Traffic-related air and noise pollution may increase the risk for cardiovascular disorders, especially among susceptible populations like pregnant women. The objective of this study was to evaluate the association of exposure to traffic-related air pollution and traffic noise with blood pressure in pregnant women. We extracted systolic blood pressure (SBP) and diastolic blood pressure (DBP) at ≥20 weeks gestation, as well as hypertensive disorders of pregnancy from medical records in the HOME Study, a prospective pregnancy and birth cohort from Cincinnati, OH (n = 370). We estimated exposure to elemental carbon attributable to traffic (ECAT),1 a marker of traffic-related air pollution, at women's residences at ~20 weeks gestation using a validated land use regression model and traffic noise using a publicly available transportation noise model. We used linear mixed models and modified Poisson regression adjusted for covariates to examine associations of ECAT and traffic noise with blood pressure and hypertensive disorders of pregnancy risk, respectively. In adjusted models, we found a 1.6 (95% CI = 0.02, 3.3; p = 0.048) mm Hg increase in SBP associated with an interquartile range increase in ECAT concentration; the association was stronger after adjusting for traffic noise (1.9 mm Hg, 95% = 0.1, 3.7; p = 0.035). ECAT concentrations were not significantly associated with DBP or hypertensive disorders of pregnancy, and traffic noise was not associated with SBP, DBP, or hypertensive disorders of pregnancy. There was no evidence of a joint effect of traffic noise and ECAT on any outcome. In this cohort, higher residential traffic-related air pollution exposure at ~20 weeks gestation was associated with higher SBP in late pregnancy. It is important for future studies of traffic-related air or noise pollution to jointly consider both exposures and neighborhood characteristics given their correlation and potential cumulative impact on cardiovascular health.

Background: Epidemiologic studies suggest cadmium exposure is associated with cardiovascular disease risk, including heart failure. However, prior findings may be influenced by tobacco smoking, a dominant source of cadmium exposure and risk factor for heart failure. The present study leverages up to 20 years of follow-up in the Danish Diet, Cancer and Health cohort to examine the relationship between urinary cadmium and incident heart failure among people who never smoked. Methods: Between 1993 and 1997, 19,394 never-smoking participants (ages 50–64 years) enrolled and provided a urine sample. From this sample, we randomly selected a subcohort of 600 men and 600 women and identified 958 incident heart failure cases occurring between baseline and 2015. Using a case–cohort approach, we estimated adjusted hazard ratios (aHR) for heart failure in Cox proportional hazards models with age as the time scale. Results: Participants had relatively low concentrations of urinary cadmium, as expected for never smokers (median = 0.20; 25th, 75th = 0.13, 0.32 μg cadmium/g creatinine). In adjusted models, we found that higher urinary cadmium was associated with a higher rate of incident heart failure overall (aHR = 1.1 per interquartile range difference [95% CI = 1.0, 1.2). In sex-stratified analyses, the association seemed restricted to men (aHR = 1.5 [95% CI = 1.2, 1.9]). Conclusions: In this cohort of people who never smoked tobacco, environmental cadmium was positively associated with incident heart failure, especially among men.

Background: Recent technological advances allow for the repeated sampling of real-time data in natural settings using electronic ecological momentary assessment (eEMA). These advances are particularly meaningful for investigating physical activity, sedentary behavior, and sleep in young adults who are in a critical life stage for the development of healthy lifestyle behaviors. Objective: This study aims to describe the use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults. Methods: The PubMed, CINAHL, PsycINFO, Embase, and Web of Science electronic databases were searched through August 2022. Inclusion criteria were use of eEMA; sample of young adults aged 18 to 25 years; at least 1 measurement of physical activity, sedentary behavior, or sleep; English language; and a peer-reviewed report of original research. Study reports were excluded if they were abstracts, protocols, or reviews. The risk of bias assessment was conducted using the National Heart, Lung, and Blood Institute’s Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Screening, data extraction, and risk of bias assessments were conducted by independent authors, with discrepancies resolved by consensus. Descriptive statistics and narrative synthesis were used to identify overarching patterns within the following categories guided by the Checklist for Reporting Ecological Momentary Assessments Studies: study characteristics, outcomes and measures, eEMA procedures, and compliance. Results: The search resulted in 1221 citations with a final sample of 37 reports describing 35 unique studies. Most reports (28/37, 76%) were published in the last 5 years (2017-2022), used observational designs (35/37, 95%), consisted of samples of college students or apprentices (28/35, 80%), and were conducted in the United States (22/37, 60%). The sample sizes ranged from 14 to 1584 young adults. Physical activity was measured more frequently (28/37, 76%) than sleep (16/37, 43%) or sedentary behavior (4/37, 11%). Of the 37 studies, 11 (30%) reports included 2 movement behaviors and no reports included 3 movement behaviors. eEMA was frequently used to measure potential correlates of movement behaviors, such as emotional states or feelings (25/37, 68%), cognitive processes (7/37, 19%), and contextual factors (9/37, 24%). There was wide variability in the implementation and reporting of eEMA procedures, measures, missing data, analysis, and compliance. Conclusions: The use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults has greatly increased in recent years; however, reports continue to lack standardized reporting of features unique to the eEMA methodology. Additional areas in need of future research include the use of eEMA with more diverse populations and the incorporation of all 3 movement behaviors within a 24-hour period. The findings are intended to assist investigators in the design, implementation, and reporting of physical activity, sedentary behavior, and sleep research using eEMA in young adults. Trial Registration: PROSPERO CRD42021279156; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021279156

Coal ash, the byproduct of burning coal made up of small particles, including heavy metals and radioactive elements, is discarded in open-air landfills where it can be emitted into the air, contributing to air pollution in the surrounding community. Few regulations exist regarding the storage, disposal, and transport of coal ash. There is limited research on the health impacts of coal ash exposure on communities. The purpose of this study was to examine the prevalence of respiratory symptoms among adults exposed to coal ash and non-exposed adults. A cross-sectional epidemiological study was conducted among two populations: one exposed to coal ash and one not exposed to coal ash. Perception of health (p-Value < 0.0001), cough (Adjusted Odds Ratio (AOR) = 5.30, 95% Confidence Intervals (CI) = 2.60–11), shortness of breath (AOR = 2.59, 95% CI = 1.56–4.31), hoarseness (AOR = 4.02, 95% CI = 2.45–6.60), respiratory infections (AOR = 1.82, 95% CI = 1.14–2.89), and mean overall respiratory health score (p-Value < 0.0001) were all statistically significantly greater in exposed adults (N = 231) when compared to non-exposed adults (N = 170). Adults residing near the coal ash facility were more likely to report respiratory symptoms than the non-exposed population. More research on the health impact of coal ash and storage regulations needs to be conducted.

Cadmium exposure has been associated with cardiovascular disease. Cigarette smoking is a key source of cadmium exposure and thus a potential confounder in observational studies of environmental cadmium and cardiovascular disease that include tobacco smokers. We leveraged up to 20 years of follow-up in the Danish Diet, Cancer and Health cohort to test the hypothesis that cadmium exposure is associated with acute myocardial infarction (AMI) among people who never smoked. Between 1993 and 1997, 19,394 never-smoking participants (ages 50-64 years) were enrolled and provided a urine sample. From this sample, we randomly selected a subcohort of 600 males and 600 females. We identified 809 AMI cases occurring between baseline and the end of 2015 using the Danish National Patient Registry. We quantified cadmium, creatinine, and osmolality in baseline urine samples. Using an unweighted case-cohort approach, we estimated adjusted hazard ratios (aHR) for AMI in Cox proportional hazards models with age as the time axis. Participants had relatively low concentrations of urinary cadmium, as expected for never smokers (median = 0.20; 25th, 75th = 0.13, 0.32 μg cadmium/g creatinine). We did not find strong evidence to support an association between higher urinary cadmium and AMI when comparing the highest versus lowest quartile (aHR = 1.16; 95% CI: 0.86 - 1.56) and per IQR increment in cadmium concentration (aHR = 1.02; 95% CI: 0.93 - 1.12). Results were not materially different across strata defined by sex. Results were generally similar using creatinine or osmolality to account for differences in urine dilution. While cadmium exposure has been identified as a risk factor for cardiovascular disease, we did not find strong evidence that urinary cadmium at relatively low-levels is associated with AMI among people who have never smoked.