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Air pollution, physical activity, and markers of acute airway oxidative stress and inflammation in adolescentsBackground: The airway inflammatory response is likely the mechanism for adverse health effects related to exposure to air pollution. Increased ventilation rates during physical activity in the presence of air pollution increases the inhaled dose of pollutants. However, physical activity may moderate the relationship between air pollution and the inflammatory response. The present study aimed to characterize, among healthy adolescents, the relationship between dose of inhaled air pollution, physical activity, and markers of lung function, oxidative stress, and airway inflammation. Methods: With a non-probability sample of adolescents, this observational study estimated the association between air pollution dose and outcome measures by use of general linear mixed models with an unstructured covariance structure and a random intercept for subjects to account for repeated measures within subjects. Results: A one interquartile range (IQR) (i.e., 345.64 μg) increase in ozone (O3) inhaled dose was associated with a 29.16% average decrease in the percentage of total oxidized compounds (%Oxidized). A one IQR (i.e., 2.368E+10 particle) increase in total particle number count in the inhaled dose (PNT) was associated with an average decrease in forced expiratory flow (FEF25-75) of 0.168 L/second. Increasing activity levels attenuated the relationship between PNT inhaled dose and exhaled nitric oxide (eNO). The relationship between O3 inhaled dose and percent oxidized exhaled breath condensate cystine (%CYSS) was attenuated by activity level, with increasing activity levels corresponding to smaller changes from baseline for a constant O3 inhaled dose. Conclusions: The moderating effects of activity level suggest that peaks of high concentration doses of air pollution may overwhelm the endogenous redox balance of cells, resulting in increased airway inflammation. Further research that examines the relationships between dose peaks over time and inflammation could help to determine whether a high concentration dose over a short period of time has a different effect than a lower concentration dose over a longer period of time.
Human papillomavirus-associated cancers in Georgia, 2008-2012Background: High-risk human papillomaviruses (HPV) cause most anal, vaginal, vulvar, penile, and oropharyngeal cancers, and virtually all cervical cancers. In 2014, in Georgia (GA), fewer than half of adolescent females and males aged 13-17 years received the three doses of the HPV vaccine. Increasing vaccination coverage among this age group, education of adolescents in regard to HPV risks, and cervical cancer screening of adults can prevent HPV-associated cancers. Methods: The incidence of HPV-associated cancers for 2008-2012 in GA was obtained from GA Comprehensive Cancer Registry data. Case definitions for HPV-associated cancers were based on standard definitions of the Centers for Disease Control and Prevention (CDC). Data for anatomic sites known to have HPV-associated cancers, including the cervix, vulva, vagina, penis, anus, and oropharynx, were analyzed. Also derived were ageadjusted rates, age-specific incidence rates, the percentage of each cancer found attributable to HPV, and ageadjusted incidence rates by geography. Results: During 2008-2012, a total of 6,056 HPV-associated cancers were diagnosed (males, 2,408; females, 3,648). Of these, 4,629 cancers were attributable to HPV (males, 1,574; females, 3,055). The most common cancers attributable to HPV were oropharyngeal cancers among males (1,182); and cervical cancers (1,862) among females. Females living in smaller urban counties had a higher cervical cancer incidence rate than females living in metropolitan counties and metro areas (1 million or more population). Males living in rural counties had a lower oropharyngeal cancer incidence compared to the state incidence rate. Conclusions: Since HPV vaccination at age 11-12 years can prevent HPV-related cancers in adulthood, clinicians should promote HPV vaccination along with routine immunizations to adolescents. Surveillance of HPVassociated cancers using GA cancer registry data is needed to track future changes in incidence data due to administering the HPV vaccine, increasing cervical cancer screening, and educating youth in GA about HPV risk factors.