title: Air pollution associated hypertension and increased blood pressure may be reduced by breastfeeding in Chinese children: the Seven Northeastern Cities Chinese Children's Study.
abstract: BACKGROUND
  Little is known about the association between air pollution and hypertension among children, and no studies report whether breastfeeding modifies this association in children.
  
  
  METHODS
  Nine thousand three hundred fifty-four Chinese children, ages 5-17 years old, from 24 elementary schools and 24 middle schools in the Seven Northeastern Cities during 2012-2013 were evaluated. The weight, height, and BP were measured. Four-year average concentrations of particles with an aerodynamic diameter of ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxides (NO2), ozone (O3), and carbon monoxide (CO) were calculated from monitoring stations. Two-level regression analysis was used to examine the effects, controlling for covariates.
  
  
  RESULTS
  The results showed that associations existed between hypertension and pollutants. The odds ratios for hypertension ranged from 1.12 per 46.3 μg/m3 increase for O3 (95% confidence interval [CI], 1.10-1.13) to 1.68 per 30.6 μg/m3 increase for PM10 (95% CI, 1.53-1.86). The increases in mean diastolic BP ranged from 0.58 mm Hg per 46.3 μg/m3 increase for O3 (95% CI, 0.52-0.63 mm Hg) to 2.89 mm Hg per 563.4 μg/m3 increase for CO (95% CI: 2.53-3.24 mm Hg). The increase in systolic BP ranged from 0.50 mm Hg per 46.3 μg/m3 increase for O3 (95% CI: 0.43-0.57 mm Hg) to 2.10 mm Hg per 30.6 μg/m3 increase for PM10 (95% CI, 1.73-2.47 mm Hg). Compared with children who had been breastfed, non-breastfed children exhibited consistently stronger effects.
  
  
  CONCLUSIONS
  Study findings indicate that high levels of PM10, SO2, NO2, O3, and CO are associated with increased arterial BP and hypertension among the children. Breastfeeding may reduce the risk.
authors.affiliation: Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province 510080, PR China. Electronic address: donggh5@mail.sysu.edu.cn.
authors.forename: Guang-Hui
authors.initials: GH
authors.lastname: Dong
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.
authors.forename: Zhengmin Min
authors.initials: ZM
authors.lastname: Qian
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.
authors.forename: Edwin
authors.initials: E
authors.lastname: Trevathan
authors.affiliation: Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province 510080, PR China.
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Zeng
authors.affiliation: School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Vaughn
authors.affiliation: Department of Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China.
authors.forename: Yu-Qin
authors.initials: YQ
authors.lastname: Liu
authors.affiliation: Department of Ambient Air Pollution Monitor, Shenyang Environmental Monitoring Center, Shenyang, China.
authors.forename: Wan-Hui
authors.initials: WH
authors.lastname: Ren
authors.affiliation: Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province 510080, PR China.
authors.forename: Xiao-Di
authors.initials: XD
authors.lastname: Qin
mesh_terms: D000293:Adolescent; D000393:Air Pollutants / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D001794:Blood Pressure; D001827:Body Height; D001835:Body Weight; D001942:Breast Feeding; D002248:Carbon Monoxide / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D002681:China; D002947:Cities; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D009585:Nitrogen Dioxide / Q000032:analysis; D010126:Ozone / Q000032:analysis; D015995:Prevalence; D013458:Sulfur Dioxide / Q000032:analysis
chemical_list: D000393:Air Pollutants; D013458:Sulfur Dioxide; D010126:Ozone; D002248:Carbon Monoxide; D009585:Nitrogen Dioxide
keywords: Air pollution; Blood pressure; Breastfeeding; Hypertension; Interaction effect