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Int. J. Environ. Res. Public Health, Volume 12, Issue 1 (January 2015), Pages 1-1053

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Open AccessEditorial International Journal of Environmental Research and Public Health Best Paper Award 2015
Int. J. Environ. Res. Public Health 2015, 12(1), 1050-1053; https://doi.org/10.3390/ijerph120101050
Received: 19 January 2015 / Revised: 19 January 2015 / Accepted: 19 January 2015 / Published: 20 January 2015
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Abstract
International Journal of Environmental Research and Public Health started to institute an annual award in 2013 to recognize outstanding papers related to environmental health sciences and public health that meet the aims, scope and high standards of this journal. We are pleased to
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International Journal of Environmental Research and Public Health started to institute an annual award in 2013 to recognize outstanding papers related to environmental health sciences and public health that meet the aims, scope and high standards of this journal. We are pleased to announce the third “International Journal of Environmental Research and Public Health Best Paper Awards” for 2015. Nominations were solicited from the Editor-in-Chief and Editorial Board members, with all papers published in 2011 eligible for consideration. The following nine papers were selected for recognition awards:[...] Full article
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Open AccessOpinion Assessing Health Impacts within Environmental Impact Assessments: An Opportunity for Public Health Globally Which Must Not Remain Missed
Int. J. Environ. Res. Public Health 2015, 12(1), 1044-1049; https://doi.org/10.3390/ijerph120101044
Received: 3 December 2014 / Revised: 22 December 2014 / Accepted: 15 January 2015 / Published: 20 January 2015
Cited by 9 | PDF Full-text (610 KB) | HTML Full-text | XML Full-text
Abstract
Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA) which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment
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Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA) which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC), this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process to approve projects. Full article
(This article belongs to the Special Issue Health Impact Assessment: Realizing Its Potential)
Open AccessArticle Ethanol and Acetic Acid Production from Carbon Monoxide in a Clostridium Strain in Batch and Continuous Gas-Fed Bioreactors
Int. J. Environ. Res. Public Health 2015, 12(1), 1029-1043; https://doi.org/10.3390/ijerph120101029
Received: 30 October 2014 / Revised: 31 December 2014 / Accepted: 9 January 2015 / Published: 20 January 2015
Cited by 9 | PDF Full-text (841 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The effect of different sources of nitrogen as well as their concentrations on the bioconversion of carbon monoxide to metabolic products such as acetic acid and ethanol by Clostridium autoethanogenum was studied. In a first set of assays, under batch conditions, either NH
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The effect of different sources of nitrogen as well as their concentrations on the bioconversion of carbon monoxide to metabolic products such as acetic acid and ethanol by Clostridium autoethanogenum was studied. In a first set of assays, under batch conditions, either NH4Cl, trypticase soy broth or yeast extract (YE) were used as sources of nitrogen. The use of YE was found statistically significant (p < 0.05) on the product spectrum in such batch assays. In another set of experiments, three bioreactors were operated with continuous CO supply, in order to estimate the effect of running conditions on products and biomass formation. The bioreactors were operated under different conditions, i.e., EXP1 (pH = 5.75, YE 1g/L), EXP2 (pH = 4.75, YE 1 g/L) and EXP3 (pH = 5.75, YE 0.2 g/L). When compared to EXP2 and EXP3, it was found that EXP1 yielded the maximum biomass accumulation (302.4 mg/L) and products concentrations, i.e., acetic acid (2147.1 mg/L) and ethanol (352.6 mg/L). This can be attributed to the fact that the higher pH and higher YE concentration used in EXP1 stimulated cell growth and did, consequently, also enhance metabolite production. However, when ethanol is the desired end-product, as a biofuel, the lower pH used in EXP2 was more favourable for solventogenesis and yielded the highest ethanol/acetic acid ratio, reaching a value of 0.54. Full article
(This article belongs to the Special Issue Bioprocesses for Air Pollution Control)
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Open AccessArticle Could A Deletion in Neuraminidase Stalk Strengthen Human Tropism of the Novel Avian Influenza Virus H7N9 in China, 2013?
Int. J. Environ. Res. Public Health 2015, 12(1), 1020-1028; https://doi.org/10.3390/ijerph120101020
Received: 25 September 2014 / Revised: 5 January 2015 / Accepted: 13 January 2015 / Published: 20 January 2015
Cited by 2 | PDF Full-text (2741 KB) | HTML Full-text | XML Full-text
Abstract
Objective. A novel avian influenza A virus (AIV) H7N9 subtype which emerged in China in 2013 caused worldwide concern. Deletion of amino-acids 69 to 73 in the neuraminidase stalk was its most notable characteristic. This study is aimed to discuss the tropism and
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Objective. A novel avian influenza A virus (AIV) H7N9 subtype which emerged in China in 2013 caused worldwide concern. Deletion of amino-acids 69 to 73 in the neuraminidase stalk was its most notable characteristic. This study is aimed to discuss the tropism and virulence effects of this deletion. Methods: Neuraminidase gene sequences of N9 subtype were collected from NCBI and GISAID. MEGA6.0, Stata12.0, and UCSF Chimera were employed for sequence aligning, significance testing, and protein tertiary structure homology modeling. Results: A total of 736 sequences were obtained; there were 81 human isolates of the novel AIV H7N9, of which 79 had the deletion. Among all the 654 avian origin sequences, only 43 had the deletion (p < 0.001). Tertiary structure displayed that the deletion obviously changed the spatial direction of neuraminidase. Conclusions: The deletion in neuraminidase stalk could have strengthened human tropism of the novel AIV H7N9, as well as its virulence. Full article
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Open AccessArticle The Healthy Lifestyles Programme (HeLP) — An Overview of and Recommendations Arising from the Conceptualisation and Development of an Innovative Approach to Promoting Healthy Lifestyles for Children and Their Families
Int. J. Environ. Res. Public Health 2015, 12(1), 1003-1019; https://doi.org/10.3390/ijerph120101003
Received: 24 October 2014 / Revised: 10 December 2014 / Accepted: 13 January 2015 / Published: 20 January 2015
Cited by 8 | PDF Full-text (693 KB) | HTML Full-text | XML Full-text
Abstract
Despite the rise in childhood obesity, there remains a paucity of evidence for effective interventions that engage children and parents sufficiently to make and sustain lifestyle behaviour change. The Healthy Lifestyles Programme (HeLP) is a school-located obesity prevention programme, which has been developed
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Despite the rise in childhood obesity, there remains a paucity of evidence for effective interventions that engage children and parents sufficiently to make and sustain lifestyle behaviour change. The Healthy Lifestyles Programme (HeLP) is a school-located obesity prevention programme, which has been developed with teachers, families and healthcare professionals. The underpinning assumption in the development of HeLP was to take a relational approach to changing behaviour, building relationships with the schools, children and their families to create supportive environments for healthy lifestyle choices. Thus, HeLP was conceptualised as a complex intervention within a complex system and developed as a dynamic, evolving set of processes to support and motivate children towards healthy behaviours. The delivery methods used are highly interactive and encourage identification with and ownership of the healthy lifestyle messages so that the children are motivated to take them home to their parents and effect change within the family. We have good evidence that HeLP engages schools and children such that they want to participate in the Programme. Results from an exploratory trial showed that the Programme is feasible and acceptable and has the potential to change behaviours and affect weight status. This paper presents an overview of and recommendations arising from the conceptualization; development and evaluation of the Healthy Lifestyles Programme as part of a special issue focusing on novel approaches to the global problem of childhood obesity. Full article
(This article belongs to the Special Issue Childhood Obesity: Novel Approaches to a Global Problem)
Open AccessArticle Risk Communication Concerning Welding Fumes for the Primary Preventive Care of Welding Apprentices in Southern Brazil
Int. J. Environ. Res. Public Health 2015, 12(1), 986-1002; https://doi.org/10.3390/ijerph120100986
Received: 19 September 2014 / Accepted: 15 January 2015 / Published: 19 January 2015
Cited by 3 | PDF Full-text (693 KB) | HTML Full-text | XML Full-text
Abstract
This study’s aim was to assess the perceptions of welding apprentices concerning welding fumes being associated with respiratory and cardiovascular disorders and assess the implementation of risk communication as a primary prevention tool in the welding training process. This quasi-experimental, non-randomized study with
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This study’s aim was to assess the perceptions of welding apprentices concerning welding fumes being associated with respiratory and cardiovascular disorders and assess the implementation of risk communication as a primary prevention tool in the welding training process. This quasi-experimental, non-randomized study with before-and-after design was conducted with 84 welding apprentices in Southern Brazil. Poisson Regression analysis was used. Relative Risk was the measure used with a 95% confidence interval and 5% (p ≤ 0.05) significance level. Significant association was found between perceptions of worsened symptoms of respiratory disorders caused by welding fumes and educational level (p = 0.049), the use of goggles to protect against ultraviolet rays (p = 0.023), and access to services in private health facilities without insurance coverage (p = 0.001). Apprentices younger than 25 years old were 4.9 times more likely to perceive worsened cardiovascular symptoms caused by welding fumes after risk communication (RR = 4.91; CI 95%: 1.09 to 22.2). The conclusion is that risk communication as a primary preventive measure in continuing education processes implemented among apprentices, who are future welders, was efficacious. Thus, this study confirms that risk communication can be implemented as a primary prevention tool in welding apprenticeships. Full article
(This article belongs to the Special Issue Preventive Medicine)
Open AccessArticle Prevalence of Virulence Determinants and Antimicrobial Resistance among Commensal Escherichia coli Derived from Dairy and Beef Cattle
Int. J. Environ. Res. Public Health 2015, 12(1), 970-985; https://doi.org/10.3390/ijerph120100970
Received: 10 October 2014 / Accepted: 22 December 2014 / Published: 19 January 2015
Cited by 6 | PDF Full-text (911 KB) | HTML Full-text | XML Full-text
Abstract
Cattle is a reservoir of potentially pathogenic E. coli, bacteria that can represent a significant threat to public health, hence it is crucial to monitor the prevalence of the genetic determinants of virulence and antimicrobial resistance among the E. coli population. The
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Cattle is a reservoir of potentially pathogenic E. coli, bacteria that can represent a significant threat to public health, hence it is crucial to monitor the prevalence of the genetic determinants of virulence and antimicrobial resistance among the E. coli population. The aim of this study was the analysis of the phylogenetic structure, distribution of virulence factors (VFs) and prevalence of antimicrobial resistance among E. coli isolated from two groups of healthy cattle: 50 cows housed in the conventional barn (147 isolates) and 42 cows living on the ecological pasture (118 isolates). The phylogenetic analysis, identification of VFs and antimicrobial resistance genes were based on either multiplex or simplex PCR. The antimicrobial susceptibilities of E. coli were examined using the broth microdilution method. Two statistical approaches were used to analyse the results obtained for two groups of cattle. The relations between the dependent (VFs profiles, antibiotics) and the independent variables were described using the two models. The mixed logit model was used to characterise the prevalence of the analysed factors in the sets of isolates. The univariate logistic regression model was used to characterise the prevalence of these factors in particular animals. Given each model, the odds ratio (OR) and the 95% confidence interval for the population were estimated. The phylogroup B1 was predominant among isolates from beef cattle, while the phylogroups A, B1 and D occurred with equal frequency among isolates from dairy cattle. The frequency of VFs-positive isolates was significantly higher among isolates from beef cattle. E. coli from dairy cattle revealed significantly higher resistance to antibiotics. Some of the tested resistance genes were present among isolates from dairy cattle. Our study showed that the habitat and diet may affect the genetic diversity of commensal E. coli in the cattle. The results suggest that the ecological pasture habitat is related to the increased spreading rate of the VFs, while the barn habitat is characterised by the higher levels of antimicrobial resistance among E. coli. Full article
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Open AccessArticle Assessing Metal Exposures in a Community near a Cement Plant in the Northeast U.S.
Int. J. Environ. Res. Public Health 2015, 12(1), 952-969; https://doi.org/10.3390/ijerph120100952
Received: 21 October 2014 / Accepted: 13 January 2015 / Published: 19 January 2015
Cited by 8 | PDF Full-text (1078 KB) | HTML Full-text | XML Full-text
Abstract
Cement production is a major source of metals and metalloids in the environment, while exposures to metals and metalloids may impact human health in the surrounding communities. We recruited 185 participants living in the vicinity of a cement plant in the northeast U.S.,
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Cement production is a major source of metals and metalloids in the environment, while exposures to metals and metalloids may impact human health in the surrounding communities. We recruited 185 participants living in the vicinity of a cement plant in the northeast U.S., and measured the levels of aluminum (Al), arsenic (As), cadmium (Cd), lead (Pb), mercury (Hg), and selenium (Se) in blood and Hg in hair samples from them. A questionnaire was used to assess potential sources of Hg exposure. Multivariate regressions and spatial analyses were performed to evaluate the relative importance of different routes of exposures. The metal concentrations in blood or hair samples of our study participants were comparable to the U.S. general or regional population. Smoking contributed significantly to Cd and Pb exposures, and seafood consumption contributed significantly to Hg and As exposures, while variables related to the cement plant were not significantly associated with metal concentrations. Our results suggest that our study population was not at elevated health risk due to metal exposures, and that the contribution of the cement plant to metal exposures in the surrounding community was minimal. Full article
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Open AccessArticle Benzo[a]pyrene and Benzo[k]fluoranthene in Some Processed Fish and Fish Products
Int. J. Environ. Res. Public Health 2015, 12(1), 940-951; https://doi.org/10.3390/ijerph120100940
Received: 2 October 2014 / Accepted: 13 January 2015 / Published: 19 January 2015
Cited by 4 | PDF Full-text (672 KB) | HTML Full-text | XML Full-text
Abstract
In this study, the concentration levels of the probable carcinogenic PAH fractions, benzo[a]pyrene (BaP) and benzo[k]fluoranthrene (BkF) in fillets of some processed fish species were investigated. Fish species comprising Merluccius poli (hake), Tyrsites atun (snoek), Seriola lalandi (yellow-tail) and Brama brama (angel fish)
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In this study, the concentration levels of the probable carcinogenic PAH fractions, benzo[a]pyrene (BaP) and benzo[k]fluoranthrene (BkF) in fillets of some processed fish species were investigated. Fish species comprising Merluccius poli (hake), Tyrsites atun (snoek), Seriola lalandi (yellow-tail) and Brama brama (angel fish) were bought in fish shops at Gordon’s Bay, Western Cape, South Africa. The fish were gutted, filleted and prepared for edibility by frying, grilling and boiling. Polycyclic aromatic hydrocarbons were extracted from each homogenized fish sample, cleaned-up using solid phase extraction (SPE), and analysed for the PAH fractions, BaP and BkF using a Gas Chromatograph coupled with a Flame Ionization Detector (GC-FID). The sum of the two PAHs (∑2PAH) i.e., BaP and BkF ranged between 0.56 and 1.46 µg/kg, in all boiled, grilled and fried fish species. The fried fish extracts showed significantly higher (p < 0.05) abundance of ∑2PAH, than grilled and boiled fish. Dietary safety and PAHs toxicity was also discussed. Full article
Open AccessArticle Local Sustainability and Gender Ratio: Evaluating the Impacts of Mining and Tourism on Sustainable Development in Yunnan, China
Int. J. Environ. Res. Public Health 2015, 12(1), 927-939; https://doi.org/10.3390/ijerph120100927
Received: 14 November 2014 / Accepted: 14 January 2015 / Published: 19 January 2015
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Abstract
This study employed rapid evaluation methods to investigate how the leading industries of mining and tourism impact sustainability as manifest through social, economic and environmental dimensions in Yunnan, China. Within the social context, we also consider the differentiated impact on gender ratio—which is
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This study employed rapid evaluation methods to investigate how the leading industries of mining and tourism impact sustainability as manifest through social, economic and environmental dimensions in Yunnan, China. Within the social context, we also consider the differentiated impact on gender ratio—which is a salient feature of sustained development trajectories. Our results indicate that mining areas performed better than tourism areas in economic aspects but fell behind in social development, especially regarding the issue of gender balance. Conclusions on environmental status cannot be drawn due to a lack of data. The results from the environmental indicators are mixed. Our study demonstrates that rapid evaluation using currently available data can provide a means of greater understanding regarding local sustainability and highlights areas that need attention from policy makers, agencies and academia. Full article
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Open AccessArticle Effects of Horizontal Acceleration on Human Visual Acuity and Stereopsis
Int. J. Environ. Res. Public Health 2015, 12(1), 910-926; https://doi.org/10.3390/ijerph120100910
Received: 26 November 2014 / Accepted: 13 January 2015 / Published: 19 January 2015
Cited by 2 | PDF Full-text (1256 KB) | HTML Full-text | XML Full-text
Abstract
The effect of horizontal acceleration on human visual acuity and stereopsis is demonstrated in this study. Twenty participants (mean age 22.6 years) were enrolled in the experiment. Acceleration from two different directions was performed at the Taiwan High-Speed Rail Laboratory. Gx and Gy
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The effect of horizontal acceleration on human visual acuity and stereopsis is demonstrated in this study. Twenty participants (mean age 22.6 years) were enrolled in the experiment. Acceleration from two different directions was performed at the Taiwan High-Speed Rail Laboratory. Gx and Gy (< and >0.1 g) were produced on an accelerating platform where the subjects stood. The visual acuity and stereopsis of the right eye were measured before and during the acceleration. Acceleration <0.1 g in the X- or Y-axis did not affect dynamic vision and stereopsis. Vision decreased (mean from 0.02 logMAR to 0.25 logMAR) and stereopsis declined significantly (mean from 40 s to 60.2 s of arc) when Gx > 0.1 g. Visual acuity worsened (mean from 0.02 logMAR to 0.19 logMAR) and poor stereopsis was noted (mean from 40 s to 50.2 s of arc) when Gy > 0.1 g. The effect of acceleration from the X-axis on the visual system was higher than that from the Y-axis. During acceleration, most subjects complained of ocular strain when reading. To our knowledge, this study is the first to report the exact levels of visual function loss during Gx and Gy. Full article
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Open AccessArticle Smoking-Related Knowledge, Attitude, Social Pressure, and Environmental Constraints among New Undergraduates in Chongqing, China
Int. J. Environ. Res. Public Health 2015, 12(1), 895-909; https://doi.org/10.3390/ijerph120100895
Received: 17 July 2014 / Revised: 30 December 2014 / Accepted: 12 January 2015 / Published: 19 January 2015
Cited by 3 | PDF Full-text (703 KB) | HTML Full-text | XML Full-text
Abstract
Background: Smoking has resulted in numerous deaths in China. Data indicate that 21% of college students in China are smokers. Objective: This study aimed to examine the smoking-related behaviors of undergraduates, as influenced by knowledge, attitude, social pressure, and environmental constraints.
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Background: Smoking has resulted in numerous deaths in China. Data indicate that 21% of college students in China are smokers. Objective: This study aimed to examine the smoking-related behaviors of undergraduates, as influenced by knowledge, attitude, social pressure, and environmental constraints. Method: A convenience sampling of 412 fresh undergraduates from two universities in the University Town in Chongqing, China was recruited. Chi-square tests were used to compare the smoking-related variables between smokers and non-smokers. Moreover, logistic regression was used to examine the factors that associated with smoking status in undergraduates. Results: Smokers and non-smokers differ in terms of knowledge, attitudes toward smoking, participation in tobacco promotional activities, and sources of social pressure. Logistic regression model identified that sex, living cost, five smoking-related attitudes of “Smoking is pleasurable, Smoking relaxes me, Smoking makes me look strong, Smoking is a waste of money, Smoking can help me study better”, the social pressure “Smoking brings comfort during celebration”, and the environmental constraints “How did you get your cigarettes in the past 30 days?” are significantly associated with smoking. Conclusions: The findings provide a better understanding of the epidemic of smoking among fresh undergraduates in Chongqing, China. This study provides more detailed consideration of the implications for the WHO Framework Convention on Tobacco Control (FCTC) policies, especially on restriction of retail sales outlets and tobacco promotion activities near universities in China. Full article
Open AccessArticle Determination of Total Tritium in Urine from Residents Living in the Vicinity of Nuclear Power Plants in Qinshan, China
Int. J. Environ. Res. Public Health 2015, 12(1), 888-894; https://doi.org/10.3390/ijerph120100888
Received: 23 October 2014 / Accepted: 12 January 2015 / Published: 16 January 2015
Cited by 2 | PDF Full-text (321 KB) | HTML Full-text | XML Full-text
Abstract
To estimate the tritium doses of the residents living in the vicinity of a nuclear power plant, urine samples of 34 adults were collected from residents living near the Qinshan nuclear power plant. The tritium-in-urine (HTO plus OBT) was measured by liquid scintillation
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To estimate the tritium doses of the residents living in the vicinity of a nuclear power plant, urine samples of 34 adults were collected from residents living near the Qinshan nuclear power plant. The tritium-in-urine (HTO plus OBT) was measured by liquid scintillation counting. The doses of tritium-in-urine from participants living at 2, 10 and 22 km were in a range of 1.26–6.73 Bq/L, 1.31–3.09 Bq/L and 2.21–3.81 Bq/L, respectively, while the average activity concentrations of participants from the three groups were 3.53 ± 1.62, 2.09 ± 0.62 and 2.97 ± 0.78 Bq/L, respectively. The personal committed effective doses for males were 2.5 ± 1.7 nSv and for females they were 2.9 ± 1.3 nSv. These results indicate that tritium concentrations in urine samples from residents living at 2 km from a nuclear power plant are significantly higher than those at 10 km. It may be the downwind direction that caused a higher dose in participants living at 22 km. All the measured doses of tritium-in-urine are in a background level range. Full article
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Open AccessArticle Prevalence and Determinants of Mucous Membrane Irritations in a Community Near a Cement Factory in Zambia: A Cross Sectional Study
Int. J. Environ. Res. Public Health 2015, 12(1), 871-887; https://doi.org/10.3390/ijerph120100871
Received: 5 November 2014 / Accepted: 6 January 2015 / Published: 16 January 2015
Cited by 2 | PDF Full-text (646 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Exposure to cement dust has been associated with deleterious health effects in humans. This study investigated whether residing near a cement factory increases the risk of irritations to the mucous membranes of the eyes and respiratory system. A cross sectional study was conducted
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Exposure to cement dust has been associated with deleterious health effects in humans. This study investigated whether residing near a cement factory increases the risk of irritations to the mucous membranes of the eyes and respiratory system. A cross sectional study was conducted in Freedom Compound, a community bordering a cement factory in Chilanga, Zambia and a control community, Bauleni, located 18 km from the cement plant. A modified American Thoracic Society questionnaire was administered to 225 and 198 respondents aged 15–59 years from Freedom and Bauleni, respectively, to capture symptoms of the irritations. Respondents from Freedom Compound, were more likely to experience the irritations; adjusted ORs 2.50 (95% CI: 1.65, 3.79), 4.36 (95% CI (2.96, 6.55)) and 1.94 (95% CI (1.19, 3.18)) for eye, nose and sinus membrane irritations respectively. Cohort panel studies to determine associations of cement emissions to mucous membrane irritations and respiratory symptoms, coupled with field characterization of the exposure are needed to assess whether the excess prevalence of symptoms of mucous membrane irritations observed in Freedom compound are due to emissions from the cement factory. Full article
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Open AccessArticle Exploring HIV Prevention Strategies among Street-Based Female Sex Workers in Chongqing, China
Int. J. Environ. Res. Public Health 2015, 12(1), 855-870; https://doi.org/10.3390/ijerph120100855
Received: 6 November 2014 / Accepted: 5 January 2015 / Published: 16 January 2015
Cited by 3 | PDF Full-text (299 KB) | HTML Full-text | XML Full-text
Abstract
Background: Commercial sex plays an increasingly important role in China’s growing HIV and sexually transmitted infection (STI) epidemics. In China, street-based sex workers (SSWs) are a subgroup of female sex workers with a particularly high risk of HIV/STI infections but are neglected
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Background: Commercial sex plays an increasingly important role in China’s growing HIV and sexually transmitted infection (STI) epidemics. In China, street-based sex workers (SSWs) are a subgroup of female sex workers with a particularly high risk of HIV/STI infections but are neglected in responses to HIV. This study assesses changes in HIV voluntary counseling and testing (VCT) utilization and high-risk sexual behaviors following a three-month HIV preventive intervention among SSWs in Chongqing, China. Methods: A three-month intervention was conducted by a team of peer educators, outreach workers from community-based organizations and health professionals. It mainly included distribution of free pamphlets and condoms and delivery of onsite and clinic-based VCT. Cross-sectional surveys were conducted prior to (n = 100) and immediately following (n = 112) the intervention to assess its impact. In-depth interviews were conducted among 12 SSWs after the intervention to further explore potential barriers to HIV prevention. Results: The intervention significantly increased SSWs’ participation in VCT (from 2.0%–15.2%, P < 0.001). Despite participants’ improved HIV-related knowledge level (from 24.0%–73.2%, P < 0.001), there were minimal changes in the levels of condom use with clients. Qualitative research revealed that fear of police arrest and stigma were the main barriers to VCT utilization. Low condom use was associated with family financial constraints, inadequate power in condom negotiation, low awareness and misconceptions of HIV infection risks. Conclusion: HIV intervention improved VCT utilization and knowledge but we did not observe an increase in condom use after this short intervention. SSWs faced substantial economic, social and environmental barriers to VCT utilization and condom use. Full article
(This article belongs to the Special Issue HIV/AIDS: Social Perspectives)
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