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Open AccessArticle Impacts of Tropical Cyclones and Accompanying Precipitation on Infectious Diarrhea in Cyclone Landing Areas of Zhejiang Province, China

by Zhengyi Deng, Huanmiao Xun, Maigeng Zhou, Baofa Jiang, Songwang Wang, Qing Guo, Wei Wang, Ruihua Kang, Xin Wang, Gifty Marley and Wei Ma

Int. J. Environ. Res. Public Health 2015, 12(2), 1054-1068; doi:10.3390/ijerph120201054

Received: 1 November 2014 / Accepted: 16 January 2015 / Published: 22 January 2015

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Abstract

Background: Zhejiang Province, located in southeastern China, is frequently hit by tropical cyclones. This study quantified the associations between infectious diarrhea and the seven tropical cyclones that landed in Zhejiang from 2005–2011 to assess the impacts of the accompanying precipitation on the

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Background: Zhejiang Province, located in southeastern China, is frequently hit by tropical cyclones. This study quantified the associations between infectious diarrhea and the seven tropical cyclones that landed in Zhejiang from 2005–2011 to assess the impacts of the accompanying precipitation on the studied diseases. Method: A unidirectional case-crossover study design was used to evaluate the impacts of tropical storms and typhoons on infectious diarrhea. Principal component analysis (PCA) was applied to eliminate multicollinearity. A multivariate logistic regression model was used to estimate the odds ratios (ORs) and the 95% confidence intervals (CIs). Results: For all typhoons studied, the greatest impacts on bacillary dysentery and other infectious diarrhea were identified on lag 6 days (OR = 2.30, 95% CI: 1.81–2.93) and lag 5 days (OR = 3.56, 95% CI: 2.98–4.25), respectively. For all tropical storms, impacts on these diseases were highest on lag 2 days (OR = 2.47, 95% CI: 1.41–4.33) and lag 6 days (OR = 2.46, 95% CI: 1.69–3.56), respectively. The tropical cyclone precipitation was a risk factor for both bacillary dysentery and other infectious diarrhea when daily precipitation reached 25 mm and 50 mm with the largest OR = 3.25 (95% CI: 1.45–7.27) and OR = 3.05 (95% CI: 2.20–4.23), respectively. Conclusions: Both typhoons and tropical storms could contribute to an increase in risk of bacillary dysentery and other infectious diarrhea in Zhejiang. Tropical cyclone precipitation may also be a risk factor for these diseases when it reaches or is above 25 mm and 50 mm, respectively. Public health preventive and intervention measures should consider the adverse health impacts from tropical cyclones. Full article

(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)

Open AccessArticle Delineating Biophysical Environments of the Sunda Banda Seascape, Indonesia

by Mingshu Wang, Gabby N. Ahmadia, Iliana Chollett, Charles Huang, Helen Fox, Anton Wijonarno and Marguerite Madden

Int. J. Environ. Res. Public Health 2015, 12(2), 1069-1082; doi:10.3390/ijerph120201069

Received: 3 October 2014 / Accepted: 29 December 2014 / Published: 22 January 2015

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Abstract

The Sunda Banda Seascape (SBS), located in the center of the Coral Triangle, is a global center of marine biodiversity and a conservation priority. We proposed the first biophysical environmental delineation of the SBS using globally available satellite remote sensing and model-assimilated data

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The Sunda Banda Seascape (SBS), located in the center of the Coral Triangle, is a global center of marine biodiversity and a conservation priority. We proposed the first biophysical environmental delineation of the SBS using globally available satellite remote sensing and model-assimilated data to categorize this area into unique and meaningful biophysical classes. Specifically, the SBS was partitioned into eight biophysical classes characterized by similar sea surface temperature, chlorophyll a concentration, currents, and salinity patterns. Areas within each class were expected to have similar habitat types and ecosystem functions. Our work supplemented prevailing global marine management schemes by focusing in on a regional scale with finer spatial resolution. It also provided a baseline for academic research, ecological assessments and will facilitate marine spatial planning and conservation activities in the area. In addition, the framework and methods of delineating biophysical environments we presented can be expanded throughout the whole Coral Triangle to support research and conservation activities in this important region. Full article

(This article belongs to the Special Issue Proceedings from 2014 Global Land Project (GLP) Asia Conference)

Open AccessArticle Migration, Acculturation and Environment: Determinants of Obesity among Iranian Migrants in Australia

by Maryam Delavari, Anders Larrabee Sønderlund, David Mellor, Mohammadreza Mohebbi and Boyd Swinburn

Int. J. Environ. Res. Public Health 2015, 12(2), 1083-1098; doi:10.3390/ijerph120201083

Received: 18 June 2014 / Revised: 23 December 2014 / Accepted: 13 January 2015 / Published: 22 January 2015

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Abstract

While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to

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While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to explain post-migration risks for obesity. The present study examines the interaction between obesity-related environmental factors and the pattern of migrant acculturation in a sample of 152 Iranian immigrants in Victoria, Australia. Weight measurements, demographics, physical activity levels and diet habits were also surveyed. The pattern of acculturation (relative integration, assimilation, separation or marginalization) was not related to body mass index, diet, or physical activity behaviours. Three relevant aspects of participants’ perception of the Australian environment (physically active environments, social pressure to be fit, unhealthy food environments) varied considerably by demographic characteristics, but only one (physically active environments) was related to a pattern of acculturation (assimilation). Overall, this research highlighted a number of key relationships between acculturation and obesity-related environments and behaviours for our study sample. Theoretical models on migration, culture and obesity need to include environmental factors. Full article

(This article belongs to the Special Issue Migrant Health)

Open AccessArticle Analysis of the Characteristics and Evolution Modes of PM_2.5 Pollution Episodes in Beijing, China During 2013

by Ci Song, Tao Pei and Ling Yao

Int. J. Environ. Res. Public Health 2015, 12(2), 1099-1111; doi:10.3390/ijerph120201099

Received: 27 October 2014 / Accepted: 23 December 2014 / Published: 22 January 2015

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Abstract

Fine particulate matter (PM_2.5) has been recognized as a serious hazard linked to deleterious health effects. In this study, all PM_2.5 Pollution Episodes (PPEs) in Beijing during 2013 were investigated with hourly PM_2.5 observations from the Olympic Sport Center

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Fine particulate matter (PM_2.5) has been recognized as a serious hazard linked to deleterious health effects. In this study, all PM_2.5 Pollution Episodes (PPEs) in Beijing during 2013 were investigated with hourly PM_2.5 observations from the Olympic Sport Center site, and then their characteristics and evolution modes analysed. Results show that 80 PPEs, covering 209 days, occurred in Beijing during 2013. Average PM_2.5 concentrations during PPEs were almost twice (1.86) the annual mean value, although the PPEs showed significant seasonal variations. The most hazardous PPEs tended to occur in winter, whereas PPEs with long duration occurred in autumn. The PPEs could be divided into six clusters based on their compositions of different pollution levels, which were strongly related to meteorological factors. We used series peaks of PM_2.5 concentrations to analyse the evolution modes of PPEs and found that the more peaks there were within the evolution mode, the longer the duration, and the higher the average and maximum PM_2.5 concentrations. Each peak within a PPE can be identified by “rise” and “fall” patterns. The “rise” patterns are widely related to relative humidity, whereas the “fall” patterns are affected principally by wind speed for one-peak PPEs and boundary layer height for multi-peak PPEs. The peak patterns cannot be explained fully by meteorological factors; however, they might also be closely related to complex and diversified human activities. Full article

Open AccessArticle Preventing Obesity in the Military Community (POMC): The Development of a Clinical Trials Research Network

by Elena A. Spieker, Tracy Sbrocco, Kelly R. Theim, Douglas Maurer, Dawn Johnson, Edny Bryant, Jennifer L. Bakalar, Natasha A. Schvey, Rachel Ress, Dean Seehusen, David A. Klein, Eric Stice, Jack A. Yanovski, Linda Chan, Shari Gentry, Carol Ellsworth, Joanne W. Hill, Marian Tanofsky-Kraff and Mark B. Stephens

Int. J. Environ. Res. Public Health 2015, 12(2), 1174-1195; doi:10.3390/ijerph120201174

Received: 2 September 2014 / Accepted: 12 December 2014 / Published: 22 January 2015

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Abstract

Obesity impacts the U.S. military by affecting the health and readiness of active duty service members and their families. Preventing Obesity in Military Communities (POMC) is a comprehensive research program within Patient Centered Medical Homes (PCMHs) in three Military Training Facilities. This paper

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Obesity impacts the U.S. military by affecting the health and readiness of active duty service members and their families. Preventing Obesity in Military Communities (POMC) is a comprehensive research program within Patient Centered Medical Homes (PCMHs) in three Military Training Facilities. This paper describes three pilot randomized controlled trials that target critical high risk periods for unhealthy weight gain from birth to young adulthood: (1) pregnancy and early infancy (POMC-Mother-Baby), (2) adolescence (POMC-Adolescent), and (3) the first tour of duty after boot camp (POMC-Early Career). Each study employs a two-group randomized treatment or prevention program with follow up. POMC offers a unique opportunity to bring together research and clinical expertise in obesity prevention to develop state-of-the-art programs within PCMHs in Military Training Facilities. This research builds on existing infrastructure that is expected to have immediate clinical benefits to DoD and far-reaching potential for ongoing collaborative work. POMC may offer an economical approach for widespread obesity prevention, from conception to young adulthood, in the U.S. military as well as in civilian communities. Full article

(This article belongs to the Special Issue Childhood Obesity: Novel Approaches to a Global Problem)

Open AccessArticle Trends in Water Level and Flooding in Dhaka, Bangladesh and Their Impact on Mortality

by Insa Thiele-Eich, Katrin Burkart and Clemens Simmer

Int. J. Environ. Res. Public Health 2015, 12(2), 1196-1215; doi:10.3390/ijerph120201196

Received: 17 October 2014 / Accepted: 16 January 2015 / Published: 22 January 2015

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Abstract

Climate change is expected to impact flooding in many highly populated coastal regions, including Dhaka (Bangladesh), which is currently among the fastest growing cities in the world. In the past, high mortality counts have been associated with extreme flood events. We first analyzed

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Climate change is expected to impact flooding in many highly populated coastal regions, including Dhaka (Bangladesh), which is currently among the fastest growing cities in the world. In the past, high mortality counts have been associated with extreme flood events. We first analyzed daily water levels of the past 100 years in order to detect potential shifts in extremes. A distributed lag non-linear model was then used to examine the connection between water levels and mortality. Results indicate that for the period of 2003–2007, which entails two major flood events in 2004 and 2007, high water levels do not lead to a significant increase in relative mortality, which indicates a good level of adaptation and capacity to cope with flooding. However, following low water levels, an increase in mortality could be found. As our trend analysis of past water levels shows that minimum water levels have decreased during the past 100 years, action should be taken to ensure that the exposed population is also well-adapted to drought. Full article

(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)

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Open AccessArticle A Simple Risk Score for Identifying Individuals with Impaired Fasting Glucose in the Southern Chinese Population

by Hui Wang, Tao Liu, Quan Qiu, Peng Ding, Yan-Hui He and Wei-Qing Chen

Int. J. Environ. Res. Public Health 2015, 12(2), 1237-1252; doi:10.3390/ijerph120201237

Received: 17 November 2014 / Accepted: 20 January 2015 / Published: 23 January 2015

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Abstract

This study aimed to develop and validate a simple risk score for detecting individuals with impaired fasting glucose (IFG) among the Southern Chinese population. A sample of participants aged ≥20 years and without known diabetes from the 2006–2007 Guangzhou diabetes cross-sectional survey was

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This study aimed to develop and validate a simple risk score for detecting individuals with impaired fasting glucose (IFG) among the Southern Chinese population. A sample of participants aged ≥20 years and without known diabetes from the 2006–2007 Guangzhou diabetes cross-sectional survey was used to develop separate risk scores for men and women. The participants completed a self-administered structured questionnaire and underwent simple clinical measurements. The risk scores were developed by multiple logistic regression analysis. External validation was performed based on three other studies: the 2007 Zhuhai rural population-based study, the 2008–2010 Guangzhou diabetes cross-sectional study and the 2007 Tibet population-based study. Performance of the scores was measured with the Hosmer-Lemeshow goodness-of-fit test and ROC c-statistic. Age, waist circumference, body mass index and family history of diabetes were included in the risk score for both men and women, with the additional factor of hypertension for men. The ROC c-statistic was 0.70 for both men and women in the derivation samples. Risk scores of ≥28 for men and ≥18 for women showed respective sensitivity, specificity, positive predictive value and negative predictive value of 56.6%, 71.7%, 13.0% and 96.0% for men and 68.7%, 60.2%, 11% and 96.0% for women in the derivation population. The scores performed comparably with the Zhuhai rural sample and the 2008–2010 Guangzhou urban samples but poorly in the Tibet sample. The performance of pre-existing USA, Shanghai, and Chengdu risk scores was poorer in our population than in their original study populations. The results suggest that the developed simple IFG risk scores can be generalized in Guangzhou city and nearby rural regions and may help primary health care workers to identify individuals with IFG in their practice. Full article

Open AccessArticle Evaluating the Performance of a Climate-Driven Mortality Model during Heat Waves and Cold Spells in Europe

by Rachel Lowe, Joan Ballester, James Creswick, Jean-Marie Robine, François R. Herrmann and Xavier Rodó

Int. J. Environ. Res. Public Health 2015, 12(2), 1279-1294; doi:10.3390/ijerph120201279

Received: 31 October 2014 / Accepted: 19 January 2015 / Published: 23 January 2015

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Abstract

The impact of climate change on human health is a serious concern. In particular, changes in the frequency and intensity of heat waves and cold spells are of high relevance in terms of mortality and morbidity. This demonstrates the urgent need for reliable

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The impact of climate change on human health is a serious concern. In particular, changes in the frequency and intensity of heat waves and cold spells are of high relevance in terms of mortality and morbidity. This demonstrates the urgent need for reliable early-warning systems to help authorities prepare and respond to emergency situations. In this study, we evaluate the performance of a climate-driven mortality model to provide probabilistic predictions of exceeding emergency mortality thresholds for heat wave and cold spell scenarios. Daily mortality data corresponding to 187 NUTS2 regions across 16 countries in Europe were obtained from 1998–2003. Data were aggregated to 54 larger regions in Europe, defined according to similarities in population structure and climate. Location-specific average mortality rates, at given temperature intervals over the time period, were modelled to account for the increased mortality observed during both high and low temperature extremes and differing comfort temperatures between regions. Model parameters were estimated in a Bayesian framework, in order to generate probabilistic simulations of mortality across Europe for time periods of interest. For the heat wave scenario (1–15 August 2003), the model was successfully able to anticipate the occurrence or non-occurrence of mortality rates exceeding the emergency threshold (75th percentile of the mortality distribution) for 89% of the 54 regions, given a probability decision threshold of 70%. For the cold spell scenario (1–15 January 2003), mortality events in 69% of the regions were correctly anticipated with a probability decision threshold of 70%. By using a more conservative decision threshold of 30%, this proportion increased to 87%. Overall, the model performed better for the heat wave scenario. By replacing observed temperature data in the model with forecast temperature, from state-of-the-art European forecasting systems, probabilistic mortality predictions could potentially be made several months ahead of imminent heat waves and cold spells. Full article

(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)

Open AccessArticle An Innovative Approach to Addressing Childhood Obesity: A Knowledge-Based Infrastructure for Supporting Multi-Stakeholder Partnership Decision-Making in Quebec, Canada

by Nii Antiaye Addy, Arash Shaban-Nejad, David L. Buckeridge and Laurette Dubé

Int. J. Environ. Res. Public Health 2015, 12(2), 1314-1333; doi:10.3390/ijerph120201314

Received: 1 November 2014 / Accepted: 14 January 2015 / Published: 23 January 2015

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Abstract

Multi-stakeholder partnerships (MSPs) have become a widespread means for deploying policies in a whole of society strategy to address the complex problem of childhood obesity. However, decision-making in MSPs is fraught with challenges, as decision-makers are faced with complexity, and have to reconcile

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Multi-stakeholder partnerships (MSPs) have become a widespread means for deploying policies in a whole of society strategy to address the complex problem of childhood obesity. However, decision-making in MSPs is fraught with challenges, as decision-makers are faced with complexity, and have to reconcile disparate conceptualizations of knowledge across multiple sectors with diverse sets of indicators and data. These challenges can be addressed by supporting MSPs with innovative tools for obtaining, organizing and using data to inform decision-making. The purpose of this paper is to describe and analyze the development of a knowledge-based infrastructure to support MSP decision-making processes. The paper emerged from a study to define specifications for a knowledge-based infrastructure to provide decision support for community-level MSPs in the Canadian province of Quebec. As part of the study, a process assessment was conducted to understand the needs of communities as they collect, organize, and analyze data to make decisions about their priorities. The result of this process is a “portrait”, which is an epidemiological profile of health and nutrition in their community. Portraits inform strategic planning and development of interventions, and are used to assess the impact of interventions. Our key findings indicate ambiguities and disagreement among MSP decision-makers regarding causal relationships between actions and outcomes, and the relevant data needed for making decisions. MSP decision-makers expressed a desire for easy-to-use tools that facilitate the collection, organization, synthesis, and analysis of data, to enable decision-making in a timely manner. Findings inform conceptual modeling and ontological analysis to capture the domain knowledge and specify relationships between actions and outcomes. This modeling and analysis provide the foundation for an ontology, encoded using OWL 2 Web Ontology Language. The ontology is developed to provide semantic support for the MSP process, defining objectives, strategies, actions, indicators, and data sources. In the future, software interacting with the ontology can facilitate interactive browsing by decision-makers in the MSP in the form of concepts, instances, relationships, and axioms. Our ontology also facilitates the integration and interpretation of community data, and can help in managing semantic interoperability between different knowledge sources. Future work will focus on defining specifications for the development of a database of indicators and an information system to help decision-makers to view, analyze and organize indicators for their community. This work should improve MSP decision-making in the development of interventions to address childhood obesity. Full article

(This article belongs to the Special Issue Childhood Obesity: Novel Approaches to a Global Problem)

Open AccessArticle Conversion Characteristics and Production Evaluation of Styrene/o-Xylene Mixtures Removed by DBD Pretreatment

by Liying Jiang, Runye Zhu, Yubo Mao, Jianmeng Chen and Liang Zhang

Int. J. Environ. Res. Public Health 2015, 12(2), 1334-1350; doi:10.3390/ijerph120201334

Received: 31 October 2014 / Revised: 26 November 2014 / Accepted: 30 December 2014 / Published: 26 January 2015

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Abstract

The combination of chemical oxidation methods with biotechnology to removal recalcitrant VOCs is a promising technology. In this paper, the aim was to identify the role of key process parameters and biodegradability of the degradation products using a dielectric barrier discharge (DBD) reactor,

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The combination of chemical oxidation methods with biotechnology to removal recalcitrant VOCs is a promising technology. In this paper, the aim was to identify the role of key process parameters and biodegradability of the degradation products using a dielectric barrier discharge (DBD) reactor, which provided the fundamental data to evaluate the possibilities of the combined system. Effects of various technologic parameters like initial concentration of mixtures, residence time and relative humidity on the decomposition and the degradation products were examined and discussed. It was found that the removal efficiency of mixed VOCs decreased with increasing initial concentration. The removal efficiency reached the maximum value as relative humidity was approximately 40%–60%. Increasing the residence time resulted in increasing the removal efficiency and the order of destruction efficiency of VOCs followed the order styrene > o-xylene. Compared with the single compounds, the removal efficiency of styrene and o-xylene in the mixtures of VOCs decreased significantly and o-xylene decreased more rapidly. The degradation products were analyzed by gas chromatography and gas chromatography-mass spectrometry, and the main compounds detected were O₃, CO_x and benzene ring derivatives. The biodegradability of mixed VOCs was improved and the products had positive effect on biomass during plasma application, and furthermore typical results indicated that the biodegradability and biotoxicity of gaseous pollutant were quite depending on the specific input energy (SIE). Full article

(This article belongs to the Special Issue Bioprocesses for Air Pollution Control)

Open AccessArticle An Approach for Prioritizing “Down-the-Drain” Chemicals Used in the Household

by Marina Rotsidou and Mark D. Scrimshaw

Int. J. Environ. Res. Public Health 2015, 12(2), 1351-1367; doi:10.3390/ijerph120201351

Received: 26 November 2014 / Accepted: 21 January 2015 / Published: 26 January 2015

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Abstract

Many chemicals are present in cleaning and personal care products, which after use are washed down the drain and find their way into water bodies, where they may impact the environment. This study surveyed individuals to determine what products were used most in

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Many chemicals are present in cleaning and personal care products, which after use are washed down the drain and find their way into water bodies, where they may impact the environment. This study surveyed individuals to determine what products were used most in the home, in an attempt to prioritize which compounds may be of most concern. The survey resulted in the identification of 14 categories of products consisting of 315 specific brands. The survey estimated that individuals each discharge almost 33 L of products per year down the drain. Dishwashing liquids and hand wash gels, which accounted for 40% of this volume, were selected for identification of specific ingredients. Ingredients were classified as surfactants, preservatives, fragrances or miscellaneous, with hand wash gels having a wider range of ingredients than dishwashing liquids. A review of the literature suggested that preservatives, which are designed to be toxic, and fragrances, where data on toxicity are limited, should be prioritized. The approach undertaken has successfully estimated use and provisionally identified some classes of chemicals which may be of most concern when used in cleaning and personal care products. Full article

(This article belongs to the Special Issue Emerging Contaminants in the Environment)

Open AccessArticle The Effect of Oxygen Supply on the Dual Growth Kinetics of Acidithiobacillus thiooxidans under Acidic Conditions for Biogas Desulfurization

by Hyeong-Kyu Namgung and JiHyeon Song

Int. J. Environ. Res. Public Health 2015, 12(2), 1368-1386; doi:10.3390/ijerph120201368

Received: 23 September 2014 / Revised: 8 December 2014 / Accepted: 19 January 2015 / Published: 27 January 2015

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Abstract

In this study, to simulate a biogas desulfurization process, a modified Monod-Gompertz kinetic model incorporating a dissolved oxygen (DO) effect was proposed for a sulfur-oxidizing bacterial (SOB) strain, Acidithiobacillus thiooxidans, under extremely acidic conditions of pH 2. The kinetic model was calibrated

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In this study, to simulate a biogas desulfurization process, a modified Monod-Gompertz kinetic model incorporating a dissolved oxygen (DO) effect was proposed for a sulfur-oxidizing bacterial (SOB) strain, Acidithiobacillus thiooxidans, under extremely acidic conditions of pH 2. The kinetic model was calibrated and validated using experimental data obtained from a bubble-column bioreactor. The SOB strain was effective for H₂S degradation, but the H₂S removal efficiency dropped rapidly at DO concentrations less than 2.0 mg/L. A low H₂S loading was effectively treated with oxygen supplied in a range of 2%–6%, but a H₂S guideline of 10 ppm could not be met, even with an oxygen supply greater than 6%, when the H₂S loading was high at a short gas retention time of 1 min and a H₂S inlet concentration of 5000 ppm. The oxygen supply should be increased in the aerobic desulfurization to meet the H₂S guideline; however, the excess oxygen above the optimum was not effective because of the decline in oxygen efficiency. The model estimation indicated that the maximum H₂S removal rate was approximately 400 ppm/%-O₂ at the influent oxygen concentration of 4.9% under the given condition. The kinetic model with a low DO threshold for the interacting substrates was a useful tool to simulate the effect of the oxygen supply on the H₂S removal and to determine the optimal oxygen concentration. Full article

(This article belongs to the Special Issue Bioprocesses for Air Pollution Control)

Open AccessArticle Comparison of the Hospital Arrival Time and Differences in Pain Quality between Diabetic and Non-Diabetic STEMI Patients

by Marina Gradišer, Dario Dilber, Jasna Cmrečnjak, Branko Ostrički and Ines Bilić-Ćurčić

Int. J. Environ. Res. Public Health 2015, 12(2), 1387-1396; doi:10.3390/ijerph120201387

Received: 26 October 2014 / Revised: 16 December 2014 / Accepted: 13 January 2015 / Published: 27 January 2015

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Abstract

The aim of our study was to determine whether diabetic ST segment elevation myocardial infarction (STEMI) patients arrive in the emergency room (ER) later than non-diabetics, compare the differences in pain quality and quantity between those groups, and measure differences in the outcome

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The aim of our study was to determine whether diabetic ST segment elevation myocardial infarction (STEMI) patients arrive in the emergency room (ER) later than non-diabetics, compare the differences in pain quality and quantity between those groups, and measure differences in the outcome after an index hospitalization. A total of 266 patients with first presentation of STEMI were included in our study during a period of two years, 62 with diabetes and 204 without diabetes type 2. Pain intensity and quality at admission were measured using a McGill short form questionnaire. Diabetic patients did not arrive significantly later than non-diabetic (χ²; p = 0.105). Most diabetic patients described their pain as “slight” or “none” (χ²; p < 0.01), while most non-diabetic patients graded their pain as “moderate” or “severe” (χ²; p < 0.01). The quality of pain tended to be more distinct in non-diabetic patients, while diabetic patients reported mainly shortness of breath (χ²; p < 0.01). Diabetic patients were more likely to suffer a multi-vessel disease (χ²; p < 0.01), especially in the late arrival group. Therefore, cautious evaluation of diabetic patients and adequate education of target population could improve overall survival while well-organized care like a primary PCI Network program could significantly reduce CV mortality. Full article

Open AccessArticle Correlation between Family Environment and Suicidal Ideation in University Students in China

by Hui Zhai, Bing Bai, Lu Chen, Dong Han, Lin Wang, Zhengxue Qiao, Xiaohui Qiu, Xiuxian Yang and Yanjie Yang

Int. J. Environ. Res. Public Health 2015, 12(2), 1412-1424; doi:10.3390/ijerph120201412

Received: 30 September 2014 / Revised: 30 December 2014 / Accepted: 15 January 2015 / Published: 27 January 2015

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Abstract

Background: This study investigated the association between suicidal ideation and family environment. The sample included 5183 Chinese university students. A number of studies on suicidal ideation have focused on individuals rather than families. This paper reviews the general principles of suicidal ideation

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Background: This study investigated the association between suicidal ideation and family environment. The sample included 5183 Chinese university students. A number of studies on suicidal ideation have focused on individuals rather than families. This paper reviews the general principles of suicidal ideation and the consequences resulting from the family environment. Methods: This study used six different colleges as the dataset, which included 2645 males and 2538 females. Students were questioned with respect to social demographics and suicidal ideation factors. The data were analyzed with factor and logistic analyses to determine the association between suicidal ideation and poor family environment. Results: The prevalence of suicidal ideation was 9.2% (476/5183). Most participants with suicidal ideation had significant similarities: they had poor family structures and relationships, their parents had unstable work, and their parents used improper parenting styles. Female students were more likely to have suicidal thoughts than male students. Conclusions: This study shows that suicidal ideation is a public health issue among Chinese university students and demonstrates the importance of considering the family environment when examining university students’ suicidal ideation. Understanding family-related suicidal ideation risk factors can help to predict and prevent suicides among university students. Full article

Open AccessArticle A Spatial, Social and Environmental Study of Tuberculosis in China Using Statistical and GIS Technology

by Wenyi Sun, Jianhua Gong, Jieping Zhou, Yanlin Zhao, Junxiang Tan, Abdoul Nasser Ibrahim and Yang Zhou

Int. J. Environ. Res. Public Health 2015, 12(2), 1425-1448; doi:10.3390/ijerph120201425

Received: 10 December 2014 / Accepted: 20 January 2015 / Published: 27 January 2015

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Abstract

Tuberculosis (TB) remains a major public health problem in China, and its incidence shows certain regional disparities. Systematic investigations of the social and environmental factors influencing TB are necessary for the prevention and control of the disease. Data on cases were obtained from

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Tuberculosis (TB) remains a major public health problem in China, and its incidence shows certain regional disparities. Systematic investigations of the social and environmental factors influencing TB are necessary for the prevention and control of the disease. Data on cases were obtained from the Chinese Center for Disease and Prevention. Social and environmental variables were tabulated to investigate the latent factor structure of the data using exploratory factor analysis (EFA). Partial least square path modeling (PLS-PM) was used to analyze the complex causal relationship and hysteresis effects between the factors and TB prevalence. A geographically weighted regression (GWR) model was used to explore the local association between factors and TB prevalence. EFA and PLS-PM indicated significant associations between TB prevalence and its latent factors. Altitude, longitude, climate, and education burden played an important role; primary industry employment, population density, air quality, and economic level had hysteresis with different lag time; health service and unemployment played a limited role but had limited hysteresis. Additionally, the GWR model showed that each latent factor had different effects on TB prevalence in different areas. It is necessary to formulate regional measures and strategies for TB control and prevention in China according to the local regional effects of specific factors. Full article

Open AccessArticle Determinants of Exposure to Fragranced Product Chemical Mixtures in a Sample of Twins

by Matthew O. Gribble, Karen Bandeen-Roche and Mary A. Fox

Int. J. Environ. Res. Public Health 2015, 12(2), 1466-1486; doi:10.3390/ijerph120201466

Received: 29 November 2014 / Revised: 18 December 2014 / Accepted: 15 January 2015 / Published: 27 January 2015

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Abstract

Fragranced product chemical mixtures may be relevant for environmental health, but little is known about exposure. We analyzed results from an olfactory challenge with the synthetic musk fragrance 1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexamethyl-cyclopento-γ-2-benzopyran (HHCB), and a questionnaire about attitudes toward chemical safety and use of fragranced products,

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Fragranced product chemical mixtures may be relevant for environmental health, but little is known about exposure. We analyzed results from an olfactory challenge with the synthetic musk fragrance 1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexamethyl-cyclopento-γ-2-benzopyran (HHCB), and a questionnaire about attitudes toward chemical safety and use of fragranced products, in a sample of 140 white and 17 black twin pairs attending a festival in Ohio. Data for each product were analyzed using robust ordered logistic regressions with random intercepts for “twin pair” and “sharing address with twin”, and fixed effects for sex, age, education, and “ever being bothered by fragrances”. Due to the small number of black participants, models were restricted to white participants except when examining racial differences. Overall patterns of association were summarized across product-types through random-effects meta-analysis. Principal components analysis was used to summarize clustering of product use. The dominant axis of variability in fragranced product use was “more vs. less”, followed by a distinction between household cleaning products and personal care products. Overall, males used fragranced products less frequently than females (adjusted proportionate odds ratio 0.55, 95% confidence interval 0.33, 0.93). This disparity was driven by personal care products (0.42, 95% CI: 0.19, 0.96), rather than household cleaning products (0.79, 95% CI: 0.49, 1.25) and was particularly evident for body lotion (0.12, 95% CI: 0.05, 0.27). Overall usage differed by age (0.64, 95% CI: 0.43, 0.95) but only hand soap and shampoo products differed significantly. “Ever being bothered by fragrance” had no overall association (0.92, 95% CI: 0.65, 1.30) but was associated with laundry detergent use (0.46, 95% CI: 0.23, 0.93). Similarly, black vs. white differences on average were not significant (1.34, 95% CI: 0.55, 3.28) but there were apparent differences in use of shampoo (0.01, 95% CI: 0.00, 0.69), body lotion (4.67, 95% CI: 1.18, 18.47), and perfume (6.22, 95% CI:1.08, 35.89). There was no overall association with thinking about product risks (0.90, 95% CI: 0.79, 1.02), nor with inability to smell HHCB (0.84, 95% CI: 0.63, 1.12). Exposure to fragranced products may differ demographically. The relevance for health disparities should be studied. Full article

(This article belongs to the Special Issue Emerging Contaminants in the Environment)

Open AccessArticle Multiple Myeloma and Glyphosate Use: A Re-Analysis of US Agricultural Health Study (AHS) Data

by Tom Sorahan

Int. J. Environ. Res. Public Health 2015, 12(2), 1548-1559; doi:10.3390/ijerph120201548

Received: 18 November 2014 / Accepted: 20 January 2015 / Published: 28 January 2015

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Abstract

A previous publication of 57,311 pesticide applicators enrolled in the US Agricultural Health Study (AHS) produced disparate findings in relation to multiple myeloma risks in the period 1993–2001 and ever-use of glyphosate (32 cases of multiple myeloma in the full dataset of 54,315

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A previous publication of 57,311 pesticide applicators enrolled in the US Agricultural Health Study (AHS) produced disparate findings in relation to multiple myeloma risks in the period 1993–2001 and ever-use of glyphosate (32 cases of multiple myeloma in the full dataset of 54,315 applicators without adjustment for other variables: rate ratio (RR) 1.1, 95% confidence interval (CI) 0.5 to 2.4; 22 cases of multiple myeloma in restricted dataset of 40,719 applicators with adjustment for other variables: RR 2.6, 95% CI 0.7 to 9.4). It seemed important to determine which result should be preferred. RRs for exposed and non-exposed subjects were calculated using Poisson regression; subjects with missing data were not excluded from the main analyses. Using the full dataset adjusted for age and gender the analysis produced a RR of 1.12 (95% CI 0.50 to 2.49) for ever-use of glyphosate. Additional adjustment for lifestyle factors and use of ten other pesticides had little effect (RR 1.24, 95% CI 0.52 to 2.94). There were no statistically significant trends for multiple myeloma risks in relation to reported cumulative days (or intensity weighted days) of glyphosate use. The doubling of risk reported previously arose from the use of an unrepresentative restricted dataset and analyses of the full dataset provides no convincing evidence in the AHS for a link between multiple myeloma risk and glyphosate use. Full article

Open AccessArticle Identifying Meteorological Drivers for the Seasonal Variations of Influenza Infections in a Subtropical City — Hong Kong

by Ka Chun Chong, William Goggins, Benny Chung Ying Zee and Maggie Haitian Wang

Int. J. Environ. Res. Public Health 2015, 12(2), 1560-1576; doi:10.3390/ijerph120201560

Received: 29 October 2014 / Revised: 12 January 2015 / Accepted: 22 January 2015 / Published: 28 January 2015

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Abstract

Compared with temperate areas, the understanding of seasonal variations of influenza infections is lacking in subtropical and tropical regions. Insufficient information about viral activity increases the difficulty of forecasting the disease burden and thus hampers official preparation efforts. Here we identified potential meteorological

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Compared with temperate areas, the understanding of seasonal variations of influenza infections is lacking in subtropical and tropical regions. Insufficient information about viral activity increases the difficulty of forecasting the disease burden and thus hampers official preparation efforts. Here we identified potential meteorological factors that drove the seasonal variations in influenza infections in a subtropical city, Hong Kong. We fitted the meteorological data and influenza mortality data from 2002 to 2009 in a Susceptible-Infected-Recovered model. From the results, air temperature was a common significant driver of seasonal patterns and cold temperature was associated with an increase in transmission intensity for most of the influenza epidemics. Except 2004, the fitted models with significant meteorological factors could account for more than 10% of the variance in additional to the null model. Rainfall was also found to be a significant driver of seasonal influenza, although results were less robust. The identified meteorological indicators could alert officials to take appropriate control measures for influenza epidemics, such as enhancing vaccination activities before cold seasons. Further studies are required to fully justify the associations. Full article

(This article belongs to the Special Issue Environmental Determinants of Infectious Disease Transmission)

Open AccessArticle Contamination and Spatial Variation of Heavy Metals in the Soil-Rice System in Nanxun County, Southeastern China

by Keli Zhao, Weijun Fu, Zhengqian Ye and Chaosheng Zhang

Int. J. Environ. Res. Public Health 2015, 12(2), 1577-1594; doi:10.3390/ijerph120201577

Received: 8 November 2014 / Accepted: 10 January 2015 / Published: 28 January 2015

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Abstract

There is an increasing concern about heavy metal contamination in farmland in China and worldwide. In order to reveal the spatial features of heavy metals in the soil-rice system, soil and rice samples were collected from Nanxun, Southeastern China. Compared with the guideline

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There is an increasing concern about heavy metal contamination in farmland in China and worldwide. In order to reveal the spatial features of heavy metals in the soil-rice system, soil and rice samples were collected from Nanxun, Southeastern China. Compared with the guideline values, elevated concentrations of heavy metals in soils were observed, while heavy metals in rice still remained at a safe level. Heavy metals in soils and rice had moderate to strong spatial dependence (nugget/sill ratios: 13.2% to 49.9%). The spatial distribution of copper (Cu), nickel (Ni), lead (Pb) and zinc (Zn) in soils illustrated that their high concentrations were located in the southeast part. The high concentrations of cadmium (Cd) in soils were observed in the northeast part. The accumulation of all the studied metals is related to the long-term application of agrochemicals and industrial activities. Heavy metals in rice showed different spatial distribution patterns. Cross-correlograms were produced to quantitatively determine the spatial correlation between soil properties and heavy metals composition in rice. The pH and soil organic matter had significant spatial correlations with the concentration of heavy metals in rice. Most of the selected variables had clear spatial correlation ranges for heavy metals in rice, which could be further applied to divide agricultural management zones. Full article

Open AccessArticle Numerical Study of the Simultaneous Oxidation of NO and SO₂ by Ozone

by Bo Li, Jinyang Zhao and Junfu Lu

Int. J. Environ. Res. Public Health 2015, 12(2), 1595-1611; doi:10.3390/ijerph120201595

Received: 29 September 2014 / Revised: 8 December 2014 / Accepted: 9 January 2015 / Published: 29 January 2015

Cited by 6 | PDF Full-text (861 KB) | HTML Full-text | XML Full-text | Supplementary Files

Abstract

This study used two kinetic mechanisms to evaluate the oxidation processes of NO and SO₂ by ozone. The performance of the two models was assessed by comparisons with experimental results from previous studies. The first kinetic mechanism was a combined model developed

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This study used two kinetic mechanisms to evaluate the oxidation processes of NO and SO₂ by ozone. The performance of the two models was assessed by comparisons with experimental results from previous studies. The first kinetic mechanism was a combined model developed by the author that consisted of 50 species and 172 reactions. The second mechanism consisted of 23 species and 63 reactions. Simulation results of both of the two models show under predictions compared with experimental data. The results showed that the optimized reaction temperature for NO with O₃ ranged from 100~200 °C. At higher temperatures, O₃ decomposed to O₂ and O, which resulted in a decrease of the NO conversion rate. When the mole ratio of O₃/NO was greater than 1, products with a higher oxidation state (such as NO₃, N₂O₅) were formed. The reactions between O₃ and SO₂ were weak; as such, it was difficult for O₃to oxidize SO₂. Full article

(This article belongs to the Special Issue Bioprocesses for Air Pollution Control)

Open AccessArticle Annoyance, Sleep and Concentration Problems due to Combined Traffic Noise and the Benefit of Quiet Side

by Theo Bodin, Jonas Björk, Jonas Ardö and Maria Albin

Int. J. Environ. Res. Public Health 2015, 12(2), 1612-1628; doi:10.3390/ijerph120201612

Received: 2 December 2014 / Accepted: 23 January 2015 / Published: 29 January 2015

Cited by 11 | PDF Full-text (754 KB) | HTML Full-text | XML Full-text | Supplementary Files

Abstract

Background: Access to a quiet side in one’s dwelling is thought to compensate for higher noise levels at the most exposed façade. It has also been indicated that noise from combined traffic sources causes more noise annoyance than equal average levels from

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Background: Access to a quiet side in one’s dwelling is thought to compensate for higher noise levels at the most exposed façade. It has also been indicated that noise from combined traffic sources causes more noise annoyance than equal average levels from either road traffic or railway noise separately. Methods: 2612 persons in Malmö, Sweden, answered to a residential environment survey including questions on outdoor environment, noise sensitivity, noise annoyance, sleep quality and concentration problems. Road traffic and railway noise was modeled using Geographic Information System. Results: Access to a quiet side, i.e., at least one window facing yard, water or green space, was associated with reduced risk of annoyance OR (95%CI) 0.47 (0.38–0.59), and concentration problems 0.76 (0.61–0.95). Bedroom window facing the same environment was associated to reduced risk of reporting of poor sleep quality 0.78 (0.64–1.00). Railway noise was associated with reduced risk of annoyance below 55 dB(A) but not at higher levels of exposure. Conclusions: Having a window facing a yard, water or green space was associated to a substantially reduced risk of noise annoyance and concentration problems. If this window was the bedroom window, sleeping problems were less likely. Full article

(This article belongs to the Special Issue The Combined Health Effects of Environmental Exposures)

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Open AccessArticle Detection of Critical LUCC Indices and Sensitive Watershed Regions Related to Lake Algal Blooms: A Case Study of Taihu Lake

by Chen Lin, Ronghua Ma, Zhihu Su and Qing Zhu

Int. J. Environ. Res. Public Health 2015, 12(2), 1629-1648; doi:10.3390/ijerph120201629

Received: 24 October 2014 / Accepted: 19 January 2015 / Published: 29 January 2015

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Abstract

Taihu Lake in China has suffered from severe eutrophication over the past 20 years which is partly due to significant land use/cover change (LUCC). There is an increasing need to detect the critical watershed region that significantly affects lake water degradation, which has

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Taihu Lake in China has suffered from severe eutrophication over the past 20 years which is partly due to significant land use/cover change (LUCC). There is an increasing need to detect the critical watershed region that significantly affects lake water degradation, which has great significance for environmental protection. However, previous studies have obtained conflicting results because of non–uniform lake indicators and inadequate time periods. To identify the sensitive LUCC indices and buffer distance regions, three lake divisions (Meiliang Lake, Zhushan Lake and Western Coastal region) and their watershed region within the Taihu Lake basin were chosen as study sites, the algal area was used as a uniform lake quality indicator and modeled with LUCC indices over the whole time series. Results showed that wetland (WL) and landscape index such as Shannon diversity index (SHDI) appeared to be sensitive LUCC indices when the buffer distance was less than 5 km, while agricultural land (AL) and landscape fragmentation (Ci) gradually became sensitive indices as buffer distances increased to more than 5 km. For the relationship between LUCC and lake algal area, LUCC of the WC region seems to have no significant effect on lake water quality. Conversely, LUCC within ML and ZS region influenced algal area of corresponding lake divisions greatly, while the most sensitive regions were found in 3 km to 5 km, rather than the whole catchment. These results will be beneficial for the further understanding of the relationship between LUCC and lake water quality, and will provide a practical basis for the identification of critical regions for lake. Full article

Open AccessArticle Characterization of Extremely Low Frequency Magnetic Fields from Diesel, Gasoline and Hybrid Cars under Controlled Conditions

by Ronen Hareuveny, Madhuri Sudan, Malka N. Halgamuge, Yoav Yaffe, Yuval Tzabari, Daniel Namir and Leeka Kheifets

Int. J. Environ. Res. Public Health 2015, 12(2), 1651-1666; doi:10.3390/ijerph120201651

Received: 29 December 2014 / Accepted: 23 January 2015 / Published: 30 January 2015

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Abstract

This study characterizes extremely low frequency (ELF) magnetic field (MF) levels in 10 car models. Extensive measurements were conducted in three diesel, four gasoline, and three hybrid cars, under similar controlled conditions and negligible background fields. Averaged over all four seats under various

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This study characterizes extremely low frequency (ELF) magnetic field (MF) levels in 10 car models. Extensive measurements were conducted in three diesel, four gasoline, and three hybrid cars, under similar controlled conditions and negligible background fields. Averaged over all four seats under various driving scenarios the fields were lowest in diesel cars (0.02 μT), higher for gasoline (0.04–0.05 μT) and highest in hybrids (0.06–0.09 μT), but all were in-line with daily exposures from other sources. Hybrid cars had the highest mean and 95th percentile MF levels, and an especially large percentage of measurements above 0.2 μT. These parameters were also higher for moving conditions compared to standing while idling or revving at 2500 RPM and higher still at 80 km/h compared to 40 km/h. Fields in non-hybrid cars were higher at the front seats, while in hybrid cars they were higher at the back seats, particularly the back right seat where 16%–69% of measurements were greater than 0.2 μT. As our results do not include low frequency fields (below 30 Hz) that might be generated by tire rotation, we suggest that net currents flowing through the cars’ metallic chassis may be a possible source of MF. Larger surveys in standardized and well-described settings should be conducted with different types of vehicles and with spectral analysis of fields including lower frequencies due to magnetization of tires. Full article

(This article belongs to the Special Issue Electromagnetic Fields and Health)

Open AccessArticle Indoor and Outdoor Exposure to Ultrafine, Fine and Microbiologically Derived Particulate Matter Related to Cardiovascular and Respiratory Effects in a Panel of Elderly Urban Citizens

by Dorina Gabriela Karottki, Michal Spilak, Marie Frederiksen, Zorana Jovanovic Andersen, Anne Mette Madsen, Matthias Ketzel, Andreas Massling, Lars Gunnarsen, Peter Møller and Steffen Loft

Int. J. Environ. Res. Public Health 2015, 12(2), 1667-1686; doi:10.3390/ijerph120201667

Received: 29 August 2014 / Revised: 12 November 2014 / Accepted: 23 January 2015 / Published: 2 February 2015

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Abstract

To explore associations of exposure to ambient and indoor air particulate and bio-aerosol pollutants with cardiovascular and respiratory disease markers, we utilized seven repeated measurements from 48 elderly subjects participating in a 4-week home air filtration study. Microvascular function (MVF), lung function, blood

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To explore associations of exposure to ambient and indoor air particulate and bio-aerosol pollutants with cardiovascular and respiratory disease markers, we utilized seven repeated measurements from 48 elderly subjects participating in a 4-week home air filtration study. Microvascular function (MVF), lung function, blood leukocyte counts, monocyte adhesion molecule expression, C-reactive protein, Clara cell protein (CC16) and surfactant protein-D (SPD) were examined in relation to exposure preceding each measurement. Exposure assessment included 48-h urban background monitoring of PM₁₀, PM_2.5and particle number concentration (PNC), weekly measurements of PM_2.5 in living- and bedroom, 24-h measurements of indoor PNC three times, and bio-aerosol components in settled dust on a 2-week basis. Statistically significant inverse associations included: MVF with outdoor PNC; granulocyte counts with PM_2.5; CD31 expression with dust fungi; SPD with dust endotoxin. Significant positive associations included: MVF with dust bacteria; monocyte expression of CD11 with PM_2.5in the bedroom and dust bacteria and endotoxin, CD31 expression with dust serine protease; serum CC16 with dust NAGase. Multiple comparisons demand cautious interpretation of results, which suggest that outdoor PNC have adverse effects on MVF, and outdoor and indoor PM_2.5and bio-aerosols are associated with markers of inflammation and lung cell integrity. Full article

(This article belongs to the Special Issue Ultrafine Particles and Potential Health Effects)

Open AccessArticle Ultrafine Particles from Traffic Emissions and Children’s Health (UPTECH) in Brisbane, Queensland (Australia): Study Design and Implementation

by Wafaa Nabil Ezz, Mandana Mazaheri, Paul Robinson, Graham R. Johnson, Samuel Clifford, Congrong He, Lidia Morawska and Guy B. Marks

Int. J. Environ. Res. Public Health 2015, 12(2), 1687-1702; doi:10.3390/ijerph120201687

Received: 30 July 2014 / Accepted: 13 January 2015 / Published: 2 February 2015

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Abstract

Ultrafine particles are particles that are less than 0.1 micrometres (µm) in diameter. Due to their very small size they can penetrate deep into the lungs, and potentially cause more damage than larger particles. The Ultrafine Particles from Traffic Emissions and Children’s Health

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Ultrafine particles are particles that are less than 0.1 micrometres (µm) in diameter. Due to their very small size they can penetrate deep into the lungs, and potentially cause more damage than larger particles. The Ultrafine Particles from Traffic Emissions and Children’s Health (UPTECH) study is the first Australian epidemiological study to assess the health effects of ultrafine particles on children’s health in general and peripheral airways in particular. The study is being conducted in Brisbane, Australia. Continuous indoor and outdoor air pollution monitoring was conducted within each of the twenty five participating school campuses to measure particulate matter, including in the ultrafine size range, and gases. Respiratory health effects were evaluated by conducting the following tests on participating children at each school: spirometry, forced oscillation technique (FOT) and multiple breath nitrogen washout test (MBNW) (to assess airway function), fraction of exhaled nitric oxide (FeNO, to assess airway inflammation), blood cotinine levels (to assess exposure to second-hand tobacco smoke), and serum C-reactive protein (CRP) levels (to measure systemic inflammation). A pilot study was conducted prior to commencing the main study to assess the feasibility and reliably of measurement of some of the clinical tests that have been proposed for the main study. Air pollutant exposure measurements were not included in the pilot study. Full article

(This article belongs to the Special Issue Ultrafine Particles and Potential Health Effects)

Open AccessArticle Fuzzy Comprehensive Evaluation-Based Disaster Risk Assessment of Desertification in Horqin Sand Land, China

by Yongfang Wang, Jiquan Zhang, Enliang Guo and Zhongyi Sun

Int. J. Environ. Res. Public Health 2015, 12(2), 1703-1725; doi:10.3390/ijerph120201703

Received: 4 November 2014 / Revised: 15 December 2014 / Accepted: 22 January 2015 / Published: 3 February 2015

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Abstract

Desertification is a typical disaster risk event in which human settlements and living environments are destroyed. Desertification Disaster Risk Assessment can control and prevent the occurrence and development of desertification disasters and reduce their adverse influence on human society. This study presents the

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Desertification is a typical disaster risk event in which human settlements and living environments are destroyed. Desertification Disaster Risk Assessment can control and prevent the occurrence and development of desertification disasters and reduce their adverse influence on human society. This study presents the methodology and procedure for risk assessment and zoning of desertification disasters in Horqin Sand Land. Based on natural disaster risk theory and the desertification disaster formation mechanism, the Desertification Disaster Risk Index (DDRI) combined hazard, exposure, vulnerability and restorability factors and was developed mainly by using multi-source data and the fuzzy comprehensive evaluation method. The results showed that high risk and middle risk areas account for 28% and 23% of the study area, respectively. They are distributed with an “S” type in the study area. Low risk and very low risk areas account for 21% and 10% of the study area, respectively. They are distributed in the west-central and southwestern parts. Very high risk areas account for 18% of the study area and are distributed in the northeastern parts. The results can be used to know the desertification disaster risk level. It has important theoretical and practical significance to prevention and control of desertification in Horqin Sand Land and even in Northern China. Full article

Open AccessArticle Growth and Heavy Metal Accumulation of Koelreuteria Paniculata Seedlings and Their Potential for Restoring Manganese Mine Wastelands in Hunan, China

by Zhihong Huang, Wenhua Xiang, Yu'e Ma, Pifeng Lei, Dalun Tian, Xiangwen Deng, Wende Yan and Xi Fang

Int. J. Environ. Res. Public Health 2015, 12(2), 1726-1744; doi:10.3390/ijerph120201726

Received: 2 December 2014 / Revised: 28 January 2015 / Accepted: 29 January 2015 / Published: 3 February 2015

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Abstract

The planting of trees on mine wastelands is an effective, long-term technique for phytoremediation of heavy metal-contaminated wastes. In this study, a pot experiment with seedlings of Koelreuteria paniculata under six treatments of local mine wastes was designed to determine the major constraints

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The planting of trees on mine wastelands is an effective, long-term technique for phytoremediation of heavy metal-contaminated wastes. In this study, a pot experiment with seedlings of Koelreuteria paniculata under six treatments of local mine wastes was designed to determine the major constraints on tree establishment and to evaluate the feasibility of planting K. paniculata on manganese mine wastelands. Results showed that K. paniculata grew well in mine tailings, and also under a regime of equal amounts of mine tailings and soil provided in adjacent halves of pots. In contrast, mine sludge did not favor survival and growth because its clay texture limited fine root development. The bio-concentration factor and the translocation factor were mostly less than 1, indicating a low phytoextraction potential for K. paniculata. K. paniculata is suited to restore manganese mine sludge by mixing the mine sludge with local mine tailings or soil. Full article

(This article belongs to the Special Issue Hazardous Waste and Human Health)

Open AccessArticle Access Disparity and Health Inequality of the Elderly: Unmet Needs and Delayed Healthcare

by Tetsuji Yamada, Chia-Ching Chen, Chiyoe Murata, Hiroshi Hirai, Toshiyuki Ojima, Katsunori Kondo and Joseph R. Harris III

Int. J. Environ. Res. Public Health 2015, 12(2), 1745-1772; doi:10.3390/ijerph120201745

Received: 8 June 2014 / Revised: 29 October 2014 / Accepted: 21 January 2015 / Published: 3 February 2015

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Abstract

The purpose of this study is to investigate healthcare access disparity that will cause delayed and unmet healthcare needs for the elderly, and to examine health inequality and healthcare cost burden for the elderly. To produce clear policy applications, this study adapts a

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The purpose of this study is to investigate healthcare access disparity that will cause delayed and unmet healthcare needs for the elderly, and to examine health inequality and healthcare cost burden for the elderly. To produce clear policy applications, this study adapts a modified PRECEDE-PROCEED model for framing theoretical and experimental approaches. Data were collected from a large collection of the Community Tracking Study Household Survey 2003–2004 of the USA. Reliability and construct validity are examined for internal consistency and estimation of disparity and inequality are analyzed by using probit/ols regressions. The results show that predisposing factors (e.g., attitude, beliefs, and perception by socio-demographic differences) are negatively associated with delayed healthcare. A 10% increase in enabling factors (e.g., availability of health insurance coverage, and usual sources of healthcare providers) are significantly associated with a 1% increase in healthcare financing factors. In addition, information through a socio-economic network and support system has a 5% impact on an access disparity. Income, health status, and health inequality are exogenously determined. Designing and implementing easy healthcare accessibility (healthcare system) and healthcare financing methods, and developing a socio-economic support network (including public health information) are essential in reducing delayed healthcare and health inequality. Full article

(This article belongs to the Special Issue Inequalities in Health)

Open AccessArticle Field Testing of Alternative Cookstove Performance in a Rural Setting of Western India

by Veena Muralidharan, Thomas E. Sussan, Sneha Limaye, Kirsten Koehler, D'Ann L. Williams, Ana M. Rule, Sanjay Juvekar, Patrick N. Breysse, Sundeep Salvi and Shyam Biswal

Int. J. Environ. Res. Public Health 2015, 12(2), 1773-1787; doi:10.3390/ijerph120201773

Received: 20 November 2014 / Accepted: 27 January 2015 / Published: 3 February 2015

Cited by 7 | PDF Full-text (2330 KB) | HTML Full-text | XML Full-text

Abstract

Nearly three billion people use solid fuels for cooking and heating, which leads to extremely high levels of household air pollution and is a major cause of morbidity and mortality. Many stove manufacturers have developed alternative cookstoves (ACSs) that are aimed at reducing

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Nearly three billion people use solid fuels for cooking and heating, which leads to extremely high levels of household air pollution and is a major cause of morbidity and mortality. Many stove manufacturers have developed alternative cookstoves (ACSs) that are aimed at reducing emissions and fuel consumption. Here, we tested a traditional clay chulha cookstove (TCS) and five commercially available ACSs, including both natural draft (Greenway Smart Stove, Envirofit PCS-1) and forced draft stoves (BioLite HomeStove, Philips Woodstove HD4012, and Eco-Chulha XXL), in a test kitchen in a rural village of western India. Compared to the TCS, the ACSs produced significant reductions in particulate matter less than 2.5 µm (PM_2.5) and COconcentrations (Envirofit: 22%/16%, Greenway: 24%/42%, BioLite: 40%/35%, Philips: 66%/55% and Eco-Chulha: 61%/42%), which persisted after normalization for fuel consumption or useful energy. PM_2.5 and CO concentrations were lower for forced draft stoves than natural draft stoves. Furthermore, the Philips and Eco-Chulha units exhibited higher cooking efficiency than the TCS. Despite significant reductions in concentrations, all ACSs failed to achieve PM_2.5 levels that are considered safe by the World Health Organization (ACSs: 277–714 μg/m³ or 11–28 fold higher than the WHO recommendation of 25 μg/m³). Full article

Open AccessArticle On-Line Monitoring of Escherichia coli in Raw Water at Oset Drinking Water Treatment Plant, Oslo (Norway)

by Ingun Tryland, Fasil Ejigu Eregno, Henrik Braathen, Goran Khalaf, Ingrid Sjølander and Marie Fossum

Int. J. Environ. Res. Public Health 2015, 12(2), 1788-1802; doi:10.3390/ijerph120201788

Received: 10 December 2014 / Revised: 31 December 2014 / Accepted: 27 January 2015 / Published: 4 February 2015

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Abstract

The fully automated Colifast ALARM^TM has been used for two years for daily monitoring of the presence/absence of Escherichia coli in 100 mL raw water at Oset drinking water treatment plant in Oslo, Norway. The raw water is extracted from 35 m

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The fully automated Colifast ALARM^TM has been used for two years for daily monitoring of the presence/absence of Escherichia coli in 100 mL raw water at Oset drinking water treatment plant in Oslo, Norway. The raw water is extracted from 35 m depth from the Lake Maridalsvannet. E. coli was detected in 18% of the daily samples. In general, most samples positive for E. coli were observed during the autumn turnover periods, but even in some samples taken during warm and dry days in July, with stable temperature stratification in the lake, E. coli was detected. The daily samples gave useful additional information compared with the weekly routine samples about the hygienic raw water quality and the hygienic barrier efficiency of the lake under different weather conditions and seasons. The winter 2013/2014 was much warmer than the winter 2012/2013. The monitoring supported the hypothesis that warmer winters with shorter periods with ice cover on lakes, which may be a consequence of climate changes, may reduce the hygienic barrier efficiency in deep lakes used as drinking water sources. Full article

(This article belongs to the Special Issue Small Solutions for Big Water-Related Problems—Innovative Microarrays and Small Sensors to Cope with Water Quality and Food Security)

Open AccessArticle Estimation of Seasonal Risk Caused by the Intake of Lead, Mercury and Cadmium through Freshwater Fish Consumption from Urban Water Reservoirs in Arid Areas of Northern Mexico

by Myrna Nevárez, Luz O. Leal and Myriam Moreno

Int. J. Environ. Res. Public Health 2015, 12(2), 1803-1816; doi:10.3390/ijerph120201803

Received: 8 December 2014 / Revised: 8 January 2015 / Accepted: 27 January 2015 / Published: 4 February 2015

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Abstract

Bioavailability and hence bioaccumulation of heavy metals in fish species depends on seasonal conditions causing different risks levels to human health during the lifetime. Mercury, cadmium and lead contents in fish from Chihuahua (Mexico) water reservoirs have been investigated to assess contamination levels

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Bioavailability and hence bioaccumulation of heavy metals in fish species depends on seasonal conditions causing different risks levels to human health during the lifetime. Mercury, cadmium and lead contents in fish from Chihuahua (Mexico) water reservoirs have been investigated to assess contamination levels and safety for consumers. Muscle samples of fish were collected across the seasons. Lead and cadmium were analyzed by inductively coupled plasma-optical emission spectrometry, and mercury by cold-vapor atomic absorption spectrometry. The highest concentrations of cadmium (0.235 mg/kg), mercury (0.744 mg/kg) and lead (4.298 mg/kg) exceeded the maximum levels set by European regulations and Codex Alimentarius. Lead concentrations found in fish from three water reservoirs also surpassed the limit of 1 mg/kg established by Mexican regulations. The provisional tolerable weekly intake (PTWI) suggested by the World Health Organization for methyl mercury (1.6 µg/kg bw per week) was exceeded in the spring season (1.94 µg/kg bw per week). This might put consumers at risk of mercury poisoning. Full article

Open AccessArticle Gonadal Disorder in the Thinlip Grey Mullet (Liza ramada, Risso 1827) as a Biomarker of Environmental Stress in Surface Waters

by Lorenzo Tancioni, Riccardo Caprioli, Ayad Hantoosh Dawood Al-Khafaji, Laura Mancini, Clara Boglione, Eleonora Ciccotti and Stefano Cataudella

Int. J. Environ. Res. Public Health 2015, 12(2), 1817-1833; doi:10.3390/ijerph120201817

Received: 11 December 2014 / Revised: 29 December 2014 / Accepted: 29 January 2015 / Published: 5 February 2015

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Abstract

The aim of this study was to evaluate the use of gonadal alterations in the thinlip grey mullet (Liza ramada) as a biological indicator in assessing aquatic ecosystems health, with particular emphasis to river ecosystems exposed to sewage discharges. For this

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The aim of this study was to evaluate the use of gonadal alterations in the thinlip grey mullet (Liza ramada) as a biological indicator in assessing aquatic ecosystems health, with particular emphasis to river ecosystems exposed to sewage discharges. For this purpose, the reproductive status and the presence of gonadal alterations were studied in 206 mullets collected from two sites on the low course of the Tiber River, downstream of a large urban sewage treatment plant and in the estuarine area, and from an uncontaminated pond considered as reference site. Intersex and irregularly shaped gonads were observed in 20.8% of the mullets from the most polluted site, and intersex gonads in 10.3% of those from the estuarine area. No alterations were detected in the fish from the reference site, which also showed distinct stages of gonadal development. Conversely, unclear stages of testicular and ovary development were observed in the fish from the two polluted river sites. The results of this study suggest that L. ramada may represent a sentinel species in environmental risk assessment and support the use of gonadal alterations of this species as a bioindicator for extensive monitoring of pollution in lower stretches of rivers and estuarine areas. Full article

(This article belongs to the Special Issue Small Solutions for Big Water-Related Problems—Innovative Microarrays and Small Sensors to Cope with Water Quality and Food Security)

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Open AccessArticle Knowledge, Attitudes, and Practices (KAP) of the Relationship between Air Pollution and Children’s Respiratory Health in Shanghai, China

by Rui Wang, Yingying Yang, Renjie Chen, Haidong Kan, Jinyi Wu, Keran Wang, Jay E. Maddock and Yuanan Lu

Int. J. Environ. Res. Public Health 2015, 12(2), 1834-1848; doi:10.3390/ijerph120201834

Received: 23 December 2014 / Revised: 21 January 2015 / Accepted: 30 January 2015 / Published: 5 February 2015

Cited by 6 | PDF Full-text (742 KB) | HTML Full-text | XML Full-text

Abstract

To assess the status of, and factors associated with, residents’ knowledge, attitudes, and practices (KAP) related to air pollution and respiratory health of children in Shanghai, we conducted a cross-sectional survey. Demographic factors associated with residents’ knowledge were identified by multiple logistic regressions.

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To assess the status of, and factors associated with, residents’ knowledge, attitudes, and practices (KAP) related to air pollution and respiratory health of children in Shanghai, we conducted a cross-sectional survey. Demographic factors associated with residents’ knowledge were identified by multiple logistic regressions. The questionnaires were completed by 972 participants, half from the Shanghai Children Hospital and the other half from the Jiading communities. Half of the participants’ scores of knowledge and attitudes were equal or greater than 8.0 on a 9-point scale, over 75% of respondents’ practice scores were equal to or less than 4.0. Our studies demonstrated a significant difference of average knowledge scores between the two groups (t = 1.27, p < 0.05). The parents’ educational level (OR = 1.89, 2.48) and average annual household income (AAHI) (OR = 2.37, 2.40, 2.12) were the two strongest factors on knowledge awareness. In addition, statistical analysis revealed a significant difference between the two groups in their attitudes towards air quality and their perception of the government’s efforts to alleviate it. The hospital and community groups also showed significant differences in practices geared towards protecting their children’s health. Nearly 90% of the respondents agreed that improving air quality is the responsibility of every citizen, and the joint action of governments and all citizens should be utilized for enhanced control. In addition, more resources should be allocated towards providing citizens with appropriate practices to help lessen the effects of poor air quality. Full article

Open AccessArticle Longitudinal Effects of Physical Inactivity and Obesity on Gait Speed in Older Adults with Frequent Knee Pain: Data from the Osteoarthritis Initiative

by Saad M. Bindawas and Vishal Vennu

Int. J. Environ. Res. Public Health 2015, 12(2), 1849-1863; doi:10.3390/ijerph120201849

Received: 18 September 2014 / Revised: 22 January 2015 / Accepted: 2 February 2015 / Published: 5 February 2015

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Abstract

Physical inactivity (PI) and obesity are risk factors for many health conditions, including knee pain (KP). The purpose of the present study was to examine the 6-year effects of PI and obesity on gait speed (GS) among older adults with frequent KP. This

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Physical inactivity (PI) and obesity are risk factors for many health conditions, including knee pain (KP). The purpose of the present study was to examine the 6-year effects of PI and obesity on gait speed (GS) among older adults with frequent KP. This prospective cohort study used data from the Osteoarthritis Initiative (OAI). At baseline, we studied 1788 adults aged 45 to 79 years old. We grouped the participants into four categories according to baseline scores on the Physical Activity Scale for the Elderly (PASE) and body mass index (BMI). GS was measured using the 20-m timed walk test. Frequent KP was assessed with a self-report questionnaire, and obesity was assessed by BMI (30 kg/m² or greater). General linear mixed models were conducted using data collected at baseline and 12, 24, 36, 48, and 72 months. After adjusting for all covariates, lower levels of physical activity and obesity were associated with a decrease in GS (β = −0.095, SE = 0.011, p < 0.0001). Our results suggest that both PI and obesity are associated with decreased GS over time in older adults with frequent KP. Full article

Open AccessArticle Parity and Risk of Death from Gallbladder Cancer among a Cohort of Premenopausal Parous Women in Taiwan

by Te-Fu Chan, Chen-Hsuan Wu, Hui-Fen Chiu and Chun-Yuh Yang

Int. J. Environ. Res. Public Health 2015, 12(2), 1864-1873; doi:10.3390/ijerph120201864

Received: 22 September 2014 / Revised: 4 January 2015 / Accepted: 30 January 2015 / Published: 5 February 2015

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Abstract

Little epidemiologic research has been done on the etiology of gallbladder cancer (GC). This cohort study was undertaken to examine whether there is an association between parity and risk of death from GC. The study cohort consisted of 1,292,462 women who had a

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Little epidemiologic research has been done on the etiology of gallbladder cancer (GC). This cohort study was undertaken to examine whether there is an association between parity and risk of death from GC. The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We tracked each woman from the time of their first childbirth to 31 December 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) of death from GC associated with parity. There were 257 GC deaths during 34,980,246 person-years of follow-up. The mortality rate of GC was 0.73 cases per 100,000 person-years. As compared with women who had given birth to only one child, the adjusted HR was 1.20 (95% CI = 0.79–1.83) for women who had two children, 1.47 (95% CI = 0.95–2.29) for women who had three children, and 1.68 (95% CI = 0.99–2.85) for women with four or more births. There was a significant increasing trend in the adjusted HRs for GC with increasing parity. The findings suggested that premenopausal women of higher parity may increase the risk of death from GC. Full article

Open AccessArticle Acute Effects of Exposure to a Traditional Rural Environment on Urban Dwellers: A Crossover Field Study in Terraced Farmland

by Juyoung Lee, Bum-Jin Park, Tatsuro Ohira, Takahide Kagawa and Yoshifumi Miyazaki

Int. J. Environ. Res. Public Health 2015, 12(2), 1874-1893; doi:10.3390/ijerph120201874

Received: 25 December 2014 / Revised: 4 January 2015 / Accepted: 30 January 2015 / Published: 5 February 2015

Cited by 6 | PDF Full-text (862 KB) | HTML Full-text | XML Full-text

Abstract

Despite an increasing attention and public preference for rural amenities, little evidence is available on the health benefits of a rural environment. In this study, we identified physiological and psychological benefits of exposure to a rural environment using multiparametric methods. Twelve young male

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Despite an increasing attention and public preference for rural amenities, little evidence is available on the health benefits of a rural environment. In this study, we identified physiological and psychological benefits of exposure to a rural environment using multiparametric methods. Twelve young male adults participated in a 3-day field experiment (mean ± standard deviation age, 22.3 ± 1.3 years). Sleeping environment, diet program, physical activities, and other factors possibly affecting physiological responses were controlled during experiment period. For all participants, salivary cortisol concentration, heart rate variability, and blood pressure were measured at rural and urban field sites. Self-evaluation questionnaires were administered to analyze the psychological states in two different environments. Volatile compounds in the air were also analyzed to investigate air quality. The data were compared between rural and urban environments. The data showed that exposure to a rural environment reduced stress hormone secretion and sympathetic nervous activity and increased parasympathetic nervous activity. Short-term exposure to a rural environment also improved mood states. Our findings indicate that exposure to a rural environment effectively reduced physiological stress and enhanced psychological well-being. Full article

Open AccessArticle The Extent, Nature and Environmental Health Implications of Cottage Industries in Johannesburg, South Africa

by June Teare, Tahira Kootbodien, Nisha Naicker and Angela Mathee

Int. J. Environ. Res. Public Health 2015, 12(2), 1894-1901; doi:10.3390/ijerph120201894

Received: 24 October 2014 / Revised: 4 January 2015 / Accepted: 2 February 2015 / Published: 5 February 2015

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Abstract

Cottage industries comprise a sub-group of informal sector income generation activities which are conducted in the home environment and organized around families or households. Cottage industry workers may be at risk of exposure to harmful substances associated with their work, and given the

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Cottage industries comprise a sub-group of informal sector income generation activities which are conducted in the home environment and organized around families or households. Cottage industry workers may be at risk of exposure to harmful substances associated with their work, and given the lack of separation of cottage industry activities from living spaces, their families and neighbors may similarly be at risk of exposure. This study was undertaken to determine the extent and nature of cottage industries in five neighborhoods in Johannesburg (South Africa) A cross-sectional survey was conducted across five communities in Johannesburg in 2012. Data on metal-related cottage industry activities were collected through the administration of a pre-structured questionnaire. Metal-related cottage industry activities were defined as car repairs, spray painting, scrap metal recycling, electrical appliance repairs, welding, hairdressing and metal jewelry making. One fifth of the households interviewed were operating one or more cottage industries associated with the use of toxic substances. Therefore, the potential exists for associated ill health effects in a considerable proportion of the population. Further research is needed to fully assess exposure to the harmful aspects of cottage industry, as are scaled up campaigns to increase awareness of the risks and correct handling of toxic substances. Full article

Open AccessArticle Towards Effective and Socio-Culturally Appropriate Sanitation and Hygiene Interventions in the Philippines: A Mixed Method Approach

by Lisa Maria Pfadenhauer and Eva Rehfuess

Int. J. Environ. Res. Public Health 2015, 12(2), 1902-1927; doi:10.3390/ijerph120201902

Received: 9 September 2014 / Revised: 4 January 2015 / Accepted: 2 February 2015 / Published: 5 February 2015

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Abstract

Inadequate water, sanitation and hygiene (WASH) represent an important health burden in the Philippines. The non-governmental organisation Fit for School intends to complement its handwashing programme in schools with sanitation interventions. The objectives of this mixed-method study therefore were to describe WASH practices

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Inadequate water, sanitation and hygiene (WASH) represent an important health burden in the Philippines. The non-governmental organisation Fit for School intends to complement its handwashing programme in schools with sanitation interventions. The objectives of this mixed-method study therefore were to describe WASH practices and their impact on childhood diarrhoea in the Philippines, and to examine socio-cultural and environmental factors underlying defecation and anal cleansing practices in Northern Mindanao. We quantified the effect of WASH practices on diarrhoea through logistic regression models, using the Philippine Demographic and Health Survey 2008. When adjusting for non-modifiable factors, susceptibility and socioeconomic factors, WASH factors failed to show a statistically significant effect. Focus group discussions were held with women in urban and rural Northern Mindanao, and findings analysed using thematic analysis. Defecation and anal cleansing behaviours were constrained by the physical environment, particularly the lack of clean, safe, comfortable and private facilities. Individual determinants of behaviour were influenced by habit and motivations such as disgust, with some evidence of planned behaviour. Where available, water was the preferred material for anal cleansing. This study combines nationally-representative quantitative data with local in-depth qualitative insights, constituting critical formative research in the development of effective and appropriate interventions. Full article

Open AccessArticle Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness

by Eva Sahlin, Gunnar Ahlborg, Jr., Artur Tenenbaum and Patrik Grahn

Int. J. Environ. Res. Public Health 2015, 12(2), 1928-1951; doi:10.3390/ijerph120201928

Received: 4 November 2014 / Accepted: 30 January 2015 / Published: 9 February 2015

Cited by 3 | PDF Full-text (987 KB) | HTML Full-text | XML Full-text | Correction

Abstract

After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context

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After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Västra Götaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57) and an occupational health service (OHS) model (n = 45). Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process. Full article

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Open AccessArticle Approaching Environmental Health Disparities and Green Spaces: An Ecosystem Services Perspective

by Viniece Jennings and Cassandra Johnson Gaither

Int. J. Environ. Res. Public Health 2015, 12(2), 1952-1968; doi:10.3390/ijerph120201952

Received: 25 November 2014 / Revised: 22 December 2014 / Accepted: 28 January 2015 / Published: 10 February 2015

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Abstract

Health disparities occur when adverse health conditions are unequal across populations due in part to gaps in wealth. These disparities continue to plague global health. Decades of research suggests that the natural environment can play a key role in sustaining the health of

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Health disparities occur when adverse health conditions are unequal across populations due in part to gaps in wealth. These disparities continue to plague global health. Decades of research suggests that the natural environment can play a key role in sustaining the health of the public. However, the influence of the natural environment on health disparities is not well-articulated. Green spaces provide ecosystem services that are vital to public health. This paper discusses the link between green spaces and some of the nation’s leading health issues such as obesity, cardiovascular health, heat-related illness, and psychological health. These associations are discussed in terms of key demographic variables—race, ethnicity, and income. The authors also identify research gaps and recommendations for future research. Full article

(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)

Open AccessArticle Impact of HIV Testing and Counseling (HTC) Knowledge on HIV Prevention Practices Among Traditional Birth Attendants in Nigeria

by Alice Osuji, Jennifer R. Pharr, Uche Nwokoro, Anulika Ike, Christiana Ali, Ogheneaga Ejiro, John Osuyali, Michael Obiefune, Kevin Fiscella and Echezona E. Ezeanolue

Int. J. Environ. Res. Public Health 2015, 12(2), 1969-1982; doi:10.3390/ijerph120201969

Received: 29 December 2014 / Accepted: 3 February 2015 / Published: 10 February 2015

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Abstract

Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play

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Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play a significant role in maternal and child health. It is important that TBAs be knowledgeable about HIV prevention. The purpose of this study was to determine the impact of HIV testing and counseling (HTC) knowledge on the HIV prevention practices among TBAs in Nigeria. Five hundred TBAs were surveyed. Chi-square and logistic regression were used to assess differences in HIV prevention practices between TBAs with and without HTC knowledge. TBAs with HTC knowledge are significantly more likely to engage in HIV prevention practices than TBAs without HTC. Prevention practices included: wearing gloves during delivery (p < 0.01), sterilization of delivery equipment (p < 0.01), participation in blood safety training (p < 0.01), and disposal of sharps (p < 0.01). As long as a high percent of births occur outside health care facilities in Nigeria, there will be a need for TBAs. Providing TBAs with HTC training increases HIV prevention practices and can be a key to improve maternal and child health. Full article

(This article belongs to the Special Issue HIV/AIDS: Social Perspectives)

Open AccessArticle The Association of Weather Variability and Under Five Malaria Mortality in KEMRI/CDC HDSS in Western Kenya 2003 to 2008: A Time Series Analysis

by Maquins Sewe, Joacim Rocklöv, John Williamson, Mary Hamel, Amek Nyaguara, Frank Odhiambo and Kayla Laserson

Int. J. Environ. Res. Public Health 2015, 12(2), 1983-1997; doi:10.3390/ijerph120201983

Received: 5 November 2014 / Accepted: 30 January 2015 / Published: 10 February 2015

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Abstract

Malaria is among the leading causes of mortality in the younger under-five group of children zero to four years of age. This study aims at describing the relationship between rainfall and temperature on under-five malaria or anaemia mortality in Kenya Medical Research Institute

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Malaria is among the leading causes of mortality in the younger under-five group of children zero to four years of age. This study aims at describing the relationship between rainfall and temperature on under-five malaria or anaemia mortality in Kenya Medical Research Institute and United States Centers for Disease Control (KEMRI/CDC) Health and Demographic Surveillance System (HDSS). This study was conducted through the ongoing KEMRI and CDC collaboration. A general additive model with a Poisson link function was fit to model the weekly association of lagged cumulative rainfall and average temperature on malaria/anemia mortality in KEMRI/CDC HDSS for the period 2003 to 2008. A trend function was included in the model to control for time trends and seasonality not explained by weather fluctuations. 95% confidence intervals was presented with estimates. Malaria or anemia mortality was found to be associated with changes in temperature and rainfall in the KEMRI HDSS, with a delay up to 16 weeks. The empirical estimates of associations describe established biological relationships well. This information, and particularly, the strength of the relationships over longer lead times can highlight the possibility of developing a predictive forecast with lead times up to 16 weeks in order to enhance preparedness to high transmission episodes. Full article

Open AccessArticle Body Mass Index (BMI) Is Associated with Microalbuminuria in Chinese Hypertensive Patients

by Xinyu Liu, Yu Liu, Youming Chen, Yongqiang Li, Xiaofei Shao, Yan Liang, Bin Li, Harry Holthöfer, Guanjing Zhang and Hequn Zou

Int. J. Environ. Res. Public Health 2015, 12(2), 1998-2008; doi:10.3390/ijerph120201998

Received: 21 November 2014 / Accepted: 30 January 2015 / Published: 10 February 2015

Cited by 1 | PDF Full-text (683 KB) | HTML Full-text | XML Full-text

Abstract

There is no general consensus on possible factors associated with microalbuminuria in hypertensive patients nor any reported study about this issue in Chinese patients. To examine this issues, 944 hypertensive patients were enrolled in a study based on a cross-sectional survey conducted in

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There is no general consensus on possible factors associated with microalbuminuria in hypertensive patients nor any reported study about this issue in Chinese patients. To examine this issues, 944 hypertensive patients were enrolled in a study based on a cross-sectional survey conducted in Southern China. Multivariate regression analyses were performed to identify the factors related with the presence of microalbuminuria and urinary excretion of albumin. The prevalence of microalbuminuria in hypertensive and non-diabetic hypertensive patients were 17.16% and 15.25%, respectively. Body mass index (BMI), but not waist circumference (WC), were independently associated with microalbuminuria and the values of urinary albumin to creatinine ratio (ACR) based on multiple regression analyses, even after excluding diabetic patients and patients taking inhibitors of the renin-angiotensin system from the analyses. Furthermore, patients with obesity (BMI ≥28) had higher levels of ACR, compared with those with normal weight (BMI <24 kg/m²) and overweight (24 kg/m²≤ BMI < 28). In conclusion, BMI, as a modifiable factor, is closely associated with microalbuminuria among Chinese hypertensive patients, which may provide a basis for future development of intervention approaches for these patients. Full article

Open AccessArticle School Locations and Traffic Emissions — Environmental (In)Justice Findings Using a New Screening Method

by Philine Gaffron and Deb Niemeier

Int. J. Environ. Res. Public Health 2015, 12(2), 2009-2025; doi:10.3390/ijerph120202009

Received: 10 November 2014 / Accepted: 28 January 2015 / Published: 11 February 2015

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Abstract

It has been shown that the location of schools near heavily trafficked roads can have detrimental effects on the health of children attending those schools. It is therefore desirable to screen both existing school locations and potential new school sites to assess either

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It has been shown that the location of schools near heavily trafficked roads can have detrimental effects on the health of children attending those schools. It is therefore desirable to screen both existing school locations and potential new school sites to assess either the need for remedial measures or suitability for the intended use. Current screening tools and public guidance on school siting are either too coarse in their spatial resolution for assessing individual sites or are highly resource intensive in their execution (e.g., through dispersion modeling). We propose a new method to help bridge the gap between these two approaches. Using this method, we also examine the public K-12 schools in the Sacramento Area Council of Governments Region, California (USA) from an environmental justice perspective. We find that PM_2.5 emissions from road traffic affecting a school site are significantly positively correlated with the following metrics: percent share of Black, Hispanic and multi-ethnic students, percent share of students eligible for subsidized meals. The emissions metric correlates negatively with the schools’ Academic Performance Index, the share of White students and average parental education levels. Our PM_2.5 metric also correlates with the traffic related, census tract level screening indicators from the California Communities Environmental Health Screening Tool and the tool’s tract level rate of asthma related emergency department visits. Full article

(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)

Open AccessArticle Drinking Patterns and the Association between Socio-Demographic Factors and Adolescents’ Alcohol Use in Three Metropolises in China

by Shijun Lu, Songming Du, Xiaoqi Hu, Shurong Zou, Weijia Liu, Lei Ba and Guansheng Ma

Int. J. Environ. Res. Public Health 2015, 12(2), 2037-2053; doi:10.3390/ijerph120202037

Received: 19 December 2014 / Revised: 15 January 2015 / Accepted: 28 January 2015 / Published: 12 February 2015

Cited by 5 | PDF Full-text (345 KB) | HTML Full-text | XML Full-text

Abstract

The current study was designed to investigate the drinking patterns and association between socio-demographic factors and adolescents’ alcohol use among high school students from China’s three metropolises, Beijing, Shanghai, and Guangzhou. Using a self-administered questionnaire, we conducted a cross-sectional survey among 13,811 high

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The current study was designed to investigate the drinking patterns and association between socio-demographic factors and adolescents’ alcohol use among high school students from China’s three metropolises, Beijing, Shanghai, and Guangzhou. Using a self-administered questionnaire, we conducted a cross-sectional survey among 13,811 high school students from 136 schools between May and June 2013. A two-stage stratified sampling method was used for subject selection. The prevalence of lifetime drinking was 52.5%; in addition, 38.5% of the students were past-year drinkers, while 20.1% of them had consumed alcohol in the past 30 days. During the past year, 29.7% of the students reported that they drank once per month or less, and 22.0% of the students drank less than one standard drink (SD) per occasion. For the students who were not living with their mothers, as well as the students in higher socioeconomic status (SES), the adjusted odds of past and current drinking were significantly higher, compared with those who lived with both parents and low SES. Due to the high prevalence of alcohol consumption among junior and senior high school students in metropolises, attention should be paid by parents, school administrators, educational and public health agencies for making efforts collectively to reduce alcohol availability and drinking among adolescents. Full article

Open AccessArticle More than a Pretty Place: Assessing the Impact of Environmental Education on Children’s Knowledge and Attitudes about Outdoor Play in Nature

by Kirsten M. M. Beyer, Elizabeth F. Heller, Jessica M. Bizub, Amy J. Kistner, Aniko Szabo, Erin E. Shawgo and Corey J. Zetts

Int. J. Environ. Res. Public Health 2015, 12(2), 2054-2070; doi:10.3390/ijerph120202054

Received: 16 December 2014 / Accepted: 5 February 2015 / Published: 12 February 2015

Cited by 2 | PDF Full-text (589 KB) | HTML Full-text | XML Full-text

Abstract

Our work assessed the influence of an urban environmental education program on children’s attitudes toward outdoor play, as well as knowledge of neighborhood features that can facilitate this type of activity. The project team engaged 6 schools near the newest Urban Ecology Center

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Our work assessed the influence of an urban environmental education program on children’s attitudes toward outdoor play, as well as knowledge of neighborhood features that can facilitate this type of activity. The project team engaged 6 schools near the newest Urban Ecology Center location in Milwaukee, Wisconsin, USA, through a community-academic partnership entitled More Than a Pretty Place. Intervention classrooms participated in programming over the 2012–2013 academic year and pre and post surveys were implemented in classrooms. Data were analyzed using multilevel regression models. The intervention group reported reduced fears of outdoor play in nature and increased frequency of visits to the Urban Ecology Center. The proportion of students who acknowledged knowing of a place to play outside in nature increased significantly in both groups. Our findings indicate an important role for environmental education in addressing fears that may dissuade children from engaging in outdoor play in natural areas. Full article

Open AccessArticle Circadian Rhythmicity of Antioxidant Markers in Rats Exposed to 1.8 GHz Radiofrequency Fields

by Honglong Cao, Fenju Qin, Xueguan Liu, Jiajun Wang, Yi Cao, Jian Tong and Heming Zhao

Int. J. Environ. Res. Public Health 2015, 12(2), 2071-2087; doi:10.3390/ijerph120202071

Received: 11 December 2014 / Accepted: 28 January 2015 / Published: 12 February 2015

Cited by 2 | PDF Full-text (1239 KB) | HTML Full-text | XML Full-text

Abstract

Background: The potential health risks of exposure to Radiofrequency Fields (RF) emitted by mobile phones are currently of considerable public interest, such as the adverse effects on the circadian rhythmicities of biological systems. To determine whether circadian rhythms of the plasma antioxidants (Mel,

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Background: The potential health risks of exposure to Radiofrequency Fields (RF) emitted by mobile phones are currently of considerable public interest, such as the adverse effects on the circadian rhythmicities of biological systems. To determine whether circadian rhythms of the plasma antioxidants (Mel, GSH-Px and SOD) are affected by RF, we performed a study on male Sprague Dawley rats exposed to the 1.8 GHz RF. Methods: All animals were divided into seven groups. The animals in six groups were exposed to 1.8 GHz RF (201.7 μW/cm² power density, 0.05653 W/kg specific absorption rate) at a specific period of the day (3, 7, 11, 15, 19 and 23 h GMT, respectively), for 2 h/day for 32 consecutive days. The rats in the seventh group were used as sham-exposed controls. At the end of last RF exposure, blood samples were collected from each rat every 4 h (total period of 24 h) and also at similar times from sham-exposed animals. The concentrations of three antioxidants (Mel, GSH-Px and SOD) were determined. The data in RF-exposed rats were compared with those in sham-exposed animals. Results: circadian rhythms in the synthesis of Mel and antioxidant enzymes, GSH-Px and SOD, were shifted in RF-exposed rats compared to sham-exposed animals: the Mel, GSH-Px and SOD levels were significantly decreased when RF exposure was given at 23 and 3 h GMT. Conclusion: The overall results indicate that there may be adverse effects of RF exposure on antioxidant function, in terms of both the daily antioxidative levels, as well as the circadian rhythmicity. Full article

(This article belongs to the Special Issue Electromagnetic Fields and Health)

Open AccessArticle Chemical Characterization of Outdoor and Subway Fine (PM_2.5–1.0) and Coarse (PM_10–2.5) Particulate Matter in Seoul (Korea) by Computer-Controlled Scanning Electron Microscopy (CCSEM)

by Sang-Hoon Byeon, Robert Willis and Thomas M. Peters

Int. J. Environ. Res. Public Health 2015, 12(2), 2090-2104; doi:10.3390/ijerph120202090

Received: 16 December 2014 / Accepted: 2 February 2015 / Published: 13 February 2015

Cited by 6 | PDF Full-text (1530 KB) | HTML Full-text | XML Full-text

Abstract

Outdoor and indoor (subway) samples were collected by passive sampling in urban Seoul (Korea) and analyzed with computer-controlled scanning electron microscopy coupled with energy dispersive x-ray spectroscopy (CCSEM-EDX). Soil/road dust particles accounted for 42%–60% (by weight) of fine particulate matter larger than 1

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Outdoor and indoor (subway) samples were collected by passive sampling in urban Seoul (Korea) and analyzed with computer-controlled scanning electron microscopy coupled with energy dispersive x-ray spectroscopy (CCSEM-EDX). Soil/road dust particles accounted for 42%–60% (by weight) of fine particulate matter larger than 1 µm (PM_2.5–1.0) in outdoor samples and 18% of PM_2.5–1.0in subway samples. Iron-containing particles accounted for only 3%–6% in outdoor samples but 69% in subway samples. Qualitatively similar results were found for coarse particulate matter (PM_10–2.5) with soil/road dust particles dominating outdoor samples (66%–83%) and iron-containing particles contributing most to subway PM_10–2.5(44%). As expected, soil/road dust particles comprised a greater mass fraction of PM_10–2.5than PM_2.5–1.0. Also as expected, the mass fraction of iron-containing particles was substantially less in PM_10–2.5than in PM_2.5–1.0. Results of this study are consistent with known emission sources in the area and with previous studies, which showed high concentrations of iron-containing particles in the subway compared to outdoor sites. Thus, passive sampling with CCSEM-EDX offers an inexpensive means to assess PM_2.5–1.0and PM_10-2.5simultaneously and by composition at multiple locations. Full article

Open AccessArticle Perceived Environmental and Personal Factors Associated with Walking and Cycling for Transportation in Taiwanese Adults

by Yung Liao, I-Ting Wang, Hsiu-Hua Hsu and Shao-Hsi Chang

Int. J. Environ. Res. Public Health 2015, 12(2), 2105-2119; doi:10.3390/ijerph120202105

Received: 7 November 2014 / Revised: 15 January 2015 / Accepted: 10 February 2015 / Published: 13 February 2015

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Abstract

This study examined perceived environmental and personal factors associated with walking and cycling as means of transportation for Taiwanese adults. A random-digit-dialing telephone-based cross-sectional survey was conducted with Taiwanese adults aged 20 to 64 years. Data on time spent walking and cycling for

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This study examined perceived environmental and personal factors associated with walking and cycling as means of transportation for Taiwanese adults. A random-digit-dialing telephone-based cross-sectional survey was conducted with Taiwanese adults aged 20 to 64 years. Data on time spent walking and cycling for transportation and perceptions of neighborhood environment and personal characteristics were obtained from 1065 adults by using the International Physical Activity Questionnaire-long version and its environmental module. Adjusted binary logistic regression was performed. The results showed that, after adjusting potential confounders, common and different personal and perceived environmental factors were associated with walking and cycling for transportation. For common personal factors, adults who had employment were less likely to engage in 150 min of walking per week (odds ratio [OR] = 0.41; 95% confidence interval (CI): 0.27–0.62) and to use cycling as a means of transportation (OR = 0.51; 95% CI: 0.32–0.79). For common perceived environmental factors, adults who perceived good connectivity of streets were more likely to walk (OR = 1.95; 95% CI: 1.20–3.16) and cycle (OR = 2.02; 95% CI: 1.16–3.54) for transportation. Targeting employed adults and improving the connectivity of streets should be a priority for developing transport policies and intervention strategies to promote active transportation. Full article

Open AccessArticle Exploring the Care Relationship between Grandparents/Older Carers and Children Infected with HIV in South-Western Uganda: Implications for Care for Both the Children and Their Older Carers

by Rwamahe Rutakumwa, Flavia Zalwango, Esther Richards and Janet Seeley

Int. J. Environ. Res. Public Health 2015, 12(2), 2120-2134; doi:10.3390/ijerph120202120

Received: 12 December 2014 / Revised: 19 January 2015 / Accepted: 5 February 2015 / Published: 13 February 2015

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Abstract

The care of children orphaned by HIV/AIDS in sub-Saharan Africa is often undertaken by grandparents, yet little is known about the care relationship between grandparent and grandchild. Our aim was to examine this relationship to understand the needs and responsibilities of both the

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The care of children orphaned by HIV/AIDS in sub-Saharan Africa is often undertaken by grandparents, yet little is known about the care relationship between grandparent and grandchild. Our aim was to examine this relationship to understand the needs and responsibilities of both the HIV positive child and older carer and the nature of the relationship, and to assess the implications for care for the children and the older carers. A qualitative study was conducted with 40 purposively sampled children (13–17 years) and their older carers (50 years and above). Participants were recruited from two clinics in south-western Uganda. Up to three semi-structured interviews were held with each participant. Data were analysed using a thematic framework approach. We found that the care relationship was mostly reciprocal: HIV positive children depended on carers for basic and health needs and carers counted on the children for performing tedious household tasks. The relationship was also characterised by challenges, sometimes causing tension between child and carer. We conclude that: (1) interventions targeting HIV positive children need to also address the needs of older carers, and (2) carers and children would benefit from psychosocial support and social protection. Full article

(This article belongs to the Special Issue HIV/AIDS: Social Perspectives)

Open AccessArticle Smoking-Related Knowledge, Attitudes, Behaviors, Smoking Cessation Idea and Education Level among Young Adult Male Smokers in Chongqing, China

by Xianglong Xu, Lingli Liu, Manoj Sharma and Yong Zhao

Int. J. Environ. Res. Public Health 2015, 12(2), 2135-2149; doi:10.3390/ijerph120202135

Received: 23 November 2014 / Revised: 12 January 2015 / Accepted: 11 February 2015 / Published: 16 February 2015

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Abstract

Introduction: In 2012 in China, 52.9% of men were reported to smoke while only 2.4% of women smoked. This study explored the smoking-related Knowledge, Attitudes and Practices (KAP) among young adult male smokers. Methods: A cross-sectional study was conducted in four

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Introduction: In 2012 in China, 52.9% of men were reported to smoke while only 2.4% of women smoked. This study explored the smoking-related Knowledge, Attitudes and Practices (KAP) among young adult male smokers. Methods: A cross-sectional study was conducted in four municipal areas of Chongqing using a questionnaire administered to 536 natives young male smokers aged 18–45 years old. Results: The total score of smoking cognition, the total score of smoking attitude and the total score of positive behavior to quit smoking was significantly different among the three groups by education. Besides, 30.97% of male smokers never seriously thought about quitting smoking. Logistic regression analysis found smoking-related knowledge, attitudes, behaviors and sociodemographic factors affect having smoking cessation idea. But no statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking in a sample of higher education. No statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking (Pearson correlation coefficient = 0.03012, p = 0.6811), and also no statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking (Pearson correlation coefficient = 0.08869, p = 0.2364) in the sample of higher education young adult males Conclusions: Young adult males with higher education have a better knowledge of smoking hazards and a more positive attitude toward smoking, however, this knowledge and attitude do not necessarily translate into health behavioral outcomes such as not smoking. Overall the present findings indicate that no statistically significant correlation between the education level and quitting smoking idea exists among young adult male smokers in China. This survey gives a snapshot of the impact of education on smoking-related KAP among young adults male smokers. Full article

Open AccessArticle Antimicrobial Resistance in Commensal Escherichia coli from Pigs during Metaphylactic Trimethoprim and Sulfamethoxazole Treatment and in the Post-Exposure Period

by Justyna Mazurek, Ewa Bok, Michał Stosik and Katarzyna Baldy-Chudzik

Int. J. Environ. Res. Public Health 2015, 12(2), 2150-2163; doi:10.3390/ijerph120202150

Received: 15 November 2014 / Revised: 6 February 2015 / Accepted: 10 February 2015 / Published: 16 February 2015

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Abstract

The prevalence of trimethoprim (TMP) and sulfamethoxazole (SMX) resistance in commensal E. coli from pigs was tested in this study. E. coli was derived from three groups of piglets in successive stages of metaphylactic therapy and from two groups of sows 10 and

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The prevalence of trimethoprim (TMP) and sulfamethoxazole (SMX) resistance in commensal E. coli from pigs was tested in this study. E. coli was derived from three groups of piglets in successive stages of metaphylactic therapy and from two groups of sows 10 and 18 weeks after the treatment. MIC values of TMP and SMX were determined for a total of 352 strains. The presence of resistance genes (dfrA1, dfrA5, dfrA7, dfrA12, dfrA17, sul1, sul2, sul3) and class 1 and 2 integron-associated dfrA gene cassettes was tested. Resistance to TMP was very high during the administration of the antimicrobial (from 97 to 100%) and amounted to 86% and 69% in the post-exposure period; MIC > 32 mg/L. The isolates from all groups of pigs were resistant to sulfamethoxazole, with MIC > 1028 mg/L. The dfrA1 and sul1 genes (as part of integrons) dominated in E. coli from piglets, but the dfrA12 and sul1 genes were prevalent in E. coli from sows. Coexistence of the different dfrA genes was detected in 71 isolates from all groups of swine. Transcription analysis revealed that most of these genes were not transcribed, particularly gene cassettes of class 1 integrons. The research revealed a high level of resistance associated with the metaphylactic treatment, persistence and circulation of resistance in bacterial populations. Diverse genetic background with multiple and not transcribed resistance genes was observed. Full article

(This article belongs to the Special Issue Antibiotic Resistant and Pathogenic Bacteria in the Food Production Environment: Epidemiological Evolution and Control)

Open AccessArticle Production of the Allergenic Protein Alt a 1 by Alternaria Isolates from Working Environments

by Justyna Skóra, Anna Otlewska, Beata Gutarowska, Joanna Leszczyńska, Iwona Majak and Łukasz Stępień

Int. J. Environ. Res. Public Health 2015, 12(2), 2164-2183; doi:10.3390/ijerph120202164

Received: 12 January 2015 / Revised: 27 January 2015 / Accepted: 6 February 2015 / Published: 16 February 2015

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Abstract

The aim of the study was to evaluate the ability of Alternaria isolates from workplaces to produce Alt a 1 allergenic protein, and to analyze whether technical materials (cellulose, compost, leather) present within the working environment stimulate or inhibit Alt a 1 production

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The aim of the study was to evaluate the ability of Alternaria isolates from workplaces to produce Alt a 1 allergenic protein, and to analyze whether technical materials (cellulose, compost, leather) present within the working environment stimulate or inhibit Alt a 1 production (ELISA test). Studies included identification of the isolated molds by nucleotide sequences analyzing of the ITS1/ITS2 regions, actin, calmodulin and Alt a 1 genes. It has been shown that Alternaria molds are significant part of microbiocenosis in the archive, museum, library, composting plant and tannery (14%–16% frequency in the air). The presence of the gene encoding the Alt a 1 protein has been detected for the strains: Alternaria alternata, A. lini, A. limoniasperae A. nobilis and A. tenuissima. Environmental strains produced Alt a 1 at higher concentrations (1.103–6.528 ng/mL) than a ATCC strain (0.551–0.975 ng/mL). It has been shown that the homogenization of the mycelium and the use of ultrafiltration allow a considerable increase of Alt a 1 concentration. Variations in the production of Alt a 1 protein, depend on the strain and extraction methods. These studies revealed no impact of the technical material from the workplaces on the production of Alt a 1 protein. Full article

Open AccessArticle Childhood Leukemia and 50 Hz Magnetic Fields: Findings from the Italian SETIL Case-Control Study

by Alberto Salvan, Alessandra Ranucci, Susanna Lagorio, Corrado Magnani and on behalf of the SETIL Research Group

Int. J. Environ. Res. Public Health 2015, 12(2), 2184-2204; doi:10.3390/ijerph120202184

Received: 15 December 2014 / Revised: 29 January 2015 / Accepted: 5 February 2015 / Published: 16 February 2015

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Abstract

We report on an Italian case-control study on childhood leukemia and exposure to extremely low frequency magnetic fields (ELF-MF). Eligible for inclusion were 745 leukemia cases, aged 0–10 years at diagnosis in 1998–2001, and 1475 sex- and age-matched population controls. Parents of 683

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We report on an Italian case-control study on childhood leukemia and exposure to extremely low frequency magnetic fields (ELF-MF). Eligible for inclusion were 745 leukemia cases, aged 0–10 years at diagnosis in 1998–2001, and 1475 sex- and age-matched population controls. Parents of 683 cases and 1044 controls (92% vs. 71%) were interviewed. ELF-MF measurements (24–48 h), in the child’s bedroom of the dwelling inhabited one year before diagnosis, were available for 412 cases and 587 controls included in the main conditional regression analyses. The magnetic field induction was 0.04 μT on average (geometric mean), with 0.6% of cases and 1.6% of controls exposed to >0.3 μT. The impact of changes in the statistical model, exposure metric, and data-set restriction criteria was explored via sensitivity analyses. No exposure-disease association was observed in analyses based on continuous exposure, while analyses based on categorical variables were characterized by incoherent exposure-outcome relationships. In conclusion, our results may be affected by several sources of bias and they are noninformative at exposure levels >0.3 μT. Nonetheless, the study may contribute to future meta- or pooled analyses. Furthermore, exposure levels among population controls are useful to estimate attributable risk. Full article

(This article belongs to the Special Issue Electromagnetic Fields and Health)

Open AccessArticle Health-Related Quality of Life and Health Service Utilization in Chinese Rural-to-Urban Migrant Workers

by Chu-Hong Lu, Zhong-Cheng Luo, Jia-Ji Wang, Jian-Hu Zhong and Pei-Xi Wang

Int. J. Environ. Res. Public Health 2015, 12(2), 2205-2214; doi:10.3390/ijerph120202205

Received: 14 November 2014 / Revised: 7 January 2015 / Accepted: 13 February 2015 / Published: 16 February 2015

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Abstract

Objectives: The number of rural-to-urban migrant workers has been increasing rapidly in China over recent decades, but there is a scarcity of data on health-related quality of life (HRQOL) and health service utilization among Chinese rural-to-urban migrant workers in comparison to local

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Objectives: The number of rural-to-urban migrant workers has been increasing rapidly in China over recent decades, but there is a scarcity of data on health-related quality of life (HRQOL) and health service utilization among Chinese rural-to-urban migrant workers in comparison to local urban residents. We aimed to address this question. Methods: This was a cross-sectional study of 2315 rural-to-urban migrant workers and 2347 local urban residents in the Shenzhen-Dongguan economic zone (China) in 2013. Outcomes included HRQOL (measured by Health Survey Short Form 36) and health service utilization (self-reported). Results: Compared to local urban residents, rural-to-urban migrant workers had lower scores in all domains of HRQOL, and were more likely to report chronic illnesses (9.2% vs. 6.0%, adjusted OR = 1.62, 95% CI 1.28–2.04) and recent two-week morbidity (21.3% vs. 5.0%, adjusted OR = 5.41, 95% CI 4.26–6.88). Among individuals who reported sickness in the recent two weeks, migrant workers were much less likely to see a doctor (32.7% vs. 66.7%, adjusted OR = 0.21, 95% CI 0.13–0.36). Conclusions: Chinese rural-to-urban migrant workers have lower HRQOL, much more frequent morbidity, but are also much less likely to see a doctor in times of sickness as compared to local urban residents, indicating the existence of significant unmet medical care needs in this population. Full article

Open AccessArticle Application of QUAL2K Model to Assess Ecological Purification Technology for a Polluted River

by Wenting Zhu, Qian Niu, Ruibin Zhang, Rui Ye, Xin Qian and Yu Qian

Int. J. Environ. Res. Public Health 2015, 12(2), 2215-2229; doi:10.3390/ijerph120202215

Received: 10 November 2014 / Accepted: 4 February 2015 / Published: 16 February 2015

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Abstract

Industrialization and urbanization have caused water pollution and ecosystem degradation, especially in urban canals and rivers in China; accordingly, effective water quality improvement programs are needed. In this study, the Tianlai River in Jiangsu, China was taken as a research site, and a

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Industrialization and urbanization have caused water pollution and ecosystem degradation, especially in urban canals and rivers in China; accordingly, effective water quality improvement programs are needed. In this study, the Tianlai River in Jiangsu, China was taken as a research site, and a combination of ecological purification technologies consisting of biological rope, phytoremediation, and activated carbon were applied in a laboratory-scale study to examine degradation coefficients under dynamic water conditions. Coefficients were then input into the QUAL2K model to simulate various hypothetical scenarios and determine the minimum density of ecological purification combination and hydraulic retention time (HRT) to meet Grade V or IV of the China standard for surface water. The minimum densities for Grade V and IV were 1.6 times and 2 times the experimental density, while the minimum HRTs for Grade V and IV were 2.4 day and 3 day. The results of this study should provide a practical and efficient design method for ecological purification programs. Full article

Open AccessArticle Dynamic Assessment of Water Quality Based on a Variable Fuzzy Pattern Recognition Model

by Shiguo Xu, Tianxiang Wang and Suduan Hu

Int. J. Environ. Res. Public Health 2015, 12(2), 2230-2248; doi:10.3390/ijerph120202230

Received: 6 January 2015 / Revised: 5 February 2015 / Accepted: 10 February 2015 / Published: 16 February 2015

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Abstract

Water quality assessment is an important foundation of water resource protection and is affected by many indicators. The dynamic and fuzzy changes of water quality lead to problems for proper assessment. This paper explores a method which is in accordance with the water

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Water quality assessment is an important foundation of water resource protection and is affected by many indicators. The dynamic and fuzzy changes of water quality lead to problems for proper assessment. This paper explores a method which is in accordance with the water quality changes. The proposed method is based on the variable fuzzy pattern recognition (VFPR) model and combines the analytic hierarchy process (AHP) model with the entropy weight (EW) method. The proposed method was applied to dynamically assess the water quality of Biliuhe Reservoir (Dailan, China). The results show that the water quality level is between levels 2 and 3 and worse in August or September, caused by the increasing water temperature and rainfall. Weights and methods are compared and random errors of the values of indicators are analyzed. It is concluded that the proposed method has advantages of dynamism, fuzzification and stability by considering the interval influence of multiple indicators and using the average level characteristic values of four models as results. Full article

Open AccessArticle Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

by Hsiu-Nien Shen, Wei-Ting Lin, Chin-Li Lu and Chung-Yi Li

Int. J. Environ. Res. Public Health 2015, 12(2), 2249-2261; doi:10.3390/ijerph120202249

Received: 9 January 2015 / Revised: 11 February 2015 / Accepted: 13 February 2015 / Published: 16 February 2015

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Abstract

Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures.

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Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures. Methods: Data regarding older (≥65 years) physicians (n = 4303) and matched non-medical persons (control) were retrieved from Taiwan’s National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR) of hip fracture associated with older physicians. Results: The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively), whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively). Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37–0.79); by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged. Conclusions: Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures. Full article

Open AccessArticle Relation between Overweight/Obesity and Self-Rated Health Among Adolescents in Germany. Do Socio-Economic Status and Type of School Have an Impact on That Relation?

by Laura Krause and Thomas Lampert

Int. J. Environ. Res. Public Health 2015, 12(2), 2262-2276; doi:10.3390/ijerph120202262

Received: 24 November 2014 / Revised: 9 February 2015 / Accepted: 12 February 2015 / Published: 16 February 2015

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Abstract

This study investigates the relation between overweight/obesity and self-rated health (SRH), and whether this relation varies by social factors. Data was taken from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, baseline 2003‒2006). For the definition of overweight and

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This study investigates the relation between overweight/obesity and self-rated health (SRH), and whether this relation varies by social factors. Data was taken from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, baseline 2003‒2006). For the definition of overweight and obesity, body mass index was calculated based on standardized height and weight measurements. SRH of adolescents (n = 6813, 11‒17 years) was raised with the question: “How would you describe your health in general?” The response categories were “very good”, “good”, “fair”, “poor”, and “very poor”. We dichotomized these responses into: “very good/good” vs. “fair/poor/very poor”. Socio-economic status (SES) in the family of origin and adolescents’ school type were analyzed as modifying factors. Prevalence and age-adjusted odds ratios with 95% confidence intervals were calculated by binary logistic regression models. We found that overweight and obese boys and obese girls reported fair to very poor SRH more often than their normal weight peers, and that these differences were more apparent in early than late adolescence. In addition, the relation between obesity and SRH was similarly strong in all sub-groups, but there was seldom a relation between overweight and SRH. In summary, the results show that obesity is linked to poor SRH regardless of SES and school type, while the relation between overweight and SRH varies by social factors among adolescents. Full article

Open AccessArticle Air Pollution and Daily Clinic Visits for Headache in a Subtropical City: Taipei, Taiwan

by Hui-Fen Chiu, Yi-Hao Weng, Ya-Wen Chiu and Chun-Yuh Yang

Int. J. Environ. Res. Public Health 2015, 12(2), 2277-2288; doi:10.3390/ijerph120202277

Received: 21 January 2015 / Accepted: 2 February 2015 / Published: 17 February 2015

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Abstract

This study was undertaken to determine whether there was an association between air pollutant levels and daily clinic visits for headache in Taipei, Taiwan. Daily clinic visits for headache and ambient air pollution data for Taipei were obtained for the period from 2006–2011.

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This study was undertaken to determine whether there was an association between air pollutant levels and daily clinic visits for headache in Taipei, Taiwan. Daily clinic visits for headache and ambient air pollution data for Taipei were obtained for the period from 2006–2011. The odds ratio of clinic visits for headache was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single pollutant models, on warm days (>23 °C) statistically significant positive associations were found for increased rate of headache occurrence and levels of particulate matter (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and ozone (O₃). On cool days (<23 °C), all pollutants were significantly associated with increased headache visits except SO₂. For the two-pollutant models, PM₁₀, O₃ and NO₂ were significant for higher rate of headache visits in combination with each of the other four pollutants on cool days. On warm days, CO remained statistically significant in all two-pollutant models. This study provides evidence that higher levels of ambient air pollutants increase the risk of clinic visits for headache. Full article

Open AccessArticle Overweight and Obese Adolescent Girls: The Importance of Promoting Sensible Eating and Activity Behaviors from the Start of the Adolescent Period

by Alwyn S. Todd, Steven J. Street, Jenny Ziviani, Nuala M. Byrne and Andrew P. Hills

Int. J. Environ. Res. Public Health 2015, 12(2), 2306-2329; doi:10.3390/ijerph120202306

Received: 9 October 2014 / Revised: 4 December 2014 / Accepted: 9 February 2015 / Published: 17 February 2015

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Abstract

The adolescent period is associated with changes in eating and activity behaviors in girls. Less reliance on parental provision and choice of food, coupled with a decrease in participation in physical activity and sport, can create an energy imbalance, predisposing to weight gain.

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The adolescent period is associated with changes in eating and activity behaviors in girls. Less reliance on parental provision and choice of food, coupled with a decrease in participation in physical activity and sport, can create an energy imbalance, predisposing to weight gain. Physiological alterations to body composition, reduction in insulin sensitivity, and psychological adjustments may further amplify the risk of becoming overweight and maintaining an unhealthy level of body fat into childbearing years. During pregnancy excess body fat is a risk factor for poor pregnancy outcomes and may predispose an infant to a lifelong heightened risk of being overweight and developing chronic disease. Interventions aimed at preventing the accumulation of body fat in adolescent girls and young women may have far reaching impact and be critically important in reducing intergenerational weight gain. Lifestyle interventions in adolescence have the potential to modify adult obesity risk by switching at-risk individuals from a high to lower obesity risk trajectory. This paper discusses multiple approaches to assist at-risk individuals reduce obesity risk. A key focus is placed on engagement in food preparation and choice, and opportunities for physical activity and sport. Support, education, and opportunity at home and at school, are often associated with the success of lifestyle interventions, and may enable adolescents to make positive choices, and engage in health promoting behaviors during adolescence and childbearing years. Full article

(This article belongs to the Special Issue Childhood Obesity: Novel Approaches to a Global Problem)

Review

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Open AccessReview The Biomechanisms of Metal and Metal-Oxide Nanoparticles’ Interactions with Cells

by Sondra S. Teske and Corrella S. Detweiler

Int. J. Environ. Res. Public Health 2015, 12(2), 1112-1134; doi:10.3390/ijerph120201112

Received: 3 December 2014 / Revised: 31 December 2014 / Accepted: 14 January 2015 / Published: 22 January 2015

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Abstract

Humans are increasingly exposed to nanoparticles (NPs) in medicine and in industrial settings, where significant concentrations of NPs are common. However, NP interactions with and effects on biomolecules and organisms have only recently been addressed. Within we review the literature regarding proposed modes

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Humans are increasingly exposed to nanoparticles (NPs) in medicine and in industrial settings, where significant concentrations of NPs are common. However, NP interactions with and effects on biomolecules and organisms have only recently been addressed. Within we review the literature regarding proposed modes of action for metal and metal-oxide NPs, two of the most prevalent types manufactured. Iron-oxide NPs, for instance, are used as tracers for magnetic resonance imaging of oncological tumors and as vehicles for therapeutic drug delivery. Factors and theories that determine the physicochemical and biokinetic behaviors of NPs are discussed, along with the observed toxicological effects of NPs on cells. Key thermodynamic and kinetic models that explain the sources of energy transfer from NPs to biological targets are summarized, in addition to quantitative structural activity relationship (QSAR) modeling efforts. Future challenges for nanotoxicological research are discussed. We conclude that NP studies based on cell culture are often inconsistent and underestimate the toxicity of NPs. Thus, the effect of NPs needs to be examined in whole animal systems. Full article

(This article belongs to the Special Issue Emerging Contaminants in the Environment)

Open AccessReview Nuclear and Mitochondrial DNA Alterations in Newborns with Prenatal Exposure to Cigarette Smoke

by Francesca Pirini, Elisa Guida, Fahcina Lawson, Andrea Mancinelli and Rafael Guerrero-Preston

Int. J. Environ. Res. Public Health 2015, 12(2), 1135-1155; doi:10.3390/ijerph120201135

Received: 11 November 2014 / Accepted: 13 January 2015 / Published: 22 January 2015

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Abstract

Newborns exposed to maternal cigarette smoke (CS) in utero have an increased risk of developing chronic diseases, cancer, and acquiring decreased cognitive function in adulthood. Although the literature reports many deleterious effects associated with maternal cigarette smoking on the fetus, the molecular alterations

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Newborns exposed to maternal cigarette smoke (CS) in utero have an increased risk of developing chronic diseases, cancer, and acquiring decreased cognitive function in adulthood. Although the literature reports many deleterious effects associated with maternal cigarette smoking on the fetus, the molecular alterations and mechanisms of action are not yet clear. Smoking may act directly on nuclear DNA by inducing mutations or epigenetic modifications. Recent studies also indicate that smoking may act on mitochondrial DNA by inducing a change in the number of copies to make up for the damage caused by smoking on the respiratory chain and lack of energy. In addition, individual genetic susceptibility plays a significant role in determining the effects of smoking during development. Furthermore, prior exposure of paternal and maternal gametes to cigarette smoke may affect the health of the developing individual, not only the in utero exposure. This review examines the genetic and epigenetic alterations in nuclear and mitochondrial DNA associated with smoke exposure during the most sensitive periods of development (prior to conception, prenatal and early postnatal) and assesses how such changes may have consequences for both fetal growth and development. Full article

Open AccessReview The Challenges of Underweight and Overweight in South African Children: Are We Winning or Losing the Battle? A Systematic Review

by Makama Andries Monyeki, Adedapo Awotidebe, Gert L. Strydom, J. Hans de Ridder, Ramoteme Lesly Mamabolo and Han C. G. Kemper

Int. J. Environ. Res. Public Health 2015, 12(2), 1156-1173; doi:10.3390/ijerph120201156

Received: 18 November 2014 / Revised: 14 January 2015 / Accepted: 15 January 2015 / Published: 22 January 2015

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Abstract

Underweight and overweight are adverse effects of malnutrition and both are associated with negative health consequences in children and adolescents. In South Africa, the burden of economic and social disparity coexists with malnutrition in children. The purpose of this study was to review

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Underweight and overweight are adverse effects of malnutrition and both are associated with negative health consequences in children and adolescents. In South Africa, the burden of economic and social disparity coexists with malnutrition in children. The purpose of this study was to review available South Africa studies regarding the comprehensive summary of prevalence of underweight and overweight and evaluates government policies in addressing undernutrition and overnutrition in South African children and adolescents. We searched subject-specific electronic bibliographic databases of observational studies published on malnutrition, undernutrition, overnutrition, underweight and overweight in South African boys and girls from birth to 20 years of age in studies published on or after 1990. A total of sixteen cross-sectional, three longitudinal studies and one report met the criteria for inclusion in this review. Descriptive data synthesis revealed the small number of longitudinal studies highlights the dearth of research in tracking undernutrition and overnutrition in South African children. In this review, 0.7%–66% of underweight was reported among children in rural areas compared to a 3.1%–32.4% of overweight in urban areas. All studies reported a higher rate of underweight in boys than girls who were significantly more likely to have higher body fat. The data indicated that both underweight and overweight were positively related with health-related physical activity and psychological health problems such as low activity, low fitness, low self-image and self-esteem. Numerous recommendations were made in the reviewed studies, however effective strategic programs in eradicating both underweight and overweight are minimal. It is evident from the reviewed studies that the burden of underweight and overweight are still a problem in South African children. The most highly affected by underweight are rural children, while children in urban areas in transition are faced with burden of overweight. There is little evidence to suggest that government strategic programs are effective in addressing underweight and overweight in South African children. Based on these findings, sustainable school-based feeding schemes and physical education programmes are needed for optimal benefits in children and adolescents. Full article

(This article belongs to the Special Issue Childhood Obesity: Novel Approaches to a Global Problem)

Open AccessReview Environmental Pollution from Illegal Waste Disposal and Health Effects: A Review on the “Triangle of Death”

by Maria Triassi, Rossella Alfano, Maddalena Illario, Antonio Nardone, Oreste Caporale and Paolo Montuori

Int. J. Environ. Res. Public Health 2015, 12(2), 1216-1236; doi:10.3390/ijerph120201216

Received: 16 December 2014 / Accepted: 15 January 2015 / Published: 22 January 2015

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Abstract

The term “triangle of death” was used for the first time by Senior and Mazza in the journal The Lancet Oncology referring to the eastern area of the Campania Region (Southern Italy) which has one of the worst records of illegal waste dumping

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The term “triangle of death” was used for the first time by Senior and Mazza in the journal The Lancet Oncology referring to the eastern area of the Campania Region (Southern Italy) which has one of the worst records of illegal waste dumping practices. In the past decades, many studies have focused on the potential of illegal waste disposal to cause adverse effects on human health in this area. The great heterogeneity in the findings, and the bias in media communication has generated great healthcare doubts, anxieties and alarm. This paper addresses a review of the up-to-date literature on the “triangle of death”, bringing together the available information on the occurrence and severity of health effects related to illegal waste disposal. The Scopus database was searched using the search terms “waste”, “Campania”, “Naples”, “triangle of death” and “human biomonitoring”. Despite the methodological and sampling heterogeneity between the studies, this review examines the evidence from published data concerning cancer incidence, childhood mortality and birth defects, so that the current situation, knowledge gaps and research priorities can be established. The review aims to provide a contribution to the scientific community, and to respond to the concerns of the general population. Full article

(This article belongs to the Special Issue Hazardous Waste and Human Health)

Open AccessReview Environmental Geochemistry of Cerium: Applications and Toxicology of Cerium Oxide Nanoparticles

by Jessica T. Dahle and Yuji Arai

Int. J. Environ. Res. Public Health 2015, 12(2), 1253-1278; doi:10.3390/ijerph120201253

Received: 22 September 2014 / Accepted: 15 January 2015 / Published: 23 January 2015

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Abstract

Cerium is the most abundant of rare-earth metals found in the Earth’s crust. Several Ce-carbonate, -phosphate, -silicate, and -(hydr)oxide minerals have been historically mined and processed for pharmaceutical uses and industrial applications. Of all Ce minerals, cerium dioxide has received much attention in

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Cerium is the most abundant of rare-earth metals found in the Earth’s crust. Several Ce-carbonate, -phosphate, -silicate, and -(hydr)oxide minerals have been historically mined and processed for pharmaceutical uses and industrial applications. Of all Ce minerals, cerium dioxide has received much attention in the global nanotechnology market due to their useful applications for catalysts, fuel cells, and fuel additives. A recent mass flow modeling study predicted that a major source of CeO₂ nanoparticles from industrial processing plants (e.g., electronics and optics manufactures) is likely to reach the terrestrial environment such as landfills and soils. The environmental fate of CeO₂ nanoparticles is highly dependent on its physcochemical properties in low temperature geochemical environment. Though there are needs in improving the analytical method in detecting/quantifying CeO₂ nanoparticles in different environmental media, it is clear that aquatic and terrestrial organisms have been exposed to CeO₂ NPs, potentially yielding in negative impact on human and ecosystem health. Interestingly, there has been contradicting reports about the toxicological effects of CeO₂ nanoparticles, acting as either an antioxidant or reactive oxygen species production-inducing agent). This poses a challenge in future regulations for the CeO₂ nanoparticle application and the risk assessment in the environment. Full article

(This article belongs to the Special Issue Environmental Fate and Effect of Nanoparticles and Nanomaterials)

Open AccessReview Exposure to Mercury and Aluminum in Early Life: Developmental Vulnerability as a Modifying Factor in Neurologic and Immunologic Effects

by José G. Dórea

Int. J. Environ. Res. Public Health 2015, 12(2), 1295-1313; doi:10.3390/ijerph120201295

Received: 25 November 2014 / Accepted: 20 January 2015 / Published: 23 January 2015

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Abstract

Currently, ethylmercury (EtHg) and adjuvant-Al are the dominating interventional exposures encountered by fetuses, newborns, and infants due to immunization with Thimerosal-containing vaccines (TCVs). Despite their long use as active agents of medicines and fungicides, the safety levels of these substances have never been

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Currently, ethylmercury (EtHg) and adjuvant-Al are the dominating interventional exposures encountered by fetuses, newborns, and infants due to immunization with Thimerosal-containing vaccines (TCVs). Despite their long use as active agents of medicines and fungicides, the safety levels of these substances have never been determined, either for animals or for adult humans—much less for fetuses, newborns, infants, and children. I reviewed the literature for papers reporting on outcomes associated with (a) multiple exposures and metabolism of EtHg and Al during early life; (b) physiological and metabolic characteristics of newborns, neonates, and infants relevant to xenobiotic exposure and effects; (c) neurobehavioral, immunological, and inflammatory reactions to Thimerosal and Al-adjuvants resulting from TCV exposure in infancy. Immunological and neurobehavioral effects of Thimerosal-EtHg and Al-adjuvants are not extraordinary; rather, these effects are easily detected in high and low income countries, with co-exposure to methylmercury (MeHg) or other neurotoxicants. Rigorous and replicable studies (in different animal species) have shown evidence of EtHg and Al toxicities. More research attention has been given to EtHg and findings have showed a solid link with neurotoxic effects in humans; however, the potential synergic effect of both toxic agents has not been properly studied. Therefore, early life exposure to both EtHg and Al deserves due consideration. Full article

Open AccessReview Exposure to the Riot Control Agent CS and Potential Health Effects: A Systematic Review of the Evidence

by Yiannis Dimitroglou, George Rachiotis and Christos Hadjichristodoulou

Int. J. Environ. Res. Public Health 2015, 12(2), 1397-1411; doi:10.3390/ijerph120201397

Received: 3 December 2014 / Accepted: 20 January 2015 / Published: 27 January 2015

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Abstract

o-Chlorobenzylidene malononitrile (CS) is one of the most extensively used riot control agents. Our aim was to conduct a systematic review of the potential health effects related to CS exposure. We searched for papers in English between 1991 and 2014. Thirty five

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o-Chlorobenzylidene malononitrile (CS) is one of the most extensively used riot control agents. Our aim was to conduct a systematic review of the potential health effects related to CS exposure. We searched for papers in English between 1991 and 2014. Thirty five (35) studies (25 case reports, seven descriptive studies and three analytical studies) were included in the review. In the twenty five case reports/series 90 cases of exposure to CS and their clinical effects are presented. Their mean age was 25.7 years and 62.0% were males. In addition, 61% of the cases described dermal, 40% respiratory, 57% ocular clinical effects. Life threatening situations as well as long-term health effects were found and were related with exposure to confined/enclosed space. Descriptive and analytical studies have shown attack rates ranging from 12% to 40%. Subjects who were sprayed by the police more often needed special treatment and reported adverse health effects. Apart from transient clinical effects, CS could have lasting and serious effects on human health. Better surveillance of the subjects exposed to CS and completion of cohort studies among exposed populations will illuminate the spectrum of the health effects of exposure to CS. Full article

Open AccessReview Multidrug Efflux Pumps from Enterobacteriaceae, Vibrio cholerae and Staphylococcus aureus Bacterial Food Pathogens

by Jody L. Andersen, Gui-Xin He, Prathusha Kakarla, Ranjana KC, Sanath Kumar, Wazir Singh Lakra, Mun Mun Mukherjee, Indrika Ranaweera, Ugina Shrestha, Thuy Tran and Manuel F. Varela

Int. J. Environ. Res. Public Health 2015, 12(2), 1487-1547; doi:10.3390/ijerph120201487

Received: 16 October 2014 / Accepted: 15 January 2015 / Published: 28 January 2015

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Abstract

Foodborne illnesses caused by bacterial microorganisms are common worldwide and constitute a serious public health concern. In particular, microorganisms belonging to the Enterobacteriaceae and Vibrionaceae families of Gram-negative bacteria, and to the Staphylococcus genus of Gram-positive bacteria are important causative agents of food

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Foodborne illnesses caused by bacterial microorganisms are common worldwide and constitute a serious public health concern. In particular, microorganisms belonging to the Enterobacteriaceae and Vibrionaceae families of Gram-negative bacteria, and to the Staphylococcus genus of Gram-positive bacteria are important causative agents of food poisoning and infection in the gastrointestinal tract of humans. Recently, variants of these bacteria have developed resistance to medically important chemotherapeutic agents. Multidrug resistant Escherichia coli, Salmonella enterica, Vibrio cholerae, Enterobacter spp., and Staphylococcus aureus are becoming increasingly recalcitrant to clinical treatment in human patients. Of the various bacterial resistance mechanisms against antimicrobial agents, multidrug efflux pumps comprise a major cause of multiple drug resistance. These multidrug efflux pump systems reside in the biological membrane of the bacteria and actively extrude antimicrobial agents from bacterial cells. This review article summarizes the evolution of these bacterial drug efflux pump systems from a molecular biological standpoint and provides a framework for future work aimed at reducing the conditions that foster dissemination of these multidrug resistant causative agents through human populations. Full article

(This article belongs to the Special Issue Antibiotic Resistant and Pathogenic Bacteria in the Food Production Environment: Epidemiological Evolution and Control)

Open AccessReview Impact of Air Pollutants on Oxidative Stress in Common Autophagy-Mediated Aging Diseases

by Mohamed Saber Numan, Jacques P. Brown and Laëtitia Michou

Int. J. Environ. Res. Public Health 2015, 12(2), 2289-2305; doi:10.3390/ijerph120202289

Received: 22 November 2014 / Revised: 13 January 2015 / Accepted: 11 February 2015 / Published: 17 February 2015

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Abstract

Atmospheric pollution-induced cellular oxidative stress is probably one of the pathogenic mechanisms involved in most of the common autophagy-mediated aging diseases, including neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS), Alzheimer’s, disease, as well as Paget’s disease of bone with or without frontotemporal

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Atmospheric pollution-induced cellular oxidative stress is probably one of the pathogenic mechanisms involved in most of the common autophagy-mediated aging diseases, including neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS), Alzheimer’s, disease, as well as Paget’s disease of bone with or without frontotemporal dementia and inclusion body myopathy. Oxidative stress has serious damaging effects on the cellular contents: DNA, RNA, cellular proteins, and cellular organelles. Autophagy has a pivotal role in recycling these damaged non-functional organelles and misfolded or unfolded proteins. In this paper, we highlight, through a narrative review of the literature, that when autophagy processes are impaired during aging, in presence of cumulative air pollution-induced cellular oxidative stress and due to a direct effect on air pollutant, autophagy-mediated aging diseases may occur. Full article

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Open AccessCommentary The Meanings of Smoking to Women and Their Implications for Cessation

by Lorraine Greaves

Int. J. Environ. Res. Public Health 2015, 12(2), 1449-1465; doi:10.3390/ijerph120201449

Received: 16 October 2014 / Revised: 30 December 2014 / Accepted: 14 January 2015 / Published: 27 January 2015

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Abstract

Smoking cigarettes is a gendered activity with sex- and gender-specific uptake trends and cessation patterns. While global male smoking rates have peaked, female rates are set to escalate in the 21st century, especially in low and middle income countries. Hence, smoking cessation for

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Smoking cigarettes is a gendered activity with sex- and gender-specific uptake trends and cessation patterns. While global male smoking rates have peaked, female rates are set to escalate in the 21st century, especially in low and middle income countries. Hence, smoking cessation for women will be an ongoing issue and requires refreshed attention. Public health and health promotion messages are being challenged to be increasingly tailored, taking gender into account. Women-centred approaches that include harm-reduction, motivational interviewing and trauma-informed elements are the new frontiers in interventions to encourage smoking cessation for women. Such approaches are linked to the meanings of smoking to women, the adaptive function of, and the overall role of smoking cigarettes in the context of women’s lives. These approaches respect gender and sex-related factors that affect smoking and smoking cessation and respond to these issues, not by reinforcing destructive or negative gender norms, but with insight. This article discusses a women-centred approach to smoking cessation that could underpin initiatives in clinical, community or public health settings and could inform campaigns and messaging. Full article

(This article belongs to the Special Issue Tobacco Control)

Open AccessAddendum Addendum: Han, Y.; Grogan-Kaylor, A.; Delva, J.; Xie, Y. Estimating the Heterogeneous Relationship Between Peer Drinking and Youth Alcohol Consumption in Chile Using Propensity Score Stratification. Int. J. Environ. Res. Public Health 2014, 11, 11879–11897

by Yoonsun Han, Andrew Grogan-Kaylor, Jorge Delva and Yu Xie

Int. J. Environ. Res. Public Health 2015, 12(2), 1649-1650; doi:10.3390/ijerph120201649

Received: 14 January 2015 / Accepted: 27 January 2015 / Published: 30 January 2015

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Abstract The authors wish to update the Acknowledgments in their paper published in International Journal of Environmental Research and Public Health [1], doi:10.3390/ijerph111111879, website: http://www.mdpi.com/1660-4601/11/11/11879.[...] Full article

Open AccessShort Communication Surveillance of Hepatitis E Virus Contamination in Shellfish in China

by Shenyang Gao, Dandan Li, Enhui Zha, Tiezhong Zhou, Shen Wang and Xiqing Yue

Int. J. Environ. Res. Public Health 2015, 12(2), 2026-2036; doi:10.3390/ijerph120202026

Received: 27 October 2014 / Revised: 14 January 2015 / Accepted: 28 January 2015 / Published: 11 February 2015

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Abstract

Background: Hepatitis E virus (HEV) has been confirmed to be a zoonotic virus of worldwide distribution. HEV contamination in the water environment has not been well examined in China. The objective of this study was to evaluate HEV contamination in shellfish in

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Background: Hepatitis E virus (HEV) has been confirmed to be a zoonotic virus of worldwide distribution. HEV contamination in the water environment has not been well examined in China. The objective of this study was to evaluate HEV contamination in shellfish in a coastal area of China. Such contamination would be significant for evaluating public health risks. Methods: samples of three species shellfish were collected from thirteen points of estuarine tidal flats around the Bohai Gulf and screened for HEV RNA using an in-house nested RT-PCR assay. The detected HEV-positive samples were further verified by gene cloning and sequencing analysis. Results: the overall HEV-positive detection rate is approximately 17.5% per kilogram of shellfish. HEV was more common among S. subcrenata (28.2%), followed by A. granosa (14.3%) and R. philippinarum (11.5%). The phylogenetic analysis of the 13 HEV strains detected revealed that gene fragments fell into two known 4 sub-genotypes (4b/4d) groups and another unknown group. Conclusions: 13 different sub-genotype 4 HEVs were found in contaminated shellfish in the Bohai Gulf rim. The findings suggest that a health risk may exist for users of waters in the Bonhai area and to consumers of shellfish. Further research is needed to assess the sources and infectivity of HEV in these settings, and to evaluate additional shellfish harvesting areas. Full article

(This article belongs to the Special Issue Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns)

Open AccessAddendum Addendum: Shiue, I.; et al. 2014 Future Earth Young Scientists Conference on Integrated Science and Knowledge Co-Production for Ecosystems and Human Well-Being. Int. J. Environ. Res. Public Health 2014, 11, 11553–11558

by Ivy Shiue, Leah Samberg, Benard Kulohoma, Diana Dogaru, Carina Wyborn, Perrine Hamel, Peter Søgaard Jørgensen, Paul Lussier, Bharath Sundaram, Michelle Lim and Antonio Tironi

Int. J. Environ. Res. Public Health 2015, 12(2), 2088-2089; doi:10.3390/ijerph120202088

Received: 5 December 2014 / Revised: 1 January 2015 / Accepted: 10 February 2015 / Published: 12 February 2015

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Abstract The authors would like to add the following affiliation for Peter Søgaard Jørgensen of paper [1]: ⁸ International Network of Next-Generation Ecologists, Universitetsparken 15, Building 3, Copenhagen 2100, Denmark[...] Full article

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Int. J. Environ. Res. Public Health, Volume 12, Issue 2 (February 2015), Pages 1054-2329

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