Jing Li

Background: Arteriosclerosis (AS) and knee osteoarthritis (KOA) pose a major public health challenge, yet evidence linking diet quality to the risk of comorbidity among Chinese occupational groups remains limited. This cross-sectional occupational study examined the association between diet quality indicators and the co-occurrence of AS and KOA among 1538 iron workers from Shougang Group. Methods: Dietary data were collected using the Diet Quality Questionnaire (DQQ) for China. Multivariable logistic regression models were performed with adjustment for relevant covariates. Results: Overall, 627 workers had co-occurrence of AS and KOA, including 579 men and 48 women. Among women, a higher continuous Global Dietary Recommendations (GDR) score was inversely associated with the odds of co-occurrence (OR = 0.75; 95% CI = 0.62–0.91). Compared with a GDR score ≤ −3, a GDR score ≥ 1 was also inversely associated with co-occurrence among women (OR = 0.13; 95% CI = 0.02–0.77); however, no statistically significant associations were observed among men or in the age- and BMI-stratified analyses. Conclusion: These findings provide preliminary evidence of an inverse association between diet quality and AS–KOA co-occurrence among female workers but should be considered exploratory, requiring confirmation in larger prospective studies.

Background: Mental disorders contribute significantly to the global disease burden, with marked regional variations. This study provides the most up-to-date assessment of trends in the burden of mental disorders worldwide and in China and compares the burden of mental disorders between China and other regions. Methods: We conducted a descriptive secondary analysis of publicly available estimates from the updated Global Burden of Disease Study 2023 (GBD 2023) for the period 1990–2023, covering the 6 World Health Organization (WHO) regions and China. We summarized prevalence, disability-adjusted life years (DALYs), age-standardized prevalence rates (ASPRs), and age-standardized DALY rates (ASDRs) by year, region, age, and sex. Future trends were projected using a Bayesian age–period–cohort model with second-order random-walk priors, and uncertainty was described using 95% uncertainty or credible intervals. Results: In 2023, 1171.64 million people suffered from mental disorders globally, resulting in 171.27 million DALYs. China accounted for 16.32% of global cases and 15.39% of global DALYs, ranking second worldwide for both measures. In China, mental disorders were the fourth leading cause of DALYs. Among these, anxiety and depressive disorders were the most prevalent and the leading contributors to the burden. From 2010 to 2023, the ASDR increased by 16.18%, with the largest increase in anxiety disorders (38.37%), eating disorders (21.84%), and autism spectrum disorders (ASDs, 21.20%). Anxiety and depressive disorders were more prevalent in females, whereas attention-deficit/hyperactivity disorder (ADHD), ASDs, and conduct disorders were more prevalent in males. Although the burden was concentrated on older adults, notable increases were also observed among young people. By 2035, the numbers of mental disorder cases and associated DALYs in China are projected to reach 209.6 million and 28.7 million, respectively. Conclusions: China faces a growing burden of mental health issues, particularly anxiety disorders, eating disorders, and ASD. Immediate development and implementation of comprehensive strategies are crucial to address the escalating mental health crisis in China.

Background/Objectives: The association between sleep deprivation and mental well-being in school-aged children and adolescents has been well documented, but the specific relationship between sleep debt and mental well-being remains unclear. This study aimed to evaluate the association between sleep debt and mental well-being in school-aged children and adolescents. Methods: This cross-sectional study included 4967 children and adolescents aged 9–18 years from eight provincial-level regions in China, using data from a multicenter school-based survey conducted within the framework of the Chinese National Survey on Students’ Constitution and Health (CNSSCH). Participants self-reported relevant sleep parameters, and the sleep debt was calculated based on the difference in sleep duration between weekdays and weekends. The main outcome was mental well-being. Adjusted covariates were age, sex, urban–rural residence, body mass index (BMI), vital capacity, and waist-to-hip ratio. Results: A total of 4967 children and adolescents were included (mean [SD] age 12.77 [2.59] years; 2475 [49.83%] girls) with 3176 participants classified as having higher mental well-being and 1791 participants classified as having lower mental well-being. After adjustment for covariates, sleep debt was associated with greater odds of lower mental well-being (adjusted odds ratio [aOR] = 1.095; 95% CI, 1.050–1.143; p < 0.001). Although statistically significant, the magnitude of this association was modest. In stratified analyses, each quartile increase in sleep debt was associated with 17.8% higher odds of lower mental well-being in boys (95% CI, 8.6–27.8%), 33.8% higher odds in girls (95% CI, 23.8–44.6%), 25.3% higher odds in urban students (95% CI, 16.3–35.0%), and 28.2% higher odds in rural students (95% CI, 17.6–39.7%) (all p < 0.001). In addition, weekend sleep patterns significantly interacted with the sleep debt–mental well-being association (p for interaction < 0.05), while age-specific nonlinear patterns involving nap duration were observed among adolescents aged 15–17 years (p for nonlinearity = 0.004). Conclusions: Sleep debt showed a statistically significant but modest cross-sectional association with lower mental well-being. Numerically larger subgroup-specific estimates were observed among girls and rural students. Given the cross-sectional design, these findings should not be interpreted as evidence of causality. Despite its modest magnitude, the association may have public health relevance at the population level. The observed patterns involving weekend sleep and age-specific nap duration warrant further evaluation in longitudinal and, where appropriate, intervention studies.

Systematic investigations of biological development trajectories among ethnic minority adolescent populations are crucial for advancing health equity within the context of the Sustainable Development Goals [1,2]. Age at menarche (AAM) is a widely used marker of female pubertal development and is associated with socioeconomic, nutritional, environmental, and broader ecological conditions [3,4]. Long-term declines in AAM […]

Background Under-5 deaths remain concentrated in low-income and middle-income countries (LMICs), many of which are susceptible to photochemical oxidant pollution but lack sufficient ground-based monitoring. However, the effects of broader photochemical oxidant pollution beyond ozone alone on vulnerable children have not been sufficiently studied. We aimed to evaluate the association between prenatal photochemical oxidant pollution indicated by satellite-derived formaldehyde (HCHO) columns and under-5 mortality in LMICs, and to estimate the attributable burden. Methods We linked birth histories for 1·42 million children from Demographic and Health Surveys in 43 LMICs with OMI satellite-derived HCHO columns. Associations between prenatal HCHO-indicated photochemical oxidant pollution and under-5 mortality (U5M) were estimated using a fixed-effects Cox model. We derived a spline-based exposure–response function and applied it to gridded HCHO and under-5 mortality data for 100 LMICs to estimate HCHO-attributable U5M from 2005 to 2023. Robustness was assessed by additionally adjusting for ozone, biomass burning and solar radiation, and effect modification by temperature was examined. Findings The fixed-effects Cox model showed a robust association, with each 1 × 10¹⁵ molecules/cm² increase in prenatal HCHO column associated with higher U5M risk (hazard ratio 1·030, 95% CI 1·022–1·038). The association was strongest during the early-life period spanning pregnancy and the first year of life and intensified at higher temperatures. IQR-standardised analyses showed a stronger association for HCHO columns than for ozone. The non-linear exposure–response function indicated an overall positive association across the observed HCHO distribution. Using this function, we estimated that the HCHO-attributable fraction of U5M across 100 LMICs increased from 2·46% (95% UI 1·58–3·30) in 2005 to 5·35% (3·43–7·18) in 2023. Sub-Saharan Africa carried the heaviest absolute burden and the highest HCHO-attributable U5M rate per 1000 live births, whereas Central and South Asia showed the steepest relative increase. At the country level, Nigeria remained the leading contributor to attributable deaths and India rose from seventh to second place. Interpretation Prenatal exposure to HCHO-related photochemical oxidant pollution was associated with increased U5M in LMICs, with a growing attributable burden. These findings suggest that broader photochemical oxidant pollution beyond ozone alone may be an important child-health risk. Strengthened control of photochemical pollution and its precursors, supported by satellite-based surveillance, could help protect child survival in high-burden settings with limited ground-based monitoring.

Gasoline evaporation is a significant source of urban volatile organic compounds (VOCs). In this study, we selected Nanjing, a major city in the Yangtze River Delta of China, and developed a high-resolution (1 km × 1 km) gridded VOC species emission inventory for gas stations based on measured VOC emission characteristics and statistical data on gasoline and diesel sales. The results show that VOC emissions from gas stations were correlated with population density and road networks, and were mainly concentrated in the downtown area. The emitted VOCs were dominated by alkanes (58%) and oxygenated VOCs (19%), with i-pentane, n-butane, and methyl tert-butyl ether (MTBE) as the major components. C4–C5 alkenes were identified as the key contributors to ozone (O₃) formation, while aromatics contributed most to secondary organic aerosol (SOA) formation. Health risk assessment indicates that, for gas station workers, both carcinogenic and non-carcinogenic risks associated with gasoline and diesel VOC evaporation exceed acceptable thresholds. Benzene, 1,2-dichloroethane, and 1,2-dibromoethane posed the highest carcinogenic risks, whereas acrolein, benzene, and 1,3-butadiene contributed most to non-carcinogenic risks. For urban residents, the health risks from gas station VOC emissions were generally within acceptable levels; however, under unfavorable meteorological conditions, residents living near gas stations may still face elevated health risks. This study highlights the significant impacts of gas station-related VOC emissions on air quality and human health, and informs targeted control and mitigation strategies for gasoline evaporation.

Environmental toxicants may affect the height of children and adolescents. However, studies on the toxicological effects based on extensive internal exposure omics are still lacking. This study aimed to identify key toxicants associated with height and assess the mediating role of sex steroid hormones. To this end 1660 participants aged 6–19 years from subsample A in the National Health and Nutrition Examination Survey (NHANES) were included. Exposome was characterized by 58 toxicants within 12 families. After assessment by the exposome-wide association analysis and mixture models, we identified 17 toxicants inversely associated with height-for-age Z-scores (HAZ), predominantly metals and volatile organic compound (VOC) metabolites. Tin exhibited the strongest inverse association (β = −0.261), followed by lead (β = −0.230). The primary contributors to reduced height included tin, lead, the VOC metabolite 2-ATCA, ethylene oxide, and nitrate. Notably, males and younger children were the more susceptible subgroups. Furthermore, mediation analysis revealed that sex steroid hormones, particularly total testosterone and estradiol, mediated 8% to 37% of the associations. These findings suggest that endocrine-related pathways may link toxicant exposure to impaired linear growth, highlighting the necessity of reducing exposure during childhood.

Benzene is a common urban air pollutant with potential neurotoxicity, yet the health effects of long‐term, low‐level ambient exposure and the underlying mechanisms remain poorly characterized. Here, we used data from 288,180 UK Biobank (UKB) participants to investigate associations between benzene exposure and brain disorders as well as related genetic susceptibility and potential protein‐mediated mechanisms. We found that benzene exposure was significantly associated with seven brain disorders, including anxiety disorders, dementia, epilepsy, major depressive disorder, migraine, sleep disorders, and schizophrenia spectrum disorders. Greater genetic susceptibility to benzene exposure was most apparent for epilepsy, migraine, sleep disorder, and schizophrenia spectrum disorders. Pathway‐level mediation analyses identified 40 pathways that may mediate the associations between benzene exposure and brain disorders, converging on pathways regulating cell survival and apoptosis, immune‐inflammatory signaling, cellular stress responses, and cell–cell or cell–matrix interactions, highlighting coordinated disruptions in cellular homeostasis and immune regulation. Overall, our findings suggest that even low‐level ambient benzene exposure may be linked to adverse brain health through multiple potential biological pathways, highlighting the need for further studies in diverse exposure settings, including rural populations with potentially higher benzene exposure.

Objectives: This study aimed to investigate the impact of the food environment surrounding schools on nutritional status and body mass index (BMI) of children and adolescents, offering insights for developing evidence-based policies to promote healthier school surroundings. Methods: Based on 357,782 physical examination records from 140,578 children and adolescents aged 6 to 19 in the Shenzhen Student Health Surveillance System for the 2018–2025 academic years, this study employed latent class mixed models to analyze BMI Z-score trajectory changes among children and adolescents. Furthermore, multinomial logistic regression and logistic regression models were utilized to examine the association between the number of catering points of interest (POIs) near schools, including total number, fast-food restaurants, pastry shops, and beverage stores, and the nutritional status and BMI trajectories of children and adolescents, respectively. Data from Huairou District, Beijing, was used to verify the applicability of the findings in Northern China. Results: 20.71% of children and adolescents in Shenzhen were overweight or obese, and 44.70% were consistently overweight from 2018 to 2025. The increase in catering POIs around schools was significantly associated with nutritional status and overweight trajectory, with pastry shops having a particularly pronounced effect. Each interquartile range (IQR) change in pastry shop was associated with 4.25% (95% CI: 2.96%, 5.56%) increase in the odds of overweight compared with the normal nutritional group, and with 5.03% (95% CI: 3.62%, 6.45%) increase in the odds of the overweight trajectory compared with the normal weight trajectory. Moreover, schools in above-median GDP regions required more attention. A similar association between the number of catering POIs near schools and long-term overweight among children and adolescents was observed in Huairou District, Beijing. Conclusions: The food environment surrounding schools might play a contributory role in shaping the BMI trajectories of children and adolescents. The study emphasized the importance of focusing on the food environment near schools, providing insights for weight management interventions among children and adolescents as well as healthy urban planning.