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Hwang A.-W.,Chang Gung University | Liao H.-F.,The School and Graduate Institute of Physical Therapy | Chen P.-C.,Institute of Occupational Medicine and Industrial Hygiene | Hsieh W.-S.,National Taiwan University Hospital | And 3 more authors.
Journal of the Formosan Medical Association | Year: 2014

Background/Purpose: Previous cohort studies for the general pediatric population had a limited focus on either environmental or biological influences, or a specific theoretical framework. The child's development, however, is a composite of physical, mental, social, environmental, and personal factors. The framework of the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) provides a comprehensive model for investigating the influential factors of child development within a biopsychosocial perspective. Methods: A birth cohort study followed up 122 child-parent dyads at birth and when the children were 4 months, 6 months, and 2.5 years old. Structural equation modeling was conducted based on the concept and the definitions of ICF-CY. Results: The path coefficients linking exposures and outcome variables were significant except for the paths from birth weight to general development of infants and toddlers. Home environment explained 59% of variance of infant developmental outcomes. Conclusion: The proposed model based on ICF-CY showed acceptable fit to the data and provides support for the importance of the home environment on general development of infants and toddlers. © 2012.


Wu C.-F.,National Taiwan University | Wu C.-F.,Institute of Occupational Medicine and Industrial Hygiene | Li Y.-R.,National Taiwan University | Kuo I.-C.,National Taiwan University | And 3 more authors.
Science of the Total Environment | Year: 2012

Background: Few studies included information on components and sources when exploring the cardiovascular health effects from personal exposure to particulate matters (PM). We previously reported that exposure to PM between 1.0 and 2.5μm (PM2.5-1) was associated with increased cardio-ankle vascular index (CAVI, an arterial stiffness index), while exposure to PM smaller than 0.25μm (PM0.25) decreased the heart rate variability (HRV) indices. The purpose of this study was to investigate the association between PM elements and cardiovascular health effects and identify responsible sources. Methods: In a panel study of seventeen mail carriers, the subjects were followed for 5-6days while delivering mail outdoors. Personal filter samples of PM2.5-1 and PM0.25 were analyzed for their elemental concentrations. The source-specific exposures were further estimated by using absolute principal factor analysis. We analyzed the component- and source-specific health effects on HRV indices and CAVI using mixed models. Results: Several elements in PM2.5-1 (e.g., cadmium and strontium) were associated with the CAVI. Subsequent analyses showed that an interquartile range increase in exposure to PM from regional sources was significantly associated with a 3.28% increase in CAVI (95% confidence interval (CI), 1.47%-5.13%). This significant effect remained (3.35%, CI: 1.62%-5.11%) after controlling for the ozone exposures. For exposures to PM0.25, manganese, calcium, nickel, and chromium were associated with the CAVI and/or the HRV indices. Conclusions: Our study suggests that PM2.5-1 and PM0.25 components may be associated with different cardiovascular effects. Health risks from exposure to PM from sources other than vehicle exhaust should not be underappreciated. © 2012 Elsevier B.V..


Hung Y.-J.,National Taiwan University | Hung Y.-J.,Chung Hwa University of Medical Technology | Hwang Y.-H.,Institute of Occupational Medicine and Industrial Hygiene | Liou S.-H.,National Defense Medical Center | And 4 more authors.
Physical Therapy | Year: 2014

Background. Lumbar disk degeneration (LDD) has been related to heavy physical loading. However, the quantification of the exposure has been controversial, and the dose-response relationship with the LDD has not been established.Objective. The purpose of this study was to investigate the dose-response relationship between lifetime cumulative lifting load and LDD.Design. This was a cross-sectional study.Methods. Every participant received assessments with a questionnaire, magnetic resonance imaging (MRI) of the lumbar spine, and estimation of lumbar disk compression load. The MRI assessments included assessment of disk dehydration, annulus tear, disk height narrowing, bulging, protrusion, extrusion, sequestration, degenerative and spondylolytic spondylolisthesis, foramina narrowing, and nerve root compression on each lumbar disk level. The compression load was predicted using a biomechanical software system.Results. A total of 553 participants were recruited in this study and categorized into tertiles by cumulative lifting load (ie, <4.0 ˟ 105, 4.0 ˟ 105 to 8.9 ˟ 106, and ≥8.9 ˟ 106 N h). The risk of LDD increased with cumulative lifting load. The best dose-response relationships were found at the L5–S1 disk level, in which high cumulative lifting load was associated with elevated odds ratios of 2.5 (95% confidence interval [95% CI]=1.5, 4.1) for dehydration and 4.1 (95% CI=1.9, 10.1) for disk height narrowing compared with low lifting load. Participants exposed to intermediate lifting load had an increased odds ratio of 2.1 (95% CI=1.3, 3.3) for bulging compared with low lifting load. The tests for trend were significant.Limitations. There is no “gold standard” assessment tool for measuring the lumbar compression load.Conclusions. The results suggest a dose-response relationship between cumulative lifting load and LDD. © 2014 A merican Physical Therapy Association.


Wang Y.,U.S. National Institutes of Health | Rogan W.J.,U.S. National Institutes of Health | Chen P.-C.,Institute of Occupational Medicine and Industrial Hygiene | Chen P.-C.,National Taiwan University | And 8 more authors.
Environmental Health Perspectives | Year: 2014

Background: Perfluoroalkyl substances (PFASs) are synthetic compounds that are widely used in industry and are often detectable in humans. In pregnant rats and their pups, PFASs can interfere with thyroid hormone homeostasis. In humans, maternal thyroid hormones supply the fetus throughout pregnancy, and thyroid hormones play a critical role in fetal growth and neurodevelopment. Objectives: We investigated the association between maternal PFAS exposure and thyroid hormone status in pregnant women and neonates. Methods: In a study of environmental exposure and health in Taiwan, we measured serum concentrations of nine PFASs and four thyroid hormones for 285 pregnant women in their third trimester, and also measured cord serum thyroid hormones for 116 neonates. Associations between maternal PFASs and maternal and cord thyroid hormones were examined in multiple linear regression models. Results: Perfluorohexanesulfonic acid concentrations were positively associated with maternal thyroid-stimulating hormone (TSH) levels. Pregnant women with higher levels of perfluorononanoic acid (PFNA), perfluoroundecanoic acid (PFUnDA), and perfluorododecanoic acid (PFDoDA) had lower free thyroxine (T4) and total T4 levels. For example, we estimated that maternal free T4 levels decreased 0.019 ng/dL (95% CI: -0.028, -0.009) with each nanogram per milliliter increase in maternal PFNA. Finally, maternal PFNA, PFUnDA, and PFDoDA levels were associated with lower cord total triiodothyronine (T3) and total T4 levels, and maternal perfluorodecanoic acid (PFDeA) was associated with lower cord total T3. Conclusions: Our results suggest that exposure to some PFASs during pregnancy may interfere with thyroid hormone homeostasis in pregnant women and fetuses.


Chen C.-H.,National Taiwan University Hospital | Chen C.-H.,Institute of Occupational Medicine and Industrial Hygiene | Chao H.J.,Taipei Medical University | Shen W.-C.,National Taiwan University | And 5 more authors.
Aerobiologia | Year: 2015

The prevalence of asthma in Taiwan is one of the highest in Asia. Mold exposures have been linked to the development and exacerbation of asthma. A pilot study of mold populations in homes in Taipei, Taiwan, was conducted in the spring of 2014. Dust and air samples were collected from five homes with an asthmatic child and five from control homes. A combined, settled-dust sample was collected in the living room and bedroom in each home using a Swiffer™ cloth. The dust (5 mg) was analyzed for 36 molds using a DNA-based analysis, mold-specific quantitative PCR, and mold contamination was estimated using the Environmental Relative Moldiness Index (ERMI) metric. The ERMI values were significantly (p = 0.03) greater in the homes of asthmatic children compared to the control homes, average 26.2 versus 17.4, respectively. Aspergillusochraceus was found in significantly greater numbers in homes of asthmatic children compared to control homes. Air samples were collected in each home for 2 min (total 63 l of air) using the Burkard portable air sampler for agar plates fitted with malt extract agar plates. The plates were incubated at 25 °C for 5 days, and the resulting mold colonies were enumerated. Significantly higher total numbers of molds were cultured from the air in homes of asthmatics compared to control homes. Although this is a pilot study, it suggests that asthmatic children in Taipei, Taiwan, live in homes with significantly greater exposures to molds. © 2014, Springer Science+Business Media Dordrecht.

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