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Int. J. Environ. Res. Public Health, Volume 11, Issue 2 (February 2014), Pages 1195-2360

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Open AccessArticle Cooling Effect of Rivers on Metropolitan Taipei Using Remote Sensing
Int. J. Environ. Res. Public Health 2014, 11(2), 1195-1210; doi:10.3390/ijerph110201195
Received: 27 November 2013 / Revised: 13 January 2014 / Accepted: 14 January 2014 / Published: 23 January 2014
Cited by 3 | PDF Full-text (407 KB) | HTML Full-text | XML Full-text
Abstract
This study applied remote sensing technology to analyze how rivers in the urban environment affect the surface temperature of their ambient areas. While surface meteorological stations can supply accurate data points in the city, remote sensing can provide such data in a two-dimensional
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This study applied remote sensing technology to analyze how rivers in the urban environment affect the surface temperature of their ambient areas. While surface meteorological stations can supply accurate data points in the city, remote sensing can provide such data in a two-dimensional (2-D) manner. The goal of this paper is to apply the remote sensing technique to further our understanding of the relationship between the surface temperature and rivers in urban areas. The 2-D surface temperature data was retrieved from Landsat-7 thermal infrared images, while data collected by Formosat-2 was used to categorize the land uses in the urban area. The land surface temperature distribution is simulated by a sigmoid function with nonlinear regression analysis. Combining the aforementioned data, the range of effect on the surface temperature from rivers can be derived. With the remote sensing data collected for the Taipei Metropolitan area, factors affecting the surface temperature were explored. It indicated that the effect on the developed area was less significant than on the ambient nature zone; moreover, the size of the buffer zone between the river and city, such as the wetlands or flood plain, was found to correlate with the affected distance of the river surface temperature. Full article
Open AccessArticle The Incidence of West Nile Disease in Russia in Relation to Climatic and Environmental Factors
Int. J. Environ. Res. Public Health 2014, 11(2), 1211-1232; doi:10.3390/ijerph110201211
Received: 1 August 2013 / Revised: 5 November 2013 / Accepted: 8 November 2013 / Published: 23 January 2014
Cited by 4 | PDF Full-text (2874 KB) | HTML Full-text | XML Full-text
Abstract
Since 1999, human cases of West Nile fever/neuroinvasive disease (WND) have been reported annually in Russia. The highest incidence has been recorded in three provinces of southern European Russia (Volgograd, Astrakhan and Rostov Provinces), yet in 2010–2012 the distribution of human cases expanded
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Since 1999, human cases of West Nile fever/neuroinvasive disease (WND) have been reported annually in Russia. The highest incidence has been recorded in three provinces of southern European Russia (Volgograd, Astrakhan and Rostov Provinces), yet in 2010–2012 the distribution of human cases expanded northwards considerably. From year to year, the number of WND cases varied widely, with major WND outbreaks in 1999, 2007, 2010, and 2012. The present study was aimed at identifying the most important climatic and environmental factors potentially affecting WND incidence in the three above-mentioned provinces and at building simple prognostic models, using those factors, by the decision trees method. The effects of 96 variables, including mean monthly temperature, relative humidity, precipitation, Normalized Difference Vegetation Index, etc. were taken into account. The findings of this analysis show that an increase of human WND incidence, compared to the previous year, was mostly driven by higher temperatures in May and/or in June, as well as (to a lesser extent) by high August-September temperatures. Declining incidence was associated with cold winters (December and/or January, depending on the region and type of model). WND incidence also tended to decrease during year following major WND outbreaks. Combining this information, the future trend of WND may be, to some extent, predicted, in accordance with the climatic conditions observed before the summer peak of WND incidence. Full article
(This article belongs to the Special Issue Epidemiology of West Nile Virus)
Open AccessArticle Relating Built Environment to Physical Activity: Two Failures to Validate
Int. J. Environ. Res. Public Health 2014, 11(2), 1233-1249; doi:10.3390/ijerph110201233
Received: 20 November 2013 / Revised: 23 December 2013 / Accepted: 24 December 2013 / Published: 23 January 2014
Cited by 2 | PDF Full-text (1595 KB) | HTML Full-text | XML Full-text
Abstract
The Irvine-Minnesota Inventory (IMI) is an audit tool used to record properties of built environments. It was designed to explore the relationships between environmental features and physical activity. As published, the IMI does not provide scoring to support this use. Two papers have
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The Irvine-Minnesota Inventory (IMI) is an audit tool used to record properties of built environments. It was designed to explore the relationships between environmental features and physical activity. As published, the IMI does not provide scoring to support this use. Two papers have since been published recommending methods to form scales from IMI items. This study examined these scoring procedures in new settings. IMI data were collected in two urban settings in Alberta in 2008. Scale scores were calculated using the methods presented in previous papers and used to test whether the relationships between IMI scales and walking behaviors were consistent with previously reported results. The scales from previous work did not show expected relationships with walking behavior. The scale construction techniques from previous work were repeated but scales formed in this way showed little similarity to previous scales. The IMI has great potential to contribute to understanding relationships between built environment and physical activity. However, constructing reliable and valid scales from IMI items will require further research. Full article
Open AccessArticle Evaluation of Respirable Crystalline Silica in High School Ceramics Classrooms
Int. J. Environ. Res. Public Health 2014, 11(2), 1250-1260; doi:10.3390/ijerph110201250
Received: 29 October 2013 / Revised: 10 January 2014 / Accepted: 10 January 2014 / Published: 23 January 2014
PDF Full-text (169 KB) | HTML Full-text | XML Full-text
Abstract
Air concentrations of respirable crystalline silica were measured in eleven (11) high school ceramics classrooms located in Salt Lake County, UT, USA. Respirable dust was collected on PVC filters using precision flow pumps and cyclone samplers (n = 44). Filters were subsequently analyzed
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Air concentrations of respirable crystalline silica were measured in eleven (11) high school ceramics classrooms located in Salt Lake County, UT, USA. Respirable dust was collected on PVC filters using precision flow pumps and cyclone samplers (n = 44). Filters were subsequently analyzed for respirable dust and percent crystalline silica content. The geometric mean of the silica concentrations was 0.009 mg/m3 near the teacher’s work station and 0.008 mg/m3 near the kilns. The number of students in the classroom was correlated to the silica concentration in the ceramics classroom, but no correlation was found between the silica concentrations and either the size of the classroom or the age of the building. Results from this study indicate that ceramics teachers may be at an increased risk of exposure to crystalline silica based on the ACGIH TLV of 0.025 mg/m3, with an exceedance of 21%. Full article
Open AccessArticle Embedded Fragments from U.S. Military Personnel—Chemical Analysis and Potential Health Implications
Int. J. Environ. Res. Public Health 2014, 11(2), 1261-1278; doi:10.3390/ijerph110201261
Received: 30 November 2013 / Revised: 27 December 2013 / Accepted: 2 January 2014 / Published: 23 January 2014
Cited by 9 | PDF Full-text (3596 KB) | HTML Full-text | XML Full-text
Abstract
Background: The majority of modern war wounds are characterized by high-energy blast injuries containing a wide range of retained foreign materials of a metallic or composite nature. Health effects of retained fragments range from local or systemic toxicities to foreign body reactions
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Background: The majority of modern war wounds are characterized by high-energy blast injuries containing a wide range of retained foreign materials of a metallic or composite nature. Health effects of retained fragments range from local or systemic toxicities to foreign body reactions or malignancies, and dependent on the chemical composition and corrosiveness of the fragments in vivo. Information obtained by chemical analysis of excised fragments can be used to guide clinical decisions regarding the need for fragment removal, to develop therapeutic interventions, and to better anticipate future medical problems from retained fragment related injuries. In response to this need, a new U.S Department of Defense (DoD) directive has been issued requiring characterization of all removed fragments to provide a database of fragment types occurring in combat injuries. Objectives: The objective of this study is to determine the chemical composition of retained embedded fragments removed from injured military personnel, and to relate results to histological findings in tissue adjacent to fragment material. Methods: We describe an approach for the chemical analysis and characterization of retained fragments and adjacent tissues, and include case examples describing fragments containing depleted uranium (DU), tungsten (W), lead (Pb), and non-metal foreign bodies composed of natural and composite materials. Fragments obtained from four patients with penetrating blast wounds to the limbs were studied employing a wide range of chemical and microscopy techniques. Available adjacent tissues from three of the cases were histologically, microscopically, and chemically examined. The physical and compositional properties of the removed foreign material surfaces were examined with energy dispersive x-ray fluorescence spectrometry (EDXRF), scanning electron microscopy (SEM), laser ablation inductively-coupled plasma mass-spectrometry (LA-ICP-MS), and confocal laser Raman microspectroscopy (CLRM). Quantitative chemical analysis of both fragments and available tissues was conducted employing ICP-MS. Results: Over 800 fragments have been characterized and included as part of the Joint Pathology Center Embedded Fragment Registry. Most fragments were obtained from penetrating wounds sustained to the extremities, particularly soft tissue injuries. The majority of the fragments were primarily composed of a single metal such as iron, copper, or aluminum with traces of antimony, titanium, uranium, and lead. One case demonstrated tungsten in both the fragment and the connected tissue, together with lead. Capsular tissue and fragments from a case from the 1991 Kuwait conflict showed evidence of uranium that was further characterized by uranium isotopic ratios analysis to contain depleted uranium. Conclusions: The present study provides a systematic approach for obtaining a full chemical characterization of retained embedded fragments. Given the vast number of combat casualties with retained fragments, it is expected that fragment analysis will have significant implications for the optimal short and long-term care of wounded service members. Full article
(This article belongs to the Special Issue Recent Advances on Environmental and Toxicologic Pathology)
Open AccessArticle A Review of Telehealth Service Implementation Frameworks
Int. J. Environ. Res. Public Health 2014, 11(2), 1279-1298; doi:10.3390/ijerph110201279
Received: 20 November 2013 / Revised: 24 December 2013 / Accepted: 25 December 2013 / Published: 23 January 2014
Cited by 10 | PDF Full-text (289 KB) | HTML Full-text | XML Full-text
Abstract
Despite the potential of telehealth services to increase the quality and accessibility of healthcare, the success rate of such services has been disappointing. The purpose of this paper is to find and compare existing frameworks for the implementation of telehealth services that can
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Despite the potential of telehealth services to increase the quality and accessibility of healthcare, the success rate of such services has been disappointing. The purpose of this paper is to find and compare existing frameworks for the implementation of telehealth services that can contribute to the success rate of future endeavors. After a thorough discussion of these frameworks, this paper outlines the development methodologies in terms of theoretical background, methodology and validation. Finally, the common themes and formats are identified for consideration in future implementation. It was confirmed that a holistic implementation approach is needed, which includes technology, organizational structures, change management, economic feasibility, societal impacts, perceptions, user-friendliness, evaluation and evidence, legislation, policy and governance. Furthermore, there is some scope for scientifically rigorous framework development and validation approaches. Full article
(This article belongs to the Special Issue Advances in Telehealthcare)
Open AccessArticle Genetic Diversity of Rotavirus Strains Circulating in Environmental Water and Bivalve Shellfish in Thailand
Int. J. Environ. Res. Public Health 2014, 11(2), 1299-1311; doi:10.3390/ijerph110201299
Received: 4 December 2013 / Revised: 12 January 2014 / Accepted: 15 January 2014 / Published: 24 January 2014
Cited by 2 | PDF Full-text (497 KB) | HTML Full-text | XML Full-text
Abstract
Rotavirus is a common cause of acute diarrhea in young children worldwide. This study investigated the prevalence and molecular characterization of rotavirus in environmental water and oyster samples in Thailand. A total of 114 water samples and 110 oyster samples were collected and
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Rotavirus is a common cause of acute diarrhea in young children worldwide. This study investigated the prevalence and molecular characterization of rotavirus in environmental water and oyster samples in Thailand. A total of 114 water samples and 110 oyster samples were collected and tested for group A rotavirus using RT-nested PCR. Rotavirus genotype was identified by phylogenetic analysis of the VP7 genetic sequences. Group A rotavirus was detected in 21 water samples (18.4%) and six oyster samples (5.4%). Twenty five rotavirus strains were successfully sequenced and classified into four genotypes; G1, G2, G3, and G9. Rotavirus G1 (three strains), G2 (three strains), and G9 (two strains) demonstrated the genetic sequences similar to human strains (90%–99% nucleotide identity), whereas G3 (17 strains) was closely related to animal strains (84%–98% nucleotide identity). G1 strains belonged to lineages I (sub-lineage c) and II. G2 strains belonged to lineage II. G9 strains belonged to lineages III (sub-lineage b) and IV. G3 strains belonged to lineages I, III (sub-lineage c), and IV with a predominance of lineage I. The present study provides important information on the rotavirus strains circulating in the environment. Full article
Open AccessArticle How do People in Rural India Perceive Improved Stoves and Clean Fuel? Evidence from Uttar Pradesh and Uttarakhand
Int. J. Environ. Res. Public Health 2014, 11(2), 1341-1358; doi:10.3390/ijerph110201341
Received: 3 December 2013 / Revised: 31 December 2013 / Accepted: 2 January 2014 / Published: 27 January 2014
Cited by 8 | PDF Full-text (327 KB) | HTML Full-text | XML Full-text
Abstract
Improved cook stoves (ICS) have been widely touted for their potential to deliver the triple benefits of improved household health and time savings, reduced deforestation and local environmental degradation, and reduced emissions of black carbon, a significant short-term contributor to global climate change.
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Improved cook stoves (ICS) have been widely touted for their potential to deliver the triple benefits of improved household health and time savings, reduced deforestation and local environmental degradation, and reduced emissions of black carbon, a significant short-term contributor to global climate change. Yet diffusion of ICS technologies among potential users in many low-income settings, including India, remains slow, despite decades of promotion. This paper explores the variation in perceptions of and preferences for ICS in Uttar Pradesh and Uttarakhand, as revealed through a series of semi-structured focus groups and interviews from 11 rural villages or hamlets. We find cautious interest in new ICS technologies, and observe that preferences for ICS are positively related to perceptions of health and time savings. Other respondent and community characteristics, e.g., gender, education, prior experience with clean stoves and institutions promoting similar technologies, and social norms as perceived through the actions of neighbours, also appear important. Though they cannot be considered representative, our results suggest that efforts to increase adoption and use of ICS in rural India will likely require a combination of supply-chain improvements and carefully designed social marketing and promotion campaigns, and possibly incentives, to reduce the up-front cost of stoves. Full article
Open AccessArticle Influences of Satisfaction with Telecare and Family Trust in Older Taiwanese People
Int. J. Environ. Res. Public Health 2014, 11(2), 1359-1368; doi:10.3390/ijerph110201359
Received: 18 November 2013 / Revised: 16 December 2013 / Accepted: 23 December 2013 / Published: 27 January 2014
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Abstract
The level of trust given towards telecare by the family members of older people using the service is extremely important. Family trust may be an influential factor in deciding whether to use such services. This study focuses on older people’s satisfaction with telecare
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The level of trust given towards telecare by the family members of older people using the service is extremely important. Family trust may be an influential factor in deciding whether to use such services. This study focuses on older people’s satisfaction with telecare and examines their family’s trust in telecare services. Influences on intention to continue using telecare services are also explored. A questionnaire-based survey on 60 communities dwelling older people who had been receiving telecare services in the past two years was employed. This study developed a satisfaction and trust scale based on previous studies. Our results show that older people’s satisfaction with telecare services and families’ trust were influential in decided whether to continue to use of telecare services. These findings can help medical institutions to better insight into the user experience of telecare to help them provide future services that better comply with clients’ desires and requirements. Full article
Open AccessArticle Detection of Potential Drug-Drug Interactions for Outpatients across Hospitals
Int. J. Environ. Res. Public Health 2014, 11(2), 1369-1383; doi:10.3390/ijerph110201369
Received: 17 December 2013 / Revised: 13 January 2014 / Accepted: 14 January 2014 / Published: 27 January 2014
Cited by 3 | PDF Full-text (442 KB) | HTML Full-text | XML Full-text
Abstract
The National Health Insurance Administration (NHIA) has adopted smart cards (or NHI-IC cards) as health cards to carry patients’ medication histories across hospitals in Taiwan. The aims of this study are to enhance a computerized physician order entry system to support drug-drug interaction
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The National Health Insurance Administration (NHIA) has adopted smart cards (or NHI-IC cards) as health cards to carry patients’ medication histories across hospitals in Taiwan. The aims of this study are to enhance a computerized physician order entry system to support drug-drug interaction (DDI) checking based on a patient’s medication history stored in his/her NHI-IC card. For performance evaluation, we developed a transaction tracking log to keep track of every operation on NHI-IC cards. Based on analysis of the transaction tracking log from 1 August to 31 October 2007, physicians read patients’ NHI-IC cards in 71.01% (8,246) of patient visits; 33.02% (2,723) of the card reads showed at least one medicine currently being taken by the patient, 82.94% of which were prescribed during the last visit. Among 10,036 issued prescriptions, seven prescriptions (0.09%) contained at least one drug item that might interact with the currently-taken medicines stored in NHI-IC cards and triggered pop-up alerts. This study showed that the capacity of an NHI-IC card is adequate to support DDI checking across hospitals. Thus, the enhanced computerized physician order entry (CPOE) system can support better DDI checking when physicians are making prescriptions and provide safer medication care, particularly for patients who receive medication care from different hospitals. Full article
Open AccessArticle Airborne Particulate Matter in School Classrooms of Northern Italy
Int. J. Environ. Res. Public Health 2014, 11(2), 1398-1421; doi:10.3390/ijerph110201398
Received: 29 November 2013 / Revised: 23 December 2013 / Accepted: 18 January 2014 / Published: 27 January 2014
Cited by 9 | PDF Full-text (664 KB) | HTML Full-text | XML Full-text
Abstract
Indoor size-fractioned particulate matter (PM) was measured in seven schools in Milan, to characterize their concentration levels in classrooms, compare the measured concentrations with the recommended guideline values, and provide a preliminary assessment of the efficacy of the intervention measures, based on the
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Indoor size-fractioned particulate matter (PM) was measured in seven schools in Milan, to characterize their concentration levels in classrooms, compare the measured concentrations with the recommended guideline values, and provide a preliminary assessment of the efficacy of the intervention measures, based on the guidelines developed by the Italian Ministry of Healthand applied to mitigate exposure to undesirable air pollutants. Indoor sampling was performed from Monday morning to Friday afternoon in three classrooms of each school and was repeated in winter 2011–2012 and 2012–2013. Simultaneously, PM2.5 samples were also collected outdoors. Two different photometers were used to collect the PM continuous data, which were corrected a posteriori using simultaneous gravimetric PM2.5 measurements. Furthermore, the concentrations of carbon dioxide (CO2) were monitored and used to determine the Air Exchange Rates in the classrooms. The results revealed poor IAQ in the school environment. In several cases, the PM2.5 and PM10 24 h concentrations exceeded the 24 h guideline values established by the World Health Organization (WHO). In addition, the indoor CO2 levels often surpassed the CO2 ASHRAE Standard. Our findings confirmed that important indoor sources (human movements, personal clouds, cleaning activities) emitted coarse particles, markedly increasing the measured PM during school hours. In general, the mean PM2.5 indoor concentrations were lower than the average outdoor PM2.5 levels, with I/O ratios generally <1. Fine PM was less affected by indoor sources, exerting a major impact on the PM1–2.5 fraction. Over half of the indoor fine particles were estimated to originate from outdoors. To a first approximation, the intervention proposed to reduce indoor particle levels did not seem to significantly influence the indoor fine PM concentrations. Conversely, the frequent opening of doors and windows appeared to significantly contribute to the reduction of the average indoor CO2 levels. Full article
Open AccessArticle Arylesterase Phenotype-Specific Positive Association Between Arylesterase Activity and Cholinesterase Specific Activity in Human Serum
Int. J. Environ. Res. Public Health 2014, 11(2), 1422-1443; doi:10.3390/ijerph110201422
Received: 3 June 2013 / Revised: 27 December 2013 / Accepted: 15 January 2014 / Published: 27 January 2014
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Abstract
Context: Cholinesterase (ChE) specific activity is the ratio of ChE activity to ChE mass and, as a biomarker of exposure to cholinesterase inhibitors, has a potential advantage over simple ChE activity. Objective: To examine the association of several potential correlates (serum
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Context: Cholinesterase (ChE) specific activity is the ratio of ChE activity to ChE mass and, as a biomarker of exposure to cholinesterase inhibitors, has a potential advantage over simple ChE activity. Objective: To examine the association of several potential correlates (serum arylesterase/paraoxonase activity, serum albumin, sex, age, month of blood collection, and smoking) with plasma ChE specific activity. Methods: We analyzed data from 195 cancer-free controls from a nested case-control study, accounting for potential confounding. Results: Arylesterase activity had an independent, statistically significant positive association with ChE specific activity, and its magnitude was the greatest for the arylesterase phenotype corresponding to the QQ PON1192 genotype followed by phenotypes corresponding to QR and RR genotypes. Serum albumin was positively associated with ChE specific activity. Conclusions: Plasma arylesterase activity was positively associated with plasma ChE specific activity. This observation is consistent with protection conferred by a metabolic phenotype resulting in reduced internal dose. Full article
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Open AccessArticle Understanding Older Adults’ Usage of Community Green Spaces in Taipei, Taiwan
Int. J. Environ. Res. Public Health 2014, 11(2), 1444-1464; doi:10.3390/ijerph110201444
Received: 17 September 2013 / Revised: 20 January 2014 / Accepted: 21 January 2014 / Published: 27 January 2014
Cited by 8 | PDF Full-text (619 KB) | HTML Full-text | XML Full-text
Abstract
As the world’s population ages, there is an increasing need for community environments to support physical activity and social connections for older adults. This exploratory study sought to better understand older adults’ usage and perceptions of community green spaces in Taipei, Taiwan, through
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As the world’s population ages, there is an increasing need for community environments to support physical activity and social connections for older adults. This exploratory study sought to better understand older adults’ usage and perceptions of community green spaces in Taipei, Taiwan, through direct observations of seven green spaces and nineteen structured interviews. Descriptive statistics from observations using the System for Observing Play and Recreation in Communities (SOPARC) confirm that older adults use Taipei’s parks extensively. Our analyses of interviews support the following recommendations for age-friendly active living initiatives for older adults: make green spaces accessible to older adults; organize a variety of structured activities that appeal to older adults particularly in the morning; equip green spaces for age-appropriate physical activity; and, promote the health advantages of green spaces to older adults. Full article
Open AccessArticle Resistance Markers and Genetic Diversity in Acinetobacter baumannii Strains Recovered from Nosocomial Bloodstream Infections
Int. J. Environ. Res. Public Health 2014, 11(2), 1465-1478; doi:10.3390/ijerph110201465
Received: 28 October 2013 / Revised: 9 January 2014 / Accepted: 18 January 2014 / Published: 28 January 2014
Cited by 5 | PDF Full-text (1186 KB) | HTML Full-text | XML Full-text
Abstract
In this study, phenotypic and genotypic methods were used to detect metallo-β-lactamases, cephalosporinases and oxacillinases and to assess genetic diversity among 64 multiresistant Acinetobacter baumannii strains recovered from blood cultures in five different hospitals in Brazil from December 2008 to June 2009. High
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In this study, phenotypic and genotypic methods were used to detect metallo-β-lactamases, cephalosporinases and oxacillinases and to assess genetic diversity among 64 multiresistant Acinetobacter baumannii strains recovered from blood cultures in five different hospitals in Brazil from December 2008 to June 2009. High rates of resistance to imipenem (93.75%) and polymyxin B (39.06%) were observed using the disk diffusion (DD) method and by determining the minimum inhibitory concentration (MIC). Using the disk approximation method, thirty-nine strains (60.9%) were phenotypically positive for class D enzymes, and 51 strains (79.6%) were positive for cephalosporinase (AmpC). Using the E-test, 60 strains (93.75%) were positive for metallo-β-lactamases (MβLs). All strains were positive for at least one of the 10 studied genes; 59 (92.1%) contained blaVIM-1, 79.6% contained blaAmpC, 93.7% contained blaOXA23 and 84.3% contained blaOXA51. Enterobacteria Repetitive Intergenic Consensus (ERIC)-PCR analysis revealed a predominance of certain clones that differed from each other. However, the same band pattern was observed in samples from the different hospitals studied, demonstrating correlation between the genotypic and phenotypic results. Thus, ERIC-PCR is an appropriate method for rapidly clustering genetically related isolates. These results suggest that defined clonal clusters are circulating within the studied hospitals. These results also show that the prevalence of MDR A. baumannii may vary among clones disseminated in specific hospitals, and they emphasize the importance of adhering to appropriate infection control measures. Full article
Open AccessArticle Joint Effects of Smoking and Sedentary Lifestyle on Lung Function in African Americans: The Jackson Heart Study Cohort
Int. J. Environ. Res. Public Health 2014, 11(2), 1500-1519; doi:10.3390/ijerph110201500
Received: 21 November 2013 / Revised: 16 January 2014 / Accepted: 16 January 2014 / Published: 28 January 2014
PDF Full-text (416 KB) | HTML Full-text | XML Full-text
Abstract
This study examined: (a) differences in lung function between current and non current smokers who had sedentary lifestyles and non sedentary lifestyles and (b) the mediating effect of sedentary lifestyle on the association between smoking and lung function in African Americans. Sedentary lifestyle
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This study examined: (a) differences in lung function between current and non current smokers who had sedentary lifestyles and non sedentary lifestyles and (b) the mediating effect of sedentary lifestyle on the association between smoking and lung function in African Americans. Sedentary lifestyle was defined as the lowest quartile of the total physical activity score. The results of linear and logistic regression analyses revealed that non smokers with non sedentary lifestyles had the highest level of lung function, and smokers with sedentary lifestyles had the lowest level. The female non-smokers with sedentary lifestyles had a significantly higher FEV1% predicted and FVC% predicted than smokers with non sedentary lifestyles (93.3% vs. 88.6%; p = 0.0102 and 92.1% vs. 86.9%; p = 0.0055 respectively). FEV1/FVC ratio for men was higher in non smokers with sedentary lifestyles than in smokers with non sedentary lifestyles (80.9 vs. 78.1; p = 0.0048). Though smoking is inversely associated with lung function, it seems to have a more deleterious effect than sedentary lifestyle on lung function. Physically active smokers had higher lung function than their non physically active counterparts. Full article
Open AccessArticle Perceptions of Heat Risk to Health: A Qualitative Study of Professional Bus Drivers and Their Managers in Jinan, China
Int. J. Environ. Res. Public Health 2014, 11(2), 1520-1535; doi:10.3390/ijerph110201520
Received: 17 October 2013 / Revised: 17 December 2013 / Accepted: 3 January 2014 / Published: 28 January 2014
Cited by 3 | PDF Full-text (276 KB) | HTML Full-text | XML Full-text
Abstract
Summer extreme heat threatens the health of individuals, especially persons who are involved in outdoor activities. Ensuring the normal function of a city, bus drivers are among those who participate in outdoor physical activities and are exposed to excessive heat in hot summer
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Summer extreme heat threatens the health of individuals, especially persons who are involved in outdoor activities. Ensuring the normal function of a city, bus drivers are among those who participate in outdoor physical activities and are exposed to excessive heat in hot summer weather. This qualitative study was performed to explore professional bus drivers’ in-depth views of extreme heat risks to their health, and ultimately develop targeted advice and policy interventions for city bus drivers. An interview-based study was performed among professional bus drivers in Jinan, China, including four focus groups with professional bus drivers (n = 37) and three interviews with their managers (n = 14). Five central themes or categories from the bus driver interviews were found: concerns about summer heat; health effects related to extreme heat; adaptive measures; barriers in implementing these adaptive measures; and suggested interventions. The beneficial role of cooling facilities (particularly air-conditioning) during extreme heat are addressed. The barriers not only impede the implementation of behavioral adaptive measures but also enhance the negative attitudes of bus drivers towards their effectiveness. The responsibilities of managers in promoting preventive actions are addressed. Full article
Open AccessArticle Investigating Environmental Determinants of Injury and Trauma in the Canadian North
Int. J. Environ. Res. Public Health 2014, 11(2), 1536-1548; doi:10.3390/ijerph110201536
Received: 20 November 2013 / Revised: 10 January 2014 / Accepted: 18 January 2014 / Published: 28 January 2014
Cited by 5 | PDF Full-text (247 KB) | HTML Full-text | XML Full-text
Abstract
Unintentional injury and trauma rates are disproportionately high in Inuit regions, and environmental changes are predicted to exacerbate injury rates. However, there is a major gap in our understanding of the risk factors contributing to land-based injury and trauma in the Arctic. We
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Unintentional injury and trauma rates are disproportionately high in Inuit regions, and environmental changes are predicted to exacerbate injury rates. However, there is a major gap in our understanding of the risk factors contributing to land-based injury and trauma in the Arctic. We investigated the role of environmental and other factors in search and rescue (SAR) incidents in a remote Inuit community in northern Canada using a collaborative mixed methods approach. We analyzed SAR records from 1995 to 2010 and conducted key consultant interviews in 2010 and 2011. Data showed an estimated annual SAR incidence rate of 19 individuals per 1,000. Weather and ice conditions were the most frequent contributing factor for cases. In contrast with other studies, intoxication was the least common factor associated with SAR incidents. The incidence rate was six times higher for males than females, while land-users aged 26–35 had the highest incidence rate among age groups. Thirty-four percent of individuals sustained physical health impacts. Results demonstrate that environmental conditions are critical factors contributing to physical health risk in Inuit communities, particularly related to travel on sea ice during winter. Age and gender are important risk factors. This knowledge is vital for informing management of land-based physical health risk given rapidly changing environmental conditions in the Arctic. Full article
(This article belongs to the Special Issue IJERPH: 10th Anniversary)
Open AccessArticle Effects of Simulated Heat Waves on ApoE-/- Mice
Int. J. Environ. Res. Public Health 2014, 11(2), 1549-1556; doi:10.3390/ijerph110201549
Received: 16 December 2013 / Revised: 19 January 2014 / Accepted: 21 January 2014 / Published: 28 January 2014
Cited by 2 | PDF Full-text (322 KB) | HTML Full-text | XML Full-text
Abstract
The effects of simulated heat waves on body weight, body temperature, and biomarkers of cardiac function in ApoE-/- mice were investigated. Heat waves were simulated in a meteorological environment simulation chamber according to data from a heat wave that occurred in July 2001
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The effects of simulated heat waves on body weight, body temperature, and biomarkers of cardiac function in ApoE-/- mice were investigated. Heat waves were simulated in a meteorological environment simulation chamber according to data from a heat wave that occurred in July 2001 in Nanjing, China. Eighteen ApoE-/- mice were divided into control group, heat wave group, and heat wave BH4 group. Mice in the heat wave and BH4 groups were exposed to simulated heat waves in the simulation chamber. Mice in BH4 group were treated with gastric lavage with BH4 2 h prior to heat wave exposure. Results showed that the heat waves did not significantly affect body weight or ET-1 levels. However, mice in the heat wave group had significantly higher rectal temperature and NO level and lower SOD activity compared with mice in the control group (p < 0.01), indicating that heat wave had negative effects on cardiac function in ApoE-/- mice. Gastric lavage with BH4 prior to heat wave exposure significantly reduced heat wave-induced increases in rectal temperature and decreases in SOD activity. Additionally, pretreatment with BH4 further increased NO level in plasma. Collectively, these beneficial effects demonstrate that BH4 may potentially mitigate the risk of coronary heart disease in mice under heat wave exposure. These results may be useful when studying the effects of heat waves on humans. Full article
Open AccessArticle Diffusion of Nitrogen and Phosphorus Across the Sediment-Water Interface and In Seawater at Aquaculture Areas of Daya Bay, China
Int. J. Environ. Res. Public Health 2014, 11(2), 1557-1572; doi:10.3390/ijerph110201557
Received: 13 December 2013 / Revised: 10 January 2014 / Accepted: 18 January 2014 / Published: 28 January 2014
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Abstract
With the yearly increasing marine culture activities in floating cages in Daya Bay, China, the effects of pollution may overlap and lead to more severe water environmental problems. In order to track the impacts of the marine culture in floating cages on water
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With the yearly increasing marine culture activities in floating cages in Daya Bay, China, the effects of pollution may overlap and lead to more severe water environmental problems. In order to track the impacts of the marine culture in floating cages on water environment, sediments and overlying water were sampled by cylindrical samplers at three representative aquaculture areas of Daya Bay. The water content, porosity, density of sediments as well as the vertical distributions of ammonia nitrogen and active phosphate in pore water along sediments depth were measured. The release rate and annual released quantity of the nutrients across sediment-water interface were calculated using Fick’s Law. A horizontal two-dimensional mathematical model was developed to compute the spatial and temporal distributions of the nutrients in seawater after being released across the sediment-water interface. The results showed that the sediments, with a high content and a large annual released quantity of nitrogen and phosphorus, constitute a potential inner source of seawater pollution. Influenced by tide and water depth, the scope of diffusion and migration of the nutrients appears as a long belt which is about 1 km long and 50 m wide. Seawater in this area is vulnerable to eutrophication. Full article
Open AccessArticle An FPGA-Based Rapid Wheezing Detection System
Int. J. Environ. Res. Public Health 2014, 11(2), 1573-1593; doi:10.3390/ijerph110201573
Received: 30 December 2013 / Revised: 24 January 2014 / Accepted: 24 January 2014 / Published: 29 January 2014
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Abstract
Wheezing is often treated as a crucial indicator in the diagnosis of obstructive pulmonary diseases. A rapid wheezing detection system may help physicians to monitor patients over the long-term. In this study, a portable wheezing detection system based on a field-programmable gate array
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Wheezing is often treated as a crucial indicator in the diagnosis of obstructive pulmonary diseases. A rapid wheezing detection system may help physicians to monitor patients over the long-term. In this study, a portable wheezing detection system based on a field-programmable gate array (FPGA) is proposed. This system accelerates wheezing detection, and can be used as either a single-process system, or as an integrated part of another biomedical signal detection system. The system segments sound signals into 2-second units. A short-time Fourier transform was used to determine the relationship between the time and frequency components of wheezing sound data. A spectrogram was processed using 2D bilateral filtering, edge detection, multithreshold image segmentation, morphological image processing, and image labeling, to extract wheezing features according to computerized respiratory sound analysis (CORSA) standards. These features were then used to train the support vector machine (SVM) and build the classification models. The trained model was used to analyze sound data to detect wheezing. The system runs on a Xilinx Virtex-6 FPGA ML605 platform. The experimental results revealed that the system offered excellent wheezing recognition performance (0.912). The detection process can be used with a clock frequency of 51.97 MHz, and is able to perform rapid wheezing classification. Full article
Open AccessArticle Reliability, Validity, and Significance of Assessment of Sense of Contribution in the Workplace
Int. J. Environ. Res. Public Health 2014, 11(2), 1594-1604; doi:10.3390/ijerph110201594
Received: 10 October 2013 / Revised: 17 January 2014 / Accepted: 24 January 2014 / Published: 29 January 2014
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Abstract
The purpose of this study was to assess the validity and reliability of the Sense of Contribution Scale (SCS), a newly developed, 7-item questionnaire used to measure sense of contribution in the workplace. Workers at 272 organizations answered questionnaires that included the SCS.
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The purpose of this study was to assess the validity and reliability of the Sense of Contribution Scale (SCS), a newly developed, 7-item questionnaire used to measure sense of contribution in the workplace. Workers at 272 organizations answered questionnaires that included the SCS. Because of non-participation or missing data, the number of subjects included in the analyses for internal consistency and validity varied from 1,675 to 2,462 (response rates 54.6%–80.2%). Fifty-four workers were included in the analysis of test–retest reliability (response rate, 77.1%). The SCS showed high internal consistency (Cronbach’s α coefficients in men and women were 0.85 and 0.86, respectively) and test–retest reliability (intraclass correlation coefficient = 0.91). Significant (p < 0.001), positive, moderate correlations were found between the SCS score and scores for organization-based self-esteem and work engagement in both genders, which support the SCS’s convergent and discriminant validity. The criterion validity of the SCS was supported by the finding that in both genders, the SCS scores were significantly (p < 0.05) and inversely associated with psychological distress and sleep disturbance in crude and in multivariable analyses that adjusted for demographics, organization-based self-esteem, work engagement, effort–reward ratio, workplace bullying, and procedural and interactional justice. The SCS is a psychometrically satisfactory measure of sense of contribution in the workplace. The SCS provides a new and useful instrument to measure sense of contribution, which is independently associated with mental health in workers, for studies in organizational science, occupational health psychology and occupational medicine. Full article
Open AccessArticle Using Social Network Analysis to Evaluate Health-Related Adaptation Decision-Making in Cambodia
Int. J. Environ. Res. Public Health 2014, 11(2), 1605-1625; doi:10.3390/ijerph110201605
Received: 17 December 2013 / Revised: 15 January 2014 / Accepted: 16 January 2014 / Published: 30 January 2014
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Abstract
Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate
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Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate change in the health sector. This study uses social network research to identify key organisational players engaged in developing health-related adaptation activities in Cambodia. It finds that strong partnerships are reported as developing across sectors and different types of organisations in relation to the health risks from climate change. Government ministries are influential organisations, whereas donors, development banks and non-government organisations do not appear to be as influential in the development of adaptation policy in the health sector. Finally, the study highlights the importance of informal partnerships (or ‘shadow networks’) in the context of climate change adaptation policy and activities. The health governance ‘map’ in relation to health and climate change adaptation that is developed in this paper is a novel way of identifying organisations that are perceived as key agents in the decision-making process, and it holds substantial benefits for both understanding and intervening in a broad range of climate change-related policy problems where collaboration is paramount for successful outcomes. Full article
(This article belongs to the collection Climate Change and Human Health)
Open AccessArticle Risk Factors Associated with the Choice to Drink Bottled Water and Tap Water in Rural Saskatchewan
Int. J. Environ. Res. Public Health 2014, 11(2), 1626-1646; doi:10.3390/ijerph110201626
Received: 12 November 2013 / Revised: 30 December 2013 / Accepted: 22 January 2014 / Published: 30 January 2014
Cited by 3 | PDF Full-text (578 KB) | HTML Full-text | XML Full-text
Abstract
A cross-sectional study investigated risk factors associated with choices to drink bottled water and tap water in rural Saskatchewan. Of 7,500 anonymous postal questionnaires mailed out, 2,065 responses were analyzed using generalized linear mixed models. Those who reported a water advisory (p
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A cross-sectional study investigated risk factors associated with choices to drink bottled water and tap water in rural Saskatchewan. Of 7,500 anonymous postal questionnaires mailed out, 2,065 responses were analyzed using generalized linear mixed models. Those who reported a water advisory (p < 0.001) or living in the area for £10 years (p = 0.01) were more likely to choose bottled water. Those who reported tap water was not safe to drink were more likely to choose bottled water, an effect greater for those who had no aesthetic complaints (p ≤ 0.001), while those with aesthetic complaints were more likely to choose bottled water if they believed the water was safe (p < 0.001). Respondents who treated their water and did not use a community supply were more likely to choose bottled water (p < 0.001), while those who did not treat their water were more likely to choose bottled water regardless of whether a community supply was used (p < 0.001). A similar pattern of risk factors was associated with a decreased likelihood of consuming tap water daily; however, the use of a community water supply was not significant. Understanding the factors involved in drinking water choices could inform public health education efforts regarding water management in rural areas. Full article
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Open AccessArticle Associations of Serum Retinol, α-Tocopherol, and γ-Tocopherol with Biomarkers among Healthy Japanese Men
Int. J. Environ. Res. Public Health 2014, 11(2), 1647-1660; doi:10.3390/ijerph110201647
Received: 11 November 2013 / Revised: 16 January 2014 / Accepted: 22 January 2014 / Published: 30 January 2014
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Abstract
Retinol, α-tocopherol, and γ-tocopherol are fat-soluble vitamins acting as antioxidants via the prevention of lipid oxidation. Little is known about circulatory levels in healthy individuals. The present cross-sectional study aimed at elucidating the relationship between these antioxidants and clinical biomarkers in 206 male
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Retinol, α-tocopherol, and γ-tocopherol are fat-soluble vitamins acting as antioxidants via the prevention of lipid oxidation. Little is known about circulatory levels in healthy individuals. The present cross-sectional study aimed at elucidating the relationship between these antioxidants and clinical biomarkers in 206 male (median age 41 years, range 23–67) employees from companies located in the Okayama Prefecture, Japan. Subjects younger than 40 years (n = 94) showed a positive association of the frequency of alcohol consumption with the circulating retinol (β = 0.344, p = 0.001) and γ-tocopherol levels (β = 0.219, p = 0.041), and an inverse association of fast insulin with serum retinol (β = −0.301, p = 0.009). In participants older than 40 years (n = 112) we found that an inverse association of HOMA-R with serum retinol (β = −0.262, p = 0.021), α-tocopherol (β = −0.236, p = 0.035), and γ-tocopherol levels (β = −0.224, p = 0.052); and cigarette smoking was inversely associated with the levels of serum α-tocopherol (β = −0.286, p = 0.008) and γ-tocopherol (β = −0.229, p = 0.040). We further found negative relationships between serum ferritin and the retinol (β = −0.211, p = 0.032) and α-tocopherol levels (β = −0.223, p = 0.022) in men over 40 years of age. The present study suggests that the circulatory levels of antioxidant vitamins may modulate the action of insulin and that higher levels of iron might decrease the levels of antioxidant vitamins in the blood. Full article
Open AccessArticle A Seventeen-Year Epidemiological Surveillance Study of Borrelia burgdorferi Infections in Two Provinces of Northern Spain
Int. J. Environ. Res. Public Health 2014, 11(2), 1661-1672; doi:10.3390/ijerph110201661
Received: 3 December 2013 / Revised: 15 January 2014 / Accepted: 26 January 2014 / Published: 30 January 2014
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Abstract
This paper reports a 17-year seroepidemiological surveillance study of Borrelia burgdorferi infection, performed with the aim of improving our knowledge of the epidemiology of this pathogen. Serum samples (1,179) from patients (623, stratified with respect to age, sex, season, area of residence and
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This paper reports a 17-year seroepidemiological surveillance study of Borrelia burgdorferi infection, performed with the aim of improving our knowledge of the epidemiology of this pathogen. Serum samples (1,179) from patients (623, stratified with respect to age, sex, season, area of residence and occupation) bitten by ticks in two regions of northern Spain were IFA-tested for B. burgdorferi antibodies. Positive results were confirmed by western blotting. Antibodies specific for B. burgdorferi were found in 13.3% of the patients; 7.8% were IgM positive, 9.6% were IgG positive, and 4.33% were both IgM and IgG positive. Five species of ticks were identified in the seropositive patients: Dermacentor marginatus (41.17% of such patients) Dermacentor reticulatus (11.76%), Rhiphicephalus sanguineus (17.64%), Rhiphicephalus turanicus (5.88%) and Ixodes ricinus (23.52%). B. burgdorferi DNA was sought by PCR in ticks when available. One tick, a D. reticulatus male, was found carrying the pathogen. The seroprevalence found was similar to the previously demonstrated in similar studies in Spain and other European countries. Full article
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Open AccessArticle Analysis of Ecological Quality of the Environment and Influencing Factors in China during 2005–2010
Int. J. Environ. Res. Public Health 2014, 11(2), 1673-1693; doi:10.3390/ijerph110201673
Received: 5 December 2013 / Revised: 21 January 2014 / Accepted: 23 January 2014 / Published: 30 January 2014
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Abstract
Since the twentieth century, China has been facing various kinds of environmental problems. It is necessary to evaluate and analyze the ecological status of the environment over China, which is of great importance for environmental protection measures. In this article, an Eco-environmental Quality
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Since the twentieth century, China has been facing various kinds of environmental problems. It is necessary to evaluate and analyze the ecological status of the environment over China, which is of great importance for environmental protection measures. In this article, an Eco-environmental Quality Index (EQI) model is established using national remote sensing land-use data, NDVI data from MODIS and other statistical data. The model is used to evaluate the ecological status over China during 2005, 2008 and 2010, and spatial and temporal variations in EQI are analyzed during the period 2005–2010. We also discuss important factors affecting ecological quality, with special emphasis on meteorological conditions (including rainfall and sunshine duration) and anthropogenic factors (including normalized population and gross domestic product densities). The results show that, EQIs in northwestern China are generally lower than those in the southeast of the country, presenting a ladder-like distribution. There is significant correlation between EQI, rainfall and sunshine duration. Population density and GDP also have some relation to EQI. On the whole, the environmental quality results showed little variation during 2005–2010, with national average EQIs of 54.86, 55.07 and 54.43 in 2005, 2008 and 2010, respectively. During 2005–2010, differences in EQI were observed at the local level, but those at the provincial level were small. Full article
Open AccessArticle Association Between Health-Related Quality of Life and Being an Immigrant Among Adolescents, and the Role of Socioeconomic and Health-Related Difficulties
Int. J. Environ. Res. Public Health 2014, 11(2), 1694-1714; doi:10.3390/ijerph110201694
Received: 28 November 2013 / Revised: 20 January 2014 / Accepted: 22 January 2014 / Published: 30 January 2014
Cited by 3 | PDF Full-text (405 KB) | HTML Full-text | XML Full-text
Abstract
To develop satisfactorily, adolescents require good health-related quality of life (QOL, including physical health, psychological health, social relationships and living environment). However, for poorly understood reasons, it is often lacking, especially among immigrants with lower family and socioeconomic resources. This study assessed health-related
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To develop satisfactorily, adolescents require good health-related quality of life (QOL, including physical health, psychological health, social relationships and living environment). However, for poorly understood reasons, it is often lacking, especially among immigrants with lower family and socioeconomic resources. This study assessed health-related QOL of European and non-European immigrant adolescents and the contributions of socioeconomic difficulties, unhealthy behaviors, and violence. It included 1,559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3; 1,451 French adolescents, 54 European immigrants and 54 non-European immigrants), who completed a self-administered questionnaire including sex, age, socioeconomic characteristics (family structure, parents’ education, occupation, and income), unhealthy behaviors (uses of tobacco/alcohol/cannabis/hard drugs, obesity, and involvement in violence), having sustained violence, sexual abuse, and the four QOL domains measured with the World Health Organization’s WHOQOL-BREF (poor: score < 25PthP percentile). Data were analyzed using logistic regression models. Poor physical health, psychological health, social relationships, and living environment affected more European immigrants (26% to 35%) and non-European immigrants (43% to 54%) than French adolescents (21% to 26%). European immigrants had a higher risk of poor physical health and living environment (gender-age-adjusted odds ratio 2.00 and 1.88, respectively) while non-European immigrants had a higher risk for all poor physical health, psychological health, social relationships, and living environment (3.41, 2.07, 3.25, and 3.79, respectively). Between 20% and 58% of these risks were explained by socioeconomic difficulties, parts of which overlapped with unhealthy behaviors and violence. The associations between the two sets of covariates greatly differed among French adolescents and immigrants. Poor QOL was more common among European and non-European immigrants due to socioeconomic difficulties and associated unhealthy behaviors and violence. The different risk patterns observed between French adolescents and immigrants may help prevention. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Flow Injection Analysis with Electrochemical Detection for Rapid Identification of Platinum-Based Cytostatics and Platinum Chlorides in Water
Int. J. Environ. Res. Public Health 2014, 11(2), 1715-1724; doi:10.3390/ijerph110201715
Received: 4 December 2013 / Revised: 17 January 2014 / Accepted: 23 January 2014 / Published: 4 February 2014
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Abstract
Platinum-based cytostatics, such as cisplatin, carboplatin or oxaliplatin are widely used agents in the treatment of various types of tumors. Large amounts of these drugs are excreted through the urine of patients into wastewaters in unmetabolised forms. This phenomenon leads to increased amounts
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Platinum-based cytostatics, such as cisplatin, carboplatin or oxaliplatin are widely used agents in the treatment of various types of tumors. Large amounts of these drugs are excreted through the urine of patients into wastewaters in unmetabolised forms. This phenomenon leads to increased amounts of platinum ions in the water environment. The impacts of these pollutants on the water ecosystem are not sufficiently investigated as well as their content in water sources. In order to facilitate the detection of various types of platinum, we have developed a new, rapid, screening flow injection analysis method with electrochemical detection (FIA-ED). Our method, based on monitoring of the changes in electrochemical behavior of analytes, maintained by various pH buffers (Britton-Robinson and phosphate buffer) and potential changes (1,000, 1,100 and 1,200 mV) offers rapid and cheap selective determination of platinum-based cytostatics and platinum chlorides, which can also be present as contaminants in water environments. Full article
Open AccessArticle Data Mashups: Potential Contribution to Decision Support on Climate Change and Health
Int. J. Environ. Res. Public Health 2014, 11(2), 1725-1746; doi:10.3390/ijerph110201725
Received: 14 October 2013 / Revised: 16 January 2014 / Accepted: 16 January 2014 / Published: 4 February 2014
Cited by 5 | PDF Full-text (456 KB) | HTML Full-text | XML Full-text
Abstract
Linking environmental, socioeconomic and health datasets provides new insights into the potential associations between climate change and human health and wellbeing, and underpins the development of decision support tools that will promote resilience to climate change, and thus enable more effective adaptation. This
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Linking environmental, socioeconomic and health datasets provides new insights into the potential associations between climate change and human health and wellbeing, and underpins the development of decision support tools that will promote resilience to climate change, and thus enable more effective adaptation. This paper outlines the challenges and opportunities presented by advances in data collection, storage, analysis, and access, particularly focusing on “data mashups”. These data mashups are integrations of different types and sources of data, frequently using open application programming interfaces and data sources, to produce enriched results that were not necessarily the original reason for assembling the raw source data. As an illustration of this potential, this paper describes a recently funded initiative to create such a facility in the UK for use in decision support around climate change and health, and provides examples of suitable sources of data and the purposes to which they can be directed, particularly for policy makers and public health decision makers. Full article
(This article belongs to the collection Climate Change and Human Health)
Open AccessArticle Parental Ease in Asking Others Not to Smoke and Respiratory Symptoms and Illness among Children
Int. J. Environ. Res. Public Health 2014, 11(2), 1747-1755; doi:10.3390/ijerph110201747
Received: 30 October 2013 / Revised: 24 January 2014 / Accepted: 26 January 2014 / Published: 5 February 2014
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Abstract
Objective: Childhood exposure to secondhand tobacco smoke (SHS) increases a child’s burden of respiratory conditions, but parental smoking bans may reduce such morbidity. This study evaluated household smoking bans and their relationship to respiratory illness in an outpatient otolaryngology clinic. Methods:
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Objective: Childhood exposure to secondhand tobacco smoke (SHS) increases a child’s burden of respiratory conditions, but parental smoking bans may reduce such morbidity. This study evaluated household smoking bans and their relationship to respiratory illness in an outpatient otolaryngology clinic. Methods: The study was performed at the Heim Pal National Children’s Hospital, Ear, Nose and Throat (ENT) Department (Budapest, Hungary) from July to November, 2010. A consecutive series of children’s caregivers were approached to participate in a survey measuring household smoking bans, upper and lower respiratory tract symptoms and illnesses, and socioeconomic factors. Bivariate and multivariate logistic regression analyses were performed. Results: Of the 215 caregivers recruited for the study, 208 agreed to participate (response rate of 96.7%). More than half of the children were male (54%), and 39% lived in a household with at least one member who smoked. Smoking was frequently banned inside the car (91.3%) and home (85.1%). Respondents felt it easiest to ask friends (97.1%) and family members not living in the household (98.1%) to refrain from smoking inside the home. Respondents also found it easier to ask a stranger (81.7%) or a family member (61.1%) not to smoke around the child. Logistic regression showed that respondents for children with a history of pneumonia found it less difficult to ask visitors in the home not to smoke compared to children without pneumonia (OR = 0.23, 95% CI = 0.06–0.98). Conversely, respondents for children who had had adenoidectomy found it over three times more difficult to ask strangers not to smoke near the child compared to those of children without adenoidectomy (OR = 3.20, 95% CI = 1.43–6.38). Conclusions: In a population of children visiting an outpatient ENT clinic in Budapest, Hungary, we found a high degree of exposure to SHS. The ease with which caregivers felt towards asking others not to smoke predicted specific respiratory conditions. Since the ENT clinic offers a wonderful opportunity for clinicians to counsel parents on tobacco cessation, increased tobacco education of these providers is needed. Full article
Open AccessArticle Sero-Prevalence and Risk Factors for Leptospirosis in Abattoir Workers in New Zealand
Int. J. Environ. Res. Public Health 2014, 11(2), 1756-1775; doi:10.3390/ijerph110201756
Received: 12 December 2013 / Revised: 22 January 2014 / Accepted: 23 January 2014 / Published: 5 February 2014
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Abstract
Leptospirosis is an important occupational disease in New Zealand. The objectives of this study were to determine risk factors for sero-prevalence of leptospiral antibodies in abattoir workers. Sera were collected from 567 abattoir workers and tested by microscopic agglutination for Leptospira interrogans sv.
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Leptospirosis is an important occupational disease in New Zealand. The objectives of this study were to determine risk factors for sero-prevalence of leptospiral antibodies in abattoir workers. Sera were collected from 567 abattoir workers and tested by microscopic agglutination for Leptospira interrogans sv. Pomona and Leptospira borgpetersenii sv. Hardjobovis. Association between prevalence and risk factors were determined by species specific multivariable analysis. Eleven percent of workers had antibodies against Hardjobovis or/and Pomona. Workers from the four sheep abattoirs had an average sero-prevalence of 10%–31%, from the two deer abattoirs 17%–19% and the two beef abattoirs 5%. The strongest risk factor for sero-positivity in sheep and deer abattoirs was work position. In sheep abattoirs, prevalence was highest at stunning and hide removal, followed by removal of the bladder and kidneys. Wearing personal protective equipment such as gloves and facemasks did not appear to protect against infection. Home slaughtering, farming or hunting were not significantly associated with sero-prevalence. There is substantial risk of exposure to leptospires in sheep and deer abattoirs in New Zealand and a persisting, but lower risk, in beef abattoirs. Interventions, such as animal vaccination, appear necessary to control leptospirosis as an occupational disease in New Zealand. Full article
(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)
Open AccessArticle Differences in Age-Standardized Mortality Rates for Avoidable Deaths Based on Urbanization Levels in Taiwan, 1971–2008
Int. J. Environ. Res. Public Health 2014, 11(2), 1776-1793; doi:10.3390/ijerph110201776
Received: 26 November 2013 / Revised: 10 January 2014 / Accepted: 17 January 2014 / Published: 5 February 2014
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Abstract
The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake
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The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result. Full article
(This article belongs to the Special Issue Spatial Epidemiology)
Open AccessCommunication The Influence of Centre-Based Childcare on Preschoolers’ Physical Activity Levels: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2014, 11(2), 1794-1802; doi:10.3390/ijerph110201794
Received: 25 November 2013 / Revised: 21 January 2014 / Accepted: 27 January 2014 / Published: 5 February 2014
Cited by 22 | PDF Full-text (181 KB) | HTML Full-text | XML Full-text
Abstract
The childcare environment represents an appropriate avenue to support physical activity among preschoolers. The aim of this study was two-fold: (1) to measure the physical activity levels of a sample of preschoolers during childcare hours; and (2) to assess which attributes (e.g., space,
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The childcare environment represents an appropriate avenue to support physical activity among preschoolers. The aim of this study was two-fold: (1) to measure the physical activity levels of a sample of preschoolers during childcare hours; and (2) to assess which attributes (e.g., space, equipment, policies) within centre-based childcare environments influenced physical activity. Thirty-one preschoolers from 5 childcare centres across London, Canada participated. Actical accelerometers were worn by participants for one day during childcare hours to assess activity levels using a 15 second epoch length. The Environment and Policy Assessment and Observation instrument was used to conduct a full-day evaluation of the childcare environment. On average, participants engaged in 1.54 min/h of moderate-to-vigorous physical activity and 17.42 min/h of total physical activity. Sedentary opportunities, portable and fixed play equipment, and staff behaviour accounted for 49.3% of the variability in moderate-to-vigorous physical activity and 14.1% of the variability in total physical activity, with sedentary opportunities, fixed play equipment, and staff behaviours displaying an inverse relationship. Results emphasize the critical role the childcare environment plays in supporting physical activity among preschoolers. Full article
(This article belongs to the Special Issue Health Behavior and Public Health)
Open AccessArticle A Population-Based Case-Control Study of Drinking-Water Nitrate and Congenital Anomalies Using Geographic Information Systems (GIS) to Develop Individual-Level Exposure Estimates
Int. J. Environ. Res. Public Health 2014, 11(2), 1803-1823; doi:10.3390/ijerph110201803
Received: 1 December 2013 / Revised: 24 January 2014 / Accepted: 26 January 2014 / Published: 5 February 2014
Cited by 2 | PDF Full-text (722 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Animal studies and epidemiological evidence suggest an association between prenatal exposure to drinking water with elevated nitrate (NO3-N) concentrations and incidence of congenital anomalies. This study used Geographic Information Systems (GIS) to derive individual-level prenatal drinking-water nitrate exposure estimates from measured
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Animal studies and epidemiological evidence suggest an association between prenatal exposure to drinking water with elevated nitrate (NO3-N) concentrations and incidence of congenital anomalies. This study used Geographic Information Systems (GIS) to derive individual-level prenatal drinking-water nitrate exposure estimates from measured nitrate concentrations from 140 temporally monitored private wells and 6 municipal water supplies. Cases of major congenital anomalies in Kings County, Nova Scotia, Canada, between 1988 and 2006 were selected from province-wide population-based perinatal surveillance databases and matched to controls from the same databases. Unconditional multivariable logistic regression was performed to test for an association between drinking-water nitrate exposure and congenital anomalies after adjusting for clinically relevant risk factors. Employing all nitrate data there was a trend toward increased risk of congenital anomalies for increased nitrate exposure levels though this was not statistically significant. After stratification of the data by conception before or after folic acid supplementation, an increased risk of congenital anomalies for nitrate exposure of 1.5–5.56 mg/L (2.44; 1.05–5.66) and a trend toward increased risk for >5.56 mg/L (2.25; 0.92–5.52) was found. Though the study is likely underpowered, these results suggest that drinking-water nitrate exposure may contribute to increased risk of congenital anomalies at levels below the current Canadian maximum allowable concentration. Full article
(This article belongs to the Special Issue Spatial Epidemiology)
Open AccessArticle Discovery of a Leptospirosis Cluster Amidst a Pneumonic Plague Outbreak in a Miners’ Camp in the Democratic Republic of the Congo
Int. J. Environ. Res. Public Health 2014, 11(2), 1824-1833; doi:10.3390/ijerph110201824
Received: 8 January 2014 / Revised: 28 January 2014 / Accepted: 28 January 2014 / Published: 7 February 2014
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Abstract
Conditions in the Democratic Republic of the Congo provide an ideal environment for leptospirosis and plague, both of which can cause severe pulmonary manifestations. In December 2004, an outbreak of lethal pneumonia occurred in a local mining camp, affecting 130 persons and killing
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Conditions in the Democratic Republic of the Congo provide an ideal environment for leptospirosis and plague, both of which can cause severe pulmonary manifestations. In December 2004, an outbreak of lethal pneumonia occurred in a local mining camp, affecting 130 persons and killing 57 of them. Clinical signs, fast disease spread, and initial laboratory investigations suggested pneumonic plague. While leptospirosis had not recently been described in the region, it was considered as a differential diagnosis. Anti-Leptospira antibodies were detected by microscopic agglutination test (MAT). A confirmed case of leptospirosis was defined as having consistent clinical signs and any one of the following: seroconversion or four-fold increase in MAT titre for paired serum samples, or a MAT titre ≥ 1:400 for acute-phase serum samples. Twenty-nine of the 54 patients or convalescents tested for leptospirosis were seropositive. Two cases showed a confirmed infection for both plague and leptospirosis. While evidence supports the plague nature of this outbreak, the results suggest that some of the suspected plague cases might be due to leptospirosis. In any case, this diagnosis will have to be evoked in the future if a similar outbreak occurs in this region of Africa. Full article
(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)
Open AccessArticle Higher Household Income and the Availability of Electronic Devices and Transport at Home Are Associated with Higher Waist Circumference in Colombian Children: The ACFIES Study
Int. J. Environ. Res. Public Health 2014, 11(2), 1834-1843; doi:10.3390/ijerph110201834
Received: 15 November 2013 / Revised: 24 January 2014 / Accepted: 29 January 2014 / Published: 7 February 2014
Cited by 6 | PDF Full-text (177 KB) | HTML Full-text | XML Full-text
Abstract
Background: The current “epidemic” of childhood obesity is described as being driven by modern lifestyles with associated socioeconomic and environmental changes that modify dietary habits, discourage physical activity and encourage sedentary behaviors. Objective: To evaluate the association between household income and
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Background: The current “epidemic” of childhood obesity is described as being driven by modern lifestyles with associated socioeconomic and environmental changes that modify dietary habits, discourage physical activity and encourage sedentary behaviors. Objective: To evaluate the association between household income and the availability of electronic devices and transport at home, and the values of waist circumference (WC), as an indicator of abdominal obesity, in children and adolescents from Bucaramanga, Colombia. Methods: Cross-sectional study of public elementary and high school population, of low-middle socioeconomic status. Results: A total of 668 schoolchildren were recruited. After adjusting for potential confounders, significant positive associations between waist circumference and higher household income (p = 0.011), and waist circumference and the availability of electronic devices and transport at home (p = 0.026) were found. Conclusions: In low-middle socioeconomic status schoolchildren in a developing country, those from relatively more affluent families had greater waist circumference, an association that is opposite to that observed in developed countries. This finding could be related to higher income family’s ability to purchase electronic devices and motorized transport which discourage physical activity and for their children to buy desirable and more costly western fast food. Full article
(This article belongs to the Special Issue Childhood Obesity: Novel Approaches to a Global Problem)
Open AccessCommunication Effect of Chlorine Exposure on the Survival and Antibiotic Gene Expression of Multidrug Resistant Acinetobacter baumannii in Water
Int. J. Environ. Res. Public Health 2014, 11(2), 1844-1854; doi:10.3390/ijerph110201844
Received: 12 December 2013 / Revised: 23 January 2014 / Accepted: 28 January 2014 / Published: 7 February 2014
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Abstract
Acinetobacter baumannii is a multidrug resistant pathogen capable of causing a wide spectrum of clinical conditions in humans. Acinetobacter spp. is ubiquitously found in different water sources. Chlorine being the most commonly used disinfectant in water, the study investigated the effect of chlorine
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Acinetobacter baumannii is a multidrug resistant pathogen capable of causing a wide spectrum of clinical conditions in humans. Acinetobacter spp. is ubiquitously found in different water sources. Chlorine being the most commonly used disinfectant in water, the study investigated the effect of chlorine on the survival of A. baumannii in water and transcription of genes conferring antibiotic resistance. Eight clinical isolates of A. baumannii, including a fatal meningitis isolate (ATCC 17978) (~108 CFU/mL) were separately exposed to free chlorine concentrations (0.2, 1, 2, 3 and 4 ppm) with a contact time of 30, 60, 90 and 120 second. The surviving pathogen counts at each specified contact time were determined using broth dilution assay. In addition, real-time quantitative PCR (RT-qPCR) analysis of the antibiotic resistance genes (efflux pump genes and those encoding resistance to specific antibiotics) of three selected A. baumannii strains following exposure to chlorine was performed. Results revealed that all eight A. baumannii isolates survived the tested chlorine levels during all exposure times (p > 0.05). Additionally, there was an up-regulation of all or some of the antibiotic resistance genes in A. baumannii, indicating a chlorine-associated induction of antibiotic resistance in the pathogen. Full article
Open AccessArticle Mycotoxins’ Activity at Toxic and Sub-Toxic Concentrations: Differential Cytotoxic and Genotoxic Effects of Single and Combined Administration of Sterigmatocystin, Ochratoxin A and Citrinin on the Hepatocellular Cancer Cell Line Hep3B
Int. J. Environ. Res. Public Health 2014, 11(2), 1855-1872; doi:10.3390/ijerph110201855
Received: 18 November 2013 / Revised: 23 January 2014 / Accepted: 29 January 2014 / Published: 7 February 2014
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Abstract
Food safety organizations indicate the likelihood of constant human and animal exposure to mycotoxin mixtures as a possible negative public health impact. Risk assessment demonstrates that certain mycotoxins of Aspergillus and Penicillium spp. are toxic and hold a significant genotoxic efficacy at nanomolar
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Food safety organizations indicate the likelihood of constant human and animal exposure to mycotoxin mixtures as a possible negative public health impact. Risk assessment demonstrates that certain mycotoxins of Aspergillus and Penicillium spp. are toxic and hold a significant genotoxic efficacy at nanomolar concentrations. The aim of the current study was to investigate the potential cytogenetic effects of sterigmatocystin (STER), ochratoxin A (OTA) and citrinin (CTN) alone or in combination, at pM to μΜ concentrations, on the human hepatocellular cancer cell line Hep3B. MTT reduction, mitotic divisions, cell cycle delays and sister chromatid exchange rates (SCE) were determined as endpoints of metabolic activity, cytotoxicity, cytostaticity, and genotoxicity, respectively. All mycotoxin treatments induce SCE rates from 1012 M, while their cytotoxic and cytostatic potential varies. In PRI and MI assays, but not at MTT, STER alone or in combination with OTA + CTN appeared cytostatic and cytotoxic, even at 10−12 M, while CTN alone and all other combinations displayed substantial cellular survival inhibition in doses ≥ 10−8 M. Co-administration of STER + OTA or STER + CTN in concentrations ≤ 10−1 M, increased the MI and MTT activity, while it did not affect the PRI. Mycotoxin co-treatments revealed in general similar-to-additive or antagonistic genotoxic and cytotoxic effects. Our results for the first time describe that STER alone or in combination with OTA and/or CTN share a cytotoxic and cytogenetic potential even at picoMolar concentrations on human hepatoma cells in vitro. Full article
Open AccessArticle Perceptions of Community Health Workers (CHWs/PS) in the U.S.-Mexico Border HEART CVD Study
Int. J. Environ. Res. Public Health 2014, 11(2), 1873-1884; doi:10.3390/ijerph110201873
Received: 22 November 2013 / Revised: 30 January 2014 / Accepted: 30 January 2014 / Published: 10 February 2014
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Abstract
Although prior research has shown that Community Health Workers/Promotores de Salud (CHW/PS) can facilitate access to care, little is known about how CHW/PS are perceived in their community. The current study reports the findings of a randomized telephone survey conducted in a high-risk
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Although prior research has shown that Community Health Workers/Promotores de Salud (CHW/PS) can facilitate access to care, little is known about how CHW/PS are perceived in their community. The current study reports the findings of a randomized telephone survey conducted in a high-risk urban community environment along the U.S.-Mexico border. In preparation for a community-based CHW/PS intervention called the HEART ecological study, the survey aimed to assess perceptions of CHW/PS, availability and utilization of community resources (recreational and nutrition related) and health behaviors and intentions. A total of 7,155 calls were placed to complete 444 surveys in three zip codes in El Paso, Texas. Results showed that participants felt that healthful community resources were available, but utilization was low and variable: 35% reported going to a park, 20% reported having taken a health class, few reported using a gym (12%), recreation center (8%), or YMCA/YWCA (0.9%). Awareness and utilization of CHW/PS services were low: 20% of respondents had heard of CHW/PS, with 8% reporting previous exposure to CHW/PS services. Upon review of a definition of CHW/PS, respondents expressed positive views of CHW/PS and their value in the healthcare system. Respondents who had previous contact with a CHW/PS reported a significantly more positive perception of the usefulness of CHW/PS (p = 0.006), were more likely to see CHW/PS as an important link between providers and patients (p = 0.008), and were more likely to ask a CHW/PS for help (p = 0.009). Participants who utilized CHW/PS services also had significantly healthier intentions to reduce fast food intake. Future research is needed to evaluate if CHW/PS can facilitate utilization of available community resources such as recreational facilities among Hispanic border residents at risk for CVD. Full article
Open AccessArticle Correlates of the Intention to Implement a Tailored Physical Activity Intervention: Perceptions of Intermediaries
Int. J. Environ. Res. Public Health 2014, 11(2), 1885-1903; doi:10.3390/ijerph110201885
Received: 20 November 2013 / Revised: 15 January 2014 / Accepted: 17 January 2014 / Published: 10 February 2014
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Abstract
The public health impact of health behaviour interventions is highly dependent on large-scale implementation. Intermediaries—intervention providers—determine to a large extent whether an intervention reaches the target population, and hence its impact on public health. A cross-sectional study was performed to identify the correlates
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The public health impact of health behaviour interventions is highly dependent on large-scale implementation. Intermediaries—intervention providers—determine to a large extent whether an intervention reaches the target population, and hence its impact on public health. A cross-sectional study was performed to identify the correlates of intermediaries’ intention to implement a computer-tailored physical activity intervention. According to theory, potential correlates are intervention characteristics, organisational characteristics, socio-political characteristics and intermediary characteristics. This study investigated whether intermediary characteristics mediated the association between the intervention, organisational and socio-political characteristics and intention to implement the intervention. Results showed that intervention characteristics (i.e., observability (B = 0.53; p = 0.006); relative advantage (B = 0.79; p = 0.020); complexity (B = 0.80; p < 0.001); compatibility (B = 0.70; p < 0.001)), organisational characteristics (i.e., type of organization (B = 0.38; p = 0.002); perceived task responsibility (B = 0.66; p ≤ 0.001); capacity (B = 0.83; p < 0.001)), and the social support received by intermediary organisations (B = 0.81; p < 0.001) were associated with intention to implement the intervention. These factors should thus be targeted by an implementation strategy. Since self-efficacy and social norms perceived by the intermediary organisations partially mediated the effects of other variables on intention to implement the intervention (varying between 29% and 84%), these factors should be targeted to optimise the effectiveness of the implementation strategy. Full article
(This article belongs to the Special Issue Health Behavior and Public Health)
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Open AccessArticle Effects of Dietary Selenium on Histopathological Changes and T Cells of Spleen in Broilers Exposed to Aflatoxin B1
Int. J. Environ. Res. Public Health 2014, 11(2), 1904-1913; doi:10.3390/ijerph110201904
Received: 17 December 2013 / Revised: 16 January 2014 / Accepted: 26 January 2014 / Published: 10 February 2014
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Abstract
Aflatoxin B1 (AFB1), which causes hepatocellular carcinoma and immune-suppression, is commonly found in feedstuffs. To evaluate the ability of selenium (Se) to counteract the deleterious effects of AFB1, two hundred 1-day-old male avian broilers, divided into five groups,
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Aflatoxin B1 (AFB1), which causes hepatocellular carcinoma and immune-suppression, is commonly found in feedstuffs. To evaluate the ability of selenium (Se) to counteract the deleterious effects of AFB1, two hundred 1-day-old male avian broilers, divided into five groups, were fed with basal diet (control group), 0.3 mg/kg AFB1 (AFB1 group), 0.3 mg/kg AFB1+0.2 mg/kg Se (+Se group I), 0.3 mg/kg AFB1+0.4 mg/kg Se (+Se group II) and 0.3 mg/kg AFB1+0.6 mg/kg Se (+Se group III), respectively. Compared with control group, the relative weight of spleen in the AFB1 group was decreased at 21 days of age. The relative weight of spleen in the three +Se groups was higher than that in the AFB1 group. By pathological observation, the major spleen lesions included congestion in red pulp and vacuoles appeared in the lymphatic nodules and periarterial lymphatic sheath in the AFB1 group. In +Se groups II and III, the incidence of major splenic lesions was decreased. The percentages of CD3+, CD3+CD4+ and CD3+CD8+ T cells in the AFB1 group were lower than those in control group from 7 to 21 days of age, while there was a marked increase in the three +Se groups compared to the AFB1 group. The results indicated that sodium selenite could improve the cellular immune function impaired by AFB1 through increasing the relative weight of spleen and percentages of splenic T cell subsets, and alleviating histopathological spleen damage. Full article
Open AccessArticle Global Trade, Local Impacts: Lessons from California on Health Impacts and Environmental Justice Concerns for Residents Living near Freight Rail Yards
Int. J. Environ. Res. Public Health 2014, 11(2), 1914-1941; doi:10.3390/ijerph110201914
Received: 18 September 2013 / Revised: 19 November 2013 / Accepted: 18 December 2013 / Published: 10 February 2014
Cited by 6 | PDF Full-text (1019 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Global trade has increased nearly 100-fold since 1950, according to the World Trade Organization. Today, major changes in trade are occurring with the advent of mega-ships that can transport thousands more containers than cargo ships now in use. Because global trade is expected
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Global trade has increased nearly 100-fold since 1950, according to the World Trade Organization. Today, major changes in trade are occurring with the advent of mega-ships that can transport thousands more containers than cargo ships now in use. Because global trade is expected to increase dramatically, the railroad industry—in the U.S. alone—has invested more than $5 billion a year over the past decade to expand rail yards and enhance rail routes to transport goods from ports to retail destinations. This article describes cancer risks for residents living in close proximity to rail yards with emissions of diesel particulate matter pollution from locomotives, trucks and yard equipment. The article examines the demographics (income, race/ethnicity) of populations living in the highest estimated cancer risk zones near 18 major rail yards in California, concluding that the majority are over-represented by either lower-income or minority residents (or both). The authors also describe a review of the news media and environmental impact reports to determine if rail yards are still being constructed or expanded in close proximity to homes and schools or in working class/working poor communities of color. The paper suggests policy efforts that might provide more public health protection and result in more “environmentally just” siting of rail yards. The authors conclude that diesel pollution from rail yards, which creates significant diesel cancer risks for those living near the facilities, is an often overlooked public health, health disparities and environmental justice issue in the U.S. The conclusions are relevant to other countries where international trade is increasing and large new intermodal rail facilities are being considered. Full article
(This article belongs to the Special Issue Social and Economical Determinants of Health)
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Open AccessArticle Effect of Ambient Temperature on Australian Northern Territory Public Hospital Admissions for Cardiovascular Disease among Indigenous and Non-Indigenous Populations
Int. J. Environ. Res. Public Health 2014, 11(2), 1942-1959; doi:10.3390/ijerph110201942
Received: 22 November 2013 / Revised: 21 January 2014 / Accepted: 22 January 2014 / Published: 13 February 2014
Cited by 7 | PDF Full-text (636 KB) | HTML Full-text | XML Full-text
Abstract
Hospitalisations are associated with ambient temperature, but little is known about responses in population sub-groups. In this study, heat responses for Indigenous and non-Indigenous people in two age groups were examined for two categories of cardiac diseases using daily hospital admissions from five
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Hospitalisations are associated with ambient temperature, but little is known about responses in population sub-groups. In this study, heat responses for Indigenous and non-Indigenous people in two age groups were examined for two categories of cardiac diseases using daily hospital admissions from five Northern Territory hospitals (1992–2011). Admission rates during the hottest five per cent of days and the coolest five per cent of days were compared with rates at other times. Among 25–64 year olds, the Indigenous female population was more adversely affected by very hot days than the non-Indigenous female population, with admission rates for ischaemic heart disease (IHD) increasing by 32%. People older than 65 were more sensitive to cold, with non-Indigenous male admissions for heart failure increasing by 64%, and for IHD by 29%. For older Indigenous males, IHD admissions increased by 52% during cold conditions. For older non-Indigenous females, increases in admissions for heart failure were around 50% on these cold days, and 64% for older Indigenous females. We conclude that under projected climate change conditions, admissions for IHD amongst younger Indigenous people would increase in hot conditions, while admissions among elderly people during cold weather may be reduced. The responses to temperature, while showing significant relationships across the Northern Territory, may vary by region. These variations were not explored in this assessment. Full article
(This article belongs to the collection Climate Change and Human Health)
Open AccessArticle Strategies to Reduce the Harmful Effects of Extreme Heat Events: A Four-City Study
Int. J. Environ. Res. Public Health 2014, 11(2), 1960-1988; doi:10.3390/ijerph110201960
Received: 18 November 2013 / Revised: 4 February 2014 / Accepted: 6 February 2014 / Published: 13 February 2014
Cited by 7 | PDF Full-text (645 KB) | HTML Full-text | XML Full-text
Abstract
Extreme heat events (EHEs) are becoming more intense, more frequent and longer lasting in the 21st century. These events can disproportionately impact the health of low-income, minority, and urban populations. To better understand heat-related intervention strategies used by four U.S. cities, we conducted
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Extreme heat events (EHEs) are becoming more intense, more frequent and longer lasting in the 21st century. These events can disproportionately impact the health of low-income, minority, and urban populations. To better understand heat-related intervention strategies used by four U.S. cities, we conducted 73 semi-structured interviews with government and non-governmental organization leaders representing public health, general social services, emergency management, meteorology, and the environmental planning sectors in Detroit, MI; New York City, NY; Philadelphia, PA and Phoenix, AZ—cities selected for their diverse demographics, climates, and climate adaptation strategies. We identified activities these leaders used to reduce the harmful effects of heat for residents in their city, as well as the obstacles they faced and the approaches they used to evaluate these efforts. Local leaders provided a description of how local context (e.g., climate, governance and city structure) impacted heat preparedness. Despite the differences among study cities, political will and resource access were critical to driving heat-health related programming. Upon completion of our interviews, we convened leaders in each city to discuss these findings and their ongoing efforts through day-long workshops. Our findings and the recommendations that emerged from these workshops could inform other local or national efforts towards preventing heat-related morbidity and mortality. Full article
(This article belongs to the collection Climate Change and Human Health)
Open AccessArticle Beliefs and Knowledge about Vaccination against AH1N1pdm09 Infection and Uptake Factors among Chinese Parents
Int. J. Environ. Res. Public Health 2014, 11(2), 1989-2002; doi:10.3390/ijerph110201989
Received: 2 December 2013 / Revised: 28 January 2014 / Accepted: 29 January 2014 / Published: 14 February 2014
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Abstract
Vaccination against AH1N1pdm09 infection (human swine infection, HSI) is an effective measure of preventing pandemic infection, especially for high-risk groups like children between the ages of 6 months and 6 years. This study used a cross-sectional correlation design and aimed to identify predicting
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Vaccination against AH1N1pdm09 infection (human swine infection, HSI) is an effective measure of preventing pandemic infection, especially for high-risk groups like children between the ages of 6 months and 6 years. This study used a cross-sectional correlation design and aimed to identify predicting factors of parental acceptance of the HSI vaccine (HSIV) and uptake of the vaccination by their preschool-aged children in Hong Kong. A total of 250 parents were recruited from four randomly selected kindergartens. A self-administered questionnaire based on the health belief framework was used for data collection. The results showed that a number of factors significantly affected the tendency toward new vaccination uptake; these factors included parental age, HSI vaccination history of the children in their family, preferable price of the vaccine, perceived severity, perceived benefits, perceived barriers, and motivating factors for taking new vaccines. Using these factors, a logistic regression model with a high Nagelkerke R2 of 0.63 was generated to explain vaccination acceptance. A strong correlation between parental acceptance of new vaccinations and the motivating factors of vaccination uptake was found, which indicates the importance of involving parents in policy implementation for any new vaccination schemes. Overall, in order to fight against pandemics and enhance vaccination acceptance, it is essential for the government to understand the above factors determining parental acceptance of new vaccinations for their preschool-aged children. Full article
Open AccessArticle Beginning A Patient-Centered Approach in the Design of A Diabetes Prevention Program
Int. J. Environ. Res. Public Health 2014, 11(2), 2003-2013; doi:10.3390/ijerph110202003
Received: 18 December 2013 / Revised: 24 January 2014 / Accepted: 24 January 2014 / Published: 14 February 2014
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Abstract
Objective: The purpose of this study was to identify patient preferences for different components of a local diabetes prevention program that would improve reach. A secondary purpose was to determine if patient characteristics were related to program preferences. Methods: Participants were identified through
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Objective: The purpose of this study was to identify patient preferences for different components of a local diabetes prevention program that would improve reach. A secondary purpose was to determine if patient characteristics were related to program preferences. Methods: Participants were identified through electronic medical records from two family medicine clinics in Virginia. Participants completed a mailed survey addressing demographics, economic status, risk factors for diabetes, and preferences regarding diabetes prevention interventions—delivery mode, program length, and duration. Results: Twenty-nine percent of eligible participants responded (n = 142); 83% of participants were at risk for diabetes and 82% had a household income <$20,000. When presented with the choice between a class-based vs. a technology-based program, 83% preferred a technology-based program. Whites were less likely to choose the technology-based program, with no significant differences based on age, education, income, or gender. Conclusions: Contrary to beliefs that lower income individuals may not use technology-based interventions, lower socioeconomic patients indicated a preference for a technology- and telephone-supported diabetes prevention program over in-person class approaches. Findings provide formative data to support the design of a patient-centered, technology-enhanced diabetes prevention program in a real-world setting, thereby increasing potential participation and reach. Full article
(This article belongs to the Special Issue Diabetes Prevention: Challenges and Opportunities)
Open AccessArticle Extreme Precipitation and Beach Closures in the Great Lakes Region: Evaluating Risk among the Elderly
Int. J. Environ. Res. Public Health 2014, 11(2), 2014-2032; doi:10.3390/ijerph110202014
Received: 18 November 2013 / Revised: 27 January 2014 / Accepted: 8 February 2014 / Published: 14 February 2014
Cited by 2 | PDF Full-text (1037 KB) | HTML Full-text | XML Full-text
Abstract
As a result of climate change, extreme precipitation events are expected to increase in frequency and intensity. Runoff from these extreme events poses threats to water quality and human health. We investigated the impact of extreme precipitation and beach closings on the risk
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As a result of climate change, extreme precipitation events are expected to increase in frequency and intensity. Runoff from these extreme events poses threats to water quality and human health. We investigated the impact of extreme precipitation and beach closings on the risk of gastrointestinal illness (GI)-related hospital admissions among individuals 65 and older in 12 Great Lakes cities from 2000 to 2006. Poisson regression models were fit in each city, controlling for temperature and long-term time trends. City-specific estimates were combined to form an overall regional risk estimate. Approximately 40,000 GI-related hospital admissions and over 100 beach closure days were recorded from May through September during the study period. Extreme precipitation (≥90th percentile) occurring the previous day (lag 1) is significantly associated with beach closures in 8 of the 12 cities (p < 0.05). However, no association was observed between beach closures and GI-related hospital admissions. These results support previous work linking extreme precipitation to compromised recreational water quality. Full article
(This article belongs to the collection Climate Change and Human Health)
Open AccessArticle Risk Assessment of the Schmutzdecke of Biosand Filters: Identification of an Opportunistic Pathogen in Schmutzdecke Developed by an Unsafe Water Source
Int. J. Environ. Res. Public Health 2014, 11(2), 2033-2048; doi:10.3390/ijerph110202033
Received: 2 January 2014 / Revised: 31 January 2014 / Accepted: 8 February 2014 / Published: 14 February 2014
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Abstract
The biosand filter (BSF) is widely applied in developing counties as an appropriate technology-based product for supplying “safe” water. Biosand filters exhibit relatively high purifying efficiency because of the schmutzdecke (biofilm) embedded in them. However, schmutzdecke should be cleaned or discarded on a
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The biosand filter (BSF) is widely applied in developing counties as an appropriate technology-based product for supplying “safe” water. Biosand filters exhibit relatively high purifying efficiency because of the schmutzdecke (biofilm) embedded in them. However, schmutzdecke should be cleaned or discarded on a regular basis to maintain the purifying efficiency of the BSF. Due to its role in BSFs, the purifying function of schmutzdecke, rather than its potential risk when not properly discarded, has so far been the primary focus of research. This study aims to provide a risk assessment of schmutzdecke in an attempt to draw attention to a wholly new angle of schmutzdecke usage. We conducted 16S rRNA gene sequencing and phylogenetic analysis to identify opportunistic pathogens in schmutzdecke developed using water from the Hyung-San River. The results reveal that the schmutzdecke derived from this water source contains diverse and relatively high portions of opportunistic pathogen strains; 55% of all isolates collected from schmutzdecke were identified as opportunistic pathogens. Moreover, the diversity of microorganisms is increased in the schmutzdecke compared to its water source in terms of diversity of genus, phylum and opportunistic pathogen strain. As a whole, our study indicates a potential risk associated with schmutzdecke and the necessity of a solid guideline for the after-treatment of discarded schmutzdecke. Full article
Open AccessArticle A Prospective Cohort Study of Alcohol Exposure in Early and Late Pregnancy within an Urban Population in Ireland
Int. J. Environ. Res. Public Health 2014, 11(2), 2049-2063; doi:10.3390/ijerph110202049
Received: 18 December 2013 / Revised: 29 January 2014 / Accepted: 9 February 2014 / Published: 17 February 2014
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Abstract
Most studies of alcohol consumption in pregnancy have looked at one time point only, often relying on recall. The aim of this longitudinal study was to determine whether alcohol consumption changes in early and late pregnancy and whether this affects perinatal outcomes. We
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Most studies of alcohol consumption in pregnancy have looked at one time point only, often relying on recall. The aim of this longitudinal study was to determine whether alcohol consumption changes in early and late pregnancy and whether this affects perinatal outcomes. We performed a prospective cohort study, conducted from November 2010 to December 2011 at a teaching hospital in the Republic of Ireland. Of the 907 women with a singleton pregnancy who booked for antenatal care and delivered at the hospital, 185 (20%) abstained from alcohol in the first trimester but drank in the third trimester, 105 (12%) consumed alcohol in the first and third trimesters, and the remaining 617 (68%) consumed no alcohol in pregnancy. Factors associated with continuing to drink in pregnancy included older maternal age (30–39 years), Irish nationality, private healthcare, smoking, and a history of illicit drug use. Compared to pre-pregnancy, alcohol consumption in pregnancy was markedly reduced, with the majority of drinkers consuming ≤ 5 units per week (92% in first trimester, 72–75% in third trimester). Perhaps because of this, perinatal outcomes were similar for non-drinkers, women who abstained from alcohol in the first trimester, and women who drank in the first and third trimester of  pregnancy. Most women moderate their alcohol consumption in pregnancy, especially in the first trimester, and have perinatal outcomes similar to those who abstain. Full article
Open AccessArticle Effect of Different Disinfection Protocols on Microbial and Biofilm Contamination of Dental Unit Waterlines in Community Dental Practices
Int. J. Environ. Res. Public Health 2014, 11(2), 2064-2076; doi:10.3390/ijerph110202064
Received: 6 November 2013 / Revised: 20 January 2014 / Accepted: 28 January 2014 / Published: 18 February 2014
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Abstract
Output water from dental unit waterlines (DUWLs) may be a potential source of infection for both dental healthcare staff and patients. This study compared the efficacy of different disinfection methods with regard to the water quality and the presence of biofilm in DUWLs.
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Output water from dental unit waterlines (DUWLs) may be a potential source of infection for both dental healthcare staff and patients. This study compared the efficacy of different disinfection methods with regard to the water quality and the presence of biofilm in DUWLs. Five dental units operating in a public dental health care setting were selected. The control dental unit had no disinfection system; two were disinfected intermittently with peracetic acid/hydrogen peroxide 0.26% and two underwent continuous disinfection with hydrogen peroxide/silver ions (0.02%) and stabilized chlorine dioxide (0.22%), respectively. After three months of applying the disinfection protocols, continuous disinfection systems were more effective than intermittent systems in reducing the microbial contamination of the water, allowing compliance with the CDC guidelines and the European Council regulatory thresholds for drinking water. P. aeruginosa, Legionella spp, sulphite-reducing Clostridium spores, S. aureus and β-haemolytic streptococci were also absent from units treated with continuous disinfection. The biofilm covering the DUWLs was more extensive, thicker and more friable in the intermittent disinfection dental units than in those with continuous disinfection. Overall, the findings showed that the products used for continuous disinfection of dental unit waterlines showed statistically better results than the intermittent treatment products under the study conditions. Full article
(This article belongs to the Special Issue IJERPH: 10th Anniversary)
Open AccessArticle Casual Dock Work: Profile of Diseases and Injuries and Perception of Influence on Health
Int. J. Environ. Res. Public Health 2014, 11(2), 2077-2091; doi:10.3390/ijerph110202077
Received: 25 October 2013 / Revised: 24 December 2013 / Accepted: 3 January 2014 / Published: 19 February 2014
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Abstract
The present study aimed to identify the profile of diseases and injuries that affect casual dock workers and identify casual dock workers’ perceptions of positive and negative work influences on their health. This study consisted of two phases. The first phase was a
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The present study aimed to identify the profile of diseases and injuries that affect casual dock workers and identify casual dock workers’ perceptions of positive and negative work influences on their health. This study consisted of two phases. The first phase was a quantitative study composed of a retrospective analysis, conducted with 953 medical records. The second phase of the research is a non-random sample with 51 casual dock workers. Data analysis was performed with SPSS 19.0. The average age of the casual dock workers was 48.7. Concerning working time, the majority had more than 19.6 years of dock work experience. In the first phase, 527 pathologic diagnoses were identified. The diagnoses that affected the musculoskeletal system (15.8%, N = 152; p < 0.01) were highlighted. Consequences to physical health produced by accidents stood out, with fracture registration predominating (12.8%, N = 122; p < 0.05). Significant differences were found for positive work influence on the cardiovascular system and family health. It was concluded that the diagnoses obtained are related to the influence of dock work perception and have motivated an introduction of preventive measures. Full article
Open AccessArticle Effects of Age, Season, Gender and Urban-Rural Status on Time-Activity: Canadian Human Activity Pattern Survey 2 (CHAPS 2)
Int. J. Environ. Res. Public Health 2014, 11(2), 2108-2124; doi:10.3390/ijerph110202108
Received: 19 November 2013 / Revised: 7 February 2014 / Accepted: 10 February 2014 / Published: 19 February 2014
Cited by 22 | PDF Full-text (391 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Estimation of population exposure is a main component of human health risk assessment for environmental contaminants. Population-level exposure assessments require time-activity pattern distributions in relation to microenvironments where people spend their time. Societal trends may have influenced time-activity patterns since previous Canadian data
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Estimation of population exposure is a main component of human health risk assessment for environmental contaminants. Population-level exposure assessments require time-activity pattern distributions in relation to microenvironments where people spend their time. Societal trends may have influenced time-activity patterns since previous Canadian data were collected 15 years ago. The Canadian Human Activity Pattern Survey 2 (CHAPS 2) was a national survey conducted in 2010–2011 to collect time-activity information from Canadians of all ages. Five urban and two rural locations were sampled using telephone surveys. Infants and children, key groups in risk assessment activities, were over-sampled. Survey participants (n = 5,011) provided time-activity information in 24-hour recall diaries and responded to supplemental questionnaires concerning potential exposures to specific pollutants, dwelling characteristics, and socio-economic factors. Results indicated that a majority of the time was spent indoors (88.9%), most of which was indoors at home, with limited time spent outdoors (5.8%) or in a vehicle (5.3%). Season, age, gender and rurality were significant predictors of time activity patterns. Compared to earlier data, adults reported spending more time indoors at home and adolescents reported spending less time outdoors, which could be indicative of broader societal trends. These findings have potentially important implications for assessment of exposure and risk. The CHAPS 2 data also provide much larger sample sizes to allow for improved precision and are more representative of infants, children and rural residents. Full article
Open AccessArticle Assessing and Mapping Spatial Associations among Oral Cancer Mortality Rates, Concentrations of Heavy Metals in Soil, and Land Use Types Based on Multiple Scale Data
Int. J. Environ. Res. Public Health 2014, 11(2), 2148-2168; doi:10.3390/ijerph110202148
Received: 15 November 2013 / Revised: 30 January 2014 / Accepted: 10 February 2014 / Published: 21 February 2014
Cited by 5 | PDF Full-text (1669 KB) | HTML Full-text | XML Full-text
Abstract
In this study, a deconvolution procedure was used to create a variogram of oral cancer (OC) rates. Based on the variogram, area-to-point (ATP) Poisson kriging and p-field simulation were used to downscale and simulate, respectively, the OC rate data for Taiwan from the
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In this study, a deconvolution procedure was used to create a variogram of oral cancer (OC) rates. Based on the variogram, area-to-point (ATP) Poisson kriging and p-field simulation were used to downscale and simulate, respectively, the OC rate data for Taiwan from the district scale to a 1 km × 1 km grid scale. Local cluster analysis (LCA) of OC mortality rates was then performed to identify OC mortality rate hot spots based on the downscaled and the p-field-simulated OC mortality maps. The relationship between OC mortality and land use was studied by overlapping the maps of the downscaled OC mortality, the LCA results, and the land uses. One thousand simulations were performed to quantify local and spatial uncertainties in the LCA to identify OC mortality hot spots. The scatter plots and Spearman’s rank correlation yielded the relationship between OC mortality and concentrations of the seven metals in the 1 km cell grid. The correlation analysis results for the 1 km scale revealed a weak correlation between OC mortality rate and concentrations of the seven studied heavy metals in soil. Accordingly, the heavy metal concentrations in soil are not major determinants of OC mortality rates at the 1 km scale at which soils were sampled. The LCA statistical results for local indicator of spatial association (LISA) revealed that the sites with high probability of high-high (high value surrounded by high values) OC mortality at the 1 km grid scale were clustered in southern, eastern, and mid-western Taiwan. The number of such sites was also significantly higher on agricultural land and in urban regions than on land with other uses. The proposed approach can be used to downscale and evaluate uncertainty in mortality data from a coarse scale to a fine scale at which useful additional information can be obtained for assessing and managing land use and risk. Full article
Open AccessArticle Climate-Related Hazards: A Method for Global Assessment of Urban and Rural Population Exposure to Cyclones, Droughts, and Floods
Int. J. Environ. Res. Public Health 2014, 11(2), 2169-2192; doi:10.3390/ijerph110202169
Received: 27 November 2013 / Revised: 21 January 2014 / Accepted: 30 January 2014 / Published: 21 February 2014
Cited by 9 | PDF Full-text (1315 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Global climate change (GCC) has led to increased focus on the occurrence of, and preparation for, climate-related extremes and hazards. Population exposure, the relative likelihood that a person in a given location was exposed to a given hazard event(s) in a given period
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Global climate change (GCC) has led to increased focus on the occurrence of, and preparation for, climate-related extremes and hazards. Population exposure, the relative likelihood that a person in a given location was exposed to a given hazard event(s) in a given period of time, was the outcome for this analysis. Our objectives were to develop a method for estimating the population exposure at the country level to the climate-related hazards cyclone, drought, and flood; develop a method that readily allows the addition of better datasets to an automated model; differentiate population exposure of urban and rural populations; and calculate and present the results of exposure scores and ranking of countries based on the country-wide, urban, and rural population exposures to cyclone, drought, and flood. Gridded global datasets on cyclone, drought and flood occurrence as well as population density were combined and analysis was carried out using ArcGIS. Results presented include global maps of ranked country-level population exposure to cyclone, drought, flood and multiple hazards. Analyses by geography and human development index (HDI) are also included. The results and analyses of this exposure assessment have implications for country-level adaptation. It can also be used to help prioritize aid decisions and allocation of adaptation resources between countries and within a country. This model is designed to allow flexibility in applying cyclone, drought and flood exposure to a range of outcomes and adaptation measures. Full article
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Open AccessArticle Risk Factors of CVD Mortality among the Elderly in Beijing, 1992 – 2009: An 18-year Cohort Study
Int. J. Environ. Res. Public Health 2014, 11(2), 2193-2208; doi:10.3390/ijerph110202193
Received: 11 November 2013 / Revised: 14 January 2014 / Accepted: 21 January 2014 / Published: 21 February 2014
Cited by 6 | PDF Full-text (726 KB) | HTML Full-text | XML Full-text
Abstract
Few researchers have examined the effects of multiple risk factors of cardiovascular disease (CVD) mortality simultaneously. This study was to determine the associations of combined lifestyle and other factors with CVD mortality among the elderly (n = 3,257), in Beijing, China, through data
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Few researchers have examined the effects of multiple risk factors of cardiovascular disease (CVD) mortality simultaneously. This study was to determine the associations of combined lifestyle and other factors with CVD mortality among the elderly (n = 3,257), in Beijing, China, through data mining of the Beijing Longitudinal Study of Aging (BLSA). BLSA is a representative cohort study from 1992 to 2009, hosted by Xuan Wu Hospital. Competing risk survival analysis was conducted to explore the association between risk factors and CVD mortality. The factors focused mainly on lifestyle, physical condition, and the model was adjusted for age and gender. There were 273 of the 1,068 recorded deaths caused by CVD among the 2010 participants. Living in a suburban area (HR = 0.614, 95% CI: 0.410-0.921) was associated with lower CVD mortality. Increasing age (66–75: HR = 1.511, 95% CI: 1.111–2.055; ≥76: HR = 1.847, 95% CI: 1.256–2.717), high blood pressure (HR = 1.407, 95% CI: 1.031–1.920), frequent consumption of meat (HR = 1.559, 95% CI: 1.079–2.254) and physical inactivity (p = 0.046) were associated with higher CVD mortality. The study provides an instructional foundation for the control and prevention of CVD in Beijing, China. Full article
Open AccessArticle Indicators for Tracking European Vulnerabilities to the Risks of Infectious Disease Transmission due to Climate Change
Int. J. Environ. Res. Public Health 2014, 11(2), 2218-2235; doi:10.3390/ijerph110202218
Received: 18 November 2013 / Revised: 26 January 2014 / Accepted: 10 February 2014 / Published: 21 February 2014
Cited by 6 | PDF Full-text (1251 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
A wide range of infectious diseases may change their geographic range, seasonality and incidence due to climate change, but there is limited research exploring health vulnerabilities to climate change. In order to address this gap, pan-European vulnerability indices were developed for 2035 and
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A wide range of infectious diseases may change their geographic range, seasonality and incidence due to climate change, but there is limited research exploring health vulnerabilities to climate change. In order to address this gap, pan-European vulnerability indices were developed for 2035 and 2055, based upon the definition vulnerability = impact/adaptive capacity. Future impacts were projected based upon changes in temperature and precipitation patterns, whilst adaptive capacity was developed from the results of a previous pan-European study. The results were plotted via ArcGISTM to EU regional (NUTS2) levels for 2035 and 2055 and ranked according to quintiles. The models demonstrate regional variations with respect to projected climate-related infectious disease challenges that they will face, and with respect to projected vulnerabilities after accounting for regional adaptive capacities. Regions with higher adaptive capacities, such as in Scandinavia and central Europe, will likely be better able to offset any climate change impacts and are thus generally less vulnerable than areas with lower adaptive capacities. The indices developed here provide public health planners with information to guide prioritisation of activities aimed at strengthening regional preparedness for the health impacts of climate change. There are, however, many limitations and uncertainties when modeling health vulnerabilities. To further advance the field, the importance of variables such as coping capacity and governance should be better accounted for, and there is the need to systematically collect and analyse the interlinkages between the numerous and ever-expanding environmental, socioeconomic, demographic and epidemiologic datasets so as to promote the public health capacity to detect, forecast, and prepare for the health threats due to climate change. Full article
(This article belongs to the collection Climate Change and Human Health)
Open AccessArticle Pupillometry in Chinese Female Patients with Depression: A Pilot Study
Int. J. Environ. Res. Public Health 2014, 11(2), 2236-2243; doi:10.3390/ijerph110202236
Received: 26 November 2013 / Revised: 27 January 2014 / Accepted: 28 January 2014 / Published: 21 February 2014
PDF Full-text (162 KB) | HTML Full-text | XML Full-text
Abstract
The pupillary responses to light in patients with depression and normal controls were evaluated among Chinese females. Four parameters related to the pupil were assessed using a video-based pupillometer. The results showed that there were significant differences in the pupil area in the
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The pupillary responses to light in patients with depression and normal controls were evaluated among Chinese females. Four parameters related to the pupil were assessed using a video-based pupillometer. The results showed that there were significant differences in the pupil area in the darkness and the pupil area at the peak of constriction between depressed patients and normal controls. Full article
Open AccessArticle Exploring Powered Wheelchair Users and Their Caregivers’ Perspectives on Potential Intelligent Power Wheelchair Use: A Qualitative Study
Int. J. Environ. Res. Public Health 2014, 11(2), 2244-2261; doi:10.3390/ijerph110202244
Received: 2 December 2013 / Revised: 30 January 2014 / Accepted: 10 February 2014 / Published: 21 February 2014
Cited by 4 | PDF Full-text (308 KB) | HTML Full-text | XML Full-text
Abstract
Power wheelchairs (PWCs) can have a positive impact on user well-being, self-esteem, pain, activity and participation. Newly developed intelligent power wheelchairs (IPWs), allowing autonomous or collaboratively-controlled navigation, could enhance mobility of individuals not able to use, or having difficulty using, standard PWCs. The
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Power wheelchairs (PWCs) can have a positive impact on user well-being, self-esteem, pain, activity and participation. Newly developed intelligent power wheelchairs (IPWs), allowing autonomous or collaboratively-controlled navigation, could enhance mobility of individuals not able to use, or having difficulty using, standard PWCs. The objective of this study was to explore the perspectives of PWC users (PWUs) and their caregivers regarding if and how IPWs could impact on current challenges faced by PWUs, as well as inform current development of IPWs. A qualitative exploratory study using individual interviews was conducted with PWUs (n = 12) and caregivers (n = 4). A semi-structured interview guide and video were used to facilitate informed discussion regarding IPWs. Thematic analysis revealed three main themes: (1) “challenging situations that may be overcome by an IPW” described how the IPW features of obstacle avoidance, path following, and target following could alleviate PWUs’ identified mobility difficulties; (2) “cautious optimism concerning IPW use revealed participants” addresses concerns regarding using an IPW as well as technological suggestions; (3) “defining the potential IPW user” revealed characteristics of PWUs that would benefit from IPW use. Findings indicate how IPW use may help overcome PWC difficulties and confirm the importance of user input in the ongoing development of IPWs. Full article
Open AccessArticle Evaluation of Health Care System Reform in Hubei Province, China
Int. J. Environ. Res. Public Health 2014, 11(2), 2262-2277; doi:10.3390/ijerph110202262
Received: 6 November 2013 / Revised: 24 January 2014 / Accepted: 28 January 2014 / Published: 21 February 2014
Cited by 3 | PDF Full-text (594 KB) | HTML Full-text | XML Full-text
Abstract
This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based
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This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the “Result Chain” logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally. Full article
(This article belongs to the Special Issue Public Health Informatics)
Open AccessArticle Monitoring the Transmission of Schistosoma japonicum in Potential Risk Regions of China, 2008 – 2012
Int. J. Environ. Res. Public Health 2014, 11(2), 2278-2287; doi:10.3390/ijerph110202278
Received: 26 December 2013 / Revised: 16 January 2014 / Accepted: 21 January 2014 / Published: 21 February 2014
Cited by 10 | PDF Full-text (513 KB) | HTML Full-text | XML Full-text
Abstract
Schistosomiasis japonica, caused by Schistosoma japonicum infection, remains a major public health concern in China, and the geographical distribution of this neglected tropical disease is limited to regions where Oncomelania hupensis, the intermediate host of the causative parasite, is detected. The purpose
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Schistosomiasis japonica, caused by Schistosoma japonicum infection, remains a major public health concern in China, and the geographical distribution of this neglected tropical disease is limited to regions where Oncomelania hupensis, the intermediate host of the causative parasite, is detected. The purpose of this study was to monitor the transmission of S. japonicum in potential risk regions of China during the period from 2008 through 2012. To monitor the transmission, 10 fixed surveillance sites and 30 mobile sentinel sites were selected in 10 counties of four provinces, namely Anhui, Jiangsu, Chongqing and Hubei. There were 8, 9, 6, 2 and 3 cases infected with S. japonicum detected in the 30 mobile sentinel sites during the 5-year study period, while 27 subjects were positive for the antibody-based serum test in the 10 fixed sentinel sites; however, no infection was found. In addition, neither local nor imported livestock were found to be infected. No O. hupensis snails were detected in either the fixed surveillance or the mobile sentinel sites; however, the snail host was found to survive and reproduce at Chaohu Lake, inferring the potential of transmission of the disease. It is suggested that the continuous surveillance of schistosomiasis japonica should be carried out in both the endemic foci and potential risk regions of China, and an active, sensitive system to respond the potential risk of transmission seems justified. Full article
Open AccessArticle Assessment of Unsuspected Exposure to Drugs of Abuse in Children from a Mediterranean City by Hair Testing
Int. J. Environ. Res. Public Health 2014, 11(2), 2288-2298; doi:10.3390/ijerph110202288
Received: 9 January 2014 / Revised: 12 February 2014 / Accepted: 13 February 2014 / Published: 21 February 2014
Cited by 8 | PDF Full-text (197 KB) | HTML Full-text | XML Full-text
Abstract
Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and
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Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and 10 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. Hair samples from the accompanying parent were also collected. The samples were analyzed for the presence of opiates, cocaine, amphetamines, and cannabinoids by ultra-performance liquid chromatography-tandem mass spectrometry. Parental sociodemographics and possible drug of abuse history were recorded. Hair samples from twenty-three children (20.1%) were positive for cocaine (concentration range 0.15–3.81 ng/mg hair), those of thirteen children (11.4%) to cannabinoids (D9-THC concentration range 0.05–0.54 ng/mg hair), with four samples positive to codeine (0.1–0.25 ng/mg hair), one positive for 2.09 ng methadone per mg hair and one to 6-MAM (0.42 ng/mg hair) and morphine (0. 15 ng/mg hair) . In 69.5 and 69.2% of the positive cocaine and cannabinoids cases respectively, drugs was also found in the hair of accompanying parent. Parental sociodemographics were not associated with children exposure to drugs of abuse. However, the behavioural patterns with potential harmful effects for the child’s health (e.g., tobacco smoking, cannabis, benzodiazepines and/or antidepressants use) were significantly higher in the parents of exposed children. In the light of the obtained results (28% overall children exposure to drugs of abuse) and in agreement with 2009 unsuspected 23% cocaine exposure in pre-school children from the same hospital, we support general hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions. Full article
(This article belongs to the Special Issue IJERPH: 10th Anniversary)
Open AccessArticle Environmental Arsenic Exposure and Microbiota in Induced Sputum
Int. J. Environ. Res. Public Health 2014, 11(2), 2299-2313; doi:10.3390/ijerph110202299
Received: 23 December 2013 / Revised: 12 February 2014 / Accepted: 13 February 2014 / Published: 21 February 2014
Cited by 4 | PDF Full-text (356 KB) | HTML Full-text | XML Full-text
Abstract
Arsenic exposure from drinking water is associated with adverse respiratory outcomes, but it is unknown whether arsenic affects pulmonary microbiota. This exploratory study assessed the effect of exposure to arsenic in drinking water on bacterial diversity in the respiratory tract of non-smokers. Induced
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Arsenic exposure from drinking water is associated with adverse respiratory outcomes, but it is unknown whether arsenic affects pulmonary microbiota. This exploratory study assessed the effect of exposure to arsenic in drinking water on bacterial diversity in the respiratory tract of non-smokers. Induced sputum was collected from 10 subjects with moderate mean household water arsenic concentration (21.1 ± 6.4 ppb) and 10 subjects with low household water arsenic (2.4 ± 0.8 ppb). To assess microbiota in sputum, the V6 hypervariable region amplicons of bacterial 16s rRNA genes were sequenced using the Ion Torrent Personal Genome Machine. Microbial community differences between arsenic exposure groups were evaluated using QIIME and Metastats. A total of 3,920,441 sequence reads, ranging from 37,935 to 508,787 per sample for 316 chips after QIIME quality filtering, were taxonomically classified into 142 individual genera and five phyla. Firmicutes (22%), Proteobacteria (17%) and Bacteriodetes (12%) were the main phyla in all samples, with Neisseriaceae (15%), Prevotellaceae (12%) and Veillonellacea (7%) being most common at the genus level. Some genera, including Gemella, Lactobacillales, Streptococcus, Neisseria and Pasteurellaceae were elevated in the moderate arsenic exposure group, while Rothia, Prevotella, Prevotellaceae Fusobacterium and Neisseriaceae were decreased, although none of these differences was statistically significant. Future studies with more participants and a greater range of arsenic exposure are needed to further elucidate the effects of drinking water arsenic consumption on respiratory microbiota. Full article
Open AccessArticle The Relation between Scores on Noise Annoyance and Noise Disturbed Sleep in a Public Health Survey
Int. J. Environ. Res. Public Health 2014, 11(2), 2314-2327; doi:10.3390/ijerph110202314
Received: 23 November 2013 / Revised: 26 January 2014 / Accepted: 7 February 2014 / Published: 21 February 2014
Cited by 5 | PDF Full-text (425 KB) | HTML Full-text | XML Full-text
Abstract
The relation between responses to survey questions on noise annoyance and self-reported sleep disturbance has been analysed to gain insight in its dependency on noise source or noise type and on individual characteristics. The results show a high correlation between responses (scores 0–10)
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The relation between responses to survey questions on noise annoyance and self-reported sleep disturbance has been analysed to gain insight in its dependency on noise source or noise type and on individual characteristics. The results show a high correlation between responses (scores 0–10) with Pearson’s correlation coefficient close to 0.8 for respondents who report hearing the source. At the same level of annoyance, scooters and neighbours are associated with more sleep disturbance, air and road traffic with less. The relation between Annoyance (A) and Sleep Disturbance (SD) is also significantly related to age, the use of sleeping drugs, and living alone. However, the differences in the A-SD relations with respect to source and characteristic are small. Noise-related sleep disturbance is associated more strongly to noise annoyance than it is to noise exposure. For transportation noise both scores are more often equal when the annoyance score is 7 or higher; this change in scoring behaviour could be an indication for a change to severe annoyance. Full article
Open AccessArticle Pre-Hospital ECG E-Transmission for Patients with Suspected Myocardial Infarction in the Highlands of Scotland
Int. J. Environ. Res. Public Health 2014, 11(2), 2346-2360; doi:10.3390/ijerph110202346
Received: 16 December 2013 / Revised: 29 January 2014 / Accepted: 13 February 2014 / Published: 21 February 2014
Cited by 4 | PDF Full-text (386 KB) | HTML Full-text | XML Full-text
Abstract
Patients with ST elevation myocardial infarction (STEMI) require prompt treatment, best done by primary percutaneous coronary intervention (PPCI). However, for patients unable to receive PPCI, immediate pre-hospital thrombolysis (PHT) is the best alternative. Evidence indicates that diagnostic and management support for staff increases
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Patients with ST elevation myocardial infarction (STEMI) require prompt treatment, best done by primary percutaneous coronary intervention (PPCI). However, for patients unable to receive PPCI, immediate pre-hospital thrombolysis (PHT) is the best alternative. Evidence indicates that diagnostic and management support for staff increases the use of PHT. This study aimed to describe the patient demographics and management of patients, to determine any potential inter-area differences in referral rates to the ECG e-transmission service and to explore the views and experiences of key staff involved in ECG e-transmission within NHS Highland. Data from 2,025 patient episodes of ECG e-transmission identified a statistically significant geographical variation in ECG e-transmission and PHT delivery. Scottish Ambulance Service (SAS) staff were more likely than GPs to deliver PHT overall, however, GPs were more likely to deliver in remote areas. Interviews with six Cardiac Care Unit (CCU) nurses and six SAS staff highlighted their positive views of ECG e-transmission, citing perceived benefits to patients and interprofessional relationships. Poor access to network signal was noted to be a barrier to engaging in the system. This study has demonstrated that a specialist triage service based on e-transmission of ECGs in patients with suspected STEMI can be implemented in a diverse geographical setting. Work is needed to ensure equity of the service for all patients. Full article
(This article belongs to the Special Issue Advances in Telehealthcare)

Review

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Open AccessReview Diesel Exhaust Exposure and the Risk of Lung Cancer—A Review of the Epidemiological Evidence
Int. J. Environ. Res. Public Health 2014, 11(2), 1312-1340; doi:10.3390/ijerph110201312
Received: 25 September 2013 / Revised: 5 December 2013 / Accepted: 12 December 2013 / Published: 27 January 2014
Cited by 5 | PDF Full-text (414 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
To critically evaluate the association between diesel exhaust (DE) exposure and the risk of lung cancer, we conducted a systematic review of published epidemiological evidences. To comprehensively identify original studies on the association between DE exposure and the risk of lung cancer, literature
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To critically evaluate the association between diesel exhaust (DE) exposure and the risk of lung cancer, we conducted a systematic review of published epidemiological evidences. To comprehensively identify original studies on the association between DE exposure and the risk of lung cancer, literature searches were performed in literature databases for the period between 1970 and 2013, including bibliographies and cross-referencing. In total, 42 cohort studies and 32 case-control studies were identified in which the association between DE exposures and lung cancer was examined. In general, previous studies suffer from a series of methodological limitations, including design, exposure assessment methods and statistical analysis used. A lack of objective exposure information appears to be the main problem in interpreting epidemiological evidence. To facilitate the interpretation and comparison of previous studies, a job-exposure matrix (JEM) of DE exposures was created based on around 4,000 historical industrial measurements. The values from the JEM were considered during interpretation and comparison of previous studies. Overall, neither cohort nor case-control studies indicate a clear exposure-response relationship between DE exposure and lung cancer. Epidemiological studies published to date do not allow a valid quantification of the association between DE and lung cancer. Full article
Open AccessReview The Health Heterogeneity of and Health Care Utilization by the Elderly in Taiwan
Int. J. Environ. Res. Public Health 2014, 11(2), 1384-1397; doi:10.3390/ijerph110201384
Received: 28 October 2013 / Revised: 17 January 2014 / Accepted: 18 January 2014 / Published: 27 January 2014
Cited by 1 | PDF Full-text (223 KB) | HTML Full-text | XML Full-text
Abstract
A good understanding of the health heterogeneity of elderly people, their characteristics, patterns of health care utilization and subsequent expenditures is necessary to adequately evaluate the policy options and interventions aimed at improving quality and efficiency of care for older people. This article
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A good understanding of the health heterogeneity of elderly people, their characteristics, patterns of health care utilization and subsequent expenditures is necessary to adequately evaluate the policy options and interventions aimed at improving quality and efficiency of care for older people. This article reviews studies that used Latent Class Analysis to identify four health profiles among elderly people in Taiwan: High Comorbidity (HC), Functional Impairment (FI), Frail (FR), and Relatively Healthy (RH). Variables associated with increased likelihood of being in the FR group were older age, female gender, and living with one’s family, and these also correlated with ethnicity and level of education. The HC group tended to use more ambulatory care services compared with those in the RH group. The HC group tended to be younger, better educated, and was more likely to live in urban areas than were people in the FI group. The FI group, apart from age and gender, was less likely be of Hakka ethnicity and more likely to live with others than were individuals in the RH group. The FI group had relatively high probabilities of needing assistance, and the FR group had higher healthcare expenditures. A person-centered approach would better satisfy current healthcare needs of elderly people and help forecast future expenditures. Full article
(This article belongs to the Special Issue Health Care for Old People)
Open AccessReview Cancer Cluster Investigations: Review of the Past and Proposals for the Future
Int. J. Environ. Res. Public Health 2014, 11(2), 1479-1499; doi:10.3390/ijerph110201479
Received: 27 November 2013 / Revised: 13 January 2014 / Accepted: 20 January 2014 / Published: 28 January 2014
Cited by 3 | PDF Full-text (228 KB) | HTML Full-text | XML Full-text
Abstract
Residential clusters of non-communicable diseases are a source of enduring public concern, and at times, controversy. Many clusters reported to public health agencies by concerned citizens are accompanied by expectations that investigations will uncover a cause of disease. While goals, methods and conclusions
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Residential clusters of non-communicable diseases are a source of enduring public concern, and at times, controversy. Many clusters reported to public health agencies by concerned citizens are accompanied by expectations that investigations will uncover a cause of disease. While goals, methods and conclusions of cluster studies are debated in the scientific literature and popular press, investigations of reported residential clusters rarely provide definitive answers about disease etiology. Further, it is inherently difficult to study a cluster for diseases with complex etiology and long latency (e.g., most cancers). Regardless, cluster investigations remain an important function of local, state and federal public health agencies. Challenges limiting the ability of cluster investigations to uncover causes for disease include the need to consider long latency, low statistical power of most analyses, uncertain definitions of cluster boundaries and population of interest, and in- and out-migration. A multi-disciplinary Workshop was held to discuss innovative and/or under-explored approaches to investigate cancer clusters. Several potentially fruitful paths forward are described, including modern methods of reconstructing residential history, improved approaches to analyzing spatial data, improved utilization of electronic data sources, advances using biomarkers of carcinogenesis, novel concepts for grouping cases, investigations of infectious etiology of cancer, and “omics” approaches. Full article
Open AccessReview Ketogenic Diet for Obesity: Friend or Foe?
Int. J. Environ. Res. Public Health 2014, 11(2), 2092-2107; doi:10.3390/ijerph110202092
Received: 24 December 2013 / Revised: 29 January 2014 / Accepted: 7 February 2014 / Published: 19 February 2014
Cited by 11 | PDF Full-text (363 KB) | HTML Full-text | XML Full-text
Abstract
Obesity is reaching epidemic proportions and is a strong risk factor for a number of cardiovascular and metabolic disorders such as hypertension, type 2 diabetes, dyslipidemia, atherosclerosis, and also certain types of cancers. Despite the constant recommendations of health care organizations regarding the
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Obesity is reaching epidemic proportions and is a strong risk factor for a number of cardiovascular and metabolic disorders such as hypertension, type 2 diabetes, dyslipidemia, atherosclerosis, and also certain types of cancers. Despite the constant recommendations of health care organizations regarding the importance of weight control, this goal often fails. Genetic predisposition in combination with inactive lifestyles and high caloric intake leads to excessive weight gain. Even though there may be agreement about the concept that lifestyle changes affecting dietary habits and physical activity are essential to promote weight loss and weight control, the ideal amount and type of exercise and also the ideal diet are still under debate. For many years, nutritional intervention studies have been focused on reducing dietary fat with little positive results over the long-term. One of the most studied strategies in the recent years for weight loss is the ketogenic diet. Many studies have shown that this kind of nutritional approach has a solid physiological and biochemical basis and is able to induce effective weight loss along with improvement in several cardiovascular risk parameters. This review discusses the physiological basis of ketogenic diets and the rationale for their use in obesity, discussing the strengths and the weaknesses of these diets together with cautions that should be used in obese patients. Full article
(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)
Open AccessReview Potential for Improved Glycemic Control with Dietary Momordica charantia in Patients with Insulin Resistance and Pre-Diabetes
Int. J. Environ. Res. Public Health 2014, 11(2), 2328-2345; doi:10.3390/ijerph110202328
Received: 23 December 2013 / Revised: 2 February 2014 / Accepted: 10 February 2014 / Published: 21 February 2014
Cited by 7 | PDF Full-text (250 KB) | HTML Full-text | XML Full-text
Abstract
Bitter Melon (Momordica charantia) is a widely used traditional remedy for hyperglycemia. While the medicinal properties of this plant have been studied extensively using in vitro and animal models, the clinical efficacy and safety in humans is largely unknown. This review discusses
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Bitter Melon (Momordica charantia) is a widely used traditional remedy for hyperglycemia. While the medicinal properties of this plant have been studied extensively using in vitro and animal models, the clinical efficacy and safety in humans is largely unknown. This review discusses the benefits and limitations of bitter melon supplementation in the context of epidemic levels of insulin resistance and pre-diabetes throughout the world. Full article
(This article belongs to the Special Issue IJERPH: 10th Anniversary)

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Open AccessHypothesis Glyphosate, Hard Water and Nephrotoxic Metals: Are They the Culprits Behind the Epidemic of Chronic Kidney Disease of Unknown Etiology in Sri Lanka?
Int. J. Environ. Res. Public Health 2014, 11(2), 2125-2147; doi:10.3390/ijerph110202125
Received: 17 December 2013 / Revised: 22 January 2014 / Accepted: 27 January 2014 / Published: 20 February 2014
Cited by 36 | PDF Full-text (3182 KB) | HTML Full-text | XML Full-text
Abstract
The current chronic kidney disease epidemic, the major health issue in the rice paddy farming areas in Sri Lanka has been the subject of many scientific and political debates over the last decade. Although there is no agreement among scientists about the etiology
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The current chronic kidney disease epidemic, the major health issue in the rice paddy farming areas in Sri Lanka has been the subject of many scientific and political debates over the last decade. Although there is no agreement among scientists about the etiology of the disease, a majority of them has concluded that this is a toxic nephropathy. None of the hypotheses put forward so far could explain coherently the totality of clinical, biochemical, histopathological findings, and the unique geographical distribution of the disease and its appearance in the mid-1990s. A strong association between the consumption of hard water and the occurrence of this special kidney disease has been observed, but the relationship has not been explained consistently. Here, we have hypothesized the association of using glyphosate, the most widely used herbicide in the disease endemic area and its unique metal chelating properties. The possible role played by glyphosate-metal complexes in this epidemic has not been given any serious consideration by investigators for the last two decades. Furthermore, it may explain similar kidney disease epidemics observed in Andra Pradesh (India) and Central America. Although glyphosate alone does not cause an epidemic of chronic kidney disease, it seems to have acquired the ability to destroy the renal tissues of thousands of farmers when it forms complexes with a localized geo environmental factor (hardness) and nephrotoxic metals. Full article
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Open AccessCommentary Recent Evidence Regarding Triclosan and Cancer Risk
Int. J. Environ. Res. Public Health 2014, 11(2), 2209-2217; doi:10.3390/ijerph110202209
Received: 16 January 2014 / Revised: 12 February 2014 / Accepted: 13 February 2014 / Published: 21 February 2014
Cited by 12 | PDF Full-text (219 KB) | HTML Full-text | XML Full-text
Abstract
Triclosan is a broad-spectrum antibacterial commonly used in cosmetics, dentifrices, and other consumer products. The compound’s widespread use in consumer products and its detection in breast milk, urine, and serum have raised concerns regarding its potential association with various human health outcomes.  Recent
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Triclosan is a broad-spectrum antibacterial commonly used in cosmetics, dentifrices, and other consumer products. The compound’s widespread use in consumer products and its detection in breast milk, urine, and serum have raised concerns regarding its potential association with various human health outcomes.  Recent evidence suggests that triclosan may play a role in cancer development, perhaps through its estrogenicity or ability to inhibit fatty acid synthesis. Our aims here are to review studies of human exposure levels, to evaluate the results of studies examining the effects of triclosan on cancer development, and to suggest possible directions for future research. Full article
(This article belongs to the Special Issue Endocrine Disruptors and Human Health)

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