Tag Archives: Imperial College London

Imperial College London study: Major study finds no conclusive links to health effects from waste incinerators

27 Jun

Cheryl Katz wrote the 2012 Scientific American article, People in Poor Neighborhoods Breathe More Hazardous Particles:

Tiny particles of air pollution contain more hazardous ingredients in non-white and low-income communities than in affluent white ones, a new study shows.
The greater the concentration of Hispanics, Asians, African Americans or poor residents in an area, the more likely that potentially dangerous compounds such as vanadium, nitrates and zinc are in the mix of fine particles they breathe.
Latinos had the highest exposures to the largest number of these ingredients, while whites generally had the lowest.
The findings of the Yale University research add to evidence of a widening racial and economic gap when it comes to air pollution. Communities of color and those with low education and high poverty and unemployment face greater health risks even if their air quality meets federal health standards, according to the article published online in the scientific journal Environmental Health Perspectives.
Los Angeles, Pittsburgh, Cincinnati, St. Louis and Fresno are among the metropolitan areas with unhealthful levels of fine particles and large concentrations of poor minorities. More than 50 counties could exceed a new tighter health standard for particulates proposed by the Environmental Protection Agency.
Communities of color and those with low education and high poverty and unemployment may face greater health risks even if their air quality meets federal health standards. A pervasive air pollutant, the fine particulate matter known as PM2.5 is a mixture of emissions from diesel engines, power plants, refineries and other sources of combustion. Often called soot, the microscopic particles penetrate deep into the lungs.
The new study is the first to reveal major racial and economic differences in exposures to specific particle ingredients, some of which are linked to asthma, cardiovascular problems and cancer…. http://www.scientificamerican.com/article/people-poor-neighborhoods-breate-more-hazardous-particles/

A University of Miami Miller School of Medicine expands upon the link between neighborhood greenness and disease. https://www.sciencedaily.com/releases/2016/04/160421171345.htm

Science Daily reported in Major study finds no conclusive links to health effects from waste incinerators:

Researchers have found no link between exposure to emissions from municipal waste incinerators (MWIs) and infant deaths or reduced foetal growth.
However, they show living closer to the incinerators themselves is associated with a very small increase in the risk of some birth defects, compared to the general population. But whether this is directly related to the incinerator or not remains unclear.
The findings come from the largest and most comprehensive analysis to date of the effects of municipal waste incinerators (MWIs) on public health in the UK.
MWIs are used to burn waste that is not recycled, composted or sent to landfill and can include materials such as paper, plastic, wood and metal. While MWI emissions are governed by EU regulations, public concern remains around their potential impact on public health and scientific studies to date have been inconsistent or inconclusive.
The analysis, led by a team at Imperial College London and funded by Public Health England and the Scottish Government, looked at MWIs at 22 sites across the UK between 2003 and 2010.
Researchers from the UK Small Area Health Statistics Unit (SAHSU) at Imperial first analysed concentrations of fine particles called PM10 (particulate matter measuring 10 micrometres or less in diameter) emitted from the chimneys of the incinerators as waste is burned.
Computer models generated from the data showed how these particles spread over a 10 km radius around 22 MWIs in England, Scotland and Wales. The models show that MWIs added very little to the existing background levels of PM10 at ground level – with existing PM10 concentrations at ground level on average 100 to 10,000 times higher than levels emitted by the chimneys (Environment Science & Technology, 2017).
Using these models, the team then investigated potential links between concentrations of PM10 emitted by MWIs and any increased risk of adverse birth outcomes. In an earlier study (Environment International, 2018), they found that analysis of records covering more than one million births in England, Scotland and Wales revealed no evidence of a link between small particles emitted by the incinerators and adverse birth outcomes such as effects on birthweight, premature birth, infant death, or stillbirth, for children born within 10 km of MWIs in Great Britain…. https://www.sciencedaily.com/releases/2019/06/190620220026.htm

Citation:

Major study finds no conclusive links to health effects from waste incinerators
Date: June 20, 2019
Source: Imperial College London
Summary:
Researchers have found no link between exposure to emissions from municipal waste incinerators (MWIs) and infant deaths or reduced fetal growth.

Journal References:

Brandon Parkes, Anna L. Hansell, Rebecca E. Ghosh, Philippa Douglas, Daniela Fecht, Diana Wellesley, Jennifer J. Kurinczuk, Judith Rankin, Kees de Hoogh, Gary W. Fuller, Paul Elliott, Mireille B. Toledano. Risk of congenital anomalies near municipal waste incinerators in England and Scotland: Retrospective population-based cohort study. Environment International, 2019; 104845 DOI: 10.1016/j.envint.2019.05.039

Rebecca E. Ghosh, Anna Freni-Sterrantino, Philippa Douglas, Brandon Parkes, Daniela Fecht, Kees de Hoogh, Gary Fuller, John Gulliver, Anna Font, Rachel B. Smith, Marta Blangiardo, Paul Elliott, Mireille B. Toledano, Anna L. Hansell. Fetal growth, stillbirth, infant mortality and other birth outcomes near UK municipal waste incinerators; retrospective population based cohort and case-control study. Environment International, 2019; 122: 151 DOI: 10.1016/j.envint.2018.10.060

Philippa Douglas, Anna Freni-Sterrantino, Maria Leal Sanchez, Danielle C. Ashworth, Rebecca E. Ghosh, Daniela Fecht, Anna Font, Marta Blangiardo, John Gulliver, Mireille B. Toledano, Paul Elliott, Kees de Hoogh, Gary W. Fuller, Anna L. Hansell. Estimating Particulate Exposure from Modern Municipal Waste Incinerators in Great Britain. Environmental Science & Technology, 2017; 51 (13): 7511 DOI: 10.1021/acs.est.6b06478
A. Freni-Sterrantino, R.E. Ghosh, D. Fecht, M.B. Toledano, P. Elliott, A.L. Hansell, M. Blangiardo. Bayesian spatial modelling for quasi-experimental designs: An interrupted time series study of the opening of Municipal Waste Incinerators in relation to infant mortality and sex ratio. Environment International, 2019; 128: 109 DOI: 10.1016/j.envint.2019.04.009

Anna Font, Kees de Hoogh, Maria Leal-Sanchez, Danielle C. Ashworth, Richard J.C. Brown, Anna L. Hansell, Gary W. Fuller. Using metal ratios to detect emissions from municipal waste incinerators in ambient air pollution data. Atmospheric Environment, 2015; 113: 177 DOI: 10.1016/j.atmosenv.2015.05.002

Danielle C. Ashworth, Paul Elliott, Mireille B. Toledano. Waste incineration and adverse birth and neonatal outcomes: a systematic review. Environment International, 2014; 69: 120 DOI: 10.1016/j.envint.2014.04.003

Here is the press release from Imperial College London:

NEWS RELEASE 20-JUN-2019
Major study finds no conclusive links to health effects from waste incinerators
IMPERIAL COLLEGE LONDON
Researchers have found no link between exposure to emissions from municipal waste incinerators (MWIs) and infant deaths or reduced foetal growth.
However, they show living closer to the incinerators themselves is associated with a very small increase in the risk of some birth defects, compared to the general population. But whether this is directly related to the incinerator or not remains unclear.
The findings come from the largest and most comprehensive analysis to date of the effects of municipal waste incinerators (MWIs) on public health in the UK.
MWIs are used to burn waste that is not recycled, composted or sent to landfill and can include materials such as paper, plastic, wood and metal. While MWI emissions are governed by EU regulations, public concern remains around their potential impact on public health and scientific studies to date have been inconsistent or inconclusive.
The analysis, led by a team at Imperial College London and funded by Public Health England and the Scottish Government, looked at MWIs at 22 sites across the UK between 2003 and 2010.
Researchers from the UK Small Area Health Statistics Unit (SAHSU) at Imperial first analysed concentrations of fine particles called PM10 (particulate matter measuring 10 micrometres or less in diameter) emitted from the chimneys of the incinerators as waste is burned.
Computer models generated from the data showed how these particles spread over a 10 km radius around 22 MWIs in England, Scotland and Wales. The models show that MWIs added very little to the existing background levels of PM10 at ground level – with existing PM10 concentrations at ground level on average 100 to 10,000 times higher than levels emitted by the chimneys (Environment Science & Technology, 2017).
Using these models, the team then investigated potential links between concentrations of PM10 emitted by MWIs and any increased risk of adverse birth outcomes. In an earlier study (Environment International, 2018), they found that analysis of records covering more than one million births in England, Scotland and Wales revealed no evidence of a link between small particles emitted by the incinerators and adverse birth outcomes such as effects on birthweight, premature birth, infant death, or stillbirth, for children born within 10 km of MWIs in Great Britain.
The team’s latest findings, published in the journal Environment International, looked at occurrence of birth defects within 10 km of a subset of 10 incinerators in England and Scotland between 2003 and 2010. In their analysis, the team used health data on more than 5000 cases of birth defects among over 200,000 births, still births and terminations in England and Scotland.
They found no association between birth defects and the modelled concentrations of PM10 emitted by MWIs, but there was a small increase in the risk of two birth defects among those living closer to MWIs – specifically congenital heart defects and hypospadias (affecting the male genitalia – where the opening of the urethra is not at the top of the penis). These birth defects typically require surgery but are rarely life-threatening.
In the UK, congenital heart defects affect approximately 5.3 in 1000 births and 1.9 per 1000 males are born with hypospadias (Source: NCARDRS 2016*).
In terms of excess risk, the team estimates that the associated increase in risk for these two birth defects could be around 0.6 cases per 1,000 total births for congenital heart defects and 0.6 cases per 1,000 male births for hypospadias within 10 km of an incinerator.
Professor Paul Elliott, Director of the UK Small Area Health Statistics Unit (SAHSU) said: “Based on the available data, our findings showing that there is no significant increased risk of infant death, stillbirth, preterm birth or effects on birthweight from municipal waste incinerators are reassuring. The findings on birth defects are inconclusive, but our study design means we cannot rule out that living closer to an incinerator in itself may slightly increase the risk of some specific defects – although the reasons for this are unclear.”
Professor Mireille Toledano, Chair in Perinatal and Paediatric Environmental Epidemiology at Imperial, said: “In these studies we found a small increase in risk for children living within 10 km of an MWI being born with a heart defect, or a genital anomaly affecting boys, but did not find an association with the very low levels of particulates emitted. This increase with proximity to an incinerator may not be related directly to emissions from the MWIs. It is important to consider other potential factors such as the increased pollution from industrial traffic in the areas around MWIs or the specific population mix that lives in those areas.”
Professor Anna Hansell, Director of the Centre for Environmental Health and Sustainability at the University of Leicester, who previously led the work while at Imperial College London, added: “Taken together, this large body of work reinforces the current advice from Public Health England – that while it’s not possible to rule out all impacts on public health, modern and well-regulated incinerators are likely to have a very small, or even undetectable, impact on people living nearby.”
The team explains that while the results of the emissions studies are reassuring, they cannot rule out a link between the increased incidence of the two birth defects and the activities of the MWIs. They add that while they adjusted their results for socioeconomic and ethnic status, these may still influence birth outcomes findings. Poorer families may be living closer to MWIs due to lower housing or living costs in industrial areas, and their exposure to industrial road traffic or other pollutants may be increased.
The researchers highlight that their findings are limited by a number of factors. Also, they did not have measurements (for the hundreds of thousands of individual births considered) of metals or chemical compounds such as polychlorinated biphenyls (PCBs) and dioxins, but used PM10 concentrations as a proxy for exposure to MWI emissions – as has been used in other incinerator studies.
They add that ongoing review of evidence is needed to explore links further, as well as ongoing surveillance of incinerators in the UK to monitor any potential long-term impacts on public health.
###
The research was funded by Public Health England and the Scottish Government, with support from the Medical Research Council and the National Institute for Health Research.
https://www.eurekalert.org/pub_releases/2019-06/icl-msf062019.php

This society will not have healthy children without having healthy home and school environments.

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Resources:

What are Key Urban Environmental Problems?
http://web.mit.edu/urbanupgrading/urbanenvironment/issues/key-UE-issues.html

Understanding Neighborhood Effects of Concentrated Poverty
https://www.huduser.gov/portal/periodicals/em/winter11/highlight2.html

Where We Live Matters for Our Health: Neighborhoods and Health
http://www.commissiononhealth.org/PDF/888f4a18-eb90-45be-a2f8-159e84a55a4c/Issue%20Brief%203%20Sept%2008%20-%20Neighborhoods%20and%20Health.pdf

Where information leads to Hope. ©

Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
https://drwildareviews.wordpress.com/

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https://drwilda.com/

Imperial College London study: Feeding babies egg and peanut may prevent food allergy, study suggests

25 Sep

More children seem to have peanut allergies. Ross Brenneman wrote in the Education Week article, How Peanuts Became Public Health Enemy #1:

Researchers aren’t sure why, but over the past several years, the number of children reported to have allergies has doubled, to 5 percent of children in the United States. Yet at the same time, in schools and elsewhere, allergies have drawn what some see as an oversized amount of attention. A new paper out of Princeton University explores why that may have happened.

Allergy attacks are awful. I’ve been there plenty of times. Eyes swollen shut, coughing, hacking, sneezing—and that’s just garden-variety pollen. But severe allergic reactions, also known as anaphylaxia, can cause death, even for the constantly vigilant. That’s why the U.S. House of Representatives voted unanimously last week in favor of a bill that would incentivize states, through a pre-existing grant program, to make sure their schools have a supply of epinephrine (usually an EpiPen) on hand, as well as staff members trained in using it…

One percent. That’s it. One estimate pegs it closer to 1.4 percent for children, but only .6 percent for adults. Either way, it’s small. Not all of those affected are seriously allergic, either. One percent isn’t nothing, but it’s not the kind of number that would suggest a strong cultural reaction, either.
Why, then, have peanut allergies become such a well-known public health menace? Maybe it’s partly from the mystery surrounding all allergies; scientists don’t know why allergies exist and why some people grow out of them. It’s also not clear how much an allergy attack may be exacerbated by asthma; the two often go hand in hand….
http://blogs.edweek.org/edweek/rulesforengagement/2013/08/how_peanuts_became_public_health_enemy_number_one.html?intc=es

Kids With Food Allergies has some excellent resources.
http://www.kidswithfoodallergies.org/resourcespre.php?id=62&title=Peanut_allergy_avoidance_list&gclid=CJTC7sfLuLICFWdxQgodxHcAJQ

Kate Wighton wrote in Feeding babies egg and peanut may prevent food allergy:

Feeding babies egg and peanut may reduce their risk of developing an allergy to the foods, finds a new study.

In the research, which is the largest analysis of evidence on the effect of feeding allergenic foods to babies, scientists from Imperial College London analysed data from 146 studies. In total the studies involved more than 200,000 children.

The study, which was commissioned by the UK Food Standards Agency, also found feeding children peanut, between the ages of four and eleven months, may reduce risk of developing peanut allergy. In addition, the team analysed milk, fish (including shellfish), tree nuts (such as almonds) and wheat, but didn’t find enough evidence to show introducing these foods at a young age reduces allergy risk.

The research is published today in the Journal of the American Medical Association.

Although previous studies have found feeding children peanut and egg may reduce allergy risk, other studies have found no effect.

Dr Robert Boyle, lead author of the research from the Department of Medicine at Imperial, said: “This new analysis pools all existing data, and suggests introducing egg and peanut at an early age may prevent the development of egg and peanut allergy, the two most common childhood food allergies.

“Until now we have not been advising parents to give these foods to young babies, and have even advised parents to delay giving allergenic foods such as egg, peanut, fish and wheat to their infant.”

Allergies to foods, such as nuts, egg, milk or wheat, affect around one in 20 children in the UK. They are caused by the immune system malfunctioning and over-reacting to these harmless foods. This triggers symptoms such as rashes, swelling, vomiting and wheezing.

“The number of children diagnosed with food allergies is thought to be on the rise”, added Dr Vanessa Garcia-Larsen, a co-author on the study from the National Heart and Lung Institute at Imperial. “There are indications that food allergies in children have become much more common over the last 30 years.

The number of patients coming into our clinics has increased year-on-year, and allergy clinics across the country have seen the same pattern.”

She added that the reasons behind this rise are still unclear – doctors may be better at recognising food allergy, or there may be environmental factors involved.

In the new study, called a meta-analysis, the team initially analysed 16,289 research papers on allergies and other immune system problems. Out of these, 146 were used for data analysis of when to feed babies allergenic foods such as egg, peanut, wheat and fish.

The results showed that children who started eating egg between the ages of four and six months had a 40 per cent reduced risk of egg allergy compared to children who tried egg later in life.

Children who ate peanut between the ages of four and eleven months had a 70 per cent reduced peanut allergy risk compared to children who ate the food at a later stage. However, the authors cautioned that these percentages are estimates based on a small number of studies……                                                                   http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_20-9-2016-14-46-0

Citation:

Feeding babies egg and peanut may prevent food allergy, study suggests

Date:        September 20, 2016

Source:    Imperial College London

Summary:

Feeding babies egg and peanut may reduce their risk of developing an allergy to the foods, finds a new study.

Journal Reference:

  1. Despo Ierodiakonou et al. Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune DiseaseA Systematic Review and Meta-analysis. JAMA, 2016 DOI: 10.1001/jama.2016.12623

Here is the citation from the Journal of the American Medical Association:

September 20, 2016, Vol 316, No. 11 >

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Original Investigation|September 20, 2016

Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease A Systematic Review and Meta-analysis

Despo Ierodiakonou, MD, PhD1,2; Vanessa Garcia-Larsen, PhD2; Andrew Logan, PhD1; Annabel Groome, BSc1; Sergio Cunha, MD2; Jennifer Chivinge, BSc1; Zoe Robinson, BSc1; Natalie Geoghegan, BSc1; Katharine Jarrold, BSc1; Tim Reeves, BSc2; Nara Tagiyeva-Milne, PhD3; Ulugbek Nurmatov, MD, PhD4; Marialena Trivella, DPhil5; Jo Leonardi-Bee, PhD6; Robert J. Boyle, MD, PhD1

[+] Author Affiliations

JAMA. 2016;316(11):1181-1192. doi:10.1001/jama.2016.12623.

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CME

ABSTRACT

ABSTRACT | INTRODUCTION | METHODS AND LITERATURE SEARCH | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES

Importance  Timing of introduction of allergenic foods to the infant diet may influence the risk of allergic or autoimmune disease, but the evidence for this has not been comprehensively synthesized.

Objective  To systematically review and meta-analyze evidence that timing of allergenic food introduction during infancy influences risk of allergic or autoimmune disease.

Data Sources  MEDLINE, EMBASE, Web of Science, CENTRAL, and LILACS databases were searched between January 1946 and March 2016.

Study Selection  Intervention trials and observational studies that evaluated timing of allergenic food introduction during the first year of life and reported allergic or autoimmune disease or allergic sensitization were included.

Data Extraction and Synthesis  Data were extracted in duplicate and synthesized for meta-analysis using generic inverse variance or Mantel-Haenszel methods with a random-effects model. GRADE was used to assess the certainty of evidence.

Main Outcomes and Measures  Wheeze, eczema, allergic rhinitis, food allergy, allergic sensitization, type 1 diabetes mellitus, celiac disease, inflammatory bowel disease, autoimmune thyroid disease, and juvenile rheumatoid arthritis.

Results  Of 16 289 original titles screened, data were extracted from 204 titles reporting 146 studies. There was moderate-certainty evidence from 5 trials (1915 participants) that early egg introduction at 4 to 6 months was associated with reduced egg allergy (risk ratio [RR], 0.56; 95% CI, 0.36-0.87; I2 = 36%; P = .009). Absolute risk reduction for a population with 5.4% incidence of egg allergy was 24 cases (95% CI, 7-35 cases) per 1000 population. There was moderate-certainty evidence from 2 trials (1550 participants) that early peanut introduction at 4 to 11 months was associated with reduced peanut allergy (RR, 0.29; 95% CI, 0.11-0.74; I2 = 66%; P = .009). Absolute risk reduction for a population with 2.5% incidence of peanut allergy was 18 cases (95% CI, 6-22 cases) per 1000 population. Certainty of evidence was downgraded because of imprecision of effect estimates and indirectness of the populations and interventions studied. Timing of egg or peanut introduction was not associated with risk of allergy to other foods. There was low- to very low-certainty evidence that early fish introduction was associated with reduced allergic sensitization and rhinitis. There was high-certainty evidence that timing of gluten introduction was not associated with celiac disease risk, and timing of allergenic food introduction was not associated with other outcomes.

Conclusions and Relevance  In this systematic review, early egg or peanut introduction to the infant diet was associated with lower risk of developing egg or peanut allergy. These findings must be considered in the context of limitations in the primary studies.                                                                                                     http://jama.jamanetwork.com/article.aspx?articleid=2553447

A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/
If children have allergies, parents must work with their schools to prepare a allergy health plan. See, Journal of American Medical Association study: Consumption of nuts by pregnant woman may reduce nut allergies in their children https://drwilda.com/tag/peanut-allergy/

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code
http://www.cklawreview.com/wp-content/uploads/vol85no2/Borella.pdf

USDA’s Accomodating Children With Special Dietary Needs
http://www.k12.wa.us/ChildNutrition/pubdocs/SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet
http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html

Video: What to Expect From A Child’s Physical Exam

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

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