BACKGROUND: Biological aging reflects a decline in the functions and integrity of the human body that is closely related to chronological aging. A variety of biomarkers have been found to predict biological age. Biological age higher than chronological age (biological age acceleration) indicates an accelerated state of biological aging and a higher risk of premature morbidity and mortality. This study investigated how socioeconomic disadvantages influence biological aging. METHODS: The data from the National Health and Nutrition Examination Survey (NHANES) IV, including 10 nationally representative cross-sectional surveys between 1999-2018, were utilized. The analytic sample consisted of N = 48,348 individuals (20-84 years). We used a total of 11 biomarkers for estimating the biological age. Our main outcome was biological age acceleration, indexed by PhenoAge acceleration (PAA) and Klemera-Doubal biological age acceleration (KDM-A). Poverty was measured as a ratio of family income to the poverty thresholds defined by the U.S. Census Bureau, adjusted annually for inflation and family size (5 categories). The PAA and KDM-A were regressed on poverty levels, age, their interaction, education, sex, race, and a data collection wave. Sample weights were used to make the estimates representative of the U.S. adult population. RESULTS: The results showed that higher poverty was associated with accelerated biological aging (PAA: unstandardized coefficient B = 1.38 p <.001, KDM: B = 0.96, p = .026 when comparing the highest and the lowest poverty level categories), above and beyond other covariates. The association between PAA and KDM-A and age was U-shaped. Importantly, there was an interaction between poverty levels and age (p <.001), as the effect of poverty was most pronounced in middle-aged categories while it was modest in younger and elderly groups. CONCLUSION: In a nationally representative US adult population, we found that higher poverty was positively associated with the acceleration of biological age, particularly among middle-aged persons.
- MeSH
- Biomarkers MeSH
- Poverty * MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Cross-Sectional Studies MeSH
- Aged MeSH
- Aging * MeSH
- Nutrition Surveys MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Numerous studies reported higher levels of mental health issues during the COVID-19 pandemic but only a minority used repeated measurements. We investigated change in depressive symptoms in the Czech ageing cohort and the impact of pre-existing and COVID-19-related stressors. METHODS: We used data on 2853 participants (mean age 73.4 years) from the Czech part of the prospective Health, Alcohol and Psychosocial factors In Eastern Europe cohort that participated in postal questionnaire surveys before (September 2017-June 2018) and during the pandemic (October 2020-April 2021). Participants reported their depressive symptoms using the Centre for Epidemiological Studies-Depression Scale including 10 (CESD-10) tool. A principal component analysis (PCA) was used to create representative components of the pandemic-related stressors. The impact of the stressors on change in depressive symptoms was tested using multivariable linear regression, after adjustment for age and potential confounders. RESULTS: Three patterns of the pandemic-related stressors ('financial stressors', 'social and perception stressors' and 'death and hospitalisation stressors') were extracted from the PCA. The mean CESD-10 score increased from 4.90 to 5.37 (p<0.001). In fully adjusted models, significantly larger increases in depression score were reported by older people (β=0.052; p=0.006), those with poor self-rated health (β=0.170; p<0.001), those who experienced death or hospitalisation of a close person (β=0.064; p<0.001), social deprivation (β=0.057; p<0.001), delays in healthcare (β=0.048; p=0.005) and those who suffered from COVID-19 (β=0.045; p=0.008). CONCLUSION: This study confirms an increase in depressive symptoms in older persons during the pandemic and identified several pandemic-related risk factors suggesting that public health policies should address this vulnerable group by adopting the preventing strategies.
- MeSH
- COVID-19 * epidemiology MeSH
- Depression epidemiology MeSH
- Cohort Studies MeSH
- Humans MeSH
- Pandemics MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
- MeSH
- Diabetes Mellitus * epidemiology MeSH
- Hypertension * epidemiology MeSH
- Air Pollutants * analysis MeSH
- Humans MeSH
- Nitrogen Dioxide analysis MeSH
- Particulate Matter analysis MeSH
- Prevalence MeSH
- Environmental Exposure analysis MeSH
- Life Style MeSH
- Air Pollution * analysis MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Objectives: Evidence of the impact of COVID-19 pandemic on mental and physical health behaviours is limited. This study presents results of two cross-sectional surveys on mental health changes and its consequences on healthy and unhealthy lifestyle behaviours. Methods: An online survey was distributed during Spring 2020 (N = 9,168) and Autumn 2020 (N = 1,042) in the Czech Republic. Differences in mental health observed in both surveys were evaluated using Mann-Whitney test and logistic regressions were used to examine demographic and socio-economic determinants of COVID-19-related mental health issues and resulting healthy and unhealthy lifestyle behaviours. Results: In multivariable models, the youngest individuals, females, people with increased work demands and participants with a reduced personal income due to the COVID-19 pandemic were all negatively associated with self-reported mental health issues (p < 0.05). A worsened quality of sleep, dietary habits, physical activity and unhealthy behaviours were highly associated with affected mental health in the models adjusted for potential covariates (p < 0.05). Conclusion: Taken together, these findings suggest that health promotion strategies directed to individuals who are at risk should be encouraged to adopt and/or maintain positive health-related behaviours.
- MeSH
- COVID-19 * epidemiology MeSH
- Mental Health MeSH
- Humans MeSH
- Pandemics MeSH
- Cross-Sectional Studies MeSH
- Life Style MeSH
- Self Report MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
OBJECTIVES: In the Czech Republic, an outbreak of the coronavirus disease (COVID‑19) has been decelerated by quickly adopting strict and strongly limiting government measures. In this study, the authors present the preliminary results (April 1-5, 2020) of a public risk perception study of COVID‑19. MATERIAL AND METHODS: The online questionnaire survey was announced in the national TV and radio stations with the nationwide coverage. Respondents were recruited through the website of the University of Ostrava during the first 5 days of the survey (N = 7966). The data covered risk perception with a focus on physical and psychological aspects, the current socio-economic situation and adaptation to the lockdown. The authors used Mann-Whitney and Kruskal-Wallis tests, as well as ordered logistic regression, with a significance level of 5% using STATA version 15. RESULTS: From the total sample of the respondents aged 40 years on average (a range of 15-87 years), the present study shows that women (p < 0.001) and elderly people (p < 0.001) perceived the health risk related to COVID‑19 as significantly worse than others. Older people (>60 years) perceived their mental health as significantly better than younger participants (p < 0.001). Most of the respondents assessed the adopted measures as adequate (71%) and believed in their effectiveness (69.7%). CONCLUSIONS: This study contributes to understanding the risk perception as a public response to the COVID‑19 pandemic. Int J Occup Med Environ Health. 2021;34(2):165-76.
- MeSH
- COVID-19 epidemiology MeSH
- Adult MeSH
- Mental Health * MeSH
- Communicable Disease Control methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Pandemics * MeSH
- Perception physiology MeSH
- Surveys and Questionnaires MeSH
- SARS-CoV-2 * MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND: Air pollution exposure is associated with reduced lung function and increased cardio-pulmonary mortality (CPM). OBJECTIVES: We analyzed the potential mediating effect of reduced lung function on the association between air pollution exposure and CPM. METHODS: We used data from the German SALIA cohort including 2527 elderly women (aged 51-56 years at baseline 1985-1994) with 22-year follow-up to CPM. Exposures to PM10, PM2.5, PM2.5 absorbance, NO2 and NOx were assessed by land-use regression modelling and back-extrapolated to estimate exposures at baseline. Lung function (FVC, FEV1) was measured by spirometry and transformed to GLI z-scores. Adjusted Cox proportional hazards and causal proportional hazards mediation analysis models were fitted. RESULTS: The survival analysis showed that reduced lung function (z-scores of FVC or FEV1 below 5% predicted) reflected significantly lower survival probability from CPM (p < 0.0001). Longterm exposures to NOx and NO2 were associated with increased risks of CPM (eg. HR = 1.215; 95%CI: 1.017-1.452 for IQR increase in NOx and HR = 1.209; 95%CI: 1.011-1.445 for IQR increase in NO2) after adjusting for reduced lung function and additional covariates. The associations of PM2.5 absorbance and CPM remained significant in models adjusted for FEV1/FVC, but the associations with PM10 and PM2.5 were not significant. The mediation analysis showed significant indirect effects of NO2 and NOx on CPM mediated through reduced FEV1 and FVC. The largest indirect effects were found for exposures to NO2 (HR = 1.037; 95%CI: 1.005-1.070) and NOx (HR = 1.028; 95%CI: 1.004-1.052) mediated through reduced FVC. The mediated proportion effect ranged from 13.9% to 19.6% in fully adjusted models. DISCUSSION: This study provides insights into the mechanism of reduced lung function in association between long-term air pollution exposure and CPM. The mediated effect was substantial for exposure to nitrogen oxides (NOx and NO2), but less pronounced for PM10 and PM2.5.
- MeSH
- Cohort Studies MeSH
- Air Pollutants * adverse effects analysis MeSH
- Humans MeSH
- Follow-Up Studies MeSH
- Particulate Matter adverse effects analysis MeSH
- Lung MeSH
- Aged MeSH
- Environmental Exposure analysis MeSH
- Air Pollution * adverse effects analysis MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Cílem tohoto článku je shrnout doposud publikované výsledky epidemiologických studií zabývajících se dopadem dlouhodobých expozic znečištěnému ovzduší na zdraví a podat ucelený přehled o metodice hodnocení zdravotních dopadů. Dlouhodobá expozice znečištěnému ovzduší je považována za významnou determinantu zdraví. Dle Světové zdravotnické organizace (WHO) znečištění ovzduší přispívá ročně k 7,6 % předčasným úmrtím (odhad z roku 2016) a ke snížení let prožitých ve zdraví. Výsledky kohortových studií a metaanalýz poskytly řadu důkazů, které byly následně uplatněny při odhadování vztahů mezi expozicí (dávkou) a biologickým účinkem. Pro efektivní řízení rizika znečištěného ovzduší přijala Světová zdravotnická organizace ucelenou metodiku odhadů teoretických zdravotních dopadů, jejichž závěry mohou být využity při komunikaci rizik s veřejností, jakož i podklad pro tvorbu akčních plánů a priorit výzkumu na národní i mezinárodní úrovni. Potenciální zdravotní dopady jsou dle této metodiky vyjadřovány pomocí ukazatelů zátěže onemocněními - "attributable burden", jako jsou roky ztracené z důvodu předčasného úmrtí (Years of Life Lost - YLLs) nebo roky života strávené s disabilitou (Years Lived with Disability - YLDs), které vznikají jako důsledek dlouhodobé expozice polutantům ovzduší, konkrétně polétavým prachovým částicím o aerodynamickém průměru menším než 10 µm a 2,5 µm (PM10, PM2,5) a oxidu dusičitému (NO2). Tyto dopady vyjadřují podíl vlivu znečištění ovzduší na úmrtnost či nemocnost na závažná civilizační onemocnění jako jsou cerebrovaskulární onemocnění (ischemická choroba srdeční, mrtvice), zhoubný novotvar průdušnice, průdušek a plic, chronickou obstrukční plicní nemoc a další.
The aim of this work is to summarize the results of epidemiological studies related to the impact of long-term exposure to air pollution on health and to provide a comprehensive overview of the methodology of health risk and impact assessment. Long-term exposure to ambient air pollution is considered to be a significant determinant of health. According to the World Health Organization (WHO), air pollution contributes annually to 7.6% of deaths (estimate from 2016), and to a decrease in the number of healthy life years. Based upon the results of cohort studies and meta-analyses, the relations between exposure and biological effects were estimated. To effectively manage the risks of air pollution, the World Health Organization has adopted a unified methodology for health impact estimation. The conclusions can be used to communicate about risks with the public, as well as a basis for developing action plans and research priorities at national and international levels. Those health effects are expressed using the Years of Life Lost (YLLs) due to premature deaths or life in disability (YLDs), which originate as a consequence of long-term exposure of inhabitants to air pollutants, especially to particulate matter with aerodynamic diameters less or equal than 2.5 µm and 10 µm (PM2.5, PM10) and to nitrogen dioxide (NO2). The relations between the exposure and consequences have been described in serious diseases of civilization, which include cerebrovascular diseases (IHD, stroke), malignant tumours of the trachea, bronchi, and lungs (LC), chronic obstructive pulmonary disease (COPD), and others.
- MeSH
- Cerebrovascular Disorders epidemiology etiology MeSH
- Pulmonary Disease, Chronic Obstructive epidemiology etiology MeSH
- Global Burden of Disease * methods organization & administration MeSH
- Cardiovascular Diseases epidemiology etiology MeSH
- Smoking adverse effects MeSH
- Humans MeSH
- Life Expectancy MeSH
- Neoplasms epidemiology etiology MeSH
- Nitrogen Oxides adverse effects MeSH
- Dust MeSH
- Statistics as Topic MeSH
- Health Status Indicators MeSH
- Air Pollution * adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH