Yang Zhou

Background: There is growing interest in the joint effects of hazardous trace elements (HTEs) on lung function deficits, but the data are limited. This is a critical research gap given increased global industrialisation.Methods: A national cross-sectional study including spirometry was performed among 2112 adults across 11 provinces in China between 2020 and 2021. A total of 27 HTEs were quantified from urine samples. Generalised linear models and quantile-based g-computation were used to explore the individual and joint effects of urinary HTEs on lung function, respectively.Results: Overall, there were negative associations between forced expiratory volume in 1 s (FEV₁) and urinary arsenic (As) (z-score coefficient, −0.150; 95% CI, −0.262 to –0.038 per 1 ln-unit increase), barium (Ba) (−0.148, 95% CI: −0.258 to –0.039), cadmium (Cd) (−0.132, 95% CI: −0.236 to –0.028), thallium (Tl) (−0.137, 95% CI: −0.257 to –0.018), strontium (Sr) (−0.147, 95% CI: −0.273 to –0.022) and lead (Pb) (−0.121, 95% CI: −0.219 to –0.023). Similar results were observed for forced vital capacity (FVC) with urinary As, Ba and Pb and FEV₁/FVC with titanium (Ti), As, Sr, Cd, Tl and Pb. We found borderline associations between the ln-quartile of joint HTEs and decreased FEV₁(−20 mL, 95% CI: −48 to +8) and FVC (−14 mL, 95% CI: −49 to+2). Ba and Ti were assigned the largest negative weights for FEV₁and FVC within the model, respectively.Conclusion: Our study investigating a wide range of HTEs in a highly polluted setting suggests that higher urinary HTE concentrations are associated with lower lung function, especially for emerging Ti and Ba, which need to be monitored or regulated to improve lung health.

Introduction: There is growing interest in the impact of greenness exposure on airway diseases, but the impact of greenness on lung function in children is limited. We aimed to investigate the associations between greenness surrounding schools and lung function in children and whether these associations are modified by air pollution exposure. Methods: Between 2012 and 2013, a cross-sectional survey and spirometry were performed among 6740 school children. Lung function patterns were determined as obstructive forced expiratory volume 1 s/forced vital capacity (FEV ₁ /FVC 1 /FVC ≥0.8 but FVC 1 (+57 mL 95% CI 44 to 70) and FVC (+58 mL 95% CI 43 to 73). NDVI was similarly associated with 25% reduced odds of spirometric restriction (OR: 0.75, 95% CI 0.65 to 0.86). However, among children exposed to the highest compared with the lowest quartile of particulate matter, increasing NDVI was paradoxically associated with lower −40 mL FVC (95% CI −47 to –33, p interaction <0.05). Discussion: Our findings suggest that, in this study population, greening urban areas may promote lung health in low–moderate pollution areas but not in high air pollution areas. If the findings are replicated in other moderate-to-high pollution settings, this highlights a need to have a flexible green policy.