Improving health through policies that promote active travel: a review of evidence to support integrated health impact assessment.

Background: Substantial policy changes to control obesity, limit chronic disease, and reduce air pollution emissions, including greenhouse gasses, have been recommended. Transportation and planning policies that promote active travel by walking and cycling can contribute to these goals, potentially yielding further co-benefits. Little is known, however, about the interconnections among effects of policies considered, including potential unintended consequences.

Water disinfection by-products and bladder cancer: is there a European specificity? A pooled and meta-analysis of European case-control studies.

Several epidemiological studies suggested an association between the risk of bladder cancer and the exposure to trihalomethanes (THMs), the main disinfection by-products (DBPs) of chlorinated water. A previous pooled analysis of case-control studies from North America and Europe estimated a summarized dose-response relation. For policy guidance of drinking water disinfection in Europe and because major differences exist in water disinfection practices and DBPs occurrence between both continents, specific risk estimates for bladder cancer in relation to DBPs exposure for European populations were needed.

Living near agricultural pesticide applications and the risk of adverse reproductive outcomes: a review of the literature.

Over the last decade, there has been growing concern about the possible health effects, including a number of adverse reproductive outcomes, from pesticide exposure of people living near agricultural fields. This systematic review evaluates the current epidemiological evidence on the association between living near agricultural pesticide applications and adverse reproductive outcomes, including congenital malformations, stillbirth, intrauterine growth retardation (IUGR), low birthweight, preterm birth and miscarriage. We identified and reviewed 25 studies from a systematic search of the main scientific databases and other sources published in 1950-2007.

Water consumption and use, trihalomethane exposure, and the risk of hypospadias.

Objectives: Hypospadias is a congenital anomaly that affects up to 70 in 10 000 males. Ingestion of drinking-water-disinfection byproducts such as trihalomethanes (THMs) has been associated with hypospadias in a small sample. We examined risk of hypospadias and exposure to THMs through water consumption and use.

Ambient air pollution and risk of congenital anomalies: a systematic review and meta-analysis.

Objective: We systematically reviewed epidemiologic studies on ambient air pollution and congenital anomalies and conducted meta-analyses for a number of air pollutant-anomaly combinations.

Data Sources And Extraction: From bibliographic searches we extracted 10 original epidemiologic studies that examined the association between congenital anomaly risk and concentrations of air pollutants. Meta-analyses were conducted if at least four studies published risk estimates for the same pollutant and anomaly group.

Exposure to brominated trihalomethanes in drinking water and reproductive outcomes.

Objectives: Exposure to disinfection by-products (DBPs) during pregnancy has been associated with adverse birth outcomes. We evaluated exposure to DBPs through ingestion, inhalation and dermal absorption among pregnant women in Crete, in relation to birth weight and gestational age.

Methods: The mother-child birth cohort in Crete ('Rhea' study) enrolled 1359 pregnant women at the third month of pregnancy (2007-2008), residents in the prefecture of Heraklion.

Swimming pool attendance, asthma, allergies, and lung function in the Avon Longitudinal Study of Parents and Children cohort.

Rationale: Cross-sectional studies have reported inconsistent findings for the association between recreational swimming pool attendance and asthma and allergic diseases in childhood.

Objectives: To examine whether swimming in infancy and childhood was associated with asthma and allergic symptoms at age 7 and 10 years in a UK longitudinal population-based birth cohort, the Avon Longitudinal Study of Parents and Children.

Methods: Data on swimming were collected by questionnaire at 6, 18, 38, 42, 57, 65, and 81 months.

Short-term changes in respiratory biomarkers after swimming in a chlorinated pool.

Background: Swimming in chlorinated pools involves exposure to disinfection by-products (DBPs) and has been associated with impaired respiratory health.

Objectives: We evaluated short-term changes in several respiratory biomarkers to explore mechanisms of potential lung damage related to swimming pool exposure.

Methods: We measured lung function and biomarkers of airway inflammation [fractional exhaled nitric oxide (FeNO), eight cytokines, and vascular endothelial growth factor (VEGF) in exhaled breath condensate], oxidative stress (8-isoprostane in exhaled breath condensate), and lung permeability [surfactant protein D (SP-D) and the Clara cell secretory protein (CC16) in serum] in 48 healthy nonsmoking adults before and after they swam for 40 min in a chlorinated indoor swimming pool.

Genotoxic effects in swimmers exposed to disinfection by-products in indoor swimming pools.

Background: Exposure to disinfection by-products (DBPs) in drinking water has been associated with cancer risk. A recent study (Villanueva et al. 2007; Am J Epidemiol 165:148-156) found an increased bladder cancer risk among subjects attending swimming pools relative to those not attending.

Patterns of water use and exposure to trihalomethanes among children in Spain.

Few studies characterizing trihalomethane (THM) exposure or examining potential health effects were conducted in children. The present study describes patterns of water use in children as a source of THM exposure, and estimates the daily THM uptake and the relative contribution of each pathway of exposure. A cross-sectional population-based study was conducted in children 9-12 years of age in Sabadell, Catalonia, Spain (N=2037).

Exposure to disinfection by-products, fetal growth, and prematurity: a systematic review and meta-analysis.

Background: Exposure to total trihalomethanes in drinking water has been associated with several adverse birth outcomes relating to fetal growth and prematurity.

Methods: We carried out a systematic review and meta-analysis of epidemiologic studies featuring original peer-reviewed data on the association of total trihalomethane exposure and health outcomes related to fetal growth and prematurity.

Results: A comprehensive literature search yielded 37 studies, 15 of which were selected for the extraction of relative risks relating adverse birth outcomes to trihalomethane exposure.

Ambient particulate matter and preterm birth or birth weight: a review of the literature.

To review epidemiologic evidence on maternal exposure to particulate matter and adverse pregnancy outcomes, we performed a MEDLINE search of the literature up to June 2009. We considered all original studies published in English including information on total suspended particles (TSP), respirable (PM(10)) or fine (PM(2.5)) particles and the risk of preterm birth, low birth weight (LBW) or very low birth weight (VLBW) and small for gestational age (SGA).

Tap water use amongst pregnant women in a multi-ethnic cohort.

Background: Studies of disinfection by-products in drinking water and measures of adverse fetal growth have often been limited by exposure assessment lacking data on individual water use, and therefore failing to reflect individual variation in DBP exposure.

Methods: Pregnant women recruited to the Born in Bradford cohort study completed a questionnaire which covers water exposure. Information was collected on water consumption, showering, bathing and swimming.

Prenatal exposure to traffic-related air pollution and ultrasound measures of fetal growth in the INMA Sabadell cohort.

Background: Few studies have used longitudinal ultrasound measurements to assess the effect of traffic-related air pollution on fetal growth.

Objective: We examined the relationship between exposure to nitrogen dioxide (NO2) and aromatic hydrocarbons [benzene, toluene, ethylbenzene, m/p-xylene, and o-xylene (BTEX)] on fetal growth assessed by 1,692 ultrasound measurements among 562 pregnant women from the Sabadell cohort of the Spanish INMA (Environment and Childhood) study.

Methods: We used temporally adjusted land-use regression models to estimate exposures to NO2 and BTEX.

Chlorination disinfection by-products in drinking water and congenital anomalies: review and meta-analyses.

Objectives: The aim of this study was to review epidemiologic evidence, provide summary risk estimates of the association between exposure to chlorination disinfection by-products (DBPs) and congenital anomalies, and provide recommendations for future studies.

Data Sources And Extraction: We included all published epidemiologic studies that evaluated a relationship between an index of DBP exposure (treatment, water source, DBP measurements, and both DBP measurements and personal characteristics) and risk of congenital anomalies. When three or more studies examined the same exposure index and congenital anomaly, we conducted a meta-analysis to obtain a summary risk estimate comparing the highest exposure group with the lowest exposure group.

Use of biocides and insect repellents and risk of hypospadias.

Background: The relationship between the use of biocides and insect repellents and the risk of hypospadias was examined in a large case-control study in the South East of England.

Methods: A case-control study was carried out among 471 cases of hypospadias referred to surgeons, and 490 randomly selected population-based controls, born between 1 January 1997 and 30 September 1998. Telephone interviews were conducted between September 2000 and March 2003.

The epidemiology and possible mechanisms of disinfection by-products in drinking water.

This paper summarizes the epidemiological evidence for adverse health effects associated with disinfection by-products (DBPs) in drinking water and describes the potential mechanism of action. There appears to be good epidemiological evidence for a relationship between exposure to DBPs, as measured by trihalomethanes (THMs), in drinking water and bladder cancer, but the evidence for other cancers including colorectal cancer is inconclusive and inconsistent. There appears to be some evidence for an association between exposure to DBPs, specifically THMs, and little for gestational age/intrauterine growth retardation and, to a lesser extent, pre-term delivery, but evidence for relationships with other outcomes such as low birth weight, stillbirth, congenital anomalies and semen quality is inconclusive and inconsistent.

Determinants of personal exposure to PM2.5, ultrafine particle counts, and CO in a transport microenvironment.

Short-term human exposure concentrations to PM2.5, ultrafine particle counts (particle range: 0.02-1 microm), and carbon monoxide (CO) were investigated at and around a street canyon intersection in Central London, UK.

Association between GIS-based exposure to urban air pollution during pregnancy and birth weight in the INMA Sabadell Cohort.

Background: There is growing evidence that traffic-related air pollution reduces birth weight. Improving exposure assessment is a key issue to advance in this research area.

Objective: We investigated the effect of prenatal exposure to traffic-related air pollution via geographic information system (GIS) models on birth weight in 570 newborns from the INMA (Environment and Childhood) Sabadell cohort.

A comparison of the role of two blue-green algae in THM and HAA formation.

The contribution of two blue-green algae species, Anabaena flos-aquae and Microcystis aeruginosa, to the formation of trihalomethanes (THMs) and haloacetic acids (HAAs) was investigated. The experiments examined the formation potential of these disinfection by-products (DBPs) from both algae cells and extracellular organic matter (EOM) during four algal growth phases. Algal cells and EOM of Anabaena and Microcystis exhibited a high potential for DBP formation.

Health effects of real-world exposure to diesel exhaust in persons with asthma.

Many people, including people with asthma, experience short-term exposure to diesel exhaust (DE*) during daily activities. The health effects of such exposures, however, remain poorly understood. The present study utilized a real-world setting to examine whether short-term DE exposure would (1) worsen asthma symptoms, (2) augment airway inflammation, or (3) increase oxidative stress burdens.

Swimming pool attendance and risk of asthma and allergic symptoms in children.

Increased asthma risk has been associated with pool attendance in children but evidence is inconsistent and inconclusive. A survey was conducted of 3,223 9-12-yr-old children in Sabadell (Spain) to evaluate association between swimming pool attendance and prevalence of asthma and allergic conditions and symptoms. Parents completed a questionnaire on lifetime frequency of pool attendance and symptoms in the last 12 months (wheezing, asthma medication, rhinitis and allergic rhinitis), ever having asthma and eczema, and potential confounders.

Childhood asthma and environmental exposures at swimming pools: state of the science and research recommendations.

Objectives: Recent studies have explored the potential for swimming pool disinfection by-products (DBPs), which are respiratory irritants, to cause asthma in young children. Here we describe the state of the science on methods for understanding children's exposure to DBPs and biologics at swimming pools and associations with new-onset childhood asthma and recommend a research agenda to improve our understanding of this issue.

Data Sources: A workshop was held in Leuven, Belgium, 21-23 August 2007, to evaluate the literature and to develop a research agenda to better understand children's exposures in the swimming pool environment and their potential associations with new-onset asthma.