Long-term PM2.5 exposure is associated with earlier onset of secondary sexual characteristics and key reproductive milestones across the pubertal trajectory, with stronger associations for several milestones among overweight/obese girls and stronger associations overall in areas with higher long-term average temperatures and lower long-term relative humidity.
Abstract
Background
PM2.5, a ubiquitous air pollutant with endocrine-disrupting potential, may contribute to the global trend of earlier puberty, yet evidence remains limited to isolated milestones and largely excludes boys.
Methods
We analyzed 3,833 children from the Chongqing Child Health Cohort (2014-2024). Time-varying PM2.5 exposure was defined as cumulative average residential PM2.5 from the prenatal period to milestone onset or censoring. Cox models were used to examine associations between cumulative average PM2.5 exposure and the timing of multiple pubertal milestones, with stratification by weight status and underlying health conditions and evaluation of whether these associations varied according to long-term average temperature and relative humidity.
Results
In girls, each 1 μg/m3 increase in cumulative average PM2.5 exposure was associated with earlier breast development (HR = 1.044, 95% CI: 1.039-1.050), pubic hair (HR = 1.038, 95% CI: 1.032-1.045) and menarche (HR = 1.033, 95% CI: 1.025-1.040), with a weaker association for axillary hair development (HR = 1.012, 95% CI: 1.005-1.020). In boys, each 1 μg/m3 increase was associated with earlier testicular development (HR = 1.065, 95% CI: 1.056-1.073), penile development (HR = 1.063, 95% CI: 1.055-1.071), pubic hair (HR = 1.032, 95% CI: 1.022-1.041), and beard development (HR = 1.032, 95% CI: 1.023-1.041), with a weaker association for spermatorrhea (HR = 1.024, 95% CI: 1.003-1.046). Associations varied by weight status and according to long-term average temperature and relative humidity, with stronger associations for several milestones among overweight/obese girls and stronger associations overall in areas with higher long-term average temperatures and lower long-term relative humidity.
Conclusion
Long-term PM2.5 exposure is associated with earlier onset of secondary sexual characteristics and key reproductive milestones across the pubertal trajectory. The observed associations varied according to long-term average temperature, relative humidity, and weight status, suggesting heterogeneity according to both background environmental conditions and individual susceptibility.
Prenatal PM
2.5
exposure has been associated with preterm birth (PTB), but evidence on exposure windows and population heterogeneity remain inconsistent.
This retrospective cohort included 35,136 singleton births at a Chengdu hospital from 2015 to 2024. Satellite- and monitor-based PM
2.5
exposures were estimated for conventional and fixed gestational windows. Logistic regression adjusted for individual characteristics, meteorological factors, conception season, and district fixed effects, with cluster-robust standard errors by district and last-menstrual-period year-month. PTB was classified as earlier (28–33 weeks) or late (34–36 weeks), and exploratory subgroup analyses were conducted.
Among 35,136 births, 2,622 (7.46%) were preterm. Mean whole-pregnancy PM
2.5
concentrations were 49.11
ug/m
3
for satellite data and 51.92
ug/m
3
for monitoring data. Per 10
ug/m
3
increase, the whole-pregnancy ORs were 1.089 (95% CI: 1.010–1.174) and 1.091 (95% CI: 0.996–1.195), respectively. Positive associations were observed during the first and third trimesters. For exposure during weeks 32–33, the ORs for late PTB were 1.063 and 1.069 using monitoring and satellite data, respectively; corresponding ORs for exposure during weeks 34–35 and PTB at week 36 were 1.084 and 1.095. Positive estimates occurred for late but not earlier PTB. Exploratory analyses suggested potential heterogeneity by ethnicity, parity, and migrant status.
Prenatal PM
2.5
exposure was associated with PTB,with positive associations observed for the first and third trimesters and in the landmark analyses of weeks 32–33 and 34–35. Satellite and monitoring data yielded similar district-level estimates, while satellite data provided complete coverage and narrower confidence intervals. Reducing PM
2.5
exposure throughout pregnancy may help reduce PTB burden.
Yi Zhang, Ke-Yao Lv, Yuxuan Yuan et al.· Frontiers in Public Health· 0 citations
Childhood anemia remains a major public health concern, but evidence regarding the associations of early-life exposure to PM2.5 mass and its components with childhood anemia across regions remains limited. We conducted a cross-sectional study of 449,894 children under 5 years from China, India, and 26 African countries. Prenatal, postnatal, and cumulative exposures to PM2.5 and five components, including black carbon, organic carbon, sulfate, dust, and sea salt, were estimated using NASA's MERRA-2 reanalysis data. The prevalence of childhood anemia was 26.9% in China, 62.6% in India, and 64.5% in Africa. In multivariable logistic regression models, each 1 μg/m3 increase in cumulative PM2.5 exposure was associated with higher odds of childhood anemia in China (odds ratio [OR] = 1.019, 95% confidence interval [CI]: 1.009, 1.028), India (OR = 1.009, 95% CI: 1.008, 1.009), and Africa (OR = 1.001, 95% CI: 1.000, 1.002). Organic carbon and dust also showed positive associations across all three regions. The population attributable fractions (PAFs) for cumulative PM2.5 exposure were 28.46% in China, 10.64% in India, and 0.69% in Africa. Among the individual components, organic carbon and black carbon had the largest positive PAF estimates in China, dust had the largest estimate in India, and organic carbon and dust had the largest positive estimates in Africa. Overall, our findings highlight the potential value of region-specific air-quality strategies that address total PM2.5 mass while prioritizing locally relevant components, particularly carbonaceous aerosols in China, dust-related PM2.5 in India, and organic carbon and dust in Africa.
Hejie Wang, Xin-Jie Xiao, Xiaoli Sun et al.· Ecotoxicology and Environmen...· 0 citations
Long-term exposure to fine particulate matter (PM2.5) has been suggested as an environmental risk factor for childhood leukemia. This study examined the association between time-varying PM2.5 exposure and leukemia incidence in a nationwide cohort of Korean children and adolescents. We used data from the National Health Insurance Service-National Sample Cohort (2002-2020), including beneficiaries aged 0-18 years at enrollment who were followed until leukemia onset, death, or study end. Leukemia onset was defined as the first hospital visit with a primary diagnostic code from the 10th revision of the International Classification of Diseases. Annual PM2.5 concentrations were assigned to all 226 inland districts in South Korea using mean predictions from a machine learning-based ensemble model. Cox regression models with time-varying exposures and confounders were applied. Two-pollutant models incorporating NO2 and O3 were conducted as sensitivity analyses. Among 384,606 individuals aged 0-18 at enrollment, 272 developed leukemia during follow-up, including 83 who were diagnosed after the age of 18 years. The cohort's average annual PM2.5 concentration was 29.6 μg/m3 (standard deviation: 3.1). Each 5 μg/m3 increase in annual PM2.5 was associated with a hazard ratio of 1.40 (95% confidence interval: 1.04-1.90) for leukemia. The effect estimate remained comparable when follow-up was censored at age 18 years, suggesting that the findings were not materially influenced by the inclusion of diagnoses occurring after age 18. Long-term PM2.5 exposure was associated with increased leukemia incidence in this national cohort. These findings underscore the importance of reducing air pollution to protect the health of children and adolescents.
Y. Choi, Hyemin Jang, Whanhee Lee et al.· Environmental Research· 0 citations
The associations of PM2.5 constituents with blood glucose and GDM remain unclear, and the interplay between PM2.5 exposure and thyroid hormone levels in relation to GDM has not been well characterized. This retrospective cohort study included 1314 pregnant women with data collected through multiple methods. A generalized linear model analyzed PM2.5-glucose links, logistic regression assessed pollutant-GDM associations, and stratified analyses explored these relationships at different thyroid hormone levels. In the study population, first-trimester exposure to SO42- and BC correlated positively with FBG, as did PM2.5 and its components in the second trimester. First-trimester SO4²⁻ exposure (OR=1.26, 95% CI: 1.06, 1.51) and second-trimester exposures to PM2.5 (OR=1.67, 95% CI: 1.19, 2.35), NO3⁻ (OR=1.34, 95% CI: 1.06, 1.68), and NH4⁺ (OR=1.33, 95% CI: 1.06, 1.65) were associated with increased GDM risk. Stratified analyses showed that second-trimester BC and OM were positively correlated with FBG in the high-TSH and low-FT4 strata, respectively. In addition, first-trimester exposure to SO42- (high TSH: OR = 1.42, 95% CI: 1.10, 1.84; low FT4: OR = 1.35, 95% CI: 1.05, 1.74) and to PM2.5 (high TSH: OR = 1.93, 95% CI: 1.14, 3.27; low FT4: OR = 1.82, 95% CI: 1.46, 2.25) in the second trimester were associated with higher odds of GDM. These findings show that PM2.5 exposure was associated with glucose dysregulation and GDM in pregnant women differently by trimester and component. Across the separate TSH- and FT4-stratified analyses, women in the high-TSH and low-FT4 strata, respectively, appeared to show greater susceptibility to air pollution-related GDM. These subgroup findings should therefore be interpreted as exploratory and require validation in future studies.
Qing-Yun Huo, Huajie Yang, Xue-Yao Jia et al.· Ecotoxicology and Environmen...· 0 citations
Regulating key PM2.5 chemical constituents is a vital public health strategy to mitigate the adverse effects of prenatal air pollution on children's metabolic health, and these findings underscore that regulating key PM2.5 chemical constituents is a vital public health strategy.
Shuqi Wu, Si-Shi Liu, Huan Li et al.· Ecotoxicology and Environmen...· 0 citations
Environmental pollution, especially fine particulate matter (PM2.5), poses serious health risks, notably for vulnerable groups like pregnant women. The COVID-19 pandemic changed environmental conditions and air quality, potentially influencing pregnancy outcomes. This study assessed the impact of COVID-19 on maternal experiences, quality of health services, and various aspects of perinatal care among women in Lithuania. In a cross-sectional sample of 1559 women, data from questionnaires, air quality measurements, and logistic regression analyses were used. Residential PM2.5 exposure was categorised into three levels, and its relationships with delivery method, neonatal birth weight, and APGAR scores were evaluated while controlling for confounders. Higher prenatal PM2.5 exposure was linked to greater caesarean section rates (75.9% in the high-exposure group), lower mean birth weight (declining from 3300 g in the low-exposure group to 2900 g in the high-exposure group), and reduced APGAR scores (mean 1 min score 6.5 and 5 min score 8.0 in the high-exposure group). These findings may indicate a notable adverse effect of prenatal PM2.5 exposure on neonatal outcomes during the pandemic.
Alina Liepinaitienė, Sonata Čerkauskaitė, A. Sarantaki et al.· Environments· 0 citations
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