The association between childhood exposure to PM2.5-bound organophosphate esters (OPEs) and attention deficit hyperactivity disorder (ADHD) remains poorly understood. In this large population-based study of 131,412 children aged 6-18 years attending schools in the Pearl River Delta, China, we collected ambient fine particulate matter (PM2.5) samples from schools to quantify OPEs levels, and screened for ADHD symptoms using parent-reported ADHD/Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅳ) Scales. We employed elastic net regression for variable selection, generalized linear mixed models (GLMMs) for association estimates, and weighted quantile sum regression to evaluate mixture effects. Odds ratios (ORs) are expressed as the change in odds of ADHD symptoms per interquartile range (IQR) increase in OPE levels. Elevated PM2.5-bound OPE exposure was associated with higher odds of ADHD symptoms in children, especially for triphenyl phosphate (TPHP) (OR = 1.75, 95% CI: 1.70-1.79), tris(2-ethylhexyl) phosphate (TEHP) (OR = 1.73, 95% CI: 1.69-1.77), tris(1,3-dichloroisopropyl) phosphate (TDCIPP) (OR = 1.71, 95% CI: 1.67-1.75), and tris(3,4-dimethylphenyl) phosphate (T34DMPP) (OR = 1.45, 95% CI: 1.41-1.49). Similar associations were observed across different ADHD subtypes. Stratified analyses indicated heterogeneous associations across age, sex, and breastfeeding subgroups, with no consistent pattern of effect modification across all OPE exposures. These findings suggest that inhalation of OPE mixtures may be associated with adverse neurodevelopmental outcomes in children, highlighting a potential developmental window of susceptibility and raising public health concerns about airborne contaminants.
Chu Chu, Xuan Liu, Yan-xu Chen et al.· Neurotoxicology· 0 citations
China has invested heavily in air pollution control in recent years, yet comprehensive assessments of the associated health economic benefits remain limited. Prior research on the health economic benefits of air pollution control has mainly focused on mortality outcomes and PM2.5, which may substantially underestimates the true benefits of clean air policies. This study aims to evaluate the health economic benefits and losses associated with air pollution control by incorporating multiple health outcomes, population groups and air pollutants. We integrate daily mortality, hospital admission and outpatient visits and air pollutant (nitrogen dioxide, ozone [O3] and fine particulate matter) data from 18 cities from 2015 to 2022 to assess the health economic benefits. A generalized additive model was used to estimate concentration-response relationships. Health economic benefits were calculated based on the value of statistical life (VSL) and direct medical costs. Between 2015 and 2022, controlling PM2.5 and NO2 yielded significant health economic benefits across all health outcomes. Air pollution control generated significant health economic benefits across multiple outcomes in Guangdong Province. The total health economic benefits associated with PM2.5 and NO2 were 10,305.35 and 1017.00 million CNY, respectively. In contrast, O3 control yielded negative net benefits across all outcomes. Between 2015 and 2022, the multi-outcome health benefits of controlling PM2.5 exceeded mortality-only estimates by 31.79%, respectively For PM2.5 control, the elderly accounted for over 85% of the mortality-related benefits. These findings highlight the need for coordinated PM2.5-O3 control, the integration of multi-outcome evaluations into policy design, and targeted protection for vulnerable populations particularly the elderly.