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Int. J. Environ. Res. Public Health, Volume 14, Issue 6 (June 2017)

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Cover Story Over the last two years, Europe has been witnessing the largest migration recorded in their recent [...] Read more.
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Open AccessArticle Public Open Spaces and Leisure-Time Walking in Brazilian Adults
Int. J. Environ. Res. Public Health 2017, 14(6), 553; doi:10.3390/ijerph14060553
Received: 15 February 2017 / Revised: 14 March 2017 / Accepted: 15 March 2017 / Published: 23 May 2017
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Abstract
Access to public open space is important to increase leisure-time walking (LTW) in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks,
[...] Read more.
Access to public open space is important to increase leisure-time walking (LTW) in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks, bike paths, and squares) and the mix of these recreational destinations near the homes of adults participating in the Sao Paulo Health Survey (n = 3145). LTW was evaluated by a questionnaire. We delineated buffers (500, 1000, and 1500 m) from the geographic coordinates of the adults’ residential addresses using a geographic information system. We used multilevel logistic regression taking account of clustering by census tracts and households, and with adjustment for social, demographics, and health characteristics. The main results showed that the presence of at least two recreational destinations within a 500-m buffer of participants’ homes were associated with an increased odds of LTW compared with no destinations present (OR = 1.65; 95% CI 1.09–2.55). No associations were found for destinations further away. These results support actions outlined in the new urban plan for Sao Paulo city and could be used to highlight the importance access to a mix of public open spaces to promote physical activity in megacities of middle-income countries. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Increasing the Use of Urban Greenways in Developing Countries: A Case Study on Wutong Greenway in Shenzhen, China
Int. J. Environ. Res. Public Health 2017, 14(6), 554; doi:10.3390/ijerph14060554
Received: 16 April 2017 / Revised: 17 May 2017 / Accepted: 20 May 2017 / Published: 23 May 2017
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Abstract
Given the benefits of urban greenways on the health and well-being of urban populations, the increased use of urban greenways has garnered increasing attention. Studies on urban greenways, however, have been mostly conducted in Western countries, whereas there is limited knowledge on greenway
[...] Read more.
Given the benefits of urban greenways on the health and well-being of urban populations, the increased use of urban greenways has garnered increasing attention. Studies on urban greenways, however, have been mostly conducted in Western countries, whereas there is limited knowledge on greenway use in urban areas in developing countries. To address this shortcoming, the present study selected Wutong Greenway in Shenzhen, China, as a case study and focused on the use pattern and factors that influence the frequency and duration of urban greenway use in developing countries. An intercept survey of greenway users was conducted, and 1257 valid questionnaires were obtained. Multiple logistic regression analysis was used to examine the relationship between potential predictors and greenway use. Results showed that visitors with a varied sociodemographic background use Wutong Greenway with high intensity. Various factors affect the use of urban greenways, including individual and environmental factors and greenway use patterns. Unlike previous studies, we found that accommodation type, length of stay at present residence and mode of transportation to the greenway are important factors that affect greenway use. In contrast with studies conducted in Western countries, less-educated and low-income respondents visit the Wutong greenway even more frequently than others. Thus, the greenway is an important public asset that promotes social equity and that all residents can freely use. To better serve citizens, we suggest that the greenway network should be extended to other areas and that its environmental quality should be improved. Full article
(This article belongs to the Special Issue Sustainable Transportation and Health)
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Open AccessArticle Ephedra-Treated Donor-Derived Gut Microbiota Transplantation Ameliorates High Fat Diet-Induced Obesity in Rats
Int. J. Environ. Res. Public Health 2017, 14(6), 555; doi:10.3390/ijerph14060555
Received: 17 March 2017 / Revised: 11 May 2017 / Accepted: 15 May 2017 / Published: 23 May 2017
Cited by 1 | PDF Full-text (7194 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Changes in gut microbiota (GM) are closely associated with metabolic syndrome, obesity, type 2 diabetes and so on. Several medicinal herbs, including Ephedra sinica (Es), have anti-obesity effects that ameliorate metabolic disorders. Therefore, in this study we evaluated whether Es maintains its anti-obesity
[...] Read more.
Changes in gut microbiota (GM) are closely associated with metabolic syndrome, obesity, type 2 diabetes and so on. Several medicinal herbs, including Ephedra sinica (Es), have anti-obesity effects that ameliorate metabolic disorders. Therefore, in this study we evaluated whether Es maintains its anti-obesity effect through Es-altered gut microbiota (EsM) transplantation. GM was isolated from cecal contents of Es treated and untreated rats following repeated transplants into obese rats via oral gavage over three weeks. High-fat-diet (HFD)-induced obese rats transplanted with EsM lost significant body weight, epididymal fat, and perirenal fat weight, but no remarkable changes were observed in abdominal fat, liver, cecum weight and food efficiency ratio. In addition, treatment with EsM also significantly lowered the fasting blood glucose, serum insulin level, and insulin resistance index. Meanwhile, EsM transplantation significantly reduced gene expression of proinflammatory cytokines interleukin-1 and monocyte chemotactic protein-1. Rats treated with EsM also showed changed GM composition, especially blautia, roseburia and clostridium, significantly reduced the level of endotoxin and markedly increased the acetic acid in feces. Overall, our results demonstrated that EsM ameliorates HFD-induced obesity and related metabolic disorders, like hyperglycemia and insulin resistance, and is strongly associated with modulating the distribution of GM, enterogenous endotoxin and enteral acetic acid. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle The Influence of Neighbourhoods and the Social Environment on Sedentary Behaviour in Older Adults in Three Prospective Cohorts
Int. J. Environ. Res. Public Health 2017, 14(6), 557; doi:10.3390/ijerph14060557
Received: 30 March 2017 / Revised: 9 May 2017 / Accepted: 18 May 2017 / Published: 24 May 2017
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Abstract
Sedentary behaviour is an emerging risk factor for poor health. This study aimed to identify ecological determinants of sedentary behaviour, for which evidence is currently scarce. The study participants were community dwelling adults from, respectively, the Lothian Birth Cohort 1936 (n = 271,
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Sedentary behaviour is an emerging risk factor for poor health. This study aimed to identify ecological determinants of sedentary behaviour, for which evidence is currently scarce. The study participants were community dwelling adults from, respectively, the Lothian Birth Cohort 1936 (n = 271, mean age 79) and the 1930s (n = 119, mean age 83) and 1950s (n = 310, mean age 64) cohorts of the West of Scotland Twenty-07 study. The outcome measure, percentage of waking time spent sedentary (sedentary time), was measured using an activPAL activity monitor worn continuously for seven days. Potential determinants included objective and subjective neighbourhood measures such as natural space, crime, social cohesion and fear of crime. Other determinants included measures of social participation such as social support, social group membership and providing care. Results from multivariable regression analyses indicated that providing care was associated with reduced sedentary time in retired participants in all cohorts. Fear of crime and perceived absence of services were associated with increased sedentary time for retired 1950s cohort members. Higher crime rates were associated with increased sedentary time in all cohorts but this was not significant after adjustment for socio-demographic characteristics. Most other neighbourhood and social participation measures showed no association with sedentary time. Full article
(This article belongs to the Special Issue Aging and Health Promotion)
Open AccessArticle Enteric Viruses and Fecal Bacteria Indicators to Assess Groundwater Quality and Suitability for Irrigation
Int. J. Environ. Res. Public Health 2017, 14(6), 558; doi:10.3390/ijerph14060558
Received: 25 March 2017 / Revised: 20 May 2017 / Accepted: 22 May 2017 / Published: 24 May 2017
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Abstract
According to Italian Ministerial Decree No. 185 of 12 June 2003, water is considered suitable for irrigation if levels of fecal bacteria (i.e., Escherichia coli and Salmonella) are within certain parameters. The detection of other microorganisms is not required. The aim of
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According to Italian Ministerial Decree No. 185 of 12 June 2003, water is considered suitable for irrigation if levels of fecal bacteria (i.e., Escherichia coli and Salmonella) are within certain parameters. The detection of other microorganisms is not required. The aim of this study is to determine the bacteriological quality of groundwater used for irrigation and the occurrence of enteric viruses (Norovirus, Enterovirus, Rotavirus, Hepatovirus A), and to compare the presence of viruses with the fecal bacteria indicators. A total of 182 wells was analyzed. Widespread fecal contamination of Apulian aquifers was detected (141 wells; 77.5%) by the presence of fecal bacteria (i.e., E. coli, Salmonella, total coliforms, and enterococci). Considering bacteria included in Ministerial Decree No. 185, the water from 35 (19.2%) wells was unsuitable for irrigation purposes. Among 147 wells with water considered suitable, Norovirus, Rotavirus, and Enterovirus were detected in 23 (15.6%) wells. No Hepatovirus A was isolated. Consequently, 58 wells (31.9%) posed a potential infectious risk for irrigation use. This study revealed the inadequacy of fecal bacteria indicators to predict the occurrence of viruses in groundwater and it is the first in Italy to describe the presence of human rotaviruses in well water used for irrigation. Full article
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Open AccessArticle Epidemiological Features and Forecast Model Analysis for the Morbidity of Influenza in Ningbo, China, 2006–2014
Int. J. Environ. Res. Public Health 2017, 14(6), 559; doi:10.3390/ijerph14060559
Received: 5 April 2017 / Revised: 17 May 2017 / Accepted: 19 May 2017 / Published: 25 May 2017
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Abstract
This study aimed to identify circulating influenza virus strains and vulnerable population groups and investigate the distribution and seasonality of influenza viruses in Ningbo, China. Then, an autoregressive integrated moving average (ARIMA) model for prediction was established. Influenza surveillance data for 2006–2014 were
[...] Read more.
This study aimed to identify circulating influenza virus strains and vulnerable population groups and investigate the distribution and seasonality of influenza viruses in Ningbo, China. Then, an autoregressive integrated moving average (ARIMA) model for prediction was established. Influenza surveillance data for 2006–2014 were obtained for cases of influenza-like illness (ILI) (n = 129,528) from the municipal Centers for Disease Control and virus surveillance systems of Ningbo, China. The ARIMA model was proposed to predict the expected morbidity cases from January 2015 to December 2015. Of the 13,294 specimens, influenza virus was detected in 1148 (8.64%) samples, including 951 (82.84%) influenza type A and 197 (17.16%) influenza type B viruses; the influenza virus isolation rate was strongly correlated with the rate of ILI during the overall study period (r = 0.20, p < 0.05). The ARIMA (1, 1, 1) (1, 1, 0)12 model could be used to predict the ILI incidence in Ningbo. The seasonal pattern of influenza activity in Ningbo tended to peak during the rainy season and winter. Given those results, the model we established could effectively predict the trend of influenza-related morbidity, providing a methodological basis for future influenza monitoring and control strategies in the study area. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Burnout and Its Relationships with Alexithymia, Stress, and Social Support among Romanian Medical Students: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2017, 14(6), 560; doi:10.3390/ijerph14060560
Received: 1 March 2017 / Revised: 24 April 2017 / Accepted: 22 May 2017 / Published: 25 May 2017
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Abstract
Medical school students often experience emotional difficulties when handling the challenges of their formation, occasionally leading to burnout. In this study, we measured the prevalence of burnout and its relationships with perceived stress, perceived social support, and alexithymia in medical students from the
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Medical school students often experience emotional difficulties when handling the challenges of their formation, occasionally leading to burnout. In this study, we measured the prevalence of burnout and its relationships with perceived stress, perceived social support, and alexithymia in medical students from the largest academic medical community in Romania. A cross-sectional survey was administered to a randomized sample of 299 preclinical medical students at the University of Medicine in Bucharest. Participants completed four standardized questionnaires. In addition to the assessment of burnout prevalence, stepwise backward regression was used to establish which variables had the highest correlation to burnout components. Further, t-tests were run to assess gender-related differences. Overall, burnout prevalence was 15.05%. Perceived stress was found to be the strongest predictor of emotional exhaustion and lack of accomplishment, while the strongest predictors of depersonalization were low perceived social support (in women) and alexithymia (in men). Women appear to be more vulnerable to two of the components of burnout (emotional exhaustion and low personal accomplishment) and associate higher perceived stress and alexithymia. These results suggest that interventions addressing academic burnout could benefit from being gender-specific, with focus on key elements, such as perceived stress and alexithymia. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Lithium in the Natural Waters of the South East of Ireland
Int. J. Environ. Res. Public Health 2017, 14(6), 561; doi:10.3390/ijerph14060561
Received: 21 March 2017 / Revised: 18 May 2017 / Accepted: 23 May 2017 / Published: 26 May 2017
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Abstract
The South East of Ireland (County Carlow) contains a deposit of the valuable lithium-bearing mineral spodumene (LiAl(SiO3)2). This resource has recently attracted interest and abstractive mining in the area is a possibility for the future. The open cast mining
[...] Read more.
The South East of Ireland (County Carlow) contains a deposit of the valuable lithium-bearing mineral spodumene (LiAl(SiO3)2). This resource has recently attracted interest and abstractive mining in the area is a possibility for the future. The open cast mining of this resource could represent a potential hazard in the form of metalliferous pollution to local water. The population of County Carlow is just under 60,000. The local authority reports that approximately 75.7% of the population’s publicly supplied drinking water is abstracted from surface water and 11.6% from groundwater. In total, 12.7% of the population abstract their water from private groundwater wells. Any potential entry of extraneous metals into the area’s natural waters will have implications for people in county Carlow. It is the goal of this paper to establish background concentrations of lithium and other metals in the natural waters prior to any mining activity. Our sampling protocol totaled 115 sites along five sampling transects, sampled through 2015. From this dataset, we report a background concentration of dissolved lithium in the natural waters of County Carlow, surface water at x ¯ = 0.02, SD = 0.02 ranging from 0 to 0.091 mg/L and groundwater at x ¯ = 0.023, SD = 0.02 mg/L ranging from 0 to 0.097 mg/L. Full article
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Open AccessArticle Work-Related Musculoskeletal Disorders and Risk Factors among Chinese Medical Staff of Obstetrics and Gynecology
Int. J. Environ. Res. Public Health 2017, 14(6), 562; doi:10.3390/ijerph14060562
Received: 24 March 2017 / Revised: 30 April 2017 / Accepted: 20 May 2017 / Published: 26 May 2017
Cited by 1 | PDF Full-text (604 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Medical staff in the department of obstetrics and gynecology are a group of professionals reportedly at high risk of work-related musculoskeletal disorders (WMSD), however, little is known about the current status of this problem in China. The aim of this study was to
[...] Read more.
Medical staff in the department of obstetrics and gynecology are a group of professionals reportedly at high risk of work-related musculoskeletal disorders (WMSD), however, little is known about the current status of this problem in China. The aim of this study was to investigate prevalence and risk factors of work-related musculoskeletal disorders among this population in China. A self-developed questionnaire was distributed to 1017 obstetrics and gynecology practitioners to collect information on musculoskeletal symptoms and relevant factors. Prevalence and severity of work-related musculoskeletal disorders in different parts of the body were calculated and the relationship between personal and ergonomic factors and work-related musculoskeletal disorders was analyzed using Chi-square test and unconditional logistic regression models. The results indicated a high prevalence of 85.5% among the subjects, with the shoulder (n = 575, 62.0%), neck (n = 560, 60.3%) and lower back (n = 504, 54.3%) being the three most affected regions. Individual, postural, work-environmental as well as psychosocial factors were recognized to be associated with WMSDs in different body parts. Therefore, attention must be given to the problem of musculoskeletal disorders among Chinese obstetrics and gynecology staff. It is recommended to develop good life habits, improve work environment, adjust work organization as well as train on proper postures in their daily operation. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Measuring Blue Space Visibility and ‘Blue Recreation’ in the Everyday Lives of Children in a Capital City
Int. J. Environ. Res. Public Health 2017, 14(6), 563; doi:10.3390/ijerph14060563
Received: 17 April 2017 / Revised: 23 May 2017 / Accepted: 24 May 2017 / Published: 26 May 2017
Cited by 1 | PDF Full-text (7654 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Blue spaces (water bodies) may promote positive mental and physical health through opportunities for relaxation, recreation, and social connections. However, we know little about the nature and extent of everyday exposure to blue spaces, particularly in settings outside the home or among children,
[...] Read more.
Blue spaces (water bodies) may promote positive mental and physical health through opportunities for relaxation, recreation, and social connections. However, we know little about the nature and extent of everyday exposure to blue spaces, particularly in settings outside the home or among children, nor whether exposure varies by individual or household characteristics. Wearable cameras offer a novel, reliable method for blue space exposure measurement. In this study, we used images from cameras worn over two days by 166 children in Wellington, New Zealand, and conducted content and blue space quantification analysis on each image (n = 749,389). Blue space was identified in 24,721 images (3.6%), with a total of 23 blue recreation events. Visual exposure and participation in blue recreation did not differ by ethnicity, weight status, household deprivation, or residential proximity to the coastline. Significant differences in both visual exposure to blue space and participation in blue recreation were observed, whereby children from the most deprived schools had significantly higher rates of blue space exposure than children from low deprivation schools. Schools may be important settings to promote equitable blue space exposures. Childhood exposures to blue space may not follow the expected income inequality trends observed among adults. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Evaluation of the Dietary Intake of Cadmium, Lead and Mercury and Its Relationship with Bone Health among Postmenopausal Women in Spain
Int. J. Environ. Res. Public Health 2017, 14(6), 564; doi:10.3390/ijerph14060564
Received: 10 March 2017 / Revised: 18 May 2017 / Accepted: 20 May 2017 / Published: 26 May 2017
Cited by 1 | PDF Full-text (630 KB) | HTML Full-text | XML Full-text
Abstract
Background: Heavy metals, such as lead, cadmium, and mercury, are absorbed through contaminated food sources and water. Few studies have investigated the extent to which dietary heavy metals are associated with low bone mineral density. Aims: We aimed to characterize the dietary intake
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Background: Heavy metals, such as lead, cadmium, and mercury, are absorbed through contaminated food sources and water. Few studies have investigated the extent to which dietary heavy metals are associated with low bone mineral density. Aims: We aimed to characterize the dietary intake of the heavy metals lead, cadmium and mercury among healthy, non-smoking postmenopausal women in Spain. Furthermore, we sought to establish a putative relationship between bone health and the intake of these heavy metals in this population. Study Design: The daily intake of the heavy metals considered for the different food groups was calculated by accounting for food content and consumption in 281 postmenopausal women. Bone measurements were performed using a Quantitative Bone Ultrasound (QUS), a Dual-Energy X-ray Absorptiometry (DXA) and a Peripheral Quantitative Computed Tomography (pQCT). Results: The average estimated dietary cadmium exposure among the 281 women studied was 29.87 μg/day (20.41–41.04) and 3.03 μg/kg body weight (b.w.; 2.17–4.40). Dietary lead exposure was 46.24 μg/day (38.11–54.77) and 4.87 μg/kg b.w. (4.00–6.14). The estimated dietary mercury exposure was 11.64 μg/day and 1.19 μg/kg b.w. (0.82–1.76). Participants were classified according to their heavy metal intake (above or below the respective medians). After further adjustment for potential confounding factors, no significant differences were found in all the measured parameters (p > 0.05). Conclusions: We did not find associations between bone health and the dietary intake of three heavy metals in postmenopausal women. Dietary intake of the measured heavy metals were within the recommended values. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Gender Differences of Arterial Stiffness and Arterial Age in Smokers
Int. J. Environ. Res. Public Health 2017, 14(6), 565; doi:10.3390/ijerph14060565
Received: 18 February 2017 / Revised: 7 May 2017 / Accepted: 23 May 2017 / Published: 26 May 2017
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Abstract
The present study aimed to find gender differences for arterial stiffness and arterial aging in smokers. A total of 147 smokers (71 male and 76 female, matched for age) were explored using an Arteriograph in a cross-sectional survey. Pulse wave velocity (PWV), arterial
[...] Read more.
The present study aimed to find gender differences for arterial stiffness and arterial aging in smokers. A total of 147 smokers (71 male and 76 female, matched for age) were explored using an Arteriograph in a cross-sectional survey. Pulse wave velocity (PWV), arterial age (AA), brachial and aortic augmentation index (AixBrach, AixAo), and blood pressure variables were assessed. Data about smoking intensity, such as the number of cigarettes smoked daily, smoking period, and smoking pack years (SPY) were used. No significant differences were found for PWV, AA, AixBrach and AixAo. Significant correlations were found between SPY and PWV, augmentation indices, and AA, respectively. The cut-off values for SPY were higher for an increased arterial stiffness in male compared to female smokers (18.5 and 7.5 pack year, respectively). SPY is significantly associated with an increased arterial stiffness in smokers regardless of gender, and with an increased SBPAo only in female smokers. The results of our study indicate gender differences for arterial stiffness and arterial age in smokers. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Sleep Duration, Sleep Quality, Body Mass Index, and Waist Circumference among Young Adults from 24 Low- and Middle-Income and Two High-Income Countries
Int. J. Environ. Res. Public Health 2017, 14(6), 566; doi:10.3390/ijerph14060566
Received: 14 March 2017 / Revised: 4 May 2017 / Accepted: 25 May 2017 / Published: 26 May 2017
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Abstract
Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI), waist circumference (WC) and sleep patterns, including duration and disturbances. A cross-sectional questionnaire survey and anthropometric
[...] Read more.
Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI), waist circumference (WC) and sleep patterns, including duration and disturbances. A cross-sectional questionnaire survey and anthropometric measurements were conducted with undergraduate university students that were randomly recruited in 26 universities in 24 low- and middle-income and two high-income countries. The sample included 18,211 (42.1% male and 57.9% female, mean age 21.0 in male and 20.7 years in female students) undergraduate university students. The overall BMI was a mean of 22.5 kg/m2 for men and 22.0 kg/m2 for women, and the mean WC was 78.4 cm for men and 73.8 cm for women. More than 39% of the students reported short sleep duration (≤6 h/day) and over 30% reported moderate to extreme sleep problems. In a linear multivariable regression, adjusted for sociodemographic and lifestyle factors, short sleep duration was positively associated with BMI in both men and women, and was positively associated with WC among women but not among men. Sleep quality or problems among men were not associated with BMI, while among women mild sleep problems were inversely associated with BMI, and poor sleep quality or problems were positively associated with WC both among men and women. The study confirmed an association between short sleep duration and increased BMI and, among women, increased WC, and an association between poor sleep quality and increased WC but not BMI. Further, differences in the association between sleep characteristics and BMI and WC were found by region and country income. Full article
(This article belongs to the collection Health Behavior and Public Health)
Open AccessArticle Is Housing a Health Insult?
Int. J. Environ. Res. Public Health 2017, 14(6), 567; doi:10.3390/ijerph14060567
Received: 22 March 2017 / Revised: 12 May 2017 / Accepted: 19 May 2017 / Published: 26 May 2017
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Abstract
In seeking to understand the relationship between housing and health, research attention is often focussed on separate components of people’s whole housing ‘bundles’. We propose in this paper that such conceptual and methodological abstraction of elements of the housing and health relationship limits
[...] Read more.
In seeking to understand the relationship between housing and health, research attention is often focussed on separate components of people’s whole housing ‘bundles’. We propose in this paper that such conceptual and methodological abstraction of elements of the housing and health relationship limits our ability to understand the scale of the accumulated effect of housing on health and thereby contributes to the under-recognition of adequate housing as a social policy tool and powerful health intervention. In this paper, we propose and describe an index to capture the means by which housing bundles influence health. We conceptualise the index as reflecting accumulated housing ‘insults to health’—an Index of Housing Insults (IHI). We apply the index to a sample of 1000 low-income households in Australia. The analysis shows a graded association between housing insults and health on all outcome measures. Further, after controlling for possible confounders, the IHI is shown to provide additional predictive power to the explanation of levels of mental health, general health and clinical depression beyond more traditional proxy measures. Overall, this paper reinforces the need to look not just at separate housing components but to embrace a broader understanding of the relationship between housing and health. Full article
(This article belongs to the Special Issue Housing and Health)
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Open AccessArticle Spatial Distribution of Heavy Metals and the Environmental Quality of Soil in the Northern Plateau of Spain by Geostatistical Methods
Int. J. Environ. Res. Public Health 2017, 14(6), 568; doi:10.3390/ijerph14060568
Received: 8 April 2017 / Revised: 20 May 2017 / Accepted: 25 May 2017 / Published: 26 May 2017
Cited by 1 | PDF Full-text (12330 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The environmental quality of soil in the central part of the Northern Plateau of Spain has been analyzed by studying the heavy metal content of 166 samples belonging to the horizons A, B and C of 89 soil profiles. The analysis to assess
[...] Read more.
The environmental quality of soil in the central part of the Northern Plateau of Spain has been analyzed by studying the heavy metal content of 166 samples belonging to the horizons A, B and C of 89 soil profiles. The analysis to assess the environmental risk of heavy metals in the soil was carried out by means of the spatial distribution of nine heavy metals and the use of several pollution indices. The results showed that the concentration values of heavy metals (x ± S) in the superficial soil horizons were the following: With a total of 6.71 ± 3.51 mg kg −1, the contents of Cd is 0.08 ± 0.06 mg kg−1, Co is 6.49 ± 3.21 mg kg−1, Cu is 17.19 ± 10.69 mg kg−1, Cr is 18.68 ± 12.28 mg kg−1, Hg is 0.083 ± 0.063 mg kg−1, Ni is 12.05 ± 6.76 mg kg−1, Pb is 14.10 ± 11.32 mg kg−1 and Zn is 35.31 ± 14.63 mg kg−1. These nine metals exceed the values of the natural geological background level of Tertiary period sediments and rocks that form part of the Northern Plateau in Spain. Nemerow and Potential Ecological Risk indices were calculated, with the “improved” Nemerow index allowing pollution within the soil superficial horizons to be determined. The data obtained indicated that the majority of the soil (54.61%) showed low to moderate contamination, 22.31% showed moderate contamination and 21.54% of the samples were not contaminated. If we consider the Potential of Ecological Risk Index (RI), the largest percentage of soil samples showed low (70.79%) to moderate (25.38%) ecological risk of potential contamination, where the rest of the soil presented a considerable risk of contamination. The nine trace elements were divided into three principal components: PC1 (Cu, Cr, Ni, Co and Zn), PC2 (As and Hg) and PC3 (Cd). All metals accumulated in the soil came from parent rock, agricultural practices and the run-off of residual waters towards rivers and streams caused by industrial development and an increase in population density. Finally, cartography of the spatial distribution of the heavy metal contents in the soil of the Northern Plateau of Spain was generated using Kriging interpolation methods. Furthermore, the total heavy metal contents in three soil orders present in the area, namely Entisols, Inceptisols, and Alfisols, were analyzed. Other soil parameters, such as the organic matter content, pH, clay content and cation exchange capacity, was measured to determine their influence on and correlation with the heavy metal contents. Full article
(This article belongs to the Special Issue Soil Pollution and Public Health)
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Open AccessArticle Geographical Environment Factors and Risk Assessment of Tick-Borne Encephalitis in Hulunbuir, Northeastern China
Int. J. Environ. Res. Public Health 2017, 14(6), 569; doi:10.3390/ijerph14060569
Received: 28 March 2017 / Revised: 2 May 2017 / Accepted: 20 May 2017 / Published: 26 May 2017
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Abstract
Tick-borne encephalitis (TBE) is one of natural foci diseases transmitted by ticks. Its distribution and transmission are closely related to geographic and environmental factors. Identification of environmental determinates of TBE is of great importance to understanding the general distribution of existing and potential
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Tick-borne encephalitis (TBE) is one of natural foci diseases transmitted by ticks. Its distribution and transmission are closely related to geographic and environmental factors. Identification of environmental determinates of TBE is of great importance to understanding the general distribution of existing and potential TBE natural foci. Hulunbuir, one of the most severe endemic areas of the disease, is selected as the study area. Statistical analysis, global and local spatial autocorrelation analysis, and regression methods were applied to detect the spatiotemporal characteristics, compare the impact degree of associated factors, and model the risk distribution using the heterogeneity. The statistical analysis of gridded geographic and environmental factors and TBE incidence show that the TBE patients mainly occurred during spring and summer and that there is a significant positive spatial autocorrelation between the distribution of TBE cases and environmental characteristics. The impact degree of these factors on TBE risks has the following descending order: temperature, relative humidity, vegetation coverage, precipitation and topography. A high-risk area with a triangle shape was determined in the central part of Hulunbuir; the low-risk area is located in the two belts next to the outside edge of the central triangle. The TBE risk distribution revealed that the impact of the geographic factors changed depending on the heterogeneity. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle The Impact of Prenatal Organophosphate Pesticide Exposures on Thai Infant Neurodevelopment
Int. J. Environ. Res. Public Health 2017, 14(6), 570; doi:10.3390/ijerph14060570
Received: 17 March 2017 / Revised: 14 May 2017 / Accepted: 25 May 2017 / Published: 27 May 2017
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Abstract
A birth cohort was begun to investigate the levels and sources of pesticide exposure in pregnant women living in Thailand, and to examine the effects of pesticide exposure on infant neurodevelopment at five months of age. Subjects were interviewed using questionnaires regarding their
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A birth cohort was begun to investigate the levels and sources of pesticide exposure in pregnant women living in Thailand, and to examine the effects of pesticide exposure on infant neurodevelopment at five months of age. Subjects were interviewed using questionnaires regarding their demographic characteristics, educational background, and work and home activities related to pesticide exposures. Spot urine samples were collected at 28 weeks gestation and analyzed by gas chromatography-mass spectrometry to determine maternal metabolite levels of organophosphate pesticides including dimethyl phosphate (DMP); total DEP (diethyl phosphate (DEP), diethyl thiophosphate (DETP), and diethyl dithiophosphate (DEDTP), and total DAP (the sum of all metabolite levels). At five months of age, infant development was evaluated using the Bayley Scales of Infant and Toddler Development-III (Bayley-III). Higher total DEP and total DAP metabolite levels from the mother at 28 weeks’ gestation were significantly associated with reduced motor composite scores on the Bayley-III at five months of age. The total DEP levels were also significantly associated with reduced cognitive composite scores. Prenatal concentrations of maternal urinary metabolites were associated with infant cognitive and motor development. The results of several studies now suggest the need for public health intervention to reduce prenatal pesticide exposures from both agricultural and domestic use. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Identification of a Blue Zone in a Typical Chinese Longevity Region
Int. J. Environ. Res. Public Health 2017, 14(6), 571; doi:10.3390/ijerph14060571
Received: 14 March 2017 / Revised: 26 May 2017 / Accepted: 26 May 2017 / Published: 28 May 2017
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Abstract
Influenced by a special local environment, the proportion of centenarians is particularly high in some places, known as “blue zones”. Blue zones are mysterious regions that continue to attract research. This paper explores the spatial distribution of the longevity population in a typical
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Influenced by a special local environment, the proportion of centenarians is particularly high in some places, known as “blue zones”. Blue zones are mysterious regions that continue to attract research. This paper explores the spatial distribution of the longevity population in a typical Chinese longevity region. Longevity evaluation indexes are used to analyze the longevity phenomenon in 88 towns between 2011 and 2015. Our research findings show that longevity is more important than birth rate and migration in shaping the degree of deep aging in the research region. Fluctuations in the proportion of centenarians are much higher than for nonagenarians, both in relation to towns and to years. This is because there are so few centenarians that data collected over a short time period cannot accurately represent the overall degree of longevity in a small region; data and statistics must be collected over a longer time period to achieve this. GIS analysis revealed a stable longevity zone located in the center of the research region. This area seems to help people live more easily to 90–99 years old; however, its ability to help nonagenarians live to 100 is a weaker effect. Full article
(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)
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Open AccessArticle FADS Gene Polymorphisms, Fatty Acid Desaturase Activities, and HDL-C in Type 2 Diabetes
Int. J. Environ. Res. Public Health 2017, 14(6), 572; doi:10.3390/ijerph14060572
Received: 16 April 2017 / Revised: 20 May 2017 / Accepted: 20 May 2017 / Published: 28 May 2017
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Abstract
Polyunsaturated fatty acids (PUFA) correlate with risk of dyslipidemia and cardiovascular diseases. Fatty acid desaturase (FADS) single nucleotide polymorphisms (SNPs) modulate circulating PUFA concentrations. This study examined influence of FADS1 and FADS2 genetic variants on desaturase activities and blood lipid concentrations
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Polyunsaturated fatty acids (PUFA) correlate with risk of dyslipidemia and cardiovascular diseases. Fatty acid desaturase (FADS) single nucleotide polymorphisms (SNPs) modulate circulating PUFA concentrations. This study examined influence of FADS1 and FADS2 genetic variants on desaturase activities and blood lipid concentrations in type 2 diabetes patients, and further assessed their interrelationships. Selected SNPs (FADS1: rs174547, rs174548, rs174550; FADS2: rs174575, rs174576, rs174583, rs498793 and rs2727270) were genotyped in 820 type 2 diabetes patients and compared with those reported in the HapMap. Patient subgroups (n = 176) without taking lipid-lowering medicine were studied to assess influence of tag SNPs including rs174547, rs174575, rs498793 and rs2727270 on delta-5 desaturase (D5D: 20:4 (n-6)/20:3 (n-6)) and delta-6 desaturase (D6D:18:3 (n-6)/18:2 (n-6)) activities, and blood lipids. FADS1 rs174547 TT/TC/CC and FADS2 rs2727270 CC/CT/TT were significantly (p for trend < 0.05) associated with reduced HDL-C, D5D and D6D activities. Upon adjustment for confounders, D5D (p = 0.006) correlated significantly and D6D marginally (p = 0.07) correlated with increased HDL-C levels, whereas rs174547 and rs2727270 polymorphisms were not associated. D6D andD5D activities may play a role in modulating HDL-C levels in type 2 diabetes. Future studies with larger sample sizes are needed to investigate how FADS genetic variations interact with desaturase activities or PUFAs in the metabolism of lipoproteins in diabetic patients. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Socioeconomic, Geospatial, and Geopolitical Disparities in Access to Health Care in the US 2011–2015
Int. J. Environ. Res. Public Health 2017, 14(6), 573; doi:10.3390/ijerph14060573
Received: 30 March 2017 / Revised: 13 May 2017 / Accepted: 23 May 2017 / Published: 29 May 2017
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Abstract
Individuals forgoing needed medical care due to barriers associated with cost are at risk of missing needed care that may be necessary for the prevention or maintenance of a chronic condition among other things. Thus, continued monitoring of factors associated with forgone medical
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Individuals forgoing needed medical care due to barriers associated with cost are at risk of missing needed care that may be necessary for the prevention or maintenance of a chronic condition among other things. Thus, continued monitoring of factors associated with forgone medical care, especially among vulnerable populations, is critical. National survey data (2011–2015) for non-institutionalized adults residing in the USA were utilized to assess forgone medical care, defined as not seeking medical care when the individual thought it was necessary because of cost in the past 12 months. Logistic regression was used to predict forgone medical care vs. sought medical care. Racial/ethnic minority working-age adults, those with lower incomes, those with lower educations, those residing in the South, and those residing in states that failed to participate in Medicaid Expansion in 2014 were more likely (p < 0.01) to forgo medical care due to cost in the past year. Policy makers seeking to reduce barriers to forgone medical care can use this information to tailor their efforts (e.g., mechanisms targeted to bridge gaps in access to care) to those most at-risk and to consider state-level policy decisions that may impact access to care. Full article
(This article belongs to the Special Issue Aging and Health Promotion)
Open AccessArticle Functional Coping Dynamics and Experiential Avoidance in a Community Sample with No Self-Injury vs. Non-Suicidal Self-Injury Only vs. Those with Both Non-Suicidal Self-Injury and Suicidal Behaviour
Int. J. Environ. Res. Public Health 2017, 14(6), 575; doi:10.3390/ijerph14060575
Received: 29 January 2017 / Revised: 2 May 2017 / Accepted: 20 May 2017 / Published: 29 May 2017
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Abstract
Although emotional avoidance may be a critical factor in the pathway from psychological distress to self-injury and/or suicidality, little is known about the relative importance of differing functional coping dynamics and experiential avoidance between people with self-injury histories of differing intent (e.g., Non-Suicidal
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Although emotional avoidance may be a critical factor in the pathway from psychological distress to self-injury and/or suicidality, little is known about the relative importance of differing functional coping dynamics and experiential avoidance between people with self-injury histories of differing intent (e.g., Non-Suicidal Self-Injury only vs. Non-Suicidal Self-Injury plus Suicidal Behaviour; NSSI vs. NSSI + SB). A community-based survey (N = 313; female, 81%; ages 16–49 years, M = 19.78, SD = 3.48) explored self-reported experiential avoidance and functional coping dynamics in individuals with (i) no self-injury history (controls); (ii) a history of NSSI only; and (iii) a history of NSSI + SB. Jonckheere-Terpstra trend tests indicated that avoidance coping was higher in the NSSI and NSSI + SB groups than in controls. Emotion regulation was higher in controls than those with a history of self-injury (NSSI and NSSI + SB). Approach and reappraisal coping demonstrated significant ordered effects such that control participants were higher in these coping dynamics than those with a history of NSSI only, who, in turn, were higher than those with a history of NSSI + SB (Control > NSSI > NSSI + SB). Endorsement of the reappraisal/denial facet of experiential avoidance was most pronounced in those with a history of NSSI + SB (Control < NSSI < NSSI + SB). No significant ordered effects were observed for other dimensions of experiential avoidance. Understanding how the endorsement of functional coping dynamics and which components of experiential avoidance vary between groups with differing self-injury intent histories has important implications for treatment planning. Full article
(This article belongs to the Special Issue From Understanding Suicide Risk to Preventing Suicide)
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Open AccessArticle The Occurrence of the Colistin Resistance Gene mcr-1 in the Haihe River (China)
Int. J. Environ. Res. Public Health 2017, 14(6), 576; doi:10.3390/ijerph14060576
Received: 1 May 2017 / Revised: 23 May 2017 / Accepted: 25 May 2017 / Published: 29 May 2017
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Abstract
Antibiotic failure is occurring worldwide. In a routine surveillance study on antibioticresistance genes (ARGs) in natural water bodies, we noted the detection of colistin-resistance gene mcr-1, previously identified in Escherichia coli and Klebsiella pneumoniae isolates from human beings and animals in several countries.
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Antibiotic failure is occurring worldwide. In a routine surveillance study on antibioticresistance genes (ARGs) in natural water bodies, we noted the detection of colistin-resistance gene mcr-1, previously identified in Escherichia coli and Klebsiella pneumoniae isolates from human beings and animals in several countries. The mcr-1 gene might be present in water environments, because aquatic ecosystems are recognized as reservoirs for antibiotic resistant bacteria (ARB) and ARGs. In this study, a qPCR assay was developed to monitor and quantify the mcr-1 gene in the Haihe River, China. The results showed that all 18 samples collected from different locations over 6 months along the Haihe River were positive for the mcr-1 gene, and the highest level of mcr-1 reached 3.81 × 105 gene copies (GC) per liter of water. This is the first study to quantify mcr-1 in a natural water system by qPCR. Our findings highlight the potential for this antibiotic resistance determinant to spread extensively, suggesting a significant health and ecological impact. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Quality of Life in Women with Stage 1 Stress Urinary Incontinence after Application of Conservative Treatment—A Randomized Trial
Int. J. Environ. Res. Public Health 2017, 14(6), 577; doi:10.3390/ijerph14060577
Received: 20 April 2017 / Revised: 22 May 2017 / Accepted: 25 May 2017 / Published: 30 May 2017
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Abstract
Stress urinary incontinence (SUI) influences quality of life in female patients. In this study, we used ICIQ LUTS QoL (The International Consultation Incontinence Questionnaire Lower Urinary Tract Symptoms quality of life) to determine the quality of life (QoL) in various domains in patients
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Stress urinary incontinence (SUI) influences quality of life in female patients. In this study, we used ICIQ LUTS QoL (The International Consultation Incontinence Questionnaire Lower Urinary Tract Symptoms quality of life) to determine the quality of life (QoL) in various domains in patients with stage 1 SUI. The study included 140 perimenopausal women subjected to urodynamic tests at the Department of Gynaecology, Endocrinology and Gynaecologic Oncology, Pomeranian Medical University, Police (Poland) in 2013–2015. The study subjects were divided into two groups, A and B. Each patient completed two questionnaires, an original survey developed by the authors and the validated ICIQ LUTS QoL. Two exercise programs, each lasting for 3 months and consisting of 4 weekly sessions, were recommended to the study subjects. The program for Group A included exercises for pelvic floor muscles (PFM) with simultaneous tension of the transverse abdominal muscle (TrA), and the program for Group B, PFM exercises without TrA tension. After completing the exercise programs, patients with stage 1 SUI, both from Group A and from Group B, showed a significant improvement in most QoL domains measured with ICIQ LUTS QoL. However, more beneficial effects of the training were observed in the group subjected to PFM exercises with TrA tension. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Cognitive-Motivational Determinants of Residents’ Civic Engagement and Health (Inequities) in the Context of Noise Action Planning: A Conceptual Model
Int. J. Environ. Res. Public Health 2017, 14(6), 578; doi:10.3390/ijerph14060578
Received: 22 March 2017 / Revised: 16 May 2017 / Accepted: 25 May 2017 / Published: 30 May 2017
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Abstract
The Environmental Noise Directive expects residents to be actively involved in localising and selecting noise abatement interventions during the noise action planning process. Its intervention impact is meant to be homogeneous across population groups. Against the background of social heterogeneity and environmental disparities,
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The Environmental Noise Directive expects residents to be actively involved in localising and selecting noise abatement interventions during the noise action planning process. Its intervention impact is meant to be homogeneous across population groups. Against the background of social heterogeneity and environmental disparities, however, the impact of noise action planning on exposure to traffic-related noise and its health effects is unlikely to follow homogenous distributions. Until now, there has been no study evaluating the impact of noise action measures on the social distribution of traffic-related noise exposure and health outcomes. We develop a conceptual (logic) model on cognitive-motivational determinants of residents’ civic engagement and health (inequities) by integrating arguments from the Model on household’s Vulnerability to the local Environment, the learned helplessness model in environmental psychology, the Cognitive Activation Theory of Stress, and the reserve capacity model. Specifically, we derive four hypothetical patterns of cognitive-motivational determinants yielding different levels of sustained physiological activation and expectancies of civic engagement. These patterns may help us understand why health inequities arise in the context of noise action planning and learn how to transform noise action planning into an instrument conducive to health equity. While building on existing frameworks, our conceptual model will be tested empirically in the next stage of our research process. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Ultrafine Particle Distribution and Chemical Composition Assessment during Military Operative Trainings
Int. J. Environ. Res. Public Health 2017, 14(6), 579; doi:10.3390/ijerph14060579
Received: 26 April 2017 / Revised: 26 May 2017 / Accepted: 27 May 2017 / Published: 30 May 2017
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Abstract
(1) Background: The assessment of airborne particulate matter (PM) and ultrafine particles (UFPs) in battlefield scenarios is a topic of particular concern; (2) Methods: Size distribution, concentration, and chemical composition of UFPs during operative military training activities (target drone launches, ammunition blasting, and
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(1) Background: The assessment of airborne particulate matter (PM) and ultrafine particles (UFPs) in battlefield scenarios is a topic of particular concern; (2) Methods: Size distribution, concentration, and chemical composition of UFPs during operative military training activities (target drone launches, ammunition blasting, and inert bomb impact) were investigated using an electric low-pressure impactor (ELPI+) and a scanning electron microscope (SEM), equipped with energy-dispersive spectroscopy (EDS); (3) Results: The median of UFPs, measured for all sampling periods and at variable distance from sources, was between 1.02 × 103 and 3.75 × 103 particles/cm3 for drone launches, between 3.32 × 103 and 15.4 × 103 particles/cm3 for the ammunition blasting and from 7.9 × 103 to 1.3 × 104 particles/cm3 for inert launches. Maximum peak concentrations, during emitting sources starting, were 75.5 × 106 and 17.9 × 106 particles/cm3, respectively. Particles from the drone launches were predominantly composed of silicon (Si), iron (Fe) and calcium (Ca), and those from the blasting campaigns by magnesium (Mg), sulphur (S), aluminum (Al), iron (Fe), barium (Ba) and silicon (Si); (4) Conclusions: The investigated sources produced UFPs with median values lower than other anthropogenic sources, and with a similar chemical composition. Full article
(This article belongs to the Special Issue Air Quality and Health)
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Open AccessArticle The Effects of the Global Economic Recession and a Reduced Alcohol Tax on Hospitalizations Due to Alcohol-Attributed Diseases in Taiwan
Int. J. Environ. Res. Public Health 2017, 14(6), 580; doi:10.3390/ijerph14060580
Received: 13 April 2017 / Revised: 25 May 2017 / Accepted: 26 May 2017 / Published: 30 May 2017
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Abstract
This study is to assess the effects of the 2008 economic crisis and a 2009 alcohol tax reduction on alcohol-related morbidity for men of different socioeconomic statuses in Taiwan. Admissions data for the period from 2007 to 2012 for men aged 24–59 years
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This study is to assess the effects of the 2008 economic crisis and a 2009 alcohol tax reduction on alcohol-related morbidity for men of different socioeconomic statuses in Taiwan. Admissions data for the period from 2007 to 2012 for men aged 24–59 years in 2007 was retrieved from the National Health Insurance Research Database. With stratification over three income levels, an interrupted time-series analysis examining the effects of the crisis and taxation reduction on incidence rates of hospitalization for alcohol-attributed diseases (AADs) was employed. The low income group showed a significant (p < 0.05) change in the rate of AAD-related hospitalizations in July 2008; specifically, an abrupt 7.11% increase that was then sustained for several months thereafter. In contrast, while the middle income group exhibited a significant 22.9% decline in the rate of AAD-related hospitalizations over the course of the crisis, that downward trend was gradual. The reduction of the alcohol tax resulted in increased rates of AADs among both the low and high income groups. The economic recession and the reduction of the alcohol tax resulted in an increased rate of AAD among low income men. Full article
(This article belongs to the Special Issue Alcohol and Health)
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Open AccessArticle Heterogeneous Trajectories of Physical and Mental Health in Late Middle Age: Importance of Life-Course Socioeconomic Positions
Int. J. Environ. Res. Public Health 2017, 14(6), 582; doi:10.3390/ijerph14060582
Received: 31 March 2017 / Revised: 24 May 2017 / Accepted: 26 May 2017 / Published: 30 May 2017
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Abstract
Drawing on life course and cumulative disadvantage theory, this study examines heterogeneous trajectories of functional limitations and depressive symptoms among late middle-aged individuals. This study used prospective data from 6010 adults, 51 to 64 years old, collected over a 12-year-period from the Health
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Drawing on life course and cumulative disadvantage theory, this study examines heterogeneous trajectories of functional limitations and depressive symptoms among late middle-aged individuals. This study used prospective data from 6010 adults, 51 to 64 years old, collected over a 12-year-period from the Health and Retirement Study. Considering the empirical proposition that several physical and mental trajectories may exist, Latent Class Growth Modeling was used. Five heterogeneous patterns of joint trajectories (Relatively healthy, Moderately improving, Steadily deteriorating, Steeply deteriorating, and Persistently high comorbid) were identified. Early life adversity was related to an increasing risk of declines in physical and mental health. The Persistently high comorbid class was characterized by a concentration of disadvantages over the life course. The development of public health interventions could help reduce co-existing physical and mental health problems, especially during late middle-age. Full article
(This article belongs to the Special Issue Aging and Health Promotion)
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Open AccessArticle Water Consumption in European Children: Associations with Intake of Fruit Juices, Soft Drinks and Related Parenting Practices
Int. J. Environ. Res. Public Health 2017, 14(6), 583; doi:10.3390/ijerph14060583
Received: 14 March 2017 / Revised: 17 May 2017 / Accepted: 27 May 2017 / Published: 31 May 2017
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Abstract
Background: High intake of fruit juices and soft drinks contributes to excessive weight gain and obesity in children. Furthermore, parenting practices play an important role in the development of children’s dietary habits. The way parents play this role in the development of
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Background: High intake of fruit juices and soft drinks contributes to excessive weight gain and obesity in children. Furthermore, parenting practices play an important role in the development of children’s dietary habits. The way parents play this role in the development of their children’s choices of beverages is still unclear. Objectives: To study the associations: (1) of both fruit juices and soft drinks consumption with water consumption of children and (2) The associations between parenting practices towards fruit juices and soft drinks and water consumption of children. Design: Cross-sectional data from 6 to 8 year old children from seven European communities (n = 1187) were collected. Associations among fruit juices, soft drinks, the respective parenting practices and the child’s water consumption were assessed by parental questionnaires. Results: The consumption of water was inversely associated with that of soft drinks but not with the consumption of fruit juices. The child’s water intake was favorably influenced when stricter parenting practices towards soft drinks were adopted (e.g., less parental allowance, low home availability and high parental self-efficacy in managing intake). There was less influence observed of parenting practices towards fruit juices. Fruit juices were consumed more often than soft drinks. Conclusions: Low consumption of soft drinks—and not of fruit juices—was associated with high water consumption in children in the current study. Moreover, parenting practices towards both fruit juices and soft drinks were associated with the water intake of the children, irrespective of their socio-economic status. Full article
(This article belongs to the collection Health Behavior and Public Health)
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Open AccessArticle Health, Well-Being and Energy Poverty in Europe: A Comparative Study of 32 European Countries
Int. J. Environ. Res. Public Health 2017, 14(6), 584; doi:10.3390/ijerph14060584
Received: 13 April 2017 / Revised: 22 May 2017 / Accepted: 26 May 2017 / Published: 31 May 2017
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Abstract
Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty—which is characterised by an inability to secure adequate levels of energy services in the home—the knowledge base is largely British-centric and dominated by single-country studies. In
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Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty—which is characterised by an inability to secure adequate levels of energy services in the home—the knowledge base is largely British-centric and dominated by single-country studies. In response, this paper investigates the relationship between energy poverty, health and well-being across 32 European countries, using 2012 data from the European Quality of Life Survey. We find an uneven concentration of energy poverty, poor health, and poor well-being across Europe, with Eastern and Central Europe worst affected. At the intersection of energy poverty and health, there is a higher incidence of poor health (both physical and mental) amongst the energy poor populations of most countries, compared to non-energy poor households. Interestingly, we find the largest disparities in health and well-being levels between energy poor and non-energy poor households occur within relatively equal societies, such as Sweden and Slovenia. As well as the unique challenges brought about by rapidly changing energy landscapes in these countries, we also suggest the relative deprivation theory and processes of social comparison hold some value in explaining these findings. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Evaluation of Low-Cost Mitigation Measures Implemented to Improve Air Quality in Nursery and Primary Schools
Int. J. Environ. Res. Public Health 2017, 14(6), 585; doi:10.3390/ijerph14060585
Received: 13 April 2017 / Revised: 20 May 2017 / Accepted: 26 May 2017 / Published: 31 May 2017
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Abstract
Indoor air pollution mitigation measures are highly important due to the associated health impacts, especially on children, a risk group that spends significant time indoors. Thus, the main goal of the work here reported was the evaluation of mitigation measures implemented in nursery
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Indoor air pollution mitigation measures are highly important due to the associated health impacts, especially on children, a risk group that spends significant time indoors. Thus, the main goal of the work here reported was the evaluation of mitigation measures implemented in nursery and primary schools to improve air quality. Continuous measurements of CO2, CO, NO2, O3, CH2O, total volatile organic compounds (VOC), PM1, PM2.5, PM10, Total Suspended Particles (TSP) and radon, as well as temperature and relative humidity were performed in two campaigns, before and after the implementation of low-cost mitigation measures. Evaluation of those mitigation measures was performed through the comparison of the concentrations measured in both campaigns. Exceedances to the values set by the national legislation and World Health Organization (WHO) were found for PM2.5, PM10, CO2 and CH2O during both indoor air quality campaigns. Temperature and relative humidity values were also above the ranges recommended by American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE). In general, pollutant concentrations measured after the implementation of low-cost mitigation measures were significantly lower, mainly for CO2. However, mitigation measures were not always sufficient to decrease the pollutants’ concentrations till values considered safe to protect human health. Full article
(This article belongs to the Special Issue Air Quality and Health)
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Open AccessArticle Extending Participatory Sensing to Personal Exposure Using Microscopic Land Use Regression Models
Int. J. Environ. Res. Public Health 2017, 14(6), 586; doi:10.3390/ijerph14060586
Received: 21 April 2017 / Revised: 21 May 2017 / Accepted: 26 May 2017 / Published: 31 May 2017
Cited by 1 | PDF Full-text (1942 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Personal exposure is sensitive to the personal features and behavior of the individual, and including interpersonal variability will improve the health and quality of life evaluations. Participatory sensing assesses the spatial and temporal variability of environmental indicators and is used to quantify this
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Personal exposure is sensitive to the personal features and behavior of the individual, and including interpersonal variability will improve the health and quality of life evaluations. Participatory sensing assesses the spatial and temporal variability of environmental indicators and is used to quantify this interpersonal variability. Transferring the participatory sensing information to a specific study population is a basic requirement for epidemiological studies in the near future. We propose a methodology to reduce the void between participatory sensing and health research. Instantaneous microscopic land-use regression modeling (µLUR) is an innovative approach. Data science techniques extract the activity-specific and route-sensitive spatiotemporal variability from the data. A data workflow to prepare and apply µLUR models to any mobile population is presented. The µLUR technique and data workflow are illustrated with models for exposure to traffic related Black Carbon. The example µLURs are available for three micro-environments; bicycle, in-vehicle, and indoor. Instantaneous noise assessments supply instantaneous traffic information to the µLURs. The activity specific models are combined into an instantaneous personal exposure model for Black Carbon. An independent external validation reached a correlation of 0.65. The µLURs can be applied to simulated behavioral patterns of individuals in epidemiological cohorts for advanced health and policy research. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Short-Term Associations between Air Pollution Concentrations and Respiratory Health—Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study
Int. J. Environ. Res. Public Health 2017, 14(6), 587; doi:10.3390/ijerph14060587
Received: 22 March 2017 / Revised: 17 May 2017 / Accepted: 27 May 2017 / Published: 31 May 2017
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Abstract
Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms
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Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m3 increase in nitrogen dioxide (NO2) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m3 increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area. Full article
(This article belongs to the Special Issue Environmental Pollution and Human Health Risk)
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Open AccessArticle Socioeconomic Disparity in Later-Year Group Trajectories of Depressive Symptoms: Role of Health and Social Engagement Change
Int. J. Environ. Res. Public Health 2017, 14(6), 588; doi:10.3390/ijerph14060588
Received: 24 January 2017 / Revised: 29 May 2017 / Accepted: 30 May 2017 / Published: 1 June 2017
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Abstract
This study explored heterogeneous change patterns of South Korean older adults’ depressive symptoms by poverty status, focusing on health status and social engagement changes. We used data from four waves (2006–2012) of the Korean Longitudinal Study of Aging (KLoSA). Our sample contained 2461
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This study explored heterogeneous change patterns of South Korean older adults’ depressive symptoms by poverty status, focusing on health status and social engagement changes. We used data from four waves (2006–2012) of the Korean Longitudinal Study of Aging (KLoSA). Our sample contained 2461 poor and 1668 non-poor individuals. All were 65 years old or older at baseline. We used latent class growth analysis to identify trajectory groups’ depressive symptoms. Multinomial logistic regression was used to examine how a range of changes in health conditions and social engagement was associated with trajectories among poor and non-poor participants. Among the poor, five heterogeneous trajectories with clear patterns were identified: high-to-moderate, stable-high, slightly-increasing, steeply-increasing, and stable-low. Among non-poor, high-to-moderate, steeply-increasing, and stable-low groups were found. A decrease in health conditions was the most vulnerable subgroup’s (steeply-increasing) primary risk factor. Poor older adults who reduced participation in, or decreased contact with, social networks were likely to belong to the steeply-increasing group. Our study provides impetus for organizational and/or environmental support systems to facilitate social engagement among poor older adults. Future research should examine whether the significance of social engagement among poor elders applies in less-developed and developed countries. Full article
(This article belongs to the Special Issue Aging and Health Promotion)
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Open AccessArticle Ethnic Groups Differences in Domestic Recovery after the Catastrophe: A Case Study of the 2008 Magnitude 7.9 Earthquake in China
Int. J. Environ. Res. Public Health 2017, 14(6), 590; doi:10.3390/ijerph14060590
Received: 16 March 2017 / Revised: 26 May 2017 / Accepted: 26 May 2017 / Published: 2 June 2017
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Abstract
This research examined the ethnic differences in domestic recovery after the 2008 Wenchuan Earthquake in China. In 2014, 866 valid questionnaires were collected. Han and Qiang & Zang households were analyzed using logistic regression to determine the factors influencing household recovery. It was
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This research examined the ethnic differences in domestic recovery after the 2008 Wenchuan Earthquake in China. In 2014, 866 valid questionnaires were collected. Han and Qiang & Zang households were analyzed using logistic regression to determine the factors influencing household recovery. It was found that the householder of the Qiang & Zang group played a more important role in household recovery. Different from the Han, females from Qiang & Zang households had negative attitudes on recovery, and Qiang & Zang households did not believe in the effectiveness of public donations for post-quake recovery. The study also showed that local workers in a household were more helpful for household recovery than were migrant workers in a household, regardless of ethnicity. Therefore, the government should create more local jobs in Han and Qiang & Zang households and pay more attention to women in Qiang households. Assistance should be established specifically for the psychological recovery of Qiang women and family recovery projects. Full article
(This article belongs to the Special Issue Human Health, Risk Analysis and Environmental Hazards)
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Open AccessArticle Reduced Dietary Selenium Impairs Vascular Function by Increasing Oxidative Stress in Sprague-Dawley Rat Aortas
Int. J. Environ. Res. Public Health 2017, 14(6), 591; doi:10.3390/ijerph14060591
Received: 7 April 2017 / Revised: 15 May 2017 / Accepted: 15 May 2017 / Published: 2 June 2017
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Abstract
This study aimed to determine whether low dietary Se content affects the function and mechanisms mediating the vascular relaxation of rat aortas, and to test the role of oxidative stress in observed differences. Male Sprague Dawley (SD) rats were maintained for 10 weeks
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This study aimed to determine whether low dietary Se content affects the function and mechanisms mediating the vascular relaxation of rat aortas, and to test the role of oxidative stress in observed differences. Male Sprague Dawley (SD) rats were maintained for 10 weeks on low Se (low-Se group; N = 20) or normal Se content (norm-Se group; N = 20) rat chow. Dose responses to acetylcholine (ACh; 10−9–10−5M) and the response to reduced pO2 were tested in noradrenaline-precontracted aortic rings in the absence/presence of the nitric oxide synthase (NOS) inhibitor nitro-l-arginine methyl ester (l-NAME), the cyclooxygenase 1 and 2 (COX-1, 2) inhibitor Indomethacin, and the antioxidative agent Tempol in tissue bath. mRNA expression of glutathione peroxidase 1 (GPx1), catalase (CAT), and Cu/Zn superoxide dismutase (SOD) was measured in rat aortas. Oxidative stress (Thiobarbituric Acid Reactive Substances; TBARS), antioxidative plasma capacity (ferric reducing ability of plasma assay; FRAP), and protein levels of GPx1 were measured in plasma and serum samples, respectively. Reduced ACh-induced relaxation (AChIR) (dominantly mediated by NO) in the low-Se group compared to the norm-Se group was restored by Tempol administration. Hypoxia-induced relaxation (HIR) (dominantly mediated by COX-1, 2), TBARS, and FRAP as well as GPx1 serum concentrations were similar between the groups. mRNA GPx1 expression in rat aortas was significantly decreased in the low-Se compared to the norm-Se group. These data suggest that low dietary Se content increases the local oxidative stress level, which subsequently affects the NO-mediated vascular response. Full article
(This article belongs to the Special Issue Nutrition and Public Health)
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Open AccessArticle The Influence of Quercetin on Maternal Immunity, Oxidative Stress, and Inflammation in Mice with Exposure of Fine Particulate Matter during Gestation
Int. J. Environ. Res. Public Health 2017, 14(6), 592; doi:10.3390/ijerph14060592
Received: 3 April 2017 / Revised: 24 May 2017 / Accepted: 26 May 2017 / Published: 2 June 2017
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Abstract
The objective is to investigate the influence of PM2.5 exposure on peripheral blood lymphocyte subsets in pregnant mice and the antagonism of quercetin on adverse effects induced by PM2.5 exposure. Pregnant mice were randomly divided into control group, PM2.5 model
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The objective is to investigate the influence of PM2.5 exposure on peripheral blood lymphocyte subsets in pregnant mice and the antagonism of quercetin on adverse effects induced by PM2.5 exposure. Pregnant mice were randomly divided into control group, PM2.5 model group and 3 quercetin intervention groups. Dams in all groups except the control group were exposed to PM2.5 suspension by intratracheal instillation on gestational day (GD) 3, 6, 9, 12 and 15. Meanwhile, each dam was given 0.15% carboxymethylcellulose sodium (CMCS) (control group & PM2.5 model group) and different doses of quercetin (quercetin intervention groups) by gavage once a day from GD0 to GD17. The percentage of lymphocyte subsets, Biomarkers of systemic inflammation injuries (IL-2, IL-6, IL-8 & TNF-α) and oxidative stress indicators (CAT, GSH & HO-1) in peripheral blood of the dams were analyzed. The number of T cells increased, accompanied by increased level of IL-2, IL-6, IL-8 and HO-1 due to PM2.5 exposure. Less CD4+ and CD8+ T cells were counted in 100 mg/kg quercetin intervention group, compared with PM2.5 model group. Quercetin may inhibit cytokine production, especially in IL-6 and IL-8 and may upgrade the level of HO-1. Our findings indicate that PM2.5 could significantly influence the distribution of T-lymphocyte subsets, activate inflammatory reaction and elevate oxidative stress level in peripheral blood of pregnant mice. Certain dose of quercetin administration during pregnancy may protect the dams against the adverse effects through various ways. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Measuring Neighborhood Walkable Environments: A Comparison of Three Approaches
Int. J. Environ. Res. Public Health 2017, 14(6), 593; doi:10.3390/ijerph14060593
Received: 24 April 2017 / Revised: 28 May 2017 / Accepted: 31 May 2017 / Published: 3 June 2017
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Abstract
Multiple studies have revealed the impact of walkable environments on physical activity. Scholars attach considerable importance to leisure and health-related walking. Recent studies have used Google Street View as an instrument to assess city streets and walkable environments; however, no study has compared
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Multiple studies have revealed the impact of walkable environments on physical activity. Scholars attach considerable importance to leisure and health-related walking. Recent studies have used Google Street View as an instrument to assess city streets and walkable environments; however, no study has compared the validity of Google Street View assessments of walkable environment attributes to assessments made by local residents and compiled from field visits. In this study, we involved nearby residents and compared the extent to which Google Street View assessments of the walkable environment correlated with assessments from local residents and with field visits. We determined the assessment approaches (local resident or field visit assessments) that exhibited the highest agreement with Google Street View. One city with relatively high-quality walkable environments and one city with relatively low-quality walkable environments were examined, and three neighborhoods from each city were surveyed. Participants in each neighborhood used one of three approaches to assess the walkability of the environment: 15 local residents assessed the environment using a map, 15 participants made a field visit to assess the environment, and 15 participants used Google Street View to assess the environment, yielding a total of 90 valid samples for the two cities. Findings revealed that the three approaches to assessing neighborhood walkability were highly correlated for traffic safety, aesthetics, sidewalk quality, and physical barriers. Compared with assessments from participants making field visits, assessments by local residents were more highly correlated with Google Street View assessments. Google Street View provides a more convenient, low-cost, efficient, and safe approach to assess neighborhood walkability. The results of this study may facilitate future large-scale walkable environment surveys, effectively reduce expenses, and improve survey efficiency. Full article
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Open AccessArticle The Use of Chemoprophylaxis after Floods to Reduce the Occurrence and Impact of Leptospirosis Outbreaks
Int. J. Environ. Res. Public Health 2017, 14(6), 594; doi:10.3390/ijerph14060594
Received: 21 April 2017 / Revised: 23 May 2017 / Accepted: 31 May 2017 / Published: 3 June 2017
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Abstract
Record-breaking and devastating rainfall events have occurred in the past decade. Rain and floods are considered the main risk factors for leptospirosis and several outbreaks have been reported following extreme weather events. In such situations, one possible intervention to prevent leptospirosis cases in
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Record-breaking and devastating rainfall events have occurred in the past decade. Rain and floods are considered the main risk factors for leptospirosis and several outbreaks have been reported following extreme weather events. In such situations, one possible intervention to prevent leptospirosis cases in high-risk groups is the use of chemoprophylaxis. However, not enough evidence of its effect is available. The objectives of this study were to review the literature on the current practices of chemoprophylaxis for leptospirosis and to explore, using a mathematical model, how various chemoprophylaxis scenarios may affect the progression of a leptospirosis outbreak. Twenty-six peer-reviewed publications were selected (10 quantitative studies, two systematic reviews and 14 articles of other types). Oral doxycycline was the most used antibiotic for chemoprophylaxis of leptospirosis. Post-exposure prophylaxis was assessed in four studies following a natural disaster. Although evidence of the effectiveness of post-exposure prophylaxis is inconsistent, the direction of association supported a protective effect for morbidity and mortality. The theoretical model showed how the assumed benefit of chemoprophylaxis was influenced by the time and rate of administration. Future models should consider the heterogeneity of affected communities, improved estimates of the effect of chemoprophylaxis on leptospirosis infection and disease, as well as potential detrimental impacts. Additional research is critical to provide clear evidence-based recommendations for leptospirosis control during an outbreak. The results of this study suggest that chemoprophylaxis may provide some protection in reducing the number of leptospirosis cases after a high-risk exposure; however, the effective benefit may depend on a variety of factors such as the timing and coverage of prophylaxis. The information summarized can be used to support decision-making during a high-risk event. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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Open AccessArticle Glyphosate Residues in Groundwater, Drinking Water and Urine of Subsistence Farmers from Intensive Agriculture Localities: A Survey in Hopelchén, Campeche, Mexico
Int. J. Environ. Res. Public Health 2017, 14(6), 595; doi:10.3390/ijerph14060595
Received: 23 January 2017 / Revised: 16 May 2017 / Accepted: 22 May 2017 / Published: 3 June 2017
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Abstract
The use of pesticides in Mexican agriculture creates an interest in learning about the presence of these substances in different environmental matrices. Glyphosate (GLY) is an herbicide widely used in the state of Campeche, located in the Mayan zone in the western Yucatan
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The use of pesticides in Mexican agriculture creates an interest in learning about the presence of these substances in different environmental matrices. Glyphosate (GLY) is an herbicide widely used in the state of Campeche, located in the Mayan zone in the western Yucatan peninsula. Despite the fact that GLY is considered a non-toxic pesticide to humans, its presence in water bodies through spillage, runoff, and leaching are a risk to human health or biota that inhabit these ecosystems. In the present study, glyphosate residues were determined in groundwater, bottled drinking water, and the urine of subsistence farmers from various localities of the Hopelchén municipality in Campeche. Determination of GLY was carried out using Enzyme-Linked Immunosorbent Assay (ELISA). The highest concentrations of GLY were observed in the groundwater (1.42 μg/L) of Ich-Ek and urine (0.47 μg/L) samples of subsistence farmers from the Francisco J. Mújica communities. The glyphosate concentrations in groundwater and bottled drinking water indicate an exposure and excessive use of glyphosate in these agricultural communities. This is one of the first studies that reports glyphosate concentration levels in human urine and bottled drinking water in México and in the groundwater in the Yucatan Peninsula as part of a prospective pilot study, to which a follow-up will be performed to monitor this trend over time. Full article
(This article belongs to the Special Issue Ecological and Human-Health Effects of Pesticides in the Environment)
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Open AccessArticle Associations among Screen Time and Unhealthy Behaviors, Academic Performance, and Well-Being in Chinese Adolescents
Int. J. Environ. Res. Public Health 2017, 14(6), 596; doi:10.3390/ijerph14060596
Received: 29 March 2017 / Revised: 24 May 2017 / Accepted: 25 May 2017 / Published: 4 June 2017
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Abstract
Screen time is negatively associated with markers of health in western youth, but very little is known about these relationships in Chinese youth. Middle-school and high-school students (n = 2625) in Wuhan, China, completed questionnaires assessing demographics, health behaviors, and self-perceptions in
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Screen time is negatively associated with markers of health in western youth, but very little is known about these relationships in Chinese youth. Middle-school and high-school students (n = 2625) in Wuhan, China, completed questionnaires assessing demographics, health behaviors, and self-perceptions in spring/summer 2016. Linear and logistic regression analyses were conducted to determine whether, after adjustment for covariates, screen time was associated with body mass index (BMI), eating behaviors, average nightly hours of sleep, physical activity (PA), academic performance, and psychological states. Watching television on school days was negatively associated with academic performance, PA, anxiety, and life satisfaction. Television viewing on non-school days was positively associated with sleep duration. Playing electronic games was positively associated with snacking at night and less frequently eating breakfast, and negatively associated with sleep duration and self-esteem. Receiving electronic news and study materials on non-school days was negatively associated with PA, but on school days, was positively associated with anxiety. Using social networking sites was negatively associated with academic performance, but positively associated with BMI z-score, PA and anxiety. Screen time in adolescents is associated with unhealthy behaviors and undesirable psychological states that can contribute to poor quality of life. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders
Int. J. Environ. Res. Public Health 2017, 14(6), 597; doi:10.3390/ijerph14060597
Received: 13 March 2017 / Revised: 31 May 2017 / Accepted: 1 June 2017 / Published: 4 June 2017
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Abstract
This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease
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This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as “relatively low”, contrasting with 21.4% rated as “relatively high”. Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Sex Differences in the Association of Urinary Concentrations of Phthalates Metabolites with Self-Reported Diabetes and Cardiovascular Diseases in Shanghai Adults
Int. J. Environ. Res. Public Health 2017, 14(6), 598; doi:10.3390/ijerph14060598
Received: 28 February 2017 / Revised: 31 May 2017 / Accepted: 2 June 2017 / Published: 5 June 2017
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Abstract
Phthalate exposure was reported to be associated with diabetes mellitus (DM) and cardiovascular disease (CVD). Yet, reported associations and the potential sex differences are inconsistent. We conducted a cross-sectional study involving 2330 participants in the Fall of 2012. Urinary metabolites of 10 phthalates
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Phthalate exposure was reported to be associated with diabetes mellitus (DM) and cardiovascular disease (CVD). Yet, reported associations and the potential sex differences are inconsistent. We conducted a cross-sectional study involving 2330 participants in the Fall of 2012. Urinary metabolites of 10 phthalates were measured. The status of having DM and CVD-related outcomes were self-reported. In the overall study population, the logistic regression analyses showed that the urinary levels of mono-2-ethyl-5-oxohexyphthalate (MEOHP), mono-2-ethyl-5-hydroxyhexylphthalate(MEHHP) and mono-2-ethyl-5-carboxypentylphthalate (MECPP) were positively associated with DM. Higher urinary levels of monomethyl phthalate (MMP) and mono-2-carboxymethyl-hexyl phthalate (MCMHP) were associated with increased odds of hyperlipidemia, while mono-2-ethylhexylphthalate (MEHP) was significantly inverse-associated with hyperlipidemia. We did not observe significant associations for other CVD-related outcomes with phthalate metabolites. When stratifying by sex, MEHHP, MEOHP, MECPP, MCMHP and the micromolar sums of the oxidative metabolites of DEHP (ΣDEHPox) were all significantly related to DM in males, but not in females. No significant sex differences were found in CVD-related outcomes, except the sporadic associations between phthalates and hyperlipidemia. These findings highlight the importance of investigating the sex-specific relationship between phthalates exposure and DM. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015
Int. J. Environ. Res. Public Health 2017, 14(6), 599; doi:10.3390/ijerph14060599
Received: 26 April 2017 / Revised: 29 May 2017 / Accepted: 31 May 2017 / Published: 5 June 2017
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Abstract
Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of
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Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015. There was a total of 320 cases and the overall annual rate of ACL injuries increased by 147.8% from 2.74 per 100,000 population in 2005/2006 to 6.79 per 100,000 in 2014/2015. The majority (96.9%) of these injuries were in 10- to 14-year-olds. The main in-hospital procedure provided to over 80% of the hospitalized cases involved ACL reconstruction. Sporting activities accounted for 56.6% of ACL injuries. For females, over half (52.4%) of ACL injuries occurred whilst playing ball sports, compared to 35.4% of males. The large increase in ACL injuries in 5- to 14-year-olds in the state of Victoria, Australia over a 10-year period indicates they are a significant and emerging health burden. Population-wide ACL prevention policies are required to halt these trends. Cost effective prevention programs that involve neuromuscular training must be implemented in schools and junior sports teams. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
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Open AccessArticle Risk Perceptions on Hurricanes: Evidence from the U.S. Stock Market
Int. J. Environ. Res. Public Health 2017, 14(6), 600; doi:10.3390/ijerph14060600
Received: 16 March 2017 / Revised: 23 May 2017 / Accepted: 23 May 2017 / Published: 5 June 2017
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Abstract
This article examines the market reaction of the main Property and Casualty (P & C) insurance companies listed in the New York Stock Exchange (NYSE) to seven most recent hurricanes that hit the East Coast of the United States from 2005 to 2012.
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This article examines the market reaction of the main Property and Casualty (P & C) insurance companies listed in the New York Stock Exchange (NYSE) to seven most recent hurricanes that hit the East Coast of the United States from 2005 to 2012. For this purpose, we run a standard short horizon event study in order to test the existence of abnormal returns around the landfalls. P & C companies are one of the most affected sectors by such events because of the huge losses to rebuild, help and compensate the inhabitants of the affected areas. From the financial investors’ perception, this kind of events implies severe losses, which could influence the expected returns. Our research highlights the existence of significant cumulative abnormal returns around the landfall event window in most of the hurricanes analyzed, except for the Katrina and Sandy Hurricanes. Full article
(This article belongs to the Special Issue Human Health, Risk Analysis and Environmental Hazards)
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Open AccessArticle Quality of Life of Post-Mastectomy Women Living in a Semi-Arid Region of Brazil
Int. J. Environ. Res. Public Health 2017, 14(6), 601; doi:10.3390/ijerph14060601
Received: 18 March 2017 / Revised: 22 May 2017 / Accepted: 23 May 2017 / Published: 5 June 2017
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Abstract
Health is the major reference regarding quality of life; when it comes to breast cancer in particular, the loss of a breast traumatically affects a woman’s life, reflecting on her quality of life. Recognizing this problem, our aim was to investigate the quality
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Health is the major reference regarding quality of life; when it comes to breast cancer in particular, the loss of a breast traumatically affects a woman’s life, reflecting on her quality of life. Recognizing this problem, our aim was to investigate the quality of life of women who live in a semi-arid region of Brazil after breast cancer mastectomy. In this exploratory, transversal and observational study, a Brazilian variantof the shorter version of the original instrument from the World Health Organization Quality of Life (WHOQOL-BREF), applied in the study population, was analyzed and their socio-demographic profile was obtained. The sample was composed of 50 mastectomized women. The 50 included patients comprised women at a mean age of 54 years. Most of them had finished elementary school, and their average income was one Brazilian minimum monthly wage. Regarding the data related to quality of life, the highest score was found in the social relationships domain (4.29) followed by the psychological (4.09) and environmental (3.88) domains. The lowest score observed was for the physical domain (3.48). With these findings we can say that social and psychological parameters are driving factors of the quality of life in post-mastectomy women. Therefore, these results are useful to establish strategies to improve the quality of life of breast cancer mastectomy patients. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Understanding the Challenges of Improving Sanitation and Hygiene Outcomes in a Community Based Intervention: A Cross-Sectional Study in Rural Tanzania
Int. J. Environ. Res. Public Health 2017, 14(6), 602; doi:10.3390/ijerph14060602
Received: 7 March 2017 / Revised: 23 May 2017 / Accepted: 24 May 2017 / Published: 5 June 2017
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Abstract
Good sanitation and clean water are basic human rights yet they remain elusive to many rural communities in Sub-Saharan Africa (SSA). We carried out a cross sectional study to examine the impact of a four-year intervention aimed at improving access to water and
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Good sanitation and clean water are basic human rights yet they remain elusive to many rural communities in Sub-Saharan Africa (SSA). We carried out a cross sectional study to examine the impact of a four-year intervention aimed at improving access to water and sanitation and reducing waterborne disease, especially diarrhea in children under five years old. The study was carried out in April and May 2015 in Busangi, Chela and Ntobo wards of Kahama District of Tanzania. The interventions included education campaigns and improved water supply, and sanitation. The percentage of households (HHs) with access to water within 30 min increased from 19.2 to 48.9 and 17.6 to 27.3 in the wet and dry seasons, respectively. The percentage of HHs with hand washing facilities at the latrine increased from 0% to 13.2%. However, the incidence of diarrhea among children under five years increased over the intervention period, RR 2.91 95% CI 2.71–3.11, p < 0.0001. Availability of water alone may not influence the incidence of waterborne diseases. Factors such as water storage and usage, safe excreta disposal and other hygiene practices are critical for interventions negating the spread of water borne diseases. A model that articulates the extent to which these factors are helpful for such interventions should be explored. Full article
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Open AccessArticle Development of Activity and Participation Norms among General Adult Populations in Taiwan
Int. J. Environ. Res. Public Health 2017, 14(6), 603; doi:10.3390/ijerph14060603
Received: 14 April 2017 / Revised: 30 May 2017 / Accepted: 1 June 2017 / Published: 6 June 2017
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Abstract
Based on the International Classification of Functioning, Disability, and Health (ICF) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), The Functioning Disability Evaluation Scale-Adult version (FUNDES-Adult) began development in 2011. The FUNDES-Adult was designed to assess the difficulty level of
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Based on the International Classification of Functioning, Disability, and Health (ICF) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), The Functioning Disability Evaluation Scale-Adult version (FUNDES-Adult) began development in 2011. The FUNDES-Adult was designed to assess the difficulty level of an individual’s activities and participation in daily life. There is a lack of research regarding the profile of activity and participation for the general adult population. The purposes of this study were to establish activity and participation norms for the general adult population in Taiwan and to describe, discuss, and compare the activity and participation profile with other population. Method: A population-based survey was administered in 2013 using a computer-assisted telephone interviewing system (CATI system). Using probability proportional to size (PPS) sampling and systematic sampling with random digit dialing (RDD), 1500 adults from Taiwan’s general population were selected to participate in the survey. The FUNDES-Adult with six domains and two dimensions (performance and capability) was used to obtain data on activities and participation levels. A higher domain score indicated higher participation restriction. Results: Approximately 50% of the respondents were male, and the average age of the respondents was 45.23 years. There were no significant differences in the demographic features between the sample and the population. Among the six domains, the self-care domain score was the lowest (least restriction) and the participation domain score was the highest (most restriction). Approximately 90% of the sample scored were less than 15, and only 0.1% scored more than 80. This is the first cross-national population-based survey to assess norms of activity and participation relevant to the general population of Taiwan. As such, the results of this survey can be used as a reference for comparing the activity and participation (AP) functioning of other countries and subgroups. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Work-Related Eye Injuries: A Relevant Health Problem. Main Epidemiological Data from a Highly-Industrialized Area of Northern Italy
Int. J. Environ. Res. Public Health 2017, 14(6), 604; doi:10.3390/ijerph14060604
Received: 9 March 2017 / Revised: 29 May 2017 / Accepted: 31 May 2017 / Published: 6 June 2017
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Abstract
The province of Modena is one of the most industrialized areas of Northern Italy. The medical records of the Ophthalmological Emergency Department (OED) of Modena University Hospital were studied: there were 13,470 OED accesses in 2014 and in 754 cases that an occupational
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The province of Modena is one of the most industrialized areas of Northern Italy. The medical records of the Ophthalmological Emergency Department (OED) of Modena University Hospital were studied: there were 13,470 OED accesses in 2014 and in 754 cases that an occupational eye injury occurred. The frequency of work-related eye injuries (3‰) was lower compared to other published studies, but the absolute number is still relevant, showing the need for more adequate prevention, especially in metal work, construction work, and agriculture, where the worst prognoses were observed. Intervention programs must be implemented as early as possible in the working life, considering that the frequency in younger workers is about double that of the oldest age class (3.5‰ vs. 1.8‰), and special attention should also be given to foreigners, who have a 50% higher injury risk. Furthermore, the planning of specific interventions for eye-injured workers may be useful, considering that a previous injury does not appear to encourage the adoption of preventive interventions, and a subgroup of eye-injured workers have a potential risk for new injuries. Finally, the data presented here indicates how OED records, integrated with specific occupational information, can be applied for studies on work-related eye injuries. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Seroprevalence of Measles Antibodies and Predictors for Seropositivity among Chinese Children
Int. J. Environ. Res. Public Health 2017, 14(6), 605; doi:10.3390/ijerph14060605
Received: 13 March 2017 / Revised: 22 May 2017 / Accepted: 2 June 2017 / Published: 6 June 2017
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Abstract
Background: Supplementary measles immunization has been implemented since 2010 throughout China, yet few studies have reported its effect in the northwest regions. Methods: A cross-sectional study was conducted among children aged 2 to 4 years old (n = 755) from February
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Background: Supplementary measles immunization has been implemented since 2010 throughout China, yet few studies have reported its effect in the northwest regions. Methods: A cross-sectional study was conducted among children aged 2 to 4 years old (n = 755) from February to September 2014 in 25 towns of Qian County, Shaanxi Province. Blood samples were analyzed for measles antibodies using enzyme-linked immunosorbent immunoglobulin G (IgG) assays. Socio-demographic factors were assessed by questionnaire. Data on vaccine dose were collected from town medical records. Univariate and logistic regression analyses were used to determine factors associated with measles antibody seropositivity. Results: Measles antibody seroprevalence was 91.13% (95% CI: 89.52–92.83) in our sample. Compared with children whose mother’s highest education was primary school, seroprevalence was higher in children whose maternal education was middle school (adjusted OR: 1.4, 95% CI: 0.7–2.8), high school (adjusted OR: 2.4, 95% CI: 1.3–7.7), and college/university (adjusted OR: 2.9, 95% CI: 1.2–9.3). Vaccine dose was positively associated with seropositivity. Conclusions: Measles seroprevalence is high in China and is associated with the mother’s education and vaccine dose. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Risk Assessment of Face Skin Exposure to UV Irradiance from Different Rotation Angle Ranges
Int. J. Environ. Res. Public Health 2017, 14(6), 606; doi:10.3390/ijerph14060606
Received: 12 April 2017 / Revised: 17 May 2017 / Accepted: 2 June 2017 / Published: 6 June 2017
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Abstract
Ultraviolet (UV) is one of the environmental pathogenic factors causing skin damage. Aiming to assess the risk of face skin exposure to UV irradiance from different rotation angles, a rotating model was used to monitor the exposure of the skin on the face
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Ultraviolet (UV) is one of the environmental pathogenic factors causing skin damage. Aiming to assess the risk of face skin exposure to UV irradiance from different rotation angles, a rotating model was used to monitor the exposure of the skin on the face to UV irradiance, with skin damage action spectra used to determine the biologically effective UV irradiance (UVBEskin) and UVBEskin radiant exposure (HBEskin) causing skin damage. The results indicate that the UVBEskin is directly influenced by variations in rotation angles. A significant decrease of approximately 52.70% and 52.10% in UVBEskin was found when the cheek and nose measurement sites was rotated from 0° to 90°, while a decrease of approximately 62.70% was shown when the forehead measurement sites was rotated from an angle of 0° to 108°. When HBEskin was compared to the exposure limits (ELs; 30 J·m−2), the maximum relative risk ratios (RR) for cheek, nose, and forehead were found to be approximately 2.01, 2.40, and 2.90, respectively, which were all measured at a rotation angle of 0°. The maximal increase in the percentage of the average HBEskin for rotation angles of 60°, 120°, 180°, and 360° facing the sun to ELs were found to be approximately 62.10%, 52.72%, 43.43%, and 26.27% for the cheek; approximately 130.61%, 109.68%, 86.43%, and 50.06% for the nose; and approximately 178.61%, 159.19%, 134.38%, and 83.41% for the forehead, respectively. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Getting to Know a Place: Built Environment Walkability and Children’s Spatial Representation of Their Home-School (h–s) Route
Int. J. Environ. Res. Public Health 2017, 14(6), 607; doi:10.3390/ijerph14060607
Received: 22 March 2017 / Revised: 29 May 2017 / Accepted: 31 May 2017 / Published: 6 June 2017
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Abstract
The literature on environmental walkability to date has mainly focused on walking and related health outcomes. While previous studies suggest associations between walking and spatial knowledge, the associations between environmental walkability and spatial knowledge is yet to be explored. The current study addresses
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The literature on environmental walkability to date has mainly focused on walking and related health outcomes. While previous studies suggest associations between walking and spatial knowledge, the associations between environmental walkability and spatial knowledge is yet to be explored. The current study addresses this lacuna in research by exploring children’s mental representations of their home-school (h–s) route, vis- Full article
(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)
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Open AccessArticle Changes in Smoking Behavior over Family Transitions: Evidence for Anticipation and Adaptation Effects
Int. J. Environ. Res. Public Health 2017, 14(6), 610; doi:10.3390/ijerph14060610
Received: 13 April 2017 / Revised: 22 May 2017 / Accepted: 31 May 2017 / Published: 7 June 2017
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Abstract
The study of changes in smoking behaviors over the life course is a promising line of research. This paper aims to analyze the temporal relation between family transitions (partnership formation, first childbirth, separation) and changes in smoking initiation and cessation. We propose a
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The study of changes in smoking behaviors over the life course is a promising line of research. This paper aims to analyze the temporal relation between family transitions (partnership formation, first childbirth, separation) and changes in smoking initiation and cessation. We propose a discrete-time logistic model to explore the timing of changes in terms of leads and lags effects up to three years around the event in order to measure both anticipation and adaptation mechanisms. Retrospective biographical data from the Santé et Itinéraires Professionnels (SIP) survey conducted in France in 2006 are used. Partnership formation was followed for both genders by a fall in smoking initiation and an immediate rise in smoking cessation. Childbirth was associated with increased smoking cessation immediately around childbirth, and additionally, females showed an anticipatory increase in smoking cessation up to two years before childbirth. Couple separation was accompanied by an anticipatory increase in smoking initiation for females up to two years prior to the separation, but this effect only occurred in males during separation. Our findings highlight opportunities for more targeted interventions over the life course to reduce smoking, and therefore have relevance for general practitioners and public policy elaboration. Full article
(This article belongs to the collection Health Behavior and Public Health)
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Open AccessArticle ‘Hidden Habitus’: A Qualitative Study of Socio-Ecological Influences on Drinking Practices and Social Identity in Mid-Adolescence
Int. J. Environ. Res. Public Health 2017, 14(6), 611; doi:10.3390/ijerph14060611
Received: 24 March 2017 / Revised: 1 June 2017 / Accepted: 5 June 2017 / Published: 8 June 2017
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Abstract
This study explored mid-adolescents’ views and experiences of socio-ecological influences on their drinking practices in order to help inform the development of interventions to reduce alcohol-related risk. We conducted 31 in-depth interviews with young people aged 13–17 in North East England. Verbatim interview
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This study explored mid-adolescents’ views and experiences of socio-ecological influences on their drinking practices in order to help inform the development of interventions to reduce alcohol-related risk. We conducted 31 in-depth interviews with young people aged 13–17 in North East England. Verbatim interview transcripts and field notes were coded systematically and analysed thematically, following the principles of constant comparison. We adopted Bourdieu’s idea of social game-playing and elements of his conceptual toolkit (particularly habitus, capital and field) during analysis. Analysis yielded three intersecting themes: (1) ‘drinking etiquette’: conveying taste and disgust; (2) ‘playing the drinking game’: demonstrating cultural competency; (3) ‘hidden habitus’—the role of alcohol marketing. Our work demonstrates that there is a nexus of influential factors which come together to help shape and reinforce mid-adolescents’ behaviour, norms and values in relation to alcohol consumption. Drinking practices are not just formed by friendships and family traditions, these are also subject to wider cultural shaping including by the alcohol industry which can encourage brand identification, and gear specific products to add ‘distinction’. However young people are not inactive players and they use aspects of capital and social games to help cement their identity and present themselves in particular ways which in turn are influenced by age, gender and social status. Guided by promising work in the tobacco field, interventions which focus on critical awareness of the framing of alcohol products by key stakeholders, such as policymakers, commercial industry and public health professionals, and by wider society may facilitate behaviour change among young people. Full article
(This article belongs to the Special Issue Alcohol and Health)
Open AccessFeature PaperArticle High Manifestations of Mental Distress in Arabic Asylum Seekers Accommodated in Collective Centers for Refugees in Germany
Int. J. Environ. Res. Public Health 2017, 14(6), 612; doi:10.3390/ijerph14060612
Received: 29 March 2017 / Revised: 1 June 2017 / Accepted: 2 June 2017 / Published: 7 June 2017
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Abstract
The number of asylum seekers in Germany has significantly increased in the last two years. Coming from regions of political conflict and war, the refugees have often experienced traumatic events which designate them as a high risk group for mental disorders. In a
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The number of asylum seekers in Germany has significantly increased in the last two years. Coming from regions of political conflict and war, the refugees have often experienced traumatic events which designate them as a high risk group for mental disorders. In a sample of Arabic speaking asylum seekers in collective accommodation centers in Erlangen, Germany, we estimated the extent of posttraumatic stress, depression, and anxiety. A further objective of the study was to test the comprehensibility and cultural appropriateness of the Arabic translations of the questionnaires in this sample. Between August and September 2016, 56 Arabic speaking asylum seekers placed among three collective accommodation centers in Erlangen completed self-report questionnaires assessing posttraumatic stress disorder (Essen Trauma-Inventory, ETI), and symptoms of depression (Patient Health Questionnaire—depression module, PHQ-9) and anxiety (Generalized Anxiety Disorder, GAD-7). The prevalence of participants with personally and/or witnessed traumatic events was 80.4% (n = 45). About one-third of the examinees (35.7%, n = 20) endorsed symptoms of PTSD (posttraumatic stress disorder). The total score for depression in this sample was M = 11.9 (SD = 7.9, range: 0–27). Moderate to severe depression (PHQ-9 score ≥ 15) was found in 35.7% (n = 20) of our sample and severe depression (PHQ-9 score ≥ 20) was found in 23.2% (n = 13). The total score for anxiety was M = 8.8 (SD = 6.9, range: 0–21), with 26.8% (n = 15) of the sample showing symptoms of severe anxiety (GAD-7 score ≥ 15). No significant difference between women and men with respect to frequency and symptom scores of PTSD, depression, and anxiety was found. Amongst asylum seekers of the presented sample, the rates of traumatic events as well as the prevalence of possible PTSD, depression, and anxiety were significantly higher than in the German population. This indicates that the refugee population is in need of culturally sensitive psychological interventions. However, more studies are required to improve the understanding of mental health among this particularly vulnerable population. Full article
(This article belongs to the Special Issue Refugee Health)
Open AccessArticle Consumers’ Preferences for Electronic Nicotine Delivery System Product Features: A Structured Content Analysis
Int. J. Environ. Res. Public Health 2017, 14(6), 613; doi:10.3390/ijerph14060613
Received: 6 April 2017 / Revised: 31 May 2017 / Accepted: 2 June 2017 / Published: 7 June 2017
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Abstract
To inform potential governmental regulations, we aimed to develop a list of electronic nicotine delivery system (ENDS) product features important to U.S. consumers by age and gender. We employed qualitative data methods. Participants were eligible if they had used an ENDS at least
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To inform potential governmental regulations, we aimed to develop a list of electronic nicotine delivery system (ENDS) product features important to U.S. consumers by age and gender. We employed qualitative data methods. Participants were eligible if they had used an ENDS at least once. Groups were selected by age and gender (young adult group aged 18–25, n = 11; middle-age group aged 26–64, n = 9; and women’s group aged 26–64, n = 9). We conducted five individual older adult interviews (aged 68–80). Participants discussed important ENDS features. We conducted a structured content analysis of the group and interview responses. Of 34 participants, 68% were white and 56% were female. Participants mentioned 12 important ENDS features, including: (1) user experience; (2) social acceptability; (3) cost; (4) health risks/benefits; (5) ease of use; (6) flavors; (7) smoking cessation aid; (8) nicotine content; (9) modifiability; (10) ENDS regulation; (11) bridge between tobacco cigarettes; (12) collectability. The most frequently mentioned ENDS feature was modifiability for young adults, user experience for middle-age and older adults, and flavor for the women’s group. This study identified multiple features important to ENDS consumers. Groups differed in how they viewed various features by age and gender. These results can inform ongoing regulatory efforts. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Effects of Perceived Neighbourhood Environments on Self-Rated Health among Community-Dwelling Older Chinese
Int. J. Environ. Res. Public Health 2017, 14(6), 614; doi:10.3390/ijerph14060614
Received: 13 April 2017 / Revised: 24 May 2017 / Accepted: 2 June 2017 / Published: 7 June 2017
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Abstract
In response to the growing number of older people living in cities, the World Health Organization (WHO) introduced the concept of “Age-Friendly Cities” (AFC) to guide the way in designing physical and social environments to encourage active ageing. Limited research has studied the
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In response to the growing number of older people living in cities, the World Health Organization (WHO) introduced the concept of “Age-Friendly Cities” (AFC) to guide the way in designing physical and social environments to encourage active ageing. Limited research has studied the effects of neighbourhood age-friendliness on elderly health outcomes. Using the example of a highly urbanized city in Asia, this study examined the effects of perceived age-friendliness of neighbourhood environments on self-rated health (SRH) among community-dwelling older Chinese. A multi-stage sampling method was used to collect views of community-dwelling older people from two local districts of Hong Kong. A structured questionnaire covering the WHO’s eight AFC domains was developed to collect information on the perceived neighbourhood environments, SRH and individual characteristics. Age-friendliness of neighbourhood was assessed by mean scores of AFC domains, which was used to predict SRH with adjustment for individual and objective neighbourhood characteristics. Furthermore, 719 respondents aged ≥60 years completed the questionnaire, of which 44.5% reported good SRH. Independent of individual and objective neighbourhood characteristics, multiple logistics regressions showed that higher satisfaction on outdoor spaces and buildings, transportation, housing, social participation, and respect and social inclusion was significantly associated with increased odds of reporting good SRH by more than 20% (p < 0.05). Individuals aged 70–79 years, being female, lower education and residents of public or subsidized housing were less likely to report good SRH, after controlling for individual and neighbourhood characteristics. In addition to age, gender, education and housing type, AFC environments have important contributive influence on SRH, after controlling for individual and objective neighbourhood characteristics. Full article
(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)
Open AccessArticle Environmental Factors Associated with Type 1 Diabetes Development: A Case Control Study in Egypt
Int. J. Environ. Res. Public Health 2017, 14(6), 615; doi:10.3390/ijerph14060615
Received: 29 April 2017 / Revised: 1 June 2017 / Accepted: 3 June 2017 / Published: 7 June 2017
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Abstract
Uncertainty still exists regarding the role of some environmental risk in the development of type 1 diabetes mellitus (T1DM) both globally and in Egypt. The objective here was to explore the potential environmental risk factors associated with the development of T1DM among children
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Uncertainty still exists regarding the role of some environmental risk in the development of type 1 diabetes mellitus (T1DM) both globally and in Egypt. The objective here was to explore the potential environmental risk factors associated with the development of T1DM among children in Egypt. A case-controlled study of 204 T1DM children and an equal number of age and sex-matched controls was conducted in Assiut, Egypt. Data regarding the parental, gestational, neonatal, and childhood possible risk factors for T1DM were evaluated. The final sex adjusted multivariable logistic regression model revealed that the risk for T1DM was significantly higher among rural residents (aOR = 2.03, 95% CI: 1.30–4.25), those with parental history of T1DM (aOR = 9.03, 95% CI: 1.02–83.32), birth through cesarean section (aOR = 2.13, 95% CI: 1.09–5.03), and having history of early introduction of cow milk in the first year of life (aOR = 19.49, 95% CI: 8.73–45.53). On the other hand, a protective effect was observed between at least six months’ breastfeeding, vitamin D supplementation in the first year of life, high physical activity, and the development of T1DM. Educational programs should be adopted to improve awareness and knowledge of the parents to avoid the increased risk factors and encourage protective practices. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Enhancement of X-ray Induced Apoptosis by Mobile Phone-Like Radio-Frequency Electromagnetic Fields in Mouse Spermatocyte-Derived Cells
Int. J. Environ. Res. Public Health 2017, 14(6), 616; doi:10.3390/ijerph14060616
Received: 12 February 2017 / Revised: 26 May 2017 / Accepted: 31 May 2017 / Published: 7 June 2017
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Abstract
To explore the combined effects of environmental radio-frequency (RF) field and X-ray, mouse spermatocyte-derived (GC-1) cells were exposed to 1950 MHz RF field at specific absorption rate (SAR) of 3 W/kg for 24 h combined with or without X-ray irradiation at 6 Gy.
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To explore the combined effects of environmental radio-frequency (RF) field and X-ray, mouse spermatocyte-derived (GC-1) cells were exposed to 1950 MHz RF field at specific absorption rate (SAR) of 3 W/kg for 24 h combined with or without X-ray irradiation at 6 Gy. After treatment, the cell proliferation level was determined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) Assay and 5-Bromo-2-deoxy Uridine (BrdU) enzyme linked immunosorbent (ELISA) Assay. The apoptosis level was detected by annexin V flow cytometry assay, transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) Assay and Caspase-3 Activity Assay. It was found that the proliferation and apoptosis level did not change in GC-1 cells after RF exposure alone. However, compared with the X-ray group, the proliferation level significantly decreased and the apoptotic rate significantly increased in the RF+X-ray group. Moreover, a significant decrease in Bcl-2 protein expression and increase in Bax protein expression were observed. The findings suggested that RF exposure at SAR of 3 W/kg did not affect apoptosis and proliferation in GC-1 cells by itself, but that it did enhance the effects of X-ray induced proliferation inhibition and apoptosis, in which B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) might be involved. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle The Technology Acceptance of a TV Platform for the Elderly Living Alone or in Public Nursing Homes
Int. J. Environ. Res. Public Health 2017, 14(6), 617; doi:10.3390/ijerph14060617
Received: 3 March 2017 / Revised: 22 May 2017 / Accepted: 3 June 2017 / Published: 8 June 2017
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Abstract
In Mexico, many seniors are alone for most of the day or live in public nursing homes. Simple interaction with computer systems is required for older people. This is why we propose the exploration of a medium well known by seniors, such as
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In Mexico, many seniors are alone for most of the day or live in public nursing homes. Simple interaction with computer systems is required for older people. This is why we propose the exploration of a medium well known by seniors, such as the television (TV). The primary objective of this study is to improve the quality of life of seniors through an easier reminder system, using the television set. A technological platform was designed based on interactive television, through which seniors and their caregivers can have a better way to track their daily activities. Finally, an evaluation of the technology adoption was performed with 50 seniors living in two public nursing homes. The evaluation found that the elderly perceived the system as useful, easy to use, and they had a positive attitude and good intention to use it. This helped to generate initial evidence that the system supported them in achieving a better quality of life, by reminding them to take their medications and increasing their rate of attendance to their medical appointments. Full article
(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)
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Open AccessArticle Does the Health Impact of Exposure to Neighbourhood Green Space Differ between Population Groups? An Explorative Study in Four European Cities
Int. J. Environ. Res. Public Health 2017, 14(6), 618; doi:10.3390/ijerph14060618
Received: 9 March 2017 / Revised: 30 May 2017 / Accepted: 5 June 2017 / Published: 8 June 2017
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Abstract
It has been suggested that certain residents, such as those with a low socioeconomic status, the elderly, and women, may benefit more from the presence of neighbourhood green space than others. We tested this hypothesis for age, gender, educational level, and employment status
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It has been suggested that certain residents, such as those with a low socioeconomic status, the elderly, and women, may benefit more from the presence of neighbourhood green space than others. We tested this hypothesis for age, gender, educational level, and employment status in four European cities. Data were collected in Barcelona (Spain; n = 1002), Kaunas (Lithuania; n = 989), Doetinchem (The Netherlands; n = 847), and Stoke-on-Trent (UK; n = 933) as part of the EU-funded PHENOTYPE project. Surveys were used to measure mental and general health, individual characteristics, and perceived neighbourhood green space. Additionally, we used audit data about neighbourhood green space. In Barcelona, there were positive associations between neighbourhood green space and general health among low-educated residents. In the other cities and for the other population groups, there was little evidence that the association between health and neighbourhood green space differed between population groups. Overall, our study does not support the assumption that the elderly, women, and residents who are not employed full-time benefit more from neighbourhood green space than others. Only in the highly urbanised city of Barcelona did the low-educated group benefit from neighbourhood green spaces. Perhaps neighbourhood green spaces are more important for the health of low-educated residents in particularly highly urbanised areas. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Ecological Niche Modeling Identifies Fine-Scale Areas at High Risk of Dengue Fever in the Pearl River Delta, China
Int. J. Environ. Res. Public Health 2017, 14(6), 619; doi:10.3390/ijerph14060619
Received: 14 May 2017 / Revised: 31 May 2017 / Accepted: 1 June 2017 / Published: 9 June 2017
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Abstract
Dengue fever (DF) is one of the most common and rapidly spreading mosquito-borne viral diseases in tropical and subtropical regions. In recent years, this imported disease has posed a serious threat to public health in China, especially in the Pearl River Delta (PRD).
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Dengue fever (DF) is one of the most common and rapidly spreading mosquito-borne viral diseases in tropical and subtropical regions. In recent years, this imported disease has posed a serious threat to public health in China, especially in the Pearl River Delta (PRD). Although the severity of DF outbreaks in the PRD is generally associated with known risk factors, fine scale assessments of areas at high risk for DF outbreaks are limited. We built five ecological niche models to identify such areas including a variety of climatic, environmental, and socioeconomic variables, as well as, in some models, extracted principal components. All the models we tested accurately identified the risk of DF, the area under the receiver operating characteristic curve (AUC) were greater than 0.8, but the model using all original variables was the most accurate (AUC = 0.906). Socioeconomic variables had a greater impact on this model (total contribution 55.27%) than climatic and environmental variables (total contribution 44.93%). We found the highest risk of DF outbreaks on the border of Guangzhou and Foshan (in the central PRD), and in northern Zhongshan (in the southern PRD). Our fine-scale results may help health agencies to focus epidemic monitoring tightly on the areas at highest risk of DF outbreaks. Full article
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Open AccessArticle RF EMF Risk Perception Revisited: Is the Focus on Concern Sufficient for Risk Perception Studies?
Int. J. Environ. Res. Public Health 2017, 14(6), 620; doi:10.3390/ijerph14060620
Received: 5 April 2017 / Revised: 29 May 2017 / Accepted: 1 June 2017 / Published: 8 June 2017
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Abstract
An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in
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An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in everyday life. To that end, risk perceptions were measured by a multidimensional approach. In addition to the traditional focus on measuring the magnitude of risk perceptions, the thematic relevance (how often people think about a risk issue) and the discursive relevance (how often people think about or discuss a risk issue) of risk perceptions were also collected. Taking into account this extended view of risk perception, an online survey was conducted in six European countries with 2454 respondents, referring to radio frequency electromagnetic field (RF EMF) risk potentials from base stations, and access points, such as WiFi routers and cell phones. The findings reveal that the present study’s multidimensional approach to measuring risk perception provides a more differentiated understanding of RF EMF risk perception. High levels of concerns expressed in questionnaires do not automatically imply that these concerns are thematically relevant in everyday life. We use thematic relevance to distinguish between enduringly concerned (high concern according to both questionnaire and thematic relevance) and not enduringly concerned participants (high concern according to questionnaire but no thematic relevance). Furthermore, we provide data for the empirical value of this distinction: Compared to other participants, enduringly concerned subjects consider radio frequency electromagnetic field exposure to a greater extent as a moral and affective issue. They also see themselves as highly exposed to radio frequency electromagnetic fields. However, despite these differences, subjects with high levels of thematic relevance are nevertheless sensitive to exposure reduction as a means for improving the acceptance of base stations in their neighborhood. This underlines the value of exposure reduction for the acceptance of radio frequency electromagnetic field communication technologies. Full article
(This article belongs to the Special Issue Health Impact Assessment)
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Open AccessArticle Occlusal Features and Caries Experience of Hong Kong Chinese Preschool Children: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2017, 14(6), 621; doi:10.3390/ijerph14060621
Received: 16 April 2017 / Revised: 6 June 2017 / Accepted: 7 June 2017 / Published: 9 June 2017
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Abstract
Objective: To study occlusal features and their relation to caries experience in Hong Kong Chinese preschool children. Methods: Seven kindergarten classes in Hong Kong were selected using a stratified random sampling method, and the 4- and 5-year-old Chinese kindergarten children were invited to
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Objective: To study occlusal features and their relation to caries experience in Hong Kong Chinese preschool children. Methods: Seven kindergarten classes in Hong Kong were selected using a stratified random sampling method, and the 4- and 5-year-old Chinese kindergarten children were invited to join the survey. Two calibrated dentists performed the clinical examinations in the kindergartens. Occlusion features, including incisal overjet; canine and molar relationship; median diastema; and primate space as well as malocclusion features, including crossbite; anterior open bite; and scissor bite, were recorded. Caries experience was recorded with the dmft index. Results: A total of 538 children were invited to participate in the study, and finally 495 children were examined (92%). Approximately half (52%) had a normal incisor relationship. Most children had a class I canine relationship (left-79%; right-75%). Approximately two-thirds had a flush terminal plane (left-64%; right-65%). Most children (76%) had a maxillary primate space, and 47% had a mandibular primate space. The prevalence of median diastema, anterior crossbite, and unilateral posterior crossbite was 30%, 12% and 1%, respectively. No bilateral posterior crossbite or scissor bite was found. Approximately half (49%) had caries experience. The mean dmft score was 2.1. Gender and age were not associated with either the studied occlusal features or the mean dmft score (p > 0.05). Conclusion: Approximately half of the Hong Kong preschool children studied had a normal occlusion, and two-thirds of them had a flush terminal plane. About three-quarters of them had a maxillary primate space, and half of them had a mandibular primate space. Their occlusal traits were not associated with caries experience and prevalence. Full article
(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)
Open AccessArticle How Social Reactions to Alcohol-Related Facial Flushing Are Affected by Gender, Relationship, and Drinking Purposes: Implications for Education to Reduce Aerodigestive Cancer Risks
Int. J. Environ. Res. Public Health 2017, 14(6), 622; doi:10.3390/ijerph14060622
Received: 22 April 2017 / Revised: 20 May 2017 / Accepted: 2 June 2017 / Published: 9 June 2017
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Abstract
Alcohol-related facial flushing is a sign of compromised alcohol metabolism and increased risk of certain cancers. This project examined how facial flushing might be used to reduce alcohol use to lower cancer risks. Interviews with Chinese university students identified gender, friendship, and drinking
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Alcohol-related facial flushing is a sign of compromised alcohol metabolism and increased risk of certain cancers. This project examined how facial flushing might be used to reduce alcohol use to lower cancer risks. Interviews with Chinese university students identified gender, friendship, and drinking purpose as important variables related to whether someone would encourage a person who flushes when drinking alcohol to stop or reduce their drinking. A questionnaire was developed that incorporated these variables into 24 drinking scenarios in which someone flushed while drinking. Students responded whether they would (a) encourage the flusher to stop or drink less; (b) do nothing while wishing they could; or (c) do nothing because there was no need. Analysis of survey responses from 2912 university students showed a three-way interaction of the variables and implied that the probability students will intervene when a drinker flushes was highest when the flusher was a female, a close friend, and the drinking purpose was for fun and lowest if the flusher was a male, the friendship was general, and the drinking purpose was risky. The results provide important details about the social factors affecting how other people respond to a person who flushes when drinking alcohol. This information is useful for those considering ways to reduce and prevent aerodigestive cancers through education and information programs. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Stock Market Fluctuations and Self-Harm among Children and Adolescents in Hong Kong
Int. J. Environ. Res. Public Health 2017, 14(6), 623; doi:10.3390/ijerph14060623
Received: 31 March 2017 / Revised: 22 May 2017 / Accepted: 31 May 2017 / Published: 9 June 2017
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Abstract
Although a few studies investigated the impact of stock market fluctuations on population health, the question of whether stock market fluctuations have an impact on self-harm in children and adolescents remain unanswered. This study therefore investigated the association between stock market fluctuations and
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Although a few studies investigated the impact of stock market fluctuations on population health, the question of whether stock market fluctuations have an impact on self-harm in children and adolescents remain unanswered. This study therefore investigated the association between stock market fluctuations and self-harm among children and adolescents in Hong Kong. Daily self-harm attendance records were retrieved from all 18 local Accident and Emergency Departments (AED) from 2001 to 2012. 4931 children and adolescents who committed self-harm were included. The results indicated positive correlation between daily change in stock market index, Hang Seng Index (∇HSI, per 300 points), and daily self-harm incident risk of children and adolescents, without time lag between the two. The incident risk ratio for ∇HSI was 1.09 (p = 0.0339) in children and 1.06 (p = 0.0246) in adolescents. Importantly, non-trading days were found to impose significant protective effect in both groups against self-harm risk. Our results showed that stock market fluctuations were related to self-harm behaviors in children and adolescents. Parents and professionals should be educated about the potential harm of stock market fluctuations and the importance of effective parenting in reducing self-harm among children and adolescents. Full article
(This article belongs to the Special Issue Youth Psychology and Crime)
Open AccessArticle Validation of DESS as a DNA Preservation Method for the Detection of Strongyloides spp. in Canine Feces
Int. J. Environ. Res. Public Health 2017, 14(6), 624; doi:10.3390/ijerph14060624
Received: 12 May 2017 / Revised: 7 June 2017 / Accepted: 8 June 2017 / Published: 9 June 2017
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Abstract
Strongyloides stercoralis is a gastrointestinal parasitic nematode with a life cycle that includes free-living and parasitic forms. For both clinical (diagnostic) and environmental evaluation, it is important that we can detect Strongyloides spp. in both human and non-human fecal samples. Real-time PCR is
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Strongyloides stercoralis is a gastrointestinal parasitic nematode with a life cycle that includes free-living and parasitic forms. For both clinical (diagnostic) and environmental evaluation, it is important that we can detect Strongyloides spp. in both human and non-human fecal samples. Real-time PCR is the most feasible method for detecting the parasite in both clinical and environmental samples that have been preserved. However, one of the biggest challenges with PCR detection is DNA degradation during the postage time from rural and remote areas to the laboratory. This study included a laboratory assessment and field validation of DESS (dimethyl sulfoxide, disodium EDTA, and saturated NaCl) preservation of Strongyloides spp. DNA in fecal samples. The laboratory study investigated the capacity of 1:1 and 1:3 sample to DESS ratios to preserve Strongyloides ratti in spike canine feces. It was found that both ratios of DESS significantly prevented DNA degradation compared to the untreated sample. This method was then validated by applying it to the field-collected canine feces and detecting Strongyloides DNA using PCR. A total of 37 canine feces samples were collected and preserved in the 1:3 ratio (sample: DESS) and of these, 17 were positive for Strongyloides spp. The study shows that both 1:1 and 1:3 sample to DESS ratios were able to preserve the Strongyloides spp. DNA in canine feces samples stored at room temperature for up to 56 days. This DESS preservation method presents the most applicable and feasible method for the Strongyloides DNA preservation in field-collected feces. Full article
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Open AccessArticle The Magnitude of Occupational Class Differences in Sickness Absence: 15-Year Trends among Young and Middle-Aged Municipal Employees
Int. J. Environ. Res. Public Health 2017, 14(6), 625; doi:10.3390/ijerph14060625
Received: 14 May 2017 / Revised: 6 June 2017 / Accepted: 7 June 2017 / Published: 9 June 2017
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Abstract
Background: Our aim was to examine the magnitude of relative occupational class differences in sickness absence (SA) days over a 15-year period among female and male municipal employees in two age-groups. Methods: 18–34 and 35–59-year-old employees of the City of Helsinki
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Background: Our aim was to examine the magnitude of relative occupational class differences in sickness absence (SA) days over a 15-year period among female and male municipal employees in two age-groups. Methods: 18–34 and 35–59-year-old employees of the City of Helsinki from 2002 to 2016 were included in our data (n = ~37,500 per year). Occupational class was classified into four groups. The magnitude of relative occupational class differences in SA was studied using the relative index of inequality (RII). Results: The relative occupational class differences were larger among older than younger employees; the largest differences were among 35–59-year-old men. Among women in both age-groups the relative class differences remained stable during 2002–2016. Among younger and older men, the differences were larger during the beginning of study period than in the end. Among women in both age-groups the RII values were between 2.19 (95% confidence intervals (CI) 1.98, 2.42) and 3.60 (95% CI 3.28, 3.95). The corresponding differences varied from 3.74 (95% CI 3.13, 4.48) to 1.68 (95% CI 1.44, 1.97) among younger and from 6.43 (95% CI 5.85, 7.06) to 3.31 (95% CI 2.98, 3.68) among older men. Conclusions: Relative occupational class differences were persistent among employees irrespective of age group and gender. Preventive measures should be started at young age. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
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Open AccessArticle Solidification and Biotoxicity Assessment of Thermally Treated Municipal Solid Waste Incineration (MSWI) Fly Ash
Int. J. Environ. Res. Public Health 2017, 14(6), 626; doi:10.3390/ijerph14060626
Received: 3 May 2017 / Revised: 27 May 2017 / Accepted: 7 June 2017 / Published: 10 June 2017
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Abstract
In the present work, thermal treatment was used to stabilize municipal solid waste incineration (MSWI) fly ash, which was considered hazardous waste. Toxicity characteristic leaching procedure (TCLP) results indicated that, after the thermal process, the leaching concentrations of Pb, Cu, and Zn decreased
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In the present work, thermal treatment was used to stabilize municipal solid waste incineration (MSWI) fly ash, which was considered hazardous waste. Toxicity characteristic leaching procedure (TCLP) results indicated that, after the thermal process, the leaching concentrations of Pb, Cu, and Zn decreased from 8.08 to 0.16 mg/L, 0.12 to 0.017 mg/L and 0.39 to 0.1 mg/L, respectively, which well met the limits in GB5085.3-2007 and GB16689-2008. Thermal treatment showed a negative effect on the leachability of Cr with concentrations increasing from 0.1 to 1.28 mg/L; nevertheless, it was still under the limitations. XRD analysis suggested that, after thermal treatments, CaO was newly generated. CaO was a main contribution to higher Cr leaching concentrations owing to the formation of Cr (VI)—compounds such as CaCrO4. SEM/EDS tests revealed that particle adhesion, agglomeration, and grain growth happened during the thermal process and thus diminished the leachability of Pb, Cu, and Zn, but these processes had no significant influence on the leaching of Cr. A microbial assay demonstrated that all thermally treated samples yet possessed strong bactericidal activity according to optical density (OD) test results. Among all samples, the OD value of raw fly ash (RFA) was lowest followed by FA700-10, FA900-10, and FA1100-10 in an increasing order, which indicated that the sequence of the biotoxicity for these samples was RFA > FA700-10 > FA900-10 > FA1100-10. This preliminary study indicated that, apart from TCLP criteria, the biotoxicity assessment was indispensable for evaluating the effect of thermal treatment for MSWI fly ash. Full article
(This article belongs to the Special Issue Heavy Metals: Environmental and Human Health)
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Open AccessArticle Lithium in Drinking Water and Incidence of Suicide: A Nationwide Individual-Level Cohort Study with 22 Years of Follow-Up
Int. J. Environ. Res. Public Health 2017, 14(6), 627; doi:10.3390/ijerph14060627
Received: 29 April 2017 / Revised: 28 May 2017 / Accepted: 6 June 2017 / Published: 10 June 2017
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Abstract
Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical variation. Several studies conducted at an
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Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical variation. Several studies conducted at an aggregate level have suggested an association between lithium in drinking water and a reduced risk of suicide; however, a causal relation is uncertain. Individual-level register-based data on the entire Danish adult population (3.7 million individuals) from 1991 to 2012 were linked with a moving five-year time-weighted average (TWA) lithium exposure level from drinking water hypothesizing an inverse relationship. The mean lithium level was 11.6 μg/L ranging from 0.6 to 30.7 μg/L. The suicide rate decreased from 29.7 per 100,000 person-years at risk in 1991 to 18.4 per 100,000 person-years in 2012. We found no significant indication of an association between increasing five-year TWA lithium exposure level and decreasing suicide rate. The comprehensiveness of using individual-level data and spatial analyses with 22 years of follow-up makes a pronounced contribution to previous findings. Our findings demonstrate that there does not seem to be a protective effect of exposure to lithium on the incidence of suicide with levels below 31 μg/L in drinking water. Full article
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Open AccessArticle Prevalence and Risk Factors of Low Health Literacy: A Community-Based Study in Shanghai, China
Int. J. Environ. Res. Public Health 2017, 14(6), 628; doi:10.3390/ijerph14060628
Received: 24 April 2017 / Revised: 2 June 2017 / Accepted: 8 June 2017 / Published: 12 June 2017
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Abstract
Background: Health literacy is an increasingly important public health concern. However, little is known about the health literacy of general public in China. The aim of this study was to evaluate the prevalence of low health literacy and demographic associations in Shanghai, China.
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Background: Health literacy is an increasingly important public health concern. However, little is known about the health literacy of general public in China. The aim of this study was to evaluate the prevalence of low health literacy and demographic associations in Shanghai, China. Methods: This study was a community-based cross-sectional health survey utilizing a multi-stage random sampling design. The sample consisted of 1360 individuals aged 15–69 years with the total community-dwelling Chinese as the sample frame. Health literacy was measured by a questionnaire developed on the basis of a national health literacy manual released by the Chinese Ministry of Health. Multiple logistic regression models were used to identify whether common socio-demographic features were associated with health literacy level. Results: The prevalence of low health literacy was 84.49% (95% CI, 82.56% to 86.41%). The prevalence of low health literacy was negatively associated with the level of education, occupation, and annual household income, but was not associated with gender, age, or the presence of non-communicable chronic disease. Conclusions: Simplifying health services, enhancing health education, and promoting interventions to improve health literacy in high-risk populations should be considered as part of the strategies in the making of health policy in China. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Transportation Matters: A Health Impact Assessment in Rural New Mexico
Int. J. Environ. Res. Public Health 2017, 14(6), 629; doi:10.3390/ijerph14060629
Received: 15 May 2017 / Revised: 2 June 2017 / Accepted: 6 June 2017 / Published: 13 June 2017
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Abstract
This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic
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This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1) 84% for health services; (2) 83% for formal and informal education opportunities; and (3) 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident’s health through improved access to: (1) health services, and fresh foods, especially for older adults; (2) education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3) economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1) long distances to travel; (2) difficulties in scheduling to meet all needs; and (3) poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited. Full article
(This article belongs to the Special Issue Health Impact Assessment)
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Open AccessArticle The Effects of the Refugee Crisis on Age Estimation Analysis over the Past 10 Years: A 16-Country Survey
Int. J. Environ. Res. Public Health 2017, 14(6), 630; doi:10.3390/ijerph14060630
Received: 20 April 2017 / Revised: 31 May 2017 / Accepted: 31 May 2017 / Published: 13 June 2017
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Abstract
Dental age estimation (AE) tests are routinely done on living and deceased persons. There is anecdotal evidence suggesting an increase in age estimations due to the refugee crisis. Our aim is to determine the reasons and methods for performing dental AE tests in
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Dental age estimation (AE) tests are routinely done on living and deceased persons. There is anecdotal evidence suggesting an increase in age estimations due to the refugee crisis. Our aim is to determine the reasons and methods for performing dental AE tests in both living and deceased individuals. Global trends in AE over the past 10 years were also investigated. A database of all forensic laboratories was obtained and an electronic questionnaire was sent to all of them. The questionnaire was self-developed and included questions on the reasons for performing AE tests, the preferred methods used in living and deceased individuals, and the people/organizations who requested these AE tests. The number of tests performed annually varied between 0 and 500 and the majority were on asylum seekers, refugees, and for adoption cases. Most units used multiple techniques to determine the age among the living, but seldom used more than three techniques for the deceased. The majority of tests were requested by coroners and the legal fraternity. There has been an increase in the number of dental AEs carried out and this has been mostly due to asylum seekers and refugees. The most common techniques for the living were variations of Demirjian’s technique while country specific techniques were used for the deceased. Full article
(This article belongs to the Special Issue Refugee Health)
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Open AccessArticle Associations of Community Water Fluoridation with Caries Prevalence and Oral Health Inequality in Children
Int. J. Environ. Res. Public Health 2017, 14(6), 631; doi:10.3390/ijerph14060631
Received: 20 March 2017 / Revised: 22 May 2017 / Accepted: 6 June 2017 / Published: 13 June 2017
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Abstract
This study aimed to confirm the association between the community water fluoridation (CWF) programme and dental caries prevention on permanent teeth, comparing to a control area, neighbouring population without the programme, and verifying whether the programme can reduce the socio-economic inequality related to
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This study aimed to confirm the association between the community water fluoridation (CWF) programme and dental caries prevention on permanent teeth, comparing to a control area, neighbouring population without the programme, and verifying whether the programme can reduce the socio-economic inequality related to the oral health of children in Korea. Evaluation surveys were conducted among 6-, 8-, and 11-year-old children living in Okcheon (CWF) and neighbouring Yeongdong (non-CWF, control area) towns in South Korea. Data on monthly family income, caregiver educational level, and Family Affluence Scale scores were evaluated using questionnaires that were distributed to the parents. The effectiveness of CWF in caries reduction was calculated based on the differences in decayed, missing, and filled teeth and decayed, missing, and filled tooth surfaces indices between the two towns. The data were analysed using logistic regression and univariate analysis of variance. Both 8- and 11-year-old children living in the CWF area had lower dental caries prevalence than those living in the non-CWF community. Differences in dental caries prevalence based on educational level were found in the control area but not in the CWF area. Socio-economic factor-related inequality in oral health were observed in the non-CWF community. Additionally, 8- and 11-year-old children living in the CWF area displayed lower dental caries prevalence in the pit-and-fissure and smooth surfaces than those living in the non-CWF community. These results suggest that CWF programmes are effective in the prevention of caries on permanent teeth and can reduce oral health inequalities among children. The implementation of CWF programmes should be sustained to overcome oral health inequalities due to socio-economic factors and improve children’s overall oral health. Full article
(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)
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Open AccessArticle The Recreovía of Bogotá, a Community-Based Physical Activity Program to Promote Physical Activity among Women: Baseline Results of the Natural Experiment Al Ritmo de las Comunidades
Int. J. Environ. Res. Public Health 2017, 14(6), 633; doi:10.3390/ijerph14060633
Received: 29 March 2017 / Revised: 29 May 2017 / Accepted: 4 June 2017 / Published: 13 June 2017
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Abstract
Community-based physical activity (PA) programs in Latin America have been recognized because of the use of available environmental resources to offer PA classes. Yet, the evaluation of programs focused on PA classes involving dancing in public spaces is limited. The aim of this
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Community-based physical activity (PA) programs in Latin America have been recognized because of the use of available environmental resources to offer PA classes. Yet, the evaluation of programs focused on PA classes involving dancing in public spaces is limited. The aim of this study was to assess the physical activity levels, park use, and the contextual characteristics of public parks with and without the Recreovía in Bogotá in Colombia. Al Ritmo de las Comunidades is a natural experiment conducted in nine parks (3 parks implementing new Recreovías, 3 control parks and 3 parks with existing Recreovías) during 2013. We used the System for Observing Play and Recreation in Communities to evaluate park use (gender, age, and physical activity level) and target areas. A total of 4925 people were observed during 702 observation visits to parks. The percentage of women was higher in parks with Recreovía, compared to parks without Recreovía (53% vs. 40% vs. 33%; p < 0.001). Women using parks with Recreovía compared to women in parks without Recreovía were less likely to be sedentary (25% vs. 39%; p < 0.0001) and more likely to engage in moderate-to-vigorous activity (75% vs. 61%; p < 0.0001). Among men, the activity pattern was the opposite. The Recreovía is a promising strategy to promote park use and PA, especially among women who are less likely to meet PA recommendations during their leisure time. The provision of a cost-free community program may be an effective approach and a good investment for health. Full article
(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)
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Open AccessArticle Providing a Clean Environment for Adolescents: Evaluation of the Tobacco Hazards Prevention Act in Taiwan
Int. J. Environ. Res. Public Health 2017, 14(6), 634; doi:10.3390/ijerph14060634
Received: 14 May 2017 / Revised: 31 May 2017 / Accepted: 10 June 2017 / Published: 13 June 2017
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Abstract
Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise
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Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise awareness of the Tobacco Hazards Prevention Act to reduce the level of damage to the health of adolescents and maintain good air quality. This study had two main goals: (1) to evaluate the stipulation that no person shall provide tobacco products to persons under the age of 18 and the effects of counseling strategies on store managers confirming customer ages before tobacco sale in southern Taiwan; and (2) to evaluate the situation of tobacco hazard prevention education conducted by school in southern Taiwan. A cross-sectional design was adopted for this study. Study I: The investigation involved an analysis of 234 retailers including convenience stores (n = 70), grocery stores (n = 83), and betel nut stalls (n = 81). The results indicated that among the 234 retailers, 171 (73.1%) of them routinely failed to confirm the buyers’ ages before allowing them to purchase tobacco. The number of retailers who exhibited failure to confirm customer ages before selling tobacco products had decreased from 171 (73.1%) to 59 (25.2%) and that of those who confirmed customer ages before selling tobacco products had increased from 63 (26.9%) to 175 (74.8%) after counseling strategies had been provided, thereby revealing statistical significance (χ2 = 11.26, p < 0.001). Study II: A total of 476 (89.1%) participants had received tobacco hazards prevention education and 58 (10.9%) had not. Among the various residential areas, the highest percentage of participants that did not received tobacco hazards prevention education located in the plane regions (8.4%). The government organizations should continue to adopt counseling strategies to reduce the rate of disobedience of the Tobacco Hazards Prevention Act by selling tobacco products to minors. Schools should pay close attention to tobacco hazard prevention education for junior high school students to ensure that such students are adequately educated about tobacco hazard prevention. Full article
(This article belongs to the collection Health Behavior and Public Health)
Open AccessArticle Drivers of Microbial Risk for Direct Potable Reuse and de Facto Reuse Treatment Schemes: The Impacts of Source Water Quality and Blending
Int. J. Environ. Res. Public Health 2017, 14(6), 635; doi:10.3390/ijerph14060635
Received: 8 May 2017 / Revised: 6 June 2017 / Accepted: 7 June 2017 / Published: 13 June 2017
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Abstract
Although reclaimed water for potable applications has many potential benefits, it poses concerns for chemical and microbial risks to consumers. We present a quantitative microbial risk assessment (QMRA) Monte Carlo framework to compare a de facto water reuse scenario (treated wastewater-impacted surface water)
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Although reclaimed water for potable applications has many potential benefits, it poses concerns for chemical and microbial risks to consumers. We present a quantitative microbial risk assessment (QMRA) Monte Carlo framework to compare a de facto water reuse scenario (treated wastewater-impacted surface water) with four hypothetical Direct Potable Reuse (DPR) scenarios for Norovirus, Cryptosporidium, and Salmonella. Consumer microbial risks of surface source water quality (impacted by 0–100% treated wastewater effluent) were assessed. Additionally, we assessed risks for different blending ratios (0–100% surface water blended into advanced-treated DPR water) when source surface water consisted of 50% wastewater effluent. De facto reuse risks exceeded the yearly 10−4 infections risk benchmark while all modeled DPR risks were significantly lower. Contamination with 1% or more wastewater effluent in the source water, and blending 1% or more wastewater-impacted surface water into the advanced-treated DPR water drove the risk closer to the 10−4 benchmark. We demonstrate that de facto reuse by itself, or as an input into DPR, drives microbial risks more so than the advanced-treated DPR water. When applied using location-specific inputs, this framework can contribute to project design and public awareness campaigns to build legitimacy for DPR. Full article
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Open AccessFeature PaperArticle Dietary Calcium Intake and Adherence to the Mediterranean Diet in Spanish Children: The ANIVA Study
Int. J. Environ. Res. Public Health 2017, 14(6), 637; doi:10.3390/ijerph14060637
Received: 2 March 2017 / Revised: 6 June 2017 / Accepted: 10 June 2017 / Published: 14 June 2017
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Abstract
The aim of this study was to evaluate the relationship of dietary calcium intake with anthropometric measures, physical activity and adherence to the Mediterranean diet (MedDiet) in 1176 Spanish children aged 6–9 years. Data were obtained from “Antropometría y Nutrición Infantil de Valencia”
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The aim of this study was to evaluate the relationship of dietary calcium intake with anthropometric measures, physical activity and adherence to the Mediterranean diet (MedDiet) in 1176 Spanish children aged 6–9 years. Data were obtained from “Antropometría y Nutrición Infantil de Valencia” (ANIVA), a cross-sectional study of a representative sample. Dietary calcium intake assessed from three-day food records was compared to recommended daily intakes in Spain. Anthropometric measures (weight and height) were measured according to international standards and adherence to the MedDiet was evaluated using the Mediterranean Diet Quality Index (KIDMED) test. For the total sample of children, 25.8% had inadequate calcium intake, a significantly higher prevalence in girls (p = 0.006) and inadequate calcium intake was associated with lower height z-score (p = 0.001) for both sexes. In girls, there was an inverse relationship between calcium intake and body mass index (p = 0.001) and waist/hip ratio (p = 0.018). Boys presented a polarization in physical activity, reporting a greater level of both physical and sedentary activity in comparison with girls (p = 0.001). Children with poor adherence to MedDiet, even if they consume two yogurts or cheese (40 g) daily, adjusted by gender, age, total energy intake, physical activity and father’s level of education, are at risk of inadequate total calcium intake (odds ratio adjusted [ORa]: 3.36, 95% confidence interval [CI]: 1.13–9.94, p = 0.001). The intake of these dairy products was insufficient to cover calcium intake recommendations in this age group (6–9 years). It is important to prioritize health strategies that promote the MedDiet and to increase calcium intake in this age group. Full article
(This article belongs to the Special Issue Nutrition and Public Health)
Open AccessFeature PaperArticle Dissemination of Chronic Disease Self-Management Education (CDSME) Programs in the United States: Intervention Delivery by Rurality
Int. J. Environ. Res. Public Health 2017, 14(6), 638; doi:10.3390/ijerph14060638
Received: 1 April 2017 / Revised: 27 May 2017 / Accepted: 6 June 2017 / Published: 14 June 2017
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Abstract
Background: Alongside the dramatic increase of older adults in the United States (U.S.), it is projected that the aging population residing in rural areas will continue to grow. As the prevalence of chronic diseases and multiple chronic conditions among adults continues to
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Background: Alongside the dramatic increase of older adults in the United States (U.S.), it is projected that the aging population residing in rural areas will continue to grow. As the prevalence of chronic diseases and multiple chronic conditions among adults continues to rise, there is additional need for evidence-based interventions to assist the aging population to improve lifestyle behaviors, and self-manage their chronic conditions. The purpose of this descriptive study was to identify the geospatial dissemination of Chronic Disease Self-Management Education (CDSME) Programs across the U.S. in terms of participants enrolled, workshops delivered, and counties reached. These dissemination characteristics were compared across rurality designations (i.e., metro areas; non-metro areas adjacent to metro areas, and non-metro areas not adjacent to metro areas). Methods: This descriptive study analyzed data from a national repository including efforts from 83 grantees spanning 47 states from December 2009 to December 2016. Counts were tabulated and averages were calculated. Results: CDSME Program workshops were delivered in 56.4% of all U.S. counties one or more times during the study period. Of the counties where a workshop was conducted, 50.5% were delivered in non-metro areas. Of the 300,640 participants enrolled in CDSME Programs, 12% attended workshops in non-metro adjacent areas, and 7% attended workshops in non-metro non-adjacent areas. The majority of workshops were delivered in healthcare organizations, senior centers/Area Agencies on Aging, and residential facilities. On average, participants residing in non-metro areas had better workshop attendance and retention rates compared to participants in metro areas. Conclusions: Findings highlight the established role of traditional organizations/entities within the aging services network, to reach remote areas and serve diverse participants (e.g., senior centers). To facilitate growth in rural areas, technical assistance will be needed. Additional efforts are needed to bolster partnerships (e.g., sharing resources and knowledge), marketing (e.g., tailored material), and regular communication among stakeholders. Full article
(This article belongs to the Special Issue Aging and Health Promotion)
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Open AccessArticle Association between Food for Life, a Whole Setting Healthy and Sustainable Food Programme, and Primary School Children’s Consumption of Fruit and Vegetables: A Cross-Sectional Study in England
Int. J. Environ. Res. Public Health 2017, 14(6), 639; doi:10.3390/ijerph14060639
Received: 1 April 2017 / Revised: 9 May 2017 / Accepted: 12 June 2017 / Published: 14 June 2017
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Abstract
The promotion of dietary health is a public health priority in England and in other countries. Research shows that the majority of children do not consume the recommended amount of fruit and vegetables (F&V). There has been relatively little research on the impact
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The promotion of dietary health is a public health priority in England and in other countries. Research shows that the majority of children do not consume the recommended amount of fruit and vegetables (F&V). There has been relatively little research on the impact of programmes, such as Food for Life, that (a) integrate action on nutrition and food sustainability issues, and (b) are delivered as commissions in a local authority area. The study sought to assess pupil F&V in schools engaged with the Food for Life (FFL) programme. The design was a cross-sectional study comparing pupils in FFL engaged (n = 24) and non-engaged (n = 23) schools. A total of 2411 pupils aged 8–10 completed a validated self-report questionnaire. After adjusting for confounders, pupils in schools engaged with FFL consumed significantly more servings of F&V compared to pupils in comparison schools (M = 2.03/1.54, p < 0.001). Pupils in FFL schools were twice as likely to eat five or more portions of F&V per day (Odds Ratio = 2.07, p < 0.001, Confidence Interval = 1.54, 2.77). Total F&V consumption was significantly higher (p < 0.05) amongst pupils in schools with a higher level FFL award. Whilst limitations include possible residual confounding, the study suggests primary school engagement with the FFL programme may be an effective way of improving children’s dietary health. Full article
Open AccessArticle An Evaluation of the Proposed Worker Protection Standard with Respect to Pesticide Exposure and Parkinson’s Disease
Int. J. Environ. Res. Public Health 2017, 14(6), 640; doi:10.3390/ijerph14060640
Received: 16 February 2017 / Revised: 6 June 2017 / Accepted: 7 June 2017 / Published: 14 June 2017
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Abstract
Citing a lack of information, the U.S. Environmental Protection Agency prudently did not account for the benefits of averting many chronic diseases in analyzing the Worker Protection Standards (WPS) revisions. We demonstrate that sufficient information can exist, using the example of the benefits
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Citing a lack of information, the U.S. Environmental Protection Agency prudently did not account for the benefits of averting many chronic diseases in analyzing the Worker Protection Standards (WPS) revisions. We demonstrate that sufficient information can exist, using the example of the benefits to agricultural workers of reduced Parkinson’s disease (PD) due to reduced pesticide exposure. We define the benefits as the monetary value gained by improving quality of lives of people who would otherwise develop PD, plus the value of medical care cost averted and income not lost due to being healthy. For estimation, we use readily available parameters and obtain odds ratios of developing PD by conducting a meta-analysis of studies linking pesticide exposure to PD. The sensitivity analysis varies the number of agricultural workers affected by the regulation, the probability of being diagnosed with PD, the measurement and the timing of the benefits. Our initial assessment is that the reduced PD benefits would be a small fraction of the total WPS revision costs. However, if we define benefits as the common environmental economics willingness to pay to avoid PD incidence, then they become a substantial fraction of the costs. Our analysis demonstrates that the benefits of averting PD from the WPS revisions can be estimated using existing information, and that the results are most sensitive to the choice of valuation of benefits to the worker. We encourage other researchers to extend our framework to other chronic ailments. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle Investigation of Acute Pulmonary Deficits Associated with Biomass Fuel Cookstove Emissions in Rural Bangladesh
Int. J. Environ. Res. Public Health 2017, 14(6), 641; doi:10.3390/ijerph14060641
Received: 4 April 2017 / Revised: 20 May 2017 / Accepted: 9 June 2017 / Published: 15 June 2017
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Abstract
The use of solid biomass fuels in cookstoves has been associated with chronic health impacts that disproportionately affect women worldwide. Solid fuel stoves that use wood, plant matter, and cow dung are commonly used for household cooking in rural Bangladesh. This study investigates
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The use of solid biomass fuels in cookstoves has been associated with chronic health impacts that disproportionately affect women worldwide. Solid fuel stoves that use wood, plant matter, and cow dung are commonly used for household cooking in rural Bangladesh. This study investigates the immediate effects of acute elevated cookstove emission exposures on pulmonary function. Pulmonary function was measured with spirometry before and during cooking to assess changes in respiratory function during exposure to cookstove emissions for 15 females ages 18–65. Cookstove emissions were characterized using continuous measurements of particulate matter (PM2.5—aerodynamic diameter <2.5 μm) concentrations at a 1 s time resolution for each household. Several case studies were observed where women ≥40 years who had been cooking for ≥25 years suffered from severe pulmonary impairment. Forced expiratory volume in one second over forced vital capacity (FEV1/FVC) was found to moderately decline (p = 0.06) during cooking versus non-cooking in the study cohort. The study found a significant (α < 0.05) negative association between 3- and 10-min maximum PM2.5 emissions during cooking and lung function measurements of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC obtained during cooking intervals. This study found that exposure to biomass burning emissions from solid fuel stoves- associated with acute elevated PM2.5 concentrations- leads to a decrease in pulmonary function, although further research is needed to ascertain the prolonged (e.g., daily, for multiple years) impacts of acute PM2.5 exposure on immediate and sustained respiratory impairment. Full article
(This article belongs to the Special Issue Indoor Air Quality and Health 2016)
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Open AccessArticle Public Perceptions of Service Dogs, Emotional Support Dogs, and Therapy Dogs
Int. J. Environ. Res. Public Health 2017, 14(6), 642; doi:10.3390/ijerph14060642
Received: 5 May 2017 / Revised: 5 June 2017 / Accepted: 12 June 2017 / Published: 15 June 2017
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Abstract
As service dogs, emotional support dogs, and therapy dogs have become more prevalent in the USA, so too has the controversy surrounding their legitimacy. Yet, there is a lack of objective data regarding the public’s understanding of the role played by each of
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As service dogs, emotional support dogs, and therapy dogs have become more prevalent in the USA, so too has the controversy surrounding their legitimacy. Yet, there is a lack of objective data regarding the public’s understanding of the role played by each of these types of animals, as well as their perceptions regarding the legitimacy of their integration. An anonymous, online survey was distributed to examine the perceptions of US adults who do not own any type of assistance animal. A total of 505 individuals responded to the online survey, yielding 284 usable responses. Results suggest widespread misconceptions about definitions, rules, regulations, and rights associated with each type of assistance dog. In general, service dogs are more likely to be perceived as helping with a legitimate need, and their access to public spaces is viewed favorably. While there are some concerns about the legitimacy and necessary access rights for emotional support dogs, members of the public correctly identified the roles and rights of therapy dogs. Despite the media’s focus on abuses and false representation of these dogs, most participants reported feeling the majority of people are not taking advantage of the system. Full article
(This article belongs to the Special Issue Animal Assisted Interventions and Activities for Health and Wellbeing)
Open AccessArticle Urban Ecological Security Simulation and Prediction Using an Improved Cellular Automata (CA) Approach—A Case Study for the City of Wuhan in China
Int. J. Environ. Res. Public Health 2017, 14(6), 643; doi:10.3390/ijerph14060643
Received: 29 April 2017 / Revised: 12 June 2017 / Accepted: 13 June 2017 / Published: 15 June 2017
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Abstract
Ecological security is an important research topic, especially urban ecological security. As highly populated eco-systems, cities always have more fragile ecological environments. However, most of the research on urban ecological security in literature has focused on evaluating current or past status of the
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Ecological security is an important research topic, especially urban ecological security. As highly populated eco-systems, cities always have more fragile ecological environments. However, most of the research on urban ecological security in literature has focused on evaluating current or past status of the ecological environment. Very little literature has carried out simulation or prediction of future ecological security. In addition, there is even less literature exploring the urban ecological environment at a fine scale. To fill-in the literature gap, in this study we simulated and predicted urban ecological security at a fine scale (district level) using an improved Cellular Automata (CA) approach. First we used the pressure-state-response (PSR) method based on grid-scale data to evaluate urban ecological security. Then, based on the evaluation results, we imported the geographically weighted regression (GWR) concept into the CA model to simulate and predict urban ecological security. We applied the improved CA approach in a case study—simulating and predicting urban ecological security for the city of Wuhan in Central China. By comparing the simulated ecological security values from 2010 using the improved CA model to the actual ecological security values of 2010, we got a relatively high value of the kappa coefficient, which indicates that this CA model can simulate or predict well future development of ecological security in Wuhan. Based on the prediction results for 2020, we made some policy recommendations for each district in Wuhan. Full article
(This article belongs to the Special Issue Human Health, Risk Analysis and Environmental Hazards)
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Open AccessArticle Examining Associations of Environmental Characteristics with Recreational Cycling Behaviour by Street-Level Strava Data
Int. J. Environ. Res. Public Health 2017, 14(6), 644; doi:10.3390/ijerph14060644
Received: 20 March 2017 / Revised: 5 May 2017 / Accepted: 12 June 2017 / Published: 15 June 2017
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Abstract
Policymakers pay much attention to effectively increasing frequency of people’s cycling in the context of developing sustainable and green cities. Investigating associations of environmental characteristics and cycling behaviour could offer implications for changing urban infrastructure aiming at encouraging active travel. However, earlier examinations
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Policymakers pay much attention to effectively increasing frequency of people’s cycling in the context of developing sustainable and green cities. Investigating associations of environmental characteristics and cycling behaviour could offer implications for changing urban infrastructure aiming at encouraging active travel. However, earlier examinations of associations between environmental characteristics and active travel behaviour are limited by low spatial granularity and coverage of traditional data. Crowdsourced geographic information offers an opportunity to determine the fine-grained travel patterns of people. Particularly, Strava Metro data offer a good opportunity for studies of recreational cycling behaviour as they can offer hourly, daily or annual cycling volumes with different purposes (commuting or recreational) in each street across a city. Therefore, in this study, we utilised Strava Metro data for investigating associations between environmental characteristics and recreational cycling behaviour at a large spatial scale (street level). In this study, we took account of population density, employment density, road length, road connectivity, proximity to public transit services, land use mix, proximity to green space, volume of motor vehicles and traffic accidents in an empirical investigation over Glasgow. Empirical results reveal that Strava cyclists are more likely to cycle for recreation on streets with short length, large connectivity or low volume of motor vehicles or on streets surrounded by residential land. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Environmental, Human Health and Socio-Economic Effects of Cement Powders: The Multicriteria Analysis as Decisional Methodology
Int. J. Environ. Res. Public Health 2017, 14(6), 645; doi:10.3390/ijerph14060645
Received: 12 May 2017 / Revised: 9 June 2017 / Accepted: 10 June 2017 / Published: 16 June 2017
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Abstract
The attention to sustainability-related issues has grown fast in recent decades. The experience gained with these themes reveals the importance of considering this topic in the construction industry, which represents an important sector throughout the world. This work consists on conducting a multicriteria
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The attention to sustainability-related issues has grown fast in recent decades. The experience gained with these themes reveals the importance of considering this topic in the construction industry, which represents an important sector throughout the world. This work consists on conducting a multicriteria analysis of four cement powders, with the objective of calculating and analysing the environmental, human health and socio-economic effects of their production processes. The economic, technical, environmental and safety performances of the examined powders result from official, both internal and public, documents prepared by the producers. The Analytic Hierarchy Process permitted to consider several indicators (i.e., environmental, human health related and socio-economic parameters) and to conduct comprehensive and unbiased analyses which gave the best, most sustainable cement powder. As assumed in this study, the contribution of each considered parameter to the overall sustainability has a different incidence, therefore the procedure could be used to support on-going sustainability efforts under different conditions. The results also prove that it is not appropriate to regard only one parameter to identify the ‘best’ cement powder, but several impact categories should be considered and analysed if there is an interest for pursuing different, often conflicting interests. Full article
(This article belongs to the Special Issue Human Health, Risk Analysis and Environmental Hazards)
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Open AccessArticle Why Don’t More Smokers Switch to Using E-Cigarettes: The Views of Confirmed Smokers
Int. J. Environ. Res. Public Health 2017, 14(6), 647; doi:10.3390/ijerph14060647
Received: 21 April 2017 / Revised: 8 June 2017 / Accepted: 13 June 2017 / Published: 16 June 2017
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Abstract
Whilst e-cigarettes have been characterised by Public Health England as being around 95% less harmful than combustible tobacco products, only a minority of current smokers (around 16% within the UK) are using these devices. In this paper we report the results of an
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Whilst e-cigarettes have been characterised by Public Health England as being around 95% less harmful than combustible tobacco products, only a minority of current smokers (around 16% within the UK) are using these devices. In this paper we report the results of an online survey of 650 smokers in contact with a smokers’ rights group in the UK. A total of 91% of the smokers surveyed were smoking on a daily basis. Fifty nine percent reported having used electronic nicotine delivery systems, the majority of whom reported having used e-cigarettes. Those smokers that had not used these devices principally explained this in terms of the pleasure they derived from smoking. The features smokers’ liked most about e-cigarette had to do with the range of settings in which they could be used, the lack of an offensive smell associated with their use, the available flavours and the reduced level of harm. The elements which smokers liked least about e-cigarettes had to do with the vaping experience, the technology, the chemical nature of e-liquids and the complex technology that was associated with these devices. If a greater number of smokers are to be encouraged to take up e-cigarettes, it will be necessary not only to convey accurate information on the relative harm of these devices (compared to combustible tobacco products), but to ensure that they are able to be used in a wider range of settings than those within which smoking can currently occur and that the vaping experience more closely resembles the smoking experience. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
Open AccessArticle Geographic Variations in Cardiometabolic Risk Factors in Luxembourg
Int. J. Environ. Res. Public Health 2017, 14(6), 648; doi:10.3390/ijerph14060648
Received: 13 April 2017 / Revised: 5 June 2017 / Accepted: 5 June 2017 / Published: 16 June 2017
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Abstract
Cardiovascular disease (CVD) and associated behavioural and metabolic risk factors constitute a major public health concern at a global level. Many reports worldwide have documented different risk profiles for populations with demographic variations. The objective of this study was to examine geographic variations
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Cardiovascular disease (CVD) and associated behavioural and metabolic risk factors constitute a major public health concern at a global level. Many reports worldwide have documented different risk profiles for populations with demographic variations. The objective of this study was to examine geographic variations in the top leading cardio metabolic and behavioural risk factors in Luxembourg, in order to provide an overall picture of CVD burden across the country. The analysis conducted was based on data from the nationwide ORISCAV-LUX survey, including 1432 subjects, aged 18–69 years. A self-reported questionnaire, physical examination and blood sampling were performed. Age and sex-adjusted risk profile maps were generated using multivariate Bayesian geo-additive regression models, based on Markov Chain Monte Carlo techniques and were used to evaluate the significance of the spatial effects on the distribution of a range of cardio metabolic risk factors, namely smoking, high body mass index (BMI), high blood pressure, high fasting plasma glucose, alcohol use, high total cholesterol, low glomerular filtration rate, and physical inactivity. Higher prevalence of smoking was observed in the northern regions, higher overweight/obesity and abdominal obesity clustered in the central belt, whereas hypertension was spotted particularly in the southern part of the country. Maps revealed that subjects residing in Luxembourg canton were significantly less likely to be hypertensive or overweight/obese, whereas they were less likely to practice physical activity of ≥8000 Metabolic Equivalent of Task (MET)-min/week. These patterns were also observed at the municipality level in Luxembourg. Statistically, there were non-significant spatial patterns regarding smoking, diabetes, total serum cholesterol and low glomerular filtration rate risk distribution. This comprehensive risk profile mapping showed remarkable geographic variations in cardio metabolic and behavioural risk factors. Considering the prominent burden of CVD this research provides opportunities for tailored interventions and may help to better fight against this escalating public health problem. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle The Impact of Service Dogs on Engagement in Occupation among Females with Mobility Impairments: A Qualitative Descriptive Study
Int. J. Environ. Res. Public Health 2017, 14(6), 649; doi:10.3390/ijerph14060649
Received: 13 April 2017 / Revised: 25 May 2017 / Accepted: 12 June 2017 / Published: 16 June 2017
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Abstract
It is becoming more common for people with disabilities to procure service dogs as a form of assistive technology (AT). However, there is little qualitative research examining the impact of service dogs on engagement in valued daily activities (occupations) among persons with mobility
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It is becoming more common for people with disabilities to procure service dogs as a form of assistive technology (AT). However, there is little qualitative research examining the impact of service dogs on engagement in valued daily activities (occupations) among persons with mobility impairments. This study used a qualitative descriptive methodology to learn about the experiences of four female service dog owners with mobility impairments, with a focus on the impact of service dog use on the performance of daily occupations and participation in social activities, and their experiences utilizing a service dog as a form of AT. Data analysis indicated that each participant’s service dog made a significant impact on their everyday lives and their ability to independently perform everyday activities; however, there are also unique challenges associated with service dog ownership that must be considered when evaluating benefits of service dog partnership. Overall, the positive outcomes reported by participants indicate that service dogs can be considered a beneficial, adaptable form of AT for some persons with mobility impairments. Full article
(This article belongs to the Special Issue Animal Assisted Interventions and Activities for Health and Wellbeing)
Open AccessArticle Media Coverage of Alcohol Issues: A Critical Political Economy Framework—A Case Study from Ireland
Int. J. Environ. Res. Public Health 2017, 14(6), 650; doi:10.3390/ijerph14060650
Received: 29 April 2017 / Revised: 31 May 2017 / Accepted: 13 June 2017 / Published: 16 June 2017
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Abstract
There is a growing literature on news media representations of alcohol-related issues. However, current scholarship has neglected critical political economic frameworks to interpret media coverage of alcohol. This paper presents such a framework that conceives of news organisations as corporations that share the
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There is a growing literature on news media representations of alcohol-related issues. However, current scholarship has neglected critical political economic frameworks to interpret media coverage of alcohol. This paper presents such a framework that conceives of news organisations as corporations that share the values and interests of political and economic elites. The media are thus expected to present viewpoints that are more aligned with the alcohol industry than the scientific consensus on public health policy would warrant. The media are also expected, but to a lesser extent, to present a certain amount of support for public health perspectives because these are supported by a few socioeconomic elite groups (the medical professions, progressive politicians). The case of Ireland from 2012 to 2017 illustrates the framework empirically. Four main newspapers’ coverage of the Public Health (Alcohol) Bill and related policies is examined. Results show that, overall, 44.0% of articles support public health measures and 56.0% are opposed or remain neutral. It is argued that the media are not strong proponents of public health for multiple reasons: there are more articles opposed to or neutral toward public health measures than supporting them; the number of supportive articles remains relatively small and there are still many pieces presenting drinks industry views; there are virtually no calls in the media for stronger measures; supportive coverage is partially explained by the pub owners lobby’s support for minimum unit pricing; the media often downplay or ignore the negative consequences of alcohol, such as its role in accidents; many news articles normalise drinking and promote events sponsored by the industry; there is not a single Irish journalist covering alcohol issues systematically; and other policy issues that are prioritised by elites receive multiple times more media coverage than public health measures. In short, the media reflect the views of the political and economic establishment on public health measures: there is some support from the medical professions and progressive politicians, but overall, there is a clear reluctance to support strong public health strategies. One main recommendation for public health advocates to promote their perspectives is to diversify the mass media and make them less commercial in nature, as well as to engage with non-corporate, so-called progressive “alternative media” outlets. Full article
(This article belongs to the Special Issue Alcohol and Health)
Open AccessArticle Lower Physical Performance in Colder Seasons and Colder Houses: Evidence from a Field Study on Older People Living in the Community
Int. J. Environ. Res. Public Health 2017, 14(6), 651; doi:10.3390/ijerph14060651
Received: 15 April 2017 / Revised: 14 June 2017 / Accepted: 14 June 2017 / Published: 17 June 2017
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Abstract
The aim of this paper was to explore the effect of seasonal temperature differences and cold indoor environment in winter on the physical performance of older people living in the community based on a field study. We recruited 162 home-dwelling older people from
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The aim of this paper was to explore the effect of seasonal temperature differences and cold indoor environment in winter on the physical performance of older people living in the community based on a field study. We recruited 162 home-dwelling older people from a rehabilitation facility in the Osaka prefecture, Japan; physical performance data were available from 98/162 (60.5%). At the same time, for some participants, a questionnaire survey and a measurement of the indoor temperature of individual houses were conducted. The analysis showed that there were seasonal trends in the physical performance of older people and that physical performance was worse in the winter compared with the autumn. Furthermore, people living in colder houses had worse physical performance. The findings indicate that keeping the house warm in the winter can help to maintain physical performance. Full article
(This article belongs to the Special Issue Housing and Health)
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Open AccessArticle Structured Additive Quantile Regression for Assessing the Determinants of Childhood Anemia in Rwanda
Int. J. Environ. Res. Public Health 2017, 14(6), 652; doi:10.3390/ijerph14060652
Received: 16 March 2017 / Revised: 26 May 2017 / Accepted: 14 June 2017 / Published: 17 June 2017
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Abstract
Childhood anemia is among the most significant health problems faced by public health departments in developing countries. This study aims at assessing the determinants and possible spatial effects associated with childhood anemia in Rwanda. The 2014/2015 Rwanda Demographic and Health Survey (RDHS) data
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Childhood anemia is among the most significant health problems faced by public health departments in developing countries. This study aims at assessing the determinants and possible spatial effects associated with childhood anemia in Rwanda. The 2014/2015 Rwanda Demographic and Health Survey (RDHS) data was used. The analysis was done using the structured spatial additive quantile regression model. The findings of this study revealed that the child’s age; the duration of breastfeeding; gender of the child; the nutritional status of the child (whether underweight and/or wasting); whether the child had a fever; had a cough in the two weeks prior to the survey or not; whether the child received vitamin A supplementation in the six weeks before the survey or not; the household wealth index; literacy of the mother; mother’s anemia status; mother’s age at the birth are all significant factors associated with childhood anemia in Rwanda. Furthermore, significant structured spatial location effects on childhood anemia was found. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Association between Six CETP Polymorphisms and Metabolic Syndrome in Uyghur Adults from Xinjiang, China
Int. J. Environ. Res. Public Health 2017, 14(6), 653; doi:10.3390/ijerph14060653
Received: 8 May 2017 / Revised: 15 June 2017 / Accepted: 15 June 2017 / Published: 18 June 2017
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Abstract
Objective: To explore the association between CETP gene polymorphisms and metabolic syndrome (MS), as well as the relationship between the CETP gene polymorphisms and each component of MS. Methods: A total of 571 individuals which were randomly selected from 5692 Uyghur adults were
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Objective: To explore the association between CETP gene polymorphisms and metabolic syndrome (MS), as well as the relationship between the CETP gene polymorphisms and each component of MS. Methods: A total of 571 individuals which were randomly selected from 5692 Uyghur adults were subdivided into two groups, including 280 patients with MS and 291 control subjects, using the group-matching method after matching for gender. We detected CETP polymorphisms (rs5882, rs1800775, rs3764261, rs12149545, rs711752, and rs708272) by using the Snapshot method. Results: (1) Significant differences were found involving the frequency distribution of genotypes and alleles of rs1800775, rs3764261, rs12149545, rs711752, and rs708272 between the control and MS groups (all p < 0.05). (2) rs1800775, rs3764261, rs12149545, rs711752, and rs708272 polymorphisms were significantly related to the risk of MS (all p < 0.05). (3) The rs1800775 polymorphism was associated with high fasting blood glucose levels and low high density lipoprotein cholesterol (HDL-C); rs3764261 and rs12149545 polymorphisms were associated with all components of MS except high blood pressure; rs711752 and rs708272 polymorphisms were associated with low HDL-C (all p < 0.05). (4) Complete linkage disequilibrium (LD) was identified for two pairs of single nucleotide polymorphisms (SNPs) (rs3764261 and rs12149545 (D’ = 1.000, r2 = 0.931), rs711752 and rs708272 (D’ = 1.000, r2 = 0.996)). (5) The A-G-G-G-C (p = 0.013, odds ratio [OR] = 0.622, 95% confidence interval [95% CI] = 0.427–0.906) and A-T-A-A-T (p < 0.001, OR = 0.519, 95% CI = 0.386–0.697) haplotypes were more frequent in the control group than in the case group. Conclusions: The rs1800775, rs3764261, rs12149545, rs711752, and rs708272 polymorphisms of CETP were associated with MS and its components among the Uyghur ethnic group. Complete LD was found between two pairs of SNPs (rs3764261 and rs12149545, rs711752, and rs708272). The A-G-G-G-C and A-T-A-A-T haplotypes might be protective factors for MS. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Assessing Statistically Significant Heavy-Metal Concentrations in Abandoned Mine Areas via Hot Spot Analysis of Portable XRF Data
Int. J. Environ. Res. Public Health 2017, 14(6), 654; doi:10.3390/ijerph14060654
Received: 6 May 2017 / Revised: 14 June 2017 / Accepted: 15 June 2017 / Published: 18 June 2017
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Abstract
To develop appropriate measures to prevent soil contamination in abandoned mining areas, an understanding of the spatial variation of the potentially toxic trace elements (PTEs) in the soil is necessary. For the purpose of effective soil sampling, this study uses hot spot analysis,
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To develop appropriate measures to prevent soil contamination in abandoned mining areas, an understanding of the spatial variation of the potentially toxic trace elements (PTEs) in the soil is necessary. For the purpose of effective soil sampling, this study uses hot spot analysis, which calculates a z-score based on the Getis-Ord Gi* statistic to identify a statistically significant hot spot sample. To constitute a statistically significant hot spot, a feature with a high value should also be surrounded by other features with high values. Using relatively cost- and time-effective portable X-ray fluorescence (PXRF) analysis, sufficient input data are acquired from the Busan abandoned mine and used for hot spot analysis. To calibrate the PXRF data, which have a relatively low accuracy, the PXRF analysis data are transformed using the inductively coupled plasma atomic emission spectrometry (ICP-AES) data. The transformed PXRF data of the Busan abandoned mine are classified into four groups according to their normalized content and z-scores: high content with a high z-score (HH), high content with a low z-score (HL), low content with a high z-score (LH), and low content with a low z-score (LL). The HL and LH cases may be due to measurement errors. Additional or complementary surveys are required for the areas surrounding these suspect samples or for significant hot spot areas. The soil sampling is conducted according to a four-phase procedure in which the hot spot analysis and proposed group classification method are employed to support the development of a sampling plan for the following phase. Overall, 30, 50, 80, and 100 samples are investigated and analyzed in phases 1–4, respectively. The method implemented in this case study may be utilized in the field for the assessment of statistically significant soil contamination and the identification of areas for which an additional survey is required. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study
Int. J. Environ. Res. Public Health 2017, 14(6), 655; doi:10.3390/ijerph14060655
Received: 20 February 2017 / Revised: 9 June 2017 / Accepted: 14 June 2017 / Published: 19 June 2017
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Abstract
Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related
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Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS. Full article
Open AccessArticle Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: Representativeness of the Monitoring Results in Fukushima, Japan
Int. J. Environ. Res. Public Health 2017, 14(6), 656; doi:10.3390/ijerph14060656
Received: 13 April 2017 / Revised: 10 June 2017 / Accepted: 16 June 2017 / Published: 20 June 2017
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Abstract
Following Japan’s 2011 Fukushima nuclear incident, voluntary participation, rather than mandatory, was adopted as the default scenario for individual radiation monitoring. We evaluated the representativeness of the internal monitoring results from voluntary participants in Minamisoma City, which is located 10–40 km from the
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Following Japan’s 2011 Fukushima nuclear incident, voluntary participation, rather than mandatory, was adopted as the default scenario for individual radiation monitoring. We evaluated the representativeness of the internal monitoring results from voluntary participants in Minamisoma City, which is located 10–40 km from the Fukushima nuclear plant. Of approximately 70,000 individuals who were residing in Minamisoma City before the incident, a total of 19,263 residents (aged ≥21 years) participated in the monitoring from 1 October 2011 to 31 March 2015. Based on regression projection techniques with the available data obtained from the voluntary participants, the modeled probabilities of radiocesium (Cs) detection in October 2011 for Cs-137 and Cs-134 were 66.9% and 52.9%, respectively, which declined dramatically within a year following the incident. The rate of decline had stagnated since mid-2012, and the probability was close to zero after mid-2014. Sufficient agreement between the modeled probabilities of Cs detection (for the whole population) versus the measured Cs levels (for voluntary participants) was observed, except for Cs-134 in October 2011, indicating that the voluntary monitoring participant group was a good representative sample. Our findings affirmed the clinical importance of voluntary-based monitoring as a screening and dose-assessment tool in a post-nuclear incident. Our study informs societal decision-making regarding the long-term maintenance of the monitoring program under the current low exposure levels. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Paternal Risk Factors for Oral Clefts in Northern Africans, Southeast Asians, and Central Americans
Int. J. Environ. Res. Public Health 2017, 14(6), 657; doi:10.3390/ijerph14060657
Received: 26 April 2017 / Revised: 9 June 2017 / Accepted: 15 June 2017 / Published: 19 June 2017
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Abstract
While several studies have investigated maternal exposures as risk factors for oral clefts, few have examined paternal factors. We conducted an international multi-centered case–control study to better understand paternal risk exposures for oral clefts (cases = 392 and controls = 234). Participants were
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While several studies have investigated maternal exposures as risk factors for oral clefts, few have examined paternal factors. We conducted an international multi-centered case–control study to better understand paternal risk exposures for oral clefts (cases = 392 and controls = 234). Participants were recruited from local hospitals and oral cleft repair surgical missions in Vietnam, the Philippines, Honduras, and Morocco. Questionnaires were administered to fathers and mothers separately to elicit risk factor and family history data. Associations between paternal exposures and risk of clefts were assessed using logistic regression adjusting for potential confounders. A father’s personal/family history of clefts was associated with significantly increased risk (adjusted OR: 4.77; 95% CI: 2.41–9.45). No other significant associations were identified for other suspected risk factors, including education (none/primary school v. university adjusted OR: 1.29; 95% CI: 0.74–2.24), advanced paternal age (5-year adjusted OR: 0.98; 95% CI: 0.84–1.16), or pre-pregnancy tobacco use (adjusted OR: 0.96; 95% CI: 0.67–1.37). Although sample size was limited, significantly decreased risks were observed for fathers with selected occupations. Further research is needed to investigate paternal environmental exposures as cleft risk factors. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Attachment Style Is Related to Quality of Life for Assistance Dog Owners
Int. J. Environ. Res. Public Health 2017, 14(6), 658; doi:10.3390/ijerph14060658
Received: 28 April 2017 / Revised: 30 May 2017 / Accepted: 12 June 2017 / Published: 19 June 2017
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Abstract
Attachment styles have been shown to affect quality of life. Growing interest in the value of companion animals highlights that owning a dog can also affect quality of life, yet little research has explored the role of the attachment bond in affecting the
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Attachment styles have been shown to affect quality of life. Growing interest in the value of companion animals highlights that owning a dog can also affect quality of life, yet little research has explored the role of the attachment bond in affecting the relationship between dog ownership and quality of life. Given that the impact of dog ownership on quality of life may be greater for assistance dog owners than pet dog owners, we explored how anxious attachment and avoidance attachment styles to an assistance dog affected owner quality of life (n = 73). Regression analysis revealed that higher anxious attachment to the dog predicted enhanced quality of life. It is suggested that the unique, interdependent relationship between an individual and their assistance dog may mean that an anxious attachment style is not necessarily detrimental. Feelings that indicate attachment insecurity in other relationships may reflect more positive aspects of the assistance dog owner relationship, such as the level of support that the dog provides its owner. Full article
(This article belongs to the Special Issue Animal Assisted Interventions and Activities for Health and Wellbeing)
Open AccessArticle Level of Sedentary Behavior and Its Associated Factors among Saudi Women Working in Office-Based Jobs in Saudi Arabia
Int. J. Environ. Res. Public Health 2017, 14(6), 659; doi:10.3390/ijerph14060659
Received: 23 March 2017 / Revised: 30 May 2017 / Accepted: 8 June 2017 / Published: 19 June 2017
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Abstract
Research in Saudi Arabia has revealed a shocking level of insufficiently physically active adults, particularly women. The risk of sedentary behavior will likely increase as the number of women with office-based jobs increases. The aim of this study is to determine the level
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Research in Saudi Arabia has revealed a shocking level of insufficiently physically active adults, particularly women. The risk of sedentary behavior will likely increase as the number of women with office-based jobs increases. The aim of this study is to determine the level of sedentary behavior, and its associated factors, among Saudi women working office-based jobs in the city of Riyadh. A cross-sectional study of 420 Saudi female employees at 8 office-based worksites were measured to determine body mass index and were given a self-administered survey to evaluate their level of physical activity and sedentary behavior. Median sitting time on work days was 690 min per day (interquartile range, IQR 541–870), with nearly half accumulated during work hours, and 575 min per day (IQR 360–780) on non-work days. Predictors of work day sitting time were level of education, number of children, and working in the private sector. Number of children, whether they were single, and whether they lived in a small home were found to predict non-work day sitting time. This study identifies Saudi women in office-based jobs as a high-risk group for sedentary behavior. There is a need to promote physical activity at worksites and reduce prolonged sitting. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Effects of Sulfate, Chloride, and Bicarbonate on Iron Stability in a PVC-U Drinking Pipe
Int. J. Environ. Res. Public Health 2017, 14(6), 660; doi:10.3390/ijerph14060660
Received: 22 May 2017 / Revised: 9 June 2017 / Accepted: 15 June 2017 / Published: 19 June 2017
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Abstract
In order to describe iron stability in plastic pipes and to ensure the drinking water security, the influence factors and rules for iron adsorption and release were studied, dependent on the Unplasticized poly (vinyl chloride) (PVC-U) drinking pipes employed in this research. In
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In order to describe iron stability in plastic pipes and to ensure the drinking water security, the influence factors and rules for iron adsorption and release were studied, dependent on the Unplasticized poly (vinyl chloride) (PVC-U) drinking pipes employed in this research. In this paper, sulfate, chloride, and bicarbonate, as well as synthesized models, were chosen to investigate the iron stability on the inner wall of PVC-U drinking pipes. The existence of the three kinds of anions could significantly affect the process of iron adsorption, and a positive association was found between the level of anion concentration and the adsorption rate. However, the scaling formed on the inner surface of the pipes would be released into the water under certain conditions. The Larson Index (LI), used for a synthetic consideration of anion effects on iron stability, was selected to investigate the iron release under multi-factor conditions. Moreover, a well fitted linear model was established to gain a better understanding of iron release under multi-factor conditions. The simulation results demonstrated that the linear model was better fitted than the LI model for the prediction of iron release. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Association between Air Pollution and Emergency Room Visits for Atrial Fibrillation
Int. J. Environ. Res. Public Health 2017, 14(6), 661; doi:10.3390/ijerph14060661
Received: 14 March 2017 / Revised: 15 June 2017 / Accepted: 16 June 2017 / Published: 20 June 2017
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Abstract
Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a
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Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a 14 years’ time-series study to evaluate the association between the daily levels of air pollution (particulate matter, PM10 and PM2.5, and nitrogen dioxide, NO2) and the daily count of emergency accesses for AF (ICD-9 code: 427.31). We applied an over-dispersed conditional Poisson model to analyze the associations at different lags after controlling for time, influenza epidemics, holiday periods, temperature, and relative humidity. Additionally, we evaluated bi-pollutant models by including the other pollutant and the influence of several effect modifiers such as personal characteristics and pre-existing medical conditions. In the period of study, 79,892 individuals were admitted to the emergency departments of Rome hospitals because of AF (on average, 15.6 patients per day: min = 1, max = 36). Air pollution levels were associated with increased AF emergency visits within 24 h of exposure. Effect estimates ranged between 1.4% (0.7–2.3) for a 10 µg/m3 increase of PM10 to 3% (1.4–4.7) for a 10 µg/m3 increase of PM2.5 at lag 0–1 day. Those effects were higher in patients ≥75 years for all pollutants, male patients for PM10, and female patients for NO2. The presence of previous cardiovascular conditions, but not other effect modifiers, increase the pollution effects by 5–8% depending on the lag. This study found evidence that air pollution is associated with AF emergency visits in the short term. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Beyond Food Access: The Impact of Parent-, Home-, and Neighborhood-Level Factors on Children’s Diets
Int. J. Environ. Res. Public Health 2017, 14(6), 662; doi:10.3390/ijerph14060662
Received: 5 May 2017 / Revised: 3 June 2017 / Accepted: 13 June 2017 / Published: 20 June 2017
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Abstract
Despite the growth in empirical research on neighborhood environmental characteristics and their influence on children’s diets, physical activity, and obesity, much remains to be learned, as few have examined the relationship between neighborhood food availability on dietary behavior in children, specifically. This analysis
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Despite the growth in empirical research on neighborhood environmental characteristics and their influence on children’s diets, physical activity, and obesity, much remains to be learned, as few have examined the relationship between neighborhood food availability on dietary behavior in children, specifically. This analysis utilized data from a community-based, cross-sectional sample of children (n = 199) that was collected in New Orleans, Louisiana, in 2010. This dataset was linked to food environment data to assess the impact of neighborhood food access as well as household and parent factors on children’s diets. We observed a negligible impact of the neighborhood food environment on children’s diets, except with respect to fast food, with children who had access to fast food within 500 m around their home significantly less likely (OR = 0.35, 95% CI: 0.1, 0.8) to consume vegetables. Key parental and household factors did play a role in diet, including receipt of public assistance and cooking meals at home. Children receiving public assistance were 2.5 times (95% CI: 1.1, 5.4) more likely to consume fruit more than twice per day compared with children not receiving public assistance. Children whose family cooked dinner at home more than 5 times per week had significantly more consumption of fruit (64% vs. 58%) and vegetables (55% vs. 39%), but less soda (27% vs. 43%). Findings highlight the need for future research that focuses on the dynamic and complex relationships between built and social factors in the communities and homes of children that impact their diet in order to develop multilevel prevention approaches that address childhood obesity. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessFeature PaperArticle Community Response to Multiple Sound Sources: Integrating Acoustic and Contextual Approaches in the Analysis
Int. J. Environ. Res. Public Health 2017, 14(6), 663; doi:10.3390/ijerph14060663
Received: 1 June 2017 / Revised: 15 June 2017 / Accepted: 16 June 2017 / Published: 20 June 2017
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Abstract
Sufficient data refer to the relevant prevalence of sound exposure by mixed traffic sources in many nations. Furthermore, consideration of the potential effects of combined sound exposure is required in legal procedures such as environmental health impact assessments. Nevertheless, current practice still uses
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Sufficient data refer to the relevant prevalence of sound exposure by mixed traffic sources in many nations. Furthermore, consideration of the potential effects of combined sound exposure is required in legal procedures such as environmental health impact assessments. Nevertheless, current practice still uses single exposure response functions. It is silently assumed that those standard exposure-response curves accommodate also for mixed exposures—although some evidence from experimental and field studies casts doubt on this practice. The ALPNAP-study population (N = 1641) shows sufficient subgroups with combinations of rail-highway, highway-main road and rail-highway-main road sound exposure. In this paper we apply a few suggested approaches of the literature to investigate exposure-response curves and its major determinants in the case of exposure to multiple traffic sources. Highly/moderate annoyance and full scale mean annoyance served as outcome. The results show several limitations of the current approaches. Even facing the inherent methodological limitations (energy equivalent summation of sound, rating of overall annoyance) the consideration of main contextual factors jointly occurring with the sources (such as vibration, air pollution) or coping activities and judgments of the wider area soundscape increases the variance explanation from up to 8% (bivariate), up to 15% (base adjustments) up to 55% (full contextual model). The added predictors vary significantly, depending on the source combination. (e.g., significant vibration effects with main road/railway, not highway). Although no significant interactions were found, the observed additive effects are of public health importance. Especially in the case of a three source exposure situation the overall annoyance is already high at lower levels and the contribution of the acoustic indicators is small compared with the non-acoustic and contextual predictors. Noise mapping needs to go down to levels of 40 dBA,Lden to ensure the protection of quiet areas and prohibit the silent “filling up” of these areas with new sound sources. Eventually, to better predict the annoyance in the exposure range between 40 and 60 dBA and support the protection of quiet areas in city and rural areas in planning sound indicators need to be oriented at the noticeability of sound and consider other traffic related by-products (air quality, vibration, coping strain) in future studies and environmental impact assessments. Full article
(This article belongs to the Special Issue The Combined Health Effects of Environmental Exposures)
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Open AccessArticle Physical Fitness, Physical Activity, Sedentary Behavior, or Diet—What Are the Correlates of Obesity in Polish School Children?
Int. J. Environ. Res. Public Health 2017, 14(6), 664; doi:10.3390/ijerph14060664
Received: 7 April 2017 / Revised: 8 June 2017 / Accepted: 19 June 2017 / Published: 20 June 2017
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Abstract
There is substantial evidence of rising prevalence of overweight and obesity and its co-morbidities among children in western-high income developed countries. In the European Union, the prevalence of overweight and obesity is increasing fastest among Polish children. Yet, there is paucity of evidence
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There is substantial evidence of rising prevalence of overweight and obesity and its co-morbidities among children in western-high income developed countries. In the European Union, the prevalence of overweight and obesity is increasing fastest among Polish children. Yet, there is paucity of evidence on the relationship of behavioral factors with body weight status of children in Poland. This study examined the association of obesity with physical fitness, physical activity, sedentary behavior and diet among Polish children. A total of 641 children (10–15 years) recruited from the Lower Silesia region of Poland participated in this cross-sectional study. Participants’ anthropometrics, physical fitness, physical activity, sedentary behavior and dietary intake were assessed. Outcome variables were weight categories (according to body mass index [BMI], waist-to-hip ratio [WHR], and percentage body fat [% BF]). The strongest negative correlation was found between VO2max and %BF (r = −0.39, p <0.05). Significant negative correlation was also found between VO2max and weight categories (r = −0.15). Results of the multinomial logit analysis showed that VO2max increased in groups of overweight, normal weight and underweight children by 13%, 26% and 19%, respectively as compared to the group of obese children. VO2max and weight and obesity indices were strongly correlated in both gender and age groups. Education and intervention programs to increase physical fitness (VO2max) through aerobic training are recommended for Physical Education teachers, parents and children in order to reduce the rate of overweight and obesity among children in the Lower Silesia region of Poland. Full article
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Open AccessArticle Coverage and Influencing Determinants of Influenza Vaccination in Elderly Patients in a Country with a Poor Vaccination Implementation
Int. J. Environ. Res. Public Health 2017, 14(6), 665; doi:10.3390/ijerph14060665
Received: 7 May 2017 / Revised: 14 June 2017 / Accepted: 15 June 2017 / Published: 20 June 2017
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Abstract
The seasonal influenza vaccination uptake of the elderly in Poland is one of the lowest in Europe. Objective: to assess the vaccination coverage and influencing determinants in patients ≥65 years of age. Methods: A cross-sectional study was conducted (November 2015–April 2016) among
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The seasonal influenza vaccination uptake of the elderly in Poland is one of the lowest in Europe. Objective: to assess the vaccination coverage and influencing determinants in patients ≥65 years of age. Methods: A cross-sectional study was conducted (November 2015–April 2016) among consecutive patients admitted to a municipal hospital located in the city of Szczecin, North-west Poland. Patients completed researcher-administered, anonymous questionnaires on socio- demographic data/factors related to the vaccination. Results: The response rate: 92.0%. Among 230 patients (79.6% women, median of age 69 years, range 65–89) who agreed to participate, 34.8% (95% Confidence Interval: 28.6–41.0%) were vaccinated. About 15.7% of respondents had not previously heard about the vaccination; 41.3% of those who stated they were vaccinated or planned on being vaccinated the following year, compared to 19.3% of respondents who stated they were not currently vaccinated (p < 0.001). A multivariable regression analysis revealed that patient factors, such as younger age (Odds Ratio, OR = 7.69), living in the urban area (OR = 7.69), having comorbidities (OR = 2.70), having a vaccinated family member (OR = 3.57), and being informed about vaccination (OR = 5.00) were each associated with greater odds of being immunized. Willingness for vaccination the next year was strongly associated (OR = 8.59) with vaccination status. Conclusions: The influenza vaccination uptake in the elderly population in Poland is disturbingly low. Improved education strategies are needed to increase the uptake. Vaccinated respondents are more likely to plan on being vaccinated the following year. Future interventions related to maximizing vaccination coverage should be more tailored, focusing especially on older patients living in rural areas. Full article
(This article belongs to the Section Global Health)
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Open AccessFeature PaperArticle The Fate of Pollutants in Porous Asphalt Pavements, Laboratory Experiments to Investigate Their Potential to Impact Environmental Health
Int. J. Environ. Res. Public Health 2017, 14(6), 666; doi:10.3390/ijerph14060666
Received: 28 March 2017 / Revised: 17 June 2017 / Accepted: 19 June 2017 / Published: 21 June 2017
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Abstract
Pervious Paving Systems (PPS) are part of a sustainable approach to drainage in which excess surface water is encouraged to infiltrate through their structure, during which potentially toxic elements, such as metals and hydrocarbons are treated by biodegradation and physical entrapment and storage.
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Pervious Paving Systems (PPS) are part of a sustainable approach to drainage in which excess surface water is encouraged to infiltrate through their structure, during which potentially toxic elements, such as metals and hydrocarbons are treated by biodegradation and physical entrapment and storage. However, it is not known where in the PPS structure these contaminants accumulate, which has implications for environmental health, particularly during maintenance, as well as consequences for the recycling of material from the PPS at the end-of-life. A 1 m3 porous asphalt (PA) PPS test rig was monitored for 38 months after monthly additions of road sediment (RS) (367.5 g in total) and unused oil (430 mL in total), characteristic of urban loadings, were applied. Using a rainfall simulator, a typical UK rainfall rate of 15 mm/h was used to investigate its efficiency in dealing with contamination. Water quality of the effluent discharged from the rig was found to be suitable for discharge to most environments. On completion of the monitoring, a core was taken down through its surface, and samples of sediment and aggregate were taken. Analysis showed that most of the sediment remained in the surface course, with metal levels lower than the original RS, but higher than clean, unused aggregate or PA. However, even extrapolating these concentrations to 20 years’ worth of in-service use (the projected life of PPS) did not suggest their accumulation would present an environmental pollution risk when carrying out maintenance of the pavement and also indicates that the material could be recycled at end-of-life. Full article
(This article belongs to the Special Issue Heavy Metals: Environmental and Human Health)
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Open AccessArticle Toxicity of Naphthalene and Benzene on Tribollium castaneum Herbst
Int. J. Environ. Res. Public Health 2017, 14(6), 667; doi:10.3390/ijerph14060667
Received: 26 March 2017 / Revised: 4 June 2017 / Accepted: 8 June 2017 / Published: 21 June 2017
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Abstract
Naphthalene and benzene are widely-used volatile organic compounds. The aim of this research was to examine the toxicological effects of naphthalene and benzene against Tribolium castaneum as an animal model. Adult insects were exposed to these aromatic compounds to assess mortality after 4–48
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Naphthalene and benzene are widely-used volatile organic compounds. The aim of this research was to examine the toxicological effects of naphthalene and benzene against Tribolium castaneum as an animal model. Adult insects were exposed to these aromatic compounds to assess mortality after 4–48 h of exposure. The lethal concentration 50 (LC50) for naphthalene, naphthalin, and benzene were 63.6 µL/L, 20.0 µL/L, and 115.9 µL/L in air, respectively. Real-time polymerase chain reaction (PCR) analysis revealed expression changes in genes related to oxidative stress and metabolism [Glutathione S-Transferase (Gst), and Cytochrome P450 6BQ8 (Cyp6bq8)]; reproduction and metamorphosis [Hormone receptor in 39-like protein (Hr39), Ecdysone receptor: (Ecr), and Chitin synthase 2 (Chs2)]; and neurotransmission [Histamine-gated chloride channel 2 (Hiscl2)] in insects exposed for 4 h to 70.2 µL/L naphthalene. Adults exposed to benzene (80 µL/L; 4 h) overexpressed genes related to neurotransmission [GABA-gated anion channel (Rdl), Hiscl2, and GABA-gated ion channel (Grd)]; reproduction and metamorphosis [Ultraspiracle nuclear receptor (USP), Ecr; and Hr39]; and development (Chs2). The data presented here provides evidence that naphthalene and benzene inhalation are able to induce alterations on reproduction, development, metamorphosis, oxidative stress, metabolism, neurotransmission, and death of the insect. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Antibiotic Concentrations Decrease during Wastewater Treatment but Persist at Low Levels in Reclaimed Water
Int. J. Environ. Res. Public Health 2017, 14(6), 668; doi:10.3390/ijerph14060668
Received: 18 May 2017 / Revised: 13 June 2017 / Accepted: 14 June 2017 / Published: 21 June 2017
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Abstract
Reclaimed water has emerged as a potential irrigation solution to freshwater shortages. However, limited data exist on the persistence of antibiotics in reclaimed water used for irrigation. Therefore, we examined the fate of nine commonly-used antibiotics (ampicillin, azithromycin, ciprofloxacin, linezolid, oxacillin, oxolinic acid,
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Reclaimed water has emerged as a potential irrigation solution to freshwater shortages. However, limited data exist on the persistence of antibiotics in reclaimed water used for irrigation. Therefore, we examined the fate of nine commonly-used antibiotics (ampicillin, azithromycin, ciprofloxacin, linezolid, oxacillin, oxolinic acid, penicillin G, pipemidic acid, and tetracycline) in differentially treated wastewater and reclaimed water from two U.S. regions. We collected 72 samples from two Mid-Atlantic and two Midwest treatment plants, as well as one Mid-Atlantic spray irrigation site. Antibiotic concentrations were measured using liquid-chromatography- tandem mass spectrometry. Data were analyzed using Mann-Whitney-Wilcoxon tests and Kruskal Wallis tests. Overall, antibiotic concentrations in effluent samples were lower than that of influent samples. Mid-Atlantic plants had similar influent but lower effluent antibiotic concentrations compared to Midwest plants. Azithromycin was detected at the highest concentrations (of all antibiotics) in influent and effluent samples from both regions. For most antibiotics, transport from the treatment plant to the irrigation site resulted in no changes in antibiotic concentrations, and UV treatment at the irrigation site had no effect on antibiotic concentrations in reclaimed water. Our findings show that low-level antibiotic concentrations persist in reclaimed water used for irrigation; however, the public health implications are unclear at this time. Full article
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Open AccessReview A Review of the Effects of Chronic Arsenic Exposure on Adverse Pregnancy Outcomes
Int. J. Environ. Res. Public Health 2017, 14(6), 556; doi:10.3390/ijerph14060556
Received: 27 March 2017 / Revised: 18 May 2017 / Accepted: 18 May 2017 / Published: 23 May 2017
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Abstract
Exposure to arsenic has a number of known detrimental health effects but impact on pregnancy outcomes is not as widely recognized. This narrative review examines existing epidemiological evidence investigating the association between arsenic exposure via drinking water and adverse pregnancy outcomes. We reviewed
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Exposure to arsenic has a number of known detrimental health effects but impact on pregnancy outcomes is not as widely recognized. This narrative review examines existing epidemiological evidence investigating the association between arsenic exposure via drinking water and adverse pregnancy outcomes. We reviewed published epidemiological studies from around the world on impact of chronic arsenic exposure on spontaneous abortion, stillbirth, neonatal death, post neonatal death, low birth weight and preterm baby. Plausible mechanisms of arsenic toxicity causing adverse pregnancy outcomes were also determined through literature review. There is convincing evidence to support the association between high inorganic arsenic exposure (>50 ppb) and spontaneous abortion, stillbirth and low birth weight. Limitations of certain studies include study design, small sample size, recall constraints and exposure assessment. There needs to be further research investigating the dose metered impact of arsenic exposure on pregnancy outcomes. Further research on impact of low–moderate arsenic concentration exposure on pregnancy outcomes will allow for appropriate public health policy recommendations. Full article
Open AccessReview Transtheoretical Model of Change during Travel Behavior Interventions: An Integrative Review
Int. J. Environ. Res. Public Health 2017, 14(6), 581; doi:10.3390/ijerph14060581
Received: 25 April 2017 / Revised: 24 May 2017 / Accepted: 26 May 2017 / Published: 30 May 2017
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Abstract
This study aims to identify the relevant empirical work, to synthesize its findings, and to thus attain a general understanding of the application of the Transtheoretical Model (TTM) in transport behavior research. An integrative literature review was used to determine whether or not
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This study aims to identify the relevant empirical work, to synthesize its findings, and to thus attain a general understanding of the application of the Transtheoretical Model (TTM) in transport behavior research. An integrative literature review was used to determine whether or not the implemented interventions impact the stages and processes of travel behavior change. Data was collected from different databases. English language articles published between 2002 and 2017 were included. After sequentially narrowing the search and removing duplicates, 53 relevant papers remained, 13 of which fulfilled the stated criteria of constituting a transport intervention study using the TTM as a reference frame. The final 13 studies were classified and categorized according to stages and processes in the TTM. Findings showed that none of the interventions met the method requirements for a proper evaluation of design and outcome measurement. Reporting did not follow a standardized structure desirable when enabling comparative analyses. Allowing for these shortcomings, it is inferred that positive travel behavior changes have been obtained during some interventions. Importantly, although it was stated that the empirical studies were based on the TTM, the included interventions were implemented irrespective of the individual’s stage of change. For future research, it will be necessary to conduct evaluations of higher quality. Full article
(This article belongs to the Special Issue Sustainable Transportation and Health)
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Open AccessReview Interventions Aimed at the Prevention of Childhood Injuries in the Indigenous Populations in Canada, Australia and New Zealand in the Last 20 Years: A Systematic Review
Int. J. Environ. Res. Public Health 2017, 14(6), 589; doi:10.3390/ijerph14060589
Received: 16 April 2017 / Revised: 24 May 2017 / Accepted: 27 May 2017 / Published: 2 June 2017
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Abstract
Globally, Indigenous children are found to be at a significantly higher risk of injury compared to non-Indigenous children. It has been suggested that mainstream injury prevention strategies are ineffective within Indigenous communities. The aim of this review is to identify existing interventions aimed
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Globally, Indigenous children are found to be at a significantly higher risk of injury compared to non-Indigenous children. It has been suggested that mainstream injury prevention strategies are ineffective within Indigenous communities. The aim of this review is to identify existing interventions aimed at preventing injury in Indigenous children in the hope that it guides future strategies. To the best of the authors’ knowledge, no prior systematic reviews exist looking at interventions specifically aimed at preventing injury in Indigenous child populations in the three chosen countries. Electronic databases were systematically searched for relevant childhood interventions aimed at the prevention of injuries in Indigenous populations based in Canada, Australia and New Zealand from 1996 to 2016. A manual search of the reference lists of relevant articles and a manual search of relevant websites were also completed. After 191 records were screened, six interventions were identified meeting the criteria for inclusion. Eligible papers underwent a quality appraisal using adapted assessment checklists and key information was extracted. Findings were then synthesized using a narrative approach. The interventions mainly promoted child safety through activities focusing on education and awareness. Only three of the six studies measured changes in injury hospitalization rates, all but one evaluation reporting a significant decrease. Studies which measured awareness all demonstrated positive changes. Results suggest that interventions delivered in a culturally appropriate manner acted as a main success factor. Barriers identified as hindering intervention success included lack of cohesion within the intervention due to staff turnover and lack of experienced staff with Indigenous knowledge. This review revealed a limited amount of evaluated interventions for the prevention of Indigenous childhood injuries. Conclusive evidence of the effectiveness of existing interventions is lacking due to the predominantly small-scale evaluations of pilot interventions. Future research is needed to provide more rigorous evidence of the mechanisms driving the successful implementation, delivery and uptake of such strategies tailored to Indigenous children. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
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Open AccessReview Occurrence, Toxicity, and Analysis of Major Mycotoxins in Food
Int. J. Environ. Res. Public Health 2017, 14(6), 632; doi:10.3390/ijerph14060632
Received: 15 May 2017 / Revised: 6 June 2017 / Accepted: 6 June 2017 / Published: 13 June 2017
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Abstract
Mycotoxins are toxic secondary metabolites produced by certain filamentous fungi (molds). These low molecular weight compounds (usually less than 1000 Daltons) are naturally occurring and practically unavoidable. They can enter our food chain either directly from plant-based food components contaminated with mycotoxins or
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Mycotoxins are toxic secondary metabolites produced by certain filamentous fungi (molds). These low molecular weight compounds (usually less than 1000 Daltons) are naturally occurring and practically unavoidable. They can enter our food chain either directly from plant-based food components contaminated with mycotoxins or by indirect contamination from the growth of toxigenic fungi on food. Mycotoxins can accumulate in maturing corn, cereals, soybeans, sorghum, peanuts, and other food and feed crops in the field and in grain during transportation. Consumption of mycotoxin-contaminated food or feed can cause acute or chronic toxicity in human and animals. In addition to concerns over adverse effects from direct consumption of mycotoxin-contaminated foods and feeds, there is also public health concern over the potential ingestion of animal-derived food products, such as meat, milk, or eggs, containing residues or metabolites of mycotoxins. Members of three fungal genera, Aspergillus, Fusarium, and Penicillium, are the major mycotoxin producers. While over 300 mycotoxins have been identified, six (aflatoxins, trichothecenes, zearalenone, fumonisins, ochratoxins, and patulin) are regularly found in food, posing unpredictable and ongoing food safety problems worldwide. This review summarizes the toxicity of the six mycotoxins, foods commonly contaminated by one or more of them, and the current methods for detection and analysis of these mycotoxins. Full article
(This article belongs to the Special Issue Mycotoxins in the Agri-Food Chain)
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Open AccessReview Systematic Review and Meta-Analysis of the Association between Ambient Nitrogen Dioxide and Respiratory Disease in China
Int. J. Environ. Res. Public Health 2017, 14(6), 646; doi:10.3390/ijerph14060646
Received: 6 May 2017 / Revised: 7 June 2017 / Accepted: 14 June 2017 / Published: 16 June 2017
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Abstract
Objective: This study aimed to assess the quantitative effects of short-term exposure of ambient nitrogen dioxide (NO2) on respiratory disease (RD) mortality and RD hospital admission in China through systematic review and meta-analysis. Methods: A total of 29 publications were finally
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Objective: This study aimed to assess the quantitative effects of short-term exposure of ambient nitrogen dioxide (NO2) on respiratory disease (RD) mortality and RD hospital admission in China through systematic review and meta-analysis. Methods: A total of 29 publications were finally selected from searches in PubMed, Web of Science, CNKI and Wanfang databases. Generic inverse variance method was used to pool effect estimates. Pooled estimates were used to represent the increased risk of RD mortality and RD hospital admission per 10 μg/m3 increase in NO2 concentration. Results: Positive correlations were found between short-term NO2 exposure and RD in China. RD mortality and RD hospital admission respectively increased by 1.4% (95% CI: 1.1%, 1.7%) and 1.0% (95% CI: 0.5%, 1.5%) per 10 μg/m3 increase in NO2 concentration. Differences were observed across geographic regions of China. The risk of RD mortality due to NO2 was higher in the southern region (1.7%) than in the north (0.7%). Conclusions: Evidence was found that short-term exposure to NO2 was associated with an increased risk of RD mortality and RD hospital admission in China and these risks were more pronounced in the southern regions of the country, due in part to a larger proportion of elderly persons with increased susceptibility to NO2 in the population compared with the north. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessConcept Paper A Three-Year Follow-Up Study of Antibiotic and Metal Residues, Antibiotic Resistance and Resistance Genes, Focusing on Kshipra—A River Associated with Holy Religious Mass-Bathing in India: Protocol Paper
Int. J. Environ. Res. Public Health 2017, 14(6), 574; doi:10.3390/ijerph14060574
Received: 19 April 2017 / Revised: 24 May 2017 / Accepted: 26 May 2017 / Published: 29 May 2017
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Abstract
Background: Antibiotic resistance (ABR) is one of the major health emergencies for global society. Little is known about the ABR of environmental bacteria and therefore it is important to understand ABR reservoirs in the environment and their potential impact on health. Method/Design: Quantitative
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Background: Antibiotic resistance (ABR) is one of the major health emergencies for global society. Little is known about the ABR of environmental bacteria and therefore it is important to understand ABR reservoirs in the environment and their potential impact on health. Method/Design: Quantitative and qualitative data will be collected during a 3-year follow-up study of a river associated with religious mass-bathing in Central India. Surface-water and sediment samples will be collected from seven locations at regular intervals for 3 years during religious mass-bathing and in absence of it to monitor water-quality, antibiotic residues, resistant bacteria, antibiotic resistance genes and metals. Approval has been obtained from the Ethics Committee of R.D. Gardi Medical College, Ujjain, India (No. 2013/07/17-311). Results: The results will address the issue of antibiotic residues and antibiotic resistance with a focus on a river environment in India within a typical socio-behavioural context of religious mass-bathing. It will enhance our understanding about the relationship between antibiotic residue levels, water-quality, heavy metals and antibiotic resistance patterns in Escherichia coli isolated from river-water and sediment, and seasonal differences that are associated with religious mass-bathing. We will also document, identify and clarify the genetic differences/similarities relating to phenotypic antibiotic resistance in bacteria in rivers during religious mass-bathing or during periods when there is no mass-bathing. Full article
(This article belongs to the Section Environmental Health)
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Open AccessCorrection Correction: Vialard, L., et al. Toward a Socio-Territorial Approach to Health: Health Equity in West Africa. Int. J. Environ. Res. Public Health 2017, 14, 106
Int. J. Environ. Res. Public Health 2017, 14(6), 608; doi:10.3390/ijerph14060608
Received: 10 May 2017 / Revised: 15 May 2017 / Accepted: 15 May 2017 / Published: 8 June 2017
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Abstract
In the original version of our article [1], insufficient acknowledgement was given to the organizers of the medical survey. [...]
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Open AccessBrief Report Volatile Organic Compounds in Anatomical Pathology Wards: Comparative and Qualitative Assessment of Indoor Airborne Pollution
Int. J. Environ. Res. Public Health 2017, 14(6), 609; doi:10.3390/ijerph14060609
Received: 27 April 2017 / Revised: 26 May 2017 / Accepted: 29 May 2017 / Published: 7 June 2017
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Abstract
The impact of volatile organic compounds (VOCs) on indoor air quality and on human health is widely recognized. However, VOC contamination in hospital indoor air is rarely studied and chemical compounds that singularly do not show high toxicity are not submitted to any
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The impact of volatile organic compounds (VOCs) on indoor air quality and on human health is widely recognized. However, VOC contamination in hospital indoor air is rarely studied and chemical compounds that singularly do not show high toxicity are not submitted to any regulation. This study aimed to compare VOC contamination in two different anatomical pathology wards in the same hospital. Hydrocarbons, alcohols, and terpenes were sampled by passive diffusive samplers. Analytical tests were performed by thermal desorption coupled with gas chromatography and mass spectrometry detector. Results highlighted a different VOC pollution in the two wards, due to the structural difference of the buildings and different organizational systems. The scarcity of similar data in the literature shows that the presence of VOCs in pathology wards is an underestimated problem. We believe that, because of the adverse effects that VOCs may have on the human health, this topic is worth exploring further. Full article
(This article belongs to the Special Issue Indoor Air Quality and Health 2016)
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Open AccessFeature PaperPerspective Fungal Contaminants in Drinking Water Regulation? A Tale of Ecology, Exposure, Purification and Clinical Relevance
Int. J. Environ. Res. Public Health 2017, 14(6), 636; doi:10.3390/ijerph14060636
Received: 3 May 2017 / Revised: 2 June 2017 / Accepted: 8 June 2017 / Published: 13 June 2017
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Abstract
Microbiological drinking water safety is traditionally monitored mainly by bacterial parameters that indicate faecal contamination. These parameters correlate with gastro-intestinal illness, despite the fact that viral agents, resulting from faecal contamination, are usually the cause. This leaves behind microbes that can cause illness
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Microbiological drinking water safety is traditionally monitored mainly by bacterial parameters that indicate faecal contamination. These parameters correlate with gastro-intestinal illness, despite the fact that viral agents, resulting from faecal contamination, are usually the cause. This leaves behind microbes that can cause illness other than gastro-intestinal a