2010
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Studies have presented conflicting associations between cat allergen exposure and sensitisation and atopic disease. We therefore investigated the association between the observed domestic cat allergen level and cat sensitisation in young children in four study populations from three European countries. We recruited children from a nested case-control study, which is composed of four ongoing birth cohorts conducted in three European countries. Children at 2-4 years of age in the four cohorts who were sensitised to cat allergens (n=106) were compared with 554 non-sensitised children (controls). House dust samples were collected when the children were 5 to 7 years old, and cat allergen levels were measured in ng/g dust and ng/m(2) surface area. In the German study population we found a positive association between domestic cat allergen in house dust and cat sensitisation (OR (CI)=3.01 (1.16, 7.99)) while in the Swedish study population, we found a negative association (OR (CI)=0.41 (0.16, 0.98)). No association was found in the Dutch study population (OR (CI)=0.83 (0.22, 2.93)). Looking into the family history of cat keeping, we found the lowest prevalence of cat sensitisation in children who were cat owners at the age of blood sampling (11%) and the highest prevalence was found in those who have had a cat but not anymore, at the age of blood sampling (41%). The mixed results may be explained by differences in age and avoidance patterns.
AU  - Chen, C.M.
AU  - Gehring, U.
AU  - Wickman, M.*
AU  - Hoek, G.*
AU  - Giovannangelo, M.*
AU  - Nordling, E.*
AU  - Wijga, A.*
AU  - de, Jongste, J.*
AU  - Pershagen, G.*
AU  - Almqvist, C.*
AU  - Kerkhof, M.*
AU  - Bellander, T.*
AU  - Wichmann, H.-E.
AU  - Brunekreef, B.*
AU  - Heinrich, J.
C1  - 3144
C2  - 25556
SP  - 337-344
TI  - Domestic cat allergen and allergic sensitisation in young children.
JO  - Int. J. Hyg. Environ. Health
VL  - 211
IS  - 3-4
PB  - Elsevier
PY  - 2008
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Swimming pool attendance and exposure to chlorination by-products showed adverse health effects on children. We assessed whether early swimming pool attendance, especially baby swimming, is related to higher rates of early infections and to the development of allergic diseases. In 2003-2005, 2192 children were analysed for the 6-year follow-up of a prospective birth cohort study. Data on early swimming pool attendance, other lifestyle factors and medical history were collected by parental-administered questionnaire. Bivariate and multivariate logistic regression analyses were used to evaluate associations. Babies who did not participate in baby swimming had lower rates of infection in the 1st year of life (i) diarrhoea: OR 0.68 CI 95% 0.54-0.85; (ii) otitis media: OR 0.81 CI 95% 0.62-1.05; (iii) airway infections: OR 0.85 CI 95% 0.67-1.09. No clear association could be found between late or non-swimmers and atopic dermatitis or hay fever until the age of 6 years, while higher rates of asthma were found (OR 2.15 95% CI 1.16-3.99), however, potentially due to reverse causation. The study indicates that, in terms of infections, baby swimming might not be as harmless as commonly thought. Further evidence is needed to make conclusions if the current regulations on chlorine in Germany might not protect swimming pool attendees from an increased risk of gastrointestinal infections. In terms of developing atopic diseases there is no verifiable detrimental effect of early swimming.
AU  - Schoefer, Y.
AU  - Zutavern, A.*
AU  - Brockow, I.*
AU  - Schäfer, T.*
AU  - Krämer, U.*
AU  - Schaaf, B.*
AU  - Herbarth, O.*
AU  - von Berg, A.*
AU  - Wichmann, H.-E.
AU  - Heinrich, J.
AU  - LISAplus Study Group (Wichmann, H.-E.
AU  - Heinrich, J.
AU  - Bolte, G.
AU  - Belcredi, P.
AU  - Jacob, B.
AU  - Schoetzau, A.
AU  - Mosetter, M.
AU  - Schindler, J.
AU  - Höhnke, A.
AU  - Franke, K.
AU  - Laubereau, B.
AU  - Sausenthaler, S.
AU  - Traidl-Hoffmann, C.*
AU  - Thaqi, A.
AU  - Zirngibl, A.
AU  - Zutavern, A.)
C1  - 3146
C2  - 25729
SP  - 367-373
TI  - Health risks of early swimming pool attendance.
JO  - Int. J. Hyg. Environ. Health
VL  - 211
IS  - 3-4
PB  - Elsevier
PY  - 2008
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - There is a growing body of evidence for serious health consequences of exposure to ambient air pollution. The general question of who is susceptible is one of the most important gaps in current knowledge regarding particulate matter (PM)-related health effects. Who is susceptible depends on the specific health endpoint being evaluated and the level and length of exposure. Here, we restrict the review on the impact of fine particle exposure on children's health to the following outcomes: infant death, lung function, respiratory symptoms and reproductive outcomes. METHODS: This is a strategic review of children's susceptibility to ambient fine particles and characteristics of infant and children which underlie their increased susceptibility to PM. RESULTS: Ambient fine PM is associated with intra-uterine growth retardation, infant mortality; it is associated with impaired lung function and increased respiratory symptoms, particularly in asthmatics. Concerning infant mortality, exposure to PM is strongly and consistently associated with postneonatal respiratory mortality and less consistently with sudden infant death syndrome. Although most of the studies reported adverse effects for this health outcome, the evidence is weaker than for infant death. Exposure to fine PM has been associated with impaired lung function and lung function growth. Most of the studies reported increased prevalence of symptom with increased exposure to fine PM. CONCLUSION: Fine PM is a major threat to children, because of their higher exposure to PM compared to adults, the immature state of the lung in childhood and also of the immune function at birth. The first months of life might be a period of particular sensitivity. Although the mechanisms of air pollution effects have not yet been completely understood, pregnant women, infants and children need specific protection against exposure to fine particles.
AU  - Heinrich, J.
AU  - Slama, R.
C1  - 3810
C2  - 24927
SP  - 617-622
TI  - Fine particles, a major threat to children.
JO  - Int. J. Hyg. Environ. Health
VL  - 210
IS  - 5
PB  - Elsevier
PY  - 2007
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - The aim of this study was to evaluate exposure and health outcome of children living close to industrial sources. Exposure and health outcome was assessed in nearly 1000 children at school beginner age living in the vicinity of industrial sources of three different hot spots (Duisburg North, Duisburg South and Dortmund Hörde) and in a rural area of North Rhine Westphalia (NRW), Germany. The cross-sectional study was undertaken between March and May 2000. Exposure assessment comprised modelling of ambient air quality data and human biomonitoring (HBM). Depending on the site-specific contaminants, HBM included the measurement of PAH (polycyclic aromatic hydrocarbons) and benzene metabolites in urine as well as heavy metals in blood and urine. Markers of early effects were DNA strand breaks as measured by the comet assay in lymphocytes and excretion of alpha-1-microglobuline and N-acetyl-beta-d-glucosamidase in urine. Health outcome was assessed by questionnaire, lung function test, dermatological examination as well as by RAST (radioallergosorbent test), patch tests and prick tests. The influence of exposure variables on biomarkers and health outcome was measured by means of multiple linear and logistic regression analysis. The most striking results were as follows. Children living close to a coke oven plant (Duisburg North) had increased levels of PAH metabolites in urine, and DNA exposure was increased. Children living at the Dortmund Hörde hot spot (increased chromium and nickel ambient air levels from a steel mill) revealed a high prevalence of allergic sensitizations. Sensitization, especially against nickel, was associated with the current internal nickel exposure, and nickel in ambient air was positively associated with the frequency of allergic symptoms. Children from the hot spot areas had increased specific airway resistance and total lung capacity as compared to those of the reference area. In Duisburg North particularly, specific airway resistance and total lung capacity significantly increased with increasing TSP (total suspended particulate). The only positive associations between external and internal exposure were found between benzo[a]pyrene in ambient air and 1-hydroxypyrene in urine, and between lead in ambient air and in the blood of the children. It is concluded that despite improvements of the general air quality during the last decades, living in the vicinity of industrial sources results to some extent in increased internal contaminant exposure and in effects on health outcome. Still ongoing studies are aimed to find out whether the increased PAH and DNA exposure of children from Duisburg North had decreased after the coke oven plant had been shut down in 2003, and if the striking results on the high prevalence of allergic sensitization can be confirmed by introducing an expanded cross-sectional study at four hot spots with increased chromium and nickel ambient air levels.
AU  - Wilhelm, M.*
AU  - Eberwein, G.*
AU  - Hölzer, J.*
AU  - Gladtke, D.
AU  - Angerer, J.*
AU  - Marczynski, B.*
AU  - Behrendt, H.
AU  - Ring, J.*
AU  - Sugirim, D.
AU  - Ranft, U.
C1  - 4522
C2  - 24733
SP  - 591-599
TI  - Influence of industrial sources on children's health - Hot spot studies in North Rhine Westphalia, Germany.
JO  - Int. J. Hyg. Environ. Health
VL  - 210
IS  - 5
PB  - Elsevier
PY  - 2007
SN  - 1438-4639
ER  - 

TY  - JOUR
AB  - Epidemiological studies have shown weak or inconsistent associations between ambient air pollutants and allergic sensitization. The aim of this study was to evaluate whether regional urban air pollution may partly explain the large variation in the prevalence of allergic sensitization across cities of the European Community Respiratory Health Survey (ECRHS) II. METHODS: ECRHS is a cross-sectional survey initiated in 29 countries across Europe in the 1990s (ECRHS I) with a follow-up conducted 10 years later (ECRHS II). Subject characteristics were measured by questionnaires and blood tests conducted for the measurement of specific immunoglobulin E. Fine particle mass (PM(2.5), <2.5mum) and sulphur on PM(2.5) were measured in 21 centres and annual averages of urban regional background air pollution were calculated. Results were scaled by an interquartile range increase in ambient PM(2.5) (6.03mug/m(3)) and sulphur (1336ng/m(3)). Generalized estimating equations were applied to compute population average effect estimates with adjustment for age, gender, smoking habit, education and number of siblings. RESULTS: A notable variation in pollution level and prevalence of allergic sensitization was observed. Moreover, exposure to urban regional background air pollution was not associated with allergic sensitization; adjusted odds ratios and 95% confidence interval were 1.02 (0.95-1.09) for PM(2.5) and 1.08 (0.86-1.31) for sulphur. These statistically non-significant associations were sensitive to model specification. CONCLUSIONS: The study suggests that regional air pollution measured at fixed sites is not associated with allergic sensitization among adults in ECRHS II.
AU  - Bedada, G.B.
AU  - Heinrich, J.
AU  - Götschi, T.*
AU  - Downs, S.H.*
AU  - Forsberg, B.*
AU  - Jarvis, D.*
AU  - Luczynska, C.*
AU  - Soon, A.*
AU  - Sunyer, J.*
AU  - Torén, K.*
AU  - Künzli, N.*
C1  - 4231
C2  - 24947
SP  - 691-700
TI  - Urban background particulate matter and allergic sensitization in adults of ECRHS II.
JO  - Int. J. Hyg. Environ. Health
VL  - 210
IS  - 6
PB  - Elsevier
PY  - 2006
SN  - 1438-4639
ER  - 

TY  - JOUR
AU  - Kraft, M.*
AU  - Eikmann, T.*
AU  - Kappos, N.*
AU  - Künzli, N.*
AU  - Rapp, R.*
AU  - Schneider, K.*
AU  - Seitz, H.*
AU  - Voss, J.-U.*
AU  - Wichmann, H.-E.
C1  - 5524
C2  - 22991
SP  - 305-318
TI  - The German view: Effects of nitrogen dioxide on human health - derivation of health-related short-term and long-term values.
JO  - Int. J. Hyg. Environ. Health
VL  - 208
PY  - 2005
SN  - 1438-4639
ER  - 

TY  - JOUR
AU  - Kappos, A.D.*
AU  - Bruckmann, P.*
AU  - Eikmann, Th.*
AU  - Englert, N.*
AU  - Heinrich, U.*
AU  - Höppe, P.*
AU  - Koch, E.*
AU  - Krause, G.H.M.*
AU  - Kreyling, W.G.
AU  - Rauchfuss, K.*
AU  - Rombout, P.*
C1  - 1561
C2  - 22074
SP  - 399-407
TI  - Health effects of particles in ambient air.
JO  - Int. J. Hyg. Environ. Health
VL  - 207
PY  - 2004
SN  - 1438-4639
ER  - 

TY  - JOUR
AU  - Wichmann, H.-E.
C1  - 4106
C2  - 22403
SP  - 489-491
TI  - 20 years after the winter smog episode 1985 - the particle problem then and today.
JO  - Int. J. Hyg. Environ. Health
VL  - 207
PY  - 2004
SN  - 1438-4639
ER  - 

TY  - JOUR
AU  - Wichmann, H.-E.
C1  - 4107
C2  - 22404
SP  - 505-520
TI  - What can we learn today from the Central European smog episode of 1985 (and earlier episodes)?
JO  - Int. J. Hyg. Environ. Health
VL  - 207
PY  - 2004
SN  - 1438-4639
ER  - 

TY  - JOUR
AU  - Meyer, I.*
AU  - Hoelscher, B.
AU  - Frye, C.
AU  - Becker, K.*
AU  - Wichmann, H.-E.
AU  - Heinrich, J.
C1  - 10131
C2  - 21618
SP  - 1-12
TI  - Temporal changes in blood lead levels of children in East Germany.
JO  - Int. J. Hyg. Environ. Health
VL  - 206
PY  - 2003
SN  - 1438-4639
ER  - 

TY  - JOUR
AU  - Eberlein-König, B.
AU  - Przybilla, B.*
AU  - Kühnl, P.*
AU  - Golling, G.*
AU  - Gebefügi, I.
AU  - Ring, J.*
C1  - 10132
C2  - 20781
SP  - 213-220
TI  - Multiple chemical sensitivity (MCS) and others : Allergological, environmental and psychological investigations in individuals with indoor air related complaints.
JO  - Int. J. Hyg. Environ. Health
VL  - 205
PY  - 2002
SN  - 1438-4639
ER  - 

TY  - JOUR
AU  - Hölscher, B.
AU  - Heinrich, J.
AU  - Jacob, B.
AU  - Ritz, B.*
AU  - Wichmann, H.-E.
C1  - 21302
C2  - 19417
SP  - 29-37
TI  - Gas cooking respiratory health and white blood cell counts in children.
JO  - Int. J. Hyg. Environ. Health
VL  - 203
PY  - 2000
SN  - 1438-4639
ER  -