RESEARCH ARTICLE
Associations of air pollution with peripheral inflammation and cardiac autonomic physiology in children
Anna M. Parenteau,
Nicholas V. Alen, Jennifer La,
Alison T. Luck, Devin J. Teichrow,
Enya M. Daang,
Adam T. Nissen,
LillyBelle K. Deer, Camelia E. Hostinar,
Anna M. Parenteau
University of California-Davis, Davis, California, USA
Search for more papers by this authorJennifer La
University of California-San Francisco, San Francisco, California, USA
Search for more papers by this authorDevin J. Teichrow
University of California-Davis, Davis, California, USA
Search for more papers by this authorEnya M. Daang
University of California-Davis, Davis, California, USA
Search for more papers by this authorAdam T. Nissen
University of California-Davis, Davis, California, USA
Search for more papers by this authorCorresponding Author
Camelia E. Hostinar
University of California-Davis, Davis, California, USA
Correspondence
Camelia E. Hostinar, University of California-Davis, Davis, CA, USA.
Email: [email protected]
Search for more papers by this authorAnna M. Parenteau,
Nicholas V. Alen, Jennifer La,
Alison T. Luck, Devin J. Teichrow,
Enya M. Daang,
Adam T. Nissen,
LillyBelle K. Deer, Camelia E. Hostinar,
Anna M. Parenteau
University of California-Davis, Davis, California, USA
Search for more papers by this authorJennifer La
University of California-San Francisco, San Francisco, California, USA
Search for more papers by this authorDevin J. Teichrow
University of California-Davis, Davis, California, USA
Search for more papers by this authorEnya M. Daang
University of California-Davis, Davis, California, USA
Search for more papers by this authorAdam T. Nissen
University of California-Davis, Davis, California, USA
Search for more papers by this authorCorresponding Author
Camelia E. Hostinar
University of California-Davis, Davis, California, USA
Correspondence
Camelia E. Hostinar, University of California-Davis, Davis, CA, USA.
Email: [email protected]
Search for more papers by this authorAbstract
Climate change-related disasters have drawn increased attention to the impact of air pollution on health. 122 children ages 9–11 years old, M(SD) = 9.91(.56), participated. Levels of particulate matter (PM2.5) near participants’ homes were obtained from the Environmental Protection Agency. Cytokines were assayed from 100 child serum samples: IL-6, IL-8, IL-10, and TNFα. Autonomic physiology was indexed by pre-ejection period (PEP), respiratory sinus arrhythmia (RSA), cardiac autonomic regulation (CAR), and cardiac autonomic balance (CAB). IL-6 was positively related to daily PM2.5 (r = .26, p = .009). IL-8 was negatively associated with monthly PM2.5 (r = −.23, p = .02). PEP was positively related to daily (r = .29, p = .001) and monthly PM2.5 (r = .18, p = .044). CAR was negatively associated with daily PM2.5 (r = −.29, p = .001). IL-10, TNFα, RSA, and CAB were not associated with PM2.5. Air pollution may increase risk of inflammation in children.
CONFLICT OF INTERESTS
The authors have no conflicts of interest to disclose.
REFERENCES
- Adetona, O., Reinhardt, T. E., Domitrovich, J., Broyles, G., Adetona, A. M., Kleinman, M. T., Ottmar, R. D., & Naeher, L. P. (2016). Review of the health effects of wildland fire smoke on wildland firefighters and the public. Inhalation Toxicology, 28(3), 95–139. https://doi.org/10.3109/08958378.2016.1145771
- AirNow.gov, U.S. EPA. (2016). AirNow.gov, U.S. EPA. (2016). AQI Basics. AQI Basics | AirNow.gov. Retrieved November 4, 2021, from https://www.airnow.gov/aqi/aqi-basics/
- Aldo, P., Marusov, G., Svancara, D., David, J., & Mor, G. (2016). Simple Plex TM: A novel multi-analyte, automated microfluidic immunoassay platform for the detection of human and mouse cytokines and chemokines. American Journal of Reproductive Immunology, 75(6), 678–693. https://doi.org/10.1111/aji.12512
- Alen, N. V., Deer, L. K., & Hostinar, C. E. (2020). Autonomic nervous system activity predicts increasing serum cytokines in children. Psychoneuroendocrinology, 119, 104745. https://doi.org/10.1016/j.psyneuen.2020.104745
- Alen, N. V., Deer, L. K., & Hostinar, C. E. (2022). Respiratory sinus arrhythmia as a physiological resilience marker for children's health. Psychosomatic Medicine, 84(3), 374–382. https://doi.org/10.1097/PSY.0000000000001057
- Andersson, U., & Tracey, K. J. (2012). Neural reflexes in inflammation and immunity. Journal of Experimental Medicine, 209(6), 1057–1068.
- Barbone, F., Catelan, D., Pistelli, R., Accetta, G., Grechi, D., Rusconi, F., & Biggeri, A. (2019). A panel study on lung function and bronchial inflammation among children exposed to ambient SO2 from an oil refinery. International Journal of Environmental Research and Public Health, 16(6), 1057. https://doi.org/10.3390/ijerph16061057
- Beatty, T. K. M., & Shimshack, J. P. (2014). Air pollution and children's respiratory health: A cohort analysis. Journal of Environmental Economics and Management, 67(1), 39–57. https://doi.org/10.1016/j.jeem.2013.10.002
- Bekkar, B., Pacheco, S., Basu, R., & DeNicola, N. (2020). Association of air pollution and heat exposure with preterm birth, low birth weight, and stillbirth in the US: A systematic review. JAMA Network Open, 3(6), e208243. https://doi.org/10.1001/jamanetworkopen.2020.8243
- Berhane, K., Zhang, Y., Linn, W. S., Rappaport, E. B., Bastain, T. M., Salam, M. T., Islam, T., Lurmann, F., & Gilliland, F. D. (2011). The effect of ambient air pollution on exhaled nitric oxide in the Children's Health Study. European Respiratory Journal, 37(5), 1029–1036. https://doi.org/10.1183/09031936.00081410
- Bernard, K., Hostinar, C. E., & Dozier, M. (2019). Longitudinal associations between attachment quality in infancy, C-reactive protein in early childhood, and BMI in middle childhood: Preliminary evidence from a CPS-referred sample. Attachment & Human Development, 21(1), 5–22. https://doi.org/10.1080/14616734.2018.1541513
- Berntson, G. G., Lozano, D. L., Chen, Y.-J., & Cacioppo, J. T. (2004). Where to Q in PEP. Psychophysiology, 41(2), 333–337. https://doi.org/10.1111/j.1469-8986.2004.00156.x
- Berntson, G. G., Norman, G. J., Hawkley, L. C., & Cacioppo, J. T. (2008). Cardiac autonomic balance versus cardiac regulatory capacity. Psychophysiology, 45(4), 643–652. https://doi.org/10.1111/j.1469-8986.2008.00652.x
- Bobak, M., Richards, M., & Wadsworth, M. (2001). Air pollution and birth weight in Britain in 1946. Epidemiology, 12(3), 358–359. https://doi.org/10.1097/00001648-200105000-00018
- Brauer, M., Hoek, G., Smit, H. A., de Jongste, J. C., Gerritsen, J., Postma, D. S., Kerkhof, M., & Brunekreef, B. (2007). Air pollution and development of asthma, allergy and infections in a birth cohort. European Respiratory Journal, 29(5), 879–888. https://doi.org/10.1183/09031936.00083406
- Brook, R. D., & Rajagopalan, S. (2021). Getting sympathetic about air pollution exposure. Journal of the American Heart Association, 879(10), . https://doi.org/10.1161/JAHA.121.021675
- Brown, M. S., Sarnat, S. E., DeMuth, K. A., Brown, L. A. S., Whitlock, D. R., Brown, S. W., Tolbert, P. E., & Fitzpatrick, A. M. (2012). Residential proximity to a major roadway is associated with features of asthma control in children. PLoS ONE, 10(5), e37044. https://doi.org/10.1371/journal.pone.0037044
- Brunekeef, B., & Holgate, S. (2002). Air pollution and health. The Lancet, 7(9341), 1233–1242. https://doi.org/10.1016/S0140-6736(02)11274-8
10.1016/S0140?6736(02)11274?8 Google Scholar
- Calderón-Garcidueñas, L., Kulesza, R. J., Doty, R. L., D'Angiulli, A., & Torres-Jardón, R. (2015). Megacities air pollution problems: Mexico City Metropolitan Area critical issues on the central nervous system pediatric impact. Environmental Research, 360, 1233–1242. https://doi.org/10.1016/j.envres.2014.12.012
- Calderón-Garcidueñas, L., Mora-Tiscareño, A., Francolira, M., Torres-Jardón, R., Peña-Cruz, B., Palacios-López, C., Zhu, H., Kong, L., Mendoza-Mendoza, N., Montesinoscorrea, H., Romero, L., Valencia-Salazar, G., Kavanaugh, M., & Frenk, S. (2013). Exposure to urban air pollution and bone health in clinically healthy six-year-old children. Archives of Industrial Hygiene and Toxicology, 137(1), 157–169. https://doi.org/10.2478/10004-1254-64-2013-2219
10.2478/10004?1254?64?2013?2219 Google Scholar
- Calderón-Garcidueñas, L., Villarreal-Calderon, R., Valencia-Salazar, G., Henríquez-Roldán, C., Gutiérrez-Castrellón, P., Torres-Jardón, R., Osnaya-Brizuela, N., Romero, L., Torres-Jardón, R., Solt, A., & Reed, W. (2008). Systemic inflammation, endothelial dysfunction, and activation in clinically healthy children exposed to air pollutants. Inhalation Toxicology, 64(5), 23–34. https://doi.org/10.1080/08958370701864797
- Carll, A. P., Hazari, M. S., Perez, C. M., Krantz, Q. T., King, C. J., Haykal-Coates, N., Cascio, W. E., Costa, D. L., & Farraj, A. K. (2013). An autonomic link between inhaled diesel exhaust and impaired cardiac performance: insight from treadmill and dobutamine challenges in heart failure–prone rats. Toxicological Sciences, 20(2), 499–506. https://doi.org/10.1093/toxsci/kft155
- Cavaillon, J. M. (2018). Exotoxins and endotoxins: Inducers of inflammatory cytokines. Toxicon: Official Journal of the International Society on Toxicology, 135, 425–436. https://doi.org/10.1016/j.toxicon.2017.10.016
- Chen, B. -Y., Chan, C. -C., Lee, C. -T., Cheng, T. -J., Huang, W. -C., Jhou, J. -C., Han, Y. -Y., Chen, C. -C., & Guo, Y. L. (2012). The association of ambient air pollution with airway inflammation in schoolchildren . American Journal of Epidemiology, 149(8), 45–53. https://doi.org/10.1093/aje/kwr380
- Currie, J., & Deschênes, O. (2016). Children and climate change: Introducing the issue. The Future of Children, 26(1), 3–9. https://doi.org/10.1353/foc.2016.0000
- Dantzer, R., Cohen, S., Russo, S. J., & Dinan, T. G. (2018). Resilience and immunity. Brain, Behavior, and Immunity, 26, 3–9. https://doi.org/10.1016/j.bbi.2018.08.010
- Doom, J. R., Reid, B. M., Nagel, E., Gahagan, S., Demerath, E. W., & Lumeng, J. C. (2021). Integrating anthropometric and cardiometabolic health methods in stress, early experiences, and development (SEED) science. Developmental Psychobiology, 74(4), 28–42. https://doi.org/10.1002/dev.22032
- Esposito, S., Tenconi, R., Lelii, M., Preti, V., Nazzari, E., Consolo, S., & Patria, M. F. (2014). Possible molecular mechanisms linking air pollution and asthma in children. BMC Pulmonary Medicine, 63(1), 593. https://doi.org/10.1186/1471-2466-14-31
10.1186/1471?2466?14?31 Google Scholar
- Eyre, E. L. J., Duncan, M. J., Birch, S. L., & Fisher, J. P. (2014). The influence of age and weight status on cardiac autonomic control in healthy children: A review. Autonomic Neuroscience, 14, 8–21. https://doi.org/10.1016/j.autneu.2014.09.019
- Gruzieva, O., Merid, S. K., Gref, A., Gajulapuri, A., Lemonnier, N., Ballereau, S., Gigante, B., Kere, J., Auffray, C., Melén, E., & Pershagen, G. (2017). Exposure to traffic-related air pollution and serum inflammatory cytokines in children. Environmental Health Perspectives, 186(6), 8. https://doi.org/10.1289/EHP460
- Ha, S., Yeung, E., Bell, E., Insaf, T., Ghassabian, A., Bell, G., Muscatiello, N., & Mendola, P. (2019). Prenatal and early life exposures to ambient air pollution and development. Environmental Research, 125, 170–175. https://doi.org/10.1016/j.envres.2019.03.064
- Hall, E., Kaushik, S., Vanderpool, R., Duvall, R., Beaver, M., Long, R., & Solomon, P. (2014). Integrating sensor monitoring technology into the current air pollution regulatory support paradigm: Practical considerations. American Journal of Environmental Engineering, 174(6), 170–175. https://doi.org/10.5923/j.ajee.20140406.02
10.5923/j.ajee.20140406.02 Google Scholar
- Heinrich, H., Pitz, M., Bischof, W., Krug, N., & Borm, P. J. A. (2003). Endotoxin in fine (PM2.5) and coarse (PM2.5–10) particle mass of ambient aerosols. A temporo-spatial analysis. Atmospheric Environment, 37(26), 3659–3667. https://doi.org/10.1016/S1352-2310(03)00467-9
- Heusser, K., Tank, J., Holz, O., May, M., Brinkmann, J., Engeli, S., Diedrich, A., Framke, T., Koch, A., Großhennig, A., Jan Danser, A. H., Sweep, F. C. G. J., Schindler, C., Schwarz, K., Krug, N., Jordan, J., & Hohlfeld, J. M. (2019). Ultrafine particles and ozone perturb norepinephrine clearance rather than centrally generated sympathetic activity in humans. Scientific Reports, 9(1), 3641. https://doi.org/10.1038/s41598-019-40343-w
- Hill, D. T., Petroni, M., Larsen, D. A., Bendinskas, K., Heffernan, K., Atallah-Yunes, N., Parsons, P. J., Palmer, C. D., MacKenzie, J. A., Collins, M. B., & Gump, B. B. (2021). Linking metal (Pb, Hg, Cd) industrial air pollution risk to blood metal levels and cardiovascular functioning and structure among children in Syracuse, NY. Environmental Research, 193, 110557. https://doi.org/10.1016/j.envres.2020.110557
- Holm, S. M., Miller, M. D., & Balmes, J. R. (2021). Health effects of wildfire smoke in children and public health tools: A narrative review. Journal of Exposure Science & Environmental Epidemiology, 31(1), 1–20. https://doi.org/10.1038/s41370-020-00267-4
- Hotamisligil, G. S. (2006). Inflammation and metabolic disorders. Nature, 444(7121), 860–867. https://doi.org/10.1038/nature05485
- Kan, H., Chen, R., & Tong, S. (2012). Ambient air pollution, climate change, and population health in China. Environment International, 42, 10–19. https://doi.org/10.1016/j.envint.2011.03.003
- Künzli, N., Avol, E., Wu, J., Gauderman, W. J., Rappaport, E., Millstein, J., Bennion, J., McConnell, R., Gilliland, F. D., Berhane, K., Lurmann, F., Winer, A., & Peters, J. M. (2006). Health effects of the 2003 Southern California wildfires on children. American Journal of Respiratory and Critical Care Medicine, 174(11), 1221–1228. https://doi.org/10.1164/rccm.200604-519OC
- Laborde, S., Mosley, E., & Thayer, J. F. (2017). Heart rate variability and cardiac vagal tone in psychophysiological research – Recommendations for experiment planning, data analysis, and data reporting. Frontiers in Psychology, 08, 1–18. https://doi.org/10.3389/fpsyg.2017.00213
- Larr, A. S., & Neidell, M. (2016). Pollution and climate change. The Future of Children, 26(1), 93–113. https://doi.org/10.1353/foc.2016.0005
- Leffers, J. M. (2021). Climate change and health of children: Our borrowed future. Journal of Pediatric Health Care, 36, 12–19. S0891524521002133. https://doi.org/10.1016/j.pedhc.2021.09.002
- Li, X., Zhang, X., Zhang, Z., Han, L., Gong, D., Li, J., Wang, T., Wang, Y., Gao, S., Duan, H., & Kong, F. (2019). Air pollution exposure and immunological and systemic inflammatory alterations among schoolchildren in China. Science of The Total Environment, 657, 1304–1310. https://doi.org/10.1016/j.scitotenv.2018.12.153
- Liu, J. C., Mickley, L. J., Sulprizio, M. P., Dominici, F., Yue, X., Ebisu, K., Anderson, G. B., Khan, R. F. A., Bravo, M. A., & Bell, M. L. (2016). Particulate air pollution from wildfires in the Western US under climate change. Climatic Change, 138(3–4), 655–666. https://doi.org/10.1007/s10584-016-1762-6
- Lourenço, B. H., Cardoso, M. A., & for the ACTION Study Team. (2014). C-Reactive protein concentration predicts change in body mass index during childhood. PLoS One, 9(3), e90357. https://doi.org/10.1371/journal.pone.0090357
- Madl, A. K., Plummer, L. E., Carosino, C., & Pinkerton, K. E. (2014). Nanoparticles, lung injury, and the role of oxidant stress. Annual Review of Physiology, 76(1), 447–465. https://doi.org/10.1146/annurev-physiol-030212-183735
- Manzano-León, N., Serrano-Lomelin, J., Sánchez, B. N., Quintana-Belmares, R., Vega, E., Vázquez-López, I., … & Osornio-Vargas, A. R. (2016). TNFα and IL-6 responses to particulate matter in vitro: Variation according to PM size, season, and polycyclic aromatic hydrocarbon and soil content. Environmental Health Perspectives, 124(4), 406–412. https://doi.org/10.1289/ehp.1409287
- Miller, J. G., Gillette, J. S., Manczak, E. M., Kircanski, K., & Gotlib, I. H. (2019). Fine particle air pollution and physiological reactivity to social stress in adolescence: The moderating role of anxiety and depression. Psychosomatic Medicine, 81(7), 641–648. https://doi.org/10.1097/PSY.0000000000000714
- Miller, L. A. (2019). Are adverse health effects from air pollution exposure passed on from mother to child? University of California, Davis. California Air Resources Board Contract, ( 15–303).
- Naeher, L. P., Brauer, M., Lipsett, M., Zelikoff, J. T., Simpson, C. D., Koenig, J. Q., & Smith, K. R. (2007). Woodsmoke health effects: A review. Inhalation Toxicology, 19(1), 67–106. https://doi.org/10.1080/08958370600985875
- Oehha.ca.gov, CA OEHHA. (2021). Oehha.ca.gov, CA OEHHA (2021). Air Quality: PM2.5. Retrieved November 4, 2021, from https://oehha.ca.gov/calenviroscreen/indicator/air-quality-pm25
- Oliveira, M., Slezakova, K., Delerue-Matos, C., Pereira, M. C., & Morais, S. (2019). Children environmental exposure to particulate matter and polycyclic aromatic hydrocarbons and biomonitoring in school environments: A review on indoor and outdoor exposure levels, major sources and health impacts. Environment International, 124, 180–204. https://doi.org/10.1016/j.envint.2018.12.052
- Parasin, N., Amnuaylojaroen, T., & Saokaew, S. (2021). Effect of air pollution on obesity in children: A systematic review and meta-analysis. Children, 8(5), 327. https://doi.org/10.3390/children8050327
- Parenteau, A. M., Alen, N. V., Deer, L. K., Nissen, A. T., Luck, A. T., & Hostinar, C. E. (2020). Parenting matters: Parents can reduce or amplify children's anxiety and cortisol responses to acute stress. Development and Psychopathology, 32(5), 1799–1809. https://doi.org/10.1017/S0954579420001285
- Pereira, L. A. A., Loomis, D., Concei, G. M. S., Kishi, H. S., Singer, J. M., BOhm, G. M., & Saldiva, P. H. N. (1998). Association between air pollution and intrauterine mortality in Sao Paulo, Brazil. Environmental Health Perspectives, 106(6), 5.
- Pope, C. A., Verrier, R. L., Lovett, E. G., Larson, A. C., Raizenne, M. E., Kanner, R. E., Schwartz, J., Villegas, G. M., Gold, D. R., & Dockery, D. W. (1999). Heart rate variability associated with particulate air pollution. American Heart Journal, 138(5 Pt 1), 890–899. https://doi.org/10.1016/s0002-8703(99)70014-1
- Prunicki, M., Kelsey, R., Lee, J., Zhou, X., Smith, E., Haddad, F., Wu, J., & Nadeau, K. (2019). The impact of prescribed fire versus wildfire on the immune and cardiovascular systems of children. Allergy, 74(10), 1989–1991. https://doi.org/10.1111/all.13825
- Rajagopalan, S., Al-Kindi, S. G., & Brook, R. D. (2018). Air pollution and cardiovascular disease. Journal of the American College of Cardiology, 72(17), 2054–2070. https://doi.org/10.1016/j.jacc.2018.07.099
- Rankin, G. D., Kabéle, M., Brown, R., Macefield, V. G., Sandström, T., & Bosson, J. A. (2021). acute exposure to diesel exhaust increases muscle sympathetic nerve activity in humans. Journal of the American Heart Association, 10(10), . https://doi.org/10.1161/JAHA.120.018448
- R Core Team (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.R-project.org/
- RStudio Team (2020). RStudio: Integrated Development for R. RStudio, PBC, http://www.rstudio.com/
- Rundle, A., Hoepner, L., Hassoun, A., Oberfield, S., Freyer, G., Holmes, D., Reyes, M., Quinn, J., Camann, D., Perera, F., & Whyatt, R. (2012). Association of childhood obesity with maternal exposure to ambient air polycyclic aromatic hydrocarbons during pregnancy. American Journal of Epidemiology, 175(11), 1163–1172. https://doi.org/10.1093/aje/kwr455
- Salvi, S. (2007). Health effects of ambient air pollution in children. Paediatric Respiratory Reviews, 8(4), 275–280. https://doi.org/10.1016/j.prrv.2007.08.008
- Schraufnagel, D. E., Balmes, J. R., Cowl, C. T., De Matteis, S., Jung, S.-H., Mortimer, K., Perez-Padilla, R., Rice, M. B., Riojas-Rodriguez, H., Sood, A., Thurston, G. D., To, T., Vanker, A., & Wuebbles, D. J. (2019). Air pollution and noncommunicable diseases. Chest, 155(2), 409–416. https://doi.org/10.1016/j.chest.2018.10.042
- Schwartz, J. (2004). Air pollution and children's health. Pediatrics, 113((Supplement) 3), 1037–1043.
- Shader, T. M., Gatzke-Kopp, L. M., Crowell, S. E., Jamila Reid, M., Thayer, J. F., Vasey, M. W., Webster-Stratton, W.-C., Bell, Z., & Beauchaine, T. P. (2018). Quantifying respiratory sinus arrhythmia: Effects of mis-specifying breathing frequencies across development. Development and Psychopathology, 30(1), 351–366. https://doi.org/10.1017/S0954579417000669
- Sherwood, A., Allen, M. T., Fahrenberg, J., Kelsey, R. M., Lovallo, W. R., & Van Doornen, L. J. (1990). Methodological guidelines for impedance cardiography. Psychophysiology, 27(1), 1–23.
- Suades-González, E., Gascon, M., Guxens, M., & Sunyer, J. (2015). Air pollution and neuropsychological development: A review of the latest evidence. Endocrinology, 156(10), 3473–3482. https://doi.org/10.1210/en.2015-1403
- Tessum, C. W., Paolella, D. A., Chambliss, S. E., Apte, J. S., Hill, J. D., & Marshall, J. D. (2012). PM 2.5 polluters disproportionately and systemically affect people of color in the United States. Science Advances, 7(18), eabf4491. https://doi.org/10.1126/sciadv.abf4491
- Thayer, J. F., & Sternberg, E. (2006). Beyond heart rate variability: Vagal regulation of allostatic systems. Annals of the New York Academy of Sciences, 1088(1), 361–372. https://doi.org/10.1196/annals.1366.014
- Thayer, J. F., Yamamoto, S. S., & Brosschot, J. F. (2010). The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. International Journal of Cardiology, 141(2), 122–131. https://doi.org/10.1016/j.ijcard.2009.09.543
- Trentacosta, C. J., Davis-Kean, P., Mitchell, C., Hyde, L., & Dolinoy, D. (2016). Environmental contaminants and child development. Child Development Perspectives, 10(4), 228–233. https://doi.org/10.1111/cdep.12191
- Trentacosta, C. J., & Mulligan, D. J. (2020). New directions in understanding the role of environmental contaminants in child development: Four themes. New Directions for Child and Adolescent Development, 2020(172), 39–51. https://doi.org/10.1002/cad.20363
- Wang, F., Liang, Q., Sun, M., Ma, Y., Lin, L., Li, T., Duan, J., & Sun, Z. (2020). The relationship between exposure to PM2.5 and heart rate variability in older adults: A systematic review and meta-analysis. Chemosphere, 261, 127635. https://doi.org/10.1016/j.chemosphere.2020.127635
- Wu, X., Nethery, R. C., Sabath, M. B., Braun, D., & Dominici, F. (2020). Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. Science Advances, 6(45), https://doi.org/10.1126/sciadv.abd4049
- Xin, L., Wang, J., Sun, J., Zhang, C., Tong, X., Wan, J., Feng, J., Tian, H., & Zhang, Z. (2021). Cellular effects of PM2.5 from Suzhou, China: Relationship to chemical composition and endotoxin content. Environmental Science and Pollution Research International, 28(1), 287–299. https://doi.org/10.1007/s11356-020-10403-0
- Xu, X., Ding, H., & Wang, X. (1995). Acute effects of total suspended particles and sulfur dioxides on preterm delivery: A community-based cohort study. Archives of Environmental Health: An International Journal, 50(6), 407–415. https://doi.org/10.1080/00039896.1995.9935976
