Yaqi Wang

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.

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.

Over the past decade, the previously declining trend in coronary heart disease burden has reversed, particularly among younger adults. Using an exposure-wide association study with data from 394,579 UK Biobank participants, we examined the relationship between 213 modifiable factors across eight domains and coronary heart disease. Weighted domain scores were calculated to assess the combined effects of these factors and their interactions with genetic risk. We identified 155 modifiable factors associated with coronary heart disease, 31 of which showed evidence of causality. The major contributors are health and medical history (15.75%), including diabetes mellitus; blood assays (13.87%), including cystatin C; lifestyle factors (10.01%), including time spent watching television; and physical measures (8.70%), including systolic blood pressure. We estimate that 40% to 62% of cases could be prevented by modifying these factors, which have a stronger effect on younger populations. These findings underscore the importance of early and comprehensive prevention strategies.

Despite spending a substantial proportion of their time indoors, the mental health effects of indoor air pollution on children and adolescents remain inadequately explored. This study aimed to elucidate the spatiotemporal variations and sociodemographic inequalities in exposure to multiple indoor pollutants and to assess their potential associations with depressive symptoms among school-aged children in Beijing. Using real-time portable monitors, concentrations of fine particulate matter (PM_2.5), coarse particulate matter (PM₁₀), carbon dioxide (CO₂), formaldehyde (HCHO), total volatile organic compounds (TVOC), temperature, and humidity in classrooms and bedrooms were measured during both weekdays and weekends. Moreover, substantial spatiotemporal heterogeneity was observed. It was found that concentrations of PM_2.5, PM₁₀, and TVOC peaked in classrooms during weekday daytime, while CO₂ levels were highest in bedrooms on weekend nights. Exposure levels were notably higher among children whose mothers had lower educational attainment and those living in recently renovated homes, indicating marked socio-demographic disparities. In multivariable logistic regression models, indoor exposure to CO₂ and TVOC was significantly associated with increased odds of depressive symptoms. These findings highlight the critical need to improve indoor air quality through enhanced ventilation and the mitigation of emissions from indoor sources, particularly within school and residential settings. The results offer valuable empirical evidence to guide the development of targeted environmental interventions and public health policies designed to support and enhance the psychological well-being of children.

The relevance of O₃ exposure in critical congenital heart disease (CCHD) remains uncertain and requires further investigation. The present study aims at quantitatively assessing the association between ambient O₃ exposure during the early pregnancy period with fetal CCHD and identifying possible susceptible exposure windows. A retrospective cohort study involving 24,516 pregnant women was conducted using data from the Maternal–Fetal Medicine Consultation Network, which encompassed 1313 medical centers across China from 2013 to 2021. We extracted daily O₃ concentrations from a validated grid dataset with a spatial resolution of 0.1° at each participant’s residential county to assess ambient O₃ exposure, followed by calculating the average exposure levels in the periconceptional period, embryonic period, first trimester, and preconception period. The diagnosis of CCHD was based on fetal echocardiography. Exposure–response analyses were carried out using logistic regression models. During the study period, a total of 1541 (17.4%) subjects were diagnosed with fetal CCHD. Each 10 µg/m³ increase in ambient O₃ exposure in the periconceptional period was associated with a 26.0% increase in the odds of CCHD (odds ratio [OR]: 1.260, 95% confidence interval [CI]: 1.189, 1.335; p < 0.001). Importantly, the association was not modified by factors including maternal age and occupation status, paternal age and smoking status, conception mode, and the presence of risk factors. In the sensitivity analysis, significant associations were observed between O₃ exposure and CCHD in the embryonic period, first trimester, and preconception period, which was consistent with the results of the main analyses. These findings suggest that lowering ambient O₃ exposure in the preconception and early pregnancy periods may be beneficial in reducing the risk of fetal CCHD, especially in regions with elevated O₃ levels.

Despite growing concern, there is limited comprehensive and up-to-date research on the burden, disparities, and inequalities of depressive disorders in the Western Pacific region. We obtained data from the Global Burden of Disease Study (GBD; 2021) for the Western Pacific region. We reported the prevalence and disability-adjusted life years (DALYs) rates of depressive disorders from 1990 to 2021. Our results showed that the prevalence of depressive disorders in the Western Pacific region was 1723.1 per 100,000 people (95% UI: 1359.2–2164.9), contributing to 1057.3 DALYs per 100,000 (95% UI: 683.0–1551.8). From 1990 to 2021, the burden of depressive disorders initially decreased but then increased, with Japan, Malaysia, and South Korea seeing the most significant rise. The burden grew with age, especially in the 10–14 age group, and exhibited significant sex disparities, especially in this age group. Among 31 countries, those with higher UHC scored had higher prevalence rates, but the gap between high- and low-UHC countries has decreased over time, indicating that countries with lower UHC might face greater challenges in the future. Our results highlight the differences in burden by sex and age call for targeted policies and interventions to promote youth mental health. Accelerating universal health coverage could be a key strategy to further reduce this high burden.

The concurrent rise in multiple health conditions among students, including myopia, obesity, spinal curvature abnormalities, and mental health disorders, represents a critical public health challenge. These interconnected health issues necessitate comprehensive prevention strategies that simultaneously address multiple conditions through synchronized behavioral and environmental interventions. In response to this need, the National Disease Control and Prevention Administration issued the Technical Guidelines for Co-Prevention of Common Diseases in Students on 30 April 2024, marking a significant advancement in China’s student health protection initiatives. The guidelines establish three core strategic priorities: enhancing surveillance of shared risk factors, implementing a systematic tiered approach to public health interventions, and developing an integrated, multisector prevention framework. This evidence-based, comprehensive initiative provides practical solutions for preventing comorbidities and enhancing overall student health outcomes. Further research is warranted to assess long-term effectiveness, explore regional implementation challenges, and support the development of standardized monitoring and evaluation systems.

The synergistic pollution of fine particulate matter (PM_2.5) and ozone (O₃) has become one of the major factors affecting ambient air quality. Due to the unique geographical location of the Sichuan Basin, air pollution is more likely to occur. To assess the synergistic pollution status of PM_2.5 and O₃ in the Sichuan Basin, this study analyzed time series analysis, correlation analysis, and interaction analysis of PM_2.5 and O₃ based on hourly data from national monitoring stations in the Sichuan Basin from 2015 to 2024. Additionally, the approximate envelope method (AEM) was used to estimate the secondary PM_2.5 concentration. The results showed the following: Chongqing, Zigong, Luzhou, Chengdu, and Deyang experienced severe pollution. From 2015 to 2018, these cities showed high pollution levels. Since 2019, such high levels of pollution have not been observed; during the PM_2.5 pollution period (November to January of the following year), PM_2.5 and O₃-8h exhibited a negative correlation. During the O₃-8 pollution period (May to August), PM_2.5 and O₃-8h showed a positive correlation; secondary PM_2.5 increased with the intensity of photochemical reactions, while the concentration of primary PM_2.5 showed little change compared to secondary PM_2.5. Secondary PM_2.5 concentrations peaked around 8:00–12:00 and reached a trough between 16:00 and 20:00 in all five cities; during the PM_2.5 pollution period, the trend of O₃ in the five cities was consistent. Ozone concentration showed a distinct single-peak daily variation under different PM_2.5 pollution levels. As PM_2.5 concentration increased, the peak O₃ concentration decreased, and the valley concentration became lower. In different seasons, the increase in PM_2.5 concentration can both enhance and suppress the concentration of O₃. The enhanced atmospheric photochemical activity level promotes the formation of secondary components in particles. This achievement can provide a reference for the coordinated control and improvement of air quality in the Sichuan Basin.

Ozone pollution in Hangzhou Bay, one of the seven petrochemical clusters in China, is severe. Early ozone pollution has been detected recently, such as the maximum daily 8 h average (MDA8) ozone concentration in Jiaxing achieving 171.0 μg/m³ on 7 March 2023. Satellites have observed tropospheric column concentrations of ozone precursors formaldehyde (HCHO) and nitrogen dioxide (NO_x), and quantitative models are proposed to reveal the causes of the early onset of ozone pollution. VOC-limited and transitional regimes dominate most areas in Hangzhou Bay, and NO_x-limited regimes dominate the region around Hangzhou Bay, such as northeastern Jiangsu Province. Results show that HCHO column concentrations are increasing in VOC-limited regions, and NO_x column concentrations are increasing more rapidly than HCHO in NO_x-limited regions. According to multivariate linear regression (MLR), early spring ozone pollution in Hangzhou Bay is mainly caused by meteorological drivers. Hangzhou Bay has formed an atmospheric meteorological environment with high temperature and low humidity. The richer solar radiation intensifies the photochemical reactions associated with tropospheric ozone formation, producing more tropospheric ozone. Based on the Shapley Additive Explanation (SHAP) algorithm, ozone pollution increases when solar radiation exceeds 12 million J/m² and is accompanied by high temperatures. Overall, reducing VOC emissions helps to mitigate ozone growth in Shanghai and northern Hangzhou Bay, while reducing NO_x emissions is more effective in northeastern Jiangsu Province.