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Beate Ritz, PhD, and Michael Jerrett, PhD, in a statewide collaborative study, found that people who exercised in outdoor ozone pollution had a greater risk (up to 1.5x) of developing Type 2 Diabetes.

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Older Californians who live in communities with poor air quality, even those who engage – as recommended – in physical activities but do so outdoors, have a higher risk of Type 2 diabetes, a complex and chronic metabolic disorder caused by insulin resistance and cell dysfunction.

Although development of diabetes has typically been related to obesity and physical inactivity, its causes are complex; recent research has suggested that environmental risk factors, including air pollution, also play a major role, said Dr. Beate Ritz, a UCLA Fielding School of Public Health professor of epidemiology and environmental health sciences who has studied the impact of ozone (O3), a common element of air pollution, on human health.

“The O3-related risk of developing diabetes was 1.5 times higher in the higher-outdoor activity group, and even in the lower activity group, there is an observably higher risk compared with those living in less polluted communities,” said Ritz, a co-author of the research, who also serves as a professor of neurology at UCLA’s David Geffen School of Medicine. “Physical activity is well known and widely recognized for its health benefits, but the beneficial effects that outdoor physical activities have on human health may have to be weighed against the detrimental impacts of air pollution in areas affected by high pollution levels.”

The study, published in the September edition of the peer-reviewed journal Environmental Health Perspectives, or EHP, is available on-line as “Ozone Exposure, Outdoor Physical Activity, and Incident Type2 Diabetes in the SALSA Cohort of Older Mexican Americans.” EHP is a monthly journal of environmental health research and news published with support from the National Institute of Environmental Health Sciences, itself part of the U.S. Department of Health and Human Services’ National Institutes of Health. Diabetes is a chronic health condition that can cause serious health problems, including heart disease, vision loss, and kidney disease.

The researchers, from four different University of California campuses (UCLA, Berkeley, Irvine, and San Francisco), focused on residents of a six county area surrounding Sacramento, all older Mexican-Americans (60 years and up) who enrolled in the Sacramento Area Latino Study on Aging, or SALSA. The counties include Placer, Sacramento, Solano, Sutter, Yolo, and Yuba, although the researchers (including Dr. Michael Jerrett, UCLA Fielding School of Public Health professor of environmental health sciences) say the increased vulnerabilities are not limited to the region, or those surveyed.

Fore more about the study, methods, data, and publication visit https://ph.ucla.edu/news/press-release/2021/sep/ucla-led-research-finds-ozone-exposure-contributes-development-type-2

Media inquiries, please contact Brad Smith at bssmith@support.ucla.edu

Long working hours led to 745 000 deaths from stroke and ischemic heart disease in 2016, a 29 per cent increase since 2000, according to the latest estimates by the World Health Organization and the International Labour Organization published in Environment International today.

In a first global analysis of the loss of life and health associated with working long hours, WHO and ILO estimate that, in 2016, 398 000 people died from stroke and 347 000 from heart disease as a result of having worked at least 55 hours a week. Between 2000 and 2016, the number of deaths from heart disease due to working long hours increased by 42%, and from stroke by 19%.

This work-related disease burden is particularly significant in men (72% of deaths occurred among males), people living in the Western Pacific and South-East Asia regions, and middle-aged or older workers. Most of the deaths recorded were among people dying aged 60-79 years, who had worked for 55 hours or more per week between the ages of 45 and 74 years.

With working long hours now known to be responsible for about one-third of the total estimated work-related burden of disease, it is established as the risk factor with the largest occupational disease burden. This shifts thinking towards a relatively new and more psychosocial occupational risk factor to human health.

Long working hours led to 745,000 deaths from stroke and ischemic heart disease in 2016, a 29 per cent increase since 2000, according to the latest estimates by the World Health Organization (WHO) and the International Labour (cq) Organization published today in Environment International.

In a first global analysis of the loss of life and health associated with working long hours, WHO and ILO estimate that, in 2016, 398,000 people died from stroke and 347,000 from heart disease as a result of having worked at least 55 hours a week. Between 2000 and 2016, the number of deaths from heart disease due to working long hours increased by 42%, and from stroke by 19%.

“Our working group of 21 experts from 10 countries from around the globe found 37 studies on the effect of long working hours on ischemic heart disease,“ said Dr. Jian Li, a UCLA Fielding School of Public Health professor and a co-author of the study. “This huge body of evidence was by consensus rated as sufficient evidence for harmfulness and showed an increased risk of ischemic heart disease of 17%.”

This work-related disease burden is particularly significant in men (72% of deaths occurred among males), people living in the Western Pacific and South-East Asia regions, and middle-aged or older workers, said Li, who also has an appointment at the UCLA School of Nursing. Most of the deaths recorded were among people dying aged 60-79 years, who had worked for 55 hours or more per week between the ages of 45 and 74 years.

“Our finding that long working hours increases ischemic heart disease risk is ground-breaking,” said co-author Dr. Tracey J. Woodruff, director of the Program on Reproductive Health & the Environment, University of California, San Francisco. “Studies like this cannot happen without good science and rigorous systematic review methods. This type of evidence is critical to decision-making and protecting public health.”

With working long hours now known to be responsible for about one-third of the total estimated work-related burden of disease, it is established as the risk factor with the largest occupational disease burden. This shifts thinking towards a relatively new and more psychosocial occupational risk factor to human health. The study concludes that working 55 or more hours per week is associated with an estimated 35% higher risk of a stroke and a 17% higher risk of dying from ischemic heart disease, compared to working 35-40 hours a week.

“Work intensification is the new normal for many. These new estimates show that working 55 hours or more a week is common & increasing,” said Professor Frida M. Fischer of the University of São Paulo, also a member of the WHO team. “Current and new ways of working, including the gig economy and teleworking, will further this upward trend.”

Further, the number of people working long hours is increasing, and currently stands at 9% of the total population globally. This trend puts even more people at risk of work-related disability and early death. The new analysis comes as the COVID-19 pandemic shines a spotlight on managing working hours; the pandemic is accelerating developments that could feed the trend towards increased working time.

Governments, employers and workers can take the following actions to protect workers’ health:

• governments can introduce, implement and enforce laws, regulations and policies that ban mandatory overtime and ensure maximum limits on working time;
• bipartite or collective bargaining agreements between employers and workers’ associations can arrange working time to be more flexible, while at the same time agreeing on a maximum number of working hours;
• employees could share working hours to ensure that numbers of hours worked do not climb above 55 or more per week.

“Cardiovascular diseases caused by long working hours disproportionately affect people living in the Western Pacific & South-East Asia, people aged 60-74 years and men,” said Professor Sergio Iavicoli, secretary-general of the International Commission on Occupational Health. “Actions need to be targeted to protect these workers in particular.”

Methods: Two systematic reviews and meta-analyses of the latest evidence were conducted for this study. Data from 37 studies on ischemic heart disease covering more than 768,000 participants and 22 studies on stroke covering more than 839,000 participants were synthesized. The study covered global, regional and national levels, and was based on data from more than 2,300 surveys collected in 154 countries from 1970-2018.

Data availability statement: Supplementary data available at: https://www.sciencedirect.com/science/article/pii/S0160412021002208?via%3Dihub#s0150

Citation: Frank Pega, Bálint Náfrádi, Natalie C. Momen, Yuka Ujita, Kai N. Streicher, Annette M. Prüss-Üstün, Alexis Descatha, Tim Driscoll, Frida M. Fischer, Lode Godderis, Hannah M. Kiiver, Jian Li, Linda L. Magnusson Hanson, Reiner Rugulies, Kathrine Sørensen, Tracey J. Woodruff. Global, regional, and national burdens of ischemic heart disease and stroke attributable to exposure to long working hours for 194 countries, 2000–2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environment International, 2021, 106595. https://doi.org/10.1016/j.envint.2021.106595

Note for editors:

Two systematic reviews and meta-analyses of the latest evidence were conducted for this study. Data from 37 studies on ischemic heart disease covering more than 768 000 participants and 22 studies on stroke covering more than 839 000 participants were synthesized. The study covered global, regional and national levels, and was based on data from more than 2300 surveys collected in 154 countries from 1970-2018.

Originally published May 17, 2021 at https://ph.ucla.edu/news/press-release/2021/may/who-long-working-hours-increase-deaths-heart-disease-and-stroke

Image by Marcin Wichary

Stress at work and at home are found to be linked to major depressive episodes and may have different effects on men and women, according to a study led by UCLA researchers.

“A person’s situation at home may impact their experience of stress at work, and vice versa,” said Wendie Robbins, a UCLA Fielding School of Public Health professor of environmental health sciences and a co-author of the study published in the August edition of the Journal of Psychosomatic Research.

Robbins, an RN who also teaches at the UCLA School of Nursing, said the findings demonstrate a role of familial stressors in mental health among working families, and helps to clarify previous findings regarding sex differences in associations of job strain and depression.

The researchers said that in studies of work stress, it is important to consider the impact of cross-over stress between work and home.

“The objective of our study was to assess how psychosocial stressors such as job strain and family strain might affect mental health,” said Timothy Matthews, a doctoral student in Environmental Health Sciences at the UCLA Fielding School of Public Health and first author of the study.

“Job strain has been found to be consistently related to mental health conditions such as depression, but much less is known about how job strain might affect men and women differently — there has been conflicting evidence regarding this issue,” he said.

Using data collected over nine years among a national sample of 1,581 U.S. workers in good mental health at baseline, the study found that family strain was associated with a one and half times higher risk of a major depressive episode in both men and women.

Job strain was associated with a more than twofold elevated risk of major depressive episode for men, whereas job strain did not show significant effect in women, according to the research team, which included scholars from the universities of Lausanne and Zurich in Switzerland.

“These findings have implications for the design and implementation of workplace stress reduction interventions and health promotion programs targeting workers’ mental health,” said Dr. Jian Li, also a professor in the Fielding School of Public Health and School of Nursing, and senior author of the study.

“Interventions may be more effective if they consider factors outside of the workplace, such as sex roles and the family environment at home,” Li said.

Data availability statement: The data from the national population-based Midlife in the United States (MIDUS) Study were used for this research article. The data can be accessed upon request (http://midus.wisc.edu/puboverview.php)

Methods: The MIDUS study included participants across a diverse range of social demographics and occupations, including 1,581 working men and women who were free from major depressive episode within the 12 months prior to the baseline survey (2004-2006). Information on job strain and family strain at baseline were used to examine prospective associations with major depressive episode 9 years later (2013-2014).

Citation: Matthews TA, Robbins W, Preisig M, von Känel R, Li J. “Associations of job strain and family strain with risk of major depressive episode: A prospective cohort study in U.S. working men and women.” Journal of Psychosomatic Research. 2021; 147:110541. doi: 10.1016/j.jpsychores.2021.110541

Image by Jesper Sehested at PlusLexia.com.

Even as governments across the United States consider lifting mask mandates and relaxing preventative measures as vaccination numbers creep up, new research from a UCLA-led team has found that such basic techniques significantly reduce the risk of getting COVID-19.

In addition, the research found that U.S. counties with higher exposures to poor air quality, historically, saw higher county-level COVID-19 mortality rates in 2020, with a 7.6% increase in in COVID-19 risk with a one-unit increase of 2.5 micrometers (µm), or PM2.5. The use of preventative measures – like stay home orders and masking – reduced the risk of COVID-19 by 8% and 15%, respectively, but did not reduce the increase of incidence in counties with poor air quality.

“This is evidence that long-term exposure to poor air quality increased the risk of COVID-19, during each surge, and cumulatively, in the United States,” said Dr. Zuo-Feng Zhang, UCLA Fielding School of Public Health (FSPH) distinguished professor of epidemiology and associate dean for research. “And although both state-level implementation of facemasks mandates and stay home orders were effective in preventing the spread of COVID-19, no clear effects were observed in terms of long-term exposure to fine particulate matter.”

The research – “Long-Term Exposure to PM2.5, Facemask Mandates, Stay Home Orders and COVID-19 Incidence in the United States” – is being published in the June edition of the peer-reviewed International Journal of Environmental Research and Public Health. The co-authors include researchers from UCLA, FSPH, the David Geffen School of Medicine at UCLA, and the State University of New York, Buffalo.

Both the importance of improving air quality and protective measures should be considered as among the “lessons learned” from the pandemic for policy makers and the public, said Dr. Jody Heymann, a UCLA distinguished professor of public health, public policy, and medicine, and a co-author.

“The burden of environmental risks is grossly unequal in the US and globally,” said Heymann, a physician and public policy expert who serves as director of the UCLA Fielding School of Public Health’s WORLD Policy Analysis Center. “This study raises profound concerns about one more way that elevated exposure to air pollutants likely has serious consequences for the health of all people in the US and fuels health inequalities experienced by communities of color and low-income communities. There is an urgent need to lower the long-term exposure to fine particulate matter for those with the greatest exposure in the U.S. and to create a healthy environment across all locations where adults live and work and children learn and play.”

Fine particulate matter, defined as inhalable pollutant-derived particles with a diameter equal to or less than 2.5 micrometers, has been linked to heart and lung diseases, including asthma. The risks are severe, despite the tiny size of the particles, authors said.

“How small is 2.5 micrometers? Think about a single hair from your head,” said Clairy Fang, a doctoral candidate with the FSPH department of epidemiology and a co-author. “The average human hair is about 70 micrometers in diameter – 30 times larger than the largest fine particle.”

Some 3,096 counties across the United States were included in the study; as of 12 September 2020, the average COVID-19 incidence in the U.S. was 2.6%, with a median of 1.27%. Counties with COVID-19 incidence greater than the national median had higher average fine particulate matter concentrations, earlier occurrences of the first case, more tests performed, and were less likely to reopen.

“The health problems, in turn, appear to be connected with increased susceptibility to COVID-19 via chronic respiratory inflammation, which predisposes individuals to the disease; increased vulnerabilities to any viral infection, including COVID,” said Dr. Jianyu Rao, FSPH professor of epidemiology and pathology. “Air pollution could lead to the over-expression of angiotensin-converting enzyme 2 (ACE2), which is the receptor SARS-CoV-2 binds to, thus increasing susceptibility to infection.”

Higher population densities, higher proportions of African American and Hispanic residents, a larger percentage of people living in poverty, higher populations with less than a high school education, and fewer owner-occupied properties were found in the counties with increased incidences of COVID-19.

“This is the first study to examine how the association between long-term exposure to fine particulate matter and COVID-19 incidence may be affected by state prevention policies, including facemask mandates and stay home policies,” said Dr. Yifang Zhu, FSPH professor of environmental health sciences and senior associate dean for academic programs. “Importantly, this study suggests a very real mitigation effect of stay home and face mask policies; facemask mandates, in fact, showed stronger protective effects toward the later course of the pandemic – exactly where we are today.”

The study is subject to some limitations, the authors said, including that both exposure and COVID-19 incidence are measured at county/state level, not at individual level. Overall, however, these findings show that long-term exposure to fine particulate matter is a risk factor, and that the levels of exposure to in the U.S. are sufficiently high to increase the risk of COVID-19.

“Although 43% of the US population has been vaccinated and many of the states have been reopened and planned to reopen, individuals who have not yet vaccinated or not fully vaccinated will be at a high risk of infection by emerging COVID-19 variants,” said Dr. Lina Mu, with the SUNY Buffalo and a co-author. “These individuals should still practice face covering and social distancing to protect themselves from infection before they are fully vaccinated.”

Funding: This research was funded by National Cancer Institute grant number NIH/NCI T32 CA009142.

Data availability statement: All data analyzed are publicly accessible, and the sources are listed here:

Citation: Fang, Fang; Mu, Lina; Zhu, Yifang; Rao, Jianyu; Heymann, Jody; Zhang, Zuo-Feng. 2021. “Long-Term Exposure to PM_2.5, Facemask Mandates, Stay Home Orders and COVID-19 Incidence in the United States” Int. J. Environ. Res. Public Health 18, no. 12: 6274. https://doi.org/10.3390/ijerph18126274

The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public’s health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 631 students from 26 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.

Originally published June 16, 2021 by UCLA Fielding School of Public Health at https://www.newswise.com/coronavirus/ucla-led-research-finds-connections-between-air-quality-and-covid-vulnerability .

Image by Chris Zúniga

Last summer, Global Plasma Solutions wanted to test whether the company’s air-purifying devices could kill COVID-19 virus particles but could find only a lab using a chamber the size of a shoebox for its trials. In the company-funded study, the virus was blasted with 27,000 ions per cubic centimeter.

In September, the company’s founder incidentally mentioned that the devices being offered for sale actually deliver a lot less ion power — 13 times less — into a full-sized room.

The company nonetheless used the shoebox results — over 99% viral reduction — in marketing its device heavily to schools as something that could combat COVID in classrooms far, far larger than a shoebox.

School officials desperate to calm worried parents bought these devices and others with a flood of federal funds, installing them in more than 2,000 schools across 44 states, a KHN investigation found. They use the same technology — ionization, plasma and dry hydrogen peroxide — that the Lancet COVID-19 Commission recently deemed “often unproven” and potential sources of pollution themselves.

In the frenzy, schools are buying technology that academic air-quality experts warn can lull them into a false sense of security or even potentially harm kids. And schools often overlook the fact that their trusted contractors — typically engineering, HVAC or consulting firms — stand to earn big money from the deals, KHN found.

Academic experts are encouraging schools to pump in more fresh air and use tried-and-true filters, like HEPA, to capture the virus. Yet every ion- or hydroxyl-blasting air purifier sale strengthens a firm’s next pitch: The device is doing a great job in the neighboring town.

“It’s a self-fulfilling prophecy. The more people buy these technologies, the more they get legitimacy,” said Jeffrey Siegel, a civil engineering professor at the University of Toronto. “It’s really the complete wild west out there.”

Marwa Zaatari, a member of the American Society of Heating, Refrigerating and Air-Conditioning Engineers’ (ASHRAE) Epidemic Task Force, first compiled a list of schools and districts using such devices.

Schools have been “bombarded with persistent salespersons peddling the latest air and cleaning technologies, including those with minimal evidence to-date supporting safety and efficacy” according to a report released Thursday by the Center for Green Schools and ASHRAE.

Zaatari said she was particularly concerned that officials in New Jersey are buying thousands of devices made by another company that says they emit ozone, which can exacerbate asthma and harm developing lungs, according to decades of research.

“We’re going to live in a world where the air quality in schools is worse after the pandemic, after all of this money,” Zaatari said. “It’s really sickening.”

The sales race is fueled by roughly $193 billion in federal funds allocated to schools for teacher pay and safety upgrades — a giant fund that can be used to buy air cleaners. And Democrats are pushing for $100 billion more that could also be spent on air cleaners.

WATCH: What impact is ‘the COVID slide’ having on students?

In April, Global Plasma Solutions said further tests show its devices inactivate COVID in the air and on surfaces in larger chambers. The company studies still use about twice the level of ions than its leaders have publicly said the devices can deliver, KHN found.

There is virtually no federal oversight or enforcement of safe air-cleaning technology. Only California bans air cleaners that emit a certain amount of ozone.

U.S. Rep. Robert “Bobby” Scott (D-Va.), chair of the education and labor committee, said the federal government typically is not involved in local decisions of what products to buy, although he hopes for more federal guidance.

In the meantime, “these school systems are dealing with contractors providing all kinds of services,” he said, “so you just have to trust them to get the best expert advice on what to do.”

These go-between contractors — and the air cleaner companies themselves — have a stake in the sales. While their names might appear in school board records, their role in selling the device or commission from the deal is seldom made public, KHN found.

A LinkedIn job ad with the logo for one air purifier company, ActivePure Technology, which employs former Trump adviser Dr. Deborah Birx as its chief medical and science adviser, recruited salespeople this way: “Make Tons of Money with this COVID-killing Technology!!” The commission, the post said, is up to $900 per device.

“We have reps [who] made over 6-figures in 1 month selling to 1 school district,” the ad says. “This could be the biggest opportunity you have seen!”

‘A tiny bit of ozone’

Schools in New Jersey have a particularly easy time buying air cleaners called Odorox: A state education agency lists them on their group-purchasing commodity list, with a large unit selling for more than $5,100. Originally used in home restoration and mold remediation, the devices have become popular in New Jersey schools as the company says its products can inactivate COVID.

In Newark, administrators welcomed students back to class last month with more than 3,200 Odorox units, purchased with $7.5 million in federal funds, said Steven Morlino, executive director of Facilities Management for Newark Public Schools.

“I think parents feel pretty comfortable that their children are going to a safe environment,” he said. “And so did the staff.”

Environmental health and air-quality experts, though, are alarmed by the district’s plan.

The Pyure company’s Odorox devices are on California air-quality regulators’ list of “potentially hazardous ozone generators sold as air purifiers” and cannot be sold in the state.

The company’s own research shows that its Boss XL3 device pumps out as much as 77 parts per billion of ozone, a level that exceeds limits set by California lawmakers for the sale of indoor air cleaners and the EPA standard for ground-level ozone — a limit set to protect children from the well-documented harm of ozone to developing lungs.

That level exceeds the industry’s self-imposed limit by more than 10 times and is “unacceptable,” according to William Bahnfleth, an architectural engineering professor at Penn State who studies indoor air quality and leads the ASHRAE Epidemic Task Force.

Jean-Francois “JF” Huc, CEO of the Pyure company, pointed out that the company’s study was done in a space smaller than they would recommend for such a powerful Odorox device. He cautioned that it was done that way to prove that home-restoration workers could be in the room with the device without violating work-safety rules.

“We provide very stringent operating guidelines around the size of room that our different devices should be put in,” he said. But school staffers are often not warned about the problems they could face if a too-powerful device is used in a too-small room, he acknowledged.

You can’t see or smell ozone, but lungs treat it like a “foreign invader,” said Michael Jerrett, who has studied its health effects as director of the UCLA Center for Occupational and Environmental Health.

Lung cells mount an immune-like response, which can trigger asthma complications and divert energy from normal lung function, he said. Chronic exposure has been linked to more emergency room visits and can even cause premature death. Once harmed, Jerrett said, children’s lungs may not regain full function.

“Ozone is a very serious public health problem,” Jerrett said.

By Lauren Weber and Christina Jewett of Kaiser Health News. First published by PBS News Hour on May 3, 2021.
Read  the full article at https://www.pbs.org/newshour/health/as-schools-spend-millions-on-air-purifiers-experts-warn-of-overblown-claims-and-harm-to-children
Featured image by Aaron Yoo

Downey residents affected by a natural gas leak Thursday should expect evacuations to continue overnight, officials said.

The leak prompted a small evacuation but a wide warning alert after a contractor cut a gas main in a residential area, authorities said.

Downey’s fire and police departments arrived at Stewart and Gray Road and Rives Avenue at 10:32 a.m., said Tracy Gonzales, the Fire Department’s supervisor of communications. Southern California Gas responded shortly after and have worked with first responders to stop the flow of gas from the severed 6-inch main line.

At 3 p.m., SoCalGas estimated it would take four hours to cap the leak, said Juddy Montenegro, Downey’s public information officer. At about 8:30 p.m., the fire officials said repairs would take another eight hours.

Police have secured the area and road closures are in place on Stewart and Gray Road from Paramount Boulevard to Rives Avenue.

A 300-foot evacuation zone was set up around the leak. Montenegro said about 40 households were affected by the evacuation orders.

No injuries have been reported, but the department is providing shelter for those evacuated to shield them from the light rain, Gonzales said. Residents in the area may smell a natural gas odor while crews work, SoCalGas said in a statement.

As of 1 p.m., Los Angeles County’s large vaccination site in Downey was still open and unaffected by the leak.

An emergency alert was issued about 12:35 p.m., notifying L.A. County residents to avoid the area. Montenegro said the city was “testing a new system” but the alert was only intended for residents near the area.

“Unfortunately, it went out to more people,” she said.

Michael Jerrett, a professor of environmental health sciences at UCLA’s Fielding School of Public Health, said that the short duration of the evacuation order and the size of the evacuation zone signaled that there wouldn’t be a high concentration of air toxins that could endanger returning residents. But he did advise that residents open windows to increase the air flow in their homes.

“I wouldn’t be concerned about going back to my own house if it was the same circumstances,” he said.

Read the full article at: https://www.latimes.com/california/story/2021-04-22/natural-gas-leak-pro…

By Priscella Vega and Sammy Roth originally published April 22, 2021

Picture by Baltimore Sun