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Int. J. Environ. Res. Public Health, Volume 6, Issue 3 (March 2009), Pages 862-1297

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Open AccessArticle Hospital Board Infrastructure and Functions: The Role of Governance in Financial Performance
Int. J. Environ. Res. Public Health 2009, 6(3), 862-873; doi:10.3390/ijerph6030862
Received: 10 November 2008 / Accepted: 21 February 2009 / Published: 26 February 2009
Cited by 5 | PDF Full-text (355 KB) | HTML Full-text | XML Full-text
Abstract
Increased stake of boards in the leadership of the hospitals makes them play a significant role in the financial health of their institutions. Understanding of the correct approach to successfully fulfill this purpose is critical for preparing their organizations for positioning adequately [...] Read more.
Increased stake of boards in the leadership of the hospitals makes them play a significant role in the financial health of their institutions. Understanding of the correct approach to successfully fulfill this purpose is critical for preparing their organizations for positioning adequately in the health care market. Governmental agencies and public companies, including insurers, will be interested in the extent to which hospital boards have adopted the provisions of accounting reform laws like those introduced by the Sarbanes-Oxley Act. It will remain for the boards to balance their oversight role for financial performance with the pressures of financial accountability. Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle Sensorineural Hearing Loss Associated with Occupational Noise Exposure: Effects of Age-Corrections
Int. J. Environ. Res. Public Health 2009, 6(3), 889-899; doi:10.3390/ijerph6030889
Received: 8 December 2008 / Accepted: 19 February 2009 / Published: 26 February 2009
Cited by 16 | PDF Full-text (310 KB) | HTML Full-text | XML Full-text
Abstract
Noise-induced permanent threshold shifts (NIPTS) were computed from retrospective audiometric analyses by subtracting aging effects on hearing sensitivity in sixty-eight patients with bilateral sensorineural hearing loss who reported significant occupational noise exposure histories. There were significant effects of age on NIPTS but [...] Read more.
Noise-induced permanent threshold shifts (NIPTS) were computed from retrospective audiometric analyses by subtracting aging effects on hearing sensitivity in sixty-eight patients with bilateral sensorineural hearing loss who reported significant occupational noise exposure histories. There were significant effects of age on NIPTS but no significant gender- or ear- differences in terms of NIPTS. The NIPTS at 2,000 Hz was found to be significantly greater than NIPTS at frequencies 500 Hz, 1,000 Hz, 4,000 Hz, and 8,000 Hz. Defined noise notches were seen in the audiograms of 38/136 (27%) ears with SNHL. Results support models that suggest interactive effects of aging and noise on sensorineural hearing loss in ears with occupational noise exposure. Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle A Helpline Telephone Service for Tobacco Related Issues: The Italian Experience
Int. J. Environ. Res. Public Health 2009, 6(3), 900-914; doi:10.3390/ijerph6030900
Received: 24 December 2008 / Accepted: 14 February 2009 / Published: 26 February 2009
Cited by 3 | PDF Full-text (420 KB) | HTML Full-text | XML Full-text
Abstract
Antismoking helplines have become an integral part of tobacco control efforts in many countries, including Italy. The demonstrated efficacy and the convenience of telephone based counselling have led to the fast adoption of antismoking helplines. However, information on how these helplines operate [...] Read more.
Antismoking helplines have become an integral part of tobacco control efforts in many countries, including Italy. The demonstrated efficacy and the convenience of telephone based counselling have led to the fast adoption of antismoking helplines. However, information on how these helplines operate in actual practice is not often readily available. This paper provides an overview of the Italian Antismoking Helpline, an increasingly popular telephone service for tobacco problems operating in Italy since 2000. As many states, regions and nations are contemplating various telephone programs as part of large scale anti-tobacco campaigns, this paper briefly discusses the reasons the helpline is well suited to lead the cessation component of a comprehensive tobacco control program, how it operates and how it can be used in conjunction with other tobacco control activities. The Italian Antismoking Helpline provides Italians with free services that include counselling, cessation related information, self help quit kits and current legislation information. The helpline is promoted statewide by media campaigns, health care providers, local tobacco control programs and public school system. The Helpline is centrally operated through the Istituto Superiore di Sanità and it has served over 17.000 tobacco users and others. Full article
(This article belongs to the Special Issue Smoking and Tobacco Control)
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Open AccessArticle National Survey of the Smoking Cessation Services in Italy
Int. J. Environ. Res. Public Health 2009, 6(3), 915-926; doi:10.3390/ijerph6030915
Received: 24 December 2008 / Accepted: 21 February 2009 / Published: 26 February 2009
Cited by 10 | PDF Full-text (309 KB) | HTML Full-text | XML Full-text
Abstract
This investigation is aimed at providing information about structural and organizational characteristics of smoking cessation services (SCS) set up within the Italian National Health Service. Local health units and hospitals are the main institutions connected with SCS which are mainly located within [...] Read more.
This investigation is aimed at providing information about structural and organizational characteristics of smoking cessation services (SCS) set up within the Italian National Health Service. Local health units and hospitals are the main institutions connected with SCS which are mainly located within the Department of Drug Addiction and the Department of Lung and Breath Care. SCS provide different tobacco-use cessation programs. Although pharmacotherapy is always used, a combination of therapeutic treatments is highly preferred. This study shows the importance of maintaining a national coordination among different SCS supporting their activity and encouraging the start up of additional services throughout the country. Full article
(This article belongs to the Special Issue Smoking and Tobacco Control)
Open AccessArticle Global Reach of an Internet Smoking Cessation Intervention among Spanish- and English-Speaking Smokers from 157 Countries
Int. J. Environ. Res. Public Health 2009, 6(3), 927-940; doi:10.3390/ijerph6030927
Received: 30 December 2008 / Accepted: 19 February 2009 / Published: 26 February 2009
Cited by 9 | PDF Full-text (311 KB) | HTML Full-text | XML Full-text
Abstract
This investigation is a secondary analysis of demographic, smoking, and depression information in a global sample of Spanish- and English-speaking smokers who participated in a series of randomized controlled smoking cessation trials conducted via the Internet. The final sample consisted of 17,579 [...] Read more.
This investigation is a secondary analysis of demographic, smoking, and depression information in a global sample of Spanish- and English-speaking smokers who participated in a series of randomized controlled smoking cessation trials conducted via the Internet. The final sample consisted of 17,579 smokers from 157 countries. Smoking profiles were similar across languages and world regions and consistent with characteristics of participants in traditional smoking cessation studies. Participants were predominantly Spanish-speakers, evenly divided between men and women and relatively few indicated using traditional smoking cessation methods (e.g., groups or medication). This study demonstrates that substantial numbers of smokers from numerous countries seek Web-based smoking cessation resources and adds to the growing support for Web-assisted tobacco interventions as an additional tool to address the need for global smoking cessation efforts. Full article
(This article belongs to the Special Issue Smoking and Tobacco Control)
Open AccessArticle Factors Associated with Higher Body Mass Index, Weight Concern, and Weight Gain in a Multinational Cohort Study of Smokers Intending to Quit
Int. J. Environ. Res. Public Health 2009, 6(3), 943-957; doi:10.3390/ijerph6030943
Received: 29 December 2008 / Accepted: 26 February 2009 / Published: 2 March 2009
Cited by 19 | PDF Full-text (315 KB) | HTML Full-text | XML Full-text
Abstract
The ATTEMPT cohort study is multi-national, longitudinal study of smokers intending to quit recruited in the U.S.A., Canada, U.K. and France. Data on demographics, medical history, body mass index (BMI), weight concerns and smoking status were collected at baseline and after six [...] Read more.
The ATTEMPT cohort study is multi-national, longitudinal study of smokers intending to quit recruited in the U.S.A., Canada, U.K. and France. Data on demographics, medical history, body mass index (BMI), weight concerns and smoking status were collected at baseline and after six months. A total of 2,009 subjects provided data at baseline and 1,303 at six months. High baseline BMI was associated with recent quit attempts, high weight concerns and high cigarette consumption. Weight gain was associated with low income, being single and number of cigarette-free days, but not with baseline weight concerns and confidence in preventing weight gain. Quit attempts were more frequent in subjects with a high baseline BMI and low weight concerns. Full article
(This article belongs to the Special Issue Smoking and Tobacco Control)
Open AccessArticle Antecedents and Covariates of Alcohol Consumption among Swiss Male Conscripts
Int. J. Environ. Res. Public Health 2009, 6(3), 958-970; doi:10.3390/ijerph6030958
Received: 29 December 2008 / Accepted: 19 February 2009 / Published: 2 March 2009
Cited by 1 | PDF Full-text (169 KB) | HTML Full-text | XML Full-text
Abstract
This study aimed to investigate prevalence and correlates of alcohol consumption frequency in a sample of Swiss conscripts (n=25,611) in order to identify factors that predispose for frequent consumption. A self-report of drinking frequencies, as well as socio-demographic and psychosocial variables, was [...] Read more.
This study aimed to investigate prevalence and correlates of alcohol consumption frequency in a sample of Swiss conscripts (n=25,611) in order to identify factors that predispose for frequent consumption. A self-report of drinking frequencies, as well as socio-demographic and psychosocial variables, was collected at psychiatric baseline screening. Based on univariate analyses, relevant variables were included in a multivariate multinomial logistic regression model. Six percent were abstainers, 15% reported rarely drinking, 53% occasional drinking, 24% regular drinking and 2% daily drinking. Except for substance use, most associations followed a “J”-shaped curve across the categories of alcohol frequency. Abstinence and frequent drinking can be perceived as deviations from the social norm. Both behaviors are associated with more psychosocial stressors and might be therefore special targets for further studies and new prevention programs. Full article
(This article belongs to the Special Issue Drug Abuse and Addiction)
Open AccessArticle Prevalence and Risk Factors for Initiation of Smoking in Greek High-School Students
Int. J. Environ. Res. Public Health 2009, 6(3), 971-979; doi:10.3390/ijerph6030971
Received: 15 December 2008 / Accepted: 14 February 2009 / Published: 2 March 2009
Cited by 7 | PDF Full-text (161 KB) | HTML Full-text | XML Full-text
Abstract
The smoking habits of 9,276 high-school students (15-18 years old) in six cities of Northern Greece were studied using a questionnaire in order to determine the prevalence and possible risk factors for initiation of smoking. We observed that 29.6% of high-school students [...] Read more.
The smoking habits of 9,276 high-school students (15-18 years old) in six cities of Northern Greece were studied using a questionnaire in order to determine the prevalence and possible risk factors for initiation of smoking. We observed that 29.6% of high-school students (32.6% of boys and 26.7% of girls) were current smokers. A percentage of 43.3% had started smoking before the age of 14. Reactive behaviour towards parents’ and teachers’ advice (40.2%) and the existence of smoking friends (40.1%) were the main reasons of initiation. A well-planned integrated anti-smoking campaign is urgently required, especially among students and teachers. Full article
(This article belongs to the Special Issue Tobacco Smoking and Public Health)
Open AccessArticle Exploring Fragility: Industrial Delocalization, Occupational and Environmental Risks, and Non-Governmental Organizations
Int. J. Environ. Res. Public Health 2009, 6(3), 980-998; doi:10.3390/ijerph6030980
Received: 22 December 2008 / Accepted: 3 March 2009 / Published: 5 March 2009
Cited by 5 | PDF Full-text (688 KB) | HTML Full-text | XML Full-text
Abstract
What is the role of non-governmental organizations – NGOs – in the process of industrial delocalization and socio-spatial redistribution of occupational and environmental risks? In an attempt to contribute to this debate, this study approaches the issue in a very specific socio-historical [...] Read more.
What is the role of non-governmental organizations – NGOs – in the process of industrial delocalization and socio-spatial redistribution of occupational and environmental risks? In an attempt to contribute to this debate, this study approaches the issue in a very specific socio-historical context, marked by recent accelerated industrialization in a small town in Northeast Brazil. Based on semi-structured interviews with leaders of four local NGOs, the way they perceive and value the risks introduced into the area and relations between industrialization and local development are analyzed. Findings show a strong adherence to the industrial plan by workers’ trade unions, whilst other NGOs are highly critical with regard thereto, but undertake no social or political activity regarding the issues they identify. This phenomenon is discussed in terms of the modus operandi of ideology and its strategies for symbolic construction, enabling a comprehensive reinterpretation of how capital also benefits, in its mobility, from local society’s fragility in organizing and protecting quality of life and public health. Full article
(This article belongs to the Special Issue Sustainability: Environmental Studies and Public Health)
Open AccessArticle Association between a Polymorphism of Aminolevulinate Dehydrogenase (ALAD) Gene and Blood Lead Levels in Japanese Subjects
Int. J. Environ. Res. Public Health 2009, 6(3), 999-1009; doi:10.3390/ijerph6030999
Received: 4 January 2009 / Accepted: 4 March 2009 / Published: 6 March 2009
Cited by 11 | PDF Full-text (193 KB) | HTML Full-text | XML Full-text
Abstract
This cross-sectional study investigated the relationship between the aminolevulinate dehydrogenase (ALAD) genotype and blood lead levels among 101 Japanese workers. Blood lead concentration measurement, biomarkers, and genotyping were performed. The minor allele frequency (MAF) for ALAD (ALAD2) was 0.08. Although the blood [...] Read more.
This cross-sectional study investigated the relationship between the aminolevulinate dehydrogenase (ALAD) genotype and blood lead levels among 101 Japanese workers. Blood lead concentration measurement, biomarkers, and genotyping were performed. The minor allele frequency (MAF) for ALAD (ALAD2) was 0.08. Although the blood lead level in the subjects with heterozygous GC genotype was significantly higher than those with homozygous GG genotype, there were no significant differences for hemoglobin, hematocrit, serum and urinary ALA levels among genotypes. ALAD2 genotype was significantly associated with the blood lead concentration, even in the environmental lead exposed subjects. Further confirmation with a large sample size is needed. Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle Well Water Arsenic Exposure, Arsenic Induced Skin-Lesions and Self-Reported Morbidity in Inner Mongolia
Int. J. Environ. Res. Public Health 2009, 6(3), 1010-1025; doi:10.3390/ijerph6031010
Received: 19 January 2009 / Accepted: 26 February 2009 / Published: 9 March 2009
Cited by 17 | PDF Full-text (179 KB) | HTML Full-text | XML Full-text
Abstract
Residents of the Bayingnormen region of Inner Mongolia have been exposed to arsenic-contaminated well water for over 20 years, but relatively few studies have investigated health effects in this region. We surveyed one village to document exposure to arsenic and assess the [...] Read more.
Residents of the Bayingnormen region of Inner Mongolia have been exposed to arsenic-contaminated well water for over 20 years, but relatively few studies have investigated health effects in this region. We surveyed one village to document exposure to arsenic and assess the prevalence of arsenic-associated skin lesions and self-reported morbidity. Five-percent (632) of the 12,334 residents surveyed had skin lesions characteristics of arsenic exposure. Skin lesions were strongly associated with well water arsenic and there was an elevated prevalence among residents with water arsenic exposures as low as 5 μg/L-10 μg/L. The presence of skin lesions was also associated with self-reported cardiovascular disease. Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle Internally-Developed Teen Smoking Cessation Programs: Characterizing the Unique Features of Programs Developed by Community-Based Organizations
Int. J. Environ. Res. Public Health 2009, 6(3), 1026-1040; doi:10.3390/ijerph6031026
Received: 4 February 2009 / Accepted: 4 March 2009 / Published: 10 March 2009
Cited by 1 | PDF Full-text (242 KB) | HTML Full-text | XML Full-text
Abstract
We have compared the unique features of teen tobacco cessation programs developed internally by community-based organizations (N=75) to prepackaged programs disseminated nationally (N=234) to expand our knowledge of treatment options for teen smokers. Internally-developed programs were more likely offered in response to the sponsoring organization’s initiative (OR=2.16, p<0.05); had fewer trained cessation counselors (OR=0.31, p<0.01); and were more likely found in urban areas (OR=2.89, p=0.01). Internally-developed programs more often provided other substance-abuse treatment services than prepackaged programs and addressed other youth-specific problem behaviors (p≤0.05). Studies that examine the effectiveness of internally-developed programs in reducing smoking and maintaining cessation for teen smokers are warranted. Full article
(This article belongs to the Special Issue Smoking and Tobacco Control)
Open AccessArticle Psychoactive Medication and Traffic Safety
Int. J. Environ. Res. Public Health 2009, 6(3), 1041-1054; doi:10.3390/ijerph6031041
Received: 1 February 2009 / Accepted: 2 March 2009 / Published: 10 March 2009
Cited by 37 | PDF Full-text (444 KB) | HTML Full-text | XML Full-text
Abstract
Driving a car is important to maintain independence and participate in society. Many of those who use psychoactive medication are outpatients and are thus likely to drive a vehicle. Most common adverse effects that impair driving are reduced alertness, affected psychomotor functioning [...] Read more.
Driving a car is important to maintain independence and participate in society. Many of those who use psychoactive medication are outpatients and are thus likely to drive a vehicle. Most common adverse effects that impair driving are reduced alertness, affected psychomotor functioning and impaired vision. This review discusses the effects on driving ability of most commonly prescribed psychoactive drugs, including hypnotics, antidepressants, antihistamines, analgesics and stimulant drugs. Within these categories of medicines significant differences concerning their impact on driving ability are evident. The International Council on Alcohol, Drugs and Traffic Safety (ICADTS) categorization can help physicians to make a choice between treatments when patients want to drive a car. Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle Simulation of Atmospheric Dispersion of Elevated Releases from Point Sources in Mississippi Gulf Coast with Different Meteorological Data
Int. J. Environ. Res. Public Health 2009, 6(3), 1055-1074; doi:10.3390/ijerph6031055
Received: 19 January 2009 / Accepted: 2 March 2009 / Published: 11 March 2009
Cited by 8 | PDF Full-text (1888 KB) | HTML Full-text | XML Full-text
Abstract
Atmospheric dispersion calculations are made using the HYSPLIT Particle Dispersion Model for studying the transport and dispersion of air-borne releases from point elevated sources in the Mississippi Gulf coastal region. Simulations are performed separately with three meteorological data sets having different spatial [...] Read more.
Atmospheric dispersion calculations are made using the HYSPLIT Particle Dispersion Model for studying the transport and dispersion of air-borne releases from point elevated sources in the Mississippi Gulf coastal region. Simulations are performed separately with three meteorological data sets having different spatial and temporal resolution for a typical summer period in 1-3 June 2006 representing a weak synoptic condition. The first two data are the NCEP global and regional analyses (FNL, EDAS) while the third is a meso-scale simulation generated using the Weather Research and Forecasting model with nested domains at a fine resolution of 4 km. The meso-scale model results show significant temporal and spatial variations in the meteorological fields as a result of the combined influences of the land-sea breeze circulation, the large scale flow field and diurnal alteration in the mixing depth across the coast. The model predicted SO2 concentrations showed that the trajectory and the concentration distribution varied in the three cases of input data. While calculations with FNL data show an overall higher correlation, there is a significant positive bias during daytime and negative bias during night time. Calculations with EDAS fields are significantly below the observations during both daytime and night time though plume behavior follows the coastal circulation. The diurnal plume behavior and its distribution are better simulated using the mesoscale WRF meteorological fields in the coastal environment suggesting its suitability for pollution dispersion impact assessment in the local scale. Results of different cases of simulation, comparison with observations, correlation and bias in each case are presented. Full article
Open AccessArticle Evaluation of the Waste Tire Resources Recovery Program and Environmental Health Policy in Taiwan
Int. J. Environ. Res. Public Health 2009, 6(3), 1075-1094; doi:10.3390/ijerph6031075
Received: 5 January 2009 / Accepted: 7 March 2009 / Published: 12 March 2009
Cited by 3 | PDF Full-text (184 KB) | HTML Full-text | XML Full-text
Abstract
This paper examines the effectiveness of Taiwanese environmental health policies, whose aim is to improve environmental quality by reducing tire waste via the Tire Resource Recovery Program. The results confirm that implemented environmental health policies improve the overall health of the population [...] Read more.
This paper examines the effectiveness of Taiwanese environmental health policies, whose aim is to improve environmental quality by reducing tire waste via the Tire Resource Recovery Program. The results confirm that implemented environmental health policies improve the overall health of the population (i.e. a decrease in death caused by bronchitis and other respiratory diseases). Current policy expenditures are far below the optimal level, as it is estimated that a ten percent increase in the subsidy would decrease the number of deaths caused by bronchitis and other respiratory diseases by 0.58% per county/city per year on average. Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle Disparities in Health Care Utilization by Smoking Status – NHANES 1999-2004
Int. J. Environ. Res. Public Health 2009, 6(3), 1095-1106; doi:10.3390/ijerph6031095
Received: 16 December 2008 / Accepted: 10 March 2009 / Published: 13 March 2009
Cited by 19 | PDF Full-text (115 KB) | HTML Full-text | XML Full-text
Abstract
The objective of this study was to assess disparities in health care utilization, by smoking status, among adults in the United States.We used 1999–2004 National Health and Nutrition Examination Survey (NHANES) data from 15,332 adults.Multivariate logistic regressions were used to examine the relationship between smoking status (current, former, and never smoker), with health care utilization.After controlling for demographic characteristics, current smokers and former smokers who quit either <2 years or ≥10 years prior to the survey were more likely to have had inpatient admission in the past year than never smokers.Current smokers did not differ from never smokers on whether they had an outpatient visit in the past year.They were, however, more likely than never smokers to have ≥ 4 outpatient visits.Smokers who quit either <2 years ago or ≥10 years ago were more likely to have had an outpatient visit than never smokers.Former smokers were more likely than never smokers to have ≥ 4 outpatient visits regardless of when they quit.Our results show that cigarette smoking is associated with higher health care utilization for current and former smokers than for never smokers.Frequent hospitalization and outpatient visits translate into higher medical costs.Therefore, more efforts are needed to promote interventions that discourage smoking initiation and encourage cessation. Full article
(This article belongs to the Special Issue Tobacco Smoking and Public Health)
Open AccessArticle Increased Mortality Associated with Well-Water Arsenic Exposure in Inner Mongolia, China
Int. J. Environ. Res. Public Health 2009, 6(3), 1107-1123; doi:10.3390/ijerph6031107
Received: 16 January 2009 / Accepted: 24 February 2009 / Published: 16 March 2009
Cited by 17 | PDF Full-text (226 KB) | HTML Full-text | XML Full-text
Abstract
We conducted a retrospective mortality study in an Inner Mongolian village exposed to well water contaminated by arsenic since the 1980s. Deaths occurring between January 1, 1997 and December 1, 2004 were classified according to underlying cause and water samples from household [...] Read more.
We conducted a retrospective mortality study in an Inner Mongolian village exposed to well water contaminated by arsenic since the 1980s. Deaths occurring between January 1, 1997 and December 1, 2004 were classified according to underlying cause and water samples from household wells were tested for total arsenic. Heart disease mortality was associated with arsenic exposure, and the association strengthened with time exposed to the water source. Cancer mortality and all-cause mortality were associated with well-water arsenic exposure among those exposed 10-20 years. This is the first study to document increased arsenic-associated mortality in the Bayingnormen region of Inner Mongolia. Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle Adverse Effects of a Clinically Relevant Dose of Hydroxyurea Used for the Treatment of Sickle Cell Disease on Male Fertility Endpoints
Int. J. Environ. Res. Public Health 2009, 6(3), 1124-1144; doi:10.3390/ijerph6031124
Received: 16 January 2009 / Accepted: 10 March 2009 / Published: 16 March 2009
Cited by 16 | PDF Full-text (280 KB) | HTML Full-text | XML Full-text
Abstract
Two experiments were conducted to determine: 1) whether the adult male transgenic sickle cell mouse (Tg58 × Tg98; TSCM), exhibits the patterns of reproductive endpoints (hypogonadism) characteristic of men with sickle cell disease (SCD) and 2) whether hydroxyurea (HU) exacerbates this condition. [...] Read more.
Two experiments were conducted to determine: 1) whether the adult male transgenic sickle cell mouse (Tg58 × Tg98; TSCM), exhibits the patterns of reproductive endpoints (hypogonadism) characteristic of men with sickle cell disease (SCD) and 2) whether hydroxyurea (HU) exacerbates this condition. In Experiment 1, blood samples were collected from adult age-matched TSCM and ICR mice (ICRM) (N = 10/group) for plasma testosterone measurements. Subsequently, mice were sacrificed, testes excised and weighed and stored spermatozoa recovered for the determination of sperm density, progressive motility and percentage of spermatozoa with normal morphology. In experiment 2, adult male TSCM were orally treated with 25 mg HU/kg body weight/day for 28 or 56 days. Control mice received the vehicle for HU (saline) as described above. At the end of the treatment periods, blood samples were collected for quantification of circulating testosterone. Subsequently, mice were sacrificed, testes and epididymides were recovered and weighed and one testis per mouse was subjected to histopathology. Stored spermatozoa were recovered for the determination of indices of sperm quality mentioned in Experiment 1. Testis weight, stored sperm density, progressive motility, percentage of spermatozoa with normal morphology and plasma testosterone concentrations of TSCM were significantly lower by 40, 65, 40, 69 and 66%, respectively than those of ICRM. These data indicate that adult TSCM used in this study suffered from hypogonadism, characteristically observed among adult male SCD patients. In Experiment 2, HU treatment significantly decreased testis weight on day 28, (0.09 ± 0.004g) that was further decreased on day 56 (0.06 ± 0.003g; treatment x time interaction) compared with controls (day 28, 0.15 ± 0.01g; day 56, 2, 0.16 ± 0.01g). Concomitant with a 52% shrinkage (P Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle Combined System of Activated Sludge and Ozonation for the Treatment of Kraft E1 Effluent
Int. J. Environ. Res. Public Health 2009, 6(3), 1145-1154; doi:10.3390/ijerph6031145
Received: 18 February 2009 / Accepted: 10 March 2009 / Published: 17 March 2009
Cited by 10 | PDF Full-text (113 KB) | HTML Full-text | XML Full-text
Abstract
The treatment of paper mill effluent for COD, TOC, total phenols and color removal was investigated using combined activated sludge-ozonation processes and single processes. The combined activated sludge-O3/pH 10 treatment was able to remove around 80% of COD, TOC and [...] Read more.
The treatment of paper mill effluent for COD, TOC, total phenols and color removal was investigated using combined activated sludge-ozonation processes and single processes. The combined activated sludge-O3/pH 10 treatment was able to remove around 80% of COD, TOC and color from Kraft E1 effluent. For the total phenols, the efficiency removal was around 70%. The ozonation post treatment carried out at pH 8.3 also showed better results than the single process. The COD, TOC, color and total phenols removal efficiency obtained were 75.5, 59.1, 77 and 52.3%, respectively. The difference in the concentrations of free radical produced by activated sludge-O3/pH 10 and activated sludge-O3/pH 8.3 affected mainly the TOC and total phenol removal values. Full article
(This article belongs to the Special Issue Biodegradability and Environmental Sciences)
Open AccessArticle Notes on the Particulate Matter Standards in the European Union and the Netherlands
Int. J. Environ. Res. Public Health 2009, 6(3), 1155-1173; doi:10.3390/ijerph6031155
Received: 5 December 2008 / Accepted: 26 February 2009 / Published: 17 March 2009
Cited by 8 | PDF Full-text (1424 KB) | HTML Full-text | XML Full-text
Abstract
The distribution of Particulate Matter in the atmosphere, resulting from emissions produced by cars, trucks, ships, industrial estates and agricultural complexes, is a topical public health problem that has increased in recent decades due to environmental factors in advanced economies in particular. [...] Read more.
The distribution of Particulate Matter in the atmosphere, resulting from emissions produced by cars, trucks, ships, industrial estates and agricultural complexes, is a topical public health problem that has increased in recent decades due to environmental factors in advanced economies in particular. This contribution relates the health impact caused by concentrations of Particulate Matter (PM) in ambient air to the PM standards, the size of the particles and spatial planning. Diverging impacts of PM standards in legal regulation are discussed. The authors present a review of the development of legal PM standards in the European Union, with a specific reference to The Netherlands. Full article
(This article belongs to the Special Issue Sustainability: Environmental Studies and Public Health)
Open AccessArticle Beyond Climate Focus and Disciplinary Myopia. The Roles and Responsibilities of Hospitals and Healthcare Professionals
Int. J. Environ. Res. Public Health 2009, 6(3), 1204-1214; doi:10.3390/ijerph6031204
Received: 1 February 2009 / Accepted: 13 March 2009 / Published: 19 March 2009
Cited by 4 | PDF Full-text (62 KB) | HTML Full-text | XML Full-text
Abstract
This paper calls for the need to address climate change within the concept of sustainable development, in recognition of the interrelationships between environmental, economic and social systems. So far, health- providing organizations such as hospitals have paid surprisingly little attention to the [...] Read more.
This paper calls for the need to address climate change within the concept of sustainable development, in recognition of the interrelationships between environmental, economic and social systems. So far, health- providing organizations such as hospitals have paid surprisingly little attention to the relationships between environmental change (e.g. climate change) and human health, or between hospitals (as professional organizations) and their impact on sustainable development. Although it is usually such industries as the chemical, extractive and metal industries, etc., that are associated with environmentally harmful activities, there is also an urgent need to emphasize the roles and responsibilities of hospitals and their embeddedness in a wider ecological, economic and social context. The key objective here is to discuss the relevance of sustainability and environmental management issues in a sector that until now has conveniently ignored its roles and responsibilities in relation to sustainability issues. The paper concludes that arguments based on systems theory, environment, medicine, economics and innovation strongly urge hospitals to reconsider their present roles and environmental responsibilities. Full article
(This article belongs to the Special Issue Sustainability: Environmental Studies and Public Health)
Open AccessArticle Smoking Enhances Risk for New External Genital Warts in Men
Int. J. Environ. Res. Public Health 2009, 6(3), 1215-1234; doi:10.3390/ijerph6031215
Received: 26 November 2008 / Accepted: 17 March 2009 / Published: 20 March 2009
Cited by 9 | PDF Full-text (98 KB) | HTML Full-text | XML Full-text
Abstract
Repeat episodes of HPV-related external genital warts reflect recurring or new infections. No study before has been sufficiently powered to delineate how tobacco use, prior history of EGWs and HIV infection affect the risk for new EGWs. Behavioral, laboratory and examination data [...] Read more.
Repeat episodes of HPV-related external genital warts reflect recurring or new infections. No study before has been sufficiently powered to delineate how tobacco use, prior history of EGWs and HIV infection affect the risk for new EGWs. Behavioral, laboratory and examination data for 2,835 Multicenter AIDS Cohort Study participants examined at 21,519 semi-annual visits were evaluated. Fourteen percent (391/2835) of men reported or were diagnosed with EGWs at 3% (675/21,519) of study visits. Multivariate analyses showed smoking, prior episodes of EGWs, HIV infection and CD4+ T-lymphocyte count among the infected, each differentially influenced the risk for new EGWs. Full article
(This article belongs to the Special Issue Tobacco Smoking and Public Health)
Open AccessArticle How the Mid-Victorians Worked, Ate and Died
Int. J. Environ. Res. Public Health 2009, 6(3), 1235-1253; doi:10.3390/ijerph6031235
Received: 9 February 2009 / Accepted: 28 February 2009 / Published: 20 March 2009
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Abstract
Analysis of the mid-Victorian period in the U.K. reveals that life expectancy at age 5 was as good or better than exists today, and the incidence of degenerative disease was 10% of ours. Their levels of physical activity and hence calorific intakes [...] Read more.
Analysis of the mid-Victorian period in the U.K. reveals that life expectancy at age 5 was as good or better than exists today, and the incidence of degenerative disease was 10% of ours. Their levels of physical activity and hence calorific intakes were approximately twice ours. They had relatively little access to alcohol and tobacco; and due to their correspondingly high intake of fruits, whole grains, oily fish and vegetables, they consumed levels of micro- and phytonutrients at approximately ten times the levels considered normal today. This paper relates the nutritional status of the mid-Victorians to their freedom from degenerative disease; and extrapolates recommendations for the cost-effective improvement of public health today. Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle Susceptibility to Smoking among Adolescents and Its Implications for Mexico’s Tobacco Control Programs. Analysis of the Global Youth Tobacco Survey 2003-2004 and 2006-2007
Int. J. Environ. Res. Public Health 2009, 6(3), 1254-1267; doi:10.3390/ijerph6031254
Received: 29 December 2008 / Accepted: 27 February 2009 / Published: 23 March 2009
Cited by 4 | PDF Full-text (204 KB) | HTML Full-text | XML Full-text
Abstract
Smoking prevention efforts should either prevent target groups from becoming susceptible to smoking or prevent susceptible adolescents from progressing to becoming regular smokers. To describe the prevalence of susceptibility to smoking among never smoker students from cities that applied the GYTS in [...] Read more.
Smoking prevention efforts should either prevent target groups from becoming susceptible to smoking or prevent susceptible adolescents from progressing to becoming regular smokers. To describe the prevalence of susceptibility to smoking among never smoker students from cities that applied the GYTS in 2003 and 2006. The GYTS uses a two-stage cluster sample survey design that produces representative samples of students aged 12-15 years enrolled in public, private, and technical schools. The survey was undertaken at 399 schools in 9 cities. The GYTS surveyed 33,297 students during the academic years 2003-04 and 2006-07. Among never smokers, about 25% are likely to initiate smoking in the next 12 months. There are no differences in susceptibility to smoking by gender. When comparing results from 2003 and 2006, the susceptibility index has not changed, but for one city. The GYTS results are useful for monitoring susceptibility to smoking among adolescents and provide evidence for strengthening the efforts of tobacco control programs in Mexico. Full article
(This article belongs to the Special Issue Smoking and Tobacco Control)
Figures

Open AccessArticle Parents’ and Teachers’ Opinions about the School Food Policy in Belgian Flemish Nursery Schools
Int. J. Environ. Res. Public Health 2009, 6(3), 1268-1281; doi:10.3390/ijerph6031268
Received: 24 February 2009 / Accepted: 19 March 2009 / Published: 24 March 2009
Cited by 3 | PDF Full-text (230 KB) | HTML Full-text | XML Full-text
Abstract
The partnership of parents, teachers, and schools is necessary to develop effective school food interventions. To gather parents’ and teachers’ opinions and perceptions about the school food policy, 884 parents and 70 teachers of preschoolers completed a questionnaire. School food policy is [...] Read more.
The partnership of parents, teachers, and schools is necessary to develop effective school food interventions. To gather parents’ and teachers’ opinions and perceptions about the school food policy, 884 parents and 70 teachers of preschoolers completed a questionnaire. School food policy is an issue of importance for parents and teachers: the majority agrees that schools should restrict the availability of snacks and soft drinks; however, to replace fruit juice and sugared milk drinks with sugarless alternatives will take special effort. Fruit is not always available at school, although parents would appreciate it. Parents of lower educational level are in general more permissive. Full article
(This article belongs to the Special Issue Public Health: Feature Papers)
Open AccessArticle Maternal Smoking,GSTM1 and GSTT1 Polymorphism and Susceptibility to Adverse Pregnancy Outcomes
Int. J. Environ. Res. Public Health 2009, 6(3), 1282-1297; doi:10.3390/ijerph6031282
Received: 4 February 2009 / Accepted: 21 March 2009 / Published: 26 March 2009
Cited by 27 | PDF Full-text (205 KB) | HTML Full-text | XML Full-text
Abstract
The objective of the study was to investigate the association between maternal smoking, GSTM1, GSTT1 polymorphism, low birth weight (LBW, < 2,500 g) and intra-uterine growth restriction (IUGR, < 2,500 g and gestation ≥ 37 weeks) risk. Within a prospective cohort study in Kaunas (Lithuania), a nested case-control study on LBW and IUGR occurrence among 646women with genotyping of GSTT1 and GSTM1 polymorphisms who delivered live singletons was conducted. Multivariate logistic regression analysis was used to study the association of maternal smoking and polymorphism in two genes metabolizing xenobiotics. Without consideration of genotype, light-smoking (mean 4.8 cigarettes/day) during pregnancy was associated with a small increase in LBW risk, adjusted OR 1.21; 95% CI 0.44 – 3.31. The corresponding odds for IUGR risk was 1.57; 95% CI 0.45 – 5.55. The findings suggested the greater LBW risk among light-smoking mothers with the GSTM1-null genotype (OR 1.91; 95% CI 0.43 – 8.47) compared to those with GSTM1-present genotype (OR 1.11; 95% CI 0.26 – 4.47). When both GSTM1 and GSTT1 genotypes were considered, the synergistic effect was found among smoking mothers: GSTT1-present and GSTM1-null genotype OR for LBW was 3.31; 95% CI 0.60-18.4 and that for IUGR was 2.47; 95% CI 0.31 – 13.1. However there was no statistically significant interaction between maternal smoking, GSTT1- present and GSTM1-null genotypes for LBW (OR 1.45; 95% CI 0.22 – 10.1, p = 0.66) and for IUGR (OR 1.10; 95% CI 0.10 – 12.6, p = 0.93).The results of this study suggested that smoking, even at a low-level, ought to be considered a potential risk factor for adverse birth outcomes and that genetic polymorphism may contribute to individual variation in tobacco smoke response. Full article
(This article belongs to the Special Issue Tobacco Smoking and Public Health)

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Open AccessReview Biomarkers of Induced Active and Passive Smoking Damage
Int. J. Environ. Res. Public Health 2009, 6(3), 874-888; doi:10.3390/ijerph6030874
Received: 23 December 2008 / Accepted: 20 February 2009 / Published: 26 February 2009
Cited by 27 | PDF Full-text (293 KB) | HTML Full-text | XML Full-text
Abstract
In addition to thewell-known link between smoking and lung cancer, large epidemiological studies have shown a relationship between smoking and cancers of the nose, oral cavity, oropharynx, larynx, esophagus, pancreas, bladder, kidney, stomach, liver, colon and cervix, as well as myeloid leukemia. [...] Read more.
In addition to thewell-known link between smoking and lung cancer, large epidemiological studies have shown a relationship between smoking and cancers of the nose, oral cavity, oropharynx, larynx, esophagus, pancreas, bladder, kidney, stomach, liver, colon and cervix, as well as myeloid leukemia. Epidemiological evidence has reported a direct link between exposure of non-smokers to environmental tobacco smoke and disease, most notably, lung cancer. Much evidence demonstrates that carcinogenic-DNA adducts are useful markers of tobacco smoke exposure, providing an integrated measurement of carcinogen intake, metabolic activation, and delivery to the DNA in target tissues. Monitoring accessible surrogate tissues, such as white blood cells or bronchoalveolar lavage (BAL) cells, also provides a means of investigating passive and active tobacco exposure in healthy individuals and cancer patients. Levels of DNA adducts measured in many tissues of smokers are significantly higher than in non-smokers. While some studies have demonstrated an association between carcinogenic DNA adducts and cancer in current smokers, no association has been observed in ex or never smokers. The role of genetic susceptibility in the development of smoking related-cancer is essential. In order to establish whether smoking-related DNA adducts are biomarkers of tobacco smoke exposure and/or its carcinogenic activity we summarized all data that associated tobacco smoke exposure and smoking-related DNA adducts both in controls and/or in cancer cases and studies where the effect of genetic polymorphisms involved in the activation and deactivation of carcinogens were also evaluated. In the future we hope we will be able to screen for lung cancer susceptibility by using specific biomarkers and that subjects of compared groups can be stratified for multiple potential modulators of biomarkers, taking into account various confounding factors. Full article
(This article belongs to the Special Issue Tobacco Smoking and Public Health)
Open AccessReview Indirect Potable Reuse: A Sustainable Water Supply Alternative
Int. J. Environ. Res. Public Health 2009, 6(3), 1174-1203; doi:10.3390/ijerph6031174
Received: 22 December 2008 / Accepted: 11 March 2009 / Published: 17 March 2009
Cited by 38 | PDF Full-text (191 KB) | HTML Full-text | XML Full-text
Abstract
The growing scarcity of potable water supplies is among the most important issues facing many cities, in particular those using single sources of water that are climate dependent. Consequently, urban centers are looking to alternative sources of water supply that can supplement [...] Read more.
The growing scarcity of potable water supplies is among the most important issues facing many cities, in particular those using single sources of water that are climate dependent. Consequently, urban centers are looking to alternative sources of water supply that can supplement variable rainfall and meet the demands of population growth. A diversified portfolio of water sources is required to ensure public health, as well as social, economical and environmental sustainability. One of the options considered is the augmentation of drinking water supplies with advanced treated recycled water. This paper aims to provide a state of the art review of water recycling for drinking purposes with emphasis on membrane treatment processes. An overview of significant indirect potable reuse projects is presented followed by a description of the epidemiological and toxicological studies evaluating any potential human health impacts. Finally, a summary of key operational measures to protect human health and the areas that require further research are discussed. Full article
(This article belongs to the Special Issue Sustainability: Environmental Studies and Public Health)

Other

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Open AccessCorrection Correction: Addison, C.C., et al. Psychometric Evaluation of a Coping Strategies Inventory Short-Form (CSI-SF) in the Jackson Heart Study Cohort. Int. J. Environ. Res. Public Health 2007, 4, 243-249.
Int. J. Environ. Res. Public Health 2009, 6(3), 941-942; doi:10.3390/ijerph6030941
Received: 20 February 2009 / Published: 2 March 2009
Cited by 1 | PDF Full-text (127 KB) | HTML Full-text | XML Full-text
Abstract We found some errors in Table 4 in our paper published in the International Journal of Environmental Research and Public Health recently [1]. Table 4 is corrected as follows: [...] Full article

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