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Article ; Online: Using individual approach to examine the association between urban heat island and preterm birth

Xiang Xiao / Ruixia Liu / Zheng Zhang / Bin Jalaludin / Joachim Heinrich / Xiangqian Lao / Lidia Morawska / Shyamali C. Dharmage / Luke D. Knibbs / Guang-Hui Dong / Meng Gao / Chenghong Yin

Environment International, Vol 183, Iss , Pp 108356- (2024)

A nationwide cohort study in China

1481

Abstract: Background: Evidence suggests that maternal exposure to heat might increase the risk of preterm birth (PTB), but no study has investigated the effect from urban heat island (UHI) at individual level. Aims: Our study aimed to investigate the association ... ...

Abstract	Background: Evidence suggests that maternal exposure to heat might increase the risk of preterm birth (PTB), but no study has investigated the effect from urban heat island (UHI) at individual level. Aims: Our study aimed to investigate the association between individual UHI exposure and PTB. Methods: We utilized data from the ongoing China Birth Cohort Study (CBCS), encompassing 103,040 birth records up to December 2020. UHI exposure was estimated for each participant using a novel individual assessment method based on temperature data and satellite-derived land cover data. We used generalized linear mixed-effects models to estimate the association between UHI exposure and PTB, adjusting for potential confounders including maternal characteristics and environmental factors. Results: Consistent and statistically significant associations between UHI exposure and PTB were observed up to 21 days before birth. A 5 °C increment in UHI exposure was associated with 27 % higher risk (OR = 1.27, 95 % confident interval: 1.20, 1.34) of preterm birth in lagged day 1. Stratified analysis indicated that the associations were more pronounced in participants who were older, had higher pre-pregnancy body mass index level, of higher socioeconomic status and living in greener areas. Conclusion: Maternal exposure to UHI was associated with increased risk of PTB. These findings have implications for developing targeted interventions for susceptible subgroups of pregnant women. More research is needed to validate our findings of increased risk of preterm birth due to UHI exposure among pregnant women.
Keywords	Urban heat island ; Heat exposure ; Individual-level ; Preterm birth ; Environmental sciences ; GE1-350
Subject code	610
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Review of the Respiratory Health Burden Attributable to Short-Term Exposure to Pollen

Nur Sabrina Idrose / Caroline J. Lodge / Bircan Erbas / Jo A. Douglass / Dinh S. Bui / Shyamali C. Dharmage

International Journal of Environmental Research and Public Health, Vol 19, Iss 7541, p

2022 Volume 7541

Abstract: Respiratory diseases such as asthma, allergic rhinitis (AR) and chronic obstructive pulmonary disease (COPD) affect millions worldwide and pose a significant global public health burden. Over the years, changes in land use and climate have increased ... ...

Abstract	Respiratory diseases such as asthma, allergic rhinitis (AR) and chronic obstructive pulmonary disease (COPD) affect millions worldwide and pose a significant global public health burden. Over the years, changes in land use and climate have increased pollen quantity, allergenicity and duration of the pollen season, thus increasing its impact on respiratory disease. Many studies have investigated the associations between short-term ambient pollen (i.e., within days or weeks of exposure) and respiratory outcomes. Here, we reviewed the current evidence on the association between short-term outdoor pollen exposure and thunderstorm asthma (TA), asthma and COPD hospital presentations, general practice (GP) consultations, self-reported respiratory symptoms, lung function changes and their potential effect modifiers. The literature suggests strong evidence of an association between ambient pollen concentrations and almost all respiratory outcomes mentioned above, especially in people with pre-existing respiratory diseases. However, the evidence on sub-clinical lung function changes, COPD, and effect modifiers other than asthma, hay fever and pollen sensitisation are still scarce and requires further exploration. Better understanding of the implications of pollen on respiratory health can aid healthcare professionals to implement appropriate management strategies.
Keywords	asthma ; allergic rhinitis ; pollen ; COPD ; COVID ; respiratory health ; Medicine ; R
Subject code	333
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Longitudinal Sleep Study in Pregnancy

Chamara V. Senaratna / Nirmala Priyadarshanie / Sharaine Fernando / Sampatha Goonewardena / Pramodya Piyumanthi / Jennifer Perret / Caroline Lodge / Garun S. Hamilton / Shyamali C. Dharmage

International Journal of Environmental Research and Public Health, Vol 20, Iss 2070, p

Cohort Profile and Prevalence and Risk Factors for Sleep Symptoms in the First Trimester

2023 Volume 2070

Abstract: Sleep disorders could influence pregnancy outcomes but evidence for longitudinal associations is scarce. We established a prospective cohort of women to determine incident sleep issues and their adverse health outcomes during pregnancy and beyond, and ... ...

Abstract	Sleep disorders could influence pregnancy outcomes but evidence for longitudinal associations is scarce. We established a prospective cohort of women to determine incident sleep issues and their adverse health outcomes during pregnancy and beyond, and present here the baseline cohort profile. Antenatal women in gestational weeks 8–12 were recruited (n = 535) and followed-up in each trimester and at 5–6 weeks postpartum (no attrition). Sleep symptoms and disorders were measured using STOP-Bang and Berlin questionnaires and Pittsburgh Sleep Quality Index. Incident health outcomes were extracted from clinical records. At the time of recruitment, habitual snoring was present in 13.8% of participants; “excessive sleepiness during the day” (EDS) in 42.8%; short (<7 h) sleep duration in 46.4%; “having trouble sleeping” in 15.3%; and “poor subjective sleep quality” in 8.6%. Habitual snoring was strongly associated with irregular menstrual periods for one year preceding pregnancy ( p = 0.014) and higher BMI ( p < 0.001). Higher age was associated with less “trouble sleeping” (OR 0.9, p = 0.033) and longer sleep duration was associated with better “subjective sleep quality” (OR 0.8, p = 0.005). Sleep issues were highly prevalent at baseline and associated with age, irregular menstruation, and obesity. This cohort will provide a robust platform to investigate incident sleep disorders during pregnancy and their effects on adverse pregnancy outcomes and long-term health of women and their offspring.
Keywords	sleep ; sleep-disordered breathing ; sleep apnoea ; antenatal ; cohort ; incidence ; Medicine ; R
Subject code	150 ; 610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Undiagnosed and ‘overdiagnosed’ COPD using postbronchodilator spirometry in primary healthcare settings

E Haydn Walters / Michael J Abramson / Shyamali C Dharmage / Kerry Hancock / Jennifer Perret / Sui Wah Sean Yip / Nur Sabrina Idrose / Nilakshi Waidyatillake

BMJ Open Respiratory Research, Vol 10, Iss

a systematic review and meta-analysis

2023 Volume 1

Abstract: Background Despite chronic obstructive pulmonary disease (COPD) being a major global cause of mortality and hospitalisation, it is often undiagnosed or inaccurately diagnosed in clinical settings.Objective To systematically synthesise all peer-reviewed ... ...

Abstract	Background Despite chronic obstructive pulmonary disease (COPD) being a major global cause of mortality and hospitalisation, it is often undiagnosed or inaccurately diagnosed in clinical settings.Objective To systematically synthesise all peer-reviewed papers from primary healthcare settings that have reported data on: (1) undiagnosed COPD, that is, patients with respiratory symptoms and postbronchodilator airflow obstruction consistent with COPD, without a formal clinician’s diagnosis of COPD either documented in health records or reported by patients and (2) ‘overdiagnosed COPD’, that is, clinician’s diagnosis without postbronchodilator airflow obstruction.Methods Studies investigating these diagnostic metrics in patients from primary healthcare clinics (according to predefined inclusion/exclusion criteria) were sourced from Medline and Embase and assessed for bias (Johanna Briggs Institute tools for prevalence studies and case series). Meta-analyses of studies of adequate sample size used random effect modelling stratified by risk factor categories.Results Of 26 eligible articles, 21 cross-sectional studies investigated 3959 cases of spirometry-defined COPD (with or without symptoms), and 5 peer-reviewed COPD case series investigated 7381 patients. The prevalence of spirometry-confirmed COPD without a diagnosis documented in their health records was 14%–26% in studies of symptomatic smokers (N=3). 1 in 4 patients taking inhaled therapies (25% (95% CI 22% to 28%), N=2) and 1 in 6 smokers irrespective of symptoms (16% (95% CI 14% to 18%), N=6) fulfilled diagnostic spirometry criteria but did not report receiving a COPD-related diagnosis. In an adequately powered series of COPD cases documented in primary healthcare records (N=4), only between 50% and 75% of subjects had any airflow obstruction on postbronchodilator spirometry performed by study researchers, therefore, COPD was clinically ‘overdiagnosed’ in 25%–50% of subjects.Discussion Although data were heterogeneous and of modest quality, undiagnosed COPD ...
Keywords	Medicine ; R ; Diseases of the respiratory system ; RC705-779
Subject code	610
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Particulate Matter and Premature Mortality

Nilakshi T. Waidyatillake / Patricia T. Campbell / Don Vicendese / Shyamali C. Dharmage / Ariadna Curto / Mark Stevenson

International Journal of Environmental Research and Public Health, Vol 18, Iss 7655, p

A Bayesian Meta-Analysis

2021 Volume 7655

Abstract: Background: We present a systematic review of studies assessing the association between ambient particulate matter (PM) and premature mortality and the results of a Bayesian hierarchical meta-analysis while accounting for population differences of the ... ...

Abstract	Background: We present a systematic review of studies assessing the association between ambient particulate matter (PM) and premature mortality and the results of a Bayesian hierarchical meta-analysis while accounting for population differences of the included studies. Methods: The review protocol was registered in the PROSPERO systematic review registry. Medline, CINAHL and Global Health databases were systematically searched. Bayesian hierarchical meta-analysis was conducted using a non-informative prior to assess whether the regression coefficients differed across observations due to the heterogeneity among studies. Results: We identified 3248 records for title and abstract review, of which 309 underwent full text screening. Thirty-six studies were included, based on the inclusion criteria. Most of the studies were from China ( n = 14), India ( n = 6) and the USA ( n = 3). PM 2.5 was the most frequently reported pollutant. PM was estimated using modelling techniques (22 studies), satellite-based measures (four studies) and direct measurements (ten studies). Mortality data were sourced from country-specific mortality statistics for 17 studies, Global Burden of Disease data for 16 studies, WHO data for two studies and life tables for one study. Sixteen studies were included in the Bayesian hierarchical meta-analysis. The meta-analysis revealed that the annual estimate of premature mortality attributed to PM 2.5 was 253 per 1,000,000 population (95% CI: 90, 643) and 587 per 1,000,000 population (95% CI: 1, 39,746) for PM 10 . Conclusion: 253 premature deaths per million population are associated with exposure to ambient PM 2.5 . We observed an unstable estimate for PM 10 , most likely due to heterogeneity among the studies. Future research efforts should focus on the effects of ambient PM 10 and premature mortality, as well as include populations outside Asia. Key messages: Ambient PM 2.5 is associated with premature mortality. Given that rapid urbanization may increase this burden in the coming decades, our ...
Keywords	Bayesian hierarchical meta-analysis ; particulate matter ; PM 2.5 ; PM 10 ; premature mortality ; Medicine ; R
Subject code	310
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Diabetes in young adult men

Rachel L. Koelmeyer / Shyamali C. Dharmage / Dallas R. English

BMC Public Health, Vol 16, Iss S3, Pp 63-

social and health-related correlates

2016 Volume 69

Abstract: Abstract Background Diabetes is a global public health issue. It is associated with significant disability, morbidity and mortality risks and substantial healthcare costs. Of great concern is the fact that its prevalence is rising, particularly amongst ... ...

Abstract	Abstract Background Diabetes is a global public health issue. It is associated with significant disability, morbidity and mortality risks and substantial healthcare costs. Of great concern is the fact that its prevalence is rising, particularly amongst the young, while epidemiological data regarding the incidence, prevalence and complications of early-onset type 2 diabetes is noted to be sparse. Methods We used data from the baseline wave of Ten to Men, a national cohort study of Australian males, to investigate the social and health-related correlates of Australian males aged 18–49 years reporting being diagnosed with diabetes. Results The estimated prevalence of a self-reported diabetes diagnosis amongst Australian males aged 18–49 years was 2.95 % (95 % CI: 2.54–3.43 %). Within this age group, approximately 75 % of those diagnosed with diabetes are expected to be living with a known diagnosis of type 2 diabetes; the remainder are expected to be living with type 1 diabetes. Of the 20 social and health-related factors considered, we found evidence to support the association of eighteen factors after adjusting for age and body mass index. The strongest correlates of reporting a diabetes diagnosis, associated with a ≥2-fold increase in the odds of reporting diabetes were being aged 35–49 years, being unemployed, being obese, seeing a doctor for a check-up more frequently, reporting comorbid high blood pressure or physical or mental health comorbidities and worse self-rated and physical health status. Conclusion Australian males aged 18–49 years who are living with a known diagnosis of diabetes are more likely to be socio-economically disadvantaged and suffer substantially worse health status than Australian males aged 18–49 years living without a diabetes diagnosis. Based on the associations detected in this study, older, single males living in regional areas who are socioeconomically disadvantaged, obese and/or who have other comorbidities may be an important subgroup to target for diabetes screening, disease ...
Keywords	Diabetes Diagnosis ; Mental Component Score ; Personal Wellbeing Index ; Reporting Diabetes ; Mental Health Comorbidities ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2016-10-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Early Childhood Pneumonia Is Associated with Reduced Lung Function and Asthma in First Nations Australian Children and Young Adults

Andrew J. Collaro / Anne B. Chang / Julie M. Marchant / Mark D. Chatfield / Don Vicendese / Tamara L. Blake / Margaret S. McElrea / Shyamali C. Dharmage

Journal of Clinical Medicine, Vol 10, Iss 5727, p

2021 Volume 5727

Abstract: Background: Some but not all previous studies report that pneumonia in children aged less than five years is associated with lower lung function and elevated risk of respiratory disease. To date, none have explored these associations in at-risk ... ...

Abstract	Background: Some but not all previous studies report that pneumonia in children aged less than five years is associated with lower lung function and elevated risk of respiratory disease. To date, none have explored these associations in at-risk populations such as First Nations Australians, whose incidence of early childhood pneumonia is among the highest reported in the world. Methods: This cross-sectional study included 1276 First Nations Australian children/young adults aged 5–25 years recruited from regional/remote Queensland and Northern Territory communities and schools. Associations between pneumonia and both spirometry values and asthma were investigated using linear and logistic regression. Results: Early childhood pneumonia was associated with lower FEV1 and FVC Z-scores, but not FEV1/FVC% Z-scores, when occurring before age three (FEV1 β = −0.42, [95%CI −0.79, −0.04]; FVC β = −0.62, [95%CI −1.14, −0.09]), and between three and five years (β = −0.50, [95%CI −0.88, −0.12]; β = −0.63, [95%CI −1.17, −0.10]), compared to those who never had pneumonia. Similarly, pneumonia occurring when aged before age three years (OR = 3.68, 95%CI 1.96–6.93) and three to five years (OR = 4.81, 95%CI 1.46–15.8) was associated with increased risk of asthma in later childhood. Conclusions: Early childhood pneumonia is associated with lung function deficits and increased asthma risk in later childhood/early adulthood in First Nations Australians. The disproportionate impact of pneumonia on at-risk children must be addressed as a priority.
Keywords	pneumonia ; early childhood ; respiratory tract infection ; lrti ; spirometry ; Medicine ; R
Subject code	410
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Protein levels, air pollution and vitamin D deficiency

Yong Song / E. Haydn Walters / Michael J. Abramson / Gayan Bowatte / Dinh S. Bui / Jennifer Perret / Iain Feather / Luke D. Knibbs / Richard Wilson / David S. Nichols / Shyamali C. Dharmage / Graeme R. Zosky

ERJ Open Research, Vol 7, Iss

links with allergy

2021 Volume 4

Keywords	Medicine ; R
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	European Respiratory Society
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ambient PM 2.5 and PM 10 Exposure and Respiratory Disease Hospitalization in Kandy, Sri Lanka

Sajith Priyankara / Mahesh Senarathna / Rohan Jayaratne / Lidia Morawska / Sachith Abeysundara / Rohan Weerasooriya / Luke D. Knibbs / Shyamali C. Dharmage / Duminda Yasaratne / Gayan Bowatte

International Journal of Environmental Research and Public Health, Vol 18, Iss 9617, p

2021 Volume 9617

Abstract: Evidence of associations between exposure to ambient air pollution and health outcomes are sparse in the South Asian region due to limited air pollution exposure and quality health data. This study investigated the potential impacts of ambient ... ...

Abstract	Evidence of associations between exposure to ambient air pollution and health outcomes are sparse in the South Asian region due to limited air pollution exposure and quality health data. This study investigated the potential impacts of ambient particulate matter (PM) on respiratory disease hospitalization in Kandy, Sri Lanka for the year 2019. The Generalized Additive Model (GAM) was applied to estimate the short-term effect of ambient PM on respiratory disease hospitalization. As the second analysis, respiratory disease hospitalizations during two distinct air pollution periods were analyzed. Each 10 μg/m 3 increase in same-day exposure to PM 2.5 and PM 10 was associated with an increased risk of respiratory disease hospitalization by 1.95% (0.25, 3.67) and 1.63% (0.16, 3.12), respectively. The effect of PM 2.5 or PM 10 on asthma hospitalizations were 4.67% (1.23, 8.23) and 4.04% (1.06, 7.11), respectively ( p < 0.05). The 65+ years age group had a higher risk associated with PM 2.5 and PM 10 exposure and hospital admissions for all respiratory diseases on the same day (2.74% and 2.28%, respectively). Compared to the lower ambient air pollution period, higher increased hospital admissions were observed among those aged above 65 years, males, and COPD and pneumonia hospital admissions during the high ambient air pollution period. Active efforts are crucial to improve ambient air quality in this region to reduce the health effects.
Keywords	ambient particulate matter ; asthma ; COPD ; respiratory disease hospitalization ; generalized additive model ; Medicine ; R
Subject code	333
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Is asthma associated with COVID-19 infection? A UK Biobank analysis

Caroline J. Lodge / Alice Doherty / Dinh S. Bui / Raisa Cassim / Adrian J. Lowe / Alvar Agusti / Melissa A. Russell / Shyamali C. Dharmage

ERJ Open Research, Vol 7, Iss

2021 Volume 4

Abstract: Background The relationship between asthma and coronavirus disease 2019 (COVID-19) risk is not clear and may be influenced by level of airway obstruction, asthma medication and known COVID-19 risk factors. We aimed to investigate COVID-19 risk in people ... ...

Abstract	Background The relationship between asthma and coronavirus disease 2019 (COVID-19) risk is not clear and may be influenced by level of airway obstruction, asthma medication and known COVID-19 risk factors. We aimed to investigate COVID-19 risk in people with asthma. Methods We used UK Biobank data from all participants tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n=107 412; 17 979 test positive). Questions at baseline defined ever asthma and asthma medications. Baseline forced expiratory volume in 1 s (FEV1) was categorised into quartiles. Logistic regression modelled relationships between asthma, and asthma categories (age at onset, medications, FEV1 quartiles), and risk of SARS-CoV-2 positive test. We investigated modification by sex, ethnic group, smoking and body mass index. Results There was a reduced risk of a positive test associated with early-onset asthma (<13 years) (OR 0.91, 95% CI 0.84–0.99). This was found for participants with early-onset asthma who were male (OR 0.87, 95% CI 0.78–0.98), nonsmokers (OR 0.87, 95% CI 0.78–0.98), overweight/obese (OR 0.85, 95% CI 0.77–0.93) and non-Black (OR 0.90, 95% CI 0.82–0.98). There was increased risk amongst early-onset individuals with asthma in the highest compared to lowest quartile of lung function (1.44, 1.05–1.72). Conclusion Amongst male, nonsmoking, overweight/obese and non-Black participants, having early-onset asthma was associated with lower risk of a SARS-CoV-2 positive test. We found no evidence of a protective effect from asthma medication. Individuals with early-onset asthma of normal weight and with better lung function may have lifestyle differences placing them at higher risk. Further research is needed to elucidate the contribution of asthma pathophysiology and different health-related behaviour, across population groups, to the observed risks.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	European Respiratory Society
Document type	Article ; Online
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